Inspection on 19/03/78 for Chiltern View (A)

Inspecting for better livesKey inspection reportCare homes for adults (18-65 years)Name: Address: Chiltern View (A) Oving Road Whitchurch Aylesbury Bucks HP22 4ER two star good serviceThe quality rating for this care home is: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: Barbara Mulligan Date: 2 0 1 1 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 areaOutcome area (for example: 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: 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 judgementCopies 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.Reader InformationDocument Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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. Internet address www.csci.org.uk Information about the care homeName of care home: Address: Chiltern View (A) Oving Road Whitchurch Aylesbury Bucks HP22 4ER 01296641146 F/P01296641146Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s):Milbury Care Services Ltd The registered provider is responsible for running the serviceName of registered manager (if applicable):Name of registered manager (if applicable) Elizabeth Cypher Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 10 0 care home 10learning disability Additional conditions:The registered person may provide the following category/ies of service only: Care Home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability (LD) The maximum number of service users who can be accommodated is: 10 Date of last inspection 1 2 1 2 2 0 0 7A bit about the care home Chiltern View is registered to provide accommodation for up to ten adults with learning disabilities. The home is owned and staffed by Voyage formerly Milbury Care Services and is located in a rural location outside of the village of Whitchurch. The home is not on a bus route and is 15 to 20 minutes walk from a few local shops and pubs. The towns of Winslow and Aylesbury are a short drive away. All bedrooms at the home are single and accommodation is on the ground floor with level access throughout. Service users have a range of learning and physical disabilities. Chiltern View has a cat, Thomas. The fees range from £932.64 to £1218.37 SummaryThis 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 serviceChoice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection:This is what the inspector did when they were at the care home. This unannounced key inspection was conducted over the course of a day and covered the entire key National Minimum Standards for younger adults. Prior to the visit, a detailed self-assessment questionnaire was sent to the manager for completion. Information received by the Commission since the last inspection was also taken into account. Nine CSCI surveys were received before the site visit was completed. The inspection officer was Barbara Mulligan. The registered manager is Elizabeth Cypher. The inspection consisted of discussion with the manager and other staff, opportunities to meet with some service users, examination of some of the homes required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and service users are thanked for their cooperation and hospitality during this unannounced visit.What the care home does wellThe home is a nice and comfortable place to live.People who want to live at Chiltern View will have their needs assessed before they move in, to make sure the staff can meet the needs of the people who live there.?The care plans tell the staff how to care for the people living in the home.The staff make sure that the people who live in the home are safe when they go out and take part in activities.The home provides good healthy meals for all the people who live there. The people who live in the home, and their friends and family, are supported to make their views known.Staff working in the home have received up to date training.The evidence seen and comments received indicate that this service meets the diverse needs e.g. religious, racial, cultural, disability of individuals within the limits of its Statement of Purpose.What has got better from the last inspection Moving and handling risk assessments are kept up to date and changes are made if necessary. The way people living in the home are receiving their medicines has improved and practices are safer and more robust.The damp in the shower room has been resolved and the home is kept nicely decorated and repairs are now carried out in a more timely manner.Portable appliance testing has taken place.What the care home could do better This inspection at the home has shown 2 things need to be done to make it okay.Hand written entries on Medication Administration records should be signed and dated by two staff.It is recommended that the home has access to the Internet.If you want to read the full report of our inspection please ask the person in charge of the care homeIf you want to speak to the inspector please contact Barbara Mulligan 33 Greycoat Street London SW1P 2QF 02079792000 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 Details of our findingsContents 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 Choice of homeThese 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.Prospective service users are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs.Evidence: An updated service users guide and statement of purpose were in place at the home, outlining the scope and philosophy of the service and how it aims to meet peoples needs. These were in good order and easy to follow. There have not been any new admissions to the service in the past twelve months, according to information supplied prior to the inspection. At the last inspection, documents relating to the most recently admitted service user were examined and found to be in good order with a detailed and comprehensive needs assessment which indicated that the service user had been involved in the process. The home does not take emergency admissions and is not registered to provide intermediate care. Individual needs and choicesThese 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.Effective and detailed care plans are in place which adequately document service users needs and how these are to be met, within a risk assessment framework.Evidence: The care of three service users was case tracked and their care plans were examined as