Inspection on 21/04/10 for Five Gables Nursing and Residential Home

This is the latest available inspection report for this service, carried out on 21st April 2010.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Five Gables Nursing and... 03/10/08

Five Gables Nursing and... 24/04/08

Five Gables Nursing and... 03/05/06

Five Gables Nursing and... 12/01/06

Five Gables Nursing and... 12/05/05

Five Gables Nursing and... 18/10/04

Five Gables Nursing and... 15/04/04

Five Gables Nursing and... 08/01/04

Extracts from inspection reports are licensed from CQC, this page was updated on 29/06/2010.

Key inspection report Care homes for older people Name: Address: Five Gables Nursing and Residential Home 32 Denford Road Ringstead Kettering Northants NN14 4DF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Irene Miller     Date: 2 3 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 Older People Page 2 of 29 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 Older People 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 Older People Page 3 of 29 Information about the care home Name of care home: Address: Five Gables Nursing and Residential Home 32 Denford Road Ringstead Kettering Northants NN14 4DF 01933460414 01933622807 fivegablesnh@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Jade County Care Homes Limited Name of registered manager (if applicable) Darren McGregor Type of registration: Number of places registered: care home 43 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be admitted to the home is:43. The registered provider may provide the following category of service: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary needs on admission to the home are within the following categories: Old age, not falling into any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Five Gables Residential Care and Nursing Home can accommodate up to 43 older people, some of who have dementia and/or physical disabilities. The home is situated in the rural village of Ringstead. Residents are accommodated in one of three units depending on their needs. The Villa, at the rear of the property, caters for mainly Care Homes for Older People Page 4 of 29 Over 65 0 43 43 0 2 2 0 4 2 0 0 9 Brief description of the care home nursing residents, and has a small dementia unit within it. The Lodge, at the front of the property, accommodates those needing residential care only. The Villa, dementia unit, and most areas of the Lodge are accessible to people with limited mobility. The grounds include a car park, mature gardens, and patio areas. Information on the current fees are made available within the homes Statement of Purpose or from the Registered Manager. Care Homes for Older People 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The focus of all inspections undertaken by the Care Quality Commission are based upon seeking the outcomes for people using the service and their views of the services provided. This visit was unannounced and focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The care records of people using the service were sample checked which involved looking through written information available on their care, such as their individual care plans (a care plan sets out how the home aims to meet the individual service users personal, healthcare, social and spiritual needs). Due to communication difficulties, some people using the service were unable to give Care Homes for Older People Page 6 of 29 verbal feedback on the care they receive at the home. Observations of care practices and discussions with people using the service where possible gave an indication on the quality of the service provided at Five Gables. Records in relation to the homes management and administration systems, quality assurance, staffing and general policies and procedures were viewed. Prior to this visit we sent out to the provider an Annual Quality Assurance Assessment (AQAA) this document allows the provider to supply us with information on how they view their own performance, such as what they do well, what they could do better and plans for future improvements. The AQAA was returned to us within the timescale set, and gave an insight into how the home is managed and quality assessed. Care Homes for Older People Page 7 of 29 What the care home does well: What has improved since the last inspection? The registered manager has acted upon the requirements and recommendations from the last inspection, a senior nurse has been appointed who oversees care planning, staff supervision to ensure a high standard of care is achieved. Improvements have taken place to the environment to include redecoration, new carpets and refurbishments. Profile nursing beds have been purchased for all people receiving nursing care. The home has increased the number of domestic staff which enables regular deep cleaning of areas throughout the home to take place, we were informed that the domestic staff have taken on the responsibility for ensuring pressure mattresses are regularly decontaminated. New cross infection control measures have been implemented within the laundry by the use of an innovative ozone laundry disinfection Care Homes for Older People Page 8 of 29 and sterilization process to further reduce any risks of cross infection. 