Inspection on 22/06/09 for Clemsfold House

This inspection was carried out on 22nd June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clemsfold House 24/11/09

Clemsfold House 29/09/09

Clemsfold House 01/11/07

Clemsfold House 31/08/06

Clemsfold House 08/11/05

Clemsfold House 07/06/05

Clemsfold House 05/10/04

Clemsfold House 25/05/04

Similar services:

1 Marten Road

Daubeney House

Three Gables

Deepdene Care Centre

Aldwick House

49 Glendale

Ferndale Residential Care Home

David Gresham House

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Key inspection report Care homes for older people Name: Address: Clemsfold House Guildford Road Broadbridge Heath Horsham West Sussex RH12 3PW The quality rating for this care home is: One Star Adequate Service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Val Sevier Date: 2 2 0 6 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. 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 judgement They reflect the Care Homes for Older People Page 2 of 20 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 20 Information about the care home Name of care home: Address: Clemsfold House Guildford Road Broadbridge Heath Horsham West Sussex RH12 3PW Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: Conditions of registration Category(ies): Dementia Mental Disorder, excluding learning disability or dementia Number of places (if applicable): Under 65 48 48 Over 65 0 0 Dr Shafik Hussien Sachedina Mr Shiraz Boghani Mrs Doreen Rebecca Holmes Care Home (PC) 48 clemsfoldhouse@sussexhealthcare.org 01403 790312 Additional conditions: The maximum number of service users who can be accommodated is: 48 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: Dementia – DE, Mental Disorder, excluding learning disability or dementia – MD Care Homes for Older People Page 4 of 20 Date of last inspection: Brief description of the care home: D D M M Y Y Y Y Clemsfold House is registered to provide personal care for up to forty eight people. Registration categories allow for forty eight people who have dementia and mental disorder over sixty five years of age. This includes up to eight service users in the category DE over the age of forty and under sixty five years. Current service users over the age of sixty five not falling within any other may still be accommodated but no others in this category may be admitted. The categories of registration will undergoing review by the South East Registration Team as part of the Modernising Registration Agenda. Clemsfold House is a detached property situated in a rural area about three miles from Horsham. It has a well maintained, accessible garden. Dr S Sachedina and Mr S Boghani privately own the service. Mrs D Holmes is the registered manager responsible for the day-to-day running of the home. The weekly fees for the home range from £516 to £680 for an ensuite single room, the CSCI was informed of the current fees on the 1st November 2007. Fees do not include charges for extra services such as chiropody and hairdressing. Details of these are available from the manager. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: One Star Adequate Service Care Homes for Older People Page 5 of 20 How we did our inspection: The quality rating for this service 1 star. This means the people that use this service experience adequate quality outcomes. The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The visit was carried out on the 22nd June 2009 between the hours of 10:00 am and 4:00 pm Prior to the visit to the home we reviewed, previous inspection reports and information received from the home since it was last visited in November 2007. The Annual Quality Assurance Assessment (AQAA) was returned to the Commission by the due date before we visited the home. The AQAA is a document that we send to a service once a year, in it they are able to comment on improvements they have made, any barriers to improvement to meeting the standards and how they feel the service is meeting the needs of people who live at the home. We met with three staff, two visitors and there were three people who use the service involved in the inspection visit. We have sent ten surveys to staff, people who use the service and five to other professionals. At the time of writing the draft report we have had nine surveys returned, two professional, two staff and five from people who use the service. We looked at four pre admission assessments, four care plans, medication records, staff files and training records and fire prevention testing and training records. We used a Short Observational tool (SOFI) during the inspection which meant we sat and observed interaction between staff and people who use the service and between people for a period of two hours. The observations from this are included in this report. What the care home does well: The home carries out assessment visits to prospective residents to ensure that they can meet the needs of the individual. The home has care plans which describe the needs of the individual and what they are able to do independently. The plans describe the support staff have to give. Daily routines in the home were flexible and people who use the service being encouraged to make choices for themselves and exercise personal autonomy as far as was reasonably possible. Residents have access to a well-maintained secure rear garden, which includes a sensory garden, and are able to walk to a pond in the grounds, which has attracted wild ducks. A variety of social and leisure activities have been planned and residents have a choice of whether to participate in these or not. The activities programme includes outings to local venues twice a week in a minibus provided by the company, which owns the home. Staff have undertaken training in mandatory areas and in dementia. Care Homes for Older People Page 6 of 20 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Care Homes for Older People Page 7 of 20 Details of our findings Contents Choice of home (standards 1-6) Health and personal care (standards 7-11) Daily life and social activities (standards 12-15) Complaints and protection (standards 16-18) Environment (standards 19-26) Staffing (standards 27-30) Management and administration (standards 31-38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 20 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 