Inspection on 01/05/09 for Elm Residential Care Home

This inspection was carried out on 1st May 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elm Residential Care Home 07/05/08

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Elm Residential Care Home 7 Elm Close Bolsover Nr Chesterfield Derbyshire S44 6EA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Bridgette Hill     Date: 0 5 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 31 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Elm Residential Care Home 7 Elm Close Bolsover Nr Chesterfield Derbyshire S44 6EA 01246826230 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : elm-house@msn.com Jaywantee O`Farrell care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following categories of service only: Care Home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home fall within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home Elm House is a small residential home, offering 4 places for adults with a learning disability. Situated in a residential cul-de-sac, the accommodation is a large detached family house. It is spacious and comfortable, with a good sized and private garden and patio area. The home is occupied by the providers and provides an extended family style of environment where the residents can join in very much as if it were their own home. The home is close to the town centre of Bolsover with its range of facilities, and more locally there are small general stores for immediate needs. Good links have been developed with local care professionals, and residents are encouraged to maintain Care Homes for Adults (18-65 years) Page 4 of 31 Brief description of the care home community links with the social contacts and organisations they had prior to their admission. Fees are £358.64 per week. Extra charges are made for hairdressing, chiropody, magazines and newspapers. Care Homes for Adults (18-65 years) Page 5 of 31 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 Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit which focused on assessing compliance to previously listed requirements and on assessing all key standards. As part of the inspection a sample of service users care files and a range of documents were examined. A tour of the building was conducted. During the visit opportunity was taken to have discussions with management, residents and a relative. Some information included in this report was received in the form a pre inspection questionnaire which was completed by the Providers before the inspection. Additionally questionnaires were sent to residents and staff before our visit and the information we received has been considered and included as part of this inspection visit. Care Homes for Adults (18-65 years) Page 6 of 31 The Provider Jawantee OFarell was on duty throughout the visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 Adults (18-65 years) Page 8 of 31 Care Homes for Adults (18-65 years) Page 9 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to provide information to residents and ensure they are assessed to ensure the home can meet their needs prior to admissions taking place. Evidence: There had not been any residents since our last inspection so we were not able to examine what information and assessments had been sought by this provider as all admissions had taken place under the previous provider. We did however talk to the Provider about assessment procedures. They told us that a new assessment format was in place and and showed us a copy of this. They also said that prospective residents would be invited to visit the home and possibly stay overnight if they wished to allow them to make an informed decision about moving in. The admission procedure was also detailed in the annual quality assurance the provider completed. We viewed information packs in residents bedrooms and spoke to residents about Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: them. All residents we spoke with told us that these had been placed in their rooms during that day and they had not seen them before. Some information such as the inspection report was available in the entrance hallway. Residents told us the home was a good place to live. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Insufficient recording of assessed care needs and associated risks may lead to residents not receiving the care they need. Evidence: We looked at 2 care plans during our visit to examine how assessed needs were being recorded. We found that since our last inspection in May 2008 there had been little work completed on care plans, this is despite there being a previous requirement listed that this was needed. A few new care plans had been added to current care files on a different format to the one in use which were the old care plans from the previous provider. There was no evidence of any reviews being completed on any of the plans. We discussed some aspects of the care plans with the provider and was told that some of the recorded Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: assessed needs were no longer relevant to the residents care. There were deficits in describing the assessed needs in the care plans as there were no plans to describe residents medication needs as detailed at our last visit and other key areas such as challenging behaviour was also not included. As our previous requirement was unmet we issued an immediate requirement during our visit that required the provider to send us additional information , this was sent in a timely manner. An assessment of the new care plans are that a new format is being used, they were typed in large print, easy to read and were generally personalised with respect to personal care needs. A template had been used however and there occasions when the wrong residents name was included even though the information was relevant to the resident whose plan it was. Initially at our visit we found poor recording of risk with some aspects not documented at all such as risks associated with challenging behaviour, smoking and going out alone. The updated care plans we received after our visit again did not detail all the possible regular risks Deficits were still evident too as the plan did not describe the residents abilities regarding going out safely with respect to road safety and how it should be handled if the resident doesnt return at the expected time. Some information onto how staff should deal with challenging behaviour was included however the risk of residents smoking was not considered and this may place other residents and staff at risk as there have been documented concerns previously regarding residents potentially smoking in their rooms. The care plans were also not clear in how residents leisure and social needs were being met. We talked to residents about how they liked the home, they told us it was a good place to live. They told about enjoying the privacy of their room to watch television when they wanted. Residents said that staff knocked on the door before they entered and their privacy when using the bathroom was respected. Different residents told us about how they were supported with personal care and it was evident that the approaches and support was different dependant on assessed needs. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides good opportunities for residents to access community services and leisure activities. Evidence: All of the residents currently attended day services outside of the home. These were different ones depending on the interests of the residents and not all residents attended each day so they had opportunity to spend time at the home and get involved with shopping and daily living tasks at the home. One resident told us they were happy to home each day after the day services as they enjoyed living at the home. We saw an example of a daily routine for residents however not part of any care plan Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: and was aimed at informing staff about how the home ran. It did however reflect their was good knowledge and variation in each residents routine. We spoke to a relative during our visit who said that they were always made welcome. We were told there was good communication with the Provider and they were involved in the care of their relative. Relatives told us the home had a relaxed feel about it and the Provider was very approachable. Relatives told us that some social events were organised in the home to celebrate birthdays were held as well as barbeques and events to celebrate Christmas where relatives were invited. Residents told us they had opportunities to go out and enjoyed pub lunches, football matches and went out shopping. This was one of the aspects they particularly complimented the Provider on. As the previous owner of the home had a dog and some residents missed this the Provider had got a dog and residents told us how they enjoyed taking him for a walk and participated in caring for him. There were records kept of what food was served in the home and residents told us they were offered choices. Opinions residents gave about the food was that it was good and perfect. Some residents told us they went shopping with staff to buy the food for the home. The training records informed us that all staff were suitably trained to prepare food safely. Care Homes for Adults (18-65 years) Page 16 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and medicinal needs of residents are being met at a home where residents are regarded with dignity and respect. Evidence: Residents told us that staff respected their privacy in the home. Residents told us they were able to enjoy time in their room or use the communal lounge as they wished. Residents care plan considered the abilities of residents regarding self care and described how residents privacy should be respected when using the bathroom. Residents told us that there were flexible routines in the home and they retired to bed when they wished, some constraints were in place as regards getting up as all residents attended day centres. Residents accessed local healthcare services generally in the community. Some relatives were actively involved in this however if they werent they able to they reported good communication from the home if there were any concerns. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: There were some nutritional assessments completed and residents indicated general stability. Generally apart from some slight instabilities residents in the home were fully mobile and moving and handling assessments in the updated care plans reflected this. Where it was an assessed need residents attended physiotherapy. There were few medicines being handled in the home and since our last visit a new cupboard had been fitted for controlled drugs which met the required standard. Some residents did not take any medication, for those who did the home managed all aspects of this and signed consent forms were in care files to record the residents agreement to this. Storage of medicines was acceptable and medication administration records indicated that residents received their medications regularly. We identified from some records that whilst no homely remedies were kept in the home some residents did take these as they were obtained by relatives. These were not fully documented on the medication administration records so could lead to repeat doses being given. The updated care plans we received as a result of our immediate requirement being issued considered if some residents had post death wishes. Care Homes for Adults (18-65 years) Page 18 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable systems in place to ensure complaints and safeguarding concerns are dealt with in the best interests of residents. Evidence: The Aqaa told us there had not been any complaints or safeguarding concerns received in the past year and on discussion with the Provider it was confirmed that this had not changed since the Aqaa was completed. There was a safeguarding adults policy in place referred to locally agreed multi agency procedures. Staff training records confirmed that staff had received training on Protection of vulnerable adults. The residents we spoke to told us that they would speak to the Provider if they had any worries. There appeared to be an open culture and at some of the residents meetings issues that affected communal living arrangements such as loud music being played had been raised and discussed. An information pack had recently being given to residents which included a copy of the complaints procedure and a copy was in the entrance hallway. We talked to a relative to ask if they knew how to raise concerns and whilst they said they hadnt seen a procedure they told us they would have no hesitation in approaching the Provider if Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: they had worries but had so far had no reason to. We talked to the provider about residents monies and some were stored for safekeeping as well as some documents. Some practices we saw potentially compromised the security of residents money, these were discussed with the provider during our visit but not specifically detailed in this report to ensure security of monies are not compromised further. Care Homes for Adults (18-65 years) Page 20 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean and comfortable environment for residents to live in. The managemnt of fire risk was not robust enough to ensure residents would as fully protected from fire as possible. Evidence: The home is a large detached family type residence in a quiet residential cul de sac. It is spacious and well maintained with good quality furnishings. The Aqaa told us that the home aims to create a homely, colourful non-clinical environment which is supportive, sometimes appropriately busy or quiet. Each resident had their own bedroom which was personalised with their own belongings and reflected their preferences such as bedding with football logos of the team they supported. Residents told us they undertook some of the general cleaning of their rooms. We examined the fire safety aspects that were in place in the home. Domestic style detectors were fitted throughout and there were recorded checks of these typically twice monthly to ensure they were working. Residents had recently participated in a fire drill and two staff had completed fire safety training but one staff member had not Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: yet completed this. The fire safety training was however due as it is required 6 monthly for staff who do night shifts. We asked to see the homes fire risk assessment but was told there wasnt one. Whilst there were some documents relating to the risk of fire for example of the cooker there was not an overall assessment of risk in the home with the required information on how this would be managed. A laundry area was situated outside of the main property and had 2 washers and dryers. Residents told us there were regular days when they did their washing. Staff generally took care of the laundry needs of residents but residents told s they sometimes helped staff to put laundry in. All residents and relatives told us the home was clean and well cared for. Care Homes for Adults (18-65 years) Page 22 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a small team who have been suitably recruited and trained to care for residents. Evidence: The home is a small one with the staff group comprising of the Provider, her husband and one full time staff member. We asked for staff rotas but was told that the home was run on an informal basis and they did not keep these as at least one member was always at the home when residents were there. Residents told us that the staff were brilliant and kind. One resident told us that the home was like a big happy family. We looked at two staff recruitment files. The Aqaa told us that robust recruitment was in place. It was a requirement at our last visit that recruitment procedures must be robust and protect residents. In the files we viewed some information was not available such as an application form and references. We issued an immediate requirement during our visit that the information be forwarded to us as the provider said these had been obtained but could not be located. Information was then sent to us in a timely manner which confirmed all recruitment checks were on file. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: There were training records in place which told us that staff at the home had been involved in a range of training to improve their knowledge and skills. A rolling training planner was in place which described what training was going to be completed. This did not always meet the frequency that was required for some training such as fire safety which it stated would be completed annually. At least 2 of the three staff working at the home had achieved at least NVQ level 2 in care with the Provider being a qualified nurse. The third staff member was also in the process of completing an NVQ course. Since our last visit the provider had obtained a copy of the record of achievement document for the skill based induction but a copy of the work book which related to this was not available. We looked at the induction for the newest staff member who was a well qualified staff member and an induction checklist had been completed which was considered suitable given he experience and qualifications of the member of staff. We were told that no formal staff meetings were held as there is day to day communication and a very small staff group. We discussed staff supervision with the provider and looked at records. For some staff there were no supervisions completed though as part of information received shortly after our visit supervision records were supplied to us that evidenced a supervision session had been held with staff. These records reviewed training needs and documented progress and training already completed. Care Homes for Adults (18-65 years) Page 24 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The informal approach to managing the home is not ensuring all requirements are being met which can adversely affect the care residents receive. Evidence: Since our last visit the Provider/manager has progressed towards completing their registered managers award and completed a range of training to improve and update skills. We found a number of areas during our visit where action had not been taken to address previously listed requirements. This included care plans being in place that described all assessed needs, evidence of robust recruitment procedures and findings from quality assurance processes. We therefore issued an immediate requirement during our visit that additional information must be sent to us to confirm to us that actions had been taken. A pack of further information has been received in a timely manner and the content assessed and included as part of the relevant sections of the report. Whilst on the whole this has been satisfactory the management systems to Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: ensure this was addressed within the timescale of the past report and as detailed in the improvement plan were not in place and it has required further action from CQC to secure compliance. We were told that the home is run on an informal basis and as such some records were not kept such as staff rotas and supervision of some staff was not in place. The Provider told us that there had been one relative survey completed and this was all of the quality monitoring that had been completed through surveys. The form however could not be located. Generally trying to find information that was needed was at times difficult with the Provider being unsure of what we were asking for for example the safeguarding report pad. The provider said they did not know what this was but it was viewed in one of the cupboards. Administratively the home was poor in storing records in a way which enabled them to locate them. An immediate requirement issued at this visit as no quality assurance info available and this was an unmet requirement. After our visit additional information was submitted to us which included completed resident surveys these told us that residents were happy with the friendly environment of the home, food and the opportunities to go out. Residents recorded on the surveys that were very satisfied and well looked after. A diary documented residents meetings which were being held on a regular basis. The residents had been consulted about trips out, kept informed about new staff and been able to share concerns such as loud music being played at these meetings. The opinion given by all residents and the relative we spoke to was that the home was a good place to live and the providers and staff were approachable. Significant praise was given for some aspects which have improved under their ownership such as residents being given opportunity to go out regularly. We discussed this with the Provider who acknowledged that paperwork had not been given the attention that it required and a balance had not yet been reached. The Aqaa told us that thermostatic stoppers have been fitted to radiators to control temperature to limit the temperatures of radiators. Whilst there was a procedure on file for recording accidents we were told that none had occurred. The recording of hot water temperatures of the kitchen was being checked however the temperatures at bathing outlets where full body and immersion and potential scalding was possible was not being checked. We talked to the Provider who told us that as regulators were fitted they had not thought this was necessary, as these can Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: fail it is necessary. The Aqaa told us that all other service checks were in date. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes R 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 1 6 14 Care plans in place must 30/06/2008 reflect all the assessed needs of the resident and describe the interventions that are needed to ensure that needs are met This was not met at this visit and an immediate requirement was issued to provide updated care plans during our visit. These were received but continued to be deficient in some areas. Further enforcement action is being considered. Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 If residents utilise homely remedies these must be documented to ensure a full record of treatment is recorded This will ensure staff are aware of what medicines are being taken and any interactions and limits on medications are well recorded 30/06/2009 2 31 18 A rota of staff on duty must be kept This is required to provide an audit trail of staff on duty and evidence that there are sufficient staff on duty 30/06/2009 3 42 13 Water temperatures must be 30/06/2009 monitored at outlets where full body immersion is possible This is to ensure temperatures are maintained at a level where Care Homes for Adults (18-65 years) Page 29 of 31 residents will not be placed at risk of scalding Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 23 39 Good security measures should be implemented to ensure that residetns monies are as protected as possible Some documented meetings amongst staff should be held. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!