Inspection on 22/08/09 for Lydfords Care Home

This inspection was carried out on 22nd August 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Lydfords Care Home 11/06/08

Lydfords Care Home 23/07/07

Lydfords Care Home 02/05/06

Lydfords Care Home 16/11/05

Lydfords Care Home 13/05/05

Lydfords Care Home 18/10/04

Lydfords Care Home 26/04/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for older people Name: Address: Lydfords Care Home 23 High Street East Hoathly Lewes East Sussex BN8 6DR     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kathy Flynn     Date: 2 2 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Care Homes for Older People Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Lydfords Care Home 23 High Street East Hoathly Lewes East Sussex BN8 6DR 01825-840259 01825840997 lydfords@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Tamaris (South East) Limited (a wholly owned subsidiary of Four Seasons Health Care Limited) Name of registered manager (if applicable) Type of registration: Number of places registered: care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 50 The registered person may provide the following category of service : Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Lydfords Care Centre was originally a Victorian private family home that has been extended and adapted with two purpose built extensions. It is a home registered to provide both nursing and social care for fifty residents, and is situated in a village location in a semi rural position. The accommodation is divided into two units, Firs and Care Homes for Older People Page 4 of 29 0 Over 65 50 Brief description of the care home Orchard and is on two floors with level access provided by a lift and a chair stair lift. There are four double rooms without an ensuite facility and forty-two single rooms, twenty-four of which have an ensuite bathroom. There is ample communal space consisting of a large dining room, two lounge areas and an activity room, which are on the ground floor and central in the home. On the first floor and on Orchard unit, there is a comfortable quiet lounge; also on Orchard unit there are two areas with comfortable chairs, which are used by families and residents. The gardens are natural, large and are to the side and rear of the property. There are car-parking facilities to the front of the home for approximately fifteen cars. The village shops are 200 yards away and there is also a public house and church in close proximity to the home. A local bus service runs through the village and Uckfield town centre is approximately five miles away. Inspections have identified that fees do not include the cost of toiletries, hairdressing, massage, chiropody, newspapers and outside activities such as visits to the theatre. Full information about the service provided is recorded in the homes Service Users Guide and details of the fees can be obtained from the home, and the latest inspection report is available from the Acting Manager. Care Homes for Older People Page 5 of 29 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: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Lydfords Care Centre will be referred to as residents. This was a key inspection that included an unannounced visit to the home by two inspectors. A range of documentation was reviewed including care plans, medication charts, recruitment files, and the menus. The manager, registered nurses, care staff and cook were happy to discuss the support they provide. They were very positive and felt they could meet the residents needs. Care Homes for Older People Page 6 of 29 The Annual Quality Assurance Assessment (AQAA) was completed by the manager at that time, within the required timescale, and identified areas where improvements have been made, and where others are planned for the benefit of residents. Care Homes for Older People Page 7 of 29 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 29 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 9 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users guide contains most of the information needed for people to decide if the home can meet their needs, it should be reviewed and updated to include specific details about the home. Assessments are completed for prospective residents before they are offered a place, these should focus on the homes capacity to meet their individual needs. Evidence: The service users guide contains most of the information listed in Schedule 1 in the National Minimum Standards NMS for Older People. However additional information is required to ensure that prospective residents and their relatives have a clear understanding of the care and support offered at Lydfords Care Centre. The guide should include clear details of the range of needs that the home intends to meet, and that the home provides nursing care and personal care for the people who live there. Relatives involved in the inspection said that they had visited the home and had been Care Homes for Older People Page 10 of 29 Evidence: given information about the support offered. Some residents did not choose the home themselves but said they are pleased with the choice, they are comfortable and said the staff are very good. People who want to move into the home are assessed by the manager or a senior staff member. A new assessment format has been introduced, and when this is completed there is a considerable amount of information for the assessors to discuss, with the prospective resident and their relatives, to decide if the home can meet their individual needs. Five assessments were examined and found to contain details of the medical, social and psychological needs of the residents, which are used as the basis of their care plans. However the assessors should be aware that all the needs of prospective residents should be considered when deciding if the home has the capacity to meet them, as identified in Standard 3 of the NMS. A requirement for nursing care does