Inspection on 30/12/08 for Saxon Lodge

This inspection was carried out on 30th December 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Saxon Lodge 03/01/08

Saxon Lodge 09/10/06

Saxon Lodge 27/02/06

Saxon Lodge 24/10/05

Similar services:

22 Sandown Road

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Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Saxon Lodge South Road Norton Stockton-on-Tees TS20 2TB Three star excellent service The quality rating for this care home is: 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: Stephen Ellis Date: 3 0 1 2 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: Saxon Lodge South Road Norton Stockton-on-Tees TS20 2TB 01642 553795 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Milbury Care Services Ltd Name of registered manager (if applicable) Mrs Christine Tray Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 8 0 0 Care home 8 learning disability physical disability Additional conditions: Date of last inspection 0 3 0 1 2 0 0 8 A bit about the care home Saxon Lodge is a service offering residential placements to children and young adults aged 16 - 25 with a learning disability and physical disability. The home has been specially designed and equipped to meet the needs of people with a high physical dependency. The current weekly charge ranges from £1530 to £1930, but the actual amount payable depends on individual circumstances. 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home This key unannounced inspection was carried out on 30th December 2008. It was informed by the homes selfassessment of its performance, called an Annual Quality Assurance Assessment (AQAA) completed on 22nd September 2008. At the time of the inspection, there were eight people who use the service living at Saxon Lodge. Most participated in the inspection, including the return of four written surveys to the inspector, often with the assistance of relatives. The fieldwork part of the inspection took place on 30th December 2008 and included a tour of the building, plus discussions with several people who use the service and five members of staff. A sample of key records was examined, including support care plans and staff files. What the care home does well The needs and aspirations of people who are considering using the service are thoroughly assessed and acted on wherever possible. Peoples individual needs and choices are very well assessed and acted on, so that people who use the service are supported in their daily lives and decision making and encouraged to take responsible risks to maximise opportunities for fulfilment. The service promotes person centred lifestyles that provide numerous opportunities for independence, choice, social inclusion and fulfilment. Typical comments received from people who use the service included: I got enough information about this home before I moved in so that I could decide if it was the right place for me. A thorough assessment over several months took place to ensure this was the right home for me. My Mum met with everyone involved with the home before she made a decision to let me move into the home. X cannot make any decisions on things he would like to do. Staff at the home have to make them for him on a daily basis and I think that they do it really well. I always make decisions about what I do each day. X needs 24 hour care...and he is very happy there...there is nothing that anyone of the staff wouldnt do for him...I could not have found a nicer home...the staff at the home I cannot praise enough for looking after my son. The staff always treat me well. The carers always listen and act on what I say. I know how to make a complaint. I dont know (how to make a complaint) but if my Mam thinks she needs to make a complaint, she knows how to make one. the premises were comfortable and always fresh and clean. The health and personal care of people who use the service is based on their individual needs and wishes. The principles of respect, dignity and privacy are put into practice. People who use the service have access to a robust, effective complaints procedure and are protected from abuse. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. Staff members are trained, skilled and in sufficient numbers to fulfil the aims of the home and the changing needs of people who use the service. The management and administration of the home is based on openness and respect, with effective quality assurance systems implemented by a highly experienced and well qualified, registered manager. What has got better from the last inspection What the care home could do better The service is committed to continuous improvement and has an action plan that is monitored and updated monthly. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Stephen Ellis St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB Tel. 0191 233 3300 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 needs and aspirations of people who are about to use the service are thoroughly assessed and acted on wherever possible. Evidence: Plans of care of three people who use the service were examined and found to be impressive in their detail and breadth of coverage concerning peoples assessed needs and aspirations, plus detailed risk assessments. They showed that a person centred approach was followed in supporting the people who use the service. Each person had the assistance of a key worker at the home and there was much written evidence to show that each persons views and feelings were taken into consideration by the service, including the meetings held regularly with the people who use the service by the support staff. The plans of care showed that people were only admitted to the service after a full assessment of their needs, wishes and aspirations had taken place. The service supports introductory visits and trial stays and provides full information to people who are thinking of using the service, plus their relatives and representatives. Each person who uses the service has a contract and a personalised service users guide, including pictorial information, to aid communication. Comments received from four people who use the service included: I got enough information about this home before I moved in so that I could decide if it was the right place for me. A thorough assessment over several months took place to ensure this was the right home for me. My Mum met with everyone involved with the home before she made a decision to let me move into the home. Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples individual needs and choices are very well assessed and acted on, so that people who use the service are supported in their daily lives and decision making and encouraged to take responsible risks to maximise opportunities for personal fulfilment. Evidence: Comments were received from four people who use the service or their representatives, such as relatives, and three plans of care were examined. Four members of staff, including the manager were also spoken with. People who use the service or their representatives confirmed that they were closely involved with the development and maintenance of their support plans of care and were encouraged to take responsible risks that were appropriate for the individual and their circumstances. Typical comments received included: X cannot make any decisions on things he would like to do. Staff at the home have to make them for him on a daily basis and I think that they do it really well. I always make decisions about what I do each day. All people who use the service have a key worker plus an assigned Social Worker from the Local Authority. There was much evidence of people being closely involved in personal decision-making and in decisions affecting the life of the home. For example, each person who uses the service has a detailed support plan, showing how each person should be supported in all aspects of daily living and decision making, including a 24 hour care plan in pictorial, user-friendly format. People who use the service are engaged in frequent discussions with their key workers and in group-meetings, where their views, opinions and choices are expressed and acted on wherever possible. Daily records of key events, decisions and activities are maintained for each person who uses the service. There are opportunities for people who use the service to be involved in staff recruitment and consultation about any proposed new admission to the home. Evidence: There are regular, multi-disciplinary reviews of peoples individual progress, plus monthly evaluations of the plans of care, involving each person who uses the service. Plans of care were found to be impressive in their thoroughness and attention to detail. Issues addressed included: confidentiality agreements, individual support plan, physical health, communication, personal care, mobility, social skills, finances, relationships, activities and holidays, living skills, behaviour, cultural and spiritual expression, medication, ageing, death and illness, decision making, risk assessments for each activity, diet, allergies, preferred daily routines, professional support networks, plus likes and dislikes. Within these documents, peoples wishes, aspirations and preferences were clearly recorded, using pictorial representations to aid communication wherever appropriate. A person centred approach is taken in the compilation of individual support plans and in the way in which people who use the service are supported. Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 service promotes person centred lifestyles that provide numerous opportunities for independence, choice, social inclusion and fulfilment. Evidence: Four people who use the service (some with the assistance of relatives) said that they enjoyed lifestyles that were individual and suitable for their wishes and needs. Activities and personal interests included music, television, helping with meal preparation, visits to and from relatives and friends, day service attendance, education and training, shopping, outings to places of interest (often in one of the homes two minibuses), hairdresser, sensory room, art and craft work, holidays and local community events. A dedicated activities coordinator is employed at the home. People who use the service confirmed that they kept in touch with their relatives and were supported to develop and maintain friendships with others where appropriate. They said that staff supported them well and were interested in their views and opinions about their daily lives and lifestyle choices. For example, clothing, meals, voting in political elections, plus personal activities and preferences are all discussed and people who use the service are supported to make choices and assisted in the achievement of personal goals. As one relative said: X needs 24 hour care...and he is very happy there...there is nothing that anyone of the staff wouldnt do for him...I could not have found a nicer home...the staff at the home I cannot praise enough for looking after my son. Comments received from staff supported well-documented records of individual activities, consultation and support with each person who used the service, often in pictorial format. Menus were observed to be varied and nutritious, reflecting peoples Evidence: dietary preferences. People may eat alone or with others and at preferred times. Aids and adaptations are supplied to meet individual requirements and staff always support and assist wherever needed. Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The health and personal care of people who use the service is based on their individual needs and wishes. The principles of respect, dignity and privacy are put into practice. Evidence: Four people who use the service (and/or their relatives) said that they were well supported in their personal care needs and lifestyle choices involving assistance or support. Typical comments included: The staff always treat me well. The carers always listen and act on what I say. Ten of the twenty permanent care staff have achieved National Vocational Qualifications in care at level 2 or above, which is good, and all have completed in-house training, including very good induction and foundation training, as confirmed by staff records. This approach to staff development helps to ensure very good personal care, based on sound caring values and principles, reinforcing the homes policies, procedures and philosophy of care. Each person who uses the service has an individual support plan that is person centred and wide ranging, covering all of the activities of daily living, along with careful risk assessments, so that only responsible risks are taken. Pictorial images are well used to aid communication. The health care arrangements for people who use the service were well documented in their support plans and showed that all health and social care professionals were engaged in constructive ways. These included local doctors, community nurses, social workers, occupational therapists, dentists, psychologists, hospital medical specialists, speech and language therapists, plus physiotherapists wherever appropriate. Comments from people who use the service or their representatives confirmed observations in support plans of high quality health care arrangements, designed to promote excellent outcomes in health and wellbeing. Peoples health history, needs and aspirations were very well documented. These plans of care for both personal and health care needs were frequently reviewed and updated Evidence: with the full participation of each person who used the service, involving their relatives, social workers and key workers (staff from the service assigned to each person who uses the service, who develop a special relationship with the person who uses the service so that their needs and wishes are better understood and facilitated). The plans of care were impressive in their detail and were person centred in their focus on the needs and wishes of the individual person who uses the service. Medication administration records for the people who use the service were examined and found to be very well maintained. Two members of staff sign for each medicine administered. A photograph of each person who uses the service is maintained on the record sheet to aid identification of the individual person. The service uses a monitored dosage system supplied by a local Pharmacist. All care staff members who administer medication have completed Safe Handling of Medicines training, which is accredited under the Further Education scheme (NCFE). Medication audits are carried out by the manager or designated staff member. Staff members undergo periodic competency assessment and refresher training in medication. Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who use the service have access to a robust, effective complaints procedure and are protected from abuse. Evidence: People who use the service are supported to approach staff with any concern or complaint they might have. Typical comments included: I know how to make a complaint. I dont know (how to make a complaint) but if my Mam thinks she needs to make a complaint, she knows how to make one. Staff members confirmed that they have had training in the protection of vulnerable adults and safeguarding procedures, plus whistle blowing. The service has a full, written policy within the home available for staff members to read and follow. Complaints and concerns are carefully recorded by the service and regularly checked by management. Any issues of concern are regularly discussed with people who use the service individually, or in group-meetings, and these are documented. A service review is carried out monthly. An external manager visits the home each month and talks to people who use the service about their experiences and any concerns or complaints, and these are recorded. Staff members are only appointed after extensive checks have been completed, including enhanced criminal record bureau checks, protection of vulnerable adults checks and the taking up of at least two references per applicant. People who use the service are involved in the interview and selection of prospective members of staff. 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: A tour of the building and examination of service and maintenance records showed that the premises are spacious, well maintained, well decorated and furnished, comfortable and clean. The home is very well equipped with aids and adaptations, including ceiling hoists, special beds (profile beds), hi-low baths and individual slings. All of the bedrooms have been personalised and are spacious singles (one has been adapted so that two twins can share). They can be safely locked and unlocked by the occupants (or by staff if desired). Most of the bedrooms have en suite facilities, including access to a bathroom between two bedrooms, or a shower room. There are generous communal areas on both floors, including lounges and kitchens. People who use the service said that the premises were comfortable and always fresh and clean. They confirmed that they are actively consulted about decor, furnishings and refurbishment. For example, each person chooses the decor and furnishing of their bedroom. Also, there are written environmental risk assessments and personal risk assessments concerning the use of the premises. Since the last key inspection, there has been on-going redecoration, re-carpeting and refurnishing of parts of the premises as required. Also, there is a very good sensory room. There are good fire safety and evacuation procedures, with clear instructions and regular checks being carried out, plus regular fire training and drills involving staff and people who use the service. Staff members and some people who use the service have undergone training in health and safety issues, including food safety and infection control. Liquid soap and paper towels are provided in communal toilets and bathrooms to minimise the risk of cross- Evidence: infection. 