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Inspection on 26/01/09 for Berehill House Nursing Home

Also see our care home review for Berehill House Nursing Home for more information

This inspection was carried out on 26th January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Berehill House Nursing Home Jobsons Close Newbury Road Whitchurch Hampshire RG28 7DX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Kathryn Kirk     Date: 2 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for 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 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 Older People 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 Older People Page 3 of 28 Information about the care home Name of care home: Address: Berehill House Nursing Home Newbury Road Jobsons Close Whitchurch Hampshire RG28 7DX 01256893087 01256896795 berehill@hesclacare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hestia Care Limited Name of registered manager (if applicable) Mrs Margaret Paine Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 30 The registered person may provide the following category of service : Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Berehill House Nursing Home is a home for service users in the category of older persons. The home is located close to a small village. The building is a large old detached property, which was totally refurbished in 2006. The home provides 2 Bathrooms with assisted baths and WC?s, 2 shower rooms with WC and 1 standard bathroom with WC. In addition there are 4 WC?s situated around the home and these are close to communal facilities. Care Homes for Older People Page 4 of 28 care home 30 Over 65 30 0 Brief description of the care home The home has a passenger lift for access to all floors and there are also suitable call facilities in all rooms, bathrooms, WC?s and communal areas. There are aids, hoists and assisted toilet and bathing facilities and handrails are situated around the home. There were a total of 25 bedrooms for service users and these were broken down as follows: 13 single bedrooms, 8 single en-suite rooms, 1 double bedroom and 3 double rooms with ensuite facilities. The fees at the home are varied and based on assessed need and range between #347 & #830 The service has five beds dedicated to respite care and also admits some people for up to six weeks who have been discharged from hospital Care Homes for Older People 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: three star excellent 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 quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards (NMS) and Regulations. The findings of this report are based on several different sources of evidence. These include A visit to the home by a regulatory inspector. This took place on 26 January 2009. During this time five residents and two staff spoke about what it was like to live and work at Berehill House. One visitor also gave their views. Some time was spent observing interactions between residents and staff in the communal areas. We also looked at some records and toured parts of the building. The Care Homes for Older People Page 6 of 28 manager was available to assist throughout the visit to the home. The findings of the previous key inspection, which was carried out in March 2007 and of the Annual Service Review which was carried out in October 2007 were reviewed. Five surveys were returned to us from relatives of people living at Berehill .Six staff and one health care professional also completed surveys An Annual Quality Assurance Assessment (AQAA) was returned to us in 2008. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We also looked at the information that we have received about the service since the last inspection. 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 Care Homes for Older People Page 8 of 28 240 7535. Care Homes for Older People Page 9 of 28 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 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 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. Thorough pre admission procedures help to ensure that peoples needs can be met. Evidence: The last inspection judged that the home carried out satisfactory pre admission assessments to establish peoples needs. The AQAA says that these are still carried out. All people who are going to have respite care are invited to visit before they start having short stays. During the visit their needs are assessed. Where a visit to the home is not possible, the manager carries out a pre admission assessment either in hospital or in the persons own home. Relatives surveyed by the home were all satisfied with the pre admission process and those surveyed by us all said that they were provided with enough information about the home to help them to make a decision about whether or not it would be appropriate. During our visit the file of one recently admitted service user was seen. This contained Care Homes for Older People Page 11 of 28 Evidence: a care management assessment which detailed the persons needs and wishes. The manager had also visited the person in hospital and had gathered information for her own assessment. This included information about health and care needs, current medication and how the person communicated. Also documented was how any identified risks might be reduced, for example whether pressure relieving equipment would be required, or whether the person was at risk of wandering or falling. The file also contained a discharge summary from the hospital. Care Homes for Older People Page 12 of 28 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. Care planning has improved and now focuses more on individuals needs and preferences. Peoples privacy and dignity is respected. Medication is being managed safely and the service could improve further by providing more guidance about when to administer as required medicines. Evidence: At the time of the last key inspection in March 2007 all residents had care plans, however, the plans did not always provide staff with sufficient guidance on how to support people,The example given in