not diminish the importance of a persons physical or mental health needs Care Homes for Older People Page 11 of 29 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. The care planning system has been reviewed and there is a considerable amount of information available about the needs of the residents. However further training and additional work is required to enable staff to use the care plans as an effective tool in planning care. Policies and procedures for dealing with medicines are in place, staff were not following them and this may put residents at risk. Evidence: The care planning system has been reviewed and updated, with the expectation that a more informed care plan can be produced using the information obtained during the pre admission assessment. As already identified the pre admission assessments may not review all the prospective residents needs, and this may have an affect on the usefulness of the care plan in planning care that is aimed at meeting a persons individual needs. Training has been provided for the nurses who are responsible for completing the care plans. The manager advised that this will be an ongoing process and linked to any issues identified in the planned regular audits, that she and the deputy manager will Care Homes for Older People Page 12 of 29 Evidence: carry out. Five care plans were examined, they included the completed care health assessment process (CHAP), risk assessments for moving and handling, falls, pain assessment and continence assessment, consent for photographs, multi disciplinary team comment sheets, referrals to health professionals and regular reviews with the resident or their relative. The information available is considerable and should enable staff to offer the residents the support and care they want and need. However some residents, who took part in the inspection, said that they did not feel the home was meeting their needs. They felt that staff were not working with them to decide what support would be provided, or asking them how and when they would like to receive care. The expectation is that the audits should identify any shortfalls and action should be taken to address these. The manager advised that she will be attending training for Deprivation of Liberty Safeguards and Mental Capactity Act, and will be using the information obtained to ensure all the people living in the home receive appropriate support. The support offered to residents is recorded each day by the registered nurses, on viewing these it was noted that some staff record very little information, and comments like all care given and no problems or complaints does not reflect how the needs of the residents are met. Daily records, when well written, help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review, and to record that they are following the assessment of needs. Residents are registered with GPs linked to the home, and they have access to allied health professionals if required, including a chiropodist and optician. A recognised tool is used to assess residents nutritional requirements, and pressure relieving mattresses and cushions are provided if the risk assessment identifies them as needed to prevent pressure damage. The home has policies and procedures for the ordering, storage, and administration of medicines. The medicine administration records were viewed, a list of staff signatures and residents photos were in place, they were found to be completed correctly and staff said they had attended training. However during the inspection a nurse did not follow the homes policies for the safe administration of medicines, which may put residents at risk. Staff were noted to treat residents with respect and residents said the staff are good, Care Homes for Older People Page 13 of 29 Evidence: although they seem to be very busy and have little time to spend with us unless they are providing personal care. Communication between residents, visitors and staff was noted to be relaxed, friendly and on first name terms. Care Homes for Older People Page 14 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers a range of group and individual activities throughout the week, however some residents were unable to, or were not given the opportunity to take part in these. Food at the home is good, residents are assisted at meals times if required and choices are available, although some residents were not offered these. Evidence: The home employs a personal activity lead (PAL), working 30 hours a week Monday to Thursday and either Friday or the weekend, providing group activities, with one to one support offered by her colleague over a period of 7.5 hours each week. Relatives and residents said the activity staff are very good and fabulous, offering a number of things or trips out. The group activities are varied and have recently included a garden fete, making chutney from fruits grown in the garden, outings in the minibus, craft sessions in the activity room as well as playing bingo or watching films. The PAL explained that the one to one sessions are specific to the individual residents, and the the visit to the home of a small dog was the most memorable for residents who were involved in the inspection. Residents sitting in the activity room said the activity staff are very good, they always have something to do and relatives were equally positive saying that Care Homes for Older People Page 15 of 29 Evidence: residents can go out on the trips or join in at the home. A record is kept of the activities organised and who attends them. These were examined and it was found that some residents who remain in their rooms had very little interaction with the activity staff, and some who had identified what they would like to do, such as go on the minibus trips, had not been offered this. Feedback from the residents and relatives meeting was that residents are sometimes left doing nothing when the activity staff are busy. The AQAA states that there are plans to involve staff in