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 members are trained, skilled and in sufficient numbers to fulfil the aims of the home and the changing needs of people who use the service. Evidence: Very good procedures were evident in the recruitment and selection of new staff, including the involvement of people who use the service, in helping to select suitable candidates for employment. Careful checks are carried out on prospective employees, including enhanced criminal record bureau checks, protection of vulnerable adults checks and the taking up of at least two references. New staff members undergo an impressive induction programme and probationary period, which includes training in health and safety, infection control, moving and handling, first aid, fire safety and food hygiene. Such training is focused on working with people with learning disabilities. Service specific training is provided, including how to understand and work with challenging behaviour. Team training days are provided to ensure staff members are competent to deliver care and support plans for individual people who use the service, such as behaviour management plans that have been devised with professional guidance. Staff members confirmed the quality of training and support provided. Most staff training is accredited with the Learning Disability Award Framework (LDAF) and Skills for Care sector standards, or equivalent. There are numerous opportunities for computer-based electronic learning at the service, whereby staff can progress through learning programmes and examinations, leading to qualifications. Staff files were found to be well organised and detailed in relation to personnel information, qualifications, training needs analysis, induction and foundation training, plus specialist training to meet the particular needs of people who use the service. At least half of the twenty permanent members of care staff had achieved National Vocational Qualifications (NVQ) in care at level 2 or above. All staff members are required to register for NVQ awards in care, or health and social care, within 6 months of commencement of employment, unless they already have achieved these qualifications. Additional Evidence: training and the pursuit of further, relevant professional qualifications is promoted through staff training needs analysis, supervision and appraisal processes. Very good staff supervision and support procedures are in place, with each member of staff receiving 1 to 1 supervision at least six times per year. There are monthly team meetings, which each member of staff is expected to attend. Staffing levels were impressive, with typically at least 5 members of care staff on duty during the day between 7.30 am and 9.30 pm, and 2 awake members on duty at night. There is always at least one senior member of care staff on duty at any time and at least half of the full time managers hours are supernumerary (that is, not included in the care hours provided). Each member of staff has a key worker role and other specific responsibilities, clearly set out in their job description and contract. Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The management and administration of the home is based on openness and respect, with effective quality assurance systems developed and implemented by an experienced manager and wider management team. Evidence: The manager is highly experienced and well qualified with the Registered Managers Award (RMA) at National Vocational Qualification (NVQ) level 4, Certificate in Management Studies (CMS) and Registered Nurse in Learning Disability (RNLD). The home is well run, with strong emphasis placed on quality assurance. For example, the service completes monthly health and safety audits (based on daily and weekly checks of equipment and systems where appropriate, such as bedrails and water temperatures), regular meetings with people who use the service and with their key workers, staff supervision sessions and appraisals, team meetings, individual service reviews, monthly service reviews and annual service reviews (including the views of people who use the service, their relatives and external professional staff involved) plus audits carried out by external operations manager and advice and guidance delivered by regional quality assurance manager. Records and minutes are kept of all meetings. Line managers and/or advisors visit the home frequently, to monitor progress, offer support and guidance and to report on key issues such as performance and recommendations for improvement. A monthly report is made under regulation 26 of the Care Homes Regulations. Evidence of progress is available in the homes continuous improvement and business plan. Feedback from people who use the service is regularly obtained, including the use of annual satisfaction surveys involving relatives, and their views and opinions are reflected in the homes action plan. External agencies are also consulted about a range of issues, including fire safety, and their recommendations are implemented wherever appropriate. There is much evidence of Evidence: safe working practices carried on at the home, including regular moving and handling refresher training, plus fire training and drills. Are there any outstanding requirements from the last inspection? Yes  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 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 Description 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 Description Timescale for action 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. 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