Inspection on 28/11/08 for 1 Bradd Close

This inspection was carried out on 28th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Bradd Close 15/11/06

1 Bradd Close 25/10/05

1 Bradd Close 25/10/05

1 Bradd Close 23/11/04

1 Bradd Close 12/07/04

1 Bradd Close 06/11/03

Similar services:

Coopers Mill Ltd

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Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Bradd Close 1 Bradd Close Off South Road South Ockendon Essex RM15 6SA     The quality rating for this care home is:   two star good 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: Alan Thompson     Date: 0 2 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 28 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 1 Bradd Close 1 Bradd Close Off South Road South Ockendon Essex RM15 6SA 01708670568 01708670568 diane.harley@estuary.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Diane Helen Harley Type of registration: Number of places registered: Estuary Housing Association Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Excluding any person who is liable to be detained under the provision of the Mental Health Act 1983 Date of last inspection Brief description of the care home Bradd Close is a care home with nursing for eight service users who have a learning disability, some of whom also have a physical disability. It is situated in South Ockendon, and is near to local shops and public transport, including bus services and a rail station. The current weekly fees are £1604.85. The premises are on one level and are divided into two identical areas at each end. Each area consists of four single bedrooms, a bathroom, shower room, lounge, dining room and a kitchen. There is a large garden at the rear of the premises with covered seating areas and raised flowerbeds. The home provides transport for the service users. Visitor car parking is available at the side of the home. CSCI inspection reports can be obtained from the home, or via the CSCI internet website. Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 8 Care Homes for Adults (18-65 years) Page 5 of 28 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 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: This key inspection commenced on Friday 28th November 2008, with a second visit taking place on Tuesday 2nd December to complete the process. Contact was made with the service prior to the visit to ensure service users would be at home. (Our most recent inspection prior to this was on 15/11/2006). The content of this report reflects the inspectors findings on the day/s of the inspection along with information provided by the service and feedback by service users, staff and other parties. The registered manager of the home was on duty on both days. The manager had completed and returned their Annual Quality Assurance Assessment Care Homes for Adults (18-65 years) Page 6 of 28 (AQAA) to us prior to the inspection. This document gives homes the opportunity of recording what they do well, what they could do better, what has improved in the previous twelve months as well as their future plans for improving the service. Some of the information and detail provided within the AQAA has been included in this report. Discussions were entered into with the manager, service users, visitors and staff on duty. CSCI survey questionnaires were also provided to service users, relatives and staff. We received eight completed surveys and reference to feedback from these has been made within this report. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All matters relating to the outcome of the inspection were discussed with the manager of the home, with full opportunity for discussion given and/or clarification where necessary. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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 considering moving into the home can be confident that the admission process ensures that the home can meet their needs. Evidence: The homes Statement of Purpose and Service users Guide were seen. These included the information needed to help new services users and their advocates make an informed choice when considering moving into Bradd Close. The current service users are placed and funded by local authorities. Records confirmed that these organisations had provided an assessment of needs to the home before admission. The manager said that in addition to this senior staff at Bradd Close would undertake a written assessment of needs for all prospective service users prior to admission. No new service users had moved into the home since the last inspection and so a file was looked at for a person admitted prior to 2008. Included was information on the Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: individuals previous lifestyle, likes and dislikes around routines, choices and preferences. The initial assessment included headings of background information, communication, mobility, self help skills and personal care needs, eating and drinking, continence, social and leisure and behaviour needs. The manager advised that prospective new service users are able to visit the home prior to making any decision on admission. She said that visits are enabled to try to ensure that the home is suitable. Existing service users views and needs are included in this process. Relatives spoken with at the inspection confirmed that they had seen the home prior to their relative moving in. Care Homes for Adults (18-65 years) Page 11 of 28 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. The information in care plans ensures that individuals needs could be met in a way they would wish. Evidence: Two individual support care plan files were inspected. These incorporated detailed risk assessments with information for staff on methods to minimise risk and meet daily assessed care needs. Risks and care needs had been reviewed regularly. Daily assessed needs were listed under individual headings including self care, personal hygiene, domestic skills, medication, relationships, physical health and manual handling, finances, mental wellbeing, communication, specific risks, diet and social activities. Assessments detailed the service users perceived strengths, needs, likes and dislikes. Each file also contained a personal touch policy, which listed information for carers on Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: how the service user preferred to be approached and handled with regard to receiving personal care support. The manager said that this helped new or agency staff to provide the right support to individuals. Files also had a pictorial weekly activities plan with records of actual activities participated in kept separately. Healthcare issues were seen to be recorded, including visits from, or to, medical professionals, social workers, hospital, GP consultations, dentists, opticians and chiropodists. Also seen recorded were notes of reviews of placement undertaken with the placing authority and the service user. The manager confirmed that house meeting take place about twice a year. Minutes of a meeting that took place in September 2008 included evidence of discussion on holidays, events and service user issues. Service user views and opinions were included. Service users spoken with who were willing or able to express an opinion, some could not engage in conversation with the inspector because of their disability, confirmed that they regard they are fully included in day to day decision making within the home, with staff offering choices around routines and events. Care plan notes recorded that their views and opinions are sought and staff spoken with confirmed that they liaise closely with service users regarding preferences. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are able to participate in a range of social and leisure opportunities that meet their expectations. Meals and mealtimes are flexible and suit the lifestyle of service users living at the home. Evidence: The manager confirmed that service users need full staff support in accessing the local and wider community and its facilities. Records had been kept of daily activities offered and participated in, these included day trip outings, visiting entertainers, one twice a month and one monthly, a weekly visiting aroma therapist, massages, films, cooking, singing, gardening, shopping, karaoke, lunches out, ice skating and trips to the cinema. The home has use of a vehicle with tail lift to provide easy community access. Service users spoken with confirmed that they regularly attend many of these Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: activities, with staff support. One said they liked eating out and going shopping. Service users also attend a weekly advocacy group in Thurrock where they take part in arts, games, walks, card making, and special interest sessions such as mens wellbeing, womens wellbeing and assertiveness groups. Several service users see their families regularly with staff offering to collect the relative to ensure regular contact is supported. Staff enter bedrooms only with the individuals permission, unless the welfare or well being of the service user is in question. Service users are able to have keys to their rooms however none did so at present. The manager advised that in the past one service user did choose to have the key to the main front door, but no longer does so by choice. Throughout this inspection staff were observed to interact appropriately with service users and appeared to always use the individuals preferred form of address. Discussions were seen to take place and the atmosphere in the home was friendly, relaxed and supportive. Nutrition records were inspected and evidenced a varied and balanced diet. Service users usually eat in the dining room, but some will eat in the lounge. The main daily meal is in the evening. Menus are decided week by week with service user involvement. Service users accompany staff on twice weekly food shopping trips and some will occasionally help in the kitchen with food preparation. The manager confirmed that service users food preferences and likes and dislikes form the basis of menu planning. Different meals are prepared in each of the two kitchens to ensure a choice for service users at each mealtime. Service users were spoken to about the food, those who were able to reply said they liked the food and got enough of it. Care Homes for Adults (18-65 years) Page 15 of 28 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. People living at Bradd Close can expect to receive support in an appropriate and dignified way that meets their needs. Evidence: Care records and discussion with staff, relatives and service users confirm that service users are fully supported in making their own choices, where possible, around the care support provided, clothing styles, hairstyles and general appearance. Assessment records included preferences around rising and retiring times and full details of the levels of personal care support required was also seen to be documented. Service users spoken with who were able or willing to fully express a view as to the support provided them by staff, did confirm that they liked the staff and were satisfied with the care provided them in the home. Care plans contained assessment of healthcare needs. The current service user group require staff support and guidance in recognition of their individual healthcare needs. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Service users receive annual dental check ups from a visiting dentist. If treatment is needed they go with staff to a community based health centre for this. Records of GP visits and other healthcare treatments and consultations were seen to be recorded in care files and daily communication records. All of the service users in the home were receiving full staff support with their medication needs, but care files did not include any evidence that the service user and/or appropriate relative had been asked to consent to medication. The manager said that only qualified nurses deal with medication and they are provided regular update training on medication issues by Estuary Housing Associations own trainer. Evidence was seen of this training having been provided, and all staff spoken with said they had been trained on medication administration and side effects of prescribed medications. The manager confirmed that if service users refused medication then advice and encouragement is offered to them to understand the reason for the prescribed dosage. The homes written medication procedure and policy clarified policies on the storage of medicines and of administering prescribed dosages. Records were seen relating to the reordering and returns of unused medication. A random sample of medication administration records was seen, no errors were noted. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Practices in the home safeguard service users and ensure that concerns are listened to and addressed. Evidence: The home had a complaints procedure in place, which clarified the complaints process and the timescales that the manager should respond to the complainant. There was also a pictorial style complaints procedure in the home. Some service users would not have the ability to follow any written procedure, but the document displayed clearly indicates to service users that they have a right to tell somebody if they are not satisfied with the care support provided. The inspector spoke to service users about their understanding of this and those who were able to express a view said they would tell their key worker or somebody else. Several service users have active involvement with their respective families. The home also has active links with a local advocacy service and was able to demonstrate that this service is used as appropriate to ensure that service users wellbeing is paramount to any given situation. There had not been any formal complaints received since the last inspection but there was a set template form for recording complaints. The manager said that any complaints received would be recorded along with the investigation and outcome. The home had a written safeguarding adults policy and procedure produced by the Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: registered provider. This included guidelines for staff on the adult protection procedures and on types of abuse that may occur. Staff are given annual training on this subject. Staff files inspected included certificates evidencing that abuse awareness training had been provided. Staff spoken with understood what was meant by the term safeguarding adults from harm and said that if they suspected an issue then they would contact the Manager. They also said they received regular update training on abuse awareness. Also seen was a whistleblowing policy which clarified staffs