Inspection on 23/10/09 for Mandeville Grange

This inspection was carried out on 23rd October 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mandeville Grange 04/02/10

Mandeville Grange 11/11/08

Mandeville Grange 23/11/06

Mandeville Grange 29/12/05

Mandeville Grange 28/09/05

Mandeville Grange 14/03/05

Mandeville Grange 10/08/04

Mandeville Grange 28/01/04

Mandeville Grange 21/01/03

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Mandeville Grange 201-203 Wendover Road Aylesbury Buckinghamshire HP21 9PB     The quality rating for this care home is:   zero star poor 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: Joan Browne     Date: 2 3 1 0 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 28 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 28 Information about the care home Name of care home: Address: Mandeville Grange 201-203 Wendover Road Aylesbury Buckinghamshire HP21 9PB 01296435320 01296397509 mcsmand@googlemail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mandeville Care Services Limited care home 31 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 31. The registered person may provide the following category/ies of service only: 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 categories: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Mandeville Grange Nursing Home is situated on the outskirts of Aylesbury Town, which provides a variety of shops and other local amenities. The home provides nursing care for up to thirty-one service users, who are accommodated on two floors of the building. All floors are accessible by stairs, a passenger lift or stair-lift. Registered nurses and carers staff the home. 1 1 1 1 2 0 0 8 0 Over 65 31 Care Homes for Older People Page 4 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: zero star poor 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 key inspection was carried out on the 23 October 2009 and covered all of the key National Minimum Standards for older people. The inspection lasted for approximately eight and a half hours. commencing at 09:15 am and concluding at 18:00 pm. The last key inspection on this service was completed on 11 November 2008. Prior to the inspection a detailed self assessment questionnaire known as the annual quality assurance assessment (AQAA) was sent to the home for completion and surveys were sent to a selection of people living at the home, staff and visiting professionals. The AQAA was returned by the due date and gave a reasonable picture of the current situation within the service. Six service users, five staff members and four health care professional completed surveys and their replies have helped to form judgments about the service. The manager, deputy manager, three staff members, five relatives and service users were also involved in the inspection process and their responses and views of the home have Care Homes for Older People Page 5 of 28 been incorporated into the report. Further information was gained by observing staffs practice, examination of care plan documentation, staffs records, health and safety records and a tour of the premises. Feedback was given to the proprietor, manager and deputy manager on the inspection findings. There were five requirements made on this visit. Please see health and personal care outcome area and management and administration for full disclosure. One of the requirements is a repeat requirement from the previous key inspection. It is possible that a statutory regulation 43 notice will be served for non-compliance of the breach in the regulation. We (the Commission) would like to thank all the service users, relatives and staff who made the visit so productive and pleasant on the day. Care Homes for Older People Page 6 of 28 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 Care Homes for Older People Page 7 of 28 order line 0870 240 7535. Care Homes for Older People Page 8 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 9 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission practice is not always consistent or well applied. This could mean that service users identified needs may not always be fully met because they may not be known by all staff. Evidence: The AQAA informed that each service user has an individualised pre-admission assessment to ascertain whether the home can meet their needs. We looked at the pre-admission assessment documentation for two service users who were recently admitted to the home. One person was admitted as an emergency and the second person was a booked admission and was admitted from hospital. It was noted that the nursing assessment admission sheets were not fully completed. For example, on one persons nursing assessment sheet the following sections were not completed: personal health and safety, vital signs and patients awareness of own condition. On the second nursing assessment sheet the individuals preference on how they wished to be addressed by staff was not recorded. Care Homes for Older People Page 10 of 28 Evidence: Both individuals had been referred through care management arrangements. A summary of the care management assessment was seen in their care plan documentation. We spoke to one of the relatives of the service users who were recently admitted to the home. The relative confirmed that they had visited the home prior to admission and had met with staff and was given some information about the service and was shown around the home. It was noted that there was no care plan in place for the individual who was admitted as an emergency. This was seven days after admission. It is required that the home reviews its admission procedure to ensure that a written care plan is in place for