Inspection on 06/09/05 for Houghton Regis Community Care Scheme

This inspection was carried out on 6th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Houghton Regis Community Care... 04/05/07

Houghton Regis Community Care... 19/12/05

Houghton Regis Community Care... 21/01/05

Houghton Regis Community Care... 13/07/04

Houghton Regis Community Care... 16/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Houghton Regis Community Care Scheme Roman Way Houghton Regis Beds LU5 5UB Lead Inspector Sally Snelson Announced 6 September 2005 th 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 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Houghton Regis Community Care Scheme Address Roman Way Houghton Regis Beds LU5 5UB 01582 861186 01582 861444 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) SCOPE Christine Why Care Home with Nursing 16 Category(ies) of LD Learning Disability - 16 registration, with number PD Physical Disability - 16 of places Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21.01.05 Brief Description of the Service: Houghton Regis SCOPE project was established in 1992 to accommodate 16 service users under the age of 65 years with physical and learning disabilities. At the time of the inspection the service users ranged between 30 and 59 years of age. The home is made up of four ground floor flats that are part of a small housing association development in the centre of Houghton Regis. Each of the flats has four bedrooms, a lounge, a dining room, a kitchen and fully equipped bathing facilities. The flats have access to two small outdoor areas. The two mini-buses belonging to the home have parking spaces but parking for staff and visitors is very restricted. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection of the Houghton Regis SCOPE project took place over a six-hour period on the 6th September 2005 from 09.00hrs. The manager, Christine Why, was present throughout. During the inspection the care of two service users was looked at in detail. This involved reading the documentation and tracking the care, including visiting the private accommodation for these two service users. Other service users and staff were spoken to as part of the inspection. There were no visitors to the home on the day of the inspection, however a letter was received from a relative and this has formed part of the judgement. The inspector would like to thank staff and service users for their time and support for this inspection. What the service does well: The home provides personalised individual care for 16 service users. The care is provided by a team of staff, many who are specifically qualified in caring for service users with physical and learning disabilities. The relative who wrote to the inspector commented that staff took great care in providing personal care; she went on to write of the care of her daughter, “the flat is always spotlessly clean, her room is always clean and tidy. I am involved in decisions and always made to feel welcome-the staff really do care about the clients and I am impressed with the standard of care that is given to both clients and their visitors”. Throughout the inspection it was noted that staff consulted service users and included them in the running of the home. For example they made decisions about their day, what and when they would eat, what they should wear and where, if anywhere, they should go. When driving through the village the service users are regularly seen ‘out and about’ and are known in the local community. SCOPE carry out regular inspections of the services provided. During these inspections staff and service users are consulted and policies sampled. This ensures that any shortfalls are identified early and improvement plans made. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 6 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. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR 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) Scoring of Standards Statutory Requirements Identified During the Inspection Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,4,5 Prospective service users and their families were encouraged to make preadmission visits to the home to ensure that the decision to move to Houghton Regis was an informed one. EVIDENCE: There was evidence that the service user who had been admitted most recently was given the opportunity to visit the home on a number of occasions prior to admission. Staff had also supported her to return to her previous home to say her ‘goodbyes’. This service users file also included details of the assessment that the manager carried out prior to her being offered a place. The home had a Statement of Purpose and a Service Users Guide that was upto-date. A photograph album about the daily routines of the home supported the Service Users Guide. This had been put together by one of the service users. All of the service users had a contract of terms and conditions including fees. This contract stated that the cost of any holidays were the responsibility of the service user. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 Care planning and the current practices within the home ensured that service users were given the opportunity to make individual choices. EVIDENCE: Care plans had been well-written and included sufficient detail to ensure that all the needs of the service users could be met even if the permanent staff, who knew the service users so well, were unavailable. It was noted that the care plan for a service user with epilepsy included detailed instructions for the supporting, reporting and treating of this condition. There was evidence that the service user and/or their relative were included appropriately in the care planning processes and that their individual goals and aspirations had been included. Where service users were unable to communicate the services of a music therapist was used. The music therapist had known the service users for a number of years and his reports were invaluable for confirming the ‘feelings’ of the service users. The daily progress notes detailed how and what decisions service users had made. For example Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 10 they were supported to chose and buy their own clothes, decide what they wanted to eat and what they wanted to do with their time. There was clear evidence that activities were risk assessed and service users were encouraged to take some risks. For example during holidays, trips and for special occasions those service users who wanted to, and for whom there was no obvious contra-indication, would have an alcoholic drink. Any activities and holidays were risk assessed well in advance and appropriately recorded. The homes own transport was regular serviced and checked before it was used. Care plans were stored in the individual flats and could be used as working documents. The plans were kept securely but not under lock and key. The plans were kept under review and updated appropriately as changes occurred. As part of their induction and on-going training staff were made aware of confidentiality as they were party to sensitive information about service users. Staff also made decisions about sharing information with relatives if it was necessary and in the service users best interest. