Inspection on 03/12/09 for Rawalpindi House

This is the latest available inspection report for this service, carried out on 3rd December 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rawalpindi House 04/10/06

Rawalpindi House 13/12/05

Rawalpindi House 28/07/05

Rawalpindi House 09/08/04

Rawalpindi House 22/04/04

Rawalpindi House 10/03/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Key inspection report Care homes for older people Name: Address: Rawalpindi House Rawalpindi House 81 Hermit Road Canning Town London E16 4HR     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: Sarah Greaves     Date: 0 3 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People 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 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Rawalpindi House Rawalpindi House 81 Hermit Road Canning Town London E16 4HR 02074744500 02074762225 mary.gavin@newham.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: London Borough of Newham care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical disability Code PD Date of last inspection Brief description of the care home Rawalpindi House is a 32-bedded residential home for older people. The home is owned and managed by Newham Social Services. The purpose built premises are on the ground floor and located in Canning Town, within walking distance of the underground station, local amenities and frequent bus services. The home is divided Care Homes for Older People Page 4 of 26 Over 65 0 32 0 32 0 32 Brief description of the care home into four separate units; two of these units provide care for older people with dementia and two units provide care for older people with general residential care needs. The home offers permanent and respite care. Care Homes for Older People Page 5 of 26 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 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: This unannounced inspection was conducted in one day. We gathered information through speaking to residents, staff, the acting manager and the service manager. We read a randomly selected sample of the care plans, and checked the storage and administration of medication. The premises were toured and we joined residents for lunch on one of the units. Other relevant information was read, such as staff supervision records, residents and staff meetings minutes, and health and safety records. The service was sent an Annual Quality Assurance Assessment (AQAA) after this inspection. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 7 of 26 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 8 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 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. An appropriate system was in place to assess the needs of residents prior to admission. Evidence: At the time of this inspection there were 23 residents living at the care home; all of these people were permanently placed. The service ordinarily also offers short-term respite care. Prospective residents (people that live within the London Borough of Newham) are assessed by a social worker prior to admission, in order to determine whether their needs are within the care homes registration status (general residential and residential care for older people). A review meeting is held at approximately six weeks after a new resident moves into Rawalpindi House, which is attended by the resident, their representatives (family and/or friends), the placing social worker, care home staff and any other relevant parties. This meeting provides an opportunity to discuss whether the resident wishes to remain at the care home and whether the service can meet their identified needs. The service is not registered to provide Care Homes for Older People Page 9 of 26 Evidence: nursing care, although specific nursing support can be accessed by district nurses and other community nursing services (for example, for residents that require daily injections due to diabetes). Key Standard 6 was not assessed,as the service does not provide intermediate care. Care Homes for Older People Page 10 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although residents benefitted from a pleasant and homely approach, clear improvements are needed in regard to the delivery of personal care and health care, inclusive of medication needs. Evidence: We read three care plans during this inspection, which approximately represented 10 of the available care plans. The following observations were made: There was an incomplete needs assessment in one of the care plans, although some attempt had been made to address the document. There was a lack of information in a personal care plan, for example, it stated staff to apply prescribed cream but there were no details in regard to the type of cream, or the location and times for application. The service has been advised not to use abbreviations such as is able to do her P/C (this referred to personal care) under supervision, no for number and oint instead of ointment, as such abbreviations could lead to the misinterpretation of important information. A care plan stated that reviews would take place every two months; however we noted that one care plan objective had been reviewed in June 2009, followed by its next review in November 2009. Upon discussion with the acting Care Homes for Older People Page 11 of 26 Evidence: manager, we were informed that a reduced frequency for the reviewing of some care needs had been agreed with staff. It would therefore be useful if the required reviewing periods were clearly stated on the care plans. It was noted that the service had introduced a Seven Outcomes Action Form, which required staff to assess the needs of individuals, such as health and emotional well-being, improved quality of life and increased choice and