Inspection on 05/11/08 for Foxholes Nursing Home

This inspection was carried out on 5th November 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Foxholes Nursing Home 24/03/09

Foxholes Nursing Home 12/11/07

Foxholes Nursing Home 27/10/06

Foxholes Nursing Home 07/09/05

Foxholes Nursing Home 27/07/04

Foxholes Nursing Home 15/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Foxholes Nursing Home Pirton Road Hitchin Hertfordshire SG5 2EN     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: Jeffrey Orange     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Foxholes Nursing Home Pirton Road Hitchin Hertfordshire SG5 2EN 01462459899 01462458956 care@foxholesnh.freeserve.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Post Vacant Type of registration: Number of places registered: Foxholes Nursing Home Limited care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: This home may accommodate 37 older people who have physical disability and require nursing care. This home may accommodate 37 older people who need post-operative and respite nursing care. This home may accommodate 7 older people who require personal care. This home may accommodate 7 older people with physical disability who require personal care. Date of last inspection Brief description of the care home Foxholes is a privately owned care home providing nursing care and accommodation for 37 older people. The home is situated on the outskirts of Hitchin and is set in 18 acres of landscaped gardens with views of the countryside. Accommodation is provided Care Homes for Older People Page 4 of 28 Over 65 37 37 0 0 Brief description of the care home on the ground floor, first and second floors and bedrooms are of varying style and size. There are both assisted and non-assisted bathrooms on the upper floors with a shower facility on the ground floor. The home has large central halls on each floor where service users can sit. The main sitting areas are on the ground floor where there is a linked lounge, conservatory and dining area. The majority of the homes bedrooms are single accommodation and 6 are with en-suite facilities. There is a passenger lift provided and the home has well maintained gardens, which are accessible to all service users. The current accommodation charges are five hundred pounds to six hundred pounds per week. Charges for hairdressing and chiropody are additional. A copy of the most recent inspection report can be found in the reception area. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection started in the morning in time to observe the routine of the home as people living there were being assisted to get up, have their breakfasts and generally get ready for the day ahead. It continued through until the late afternoon, which provided the opportunity to talk to people who live in Foxholes and their visitors and also to care staff that work there. We also talked to members of the homes management team, including the manager and administrator who is also a director of the home. We walked around the home to look at the physical environment, and this gave the administrator the opportunity to explain the proposed changes that are planned for the future. Care Homes for Older People Page 6 of 28 We were able to look at some key records, including those for staff recruitment and the administration of medication, together with care plans for people living in the home. We have sent surveys to a number of people who live in the home and where these have been received in time, they are reflected in this report. Any surveys received afterwards will be recorded and analysed and used to determine future regulation of Foxholes. This report also makes use of information provided by the home in their Annual Quality Assurance Assessment or AQAA. The AQAA is a self assessment document that focuses on how well care outcomes are being achieved for people who live in Foxholes, it also includes some useful statistical information. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 8 of 28 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering Foxholes as a home for themselves, or someone they are responsible for can be confident that they will only be admitted once an assessment has been carried out to ensure that their needs can be met appropriately and that they will also be given every opportunity to visit the home beforehand to help them decide if it is a home which will meet their needs and where they could be happy. Evidence: When we looked at care plans for two people living in the home, one who was admitted in June 2008 and one in November, we found that in both cases a preadmission needs assessment had been carried out in order to establish if their care needs could be met satisfactorily. When we spoke to staff they indicated that in most cases they felt they had the information they require on admission to ensure a new service users needs can be Care Homes for Older People Page 11 of 28 Evidence: identified and met. When we spoke to people who have been admitted to Foxholes for respite care, they did not always feel that their care needs had been adequately met in practise and in one recent case we were told that staff were not able immediately to access the preadmission assessment information at the time of admission,which could make it difficult for staff to readily meet the persons needs appropriately without that information. A revised format of care plan, including comprehensive information about assessment is being introduced which will, when fully completed, provide staff with the information they require in order to identify and meet the care needs of all people admitted to Foxholes. When we looked at the documentation available to people considering Foxholes as their home, including the homes Statement of Purpose, we found that it was quite clear and explict and contained the kind of information they would need in order to make a reasonably well-informed decision about whether they would feel at home there. When we spoke to people who were responsible for the choice of home for someone else, they confirmed that they had been encouraged to visit the home in order to see it for themselves. We felt this was the best one out of all the ones we saw was one comment made. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Foxholes can be confident that their care needs will be identified and recorded so that staff caring for them can provide the care required to meet them appropriately. The monitoring of the administration of medication is not sufficiently robust to always identify and address failures in a timely way and this could jeopardise the well-being of people who rely on the home to help them with their medication. People living in Foxholes can be confident that they will be treated in a way that respects their dignity. Evidence: When we looked at care plans for people living in Foxholes we found that a new format is being introduced which appears to be clear and comprehensive and includes the information care staff will require in order to identify an individuals care needs and how they are to be met. We looked at the basic pre-admission care plan for someone who had recently moved into the home and found that it had been competed satisfactorily, the main care plan Care Homes for Older People Page 13 of 28 Evidence: had not yet been completed, we were told this was because there had not yet been time to do so as admission was only two days previously, however we were told that staff did have the information they required in order to met the persons needs in line with their care plan. When we looked at medication records, we found that there were a number of gaps in medication administration records and that where medication could be given in variable dosages, for example one or two tablets as required, the exact amount of medication given each time had not been recorded. This means that medication records and practice may not be robustly monitored as these errors should have been identified and addressed. This could adversely affect those people living in the home who rely on care staff to help them with their medication. Controlled drugs were being stored and recorded properly and the temperature of the medication storage was being recorded to indicate to staff if action needed to be taken were it to rise above the recommended level. When we were observing the breakfast routine in the lounge and dining room we noted that three people were sitting in wheelchairs without any footplates fixed, which could compromise their safety as their feet could become trapped under the wheelchair. When we discussed this with the clinical manager she agreed to address this so that all those people living in the home who are moved around the home in wheelchairs have the correct footplates in place unless there are risk assessments in their care plans that explain why they are not required. When we observed how people were treated by care staff we saw that there was a relaxed and respectful atmosphere, which people living in the home that we spoke to told us they appreciated; I was very pleased to come here and More kind than I have found in any hospital were two comments made to us during this inspection visit. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Foxholes can be confident that they will be able to take part in meaningful daytime activities either individually or with other people who live in the home depending on their personal choice and that they will be able to exercise genuine choice about the routines of the home and the way their care is provided. They can also be assured that they will be able to maintain and develop important relationships with family and friends both in the home and the wider community. Evidence: When we spoke to people visiting the home, they told us that they felt welcome and that they were able to visit at any reasonable time. The Foxholes newsletter also included details of several events, including a recent BBQ that friends and families of people living in Foxholes had attended and were recorded as having enjoyed. When we spoke to people living in the home they confirmed that there are events and activities available for them most days, and they were able to show us some of the craft items they had made. In the afternoon we were able to observe a visiting entertainer, singing songs in the lounge and saw people who live in the home joining in and appearing to thoroughly enjoy themselves. Care Homes for Older People Page 15 of 28 Evidence: When we spoke to the activities organiser they provided us with details of the activities programme and also showed us what records are kept of who takes part in group activities and also the one to one sessions that are held. The programme includes craft and cooking and funds are raised for the activities budget from selling pickled onions prepared by people living in Foxholes. When we observed breakfast and lunch on the day of our visit we saw that provision has now been made to ensure that meals are kept hot and that there is now better provision for those people who would like to eat their meals together. When we spoke to some people who live in Foxholes, they told us that they choose to eat their meals in their own rooms. This suggests that people are able to exercise choice not only over what they eat, but also where they eat it. Comments about the food varied from not like I used to make to I give the food five stars We discussed our report The highlight of the day, which looks at mealtimes within care settings, with the homes administrator and he indicated that a copy of this would be obtained, and if possible an audit done of the mealtime experience of people living in Foxholes, to see if it could be enhanced in any way, which would obviously benefit the people who live in the home. The records that we saw of activities and the conversations we had with both staff and people living in the home suggests that genuine efforts are being made to meet the individual needs of people living in Foxholes. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home and those who are responsible for them can be confident that staff have the training they need to enable them to recognise abuse if it is seen and that they know what action to take to ensure people living in the home are protected from abuse. Whilst the home has a complaints policy and people should know how to make a complaint, complaints are not always recorded fully and this means trends and patterns in complaints may not be effectively identified. Evidence: In the AQAA the home recognises that; We can never be perfect and there is always room for improvement. When we looked around the home we saw that the complaints policy was clearly displayed and accessible. This should mean that anyone who wants to make a complaint knows how to do so. When we looked at the homes statement of purpose, we saw that it sets out the way complaints are to be recorded, however this had not been done in the case of a recent complaint about assessment and care issues. When complaints are not fully recorded and timescales, outcomes and actions noted it may not be possible for the manager to identify trends or patterns in complaints that could enable action to be taken that would improve the care experience for people living in the home. When we spoke to care staff they confirmed that they had received training in the Care Homes for Older People Page 17 of 28 Evidence: protection of vulnerable adults and they clearly understood how they could raise any concerns they may have about the home with relevant organisations outside of the home if they felt the need to. This should ensure that people living in the home can be confident that staff will not feel inhibited about taking appropriate action to protect them. At the time of the inspection there was one outstanding safeguarding issue being dealt with under the Hertfordshire County Council Safeguarding process, the home had not been informed of the outcome of this. When we looked at staff recruitment files we did not always find evidence that two written references had been obtained prior to employment and this could compromise the security and safety of people living in the home. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Foxholes can be confident that the home will be kept clean, tidy and free from unpleasant smells and that it will be maintained at least satisfactorily to ensure they are warm, safe and comfortable. As work is being undertaken over the next year to improve the premises, people living in the home should be able to expect that regular and routine maintenance will not be neglected as this would adversely affect their safety and sense of well-being. Evidence: The AQAA submitted by the home before this inspection visit recognised; Some areas of the home need updating, especially some of the rooms. When we talked to the homes administrator and director they had a realistic view of what needed to be done and identified problems that essentially arise from the age of the building. They told us that the planned refurbishment, which has not yet started and could, according to the Foxholes News take up to two years to complete would fully address all these areas of concern and would for example result in en-suite facilities being available in all rooms. We noticed during this inspection that two automatic door guards did not operate as Care Homes for Older People Page 19 of 28 Evidence: they should because of deficient batteries. This had been identified by staff in a maintenance log but not at that stage put right. We were assured that this was done before the end of our inspection and this then provided the necessary safeguard and protection for people living in those particular rooms. When we went through the requirements made about the homes environment in the previous inspection report, we found that they had all been satisfactorily addressed. This includes new floor covering in the conservatory, new food serving and heating facilities and the provision of additional seating in the homes dining area, which now means that a realistic number of people who live in the home can have their meals together if they choose. The additional small lounge has also now been brought back into use, which adds to the communal facilities available to people who live in the home. The home have greatly enhanced the garden area and have included some raised beds to enable people who live in the home who may use wheelchairs or find it difficult to bend down to be able to smell the flowers or do some gardening. Whilst we were in the home we saw that a number of new profiling beds were being installed which will assist both people living in the home and also staff caring for them. When we spoke to people in the home, they told us that it is usually kept clean and free from unpleasant smells. This was the case on the day we visited and we saw both cleaning and maintenance staff at work throughout the day. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Foxholes can be confident that staff that care for them will be supported by appropriate training to ensure that they have the necessary skills to enable them to identify and meet their needs appropriately and effectively. Whilst people living in Foxholes are generally well protected by the recruitment practise in the home, on occasions the procedure has not been followed in full which may leave people at risk. Evidence: When we spoke to people living in the home they were generally very positive and supportive of the care staff that cared for them. What more could you ask for one person noted. When we spoke to the manager and administrator they told us what the staffing numbers on duty in the home that day were, with three nurses and five care staff. The home told us in their AQAA that they have a number of regular bank workers, who have worked for the home for a number of years. This means that they are familiar with the routines of the home and that they are well aware of the individual needs of those people who have lived in the home for some time and are known to them so that they receive care from a familiar care worker. Care Homes for Older People Page 21 of 28 Evidence: When we spoke to a number of members of staff they confirmed the training they had