offering residents activities in addition to those organised by the PAL, however staff spoken with said they did not have the time to do this. Visitors are welcome at any time, with the residents agreement, and those spoken with were positive about the care their relatives receive. Many of the residents are from the local area, and links with the community are good with many villagers attending the summer fete. The home intends to build on this so that residents feel part of the local community. Different religious groups visit several times a week, and the staff talk to people individually to support them in making arrangements to meet their spiritual needs if required. The minibus is available and volunteers take residents to church if they want to go. The homes philosophy of care states that the home will enable residents to make choices, which will be respected and honoured at all time, and many of the residents are able to make decisions about the care they receive and how they spend their time. However some of those spoken with said that they are not always able to make choices about how they spend their time, and although the staff are good they are also very busy and dont have the time to spend with us. The food at the home is good, staff said choices are available and residents said they are asked what they want by the staff, and this is recorded for the chef to plan the meals. This record was examined and it showed that choices are available for most of the residents, however some residents were not offered a choice, the chef explained they are all given the same meal. This was discussed with the manager who advised that the new chef has been talking to residents and will be developing a new menu based on the residents preferences. Care Homes for Older People Page 16 of 29 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. Residents and relatives are provided with information about how to raise concerns and complaints, training in protecting vulnerable people is provided for staff to protect residents. Evidence: Policies and procedures for making complaints are in place and information about how residents and their relatives can do this is provided in the Service Users Guide, and on the notice board in the entrance. The policy should be updated to include the timescale for responding to and investigating complaints. The home has received three complaints from relatives in the last eight months, these have been investigated and concerns about medication and residents specific indiviudal care needs have been substantiated. Remedial action plans were put in place and the complainants were informed that the providers would monitor this through the senior management team. However concerns about nurses following the homes policies regarding medication have been identified during the inspection, staff may not meeting the residents needs, and some residents feel that the home does not meet their individual care needs. Referrals have also been made to the local authority under safeguarding adults, the home has been asked to investigate these and the relevant procedures have been followed. Care Homes for Older People Page 17 of 29 Evidence: People involved in the inspection said they can raise concerns during the meetings, or they can talk to the staff and manager as they said they are approachable. However some felt that their concerns were not always dealt with to their satisfaction. Training in protecting vulnerable adults is provided for staff, and those spoken with have attended and were able to demonstrate an awareness of abuse and what action to take if they have any concerns. Care Homes for Older People Page 18 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Lydfords Care Centre provides residents with a comfortable and homely environment, training in the control of infection is provided for staff to protect residents. Evidence: Lydfords is a large care home, an original building with extensions to the side and rear, that has 46 rooms, 25 with ensuite facilities, and is registered to offer nursing and personal care for 50 people. A shaft lift and stair lift enable residents to have access to all parts of the home, hoists and moving and handling aids are provided to assist staff to transfer residents safely, and there are assisted bathrooms and toilets. A strong odour was noted when walking along the ground floor of Orchard unit, the manager said she is aware there is a problem and is arranging for specialist cleaning of the area. There is an attractive patio area to the rear of the home and a number of residents and relatives were sitting there and enjoying the warm weather. A group were also sitting on the grass area for afternoon tea. Residents are encouraged to personalise their rooms and many have with small pieces Care Homes for Older People Page 19 of 29 Evidence: of furniture, pictures and ornaments. It was noted that in one residents room there are name stickers on the drawers of the dressing table, this should be reviewed. There are procedures in place for the control of infection and staff spoken with said they have attended this and are aware of the homes policies for the correct use of aprons and gloves. Care Homes for Older People Page 20 of 29 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. The staffing levels at the home have increased recently, however comments received stated that there are not enough staff working at the home and this may affect the residents care. Training is provided for staff so that they are aware of their roles and responsibilities. Evidence: The manager advised that 8 care staff and two nurses work at the home during the day, and the number of care staff working at night is now 4, with one nurse. The increase has been made because the needs of the residents have changed, with more requiring assistance from two staff, and the providers have agreed to this increase. Residents and relatives during the inspection said that the staff are very good, they