control. It was agreed with the acting manager and service manager that the template for this document did not leave a flexible amount of space for staff to undertake a comprehensive assessment; we were informed that the service proposed to switch to a typed format to address this issue. We noted that an auditing exercise involving some of the care plans had taken place, hence the service manager and acting manager was already aware of the shortfalls that would be identified at this inspection. For example, we found that some staff were signing care plans with their first name only, which was not acceptable for this type of document. There was also the misleading written use of different titles by staff to describe the same role (care worker, care assistant and carer); we were concerned that the use of the word carer could be confused with a residents relative or friend that supported staff with the care of the resident. We noted that a body map form had not been completed in one care plan, although other recorded documentation indicated that the resident had experienced a relevant incident that had required first aid support. There appeared to be some level of confusion for staff between what is an action plan and what is a review. Another care plan demonstrated that correcting liquid had been applied to eradicate an entry regarding a persons place of birth; it was advised that errors should be crossed out or alternatively the admission sheet could have been re-written. There appeared to be some confusion concerning the legal identity of a next of kin, who was described with three different statuses within a care plan. There were also examples of unacceptable blanks, such as staff not recording yes or no in regard to questions on an assesment form, such as whether a person had epilepsy or had previously had a stroke. Records for podiatry care were not up to date. One care plan stated that a resident had last seen a podiatrist in December 2008, although we were informed that this was not accurate (evidence was produced to demonstrate that there was a visiting podiatrist). We had observed that a resident on one of the units for people with dementia had clearly overgrown toenails; we were informed that it had been necessary for a podiatrist to cancel a visit just prior to this inspection visit, but an imminent new date had been arranged. The assessment for a resident indicated that they experienced occasional incontinence in February 2009 but by August 2009 this person was noted to need incontinence pads at all times. The significant change in this persons needs had not resulted in a new care plan for incontinence being developed. At an earlier inspection we found that the service had worked upon the production of individualised life history documents. We had previously been able to read a very detailed life history with photographs, and then Care Homes for Older People Page 12 of 26 Evidence: speak to the resident and two relatives in order to check how this work had positively impacted upon the quality of care for this person. We noted that this work had not been built upon and there was now quite limited social details about the residents, and some staff did not appear to understand the task of gathering social information. For example, one care plan stated her hobby is to have a cigarette occasionally. Whilst recognising that having a cigarette is important to the quality of life of a person that smokes, we would have anticipated a more indepth exploration related to hobbies. At the time of this inspection, the service was supporting a resident with palliative care needs during the final stage of their life, in accordance to the wishes of the individual . We noted that there were suitable guidelines in place (inclusive of good explanations for staff regarding the emotional impact of providing palliative care) and the daily records were detailed enough to evidence that care was being provided as stipulated. Additional support was being provided by the district nursing service. It was noted that a catheter stand had not been supplied and we observed that this presented a risk of infection; however, later discussions with the service manager and the acting manager clarified that the service was aware of this problem and was trying to address it. We checked the recording and administration of prescribed medications. The following observations were made: 1) An inconsistent approach to ensuring that the opening date of medications is recorded. This was particularly relevant to medications that needed to be disposed of within a given timescale, such as eyedrops. 2) A medication was recorded as being for daily use; however, it was identified that staff were administering it on an as required basis. 3) A pharmacy label had been altered with a biro mark; the service was not aware of who had made the alteration. 4) A resident was receiving either one or two tablets of a prescribed medication but the dosage was written up as two tablets. We acknowledged that this was a medication that permitted this type of flexibility; however, we were concerned that staff needed better written guidelines. 5) Gaps in the recording on the medication administration charts and failure to appropriately use the designated code of O to indicate when a medication not given for a reason not covered by the other codes. The failure to sign for prescribed medications was particularly prevalent in regard to creams and lotions. We looked at several medication administration charts for people that were supported with the application of topical creams; there was a distinct hit and miss pattern. One of the topical items that was being inconsistently signed for was bonjela for mouth ulcers, which contains paracetamol. This finding emphasised why the service needs to find a safe and consistent approach to document that all medication has been managed as prescribed. 