received, including in dementia care awareness which had been a requirement made following the previous inspection. Details of training was confirmed when we looked at training records and training profiles for staff. This means that care staff are increasingly being given the skills that they need to appropriately meet the specialist care needs of people living in the home, including those who live with dementia. We were told by some staff that I enjoy the job and that We have a manager who listens When we looked at the recruitment files for recently recruited staff we found that on two occasions the necessary references had not yet been obtained. When we spoke to the homes administrator following the inspection he was able to confirm that in one case these had now been received and in the other the recruitment process was currently suspended as the person was no longer in the country. It is important, in order to protect people living in the home, that two written references are obtained and verified prior to the commencement of employment in all cases. In all cases we found that the necessary checks had been made to ensure that any criminal convictions that might be relevant to this employment had been identified. When we observed staff at work, including during the afternoon entertainment session, we saw that they had an easy and effective relationship with people who live in the home. We did see at one point in this inspection that staff had brought three people into a communal area in wheelchairs without footplates in place. This could pose a hazard to the people concerned and only if the risk to them has been assessed and recorded in each persons care plan appropriately might it be acceptable. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People in the home will benefit once the home has a settled management team to give direction to the operation of the home in all areas. Whilst people living in the home are essentially safe and well-cared for the ability of the manager to monitor and audit all areas of activity has been compromised which has led to some failures in health and safety, recruitment procedures and medication administration that could have potentially compromised the well-being of people living in the home. Evidence: When we looked at various documents it became clear that the past few months have been a time of rapid changes in the mangement of the home. The previously registered manager is no longer in post. The homes newsletter of 16th July introduced a new manager, who was no longer in post by the newsletter of 27th September when the proprietor is said to be manager, which was confirmed in the homes AQAA dated 16th September I have taken on the managment role myself to implement the standards I want to see at Foxholes. However, on the day of the inspection the Care Homes for Older People Page 23 of 28 Evidence: homes clinical manager was undertaking the role of home manager and this was confirmed to be the case in conversations with the management team. At the time of the inspection no application for registration with the CSCI had been made and we have therefore not been able to undertake a registration process to assess the fitness of either the proprietor or clinical manager to be registered as manager of Foxholes. When we discussed the management of the home with the homes director and administrator, we were assured that both staff and people living in the home were clear as to the roles and responsibilities of all of the management team and that people living in Foxholes had not suffered in any way as a result of the changes noted above. However, the then manager in the homes AQAA notes; For a manager there is a huge amount to do within a day, especially if the manager also works hands-on. We are also trying to update and revise our documentation, but with other duties and problems during the day, sometimes these tasks are left lower on the list of priorities The AQAA suggests that the problems having been identified are going to be addressed for example with additional computerisation of records and it is also fair to note that relatives spoken to on the day of the inspection said; I have noticed some improvements and some members of staff also said that whilst things have been a bit up and down they were now much better. When we spoke to care staff they expressed the view that they were well-managed and paid tribute to the proprietor and clinical manager in equal measure. The manager is approachable was one comment made. We have noted in this report some shortcomings in the monitoring of the administration of medication, health and safety issues such as fitting of footplates on wheelchairs when in use and the maintenance of automatic door closures. It has also been noted that on two occasions the homes recruitment process was not fully complied with. When we looked at records of financial transactions carried out on behalf of people living in the home, we found that the system was basically sound, with records and receipts to support each transaction. When we discussed the possibility of additional audits of the process to provide additional safeguards for people living in Foxholes, the homes administrator agreed to consider this. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The provider must ensure 01/12/2008 that the records of medication administration in the home are monitored and checked routinely so that any errors can be quickly identified and appropriate action taken. This is so that people living in the home are protected from the effect of errors in medication not being addressed in a timely way. 2 29 19 The provider must ensure that two written references are obtained for all applicants before they start work in the home and that those references are checked and verified to ensure that they are genuine. This is to protect people living in the home from the effects of unsuitable people 01/12/2008 Care Homes for Older People Page 26 of 28 being employed to provide care for them Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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