Inspection on 29/09/08 for Pinehurst

This inspection was carried out on 29th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pinehurst 05/09/06

Pinehurst 08/12/05

Pinehurst 26/10/04

Pinehurst 06/05/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Pinehurst Pinehurst National Trust Road Boxhill Mickleham Surrey RH5 6BY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Jewell     Date: 2 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Pinehurst National Trust Road Pinehurst Boxhill Mickleham Surrey RH5 6BY 01306889942 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Theresa Schneider Type of registration: Number of places registered: Theresa Schneider care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The age/age range of the persons to be accommodated will be: OVER 65 YEARS OF AGE Up to three Service Users may be in the category DE(E) and a maximum of one may be in the categaory MD(E) Date of last inspection Brief description of the care home Pinehurst Rest Home is registered to provide residential accommodation and care for up to nineteen older people. The premises are a converted country Mansion which was used as a hunting lodge which maintains many original features. It is located in a rural Care Homes for Older People Page 4 of 30 0 0 0 Over 65 3 1 19 Brief description of the care home location overlooking Boxhill in Surrey. The premises have been used as a care home for over fifty years. Resident’s accommodation is presented across two floors, which can be accessed by stairs or a chair lift and consists of eleven single and four double rooms. Two bedrooms provide their own en-suite facilities with all bedrooms providing a wash hand basin. The third floor is used for staff accommodation. Communal space consists of a grand entrance hall, lounge, dining room and secure terraced garden which overlooks the National Trust park at Box Hill and provides beautiful views of the surrounding countryside. The nearest local amenities are accessible by car with Dorking town centre a short drive away. The home has its own small car. The homes literature states that it aims to provided all resident with as normal a life as is possible given that individual s health in a homely surroundings. Care Homes for Older People Page 5 of 30 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: two star good 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 information contained in this report has been comprised from an unannounced site visit undertaken over seven hours and information gathered about the home before and after the site visit. The manager had completed an Annual Quality Assurance Assessment form prior to the inspection and the information contained in this document has been used to inform the site visit of the home. Feedback comment cards were sent to the home in advance of the site visit for the home to distribute and three were returned. Two were from health care professionals and one from a resident. A summary of their feedback is contained in this report. Mrs Theresa Schneider (the registered Provider / Manager) facilitated the site visit. The site visit involved a tour of the premises, examination of the homes documentation and Care Homes for Older People Page 6 of 30 in-depth discussion with nine residents and five staff. Two visiting health care professionals were also interviewed. Five relatives were consulted about their experiences at the home. The inspector spend time observing a small group of residents during lunch time and in their daily routines and in their interactions with staff. This was in order to assess the well-being of residents who are not able to verbally share their experiences of the home. What the care home does well: What has improved since the last inspection? All the shortfalls noted at the previous inspection had been addressed or were in the process of being completed. This has improved residents safety through a clearer audit trail of medication, recruitment and better trained staff. The provider manager reported that the home continues to undergo a gradual programme of refurbishment, which over the previous twelve months has seen the Care Homes for Older People Page 8 of 30 redecoration of the external building. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides both prospective and existing residents, with most of the information about what services are provided and what to expect when living at the home, however the range of fees needs to be available. The way in which prospective residents are assessed ensures that the home admits only those residents whos needs can be met by living at the home. The home is able to identify and meet the needs of the residents. Evidence: There is a range of information about the home and the services it provides, this includes a statement of purpose and service user guide. These are given to prospective residents, representatives and other interested parties. Minor additions are needed to these documents to ensure that they contain all of the legally required information in Care Homes for Older People Page 11 of 30 Evidence: order to help inform prospective residents about the home. This includes the full terms and conditions of residency including any additional charges.Relatives confirmed that they received information about the home in advance of visiting the home. Relatives commented: they answered all the question we asked and gave us additional information and We were given a folder which contained useful information about the home. Residents are provided with a written contract of terms and conditions of residency with the home. This enables residents and their families to be informed of the placement arrangements and to clarify mutual expectations around rights and responsibilities. A signed copy of the contract is retained in residents files. Minor additions are needed to include the range of additional charges and a statement whether any charges are different where a residents care is being funded by another party other than the resident. The manager agreed to add this into the terms and conditions to