Care Home: Woodley Hall

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What the care home does well Potential service users get good information to help them decide if the service is right for them. Their needs are thoroughly assessed by the home, so they can be sure the person`s needs can be met. Service users are involved in drawing up their care plan and said that staff listened to and respected their views. They made positive comments about living here such as, "they look after me well", "they look after me really well. The care shown is fantastic". There are robust complaints and safeguarding processes in place, which helps to protect service users. Staff are trained and made fully aware of the safeguarding processes. The building is well maintained and located in an area where service users can easily access community facilities. The staff are well trained and supported. The staffing levels are good, which means service users receive good support in their day to day lives. Since the last inspection, a new manager has been employed who is managing the home well. Staff supported changes he had implemented and felt this had improved the quality of life for people living in the home. One said, "I feel that standards have improved significantly in recent times". What has improved since the last inspection? Service user`s views about the food are sought regularly, so that the meals provided meet with their approval. The home is being redecorated to provide a better environment for service users. What the care home could do better: Some care plans would benefit from further detail, which helps ensure staff are clear about the needs of the service user and the support staff need to provide. One service user said that staff preferred it if no visitors were received after 7 p.m. The manager should ensure that there are no unnecessary restrictions being applied by staff as to when service users can see their family and friends in their home. It is recommended that the administration of any controlled drugs be witnessed by another care worker trained in medication procedures. This helps reduce the possibility of an error occurring. Refused medications are being disposed of down the sink, which is not good practice. The home need to be make appropriate arrangements for the safe disposal of unwanted medications in order to comply with the legislation on disposal of clinical waste. Guidance on thesse medication issues are available on the Commission`s website.Records on service users` personal finances should be individualised to protect their privacy. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Woodley Hall 1 Gill Court Brunswick Village Wideopen Newcastle Upon Tyne NE13 7DU     The quality rating for this care home is:   three star excellent 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: Janine Smith     Date: 0 3 0 6 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: Woodley Hall Brunswick Village 1 Gill Court Wideopen Newcastle Upon Tyne NE13 7DU 01912171749 01912367495 manager.woodleyhall@careuk.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Care UK Mental Health Partnership Limited (Arc Healthcare Limited) care home 20 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 20 The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category of service only: Care home with nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Mental disorder, excluding learning disability or dementia - Code MD, maximum number of places: 20 Date of last inspection Brief description of the care home Woodley Hall is a 20-bed Care Home, which provides nursing care for people with enduring mental illness. The residents are former patients of St Nicholas Hospital, no longer felt to be in need of acute care and able to be cared for in a community setting. Located in Brunswick Village to the north of Newcastle upon Tyne, the home is ideally situated for shops, pubs, a wildfowl park and other local amenities which include churches and a major national racecourse. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The home is staffed by Registered Mental Nurses at all times. 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: three star excellent 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: Before this visit we looked at information we have received since the last visit on 12th June 2007; how the service dealt with any complaints and concerns since the last visit; any changes to how the home is run; the providers view of how well they care for people; the views of people who use the service and the staff. An unannounced visit was made on 3rd June 2009. During the visit we talked with people who use the service, staff and the manager. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept and checked that the staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We also checked what Care Homes for Adults (18-65 years) Page 6 of 29 improvements had been made since the last visit. We told the manager what we found. 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 services are not being put at signficant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: Some care plans would benefit from further detail, which helps ensure staff are clear about the needs of the service user and the support staff need to provide. One service user said that staff preferred it if no visitors were received after 7 p.m. The manager should ensure that there are no unnecessary restrictions being applied by staff as to when service users can see their family and friends in their home. It is recommended that the administration of any controlled drugs be witnessed by another care worker trained in medication procedures. This helps reduce the possibility of an error occurring. Refused medications are being disposed of down the sink, which is not good practice. The home need to be make appropriate arrangements for the safe disposal of unwanted medications in order to comply with the legislation on disposal of clinical waste. Guidance on thesse medication issues are available on the Commissions website. Care Homes for Adults (18-65 years) Page 8 of 29 Records on service users personal finances should be individualised to protect their privacy. 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 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. People who may use the service and their representatives have good information to help them decide if this home will meet their needs. Evidence: There is a comprehensive Service Users Guide, which helps inform potential service users about the services and care provided. Potential service users are invited to visit the home to get an idea what it is like. Records examined show that service users have their individual needs assessed before moving into the home. The staff work closely with St Nicholas Hospital, which means peoples health and social care needs can be well met. Contracts are agreed with service users and a copy kept on their care record. Part of the staff induction programme includes informing new staff about the admission process and how new residents should be welcomed into the home. Care Homes for Adults (18-65 years) Page 11 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. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: A sample of care plans looked at were well structured, identifying the service users strengths and needs, their views, the carers view. Aims and goals were identified and the interventions required to achieve these. The care plans also addressed any cultural requirements. Some would benefit from further detail, for example, if a service user displays aggression, why this happens and what action should be taken. Regular assessments are carried out, which help identify any areas of need or risk. A new risk profile, known as FACE, was being introduced by the psychiatrist. The care plans are audited regularly. A service user said he had seen and agreed his plan of care. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: Measures have been taken to implement recent legislation, known as Deprivation of Liberty, which helps to ensure that service users rights are protected. The staff help service users with budgetting their finances. They also help service users access independent advocacy services or find peer support where this would be helpful to them. One person has joined a mens club, which he enjoys going to. Two service users said they enjoyed living here. Positive comments were also received from service users, who completed a survey, such as Woodley Hall gives residents a good quality of life, they look after us well, look after me really well. The care shown is fantastic. All six service users who completed a survey, said that they made their own decisions each day and staff listened to and respected what they had to say. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live here are able to make choices about their life style and are supported to develop their life skills. Social, cultural and recreational activities meet their expectations. Evidence: Discussion with staff and service users showed that there are opportunities for service users to pursue social activities in and outside of the home. Each service user is offered at least one opportunity each week to go out. The activities are individualised and tailor made to each service user, following a survey of their interests. For example, one person is interested in opera and they have tried to stimulate his interest by going out to the theatre. Other activities included, local walks, lunches out, cinema, gardening, a mens group. Two service users attend church. There is also a cake and coffee event held at St Nicholas Hospital. They have talking book sessions, Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: bean bag exercises, board games. They also support people with life skills, such as laundry and meal preparation. Service users said they liked living here. One liked being supported to look after himself. Two more service users also described their lifestyle and how much they enjoyed living here. They said they enjoyed the meals and trips out. The staff had also helped them join an arts and crafts group where they were enjoying meeting other people and making new friends. Other service users commented that they were asked for their opinions and listened to. One service user said they could receive visitors but they can not come after 7 p.m. because staff are winding down the day and writing their records. Mixed views were received from service users in a survey, such as good activities, nice food, good atmosphere, the quality of meals could be improved, would like different activities. The menu looked well balanced and offered an alternative for each meal. Roast lamb, yorkshire pudding and vegetables, was being prepared for lunch, followed by banana and custard. Peoples likes and dislikes are recorded. A book has been placed in the home for service users to put their comments. Two service users have a soft diet but none require a pureed diet. There were plenty of fruit and vegetables in the stores. The chef makes scones, fruit loaf, and other substantial snacks. Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Service users said their personal and health care needs were being met. They see general practitioners and other health specialists, when necessary. They also receive routine check ups from dentists and opticians. Service users also said staff respect their privacy. A general practitioner and a psychiatrist, who completed surveys, said that staff respected service users privacy and dignity. The care records looked at showed that service users saw general practitioners when necessary. They also had routine check ups with dentists, opticians and podiatrist. Their weight was monitored. The records showed advice was sought from specialists, if service users developed health problems. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: A GP commented in a survey, Woodley Hall provides very good care of the patients physical and mental health problems. Six service users, who completed surveys, said that they were always or usually treated well by the staff, who listened to and acted on what they said. The system for looking after and administering medication was looked at. They have a generic stock of drugs from the Health Trust. These are checked every two weeks so that there is no over stocking. The procedures for administration were appropriate and safe. Handwritten entries on the medication administration were signed by the prescribing doctor. It is good practice for a second member of staff to witness the administration of any controlled drugs, but this is not being done. If medications are refused, they are put down the sink. A sample of medication administration records were looked at and found to be well recorded. Care Homes for Adults (18-65 years) Page 17 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 excellent 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 able to express their concerns and have access to a robust, effective complaints procedure and are protected from abuse. Evidence: The home keeps a log of concerns or complaints, which gave clear information and showed the action taken. The complaints procedure was displayed. Four staff who completed a survey said they knew what to do if someone has concerns about the home. Six service users, who completed surveys, said they knew who to speak to if they were unhappy and how to make a complaint. Service users spoken to had good relationships with the staff team. Since the last inspection of the home, the Commission has received three concerns. Care UK arranged for independent investigation of these concerns, which was done very thoroughly. The manager and owners of the home ensure that the Commission is kept informed of any concerns. The manager has written a new policy on abuse and protection of vulnerable adults. The whistle blowing policy and process was displayed in the staff room. Staff spoken to confirmed they had had alerter training and were aware of the whistle blowing policy. They were clear about the action to take if they had concerns. Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: Agreements are made with each individual about the support they need to handle their finances. A record is kept of any monies held on behalf of service users, which showed dates monies were received, withdrawn and the purpose it was used for. However, this contained details of all service users and would not help keep service users information private if any service user wanted to look at their own information. 