responsibility to report any suspected abuse. Care Homes for Adults (18-65 years) Page 19 of 28 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. Service users live in a comfortable, clean and homely environment. Evidence: During the inspection a tour of the home was made accompanied by the manager. Overall communal space comprised of two lounges and two dining rooms. There were two bathrooms, with fixed hoists and two shower rooms, all had a wc. The home was clean, homely and was mostly well maintained, furnished and decorated. It was noted that some carpets in communal areas were stained. This was discussed with the manager who said that she hoped these would be renewed in 2009. Communal areas of the home were well decorated and furnished and were comfortable and warm. The home had an attractive rear garden with garden tables and seating. One service user also has their own summerhouse in the garden, which they use as a relaxation area when the weather is fine. The manager said that service users are supported by staff to personalise their rooms according to their own tastes. Rooms inspected included various items of personal possessions. Service users spoken with who were able to express a view said that they liked their rooms and that staff kept them clean and tidy. Some service users showed Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: us their rooms and pointed out personal items that they had chosen themselves on shopping trips with staff. The laundry room was situated off the main corridor and had equipment suitable for the service. The home also had separate sluicing facilities. Care Homes for Adults (18-65 years) Page 21 of 28 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. Service users benefit from being supported by an experienced staff team who had received training. The recruitment procedure in the home provides the safeguards to ensure that appropriate staff are employed. Evidence: There is a stable staff team that work at the home that ensures consistency for the service users. The staff on duty displayed good awareness of the service users needs and demonstrated good interaction with them. The home does use agency staff however they try to ensure that agency staff have worked at the home before so that they know the care of the service users. Permanent staff spoken with confirmed this practice. The staffing numbers are one qualified nurse and three support workers on each daytime shift. At night there is one qualified nurse and one support worker. The manager confirmed that staff meetings take place approximately every 4 weeks, and minutes of these were seen. Discussion had included service user issues, job roles and rotas. The most recent meeting before this inspection was on 29/10/08. No new staff had been employed since the last inspection and a file was looked at for a member of staff employed prior to 2006. The file included an application form, proof of Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: ID, photo, a CRB check, two references and contract of employment. The manager said that new staff are subject to a six month probationary period during which time they receive in house induction training. Staff spoken with confirmed that they received induction training. Staff training records had been kept in files. These showed that staff had been trained in induction, adult protection (POVA), food hygiene, NVQ, health and safety, fire safety, manual handling, risk assessment, medication, first aid, multiple sclerosis, diabetes awareness, role of the worker and continence awareness. Staff confirmed they were well supported by the management team and that they received regular supervision. They also said that they had been offered good training opportunities appropriate to their roles. Staff spoken with were open, friendly and demonstrated sound care values. All had a good understanding of work practices and routines and the observed rapport between staff and service users was friendly and supportive. Comments made in surveys returned to us and in discussion with relatives and service users when asked about staff attitudes included, staff make me very welcome, they are extremely friendly and helpful. I am very satisfied with the overall care provided. We are always told if our relative is unwell, but we do not worry as the staff care for our relative very well. Regular staff supervision meetings had taken place, with records kept of the agenda discussions and actions. Areas included had been work role, responsibilities, key worker role, performance and training needs. The homes written supervision policy provided clear guidance to staff on the reasons for regular 1 to 1 meetings. Care Homes for Adults (18-65 years) Page 23 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed and run in their best interests. Evidence: The manager has been in post for since 2001 and has previous experience of a managing a similar service from 1994. The manager is a qualified nurse, holds the Registered Managers Award, and had undertaken various short courses to update skills and knowledge relating to the needs of the service users in the home. There is a deputy manager, also a qualified nurse, who assists with the day to day running of the service. Estuary Housing Association seeks the views on the service from staff and a report was seen which included summaries of the findings and an action plan for change. However there was no evidence to confirm that this process included taking account of the views of service users and their representatives. Random samples of records required to be kept by regulation were inspected. These Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: included, the statement of purpose, service users guide, regulation 26 reports (monthly registered person report), staff rota, visitor book, nutrition records, assessments, care plans, staff recruitment, medication records, fire drills and fire procedures. All records seen were in order. Staff had received training in fire safety, health & safety, food safety, manual handling and first aid. Service records were seen to show that the homes hoists, fire alarms, fire equipment, emergency lights, gas systems, the electrical installation supply and portable electrical appliances had all been tested or serviced within recommended timescales. The manager confirmed that hot water supply is regulated at or near 43 degress celcuis, and that weekly checks on this take place. Records of this was seen. The homes fire assessment and annual health and safety audits were seen. These contained information and actions to be taken by staff to minimise risks Care Homes for Adults (18-65 years) Page 25 of 28 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 28 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 39 24 The homes quality assurance process needs to include seeking the views of service users and their representatives. This is to evidence that service users opinions are taken account of, and acted upon, when reviewing the care and support they receive. 31/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 Services users consent to medication should be obtained where possible, and recorded within their individual care file. Carpets in some communal areas and lounges that are stained or marked should be cleaned or replaced. 2 24 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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