Care Home: White Windows Cheshire Home

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What the care home does well The home is clean, well maintained, tidy and comfortable. The medication system is well managed and people get their medication as prescribed. There are 60% of the care staff at the home who have a qualification in care. This means that they have been assessed as being competent in their role. What has improved since the last inspection? There has been some improvement in the care plans and they are giving staff more detail about what people`s needs are and what staff need to do to make sure those needs are met. Complaints are being taken seriously, documented and responded to properly. Staff have received safeguarding training and know what the procedures are and how to use them. This means that they understand the different types of abuse and what action they need to take if something untoward occurs. There has been some progress with improving activities and opportunities for people, but there is still a lot more work to be done in this area. What the care home could do better: Staff must make sure that they improve the risk management plans for people. This will make sure that risks to individuals are reduced or eliminated. Staff need to continue to develop the care planning process to make sure that people get individualised care and support. Staff should undertake Mental Capacity Act and Deprivation of Liberty training. This will make sure staff understand this legislation and can apply it to their everyday work with people. Staff need to continue to work with people to extend their opportunities for education, employment, social; and leisure activities. This will make sure people are occupied and stimulated. When the individual health care assessments have been completed, staff must make sure that appointments are made with relevant health care professionals. This will make sure people are up to date with any routine checks or treatments. There must be enough staff on each shift. To make sure that people`s care and support are met consistently. The results of the quality assurance surveys should be analysed and a report made available that tells people what the findings were and what changes will be made as a result of their comments. Key inspection report Care homes for adults (18-65 years) Name: Address: White Windows Cheshire Home Fore Lane Sowerby Bridge West Yorkshire HX6 1BH     The quality rating for this care home is:   one star adequate 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: Paula McCloy     Date: 1 9 0 4 2 0 1 0 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: White Windows Cheshire Home Fore Lane Sowerby Bridge West Yorkshire HX6 1BH 01422831981 01422836645 carole.davies@LCDisability.org www.lcdisability.org Leonard Cheshire Disability Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carole Davies Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Date of last inspection Brief description of the care home White Windows is owned and managed by the Leonard Cheshire organisation which is a registered charity. The establishment is registered to provide accommodation and and both personal and nursing care for up to 25 adults with a physical disability. The home is situated in Sowerby Bridge with easy access to the town centre of Halifax. The property, a stone built period residence is well maintained both internally and externally. All bedrooms are for single occupancy and highly personalised to reflect the residents interests and tastes. Lounges are spacious and comfortable and furnished and fitted to a good standard. Externally there are well maintained gardens and grounds which are fully accessible for wheel chair users. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 25 25 1 4 1 2 2 0 0 9 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 charges at White Windows are calculated on an individual basis according to individual peoples care and support needs. This inspection was carried out to assess the quality of care provided to people living at the home. We last inspected the home in December 2010 when it was assessed as being a 0* poor service. We asked the home to provide us with an improvement plan to tell us what they were going to do to meet the requirements we made in the inspection report. We received their improvement plan and this told us that they had or were in the process of meeting those requirements. The manager completed an annual quality assurance assessment (AQAA) prior to our inspection in December 2009, which provided us with information about the service. Care Homes for Adults (18-65 years) Page 5 of 26 We have used some of that information in this report. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home by two inspectors, which lasted approximately 6 hours. During the visit we spoke to 5 people living in the home, 5 members of staff and the manager. We also observed staff delivering care, looked at various records and looked around the home. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Staff must make sure that they improve the risk management plans for people. This will make sure that risks to individuals are reduced or eliminated. Staff need to continue to develop the care planning process to make sure that people get individualised care and support. Staff should undertake Mental Capacity Act and Deprivation of Liberty training. This will make sure staff understand this legislation and can apply it to their everyday work with people. Staff need to continue to work with people to extend their opportunities for education, employment, social; and leisure activities. This will make sure people are occupied and stimulated. When the individual health care assessments have been completed, staff must make sure that appointments are made with relevant health care professionals. This will make sure people are up to date with any routine checks or treatments. There must be enough staff on each shift. To make sure that peoples care and support are met consistently. The results of the quality assurance surveys should be analysed and a report made available that tells people what the findings were and what changes will be made as a result of their comments. Care Homes for Adults (18-65 years) Page 7 of 26 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 26 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 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff need to make sure that they use the assessment information they have to plan for peoples admission to the home. Evidence: We looked at the assessment information for someone who was recently admitted to White Windows. The home had completed their own assessment and had assessments from other professionals, that gave them a lot of information about the individual. However, staff had not used this information to put any necessary risk management plans in place or to formulate a basic care plan. It is important that staff use this assessment information to make sure they have assessed any potential risks to the individual and put measures in place to reduce or eliminate them. Care Homes for Adults (18-65 years) Page 10 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements to the care planning process need to continue so that people get the care and support they need and want. Evidence: We looked at five care plans because we wanted to see what individual needs had been identified and what action staff have to take to meet these needs. At our last visit in December 2009 we found that the care plans were not up to date, lacked detail and that it was difficult to find important information quickly. On this visit we found four of the care plans we looked at much better. It was much easier to find information quickly and staff had written down what support people require. Staff need to keep adding to this information at reviews putting in more detailed information, for example where people need the hoist to transfer them details of what hoist is used and size of sling. If people use specific continence aids the size, type and number of pads to be used on a daily basis should be recorded. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: There was no care plan in place for the person who had been most recently admitted to the home and who had lived there for 3 days. We looked at the assessment information for this person and felt that staff should have had a basic care plan in place and should have completed risk assessments either prior to or on the day of admission. There was enough information available to do this. (See section on Choice of Home). In December 2009 we felt that there were some people living in the home who were capable of making their own decisions, but were having their decisions influenced or overridden by others. We talked to the manager about this during our visit this time and think it will be helpful if staff to complete Mental Capacity Act and Deprivation of Liberty training so they will have a better understanding of peoples ability to make their own decisions. In two of the care plans we looked we found information recorded that should have prompted staff to complete a risk assessment. Staff need to make sure that at monthly care plan reviews they are also looking at the on going risk assessment and risk management plans for people. This will make sure that staff are pro active in making sure people are as safe as possible. Care Homes for Adults (18-65 years) Page 12 of 26 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples opportunities to be involved in the local community and pursue individual leisure pursuits are limited. Evidence: In December 2009 we found that there were some people living at the home that enjoyed a range of activities and were involved in going out on trips, to day centers and college, but this was not the case for everyone. There has been some improvement in this area and some people have been out to York shopping and some to the theatre. Entertainers have visited the home, quizs have been organised and a pamper evening and race night are planned in the near future. Two people we spoke to said there had been some improvement but it was still boring in the evenings and at weekends. One person also said they would like to go out to the pub but hasnt been able to do this. Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: The manager understands that more needs to happen to meet peoples individual needs. Staff need to spend time with each individual and find out what they want to do with their time in terms of occupation, education and leisure. Staff then need to make arrangements to make sure peoples needs in this area are met. From our observation there are people who are receiving very little stimulation on a day to day basis. Staff need to make sure that they spend time in the lounges so that people are not left with nothing to do and no one to talk to. A member of staff is permanently in the dining room at breakfast time and this has improved the service to people living in the home. We observed the lunchtime meal it was not a particularly social event. There were three staff all assisting people with their meal on the same table. At times they were talking among themselves rather than the to the people they were assisting. We felt that if staff were sitting assisting people at different tables and with it would give them the opportunity to engage more people in conversation and make the mealtime a more social and leisurely experience. We spoke to the manager from another Leonard Cheshire home who is spending some time at White Windows in a supporting role. Part of her role is to look at the activities co ordinators role in the home and how to develop the occupational and leisure activities that are on offer. One of the problems at the moment is that a lot of the activities co ordinators time is taken up driving the minibus, until a permanent driver is recruited. Care Homes for Adults (18-65 years) Page 14 of 26 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. Peoples ongoing healthcare needs are currently being assessed so that treatments can be brought up to date. Evidence: The care plans have improved since our last visit in December 2009 and staff are writing down details of how people like to be supported and what staff have to do to meet their needs. Staff are currently auditing the care plans to see when people last saw a dentist, optician, chiropodist etc. and will make arrangements for appointments to be made as necessary. They told us that this will be done by the end of May 2010. This will make sure people are up to date with routines checks. The medication system is well managed and people get their medication at the right times. Care Homes for Adults (18-65 years) Page 15 of 26 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. Complaints and safeguarding issues are taken seriously and dealt with properly. Evidence: The complaints procedure is in the Service User Guide and everyone living in the home has their own copy of this in their care plan. This means that people know how to make a complaint if they need to. We looked at the complaints log and could see that complaints that have been made since our last visit in December 2009 have been taken seriously and dealt with properly. The staff we spoke to all told us that they had received training in adult protection, which means that they are aware of the different types of abuse and about the safeguarding procedures. This means that people living in the home are protected and being kept safe. Care Homes for Adults (18-65 years) Page 16 of 26 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 comfortable, well maintained, clean and tidy. Evidence: The home is situated on Fore Lane in Sowerby Bridge, Halifax. It is set in its own grounds and there is a car park. It is approximately 1/2 mile from all of the local shops and facilities in Sowerby Bridge. The building itself is listed and has many period features. There are three different lounges so people have a choice of where to spend time. These are all well decorated and comfortable. Although staff have made an effort to improve the dining room it is still very large and impersonal. There are plans in place to provide a kitchen area for people living in the home to use, within the current dining area. Staff are hoping this will help improve the room. We looked at some of the bedrooms. All of them had been personalised and looked homely. At the last environmental health inspection the kitchen was awarded 4* for hygiene. Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: This means that the hygiene standards are good. The home was very clean and tidy. People living there and staff told us this is always the case. Infection control procedures are in place and the home has its own laundry. Staff we spoke to confirmed that they had received training and knew what they needed to do to stop any risk of cross infection. Care Homes for Adults (18-65 years) Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are not always enough staff on duty to ensure that peoples needs are met and that they can follow their preferred routine. Evidence: When we visited there were twenty one people living in the home. In the morning there were two nurses and four care staff on duty. Staff told us that there were usually six carers on duty, but some staff were away on training and had not been replaced. We talked to the manager about this. We were told that the home has been told not to supplement the staff numbers with agency staff and until they finish recruiting more carers they cannot always achieve the full staffing levels. This is unacceptable there must be enough staff on each shift to meet the needs of people living in the home. The majority of people living at White Windows require the support of two staff to attend to their personal needs. This level of dependence was confirmed on the information the manager gave us on the annual quality assurance assessment (AQAA). One person living at the home told us she was about an hour later than usual getting up because there had not been enough staff on duty. Although she was very understanding the home must have enough staff to make sure people can follow their chosen routines. Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: From our observation staff are still working in a very task orientated way as we found during our visit in December 2009. Again on this visit staff didnt spend any time with people unless they were carrying out a caring duty. The manager needs to look at staffing levels, the dependency of the people living in the home and the way that staff are deployed to make sure that there are enough staff on duty to meet peoples needs. We checked the recruitment procedures at the home in December 2009 and found them to be good. No new staff have been recruited since then so on this visit we did not check any files. We talked to staff about training. They told us that they get annual updates on moving and handling, first aid, fire safety, health and safety, infection control and food hygiene. They all said that they had good opportunities to undertake further courses that are on offer. There are 60 of the care staff that have completed their National Vocational Qualification (NVQ) in Care. This means that they have been assessed as competent to do their job. The home has an induction programme for new staff, which includes any new member of staff working with an experienced carer until they feel confident to do the job on their own. Care Homes for Adults (18-65 years) Page 20 of 26 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. Overall there has been some improvement in the management of the home but, more needs to be done to improve the outcomes for people living in the home. Evidence: The registered manager is a nurse who also has a management qualification. This means that she has been assessed as being competent to manage a care home. A manager from another Leonard Cheshire Home is also at White Windows to offer support to the manager and to help develop the service and move it forward. She is currently looking at ways to develop the activities and opportunities for people living in the home and the management of the staff duty rota. It is important that the manager continues to look at ways of improving the service and outcomes for the people living there. Although there has been some progress since our last visit in December 2009 more needs to be done to make sure people lead an active and fulfilled life. The home completed an Annual Quality Assurance Assessment (AQAA) before our inspection in December 2009. We did not ask them to complete another before this Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: visit. This gave us information about the service they provide. The home carries out an internal quality audit every year, surveys are sent to people using the service and their relatives to find out their views about what is being provided. At our last visit in December 2009 we were told that surveys have been sent out, but the information from them has not been collated yet. At this visit there was still no information about the results of that survey. It is important that the results of the surveys is made available to people so they know what action the manager is going to take as a result of the comments they have made. Residents meeting are held, the minutes from the most recent meeting were not available but the manager told us about some of the issues that were discussed. These were: what activities people like to do , meals, care plans and information about the changes within the Leonard Cheshire organisation. Monthly monitoring visits are also undertaken. These visits take place to check that the home is being managed properly and is being run in the best interests of the people living there. We looked at the report on the last visit. It was detailed and the manager was given points to act upon to make sure some of the administrative systems were kept up to date. When we looked at the accident reports we saw that one person had sustained a fracture following a fall. No risk assessment had been completed after this to look at ways of stopping the same thing happening again. The manager needs to make sure that all accidents are followed up and appropriate action taken to try and prevent a re occurrence. (We have made a requirement about this in the section on Individual Needs and Choices). In the annual quality assurance assessment (AQAA) the manager told us that all of the safety checks on equipment and services were up to date. Care Homes for Adults (18-65 years) Page 22 of 26 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 23 of 26 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 3 14 Staff must make sure that they use the assessment information to formulate a risk management plan for people who are moving into the home. This will make sure that risks to individuals are reduced or eliminated. 28/05/2010 2 7 13 Staff must make sure that 18/06/2010 risk assessments are completed for all identified risks to individuals, together with the action they are going to take in order to reduce or eliminate the risk. This will make sure that people are kept safe. 3 33 18 There must be enough staff on each shift. To make sure that peoples care and support are met consistently. 14/05/2010 Care Homes for Adults (18-65 years) Page 24 of 26 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 Staff need to continue to develop the care planning process to make sure that people get individualised care and support. Staff should undertake Mental Capacity Act and Deprivation of Liberty training. This will make sure staff understand this legislation and can apply it to their everyday work with people. Staff need to continue to work with people to extend their opportunities for education and employment. Staff need to continue to work with people to extend their leisure interests and their involvement in the local community. Staff need to continue to look at how they can improve mealtimes to make them a more social experience. When the health care assessments have been completed staff should make sure that appointments are make with relevant health care professionals. This will make sure people are up to date with any routine checks or treatments. The results of the quality assurance surveys should be analysed and a report made available that tells people what the findings were and what changes will be made as a result of their comments. 2 7 3 4 12 13 5 6 17 19 7 39 Care Homes for Adults (18-65 years) Page 25 of 26 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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