part of this inspection. The registered manager said that the organisation has recently introduced a new care plan format. The files seen include a photograph, personal details, an outline of important people in their lives, the persons life story, likes and dislikes, positive things about the individual, things they like and dont like and things that are important to them. Care plans cover my physical health, communication, personal care, mobility, social skills, finances, relationships, activities and holidays, living skills, behaviour, cultural and spiritual expression, medication, decision making, aging; death and illness and safety in the home. Care plans examined are detailed and reflect the persons individual care needs and the action required to meet them. Regular review of the care delivered is recorded and the care plans updated accordingly. Evidence of the relatives being involved in the care planning process was apparent. The care plans indicate that service users are supported to make choices in relation to aspects of their daily lives for example meals, activities, getting up. At the time of the visit one service user had advocacy involvement. The home does not hold service users meetings but the registered manager said that they are welcome to attend the staffs team meetings. Individual meetings between the service user and their key worker are held monthly. These demonstrate that service users are given the opportunity to indicate if there are unhappy with any aspect of life at the home so that they can raise a complaint if Evidence: necessary. A record of these meetings is held in the individuals file. The registered manager said no service users were presently managing their own money and support plans are in place that documents the support needed. The organisation is the appointee for seven services users finances. Risk assessments were observed to be in place and examples seen include use of vehicles, bathing, being in the bedroom unsupervised and moving and handling. Those risk assessments seen show evidence of review and amendment where necessary. Missing person procedures were in place in the event of anyone being absent from the home without notice and for staff to refer to, if need be. LifestyleThese 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.People who use the service have a varied and active lifestyle, which reflects their interests, and are supported to maintain family links and friendships inside and outside the home. Menus are developed by people who use the service with support from care staff that promotes independence and choice.Evidence: From the information supplied by the manager, all the individuals living at the home take part in activities of their choice, and are able to use local community facilities. Service users are involved in a number of activities which includes attending college and day care services. Some service users attend sensory sessions and a qualified aromatherapist visits the home weekly. Staff facilitate in-house art and craft sessions and service users are given the opportunity to pursue their leisure interests with activities such as trips to the cinema, meals out, swimming and ice skating. Several visiting entertainers provide karaoke and other musical sessions. During the inspection two people went out to town for a haircut, shopping and a meal. The home has its own transport and people who use the service can access taxis, buses and other forms of public transport if they wish. There are no restrictions about family and friends visiting and this is detailed in the service users guide and confirmed through comments made from the surveys. Some service users go home for visits with support from staff as required and service users are supported to remember family birthdays and special occasions. People who use the service are able to receive visitors in the privacy of their own rooms, and are able to Evidence: choose whom they see and do not see. From observations on the day of the inspection visit, staff members were seen to treat the people living in the home with respect and were encouraged to be as independent as their needs allow. Meals are planned on a weekly basis with the people who live in the home and reflect their individual choices. Pictures are used to help people with menu planning. A record of what is eaten daily by individuals is maintained. The menu is varied and service users are able to have an alternative choice if required. Service users are provided with appropriate eating aids and staff provide assistance to individuals with their meals in a respectful way. The registered manager said that individuals are weighed regularly and the inspector saw these recorded for each person. Care plans demonstrate that service users nutritional needs are assessed and regularly reviewed. Personal and healthcare supportThese are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service.The physical, emotional and health care needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis.Evidence: Some of the service users in the home are very dependent on staff who attempt, through body language and other forms of non verbal communication to determine when service users would like to go to bed, bath, have their meals and take part in other activities. This is recorded in individual care plans. This extends to supporting service users to choose the clothes they wish to wear, hairstyles, make up and general appearance. The care plans set out in detail the service users preferred routines, their likes and dislikes and partnerships with families, friends and relevant professionals outside of the home. Essential information needed by staff to be able to provide personal and health care support was included in care plans. Staff support people using the service to see their local GP and other community healthcare services when needed, both within the home and in the local community. Care plans viewed during the visit contained evidence of healthcare treatment and intervention. There is a food and health charts folder that contains a food diary, records of epileptic seizures, menstruation charts and monthly weight charts. There is also a health screening file that contains information about the service users medicines, visiting the doctor and how I like to be supported, visiting the nurse, chiropodist, opticians and the dentist. Evidence was seen in the files of hearing tests, visits to the psychologist, physiotherapist, occupational therapist, and dietician. One service user has a visual impairment and there is information in his file from the RNIB. Service users have the necessary disability equipment they require to enable them to maintain their independence and robust risk assessments are in place detailing how the care is to be delivered in a safe manner whilst maintaining and promoting the Evidence: users independence. Following the previous inspection requirements were issued for1) Medication assessments for staff should be available for inspection and signed off to confirm competency. 