6) Feint printing on some medication administration charts, which could make it difficult to decipher where to sign for medications. 7) Prescribed Care Homes for Older People Page 13 of 26 Evidence: medication (fortified supplement drinks) were being stored in a communal refrigerator in one of the unit kitchens. 8) Lack of information on pharmacy labels regarding application instructions for creams and lotions. The required instructions were not consistently found on the medication administration charts and/or the care plans. 9) Non-secure storage of prescribed creams in a few of the bedrooms that we viewed, including a prescribed cream with a steroid content ,which was observed in a prominent position in an unlocked bedroom. 10) It has been advised that a system is put in place for the care home to jointly check medication that it stores at the premises, but is administered by a visiting professional. This information has been obtained from a Care Quality Commission pharmacist inspector. We were concerned regarding the public display of information, for example, there was a list on a noticeboard in the communal hall stating daily outings to day centres and a notice on the refrigerator in a communal kitchen, which was the regime for the pressure area care of a named individual. There was also a notice in one of the unit kitchens that named a resident as being on a low-fat diet. Observations of interactions between residents and staff was positive. The residents that we spoke to stated that they were happy living at the care home, and found the staff to be helpful and kind. During the inspection a resident came back from a regular visit to a day centre and stated that she was feeling unwell. A member of staff assisted the resident in her room, whilst another staff member offered refreshments to people in the lounge. We noted that there was a relaxed atmosphere, that enabled residents to appear at ease and engage comfortably with staff and visitors. Care Homes for Older People Page 14 of 26 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. Residents were offered an overall acceptable level of care to meet their lifestyle needs, although areas for some improvement have been raised by both the managerial staff at the care home and the inspector. Evidence: As previously stated in this report, the care plans need to be expanded upon in order to gather more detailed information regarding the routines, activities and preferences of the residents. For example, we noted that one of the units maintained a bath book with residents having a bath on a fixed day each week. The book appeared to indicate that any new or respite residents would be slotted into one of the days that did not have a full quota of people already allocated for a bath. We spoke to a few residents on the unit for people with a more general frailty rather than people with a memory loss. These residents stated that they felt supported to set their own routines within certain limitations that they found acceptable (for example, people liked to ordinarily eat at the set mealtimes as they enjoyed the sociability of dining with other residents and interacting with staff). The service offered a daily programme of activities including arts and crafts, chairbased exercise, reminiscence, skittles, bingo, a visiting hairdresser and sing-a-long. Care Homes for Older People Page 15 of 26 Evidence: External specialists delivered some of the activities; on the day of this inspection the service was visited by a musician for the sing-a-long. There were also regular residents meetings, which were chaired by an external advocacy organisation. Discussions with the acting manager indicated that the service would like to move forward with the scope of activities offered. We were not aware of any residents that were able to independently manage their finances. The service supported people to personalise their bedrooms with their own items and information regarding sources of independent advice (such as advocacy) was displayed in the communal lounge. We joined some of the residents for lunch; on this occasion we dined on a unit for people with dementia. The quality of the main meal and dessert was good. The menu plan indicated that there were daily choices, which appeared varied and balanced. People were sensitively assisted with any support that they required, and one of the care plans demonstrated that the specific cultural food preferences of the individual had been identified and planned for. Care Homes for Older People Page 16 of 26 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. The service evidenced that it has been suitably responsive to complaints and concerns that have occured since the last inspection visit. Evidence: It was noted that the service had a complaints procedure in place. This was provided to residents and their representatives; additionally, information regarding how to make a complaint was publicly displayed. We looked at the services records of complaints that had been dealt with at a local level within the premises (complaints can be progressed to a Newham Council complaints officer); the available information indicated that there was a satisfactory response to the complaints. No complaints for 2009 were produced. The service possessed a clear Adult Protection policy and procedure, and staff received training. At the time of this inspection there had been some recent issues of concern that had been investigated via the Adult Protection framework. Care Homes for Older People Page 17 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, 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. Residents were provided with a homely and clean environment, although on-going