that use the service can be assured that their needs will be assessed to ensure that the home has an understanding of their care needs. Evidence: The AQAA for the home said: What we do well: We have training in specific areas of expertise e.g. Dementia Training. We do pre-assessments on all potential service users, so that we can be sure we can meet their needs in Clemsfold House. We have friendly, approachable and well trained managers and senior members of staff, who are available at all times. We offer high standards of care for our service users. How we have improved in the last 12 months: more training. We have Service User guides in all rooms. Our brochures have been updated. We looked at four pre admission assessments for people now living at the service. We saw that the pre admission assessment by the home was supported by information from social services which included a risk assessment. Areas of the assessment included: communication for example does the person respond to name, eye contact or verbal response. There was also information on external support that would be ongoing for example community psychiatric nurses and physio therapist. On the day of the visit relatives were visiting the home and they were happy with the information that the home had given them. Care Homes for Older People Page 9 of 20 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: The care plans detail the needs of the individual and support staff are to give. However medication records and administration within the home are not always carried out in safe manner to protect the people who use the service. Staff working practice helped to ensure that the privacy and dignity of people who use the service is promoted. Evidence: The AQAA for the home said: We use person centred care planning, and our service user actions are documented daily. The Clipper System is in place. All staff are trained in Personal Intimate Care. We looked at four care plans of those individuals where we had seen the pre admission assessment. We saw that following the individual moving to the home an initial assessment of care needed is undertaken for about two weeks. Where the staff see if the information they have fits the needs of the person once they are living at Clemsfold. The care plan is then written based on this assessment. We saw that in front of each care plan is a list of signatures and staff names to identify who has written in the care plans. We saw that the needs and problems are identified for example, to be content and relaxed in my environment and to have my mental health needs recognised and understood. The care plans described what the individual could do independently and areas that they may need support with for example; will walk using walking frame, can walk unassisted and independent. We noted that the person had been weighed and that a Care Homes for Older People Page 10 of 20 nutritional assessment had been carried out and where necessary the person received nutritional supplements. We saw that individuals were supported to continue interests for example likes to read the paper the individual has memory loss and still likes to keep up to date on local news. We saw that one individual had collected articles of interest and would share them with staff and other residents alike. There were risk assessments in place for the individuals for example: slips, trips and falls, moving and handling, medication, smoking and mental well being. The risk assessment looked at identified hazard, is client exposed, level of risk measures to reduce risk and further action needed. We did see that on one pre admission assessment it said that the individual was allergic to bees we could not see a risk assessment of what action staff should take. Following the raising of a safe guarding adults alert recently, social services had been to the home and looked at the recording of needs for individuals; and the risk assessments. We saw that the home was supported in caring for individual needs by support from community psychiatric nurses. The manager was also aware of the Deprivation of Liberty policy, (under the Mental Capacity Act), and had sought advice regarding some people at the home. We looked at the medication storage and administration records. The medication trolleys are secured to the wall in the downstairs clinical room. We saw a list of staff who administer medication the manager said that they have achieved NVQ level 3 and have undertaken medication training. The medication administration records (MAR) we saw were dated 8th June 2009 to 22nd June 2009. We saw that when the GP makes a change they sign the MAR chart. We saw that one individual was prescribed Paracetamol four times a day as needed and the records indicated that they had been having them three times every day. We saw that on some records where there is a choice of amount for example one or two tablets there was no record of the amount given. We saw that medication had been signed as out of stock for two individuals for up to five days. We saw a record of fridge temperatures and that for one individual they are prescribed rectal diazepam and staff commented that they have had training for this. There were instructions and guidelines available. Care Homes for Older People Page 11 of 20 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 who use the service participate in activities appropriate to their age, peer group and cultural beliefs as part of the local community. Dietary needs are well catered for with a balance and varied selection of food available that meets individual dietary requirements and choices. Evidence: The AQAA for the homes said: What we do well: We have at Clemsfold, highly skilled and training Activity coordinators and assistants. The service users go out on trips in our new bus. Our evidence to show that we do it well: Our Activity coordinator is doing a course in armchair activity for example aerobics. The home offers a range of activities that are provided both mornings and afternoons during weekdays by an activities coordinator. There is an activities programme in place and residents receive a copy of this with records being kept of the activities taking place and residents who have participated. A sensory garden has been added to the home and residents can walk in this as they wish. We