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,16,17 Each service user had a personal activity plan that he/she had been part of planning. Staff supported and encouraged service users to attend and join in a variety of activities both in and outside the home. EVIDENCE: Each of the service users had an individual care plan for their activities. These activities were varied and were planned to meet the individual needs of the particular service user. Some of the activities, for example music therapy, took place in the home and could be individual or part of a group session. A number of service users had been enrolled on, or staff were exploring for them, courses at the local college. Staff commented that they were finding it more and more difficult to secure new college courses for the service users as they had attended most of the current courses in the past. It was noted that one of the service users, whose care was being tracked, was booked to attend a catering course at the college. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 12 A number of the staff were qualified to drive one of the homes minibuses which made it easy to transport service users to different activities. The home had recently been donated a car by a service users deceased relative. This was an adapted car that carried one service user in a wheelchair. The manager commented that this had made it much easier to take service users to appointments, particularly to the doctors or the hospital where parking could be an issue. On the day of the inspection service users from one of the flats were helping a staff member to clean the car. It was noted that this was a fun activity for all involved and that the service users made sure they got staff wet and did as little cleaning as possible. As the car was parked at the front of the home this activity caused a lot of dialogue with other staff members, as they were moving about the complex and also with the residents who lived in the flats above. During the afternoon of the inspection a group of service users went in one of the mini-buses to the local hospice for hydrotherapy. This was another activity that was greeted with excitement. A happy group left the flats, some of them taking with them their own rubber rings and other swimming paraphernalia. There was evidence that a service user who had shown an interest in attending church had been supported to do this, accompanied by a member of staff. Service users were encouraged to go to the local shops and participate in menu planning and the shopping for their meals. The flats had tried different methods of menu planning and were currently buying food weekly and deciding the night before the meal for the next day and either taking food from their freezer or buying the necessary ingredients. The menu was therefore documented retrospectively. A relative who wrote as part of the inspection process commented that she and her family were always made welcome in the home and that staff kept them appropriately informed. All of the service users were supported to choose and book at least one holiday a year. The holidays were as varied as the service users and ranged from a weekend at Blackpool to a quiet a country retreat. Groups of service users tended to go on holiday together, but often with friends from one of the other flats and not those they were living with all year. The contract made it clear that holidays were not included in the fees and service users would have to pay this themselves along with the cost of the staff member needed to support them. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,21 Seven qualified staff supported by a team of carers ensure that the health care needs of the service users are identified and EVIDENCE: The Houghton Regis project was a nursing home and therefore qualified nurses were on duty at all times. All of the service users were registered with a local GP and were encouraged and supported to attend routine healthcare checks. Staff supported the service users to attend to as much of their personal care as they were able. All personal care was provided in their individual bedrooms or in the bathroom. Service users were encouraged to make decisions and plan their day. Although the four service users in one flat generally ate together there was no set mealtimes and it was noted that there was as much as an hours difference between lunchtime in one flat and another. This was due to personal choice and what the service users were doing that day. There was no routine time for bed and the staff stated that some of the service users enjoyed socialising in the evenings while others wanted to go to bed earlier. On the day of the inspection one of the service users in a flat that was not sampled as part of this inspection decided at the last minute he would like to ask other service Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 14 users into his flat to celebrate his birthday. The inspector noted that during lunch staff discussed this invitation with the service users. Over the last few years the home had had to face death on more that one occasion. All of the service users had moved in together and many had lived together before that. One service user had died, as had one staff member. The manager reported that a service user had recently lost his mother. While she had been ill staff had taken him regularly to the hospital to visit and had accompanied him to her funeral. Because she was a regular visitor to one of the flats a number of staff had also attended the funeral, as had one of the other service users. The off duty ensured that service users had the continuity of the care staff who worked with them. Ideally there would be seven permanent staff allocated to each of the flats. At the time of the inspection all of the flats had at least six permanent staff members. The home rarely had to use agency staff, as there were bank staff and a list of staff who were prepared to work extra shifts. Medication was not inspected during this visit. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 A robust complaint procedure and staff who had attended training on the Protection of Vulnerable Adults ensured that service users were kept safe. EVIDENCE: SCOPE had employed a Designated Adult Protection Advisors (DAPA) whose role was to advise and train. All staff had been offered a full days training and there were regular updates. The manager was aware of the importance of ensuring that the training and the policy was linked to the Bedfordshire Protection Of Vulnerable Adults (POVA) policy. Staff were aware of the types of abuse service users could be exposed to and their responsibility to report any concerns immediately and correctly. The manager took and responded to complaints correctly and in-line with the homes complaint policy. There had been one complaint since the last inspection from a resident who lived in the one of the first floor flats above the home. This resident believed that there were unacceptable levels of noise from the service users and the equipment used to care for them. This was investigated by the manager, the housing association and the environmental health officer and was not substantiated by any of them. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,28,29,30 The flats were decorated so as to provide service users with accommodation that had a homely feel. EVIDENCE: Each of the flats provided the service users with accommodation that was fit for purpose and easily accessible. As the home was in the centre of Houghton Regis it was close to shops and other local amenities; it was also on a bus route to Luton and Dunstable. On the day of the inspection work had started on paving a garden area to the rear of the home so that service users could have access to the rear even if the weather was wet. This improvement was being funded by SCOPE and would benefit the other residents in the complex as well. Some of the communal spaces and the individual bedrooms could appear slightly cluttered depending on the amount and the size of the chairs and other equipment that the service users had. It was noted that when all the service users and staff were sitting around the dining table access to the rest of the flat was extremely limited. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 17 Each of the bedrooms had been fitted with overhead tracking for hoists. Where the hoist was not necessary, as in the case of one of the service users that was tracked, staff disguised the tracking with personal effects. When the home had first been opened service users had provided their own bedroom equipment. The manager stated that if a new service user needed bedroom furniture this would now be supplied as part of the contract. All of the flats visited were bright, clean, tidy and free from any offensive odours. Each of the flats were very different, as the service users and staff had chosen the décor in their bedrooms and in the communal rooms. The kitchen areas were fit for purpose but had not been designed to allow wheelchair access. Therefore if service users wanted to be included in meal preparation the task had to be taken out of the kitchen and onto the dining room table. The kitchens in flat 7 and 10 had been replaced using the SCOPE refurbishment budget. It was now the responsibility of the housing association to make these upgrades and there was a real need for the kitchen in flat 4 to be replaced. Throughout the home a number of the carpets were becoming worn; however staff kept them as clean as possible and there were no unpleasant smells. Only two of the flats had been built with laundry facilities, therefore the washing machine and the tumble drier had to be shared by two flats. This was not an ideal situation, as it required staff from the flat without a washing machine to take the laundry into the flat with the machine and return to collect it when the cycle had finished. The inspector noted that when a staff member came to use the machine they knocked at the door and asked permission to come in. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35 The skill mix of qualified staff and carers, in addition to a well planned training programme and good recruitment practices ensured that service users were provided with appropriate individual and consistent support. EVIDENCE: Each of the flats had a qualified nurse and a minimum of five carers allocated to it. At the time of the inspection there was a vacancy for a qualified nurse to be a community development worker. There were also some carers positions to be filled. The vacancies were not affecting the standard of care being given, as there was a bank of staff prepared to cover extra shifts. The manager stated that it was planned that all of the team leaders would take specific responsibility for a particular area of care. This would include the identification of a team leader to be responsible for training. This person would not necessarily deliver the training but would identify training needs and organise the training. One of the team leaders had already shown an interest in this area of responsibility. There was evidence that staff were supported to attend a variety of trainings. Individual staff files included certificates of training and the manager had a matrix of staff training needs for the next few months ensuring that any mandatory training was kept updated. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 19 The staff team comprised of 28 trained first-aiders. 16 members of the care staff had NVQ level 2, another six were working towards it and three more had requested the training and were on the waiting list. The home had one internal assessor and a senior staff member on night duty was completing the assessor training. This would be particularly beneficial to those on night duty wishing to complete NVQ training. The home accessed training from a number of different sources for example; the borough council, the Primary Care Trust, and SCOPE. All new staff completed the SCOPE induction programme. The manager reported that about half of the new recruits taken on at anyone time had not worked in care before but to ensure consistency all of the staff completed the induction training. As part of the inspection process staff files were sampled. These had all the required information including an application form, details of the interview process, two references, a medical report and proof that a Criminal Record Bureau check had been requested and returned before employment commenced. Staff files contained copies of job descriptions and terms and conditions of employment along with any certificates of attendance at training sessions. There was evidence that the manager checked qualified staffs Personal Identification Number (PIN). Some of the files were missing a photograph but the manager was aware of this and had asked staff to supply one. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39 The registered manager ensured that staff morale was high at all times. This had a positive effect on the service users. EVIDENCE: The registered manager Christine Why, had worked in the home since it opened in 1992. She therefore had good knowledge of the needs of the service users and knew all of the staff team well. Staff reported that she had a very fair way of managing and was interested in all the staff and the service users. The manager reported that she regularly sent out questionnaires to various stakeholders. She stated that these were very valuable and sometimes identified issues that she and the staff team had not considered. In the past a group of parents and interested parties had met regularly for stakeholder meetings. These meeting had decreased as there was now only 2 stakeholders who could be relied on to attend and a minimum of five were needed for the meeting to be quorum. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 21 The RI carries out very thorough regulation 26 visits and sends the report to the CSCI office monthly. The manager confirmed that these visits could be used as an indicator of the service provided as any problems were identified early and dealt with. All the required testing of systems and equipment was completed by the maintenance man; these were documented correctly. The home had good policies and procedures in place in relation to safe working practices. Houghton Regis Community Care Scheme I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 4 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 x 2 3 2 Standard No 11 12 13 14 15 16 17 3 3 4 4 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Houghton Regis Community Care Scheme Score 3 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x x I51 S17675 Houghton Regis V241041 060905 Stage 4.doc Version 1.40 Page 23 no Are there any outstanding requirements from the last inspection? 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. 1. Standard 28 Regulation 23(2)(b) Requirement The kitchen in flat 4 must be refurbished. Timescale for action 01.01.06 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. 2. Refer to Standard 28 30 Good Practice Recommendations Consideration should be given to replacing the carpets in the home. Consideration should be given to the positioning of laundry facilites. 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