2) Individual guidelines on the administration of as required medication must be put in place. 3) The registered manager must ensure that staff who administer rectal diazepam are deemed competent to carry out this task by a person trained to make this assessment and that this assessment of competency is reviewed on a regular basis. 4) The practice of administering medication with yoghurt must be agreed and signed off by the General Practitioner and family. 5) The registered provider is required to ensure that training in the administration of medicines is accredited for all care staff. The inspector examined the homes medication practices to assess if the requirements issued at the previous inspection have been complied with. The registered manager said she carries out in-house medication training for staff and they are expected to complete supervised medication rounds. Medication competency assessments are in place for staff along with a copy of an up to date copy of the medicines policy. These are kept in the staff files and were examined by the inspector. These are completed and up to date and this requirement has been assessed as met. However, the inspector raised concerns that this was not accredited training. The registered manager said that staff have also completed L box training about medication awareness and medication administration which is completed on a lap top or a computer. It is the responsibility of the organisation to ensure the medication training completed by staff is accredited. The inspector observed individual guidelines in the Medication Administration Records (MAR) and in care plans for medicines prescribed to be taken as required. It is pleasing to see that this requirement has been complied with. Staff expected to administer medicines have just completed Epilepsy, Rectal Diazepam and Buccal Midazolam training. A trainer within the organisation facilitates this and certificates have been issued to staff that have completed this. The registered manager said that this would be updated annually. This requirement has been assessed as met. Available in service user files there is a letter from the service users General Practitioner and their family agreeing to the individual having their medicines taken with yoghurt or other food. Therefore this requirement has been complied with. The medication systems were found to be overall in good order. The record keeping was generally up to date and fully completed. Two handwritten entries on MAR charts Evidence: were not signed or dated by two staff and this is strongly recommended. Concerns, complaints and protectionThese 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.Procedures for managing complaints and adult protection are in place ensuring people who use the service are listened to, kept safe and protected from abuse.Evidence: The home has a complaints procedure which each person keeps a copy of in their room. Two complaints were noted in the pre-inspection self-assessment, and these are well recorded in the complaints log seen at the inspection. These have been responded to within stated timescales and demonstrate that these were investigated and responded to appropriately. No complaints have been made directly to the Commission by service users or their representatives. People who responded to the survey indicated that they knew how to make a complaint if they felt it was necessary. All service users are protected form abuse, neglect and self-harm and have all been provided with guidance and support in understanding vulnerable adults issues. All staff are provided with relevant training both in their induction training and regularly thereafter, enabling them to recognise the signs of abuse and how to respond if an allegation or incident is brought to their attention. The self assessment document sent prior to the inspection states that the service has made three safeguarding referrals all of which were dealt with under the local inter agency safeguarding policy and procedures. EnvironmentThese are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service.The standard of the environment within this home is good, providing service users with an attractive and homely place to live.Evidence: Chiltern view is located in a rural location on the outskirts of Whitchurch. The home is 15 to 20 minutes from local amenities. It is a single storey building and is accessible for service users with a physical disability. The home has a communal lounge and dining area which is bright and homely but is not a sufficient size to meet the needs of ten service users, some of whom use specialist chairs. Two requirements have been issued for the registered provider to ensure that dining space meets the collective needs of service users in a safe, comfortable and safe way, and allows for meals to be taken in a congenial setting. The registered manager said that planning permission has finally been approved for an extension to the home, which will provide adequate dining space, and arrangements have been made for a surveyor to plan and design the extension. A requirement was issued at the previous inspection for the registered provider to investigate the possible cause for the damp in the shower room and then undertake any action to resolve this. It is pleasing to see that this has been complied with. A further requirement was issued at the previous inspection for the home to be maintained and decorated and that the slow response to maintenance issues is improved. The registered manager said the organisation has set up a call centre which homes can call for emergency repairs. In addition the service managers