Inspection on 19/05/09 for St Davids Lodge

This inspection was carried out on 19th May 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Davids Lodge 21/05/08

St Davids Lodge 23/05/07

St Davids Lodge 16/05/06

St Davids Lodge 02/11/05

St Davids Lodge 01/06/05

St Davids Lodge 08/02/05

St Davids Lodge 26/08/04

St Davids Lodge 04/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Key inspection report Care homes for older people Name: Address: St Davids Lodge 98 Lodge Causeway Bristol BS16 3JP     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sandra Jones     Date: 1 9 0 5 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: St Davids Lodge 98 Lodge Causeway Bristol BS16 3JP 01179656965 01179656965 hazelprycejones@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Clive Pryce-Jones,Mrs Hazel Lilian Pryce-Jones care home 11 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: May accommodate up to 11 persons aged 50 years and over Date of last inspection Brief description of the care home St Davids Lodge is a care home for people with learning disabilities. Since conducting the last inspection, the service provider has sought to increase the registered numbers. The application was successful and the home is now registered to accommodate 11 people with learning disabilities over 50 years. The property is situated on the Lodge Causeway, close to the Fishponds Road, shops, other amenities and bus routes. The property is detached and arranged over two floors with shared space on the ground floor and personal space on both floors. It has the appearance of a domestic dwelling and blends well with its local environment. 11 Over 65 11 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection was conducted unannounced in May 2009 over one day and focused on the assessment of key standards. The main purpose of the visit was to check on the welfare of the people who use the service, ensure the premises are well maintained and to examine health and safety procedures. During the site visit, the records were examined and feedback was sought from individuals and staff. Prior to the visit some time was spent examining documentation accumulated since the previous inspection. This information was used to plan the inspection visit. Have your say surveys were sent to people who use the service and health care professionals. Four completed surveys from people and the home and one from the GP were received. Ten individuals were living at the home at the time of the inspection and four people Care Homes for Older People Page 5 of 28 were case tracked. Case tracking is the method used to assess whether people who use services receive good quality care that meets their individual needs. The inspection included looking at records such as care plans and reviews of the care of people using the service and other related documents. The homes policies and procedures were also used to confirm the findings. The views of the people living at the home, members of staff and the service provider were gathered through face-to-face discussions. 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 order line 0870 240 7535. Care Homes for Older People Page 7 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 8 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Statement of Purpose defines the aims and objectives of the home, the range of facilities and pre-admission assessments ensure the individuals needs can be met by the staff at the home. Evidence: The Statement of Purpose in format people about the aims, objectives, facilities and range of needs that can be met by the staff at the home. St Davids Lodge accommodates people between the ages of 50 years and over with learning disabilities. The admission procedure is included within the Statement of Purpose and describes the process followed to ensure that staff have the skills to meet the needs of the people wishing to live there. In advance of any admission to the home, social workers needs assessments must be provided and to fully establish that the person is suitable, introductory visits and trial periods are offered. Care Homes for Older People Page 9 of 28 Evidence: The people currently accommodated have been living at the home for sometime. There is one current vacancy and the home is actively seeking to fill the vacancy. Surveys were used to seek the comments from people at the home about the admission process. We were told that they were asked if they wanted to move to the home and they received enough information so that they could make decisions about moving into the home. Care Homes for Older People Page 10 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and Personal care is based on the needs of the people at the home and staff respect their rights. Care plans must show that people have a say about the way their care is to be delivered. Evidence: The service provider said that with the exception of one, review meetings were convened by the placing authority for the people currently living at the home. Review meetings with the person present, where appropriate their relatives and staff at the home ensure that where individuals needs change, a discussion takes place about the amendments needed to continue meeting their needs. Individuals care plans are in place and up to date for the people living at the home. While the care plans guide the staff on the actions to be taken to meet the need, there is little evidence that people had input into their care plans. Care plans must show that people at the home have a say about the way their care is to be delivered, which can be achieved by incorporating their likes, disliked and preferred routines. Care Homes for Older