Care Home: Warwick House

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What the care home does well The residents at Warwick House tell us that they like living there. They say they can go to staff and speak to them about their concerns. They enjoy the food provided for them and appreciate the independence they have at the home. Comments from resident include; "We are able to come and go as we please. I usually go round my friends." "We are treated as individuals and always with a pleasing nice manner and respect. They never raise their voices or swear or hit us. In fact the staff are excellent at treating us with care." "Its a very friendly/homely atmosphere." Residents` health needs are met. The medicines prescribed for residents are given to them according to the doctor`s directions. Medicine records are available for audit purposes. What has improved since the last inspection? Residents told us that the acting manager has made "great improvements" since she has been in post. We found that the acting manager and the Registered Provider, Jean Harrity are in the process of looking at all aspects of the running of the home to see where there are any shortfalls and where improvements are needed. A member of staff told us, "At present the proprietor and senior carer are working very hard to bring all care plans up to date and put right any shortfalls." What the care home could do better: Warwick House needs to continue to look at staffing levels to ensure there are enough staff on duty to provide activities and one to one time for residents. They need to have detailed individual documentation when there is any self administration of medication, or any procedures that are different from the norm, for example how they handle medicines when people are out for the day. The home needs to obtain a correct specification controlled drugs cupboard and register in which accurate records are maintained. They also need to review the administration process when giving medicines. At present there is no registered manager at the home. We have been told that the acting manager will be applying for registration. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Warwick House 11-17 Warwick Gardens Worthing West Sussex BN11 1PF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jo Hartley     Date: 0 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 29 Information about the care home Name of care home: Address: Warwick House 11-17 Warwick Gardens Worthing West Sussex BN11 1PF 01903235488 01903235717 christine@warwickh.fsnet.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Jean Florence Harrity care home 35 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 35 The maximum number of service users who can be accommodated is: 35 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home Warwick House is a care home registered to accommodate up to thirty five service users with a mental disorder, eight of whom may be over the age of sixty-five. It is a row of four attached houses situated in the centre of the town of Worthing, West Sussex. The accommodation is located close to shops, the sea and local transport links. Service-users live on the ground and first floors. The private accommodation for service users is predominantly for single occupancy, although there are six shared rooms. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home Mrs Jean Harrity privately owns the service. There is currently no registered manager in post. Care Homes for Adults (18-65 years) Page 5 of 29 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: one star adequate 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: The quality rating for this service is 1 star. This means the people that use this service experience adequate quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. It was carried out by Jo Hartley and CSCI Pharmacist inspector Suni Chotai. The findings of this report are based on several different sources of evidence. These include: previous reports of visits to the home, the Annual Quality Assurance Assessment (AQAA) completed by the home, responses to surveys that we sent to staff and residents, an unannounced visit to the home which was carried out on the 5th February 2009 and discussions with staff and residents. During the visit we looked at the homes policies and procedures, staff records and Care Homes for Adults (18-65 years) Page 6 of 29 residents records. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Commission for Social Care Inspection. The last inspection on this service was completed on the 20th February 2008. What the care home does well: What has improved since the last inspection? What they could do better: 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 set out 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 29 Care Homes for Adults (18-65 years) Page 9 of 29 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 10 of 29 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. Prospective residents receive enough information to make an informed choice about where to live. Their needs are assessed prior to moving into the home. Evidence: The home has recently updated its Statement of Purpose and Service User Guide which is called Welcome to Warwick House, to reflect recent changes. Residents told us that they received enough information about the home to decide if it was the right place for them. The manager and owner of the home explained the admission process to us. This includes undertaking a full assessment of individual needs and the opportunity for the prospective resident to visit the home. The visit can include an overnight stay if appropriate. We looked at the records of three residents and they all included a detailed full assessment of peoples needs. This information informs the care plan that describes Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: how these needs are to be met. Any restrictions on freedom are documented with the reasons for the restrictions. Care Homes for Adults (18-65 years) Page 12 of 29 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. Residents needs are assessed and included in their individual care plans. They are able to make decisions about their lives and take risks as part of an independent lifestyle. Evidence: The home is in the process of updating everyones care plans. A member of staff told us, At present the proprietor and senior carer are working very hard to bring all care plans up to date and put right any shortfalls. We examined three care plans in detail and found them to be comprehensive and person centred. Clear guidance is given on how to recognise symptoms of individuals mental health issues, including how to respond appropriately. Evidence was seen that key workers are going through the care plans with the resident concerned. Residents sign each section of their care plan to show that they agree with the contents. Risk assessments are in place on all residents records as part of care plan. However, we Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: could not find a risk assessment in place for a resident who self-medicates. The home needs to have a risk assessment on any self administration of medication in the home. We saw that care plans are reviewed regularly. Dates of reviews of each section of care plan are recorded and signed by the