used a short observational framework whilst we were at the home, this meant that we sat and observed interaction between staff and people that use the service. We saw that staff interacted with individuals, enabling them to have their lunch and offering them a choice of food. We also saw that there were long periods of time when there was no interaction with anyone for two individuals. We saw and heard one member of staff speaking very loudly across the dining room to one individual. We discussed the findings with the manager at the end of our visit. There is an open visiting policy with visitors able to participate in activities if they wish, Ministers of religion visit the home to see individual residents Information for residents on menus is presented in a pictorial booklet along with the written menu and this is kept in the entrance hall. Photographs of the meals for the Care Homes for Older People Page 12 of 20 day are put on menu boards in the dining room. Surveys we received said that: Care is exemplary with friendly helpful staff. The home communicates with residents and relatives. Their attitude is friendly and happy but respectful of residents. Listen to their comments well. Clemsfold has good nourishing food, caring friendly staff and a homely atmosphere. All receive a good standard of care. None is forgotten and the feeling that they matter a great deal is with them. 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: The complaints procedure enables those people using the service to know that any complaints will be taken seriously and responded to. People living at the home are safe guarded by the homes safe guarding adults procedures. Evidence: The AQAA for the home said: Take all complaints seriously and Open door policy, respond immediately! Manager is always available to deal with complaints or issues in the home. Our evidence to show that we do it well: Complaints procedure Complaints file with outcomes. How we have improved in the last 12 months: We have further smaller information about complaints all over the home, therefore any member of the family or staff know who and where to address the complaints. We have the complaints procedure in the service users guide for all to see. The home has a complaints procedure, which are outlined in the Statement of Purpose and Service User Guide and on display in a number of places around the home including on a notice board above the visitors signing in book. It includes the timescale of response and the address of CQC. The homes safe guarding adults policy was observed to have been regularly updated and included the West Sussex Multi Agency Adult Protection flow chart on how to report suspected abuse. There have been several safe guarding alerts made in the past few Care Homes for Older People Page 13 of 20 months relating to injuries sustained by individuals and how they occurred. One has been substantiated others are ongoing at the time of writing the report. Social services have been to the home and looked at records and care plans of those individuals where there has been concern. The manager showed us her recording of incidents and how and when an alert is made, following the West Sussex safeguarding process, which she feels has been tightened following the first alert and investigation. 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: The home is generally well maintained and offers people a comfortable, pleasant, environment to live in. However there was a strong malodour in several areas of the home. Evidence: The AQAA for the home said: The home is clean and very little odour; we have addressed the odour issue and purchased further air fresheners. Regular and professional carpet cleaners. The environment is airy, spacious and protected and safe for the service users. We have a new sensory garden for the use of the service users and families. We offer advice and guidance to all members of the families with a friendly approach. We have high standards of laundry and washing of service users clothes. The entrance to the home is attractive with a duck pond and pathway around it. Further garden areas consist of an enclosed lawn and sensory garden. There is a maintenance programme in place and a new lift was installed in November 2008. Most of the individual accommodation was clean and comfortable and lockable doors and drawers were provided. Five of the rooms have en suite facilities consisting of a toilet and bath. Other rooms are adjacent to bathrooms and have a washbasin in the room. Water temperatures of washbasins and baths are monitored on a regular basis. The home has moving and handling aids which includes two full body hoists and one standing hoist and there are assisted baths and grab rails in the bathrooms. A Care Homes for Older People Page 14 of 20 requirement had been made following the last visit regarding the wheelchairs and their safety and maintenance. It was seen that the home had actioned this. There were malodours noticeable in the entrance way, communal areas and some rooms. The home was required to take action regarding the malodour in the home following the last visit. We discussed this with the manager at the start of the visit as the odour was very noticeable. When we walked around the home later in the day the odour was still noticeable. The manager stated that the carpets are regularly cleaned and that the odour may come from one or two bedrooms. The manager said that the primary care trust infection control team had audited the home and that they had advised that a programme of deep cleaning be undertaken. Further action by the commission is being considered. 