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 physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment. Evidence: The home was toured, including a sample of bedrooms. Some bedrooms have an unpleasant odour. The manager said the rooms were cleaned regularly using a vax machine and they work with the continence advisor. Six service users, who completed a survey, said that the home was fresh and clean. Bedrooms have ensuite toilets. The home is currently being redecorated and service users have helped choose finishes. There is a large garden. The passenger lift was in working order. There is an assisted bath and a separate shower on the first floor and two assisted baths on the ground floor. The temperature of hot water delivered to one bath was tested and found to be safe. Warning notices are posted about the importance of testing the hot water. The laundry facilities are appropriate. There is a sluice and they have disinfection washing machines. Staff have access to protective clothing. Clothes are labelled. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: One member of staff, who completed a survey, said they thought the home needs more specialist equipment, such as raised toilet seats and hoisting equipment, to meet the needs of people who may have a disability. 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. Staff in the home are trained, skilled and in sufficient numbers to support the people living in the home. Evidence: There were 17 service users at the time of the inspection. The manager said they have recruited three senior support workers and created an Activity Co-ordinator post. They now make little use of agency staff. They have promoted some staff. There were no staff absences at the time of inspection. There are five staff on each early and late shift, which includes two qualified nurses and three support workers. One qualified nurse and two support workers are on duty through the night. The qualified staff work a fixed shift period. Support workers work two long days and two short days and have every other weekend off. The Activity Organiser has extra hours off the floor. They also employ a cook, weekend cook, domestics, maintenance and admin staff. The manager is supernumary and works a varied shift pattern, including weekends. The rota confirmed the staffing levels. The manager felt the staffing levels were appropriate to meet the needs of people living in the home. Staff spoken to also felt that the staffing levels were appropriate giving them quality time to spend with service users. Five staff who completed surveys said there were always or usually enough staff to support the people living in the home. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: There is a basic induction training programme in place for new staff but the management team are looking at developing this further so that staff have a more thorough grounding about the needs of people with mental distress. The manager confirmed that a number of the staff team have achieved National Vocational Qualifications (NVQ). Examination of staff training records and discussion with staff during the inspection confirmed that training is provided such as NVQ, managing aggression, breakaway techniques and risk assessment. Five staff who completed a survey said they received training which was relevant and helped them to understand the needs of the people they care for. Four also said the training gave them enough knowledge about health care and medication, but one disagreed. A GP and consultant psychiatrist ,who completed surveys, both said managers and staff usually had the right experience and training. The record of a recently employed worker, showed that two written references, a declaration of any offences and cautions, and a check of the Criminal Records Bureau had been obtained before they were employed. Five staff who completed a survey said that vetting checks were carried out before they started work. Staff confirmed during discussion or through surveys that they received regular support from their manager. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. There are effective quality assurance systems developed by a qualified, competent manager. Evidence: The manager, Mr Adrian Whiby, has managed the home since the beginning of the year. Staff spoken to during the inspection said that the manager had made a number of changes since taking up post, which had been necessary and had improved the running of the home. One said that the changes meant life for service users had improved and so had standards in the building and activities. A sample of comments were made in surveys from staff as follows. The home provides good care and support for people with a range of needs and disabilities over a large age range. The home caters very well to meet the needs of all the residents mental health needs, ensuring all the staff are well trained and informed to ensure health and safety, and to maintain a homely environment. I believe Woodley Hall offers good care to the residents living here and also offers care and support to all individuals according to Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: their needs, regarding personal preferences, age, race, faith, etc. One member of staff commented in a survey, that Registered Mental Nurses should appreciate the staff more, to remember we are to work as a team and we are all here to help the residents no matter what the task involves. Another commented, the home could provide better nursing staff!, but it not clear in what context this comment was made. A thorough quality assurance system was in place. This included a thorough audit of all systems covering all aspects of the national minimum standards, together with an action plan. Surveys had been carried out. An analysis of any accidents is carried out weekly. A system is in place to ensure that staff receive essential training in health and safety issues. This was confirmed by staff and by the staff records. Evidence was seen showing the bath hoist, fire systems and passenger lift had been serviced. 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 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 Some of the care plans would benefit from further detail, for example, if a service user displays aggression, the care plan should explain why this happens and what the staff should do to support the individual and prevent harm occurring to anyone. This helps ensure that the staff are well informed about the needs of the person. Ensure that there are no unnecessary restrictions on when service users can receive visits from friends or family. Proper arrangements should be made for the disposal of unwanted medication, including refused doses, in order to comply with legislation on disposal of clinical waste. This helps ensure that the water and sewarage system is not contaminated. The administration of controlled drugs should be witnessed by a trained member of staff, who should also sign the record of administration. This helps reduce the possibility of an error occurring. Guidance on both these issues is available on CQCs website. 2 3 15 20 4 23 Keep details of service users finances on separate Care Homes for Adults (18-65 years) Page 27 of 29 documents. This allows service users to look at information about their own finances, without compromising other service users confidentiality. 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!