ensure that all parties have clear information on the range of fees. The home ensures that prospective residents are accommodated only following an assessment of their needs by the Manager or senior staff. Advice is sought during the assessment process from health care professionals and others who know and understand the needs of the prospective resident. The needs assessment then forms the basis of their care plan. This helps ensure that staff are aware of the recorded needs of new residents prior to them moving into the home. Residents are assessed as mainly having medium level of needs and there was a range of evidence that the home is able to meet these needs. Staff were able to demonstrate a clear knowledge and understanding of the needs of each resident and also how those needs are consistently met. All persons consulted with about the home spoke positively about their experiences, a sample of their comments included: I feel that this is a very warm and friendly home. The staff are very caring and have a good rapour with the residents the residents are always happy and look clean and presentable in all aspects Lovely could not be better, very nice people excellent staff and nice place, all very nice its like being part of a family I dont know of anyone who is discontented here Nice atmosphere not clinical at all and Very well looked after here I feel absolutely safe here. Residents and their representatives consulted with spoke of being provided with the opportunity to visit the home in advance to assess the quality, facilities and suitability of the home. Comments made included: We just walked in having looked at various other places and Pinehurst felt right they are very welcoming and visited other homes and thought that this was the nicest environment and they offered the home as a home for life. Care Homes for Older People Page 12 of 30 Evidence: Intermediate care is not offered at the home therefore this standard is not assessed. Care Homes for Older People Page 13 of 30 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans need to accuratly reflect risks faced and posed by residents and staffs knowledge and understanding of their needs, in order to ensure consistent care is able to be provided. Medication systems generally protects residents safety with further recommendation made to better protect residents. Residents receive the health care intervention they need from a range of health care professional. Personal support is offered in ways, which promotes and protect residents privacy and dignity. Evidence: Four individual plans of care were examined which provided staff with some guidance on the needs of residents. A relative commented sometimes staff go above and Care Homes for Older People Page 14 of 30 Evidence: beyond needs very caring. However, although staff clearly demonstrated an understanding of individual residents needs and preferences this was not always recorded in order to ensure a consistent approach and the home evidencing that they are aware of residents needs. The home has been required to review the care plans to ensure that they provide clear accurate and up to date information on residents needs and how these can be met. --Not all of the risks faced and posed by residents were assessed or the actions needed to reduce or manager risks recorded. The manager has been required to ensure that as part of care planning process, comprehensive personal risk assessments are completed which are reviewed regularly. Much positive feedback was received about the high standard of medical support and the promptness in receiving medical intervention. A health care professional said: They always take on board any improvements I suggest in relation to my job and seek my advice as to improve the life of a person in their charge for the better. A relative spoke of the improvements their relative had made following their discharge from hospital, this they felt was due to the good level of medical support provided. A resident commented GP comes out whenever you need them, very accommodating. Records showed the home works closely with other health care professionals including District and specialist nurses, physiotherapist, chiropodists, opticians and dentists to ensure residents receive a range of good health care intervention. The system for the administration of medication was generally adequate with suitable arrangements in place to ensure residents medication needs are able to be safely met. However to further ensure residents safety it is recommended that additional instructions are provided for staff on the administration of As required medication, which make clear the individual requirements for when these medications are prescribed. In order to fully eliminate the associated risk when copying prescribed instructions onto medication administration records, it is recommended that these records should be checked and countersigned for accuracy by a second member of staff. Examples were noted whereby staff had forgotten to record when some medications were received, the staff member agreed to remind staff of the importance of completing this to provide an audit trail of all medication. Staff consulted with showed a good understanding of good practices in preserving residents rights to privacy and dignity. Staff were able to give examples of how they promote these rights in their every day care practices. This was supported by the inspectors own observations of the interactions between staff and residents and the experiences of visiting relatives and a health care professional. Some bedroom doors currently do not have locks fitted, the manager confirmed that residents are offered the opportunity of locks being fitted. Care Homes for Older People Page 15 of 30 Care Homes for Older People Page 16 of 30 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. Residents are helped to exercise choice and control over their lives with flexible routines being an integral part of daily practice at the home. Links with families and friends are valued and supported by the home. Residents lives are enriched