are very helpful, and one relative said she was very happy and had no complaints. However residents and staff involved in the inspection also said that the staff are rushed and they do not have the time to spend with residents. Comments about staff shortages, and that they only have time to carry out basic needs for residents, were also made during the residents and relatives meeting. The manager responded during the meeting stating that a number of staff have left and they are actively recruiting new staff, nurses and care staff, but this process takes some time. The manager confirmed that all new staff are required to complete induction training, Care Homes for Older People Page 21 of 29 Evidence: although there was no evidence available at the time of inspection to support this. There are opportunities to work towards National Vocational Qualifications NVQ when they have completed this, three staff are working toward NVQ level 2, three have completed this course and one member has level 3. Mandatory training is also provided for all staff and those spoken with said they have attended, this includes infection control, moving and handling and protecting vulnerable people. The home recruitment procedure is organised by head office and at times staff are recruited directly to the home from abroad, without clear information about their individual skills and knowledge before they start working at the home. The personnel files viewed contained the required information including application forms, two references in all but one, interview details, Criminal Records Bureau CRB and Protection of Vulnerable Adults POVA checks. It was not always easy to follow the recruitment process that the home uses. This was discussed with the manager who said she will look at developing an effective audit trail to enable her to identify if any records are missing. Care Homes for Older People Page 22 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management style encourages the involvement of residents, relatives and staff in developing the services provided at the home. There are a number of areas for improvement and the manager is aware of these. Evidence: The manager is a registered nurse and has experience of providing nursing care and personal support for people living in care homes. She has worked at the home for three months and is starting a leadership and management course, she also expects to register with the Commission as the manager for Lydfords Care Centre when she has completed her probationary period. Her management style is to encourage residents, relatives and staff to be involved in developing the services offered at the home. Regular residents and relatives and staff meetings, with daily feedback, are used to enable them to talk about any issues and ideas for improvements. The manager has been carrying out audits for all services at the home and is aware of a number of areas where improvements are required. Care Homes for Older People Page 23 of 29 Evidence: Questionnaires, provided by an external company, were distributed in April 2009 as part of the quality assurance system. However the results were not available at the time of the inspection. The manager confirmed that the home is not responsible for the residents finances. The manager said that she has recently started a supervision programme with staff, those spoken with said they have had these one to one meetings and have found them very useful. The health and safety of resident is protected by ongoing maintenance of the home, regular maintenance checks, fire checks and the training programme for staff. It was noted that the insurance certificate, on the wall in the entrance area, was out of date and the manager said she would deal with this. Care Homes for Older People Page 24 of 29 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 29 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 3 14 That the home must assesse 28/09/2009 all the prospective residents needs including physical and mental health needs. To ensure the home can offer appropriate care and support. 2 4 14 The home must demonstrate 28/09/2009 that is has the capacity to meet the needs of residents. To ensure the home can meet their individual assessed needs. 3 7 15 That the care plans identify the individual needs of the residents and that they clearly evidence how they are met. To ensure appropriate care and support is offered to residents. 28/09/2009 Care Homes for Older People Page 26 of 29 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 4 9 13 That the nurses follow the home policies and procedures for the adminstration of medicines. To ensure that residents are protected. 28/09/2009 5 12 16 That the activities are reviewed and appropriate changes made to ensure all residents have opportunities to join in if they wish. To ensure that home meets the social and recreational needs of all residents. 26/10/2009 6 14 12 That the home enables all 26/10/2009 residents to make choices about all aspects of their day to day lives. To ensure that the residents are enabled to control their lives. 7 15 16 That the home provides all residents with choices at meal times. To ensure that all residents are offered nutritious and wholesome foods. 28/09/2009 8 16 22 That the home addresses 28/09/2009 any issued identified when investigating complaints and ensure that appropriate action is taken to. Care Homes for Older People Page 27 of 29 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 To ensure the residents concerns are listened to and acted upon. 9 27 18 That the staffing levels are 26/10/2009 reviewed and changes made to meet the assessed needs of residents. To ensure that the residents needs are met. 10 29 19 That the home follows an effective recruitement procedure To ensure that residents are protected. 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 28/09/2009 Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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