resident, therefore we can see that care plans have been updated when changes have happened between scheduled reviews. Where restrictions are in place regarding an individuals choices or freedom, this is clearly recorded with the reasons for the restrictions and a risk assessment. Eleven out of the twelve residents that responded to our survey told us that they are able to do what they want to do during the days and evenings. One resident said, We are able to come and go as we please. I usually go round my friends. Care Homes for Adults (18-65 years) Page 14 of 29 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. Residents are able to take part in appropriate activities, keep in touch with family and friends and access the local community. They are offered a healthy diet and enjoy the meals provided. Evidence: Residents interests and hobbies are recorded in their care plans. Some residents attend college. Activities are often arranged for the evenings due to residents coming and going as they wish during the day. Recent evening activities include film nights, a quiz, a cards evening and bingo. Residents told us that new board games have been bought and staff play these with the residents. A chess tournament is held every Thursday. During the visit a group of residents were seen playing Scrabble with a member of staff. The majority of residents at Warwick House are very independent and access the community when they wish. The home has a games room that has a Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: pool table and dart board for residents to use. We were told by residents that trips have been arranged to Hampton Court and to see a pantomime, however some residents dont like to attend organised trips. One member of staff said there should be more time for 1:1 with residents. Another member of staff commented, We could try to arrange more outings but not many of the service users are willing to go when they are arranged. Records in care plans show that residents are supported in keeping contact with their relatives and friends. One resident told us that she had just come back from a visit with her family. Residents prepare their own breakfasts and drinks throughout the day. Breakfast consists of cereals and/or toast and spreads. The lunch menu is meals such as soup, sandwiches, scones, ravioli, sausage rolls etc. We looked at the menu for the week and found it to be nutritious and varied. It included meals such as leek pie, spaghetti bolognese and vegetable curry. A roast dinner is cooked every Sunday. The cook told us that the menu is put up in the morning and the residents come in and talk to her if they dont like it and they choose alternatives. This was confirmed by residents. Specialist diets for a resident with diabetes and a resident who prefers a low fat diet are provided. Key workers support residents in cleaning and tidying their rooms once a week. Care Homes for Adults (18-65 years) Page 16 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support in the way they prefer and their physical and emotional needs are met. They are able to administer their own medication where appropriate. However requirements have been made regarding the need for risk assessments for residents who self-medicate; the need for a correct specification controlled drugs cupboard and register in which accurate records are maintained and a written policy and procedure including a risk assessment for when a resident is out of the home at medication times. The home also needs to review the administration process when giving medicines. Evidence: Residents feel that they are treated with respect by the staff. We saw staff chatting to residents and interacting with them in a positive way. Comments from residents include; We are treated as individuals and always with a pleasing nice manner and respect. They never raise their voices or swear or hit us. In fact the staff are excellent at treating us with care. Its a very friendly/homely atmosphere. Residents receive the healthcare support that they need. We could see from the daily Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: records that residents have regular access to doctors, dentists, chiropodists, the mental health team and other specialists as needed. They told us that staff accompany them to appointments if the resident wishes. During the visit the manager arranged for extra staff to be on duty on one morning to enable them to take a resident to a medical appointment. A CSCI Pharmacist Inspector inspected the medication arrangements in the home. It was found that the home has good facilities to store and handle medicines. However, there is no controlled drugs cupboard of the correct specification so controlled drugs cannot be stored according to the law. Controlled drug records were confusing and the amount indicated as remaining did not agree with actual amount in stock. This means an audit is not possible. The medicine administration process was observed. This appeared a task oriented process as people came to a room after a bell has been sounded indicating that it is medicine time. Each person was given medicines individually, therefore preserving privacy and dignity. Two members of staff gave out medicines. The one signing on the MAR chart for medicines given did not actually remove the medicine from the labeled supply. This means that lines of responsibility are not clear. One resident took the lunch time medicine into a plastic container into his pocket to have later. This constitutes self medication and the written procedure and risk assessment on this was not available to view. This could mean that there may not be consistency in the way medicine is handled when residents are out for the day. Medicines received into the home and removed for disposal are recorded. There was recent training on medicines management for staff from the local pharmacist. One resident had started to manage their own medicines over the previous week. This process did not have documented risk assessment or a detailed procedure. Care Homes for Adults (18-65 years) Page 18 of 29 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. Residents feel their views are listened to and acted upon. They are protected from abuse, self harm and neglect. Evidence: The home has clear policies and procedures in place for responding to complaints. The complaints procedure is on display in the hall of the home so staff and visitors have access to it. Residents told us that they know who to speak to if they are not happy about anything in the home and they know how to make a complaint if they need to. Any complaints that are received are recorded, as are the timescales for responding to the complaint and the outcome. One resident told us that she is the House Representative and if someone feels they cant talk to staff about something then they go to her and she raises it on their behalf. The home also has policies and procedures for protecting vulnerable adults from harm. Staff are aware of how to report any suspicions of abuse. We saw training records that confirm that staff have received training in the protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 19 of 29 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. The home is homely, comfortable, safe, clean and hygienic. Evidence: As part of the visit we undertook a tour of the premises. We saw all the communal areas of the home and a selection of residents bedrooms. The home was clean and tidy throughout and generally well maintained. Residents are able to personalise their bedrooms and are supported by staff to keep them clean. There is a smoking room for those residents who smoke. The home employs a maintenance man to undertake general repairs and decoration within the home. The home told us in their Annual Quality Assurance Assessment that, We are committed to the continued upgrading of premises as can be evidenced by the high standards of the communal areas and individual rooms.The residents have privacy and the responsibility of their own rooms and are able to choose the colour scheme they would like when refurbishment takes place. This was confirmed by the residents. Comments we received from residents and staff include; Yes, clean and tidy. People take it in turns keeping it tidy. The service provides a clean and tidy environment, as a whole most service users seem fairly happy. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: There are policies in place to cover infection control, health and safety and food hygiene. Staff receive training in these areas on induction and they are also included in the annual training plan. During the visit we saw records that confirm that the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly. Staff are able to report any maintenance issues in a maintenance book. Care Homes for Adults (18-65 years) Page 21 of 29 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. Residents are supported by competent and qualified staff and protected by the homes recruitment policy. Their needs are met by appropriately trained staff. The home needs to look at levels of staffing to ensure they are adequate to meet the needs of the residents. Evidence: We looked at the recruitment records for three members of staff. All three contained the required information and checks including; two written references, Protection of Vulnerable Adults, (POVA), and Criminal Record Bureau, (CRB), checks and full employment histories. The home told us that, All prospective staff are interviewed and required to spend time with the residents in order to ensure that we only employ people with the right attributes to work with this client group. The residents views on prospective staff are sought prior to appointment. All the staff who responded to our survey told us that the home carried out employment checks prior to them starting work. During the visit a completed CRB check arrived for a newly recruited member of staff. The secretary rung her and arranged for her to come in to start her induction. We saw evidence that staff receive an in-house induction and a Skills for Care induction when they start work. During the visit a new member of staff was discussing Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: their induction with Mrs Harrity. We looked at staff training records that confirmed that staff receive training in areas relevant to their role such as Schizophrenia and Psychosis, Mental Health Awareness, Boundaries and Good Practice as well as mandatory Health and Safety Training. Mrs Harrity said that they have had some problems recently with accessing appropriate training but the home has recently bought some training packages including Infection Control and Fire Training. They are also now accessing training through the Care Training Consortium. The manager has undertaken an audit of staff training and is in the process of developing a more structured training programme. All but one member of staff who responded to our survey said they are given training that is relevant to their role, helps them to understand and meet the needs of residents and keeps them up to date with practice. Some concerns have been raised about staffing levels. Four staff said there are usually enough staff to meet needs of residents, one said there sometimes is but two said there never is. Comments from staff include, Staff cover is ok providing no sickness. When staff are sick the home struggles to find cover. Only two members of staff in mornings and afternoons for thirty residents. We could do with more staff to facilitate more social activities outside the home - but this is being considered. Need staff to go to hospital appointments, outings need transport etc. This was discussed with the manager who demonstrated that they are in the process of employing more staff. On the rota we saw there were two to three staff on duty throughout the day plus the manager, Mrs Harrity, a secretary and a cook. Records that we saw show that staff receive regular supervision sessions with their manager to discuss practice and training needs. Care Homes for Adults (18-65 years) Page 23 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is currently no registered manager in position. The home has a quality monitoring system in place. The health, safety and welfare of residents are promoted and protected. Evidence: The registered manager has recently resigned her position in the home. Warwick House is currently being run by the Registered Provider Jean Harrity and the Deputy Manager. The Deputy Manager is going to apply for registration as manager. Warwick House has a Quality Assurance Monitoring System in place. This includes monthly quality assessments from a representative of the company, annual questionnaires that are sent to residents and health professionals, regular residents and staff meetings. From these the home compiles an action plan which identifies what should be done, by whom and when to improve the service. We looked at staff training records and saw that staff have attended Health and Safety Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: training including Fire Safety, Infection Control, Manual Handling, First Aid and Food Hygiene. The home ensures that regular maintenance and safety checks are undertaken to ensure that the home is a safe environment for residents to live in. We saw up to date maintenance certificates for the gas boiler, electrical equipment and the fire alarm systems. The home also has regular testing for Legionella. We saw that accidents and incidents occurring in the home are recorded and reported appropriately. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 20 13 The home needs to have a 28/03/2009 written policy and procedure including a risk assessment for when a resident is out of the home at medication times. To ensure continuity of treatment and have consistency in the manner medicines are handled. To maintain the safety of medicines. 2 20 13 The home needs to have a 28/03/2009 risk assessment on any self administration of medication in the home. To protect the health, welfare and safety of people living in the home. 3 20 13 The home needs to obtain a correct specification controlled drugs cupboard and register in which accurate records are maintained. 30/04/2009 Care Homes for Adults (18-65 years) Page 27 of 29 To comply with the law regarding the recording of controlled drugs. 4 20 13 The home needs to review the administration process when giving medicines. To reflect person centred practice, to get away from a task oriented approach and to ensure that there are clear lines of accountability. 31/03/2009 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!