by the home providing various opportunities for occupation and leisure. The meals are good offering both choice and variety. Evidence: It was evident , during the inspection that the routines of daily living are flexible to suit residents individual needs e.g. rising going to bed, taking meals in their private rooms and entertaining visitors. For a few people living at the home, being able to exercising their choice was difficult due to their level of needs. Staff were seen in these instances to use their acquired knowledge of the person to help them make choices with regard to food and personal care. In line with previous requirements an activities list is now displayed to help inform residents of forthcoming activities. An occupational therapist is employed several days Care Homes for Older People Page 17 of 30 Evidence: a week to provide a range of activities including gentle exercises, quizzes and games. Residents also spoke of going out with the manager shopping, singing, arts and crafts. Relatives spoke of seeing pat dogs and musical entertainers visiting. Residents consulted with all felt that there was sufficient opportunities for occupation and for those residents who did not wish to join in this was respected. Visitors commented upon how welcomed they are made to feel during their stay, this included being offered beverages or meals and staff being friendly and approachable. Relatives commented No restrictions can visit whenever we want and very welcoming offered tea and biscuits attend the annual Christmas get together and meetings. The meal served at inspection was presented well with most residents eating their meals in a pleasantly decorated dinning room. A group of residents ate their lunch on lap tables whilst remaining in lounge chairs. Although this does not aid good posture when eating or orientation the manager was able to give the individual reasons for these residents eating separately and not at dinning room tables. It was discussed that this information should be included in care plans to ensure that it is being regularly reviewed. Residents spoke of being given an alternative meal if they did not like what was on the menu and a relative spoke of how helpful the home has been in ensuring that their relative followed a specialised diet. A sample of comments made about food included: excellent The cook has good days and bad days and Food gorgeous home cooking. In addition to main meals hot and cold drinks were provided throughout the day, a resident said Drinks are available on the side you just help yourself. Records of meals provided is not currently maintained and the cook and manager agreed to ensure that this was completely immediately. This is necessary for food safety reasons and to be able to evidence whether residents diets are satisfactory, in relation to nutrition and of any special diets prepared for individual residents. Care Homes for Older People Page 18 of 30 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. There is an effective complaints system with evidence that residents and relatives feel that their views are listened to and acted upon. Staff have the guidance and training necessary to show them what to do if abuse is suspected. Evidence: There is an accessible complaints procedure for residents, their representatives, and staff to follow should they be unhappy with any aspect of the service. Without exception all residents and relatives consulted with said that they felt able to share any concerns they had with the manager and that where they have done so their concerns have been addressed promptly and satisfactorily. The manager reported that there has been no formal complaints made to the home since the previous inspection. In line with previous requirement staff underwent refresher training in safeguarding adults following the previous inspection. The home has written policies covering safeguarding adults and whistle blowing. These make clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. Staff have received formal training in safeguarding adults and prevention of abuse and the staff consulted with showed an understanding of their roles and responsibilities under safeguarding adults guidelines. Care Homes for Older People Page 19 of 30 Care Homes for Older People Page 20 of 30 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. Residents live in a clean, well-maintained homely environment, which has been decorated and furnished to a high standard with their bedrooms furnished and decorated according to their individual lifestyles. Evidence: The property is a converted hunting lodge with many original features. The home is in a rural location with views of the surrounding countryside, the nearest local amenities are in Dorking town centre, a short drive away. The home has its own small car in order to transport residents to appointments and access local amenities. All residents consulted with felt that they had the opportunity to go out if they wanted. The home was decorated and maintained to a good standard. The manager spoke of their plan of maintenance and redecoration, which has involved the external property being refurbished over the last twelve months with, further upgrade due internally in the next twelve months. All residents consulted with said that their private space provided everything they needed. Residents bedrooms were observed to have been individualised to reflect their individual lifestyle and preferences with many of the residents saying that they were able to bring small items of furniture and personal belongings with them. Care Homes for Older People Page 21 of 30 Evidence: Communal space consists of a large lounge and separate dinging room. Much effort is made to create a homely environment throughout the home. There is a covered patio area with seating surrounding part of the home with many residents speaking of how much they liked to sit outside to look out over the countryside. There is a wellmaintained garden making the outside a very attractive and inviting area for residents to use. There is sufficient number of toilets and