the report was for mental health needs. A requirement was issued to ensure that this was addressed. Since this time, the AQAA says that the manager has re written plans of support. We looked at three plans of care during our visit. They contained clear information to let staff know what action they need to take to support people effectively. They detailed what people were able to do for themselves and gave an indication of peoples preferences, for example, one night care plan seen detailed that the person concerned liked two pillows and a duvet, could use the call bell if needed and could say when they were tired. The day plan Care Homes for Older People Page 13 of 28 Evidence: gave information about how to support the person during mealtime, for example needs food to be cut up, plate guard to be used, needs a straw to drink. Peoples health care needs were also detailed. Consideration was given to Mobility,likelihood of falls, skin integrity and fluid and food intake. Where necessary detailed records were kept Information had been reviewed and updated where necessary at least once a month. Care plans seen had not always been signed by the service user or their representative to indicate their agreement but a recent quality assurance report noted that this work has begun. Staff surveyed were asked Asked Are you given up to date information about the needs of the people you care for?. All answered always.one said, for example care plans are very detailed and are of high standard Relatives all felt that the care home meets the needs of service users and felt that generally the home gives the support or care that they expect or agreed. One said The care home is ideal for my father Records showed that any necessary equipment needed has been obtained , for example pressure relieving mattresses. Records are kept of service users contact with health care professionals, for example community psychiatric nurses and GPs.One GP was asked Does the care service seek advice and act upon it to manage and improve individuals health care needs ? and Are individuals health care needs met by the care service? They replied always to both questions Care plans have been further improved as a result of quality monitoring visits to include more information about peoples nutritional needs. Staff confirmed that no one administers their own medication at present. Medicines were observed to be securely and appropriately stored and records checked for two service users indicated that records of administration were being accurately completed. Some people are prescribed as required medicines, for example, eye drops or for pain relief. Staff said that the people concerned would generally be able to say whether they wanted medicine or not. There was, however, nothing recorded in the care plans about this. It was discussed with the manager that staff need more written guidance , for example if a person is in pain,written information should be available as to whether they would able to request an analgesic or whether staff need to look out for non verbal signs of distress. The manager siad she would look into this. Staff were observed to interact with residents in a friendly and respectful way. Surveys showedthat peoples privacy and dignity is respected. One relative said that their mother found it embarrassing to have male carers dealing with intimate hygiene. The manager said that peoples preferences on how they receive personal care are considered in the assessment and care planning process. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 of 28 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. The service is flexible and will try to ensure that peoples preferences about their daily routines are respected. Evidence: As discussed in the previous section care plans now detail peoples preferences about their daily routine. They also provide some information about peoples past lives. The AQAA says that since the last inspection the service has appointed an activity co ordinator who works for 40 hours each week. When we visited, the activity co ordinator was facilitating a beanbag game that people could play from their armchairs. A number of the residents appeared to be enjoying this. A sing along,led by outside entertainers, was held in the afternoon. Staff were observed to let residents know what was due to happen and to help them to the activity/entertainment if they wanted to go. There is a large TV available in one of the lounges and there is another lounge without TV. A few residents who were sitting in the quiet lounge said that they enjoyed being in quiet surroundings. The manager said that Peoples religious preferences are observed, for example, one service user is supported to attend their church. She said she has also contacted a catholic priest to request a visit as one service user had Care Homes for Older People Page 16 of 28 Evidence: asked for this. One service user was observed to be growing distressed at times and said she was worried about her money. Staff and the manager were observed to spend time with her and to reassure her when this happened. The manager said that as a result of listening to people some changes have been made to the routine of the home, for example menus have been changed, a further hot drink is offered after mealtimes and the main morning medication round takes place at 8am instead of 7am. People at the service talked about having visitors and confirmed that they could see them in private if they wish. Relatives surveyed confirmed that the home helps them to keep in touch. One person commented that all rooms now have individual telephones . All relatives also agreed that they are always kept up to date with important issues affecting their relative. Asked does the care service support people to live the life they choose? most generally felt that they did. There is information in the hallway about how to contact external advocates should the need arise. One resident said that they were able to bring some things for their home when they moved in and records of personal possessions are kept. These were seen on files viewed. Two service users spoken with