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 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 Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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. Detailed pre admission assessment ensures that the needs of people are identified and forms the basis for the initial care plan put in place. Evidence: No changes have taken place to the registration categories of this service since the last key inspection. The homes Statement of Purpose, provides information on the management of the home and qualifications of staff and the Service User Guide, provides information on the range of services provided at the home and within the local community. Both these documents are made available to prospective residents and their representatives. We looked at the pre admission assessment documentation within peoples care files. There was sufficient information available to demonstrate that the home had carried out a full assessment of the health and personal care, social and emotional needs of people prior to them moving into the home. Care Homes for Older People Page 11 of 29 Evidence: Additional information was available within the care files from the placing authorities. This combined information ensures that needs are known and therefore an informed decision to be made as to whether needs can be fully met by the home. Care Homes for Older People Page 12 of 29 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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 needs of people using the service are met, updates to care plans as an when needs change would ensure that this is fully recorded. Evidence: Information provided within the Annual Quality Assurance Assessment (AQAA) states that the home has succeeded in providing care for residents that have been asked to leave other homes, and have proved difficult to place by their care managers. All staff are trained to cope with any difficult behaviours, treat and care for people as individuals and meet specific needs. We looked at the care plan of a person who finds it difficult to accept help with personal care, the care plan had information available to inform staff on how care was to be provided for this individual. There was records of the care plan being regularly reviewed, in which some references had been made of changes to the persons care. We found that the respective care plans did not reflect some of the changes, it is Care Homes for Older People Page 13 of 29 Evidence: important that care plans contain up to date information to reflect the current needs. In discussion with the staff they were able to explain how they provide care for the individual, which demonstrated that staff were aware of the persons changing needs, observations of care being provided by staff for the individual supported this. Mental Capacity Assessments (MCA) and Deprivation of Liberty (DoLS) assessments are in place, however at present they are in the form of a tick box style, this does not give the scope to go into specific detail to make the assessments individualised. The need for MCA and DoLS assessments to be more detailed was discussed with the registered manager at the time of the inspection. Falls risk assessments were in place for people identified at this risk, staff said that one person had been referred to a specialist falls co ordinator. This person was vulnerable to falls at night and the suitability of bedside rails had been considered and backed up by evidence of an assessment within the persons care records, this had identified that this particular equipment may not be suitable for the individual and actually pose a greater risk. In discussion with the registered manager and staff we were informed that the option of placing a sensor mat beside the bed was being considered, with the aim of reducing the risk of falls for this person. The night care plan contained generalised information, which did not go into specific detail on how the safety of the person at night was to be managed. The care records contained information on the nutritional needs of people, and people identified at risk of being nutritionally compromised had their food and fluid intake was closely monitored. The home had recently sought the involvement of a nutritionalist to provided update training for all staff. People prescribed liquid food supplements, had sufficient stock available for their personal use, in discussion with staff they said that they were promoting people to take fortified foods and drinks and this was observed to be offered at the time of the inspection. Peoples weights are checked on a monthly basis, and recorded within their care plans. Risk assessments had been completed for pressure area care, nutrition, mobility, moving and handling and falls. Records showed that where people are assessed at risk, appropriate action had been taken to address and reduce the risks. People identified at risk of developing pressure ulcers, mainly due to immobility, frailty or poor dietary intake, where provided with pressure relieving equipment. Records were available within the bedrooms of people who required to be repositioned in bed to reduce the risks of developing pressure ulcers. We were informed at the time of inspection that no people using the service had developed pressure ulcers. Care Homes for Older People Page 14 of 29 Evidence: We observed a person who required the use of a hoist for transferring from chair to wheelchair. The staff used a portable hoist to lift the person out of their chair into a wheelchair. The person was seated in a domestic style recliner armchair, it was difficult for the staff to bring the hoist close to the chair and the staff had to improvise to stop the chair from moving backward, in all the move appeared very cumbersome. The staff did their best under very difficult circumstances to ensure that the person was reassured and moved safely. The need for specialist seating for this person was discussed with the Senior Nurse on duty and the Registered Manager at the time of inspection. Records showed that people using the service have access to the advice and support from other health and social care professionals. Recently the home has embarked on the Liverpool Care Pathway this is a palliative care programme to ensure that appropriate care is given to people who are at the end of life stage. The medication storage and administration systems showed that medication is generally well managed, controlled drugs procedures have been recently