bathrooms located around the home, including two bedrooms providing en-suite facilities and assisted bathing facilities. Fitted throughout the home are call points, which enable assistance to be summoned when pressed. Residents who said that they have used it all said that staff responded quickly to calls for assistance, including at night. All areas inspected were observed to be cleaned to a high standards. A health care professional said: the environment which they live and eat is always looking fresh and clean and I have never smelt unpleasant odours and a resident said I find Pinehurst fresh clean beautifully kept flowers in very room fresh fruit in all rooms daily as a hotel of five stars. Care Homes for Older People Page 22 of 30 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. Staff make a positive contribution in residents lives as residents benefit from a trained and enthusiastic staff team that know them and who are safely recruited and who are employed in sufficient numbers as is necessary to meet their needs. Evidence: Staff, visitors and residents felt that there was always sufficient numbers of staff on duty for staff to undertake their roles in a timely manner and for residents to receive the support they needed, when they wanted it. There is a core group of staff who have worked at the home for a number of years and showed an in-depth knowledge of individual residents needs and preferences. All staff were found to have a good rapport with residents and visitors which promoted a relaxed atmosphere in the home. Without exception all persons consulted about the home spoke positively about the staff, a sample of comments included: very kind listens to what I say and very helpful I always see the staff with caring attitude and trying to improve the care of the residents All the staff work to produce a great atmosphere all staff are very kind and helpful at all times and could not wish for better place they are treated as if the staff are looking after their own mother. The manager has been proactive in ensuring that all the staff have undertaken a National Vocational Qualification (NVQ ) in Care. Staff consulted with had undertaken Care Homes for Older People Page 23 of 30 Evidence: all of the compulsory training such as moving and handling, first aid, food hygiene and Fire safety in order to work safely with residents. The personal files of four staff were inspected and these showed that a satisfactory recruitment process is followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing. Care Homes for Older People Page 24 of 30 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. Residents benefit from an experienced and well respected provider manager who ensures a clear ethos and values of the home that enables staff to provide good quality care to residents. A range of regular health and safety checks and good practices helps to promote the health and safety of residents and staff. Evidence: he Provider / Manager has considerable experience in managing services for older people. They have undertaken the recommended management qualifications. They are supported by senior staff who undertake much of the day to day administration at the home and a management consultant who further supports the administration systems at the home. Without exception all persons consulted spoke positively about the manager, comments included: see her whenever I need to, very welcoming any issues she just addresses them there and then she seems to know what is happening Care Homes for Older People Page 25 of 30 Evidence: at the home Best thing about this place is the manager very nice and she is very welcoming generally any concerns you can just ring her. There are some informal mechanisms in place for the home to obtain feedback on the quality of the services provided and whether it is achieving its aims and objectives. Changes in menus and activities have resulted in feedback received from residents. Residents are encouraged to retain control of their own finances for as long as they are able to do so and if unable then this responsibility is taken on by a relative or another responsible persons external to the home. The manager stated that they do not manage the personal finances for any residents. Staff are in the main supervised by the manager/senior staff working along side them each shift and all staff consulted with felt well supported. Records submitted by the manager prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment has been undertaken. Systems were in place to support fire safety, which included: regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The manager reported that a fire risk assessment had been undertaken by a fire safety expert, which recorded significant findings and the actions taken to ensure adequate fire safety precautions in the home. Although not all radiators are fitted with radiator guards the manager to prevent the risk of accidental scolding the manager confirmed that these radiators they a fixed temperate within the safe temperature ranges. Care Homes for Older People Page 26 of 30 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 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 15 That care plans provide clear 28/11/2008 guidance for staff on all aspects of the health, personal and social care needs of service users and which make explicit the actions needed to meet these needs and which include personal risk assessments for all service users, which are reviewed regularly and records the actions to manage or reduce any identified risks. To improve residents safety. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 9 That additional instructions are provided for staff on the administration of As required medication, which make clear the individual requirements for when this medications was prescribed. That hand written Medication Administration Records (MAR) are checked and countersigned by a second member of Page 28 of 30 2 9 Care Homes for Older People staff for accuracy. Care Homes for Older People Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!