Care Home: The Tides

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What the care home does well People only move into the home following an assessment of their needs. People who use the service are supported to make decisions about their lives and other professionals are involved in enabling decisions to be made. People are supported to take risks as part of enabling them to lead the life they want to. People using the service are able to participate in a variety of activities in the community. People who use the service are supported to maintain contact with people who are important to them such as family and friends. People using the service are able to make choices about their daily routines. People are supported to maintain a healthy diet. People are supported with their personal care in the way they prefer. Systems are in place to ensure that individuals have their physical and emotional needs met. Systems are in place to ensure that people are supported with their medication needs. Staff receive training in safeguarding so they should understand how to keep people safe. The home is comfortable and homely. Recruitment policy and practice ensures that people who use the service are protected. There is a quality assurance system in place to listen to peoples views of the service and how it should develop. What has improved since the last inspection? This was the first key inspection of this service since it registered in March 2009. What the care home could do better: At the end of this inspection there is one requirement and seven recommendations. Further training for staff in areas which address specific needs will mean that staff have improved their skills and knowledge in how people with complex needs must be supported. Individual care plans should be person centred and demonstrate that the individual has been involved in the process and in the plans development. It is important that people who use the service are confident their information will remain confidential. It is important that recording of activities demonstrates how people made choices and a fuller explanation of those choices and how they fit with individual hobbies and interests. People who use the service have different method s of communication and to ensure they are able to voice their concerns if they have any the complaints procedure should be available in a format they can understand. It is important that the service meets current good practice guidance in infection control. Staff should be encouraged to undertake national vocational qualifications so that at least 50% of staff have this qualification. To protect the people who use the service windows on the first floor should either be restricted or a risk assessment completed. Key inspection report Care homes for adults (18-65 years) Name: Address: The Tides 136 Lower Blandford Road Broadstone Dorset BH18 8NT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Tracey Cockburn     Date: 2 1 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: The Tides 136 Lower Blandford Road Broadstone Dorset BH18 8NT 01202706160 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Eve Went Name of registered manager (if applicable) Mrs Eve Went Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 6. The registered person may provide the following category of service only - Care Home only - Code PC - to service users of either gender whose primary care needs on admission to the home are within the following category Learning disability - Code LD o Date of last inspection Brief description of the care home The Tides is a new service owned by Mrs E Went trading as Harbour Care. The service provides 24 hour care and support to up to six people whose primary needs are learning disability. The home is also equipped to support people who have physical disabilities. There is a lift to the first floor, all rooms are en suite. The home is near the centre of Broadstone and there is easy access to the towns of Poole and Bournemouth. The home has its own transport, there is also parking at the home. There is access to a large garden and patio area. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 6 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We visited the service without any warning. We spent five hours in the home looking at care records, staff records, medication, training and activities. We spoke to people who use the service, staff who work in the service and the manager. In preparation for the visit we reviewed the information the service sent to us in the annual quality assurance assessment (AQAA) we used this information to inform our visit. We sent out survey forms to people who use the service, staff and health care professionals. We had two surveys back from health care professionals, two surveys back from people who use the service and five surveys back from staff who work in the service. We reviewed information received about the service through notifications of incidents and through safeguarding alerts. This gave us information about how the service manages incidents and records the information. Care Homes for Adults (18-65 years) Page 5 of 27 Throughout the report the term we is used to demonstrate that the report is the view of the Care Quality commission and not the view and opinions of an individual. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: At the end of this inspection there is one requirement and seven recommendations. Further training for staff in areas which address specific needs will mean that staff have improved their skills and knowledge in how people with complex needs must be supported. Individual care plans should be person centred and demonstrate that the individual has been involved in the process and in the plans development. It is important that people who use the service are confident their information will Care Homes for Adults (18-65 years) Page 7 of 27 remain confidential. It is important that recording of activities demonstrates how people made choices and a fuller explanation of those choices and how they fit with individual hobbies and interests. People who use the service have different method s of communication and to ensure they are able to voice their concerns if they have any the complaints procedure should be available in a format they can understand. It is important that the service meets current good practice guidance in infection control. Staff should be encouraged to undertake national vocational qualifications so that at least 50 of staff have this qualification. To protect the people who use the service windows on the first floor should either be restricted or a risk assessment completed. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Full assessments are completed before anyone moves into the service ensuring that the home has the staff with the skills to meet individual needs. Evidence: The annual quality assurance assessment says: we do a thorough needs assessment, meet the service user, family, care manager and current support workers, ie: key worker and then do a thorough transition period We looked at the care plans for two people who live in the service. We found detailed pre admission assessments as well as care management assessments and care plans. Each person has a care plan which has been developed from the original assessment either completed by the service or by the funding authority. Where there restrictions placed on an individual this is clearly recorded and in one persons case a best interest assessment has been completed under the Mental Capacity Act 2005 and an advocate (IMCA) appointed. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have plans in place which detail their individual needs however they are not person centred and it is unclear if they were involved. Evidence: The annual quality assurance assessment says: listening to service users, family and a thorough needs assessment we put together a thorough individual care plan We found that each person has a care plan, which is very detailed however the care plans are not person centred and the manager acknowledged this is their next step. We also found it was unclear in the care plans about the level of involvement of each person or their representative. We looked at two care plans both detail the specialist needs of each person and how they need to be supported. Both plans were also very clear on behaviours each person can have and how they should be supported. Neither plan was available in any other format for the individual. However the manager was aware of this and knew this had to be developed. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: We could see that both plans had been reviewed. We were told that monthly reviews take place of activities people have done and changes to their care needs are recorded. We observed people making choices in their daily lives about activities, meals and what they wanted to wear. We observed staff supporting people to make decisions through recognising their body language and expressions. Risk assessments are in place for people using the service, further work is needed to make the information more consistent, for example information in the risk assessment about one person states they are not aware of hot and cold however this information could not be found in the care plan. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to participate in a variety of activities which interest them in the local community. Evidence: The annual quality assurance assessment says: we have individual weekly activity timetables which are reviewed monthly with the service user, family involvement is welcomed and our service users have weekly contact with their families, we also have involvement from advocates, all our service users have their own bedrooms with their own bathrooms which they can access whenever they wish too. we have a menu is place which is healthy and well balance People participate in a variety of activities, which they are either interested in or benefit their health, one person goes to hydrotherapy each week and staff are trying to source a suitable swimming pool for another person. We were told that each person has a weekly activity budget of £46. Several staff who returned comment cards suggested that there was a need for more Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: activity money. One person had a goal to get a bus pass and have access to swimming, the manager told us that finding a suitable pool has been difficult. The manager told us they had recently produced a weekly activity plan for each person that they were following. We could see that people are accessing the community to participate in various activities such as a trip to Poole park and trip to the library. It is important to be specific about where trips out are too and where a drive out is too. We noted for one person over several days the activities listed were walking around house there was no explanation as to why this was listed as an activity or if the person was unwell or unhappy on those occasions. There was no evidence of how people are being supported to make choices about the activities they choose. Two staff who returned survey forms thought the garden was under used and suggested that a vegetable patch is developed which would give the people in the home an activity they could be involved in as well as vegetables for meals. A relative who wrote to us said: they have been excellent at really listening to what X needs and then by observation adding to this themselves the person then gave an example of how one person living in the home enjoys going to the library and staff have taken this a step further and take the person to story time and singing time at the library which the person loves. The home has use of its own discreetly labeled transport for people to use. People are supported to maintain contact with family and friends. During our visit we observed staff spending time with people and focusing their attention on their needs and wishes. The dietitian has written clear details on how one person needs to be supported when eating solid food, we found in the care plan there was a section on eating solid food, it is important that both these documents are together in one place. Menu choices for the week we were at the home included; toad in the hole and vegetables, chicken curry and rice and shepherds pie and vegetables and at the weekend there was a Sunday roast. We found the cupboards were well stocked with a variety of tins and dried goods. There was a choice of fresh fruit and vegetables. Many of the tinned good in the cupboards were from a supermarket value range which could indicate that the service is having to manage a tight food budget, however one person has made choices about which food he prefers and these come from another supermarket and are more costly. We also found out that people choose to eat out several times a week and this is part of the overall food budget. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to ensure their health needs are met with the support and guidance of health care professionals. Evidence: The annual quality assurance assessment says: we have involved outside professionals ie: community nurse, occupational therapists, dietitians, chiropodists, physios and speech and language therapist We received a comment card from an occupational therapist who said the following to the question What does the service do well: Proactive approach to individuals needs, very aware of requirements of each individual, communicate effectively with OT, provide a positive environment for residents, families and visitors Another health care professional wrote: Listens to concerns of professionals and always tries to improve service This health care professional also wrote that they could do better by improving: personal care delivery and monitoring and improving their knowledge of challenging behaviour and epilepsy. Care plans we looked at contained information about Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: individual preferences such as getting up in the morning, when people preferred to have a bath and the guidance and support they completing personal hygiene tasks. People who live in the home have the equipment they need to maintain and maximise their independence. There is a small staff team who try to ensure they deliver a consistent service, through clear recording of changing needs. sometimes the information about the outcome of appointments is not always updated in the care plan even although staff are aware of the changes. We looked at the care files for two people using the service. We found evidence of appointments with health care professionals such as Dentist, dietitian, speech therapist and optician. Several of the staff who responded to the survey said they thought the service could improve by ensuring that there were scales in the home so people could be weighted properly. during our visit scales were delivered which are able to weight people who are being hoisted. When we visited the service, the staff were very concerned about the health of one of the people living in the home and spend a big part of the day getting to the bottom of the persons pain through consultation with the GP and dentist. We looked at the system in place for supporting people with their medication. There is a metal medicine cabinet in each persons room, this contains their medication which is dispensed in a monitored dosage system. All the people who live int he home are supported to manage their medication. We reviewed the records for one person and found the information in the MAR chart was the same as the medication in the monitored dosage system supplied by the pharmacy. Care plans reflect individual ways people prefer to take their medication. We found in one persons care plan details of when PRN ( as needed) medication should be given and why. Only staff who have competed the accredited training are able to dispense medication, however the manager told us that all staff are completing a training course. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have information about how to raise their concerns and should be confident they will be listened to. However the complaints procedure should be developed in different formats to support individual communication needs. Evidence: The annual quality assurance assessment says: we have a service user friendly complaints procedure. all our staff are POVA and CRB checked before they start their employment There is a complaints procedure in place and an easy read format for people who use the service. The format uses widget symbols and the service should consider the total communication needs of all the people using the service. All staff have received safeguarding training. A survey form which was completed by a relative on behalf of someone living at the home said they would know who to talk to if they were unhappy as they were clear on the structure within the organisation. There has been one safeguarding investigation since the service opened. This was fully investigated by the local authority and the outcome reported to the provider. Care Homes for Adults (18-65 years) Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a comfortable, clean home with space both inside and outside. Evidence: The annual quality assurance assessment says: we have a clean and tidy and odour free house which we and the service users take pride in,we have a lift in our home to assist service users to access their own bedroom, we have a glorious garden which is maintained by our maintenance man There is a lounge/dining area and a further smaller television room. There is a lift to the first floor which makes all the communal areas accessible. The home is decorated and furnished to a high standard, each bedroom is equipped with aids to meet the individuals needs such as an over head hoist. All rooms are en suite. All rooms were personalised, one person let us look inside their room and showed us their stuffed toy collection. The outside space is large, with a patio area and garden, this is accessible to people living in the home. A relative wrote I appreciate the lovely atmosphere at The tides We looked in bathrooms and could see liquid hand soap and paper towels. The Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: downstairs toilet had a swing bin and not a pedal bin. The home has an infection control policy and all staff receive training in this area. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by enthusiastic and competent staff who would benefit from further training to enhance their skills, knowledge and understanding of the people they are supporting. Evidence: The annual quality assurance assessment says: we have an in depth interview process and we assess new staff to which specific client group they would be best suited to. they also told us they are planning to: To have all our staff qualified to NVQ level 2 or above or working towards completely NVQ level 2 There was evidence that staff will be attending total communication training. In the four staff files we looked at we could not find any evidence that staff had completed challenging behaviour training or person centred planning training both of which would be beneficial in supporting the people who use the service. However we observed throughout the day that staff have a good understanding of how to support one person who has complex needs and behaviour which requires intense support. Two members of staff had not completed moving and handling training and one person had not yet completed epilepsy training. One person had completed Introduction to total communication training. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: Staff have told us: I feel the staff work well together as a team and give 100 to their jobs Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health, welfare and safety of people living in the home is at the centre of the aims of the home. Systems are being developed to ensrue that people in the home have a voice and are part of the services development. Evidence: The annual quality assurance assessment says: we have a manager on site who is currently studying NVQ4 and has experience in managing registered care homes, we have monthly staff meetings and service users meetings. staff have regular supervisions with their manager The current manager of the service started in July 2009. The home submitted an annual quality assurance assessment when we asked for it, we would have liked it to have contained more information about the plans to develop the service but appreciate the manager has not been in post long. Not all the windows on the first floor are restricted. One window which is small leads Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: onto a flat roof and this window should be restricted. We found there was a risk assessment in place for this window but not for others on the first floor. The rest should be risk assessed. Staff receive training in safe practice areas such as food hygiene, infection control and moving and handling. All accidents, injuries and incidents are recorded and sent to the commission when appropriate. All hazardous substances are stored safely. The premises are secure and systems such as central heating, gas and electrics are regularly serviced. The home has been open a short time and has not yet surveyed people on their views of the home and how it can be improved and developed, there is a corporate quality assurance system in place. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 The registered person shall, having regard to the size of the care home, the statement of purpose and the number and needs of service users ensure that the persons employed by the registered person to work at the care home receive training appropriate to the work they are to perform. Staff working in the care home must have a good understanding of the specialist needs of the people using the service to ensure they are safe at all times. 31/03/2010 Care Homes for Adults (18-65 years) Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 The registered provider should ensure that care plans are developed in a more person centred way and agreed with each individual. Care plans should also reflect individual aspirations and goals and how they can be achieved. The registered provider should consider how individual confidentiality can be maintained. Grouping together the same information such as, one to one hours, about each person living in the home does not maintain each persons right to confidentiality. The registered provider should ensure that individual choices about interests, hobbies and activities are clearly recorded as to how those choices are made. The registered provider should consider developing the complaints procedure in a variety of formats to meet individual communication preferences, to ensure everyone has a voice. The registered provider should maintain good infection control practice in the home by changing swing bins to pedal bins in bathrooms and toilets. The registered provider should continue to ensure that 50 of care staff (including agency staff) in the home achieve NVQ level 2. The registered provider should arrange for the small window which leads to a flat roof to be restricted, all the other windows on the 1st floor should either be risk assessed or restricted to ensure the safety of everyone living in the home. 2 10 3 14 4 22 5 30 6 32 7 42 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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