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: Current recruitment practices at the home do not always protect the people who use the service. Staff have received all the mandatory training that is expected each year, and undertaken training specific to the needs of those that use the service. Evidence: The AQAA for the home said: Excellent staff training. Good skill mix for the care of the service users, competent and appropriately trained. Staffing is within the minimum guidelines. Open and friendly and approachable staff, available at all times. NVQ training. Staff appraisal and supervision. Our evidence to show that we do it well: Staff training matrix, also all staff have had training with the Mental Capacity Act. Staff mandatory training up to date. We asked the manager for a sample of files for staff who had been employed since our last visit in November 2007. We looked at four staff files and we saw that for two individuals there were two references, there was evidence that a CRB and POVA First had been carried out and they were dated before the employee commenced work at the Care Homes for Older People Page 15 of 20 home. One staff member had transferred from another home owned by the registered providers and their paperwork related to that home. For the fourth person we saw that the two references were written in similar hand writing and that the signatures looked the same. When we showed them to the manager she felt that they had been written and signed by the individuals husband who works at another home owned by the registered providers. We saw that a POVA First had been received by the home on 23rd February 2009 however we saw on the rotas that this individual had been at work the previous week. We saw that two staff had undertaken an induction at the home. All staff information is kept at the home in a locked cabinet. We looked at the training matrix and we saw that five staff had completed training for fire safety, medication and infection control since February 2009. Three staff have undertaken a five day course in manual handling and they train others staff at the home. The manager said that she and her cook are due to go on a dementia and nutrition course in July 2009. Several staff have signed with the local college to do a level 2 dementia course which has a learner booklet which is assessed by the college. Staff confirmed in their surveys that they had regular training. We looked at the rotas for the home and saw that the manager works a variety of shifts depending on the needs of the home. Her contract is for forty hours. We saw that in the morning there are seven care staff and one senior to administer medication and manage the floor; this can be the manager or the deputy manager. In the afternoon this ratio reduces to five care staff and one senior reducing to three plus a senior at night We saw a list of staff with first aid and it seemed there was one on each shift. The home does not use agency staff preferring to cover with the homes staff. Staff confirmed they have undertaken training in mandatory areas and in medication administration and three staff including the manager have undertaken a dementia course at the local college. Care Homes for Older People Page 16 of 20 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: The quality assurance practices as well as policy and procedure do not go far enough to fully protect the welfare of all residents due to shortfalls in recruitment practices and allowing the home to continue with odours. Evidence: The AQAA for the home said: What we do well: Quality auditing, staff appraisal and supervision. Administrator is trained in NVQ. Under Sussex Health Care for clinical governance, therefore regular audits and HAQUA. Qualified Managers. Our evidence to show that we do it well: HAQUA files and audits. Documentation up to date. Manager has finished NVQ 4. The registered manager Doreen Holmes completed her NVQ4 in care in December 2008 and has the registered managers award. Mrs Holmes attended a manual handing update in March 2009, and is updating her dementia awareness through the local college. She has attended a workshop on the Mental Capacity Act in 2008 and the Deprivation of Liberty (DOLS) in July 2009.. The AQAA required by the commission did state briefly the current status of the home. The head office of Sussex Healthcare sends out surveys monthly to a sample of relatives and people who use the service. They collate the information and send this report to the manager of the home asking them what action they will take in response. Neither the manager nor administrator act as appointee or hold any money for any of Care Homes for Older People Page 17 of 20 the residents, any money given to residents for spending on outings or other items is included in the monthly invoice sent to the representatives. Records of services received by residents such as chiropody or hairdressing were seen. The manager informed the commission in the AQAA that the servicing of all utilities and equipment used in the home has taken place. The primary care trust carried out an audit at the home on 18th June 2009 regarding infection control. They advised a regular programme of deep cleaning of carpets and curtains. The manager has been in touch with social services regarding the Deprivation of Liberty of the people who live at the home and the manager said that a named person will be visiting the home to undertake assessments. The manager explained that the senior staff and herself have undertaken the fire marshals course involving the fire plan for the home, regulations, equipment and risk assessments. Staff training involves a talk about fire, a walk about the home and a questionnaire and a video and lecture; staff have to do one of each yearly. 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 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 Care Homes for Older People Page 18 of 20 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 0000565113 9 13 13 (2) The registered person must ensure that medication is administered at the times and in the amount that it has been prescribed, or are reviewed to ensure appropriate medication is given. 22/08/2009 0000565117 9 13 13 (2) The registered person must ensure that prescribed medication is always available for the individuals living at the home. 22/08/2009 0000565114 9 13 13 (2) The registered person must ensure that a record is kept of the amount of medication that is given where there is a variable dosage and why and when an as required medication is given and its effect. 22/08/2009 0000565120 29 19 19 Sch2 (7) The registered person must ensure that there is a thorough recruitment of staff which must include references, CRB and POVA First checks to protect people that use the service. 22/08/2009 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 Care Homes for Older People Page 19 of 20 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 20 of 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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