Inspection on 22/09/08 for Elizabeth House [Poole]

This inspection was carried out on 22nd September 2008.

CSCI found this care home to be providing an Good 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.

Other inspections for this house

Elizabeth House [Poole] 04/09/06

Elizabeth House [Poole] 20/12/05

Elizabeth House [Poole] 12/07/05

Elizabeth House [Poole] 01/12/04

Elizabeth House [Poole] 08/07/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Stallcombe House

Belma

Hunters Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Elizabeth House [Poole] Dolbery Road Parkstone Poole Dorset BH12 4PX Lead Inspector Vanessa Carter Key Unannounced Inspection 22nd September 2008 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Elizabeth House [Poole] Address Dolbery Road Parkstone Poole Dorset BH12 4PX 01202 744545 01202 307640 elizabeth@care-south.co.uk www.care-south.co.uk Care South Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Christine Kerr Care Home 43 Category(ies) of Dementia - over 65 years of age (11), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (11), Old age, not falling within any other category (31) Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named person (as known to CSCI) under the age of 65 may be accommodated within the category of PD (Physical Disability). This condition will not apply after the person’s 65th birthday. The person as referred to in condition (1) may be accommodated under the age of 65 (this condition will not apply after the persons 65th birthday) 4th September 2006 Date of last inspection Brief Description of the Service: Elizabeth House is a large, purpose built home in the Parkstone area of Poole. The building is leased from the Borough of Poole and managed by Care South, a local non-profit making organisation that owns and manages various care homes and community services in Dorset and the South West. The home is registered with the Commission for Social Care Inspection to accommodate a maximum of 43 adults over the age of 65 years, with 11 of these places being registered to accommodate service users with specialist mental health needs, 11 with dementia related needs, and the remainder to accommodate service users with needs relating to old age. No nursing care is provided by the home. Accommodation is offered over two floors, accessed by a 6-person passenger lift. There are various communal areas, thirteen W.C.s: seven on the ground floor and a further six upstairs. There are 6 bathroom facilities (with assisted baths) and all bedrooms are single. Two have en-suite facilities. There is a large conservatory and a secure garden and courtyard area, with further lawn and wooded garden areas. The home is close to many local amenities, and offers access to a main bus route serving nearby towns and villages. The currently weekly fees rates are from £475.00 to £660.00 Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and took place over one day. A total of six hours were spent in the home. Evidence to form the report has also been gathered from a number of other sources:• Information provided by the Home Manager in the Annual Quality Assurance Assessment (AQAA) • Talking with the Home Manager and the deputy manager • Talking with the care staff who were on duty • Observations of staff practices and their interaction with the people who live in the home • A tour of the home • Case Tracking the care of a number of people • Talking with a number of the people who live in the home • Talking with one visitor to the home • Looking at some of the homes records What the service does well: Pre-admission assessment processes and information made available about the home ensures that placement is only offered to those people whose needs can be met. The people who live in Elizabeth House can be assured their personal and healthcare needs will be appropriately met because of their care planning processes. Medication procedures are safe. People who live at Elizabeth House have the opportunity to participate in a variety of activities and to spend their time as they wish. They are provided with well-balanced and nutritious meals. People who live in this home, can be assured that any complaints they have will be listened to and acted upon and that they will be safeguarded from home. Elizabeth House is a comfortable, well furnished and well maintained home. It is equipped to meets the needs of older people. The home is warm, well lit and is kept clean and tidy. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 6 The staff team are well trained and competent, so people who live in this home can be assured that the team will have the necessary skills to meet their care needs. Elizabeth House is well managed and run in the best interests of the people who live there. The home is safe and their health, safety and welfare is promoted and protected. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre-admission assessment processes and information made available about the home ensures that placement is only offered to those people whose needs can be met. EVIDENCE: The Statement of Purpose and Service Users Guide are kept under review and were last updated in April 2008. Both documents provide a clear picture about the service and are a true reflection of what people can expect. The service users guide includes the aims and objectives of the home, information about the accommodation and the staff team. Both documents are available in the home, along with the previous inspection report and annual service review. Each person will be provided with a statement of terms and conditions after admission – these will be in a different format dependent upon whether the person is privately funded, local authority funded or primary care trust funded. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 9 Any prospective person who wishes to live at Elizabeth House will be visited prior to placement is offered, and an assessment of their care and support needs will be carried out. The assessment tool “Residents Assessment of Need”, is comprehensive and covers all areas of need – physical health, medications, mental health needs, activities of daily living, continence, fluids and nutrition, and mobility. The pre-admission assessments for two people were seen and verified that the assessment visits are completed before placement started. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in Elizabeth House can be assured their personal and healthcare needs will be appropriately met because of their care planning processes. Medication procedures are safe. EVIDENCE: Care planning documentation for four people was looked at to determine how the care delivery arrangements are determined. The care plans are prepared based upon the detailed information gained during the assessment of needs. It is evident from the plans that the person is involved in the care planning processes and therefore has a say in how their needs are met. The plans were informative but for one person, specific information about their wishes needed to be made clearer in the care plan and the risk assessment. Evidence was seen where care plans had been reviewed and amended as necessary. New “Care South” care planning documentation is in the process of being launched – for most people this has yet to be introduced but a partially completed file for one person was looked at. The information was well set out and there are easily identifiable sections within the file. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 11 The care plans are supported by a number of risk assessments – manual handling, falls and the likelihood of developing pressure sores. A nutritional screening tool is used to identify those who may be at risk from poor diet or fluid intake. Those people that were spoken to during the inspection confirmed that they received the care and support that they need, “I am very well looked after”, “Everyone is so kind and helpful. I need a lot of help and nobody seems to mind” and “I have no complaints” were comments received during the inspection. One visitor commented “I am a very regular visitor. I am very satisfied with my relatives care. There is a good staff team”. A record of all visits by the GP and other healthcare professional is maintained. People confirmed that they see their GP whenever they need to – one person spoken with on the day of the inspection, was waiting for the GP to call as they were unwell. The district nurses will visit to complete any healthcare tasks, along with chiropodists, dentists and opticians. As many of the people who live at Elizabeth House previously lived in the Poole area, they have been able to retain the services of their family GP. For this reason GP services are provided by many surgeries. A look at the homes procedures for ordering, receipt, storage, administration and disposal of medications, evidences good and safe working practices. They are in the process of changing pharmacy supplier however will not be altering any of their systems. The home must obtain official hazard warnings signs to be displayed when oxygen therapy is in use. From observations made during the inspection, it is evident that people are cared for with respect to their dignity and privacy. Personal care is provided in private and staff were observed to knock on doors before entering. People were nicely dressed in their own clothes and staff were interacting with them in a friendly and respectful manner. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 14. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Elizabeth House have the opportunity to participate in a variety of activities and to spend their time as they wish. They are provided with well-balanced and nutritious meals. EVIDENCE: The home arranges a variety of different activities, and people are able to choose whether to participate or not. An Activity Organiser arranges a programme on a weekly basis and during the day of the inspection, video exercises, a music session and pub games were arranged. Some people were actively joining in and enjoying themselves, whilst others were just observing what was going on. “I prefer to sit quietly and listen to everyone chatting” and “I normally do go downstairs but not today” were comments made during the inspection. Examples of others things that are arranged include creative cake making, small group activities, bingo, memory games and cards games. Observations made during the inspection were that the activity organiser has a good rapport with the people who live in the home and that care staff will also be involved in the activities. A hairdresser visits the home on a regular basis. Clergy from different denominations visit the home regularly, with a Church of England service being held every Sunday morning. Communion is provided Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 13 once a month. Currently all the people who live at Elizabeth House are white Christians but other religions would be catered for as necessary. Visitors are welcomed at any reasonable time. One visitor said “I can come and see Mum at any time. The staff are all very friendly and welcoming”. One person said “My daughter is visiting later. She comes most days and takes me out in the garden or out shopping”. People are supported and encouraged to go out for trips with their relatives and to go out independently if they are able. People were observed moving around the home independently within the limits of their individual abilities. Some people were in the lounge areas, whilst others had preferred places to spend their time, others remained in their bedrooms. On the day of the inspection the midday meal was soup or fruit juice, a savoury mince dish or pasta bake, followed by steamed ginger pudding and custard or something from the sweet trolley. People are provided with a well balanced and varied menu, most are served in the dining room however people can choose to have their meals served in their bedrooms. People spoken with after lunch said they had had a very nice lunch – “the food is always good”, “my only complaint is they give me too much” and “if you want a cup of tea someone will always make you a cuppa”. Special dietary requirements can be met and the Chef will meet to discuss individual’s needs. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home, can be assured that any complaints they have will be listened to and acted upon and that they will be safeguarded from home. EVIDENCE: The complaints procedure is included in the statement of purpose and service users guide and is also displayed in the main hallway. People spoken with during the course of the inspection said they would talk to the staff if they were not happy about anything – “the manager is very approachable”, “it’s like home from home here. Everyone is so kind. You only have to ask if you want something”. CSCI have received no complaints about this service. The last complaint the home received was in February 2008 – the records kept by the manager evidenced the steps taken to bring about a satisfactory resolution. The home has policies and procedures in place to ensure that people who live there are safeguarded from any form of abuse. Staff either have attended or will be attending, Adult Protection training and those spoken with during the inspection were aware of their responsibilities and of protection issues. A copy of the homes protection policy is kept in the managers and care team office. A folder with the locally agreed protocols is in the main office and this details procedures and all the necessary contact numbers. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Elizabeth House is a comfortable, well furnished and well maintained home. It is equipped to meets the needs of older people. The home is warm, well lit and is kept clean and tidy. EVIDENCE: Elizabeth House is located in a residential area of Poole and next to the Alderney Community Hospital. It is surrounded by mature gardens but also has enclosed gardens adjacent to the dining room to the rear of the building and the conservatory at the front. The building is leased from Poole Council. Accommodation is arranged over two floors. A shaft-lift means that those who have reduced mobility and cannot use the stairs, have access to the whole building. The dementia care unit is on the first floor and is accessed via a key padded door entry system. The home is well maintained throughout, comfortably furnished and tastefully decorated. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 16 The communal areas are all located on the ground floor. There is a large lounge room by the main entrance, plus a conservatory, quiet lounge and several areas throughout the home where easy chairs are placed. There are adequate numbers of toilets and bathrooms located throughout the home. There is a shaft lift installed and other items of equipment to aid with moving and handling tasks, grab rails and a variety of chairs to suit individual needs. All 43 bedrooms are for single occupation. Three rooms have en-suite facilities and all other rooms have their own vanity unit – a night commode can be provided if necessary. Most rooms were seen during the course of the inspection. Rooms had been personalised to varying degrees and people are encouraged to bring things in to make their rooms homely. A call bell system is available in all rooms and at the top of one open staircase, an alarm is fitted to alert staff when anyone is using the stairway. The home is warm, well lit, clean and tidy and free from any malodour. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team are well trained and competent, so people who live in this home can be assured that the team will have the necessary skills to meet their care needs. EVIDENCE: The staffing levels are arranged according to the dependency levels of the people who live in the home. The staff rota’s show that each morning there are six care staff plus one senior carer and the duty manager. In the afternoons there are four carers plus the two and over night three carers plus a duty manager who is on call. All staff will rotate between the three separate care teams meaning that everyone knows all the people who live at Elizabeth House. There is currently one vacancy for a senior carer. In recent months there has been a degree of agency usage – this is because of the holiday season and staff vacancies. Care staff are supported by a team of catering, housekeeping and maintenance staff in meeting the daily living needs of the people who live there. Care South have their own training department and NVQ Centre. Since the last inspection the percentage of staff who have achieved at least an NVQ level 2 in Care has risen from 57 to 81 . New staff will complete an inductiontraining programme – Induction to work in Social Care. This meets Skills for Care specification This is a five day course and takes place at Care South headquarters and covers health & safety, manual handling, fire safety, Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 18 infection control and adult protection. One new member of staff confirmed these arrangements and reported being very supported when first starting work at Elizabeth House. The staff files for four recently recruited staff members were examined to determine the procedures followed. Recruitment procedures include the completion of an application form, attendance for an interview, two satisfactory written references, and CRB and POVA1st clearance, prior to employment. These measures will ensure that the right people are employed for the home. In addition to NVQ training, staff have collectively had training in medication management, challenging behaviour, dementia care and risk assessment processes, first aid and most recently, Mental Capacity Act training. Each staff member has been provided with a Personal Development File and in these they maintain a record of their training and achievements. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Elizabeth House is well managed and run in the best interests of the people who live there. The home is safe and their health, safety and welfare is promoted and protected. EVIDENCE: Christine Kerr has been the Registered Manager at Elizabeth House for six years. During the inspection she demonstrated her competence, co-operated with the inspection process, produced all the necessary information and records and was fully conversant with peoples care needs. She is supported in the management of the home by a deputy manager, four care team managers, the chef, an administrative assistant, and managers from other Care South homes. Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 20 Observations of the working practices, and the interactions between the manager, people who live in the home and the staff on duty, evidenced that the home is run in a friendly and homely manner with the best interests of the people who live there at the heart of all decision-making. Staff meetings are held on a regular basis as are ‘resident’ and relative meetings. Residents meetings are held on a quarterly basis – the usual topics are food and menu, activities and new ideas, laundry, the environment and any care issues. In August, Care South undertook the annual customer service survey as a means of measuring how it is doing in meetings people expectations. The views and opinions of people who live in the home, relatives and staff are sought. The information gathered is in the process of being colleted but the manager explained that each service will be presented with an action plan for improvement. A look at last years plan and the measures taken to address the issues, evidence that the service is keen to “get it right”. There is also an ‘audit programme’ in place – each month a different part of the homes activities are audited. This may be health and safety, infection control procedures or medication. The home holds monies for a number of people and accounts are kept of all transactions in and out of each persons account. One person requested money to go out with their relative and this was done in line with this good practice. Staff supervision is arranged in a cascade system. The manager will supervise senior staff members and in turn senior staff will formally supervise care staff. Staff spoken with during the inspection confirmed that they receive regular supervision. All the necessary environmental checks are made on a regular basis – these include checks on the fire alarm system, water temperatures, moving and handling equipment and the emergency lighting. The fire risk assessment was last updated in June 2008 and drills are held on a regular basis. Safe systems of work in respects of manual handling procedures are devised following robust risk assessment processes. These measure evidence that the health, safety and welfare of both the people who live there and the staff are promoted . Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Elizabeth House [Poole] DS0000004045.V371775.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The one identified plan of care should be updated to make clear, the express wishes of the person regarding their bedroom door. You should obtain an official hazard warning sign and this should be displayed where oxygen is stored and in use. 2. 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