described the food as good and said that there was always plenty of it. One person said that they did not like chicken but that staff always offered her something else when this was on the menu. Staff were observed to talk with each resident before lunch to remind them what was on the menu and to check with them what they wanted to eat. A mealtime was observed. Most residents ate together in the spacious dining room but some chose to eat in their rooms. Staff were observed to provide appropriate support and gave people choice for example, asked them if they wanted brown or white bread. People were not rushed. Staff confirmed that individual needs and preferences are catered for, for example, the home provides pureed food and food for a diabetic diet. There is a record kept in the kitchen of any allergies that people have.Records are also kept which detail what food has been eaten each day and also notes what alternatives people have been given if they have requested something different. This helps staff to ensure that all service users are receiving a balanced diet. Care Homes for Older People Page 17 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is open and responsive to comments and feedback and this helps to protect people living at the home. Evidence: Information about how to make a complaint is displayed in the hallway of the home. This information is also contained in the service user guide. No complaints have been made to the service since the last inspection and no complaints have been received by CSCI either. Staff surveyed were asked if they know what to do if a service user, relative, advocate or friend had concerns about the home. All confirmed that they did. The AQAA says that there is a whistleblowing procedure available . This provides staff with guidance about their rights and responsibilities if they witness any malpractice in the service. The health care professional surveyed felt that the home acted appropriately if they had raised any concerns. Relatives surveyed said that they knew how to make a complaint should they wish to do so. Asked Has the care service responded appropriately if you have raised concerns most said always, some said that they had never raised concerns. One person described how their mother who is mentally frail, and therefore vulnerable had made an allegation . They said that this had been taken seriously and were satisfied Care Homes for Older People Page 18 of 28 Evidence: that all the correct procedures had been followed. There are policies and procedures in place to protect people from abuse. The service let us know about one incident where correct moving and handling procedures were alleged not to have been followed. The information provided shows that they followed correct procedures, taking action to protect the service user concerned and informing family and relevant professionals of the situation. The AQAA says that they have identified ways in which the service could improve in this area. This is to provide staff with more training in managing challenging behaviour The AQAA also says that all new staff complete training in the protection of vulnerable adults as part of their induction. Training records seen show that all staff have undertaken training in the Protection of Vulnerable adults as part of the mandatory training programme. Care Homes for Older People 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, 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 excellent 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 very comfortable well maintained home which is has been adapted to meet their needs. Evidence: The AQAA describes the environment as follows: Berehill House is a 200 year old building which was totally refurbished to a very high standard two years ago. We have a very attractive dining room. Two lounge areas, the home has wide corridors and is light and airy. Level access to all but one area which has a ramp with a handrail.Good access to the grounds. One raised flower bed has been built with more to be done.All furniture is of a domestic character and is new. All beds are fully profiling.Separate sluice rooms are located on each floor. Three hoisted baths and two wet rooms are available with one bedroom having an en-suite shower.There is an ongoing maintenance programme for the home. At the time of the visit the home was found to be free from adverse odour, clean well maintained and warm. Residents and a visitor confirmed that it is always so. The homes own survey (the results of which were seen during the visit.)shows that relatives were very satisfied with the decor cleanliness furnishings and temperature of the premises. Care Homes for Older People Page 20 of 28 Evidence: The home has a passenger lift for access to all floors and there are also suitable call facilities in all rooms, bathrooms, WCs and communal areas. All bedrooms meet the National Minimum Standards with regard to floor space. The service has met the requirement issued in the previous inspection by completing a risk assessment for the area next to the ground floor sluice room. since the last inspection an environmental health officer has visited the home and awarded an excellent rating for food hygiene. The laundry was seen during the visit.It was fitted out with sufficient equipment to meet the needs of service users and was well maintained.There are other measures in place to maintain hygiene and to minimise the risk of spread of infection These include handwash for visitors to use and liquid soap and paper towels are installed in communal toilets. The AQAA confirms that the home has a policy in place for prevention of infection and managing infection control which is in line with the Department of Health guide essential steps Care Homes for Older People 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 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. Service users are supported by well trained staff who have been properly recruited. Evidence: The rota was seen. This showed that two registered nurses and three carers are on duty during the day and that one registered nurse and two carers are on duty each