any individual admitted in an emergency within an appropriate timescale. The plan must be clear and detail how the service users needs in respect of his/her health and welfare are to be met. Care Homes for Older People Page 11 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not have a clear or consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users diverse needs. Inconsistency in staffs medication recording practice could place service users at risk. Evidence: We looked at three care plan documentation. Two were relating to the most recent service users admitted to the home and one for a long standing service user. It was noted that there was no care plan in place for one of the service users who was recently admitted. Risk assessments relating to moving and handling, falls, nutrition and tissue viability were also not in place. In the second persons care plan documentation a care plan was in place. The plan was developed approximately three weeks after admission. It was not comprehensive and did not provide adequate information on how all identified needs should be met. For example, the individual was not able to mobilise without staffs assistance. There was no plan in place detailing how staff should assist with this activity. No risk assessments relating to moving and handling, falls, tissue viability and nutrition had been developed. In the third care plan Care Homes for Older People Page 12 of 28 Evidence: documentation it was noted that the care plan had not been reviewed since 6 April 2009, There was a night care plan in place for this individual and between the period March 2009 to July 2009 the plan had not been kept under review. The risk assessment relating to this individuals moving and handling, falls and mobilising had not been reviewed since 6 March 2009. There was a bed rail risk assessment in place and this had not been reviewed since October 2008. The AQAA stated the following: We carry out risk assessments aiming to prevent falls and they are updated monthly as and when changes take place. We have care plans and risk assessments in place to identify those at risk of pressure damage and what action is being taken to reduce the risk, e.g. pressure relieving equipment. The three care plan documentation examined did not support the statements made in the AQAA. Daily report writing referred to personal care provided and eating and drinking. No evaluation is made of individuals identified needs or if there is a pattern to changes or improvement in their condition. A requirement is made to ensure that service users plans are kept under review. A further requirement is made to ensure that appropriate risk assessments relating to moving and handling, falls, tissue viability and nutrition are developed for service users and unnecessary risks to their health or safety are identified and so far as possible eliminated. Service users were registered with a general practitioner (GP) who visits the home as and when required and have access to health care services both within the home and in the local community. Staff are expected to record in the care plan documentation when visits are carried out and what treatment was prescribed. It was noted that this practice was not always consistent. For example, a service user was seen by the general practitioner and was prescribed food supplement this information was not recorded on the persons multi-disciplinary record sheet. Service users who were being nursed in bed did not have fluid balance or turning charts in place. This practice should be reviewed to ensure that there is an audit trail of all personal care provided. We were told that the chiropodist and hairdresser visit the home as and when required for a small charge. A recent photograph of individuals were included in their personal folder and medication record folder to reduce the risk of errors occurring during medication administration. Staff are expected to leave a sample of their signature in the medication folder. We were told that there were no service users assessed as capable to self-medicate. Examination of the medication administration record (MAR) sheets identified that there were eight unexplained gaps. This means that it was not possible to tell if service users got their medicines on these occasions. The controlled drugs were checked and the balance in stock corresponded with the record. There was an audit trail of all medicines entering the home and being disposed of. We observed staff treating individuals in a friendly and respectful manner. Those spoken to said that staff respected their privacy and dignity. Service users were Care Homes for Older People Page 13 of 28 Evidence: dressed appropriately for the weather and their attire was clean and tidy with attention to detail. The AQAA informed that within the service users documentation formal decisions regarding end of live care such as advance directives and wishes and feelings are recorded. We saw evidence to support this statement in two care plan documentation examined. In both instances the decision was made by a relative. 