call the home weekly to see if there are any outstanding issues regarding maintenance. This occurred on the day of the inspection. All bedrooms at the home are single. Six bedrooms were viewed at this inspection and found to be nicely furnished and personalised with service users personal belongings. The home has a conservatory which is used as a sensory room with various equipment Evidence: provided. The registered manager said the three bathrooms are due to be redecorated and one bathroom refurbished. The homes laundry is managed within the home, in a designated laundry room. Cleaning schedules are followed to make sure that the home remains clean and hygienic. StaffingThese 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.The home provides staff cover to meet the needs of people using the service and thorough recruitment procedures are undertaken to ensure staff have the right skills and competencies to support the people who live there.Evidence: The home has a group of 19 staff providing support and care to service users. Seven care staff have completed NVQ level 2 training or above and a further three are presently working towards this qualification. The home has a staff rota showing which members of staff are on duty over the 24 hours, and there are arrangements in place to make sure a replacement carer (relief) is available at short notice if necessary. The rota’s show adequate numbers of staff are working in the home at any time to meet the needs of the people living in the home. At the time of the inspection, the home did not need to use any agency staff to help cover the rota. The homes policies around the recruitment and selection of staff serve to protect service users health and welfare. Application forms are completed, references are collected and a face-to-face interview is undertaken. Relevant POVA (protection of vulnerable adults) and (CRB) criminal records bureau checks are undertaken prior to appointment to ensure the persons suitability with working with vulnerable people. All newly recruited members of staff receive a structured induction training including shadowing more experienced carers until both parties feel confident and comfortable. Staff are provided with mandatory training in core subject areas which is updated accordingly, and undertake ongoing development in order that they are appropriately trained and equipped with the skills to meet the varying personal care needs of the service users, thereby protecting the service users health, well being and safety. Staff training is recorded in individual staff files and those viewed demonstrate the homes commitment to staff development and training. Evidence: Specific training for individual service users needs, such as autism and epilepsy is provided to ensure that staff have the necessary skills and knowledge. Conduct and management of the homeThese 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.The home is well managed with systems in place to ensure the health and safety of services users and staff is maintained.Evidence: The registered manager has worked at the home for twelve years and has been the registered manager for seven of these. She has obtained the Registered Managers Award and all requirements issued at the previous inspection have been complied with. The registered manager is aware of the need to keep up to date with practice and continuously develop her management skills. In the previous twelve months she has undertaken epilepsy training, management and development training and all mandatory training. The home has a computer but at present no internet facility. Sources of advice and information cannot be accessed by the home, for example the CSCI website, and it is recommended that the home obtains internet access to facilitate this. The registered manager reports to an external line manager who undertakes monitoring visits on behalf of the provider. These were examined by the inspector and follow a detailed format and show that speaking with staff and service users is a regular feature of the visits. The home has an annual service review when service satisfaction questionnaires are sent out to people who use the service, relatives, staff, visitors to the home and any health care professionals involved with the home. The operational manager visits the home for a day and anyone can visit to talk to her about any concerns, compliments or ideas they have about the service. Following this an action plan is produced, some of which is in pictorial form. Service users relatives or representatives are invited to the Evidence: reviews if this is requested by the service user. Monthly staff meetings are held in the home and the manager said that service users are welcome to join these if they wish. A range of health and safety checks was in place at the service, carried out on a daily, weekly or monthly basis. Portable electrical appliances had been checked in February 2008, electrical hardwiring was checked in March 2007. There are no gas appliances in the home. There are service certificates for fire equipment and emergency lighting. There are records of weekly fire alarm testing and staff training is up to date for all care staff working in the home. Fire drills are carried out with the full involvement of the service users and these are recorded in the homes fire safety records. There is evidence of water temperature recording, work placement risk assessments, accident and incident reports and health and safety risk assessments. Are there any outstanding requirements from the last inspection? Yes 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 Requirements and recommendations from this inspectionImmediate 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 Description Timescale for actionStatutory 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 setNo Standard Regulation Description Timescale for actionRecommendations 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 Recommendations120It is strongly recommended that all hand written entries on medication administration records are signed and dated by two staff. It is strongly recommended that the home obtains internet access.242 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.Copyright © (2008) Commission for Social Care Inspection (CSCI). 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