night. Domestic staff are also employed in the laundry, kitchen and to clean the home. Service users and staff spoken with felt that generally there were enough staff on duty to meet collective needs. One staff member said generally the place is very organised and there is a spirit of teamwork which is rare in some places The AQAA says that where agency staff are employed, they only use carers familiar to the home to ensure continuity of care. the manager said that all care staff who have been employed since 2007 start NVQ by the end of the in first year of employment The AQAA shows that nearly half (42 ) of staff already have achieved NVQ level 2 or above in care and that six staff are currently studying for this qualification. The NVQ assessor comes to the home to support staff and was seeing staff on the day of the visit. The home was found to have thorough recruitment procedures at the last inspection The AQAA confirms that all people employed within the past twelve months have had satisfactory pre employment checks. All staff surveyed confirmed that the service had carried out checks such as obtaining an up to date CRB and two references. One staff file was seen during the visit and contained all necessary checks Care Homes for Older People Page 22 of 28 Evidence: to confirm that recruitment procedures at the service is thorough. All relatives surveyed said that they felt that staff had the right skills and experience to look after people properly. Comments included the staff looking after dad are brilliant the staff are encouraged to update their skills and are supported in doing so and the staff are caring and well skilled The health care professional also felt that in general staff have the right skills and experience to support individual needs. Residents spoken with were also complementary about the staff. One person said they go over and above what they need to do another said they dont interfere One resident described the staff as kind and described how they listened to her and helped her following a bereavement. Staff all said that they were given a thorough induction and one staff file seen showed that the new staff member was given plenty of opportunity to shadow more experienced members of staff whilst she was completing a trial period at the home. Staff all felt that they are given relevant training which keeps them up to date with new ways of working. one staff member for example described excellent training sessions offered throughout the year Records seen indicate that staff, following their induction have mandatory training in the following areas: fire safety, moving and handling, first aid, food handling infection control protection of vulnerable adults and COSHH. The manager has a training matrix so she can see which staff need to undertake or update their training . There are also a number of non mandatory training courses where some staff have attended sessions to give them more awareness for example of epilepsy, multiple sclerosis, Parkinsons disease and dementia. Care Homes for Older People Page 23 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed. Evidence: The Registered manager is a qualified nurse with over 40 years of experience, 25 years in elderly care. She is currently studying for the Registered managers award. She has undertaken periodic training to update her knowledge for example she has completed a course in palliative care and attended seminars on the Mental Capacity Act. She has also attended a forum at the royal society of medicine on preventing unnecessary hospital admissions. She and the registered nurses are also undertaking training in equality and diversity The manager said when she is on duty she ensures that she has contact with each service user every day. This means that she is very aware of what is happening in the service. Staff were asked Does your manager meet with you to give you support and discuss how you are working?.All said that she did regularly. One person said the manager Care Homes for Older People Page 24 of 28 Evidence: always meets with staff at morning handover She also conducts supervisions and is always ready to talk about worries or concerns staff may have another said I meet with my manager nearly every morning she comes on duty. She keeps me well informed despite me working during the night and she is very supportive. The AQAA describes how the service has a monthly visit from an external consultant who compiles a written report about the conduct of the home. As part of the visit, service users and staff are spoken with so that their views can be obtained as to the quality of the service. The service is reviewed against National Minimum Standards and recommendations are made if improvements are identified. Records seen during the visit verified that these visits take place as described. There was evidence that any improvements suggested have been acted upon ,for example there is more information regarding nutrition in care plans. The home sends out surveys to relatives and health care professionals The results of the 2007/08 showed a high level of satisfaction . There is also a suggestion box for people to use should they so wish. The manager said that residents prefer informal chats to meetings or surveys. The AQAA shows that policies and procedures have been reviewed and updated where necessary. The service manages small amounts of service users monies. This is securely and individually stored and written records of all transactions are maintained. The most recent quality assurance visit audited some service users money and found accounting to be accurate. The AQAA shows that all equipment and appliances in the home are being maintained. As discussed in previous sections risk assessment for the area around the ground floor sluice room have been included in the building risk assessment. Care Homes for Older People 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 Older People 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 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 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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