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. The home makes arrangements for activities to be provided. This means that service users can be involved in meaningful daytime activities which meet their choice, interests and diverse needs. Individuals are able to maintain contact with their family and friends. Meals provided were of a high standard and served in pleasing surroundings. Evidence: The home employs an activity person. Service users who responded to the Commissions survey said that the home always or usually arrange activities that they can take part in if they wish to. The activity programme was displayed in the home to enable service users to be aware of what was on offer. A therapist visits the home weekly and provides hot stone treatments and nail care. This seemed to be a popular activity with all the service users. A music to movement session is also facilitated weekly by an outside facilitator. The home celebrates each service user birthday with a home-made cake and relatives and friends are free to participate. A regular church service is held to enable individuals who wish to promote their spiritual needs to do so. The AQAA informed that service users can bring pets such as, canaries, budgerigars as permanent companions. Relatives spoken to during the inspection said that the homes staff always make them Care Homes for Older People Page 15 of 28 Evidence: feel welcome and provide them with refreshments. Service users are made aware of their rights to bring personal possessions such as, small pieces of furniture, television and family pictures if they wish to personalise their bedrooms. A relative spoken to during the visit said that they were pleased that they were able to bring in personal possessions and family photographs to enhance their mothers room. The home provides three meals daily with snacks and drinks throughout the day and night. Special diets such as diabetic or vegetarian are catered for. Service users spoken to and those who responded to the Commissions survey said that the food was always or usually tasty. Staff were observed assisting those service users who needed assistance in a sensitive and unhurried manner. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a complaints and safeguarding policy in place. This should ensure that service users would be confident that their complaints would be investigated and they would be protected from any potential risk of harm or abuse. Evidence: The home has a complaints procedure which is accessible to people using the service, staff and relatives. A copy of the complaints procedure was displayed on the homes notice board. It was noted that the Commissions details reflected in the complaints procedure needed to be amended. The manager was advised to amend the document. The home ensures that there is a record of all complaints made which includes details of the investigation. The manager has agreed to make some improvement to the design of the form to ensure that it reflects clear outcomes of the complaints investigated. Service users who responded to the Commissions survey said that they knew how to make a complaint. Those spoken to during the visit and relatives said that they have not had the need to make a complaint and were very happy with the care provision. The home has a safeguarding of vulnerable adult policy which incorporates Bucks County Council safeguarding protocol. Training records examined verified that all staff had undertaken updated training in the safeguarding of vulnerable adults. Staff spoken to said that they were clear about what action should be taken if they suspected or witnessed an incident of abuse. The home has had one safeguarding referral and investigation within the last twelve months which the Commission was Care Homes for Older People Page 17 of 28 Evidence: made aware of. The outcome of the investigation was unfounded. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home is satisfactory. This means that service users are provided with a homely, clean, comfortable, pleasant and hygienic place to live and their diverse needs are promoted. Evidence: The building is an Edwardian house with an extension providing a variety of rooms for service users. The sitting room and dining area are situated on the ground floor. There is a maintenance and refurbishment schedule plan in place detailing a rolling programme of routine maintenance and renewal of the fabric and decoration of the premises. It was noted that curtains in the communal areas and in some bedrooms had been replaced. The home has limited storage areas. However, a storage area had been created to store the hoist on the first floor. The grounds were tidy, attractive and accessible to service users. There is a patio area with seating and an awning, which provides space for service users to sit out weather permitting. Service users are encouraged to personalise their bedrooms and some rooms seen were personalised with family photographs and mementos. The home has some shared bedrooms and screens were provided to promote privacy. Bathrooms and toilets were fitted with the appropriate aids and adaptation to promote independence. It was noted that a bathroom on the first floor was no longer in use. The manager confirmed that it was to be replaced with a shower/wet area. The work was scheduled on the maintenance plan to be carried out in November 2009. The manager said that Care Homes for Older People Page 19 of 28 Evidence: he intends to carry out an audit of the environment. Any areas identified as requiring attention would be actioned in a reasonable timescale. The home was clean, pleasant, hygienic and free from offensive odours. Review of care workers training record demonstrated that they had undertaken training in infection control. Service users who responded to the Commissions survey said that the home was always or usually fresh and clean. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a training programme which means that staff receive relevant training which is aim at delivering improved outcomes for people using the service. The homes recruitment procedure needs to be more robust to ensure that it complies fully with current legislations. Evidence: The rota demonstrated that the staffing numbers and skill mix of staff were appropriate to meet peoples assessed needs for any twenty-four hour period. Staff who responded to the Commissions survey said that the home was reasonable staffed. The home has a programmme of planned training in place and is part of a training cluster group in the local area. The training matrix reflected that mandatory training for all staff was up to date which means that staff were being supported to maintain their competency and fulfill their duties. Staff who responded to the Commissions survey said that they were provided with training which was relevant to their role Those spoken to on the day of the visit confirmed that they attend regular training updates. Over 50 of health care staff had achieved the national vocational qualification (NVQ) at level 2. The home ensures that staff undertake induction training to support them in understanding their roles and meeting the needs of individuals in a personalised manner. The recruitment files of three staff recently recruited were examined. It was found that PoVA first checks and criminal record checks and two references were in place. Care Homes for Older People Page 21 of 28 Evidence: For the two staff members who were recruited from an employment agency it was found that references were copies and addressed To whom it may concern. The manager is advised to ensure that references are addressed to the person who requested them. There were no copies of contract of employment and signed confirmation of employees receipt of their terms and conditions and copy of the general social care council code (GSCC) of practice in staffs files. We were told that staff employment contracts were under review. 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. The home aims to provide a consistent service but weaknesses in the care care planning documentation, risk assessments and staffs practice in the safe administration and recording of medication can impede service delivery and outcomes for service users. Evidence: The manager has been in post since 1 October 2009. He is a registered general nurse and holds the ENB 119 certificate in accident and emergency. He also has a certificate in management and has managed staff in a hospital setting and has worked in the community as a night community nurse covering Bucks, Bedfordshire and Hertfordshire area. Prior to that he was the senior night practitioner at the local hospital. The manager said that there were clear lines of accountability in the home and his job description enables him to take responsibility for fulfilling his duties. It is an expectation that the manager applies to be registered with the Care Quality Commission as soon as he completes his induction. A requirement is made in this report for the manager to apply for registration when he completes his induction. Care Homes for Older People Page 23 of 28 Evidence: Since being in post the manager has held one meeting with the staff team. A meeting with relatives was arranged but there were no participants and it was canceled. The AQAA informed that service users views are sought to ensure that individuals were satisfied with the service delivery. All sections of the AQAA were completed and the information gave a reasonable picture of the current situation within the service. This inspection highlighted weaknesses in the homes admission process, inconsistency in the care planning and risk management systems which could have an impact on outcomes for service users. The homes financial policy and procedure ensure that service users money is protected. The AQAA informed if the service user does not want to or is unable to manage their finances the home can assist by appointing a casting power of attorney. A sample of health and safety records were examined and found to be up to date and well maintained. The kitchen was clean and tidy and satisfactorily maintained. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 15 Health problems identified 15/12/2008 must be supported by a care plan detailing how staff should by meeting the identified needs. This is to ensure that all aspects of individuals health needs are met. 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 4 15 It is required that care plans 15/12/2009 must be in place for all service users. This is to ensure that staff have the appropriate information and guidance to follow in order to adequately support service users in all aspects of their care needs immediately on admission. (This is an outstanding requirement and should have been met on 15/12/2008). 2 7 15 It is required that service users care plans are kept under review. This is to ensure that the plans fully identify needs of service users and explain how the identified needs would be met. 15/12/2009 3 8 13 It is required that risk 15/12/2009 assessments relating to tissue viability, falls, moving Page 26 of 28 Care Homes for Older People 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 and handling, and nutrition are put in place for the two service users recently admitted to the home. This is to ensure that unnecessary risks to their health are identified and so far as possible eliminated. 4 9 13 It is required that 15/12/2009 arrangements are made for the safe administration and recording of medicines in the home. This is to ensure that service users health and safety are protected. 5 31 8 The manager must apply for registration with the Care Quality Commission as soon as he completes his induction. This is to ensure that the home is managed by a person who is registered with the Commission. 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 15/12/2009 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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