maintenance is required. Evidence: The service occupies a purpose built premises, situated on a residential street in Canning Town. There are four separate wings, which means that residents live within relatively small units. We found that the service was homely and clean; there were no offensive odours. The bedrooms (with en-suite facilities) were noted to be pleasantly maintained and individualised. The communal areas demonstrated some degree of expected wear and tear since the last inspection, particularly the lounges which now appear more cluttered as the needs of older people within residential care have progressively altered ( for example, more people using wheelchairs and walking frames). We observed that there was a pack of unused incontinence pads left on an occasional table in one of the units; this was pointed out to the acting manager and was removed. Care Homes for Older People 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 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. Some positive achievements have been made in order to benefit the residents (such as staffing levels and the accomplishment of statutory training); however, more focused training is required to address the areas for service improvement stated within this report. Evidence: The service manager stated that the care home employed eight care workers in the morning and six in the evening; this number did not include the senior person in charge, or staff employed for catering and domestic services. The acting manager stated that the numbers of staff could be altered in order to meet any changing needs of the residents. Observations during the inspection, such as our attendance at lunch on one of the units, indicated that there was a sufficient number of staff to meet the presented needs of the residents. Staff were supported to undertake National Vocational Qualification in Care; there were no issues of concern in regard to care staff participating in this training. The recruitment files for staff were not checked at this inspection due to more time being focused upon the health and personal care standards at this inspection visit. Training records indicated that staff were provided with mandatory training and some Care Homes for Older People Page 19 of 26 Evidence: additional training relevant to the needs of the service. This inspection visit has highlighted that more training is needed for staff including topics such medication practices, care planning, promoting individualised care and how to broaden social activities and opportunities. Care Homes for Older People Page 20 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service evidenced that it has now introduced more robust management arrangements although the issues identified in this report indicate that continued work is needed to improve the standard of care for residents. Evidence: We were previously notified that the registered manager had applied for retirement. At the time of this inspection the care home was being managed by a service manager from Newham Social Services and the acting manager would be applying for the registered manager position. The service manager planned to remain at the care home for three days a week in order to provide guidance to the new manager and progress the improvement agenda. We noted that the quality assurance monitoring had not promptly picked up on evidence that aspects of care needed to be improved on, such as medication practices. Within the past few months the service had recognised problems that were now being addressed. The service had conducted a review of care plans and implemented an Care Homes for Older People Page 21 of 26 Evidence: action plan that covered a broader range of issues. The following concerns were noted with health and safety practices within the care home: 1) Some of the first aid equipment had expired. 2) We found an unlocked storage room on one of the units for people with dementia, which contained items such as descaler and carpet cleaner. 3) A bedroom that was used for smoking did not have a sign that identified this. 4) A communal bathroom had a notice on the door stating that the room was for the use of the residents and should not be used for storage. We found that the room contained a photocopier, a mattress and some buckets. We were concerned that a resident might have experienced a fall in this room due to the obstacles, hence the room should have been locked. The health and safety records that we viewed were up-to-date. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 (2) The registered manager 30/06/2008 must ensure the safe management of prescribed topical medications. Care staff must sign the medication administration records after each application The instructions for application must be recorded on the pharmacy label, recorded on the medication administration records or written in the care plan. The registered manager must ensure that arrangements are made to secure the staff changing room. 31/07/2008 2 19 13 (3) Care Homes for Older People 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 7 15 The registered person must ensure that the quality of the care plans is improved upon. So that there is safe guidance for delivering and evaluating care for the residents. 30/04/2010 2 9 13 The registered person must ensure that the residents are provided with safe administration of prescribed medications. For the safety and health care of the residents. 28/02/2010 3 38 13 The registered person must ensure the safe storage of hazardous items. For the safety and welfare of the residents. 28/02/2010 Care Homes for Older People 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 Care Homes for Older People 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. 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