reviewed to ensure that staff double check the stocks at the beginning and end of each shift. This ensures that any problems or shortfalls are quickly identified and people receive their medications as prescribed. We looked at the needs of a person who at times requires essential medication to be given disguised in their food (covertly). There was good evidence within the care plan to show that this decision had been reached through the full involvement of the persons GP, family and the dispensing Pharmacist. Information was available within the care plan of medications suitable to be crushed and any side effects the person may experience. The medication administration records for the person showed that the administration of medication covertly was only used in extreme circumstances as a last option, and was rarely given in this form. Information was available within the care plan of the persons medications being regularly reviewed. During the visit staff were observed to spend time socialising with people, within one of the lounges big band music (Glenn Miller) was playing and a member of staff was encouraging people to get up from their chairs and dance, the people participating and observing appeared to get a lot of enjoyment and fun out of this. Care Homes for Older People Page 15 of 29 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are generally happy with the activities and lifestyle at the home. Evidence: People using the service told us that the food was good, and that they enjoyed living at the home, and were happy at the home. Two activity persons are employed at the home, in discussion with one of the activity staff they told us that they work with small groups and individuals the emphasis is on providing people with the opportunities to engage in meaningful activities to stimulate them. records are made when people participated in individual and group activities. Information provided within the Annual Quality Assurance Assessment (AQAA) identifies that the home seeks to involve people from within the local community, such as entertainers and people with special interests providing opportunities for people to meet together and socialise. Friends and relatives are encouraged to play an active part in the care provided for individuals and to participate in joining in resident meetings. The registered manager said that the home is actively trying to involve families and friends in putting together Care Homes for Older People Page 16 of 29 Evidence: life histories, to help care for people living at the home with limited verbal communication due to advanced dementia. Being informed of life events such as peoples past occupations, important family links, hobbies and interests, likes and dislikes, hopes and fears helps tremendously in putting together true person centred care plans, where the whole person is seen not just the dementia illness and the difficulties this can bring. People using the service have access to regular religious services within the home and arrangement are made for people to have individual visits from a clergy of their own faith. Residents meetings take place regularly, this provided an opportunity for people to have their say as to what activities they would like to be provided by the home, families and friends are encouraged to join in the meetings. The menus have recently been reviewed to provided a greater choice, in discussion with the registered manager he confirmed that the meals are under constant review and changed and altered accordingly to individual preferences. Care Homes for Older People Page 17 of 29 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 using the service are protected by the homes policies, procedures and practices. Evidence: Since the last key inspection CQC have received two complaints about the service, the provider was asked to investigate the complaints under their own complaints procedure and to report the outcome of the investigations to CQC. We were satisfied that the complaints were fully investigated and appropriate action taken to address the concerns. One complaint involved regular failures to the homes elevator that had resulted in some people being unable to access the ground floor communal areas. Swift action was taken in response to this and an additional stair lift has been fitted to the Villa. Information supplied within the AQAA states that all relatives are made to feel welcome at the home they are encouraged to come as much as they like and feel at home. I have an open door policy to relatives and they can speak to me about concerns at any time. Residents have the opportunity to speak to me on a daily basis and raise issues, as well as attend resident meetings in order to voice any concerns. The directors of the home carry out unannounced visits to the home, during which they meet with residents and relatives, this is evidenced through written reports of the Care Homes for Older People Page 18 of 29 Evidence: visits under Regulation 26 of the Care Standards Act. The complaints procedure is available within the homes Statement of Purpose and Service Users Guide and also on display within the home. The Mental Capacity Act (MCA) and Deprivation of Liberty (DoLS) has been implemented into the dependency assessments and protection policies. Staff receive training on safeguarding of adults (SOVA), having this training ensures that staff are aware of their responsibility to keep people safe. Care Homes for Older People 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, 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. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with a clean and comfortable standard of accommodation. Evidence: Since the last key inspection work has taken place on improving the fabrics of the building to include, the purchasing of specialist profile nursing beds for all people requiring nursing care, the lodge has had new carpets fitted and furniture replaced, and a stair lift has been added to the Villa. The AQAA states that specialist equipment is purchased in order to meet the needs of all individuals, as mentioned in the health and personal care section of this report there is a need to look into the provision of specialist seating for one individual using the service as discussed during the inspection with the Senior nurse and Registered manager. We observed that generally equipment was available according to peoples identified needs, such as wheelchairs, hoists, bedside safety rails, and pressure relieving equipment. The home has increased the number of domestic staff which enables regular deep cleaning of areas throughout the home to take place, we were informed that the domestic staff have taken on the responsibility for ensuring pressure mattresses are Care Homes for Older People Page 20 of 29 Evidence: regularly decontaminated. New cross infection control measures have been implemented within the laundry by the use of an innovative ozone laundry disinfection and sterilization process to further reduce any risks of cross infection. We observed that disposable gloves, aprons, antibacterial liquid soap and hand sanitizer was readily available within the en suite facilities and within the bathrooms and WCs throughout the home. Care Homes for Older People 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service benefit from having a staff team who are appropriately trained to meet their needs. Evidence: On this visit we found that there was sufficient staff on duty to meet the current needs of people using the service. We looked at the staff recruitment files of three new staff employed at the home, all files viewed had evidence to demonstrate that appropriate pre employment checks had been carried out to include checks with the Independent Safeguarding Authority (ISA) and the Criminal Records Bureau (CRB). It was noted that within two of the files viewed written references had been accepted from ex colleagues of the applicants, the importance of obtaining a written reference from the previous employer was stressed with the registered manager, as this would ensure greater vetting of applicants. Staff are provided with a full induction on commencing employment which covers all mandatory training such as moving and handling, pressure area care, nutrition awareness, fire safety, health and safety,infection control, food hygiene, safeguarding of vulnerable adults and dementia care awareness. Training certificates were available to demonstrate training courses attended by staff. Care Homes for Older People Page 22 of 29 Evidence: One to one supervision takes place regularly and records of supervision show that staff are encouraged to reflect on their own practice and identify areas for self development. The registered manager informed us that he has recently purchased a DVD training pack supporting dignity and person centred care. This has proved a powerful tool to enable staff to reflect on their own practice and how their actions and behaviours impact on individuals using the service. Care Homes for Older People Page 23 of 29 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 pro active management of the home promotes and protects peoples health, safety and well-being. Evidence: The registered manager has worked at the home for a number of years, he is a qualified nurse, has gained the relevant experience to manage a care home and holds the registered managers award. Regular meetings are held with people using the service, staff and visitors, this ensures that people have opportunities to raise any concerns they may have about the quality of the care provided at the home. The manager is pro active in ensuring that people using the service are safe and their rights promoted. Quality assurance monitoring and audits take place regularly to measure the quality of care provision at the home. Unannounced (Regulation 26) visits take place by the registered provider, records of these visits were available to view during the Care Homes for Older People Page 24 of 29 Evidence: inspection. The registered manager informed us that he is fully supported by the registered providers in ensuring that safety and quality are promoted and upheld. We sample checked records of cash held on behalf of people using the service, this was held securely and records were available of transactions. Care Homes for Older People 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 Older People 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 7 15 Night care plans must set out in details the action required by staff to ensure the safety of people identified at risk of falls. This will ensure that staff are fully aware of the vulnerability of people at night, and the actions required to promote safety and well being. 30/06/2010 2 7 15 Care plans must be updated as and when peoples needs change. This will ensure that care records reflect the current needs of people using the service. 30/06/2010 3 29 19 When recruiting new staff at least one written references must be obtained from the applicants previous employer. This would ensure that 30/06/2010 Care Homes for Older People Page 27 of 29 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 appropriate checks are carried out to ensure that new staff are suitable to work with vulnerable people. 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 7 Mental Capacity (MCA) and Deprivation of Liberty (DoLS) Assessments should be detailed and specific to the individual. This will ensure that all areas of capacity are looked at individually, to enable full autonomy and choice to be exercised. Care Homes for Older People Page 28 of 29 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. Care Homes for Older People 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. 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