People Page 11 of 28 Evidence: Members of staff were consulted about their involvement in the care planning process. We were told that the care plans are generally devised by the service provider and staff make suggestions about the information to be included in the care plans. It was also stated that staff must record their observations of the individuals, outcomes of visits and activities undertaken. Advocates are used to support individuals with communication needs to make decisions about all aspects of their lives. Care plans must be clear about the way decisions are made by the person. Risk assessments are in place for individuals that may at times exhibit aggressive or violent behaviors. The information about the actions to be taken must be more detailed to ensure that the actions to be taken to diffuse or divert behaviors are not open to staffs interpretations. Personal care needs are included in the care plans and guide the staff to undertake the task. The number of staff needed and the actions necessary to undertake the task are stated within the care plan. A record of health care visits is maintained and demonstrates that people visit GPs, access NHS facilities that include chiropodists, optician and dentist. People at the home also attend hospital appointments for specialist support from health care professionals. Staff confirmed that they accompany people on health care visits and described the way medical information is passed on. It was explained that through handovers and daily report information is passed on to staff. Comments were sought from the GP through surveys. We were told by the GP that the inidviduals needs are met by the staff and staff have the skills to meet their needs. The dietitian is involved with two people that have nutritional needs which includes diabetes and weight maintenance care. People that have been diagnosed with dementia since their admission to the home are accommodated. The individual has input from the psychiatrist through the Community Learning Disability Team (CLDT). Reports show that the staff monitor the individuals needs and care plans in place list the way their dementia manifests itself. Two people have manual handling needs and risk assessments in place ensure that any lifting techniques are appropriate. Manual handling risk assessments state the most appropriate equipment to be used so that the maneuver can be done safely. Care Homes for Older People Page 12 of 28 Evidence: Hoists, Stand Aids, and handling belts are used by the staff to support people with mobility impairments. The individuals rights are specified within the homes Statement of Purpose, with an additional policy on Privacy and Dignity. The policy sets out the purpose and expectation of the staff to ensure that individuals rights are respected. Feedback was sought from staff about the way the individuals rights are respected. Examples such as knocking on doors, speaking at eye level abd health care check conducted in private were given about the way the people living at the home are respected. The people consulted confirmed that the staff respected their rights. Medications are administered through a monitored dosage system and the records checked correspond with the medications held. Staff use codes to record the reasons for administering medications prescribed. A record of medications no longer required is maintained and signed by the pharmacist to evidence receipt of the medication for disposal. Staff told us that all staff must be competently trained to administer medication Care Homes for Older People Page 13 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home must have better opportunities for social, learning activities. The visitors of the people living at the home are welcome and a varied diet is served at the home. Evidence: Four people attend day care services up to twice weekly. Six people have no structured day care service and in-house activities are provided for these individuals. Members of staff record in-house activities undertaken and the records show that generally people watch television. Residents meetings are held regularly to discuss topical issues and to make decisions about the menus changes and trips. There is a vehicle available for trips and to take people to day care services. People at home go on regular trips to the seafront and during the inspection staff accompanied four people on a day trip to the seafront. One person is able to leave the home to visit local shops without staff support. Three people told us through surveys that they were able to make decisions about Care Homes for Older People Page 14 of 28 Evidence: what to do each day and one person said that this was sometimes. While it is acknowledge that people go on regular trips and four people attend structured day care services, people at the home must have more personalised opportunities for social, leisure and learning activities. Feedback was sought from staff about the way they engage with people at the home. They told us that they did puzzles, sat with individuals and watched the television. It was also explained the hobbies of each person and these included crotchet, watching television and knitting. Staff said that the people at the home are not sitting bored watching the television, they said that people at the home do whatever they want and they interact with people. The manager acts as appointee for people at the home as there is no NOK available to manage their finances. A previous requirement, was made but not checked at this inspection and will be repeated through this report. The service provider must develop a procedure on managing individuals finances which must be clear about acting as appointee. Additional information about the responsibilities of the role and other financial responsibilities undertaken must be included . The homes visitors policy acknowledges that maintaining contact is essential to the people living at the home. The arrangements for visiting are open and individuals friends and family are welcome to the home. There is a visitors book and visitors to the home must record the date and nature of their visit to the home. Four people have relatives that visit and staff support one person to maintain phone contact with their family. Staff told us that visits are welcome at the home, relatives are informed about important issues and visits can be conducted in bedrooms for additional privacy. People at the home confirmed the comments made by the staff about the visiting arrangements. There is a rolling menu and shows that people at the home have a continental style breakfast, a light lunch and cooked tea except on Sundays when a roast is served at lunchtime. A list of the individuals likes and disliked is kept in the kitchen so that only the preferred meals are served and the record of food provided confirms that people eat the meals served. There is a good range of fresh, frozen and tinned foods and supports that people have a varied diet. Comments about the food were sought from people at the home and they told us that Care Homes for Older People Page 15 of 28 Evidence: the food is good and I get what I want to eat. 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. People at the home and their relatives can be reassured that their concerns will be taken seriously and acted upon, People at the home are safeguarded from abuse Evidence: The homes Complaints procedure is included in the Statement of Purpose. The service provider told us that a symbolised version with pictures and words will soon be available. Until the symbolized procedure is available, it is discussed at residents meetings to ensure people know the steps they need to take when making complaints. There were no complaints received at the home since the last inspection. Comments about the way people at the home are supported to make complaints was sought from the staff. Staff told us that complaints made by people at the home would be passed onto the service provider. It was further stated that where people have communication needs, advocates would be used to support the person. People living at the home were asked about making complaints. They said that the service provider would be approached because that is what they have been told to do. Surveys were received from four people and they told us that knew who to speak to if they were not happy and how to make a complaint. The Safeguarding Adults policies and procedures in place commit to protecting Care Homes for Older People Page 17 of 28 Evidence: individuals from abuse. Safeguarding Adults training is provided through videos and staff confirm that they have attended the training. In terms of Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DOLS) training, the service provider told us that this training is provided through the Local authority and will be attended. There are no Safeguarding Adults referrals outstanding. 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. People at the home live in well maintained and homely environment. Evidence: St Davids Lodge is located on Lodge Causeway, close to the Fishponds Road, shops, amenities and bus routes. The property is surrounded by residential and industrial environment and, maintains an appearance of a domestic dwelling. It is arranged over two floors with bedrooms on both floors and shared space on the ground floor. There is level access into the home and a passenger lift ensuring that people with mobility needs can maintain their independance with moving around the home. Shared facilities consist of a lounge/dining area and conservatory. The lounge has seating for eleven people and in the dining room there is sufficient seating for the people accommodate to have their meals together. Two individuals were consulted about their personal space and one person said they had a beautiful bedroom and another said nice place, nice people. Surevey comments from people at the home about the environment indicated that the home is always fresh and clean It is evident from the tour of the premises that the service provider continues to upgrade the property to meet the changing needs of the people at the home. Since Care Homes for Older People Page 19 of 28 Evidence: the last inspection, the service provider has changed the upstairs bathroom into a wet room with a disabled toilet and assisted bath. Assistive technology is currently used for people that have seizures and to alert staff when people leave the property. This ensures that staff are aware that people need support at night or to leave the staff. It was noted that a stair gate is in use, the service provider said that this is the most suitable method because asssistive technology would prevent other people from using the stairs. A risk assessment must be completed to ensure that this is the most suitable method of preventing individuals from falling down the stairs. The laundry room is sited upstairs away from the kitchen. The floor covering is impermeable and the walls are painted making the surface readily cleanable. The washing machine is suitable for the number of residents accommodated and has a specified programme for disinfection 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff have the skills and the experience to meet the needs of the people at the home. Staffing levels must increase to ensure that staff can support the people living at the home. Evidence: Since the last inspection staffing levels have fallen with the resignation of the cook and ancillary staff. The two support workers rostered throughout the day are now doing a combination of cooking, cleaning and caring tasks. This gives raise to concern about the way people are supported when the staff are undertaking cooking and cleaning tasks. The service provider told us that steps are been taken to recruit more staff. At present there are two staff rostered throughout the day and night with two staff awake at night. We were told that there are 35 vacant hours and once these are filled a third person will be rostered to work from midmorning to mid-evening. The service provider has purchased a training package which is delivered through videos and questionnaires to check staffs understanding. It is evident that since the last inspection there has been an emphasis on ensuring that staff attend statutory training. Food Hygiene, Moving and Handling, First Aid, Infection Control and Health and Safety training was provided to the staff. Care Homes for Older People Page 21 of 28 Evidence: Dementia training to meet the needs of people at the home diagnosed with dementia will be provided by the OT to the staff. Four new staff were employed since the last inspection and their personnel files were checked to determine the recruitment process followed at the home. The completed application forms seek the candidates employment history, disclosure of criminal background and names of two referees. Written references were validated by the professional referees and Criminal Records Bureau (CRB) checks were obtained which supports a robust recruitment process. Comments about the staff were sought from the people at the home and we were told that the staff were ok even the night staff. Survey comments from people at the home indicated that they are treated well by the staff and they listen and act upon what they say. 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 will benefit from a better understanding and application of best practice to develop standards of care. People at the home live in a safe environments and can be reassured that standards are subject to ongoing monitoring. Evidence: Comments were sought from the service provider about the direction the home is taking. We were told that steps are been taken to raise the standards of care and to ensure the home is following the correct path, training and care plan have improved. While the service provider is reassured that people at the home are safe and receive good quality care, it was recognised that the understanding and application of best practice is needed. In terms of the systems that maintain consistency at the home, the service provider told us that individuals supervision to discuss performance and training needs is used. We were told that each member of staff has six supervision sessions per year. However, supervision has not occurred within the last eight weeks. The service Care Homes for Older People Page 23 of 28 Evidence: provider must ensure that staff have supervision within eight weeks to ensure that consistency is maintained. The staff at the home were consulted about their role at the home and the arrangements for management presence. The deputy described their role which included managing the shift, ordering and administration of medications and organising appointments and activities. The senior support worker told us that the role included supporting people with personal care, preparing meals, administration of medications and supervising care assistants. Fire risk assessments were reviewed following a visit from the Avon and Fire Rescue and since the visit, supplementary information was added. This ensures that the potentially of fire in the premises is fully assessed and preventative measures put in place. The service provider ensure compliance with associated legislation and contractors are used to maintain equipment and systems. The gas boiler, passenger lift, portable equipment and lifting equipment is services annually to ensure they work efficiently and safely. Facilities for the safekeeping of cash and valuables exist at the home and the sample check of cash corresponded with the records. The home operates a Quality Assurance system which seeks feedback about the standards of care at the home. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 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 7 12 The manager must ascertain 03/08/2009 and take into account the wishes and feelings about the care to be provided. Care plans must show that people at the home have a say about the way their care is to be delivered by the staff. 2 7 17 The manager must record 03/08/2009 details of the individuals communication needs and methods of communications. For people that have communication needs the manager must ensure that care plans details the way they make decisions. 3 12 16 The registered provider must consult with people at the home about the programme of activities to meed the needs of the people at the home. 03/08/2009 Care Homes for Older People Page 26 of 28 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 The manager must ensure that people at the home have personalised care and have opportunities for social, leisure and learning activities. 4 27 18 The manager must ensure that the staffing levels are appropriate to meet the needs of the people at the home The manager must ensure that the staffing levels meet the needs of the people accommodated at the home. 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 06/07/2009 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. 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