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Inspection on 13/10/08 for St James Park Nursing Home

Also see our care home review for St James Park Nursing Home for more information

This inspection was carried out on 13th October 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home understands the importance of ensuring they have all the information necessary concerning a persons health and welfare prior to them moving in. All new residents receive a full comprehensive needs assessment before admission, records demonstrate this is undertaken sensitively. The manager ensures the home has obtained a summary of any assessment undertaken through the care management arrangements with the assisting local authority. Based on assessment information prior to the person moving to the home, a care plan is devised detailing how care needs are to be met, care files are regularly reviewed and updated to ensure care can be delivered satisfactorily and that all care needs are addressed in the daily routines. Residents at St James have access to healthcare services from local surgeries and are supported in meeting appointments with other health care professionals. Medication is well managed in the home. People living in the home are encouraged to make choices and decisions about their own lives and are able to pursue their preferred level of activity and recreational pass times. Residents maintain good levels of contact with friends and family and the local community. Residents living at the home are protected by the homes safeguarding policies and can be assured that any concerns or complaints will be taken seriously and acted upon. The home provides comfortable, clean and well appointed and maintained accommodation that meets residents needs. There is a selection of communal areas, where residents can sit quietly, meet with family and friends or be actively engaged with other residents. There are sufficient numbers of trained staff on duty to meet residents needs. The recruitment process ensures that all staff employed are suitable to work with vulnerable adults. St James is well managed and Mrs Holden has a good understanding of the principles and focus of the service, Mrs Holden is supported by the homes senior staff team and it was evident from discussion that the management systems are transparent.

What has improved since the last inspection?

There were no requirements from the last inspection. Of three recommendations one has been repeated regarding the level of training for care staff to achieve the NVQ level 2 award, this was not inspected during this visit.

What the care home could do better:

Whilst it is recognised that all services can strive for continuous improvement, this inspection has not resulted in any areas where it is required that St James Park make improvements to services or facilities provided to residents, this was a very positive inspection. Two recommendations are made in this report, one carried over from the last inspection. The second recommendation concerns an audit of medicines within the home, this was discussed with the senior nurse on duty and the manager and their positive attitude toward developing a system of audit assured the inspector that this would be addressed.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: St James Park Nursing Home St James Park Nursing Home Bradpole Bridport Dorset DT6 3EU     The quality rating for this care home is:   three star excellent 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: Jo Palmer     Date: 1 3 1 0 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 26 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 26 Information about the care home Name of care home: Address: St James Park Nursing Home St James Park Nursing Home Bradpole Bridport Dorset DT6 3EU 01308421174 01308427564 holdehe@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Helen Holden Type of registration: Number of places registered: BUPA Care Homes (CFC Homes) Ltd care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 46. The registered person may provide the following category of service only: Care home with nursing- Code N to service users of either gender whose primary care needs on admission to the home are within the folllowing category: Old age, not falling within any other category- Code OP Date of last inspection Brief description of the care home St James Park is a large care home registered to provide nursing care to a maximum of 46 older people, owned by BUPA Care Homes (CFC Homes) Limited. The nominated Responsible Individual; is Mrs Greenwood. The home is situated in the quiet country village of Bradpole, a short drive away from the town of Bridport. The home is close to a bus route, with a bus stop within walking distance for buses to and from Bridport. Care Homes for Older People Page 4 of 26 Over 65 46 0 Brief description of the care home The accommodation is arranged over three floors and a passenger lift provides access to all floors of the home. Currently available for use are 30 single and six double bedrooms; most have en-suite facilities. (Some rooms registered for use as bedrooms are not routinely used for this purpose.) Communal rooms include a lounge, library, conservatory style dining room, three communal lounges (including one with a large dining area), five assisted bathrooms and one assisted shower. Laundering of clothing and household linen is carried out at the home and arrangements can be made for chiropodists, opticians and other health and social care professionals to visit individual residents. Fees are charged weekly; at present fees range between #544 and #800 per person. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1A65A7AFD347B/0/oft780.pdf Care Homes for Older People Page 5 of 26 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 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 inspection took place on 13th October 2008 between 09.45 and 16.00. Helen Holden, registered manager was present who assisted with the inspection process. The main purpose of this key inspection was to check that the residents living in the home were safe and properly cared for and to review the homes performance against the key National Minimum Standards. The last key inspection of this service took place in October 2007, a further random inspection took place in February 2008 where it was noted that requirements made at the key inspection had been addressed. The inspector spoke with seven residents, one visitor, the chef, two staff members and the manager, took a tour of the premises and examined relevant records. The Commission for Social Care inspection sends each home an AQAA (Annual Quality Assurance Assessment) at the start of each inspection year, the completed AQAA for St Care Homes for Older People Page 6 of 26 James Park was reviewed to further inform this report. Five questionnaires were returned from service users and are commented on as relevant throughout this report, either a relative or the homes activities coordinator had completed all five on their behalf. 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 set out on page 4. Care Homes for Older People Page 8 of 26 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 26 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 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user guide contains relevant information about the home providing prospective residents and their representatives with an accurate understanding of the people for whom the service is intended. Prior to admission, the needs of each proposed resident are assessed to ensure the home will be properly able to meet them. The home does not provide Intermediate Care so Standard 6 does not apply. Evidence: The service user guide is made available to all residents and prospective residents. A recommendation of the previous key inspection has been partly addressed and the Service User Guide has been produced in a larger print. Helen Holden, the registered manager confirmed that as part of the guide concerns BUPA as an organisation, the company would consider any further review of the format. The records of three residents admitted to the home since the last key inspection were reviewed, these Care Homes for Older People Page 11 of 26 Evidence: included details of pre admission assessment which had been carried out prior to the person agreeing to take up residence at St James; the assessments evidenced the persons, and their representatives, involvement in the process. As well as the assessment of needs, the person is invited to visit the home in order that they can make their own assessment of its suitability, where the person is unable to do this, their relatives or representatives are invited to attend. Following pre admission assessment of the persons needs and circumstances the home writes to them confirming agreement and ability to accommodate and care for them; a copy of the letter of offer is kept on file. Care Homes for Older People Page 12 of 26 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. Systems are in place to provide staff with the information they need to meet the health and personal care needs of residents. The principles of respect, dignity and privacy are put into practice. Evidence: Following from an assessment prior to admission, the resident moves to St James where further, more detailed assessments are undertaken using set, well established assessment criteria. All aspects of the persons health, welfare and personal care needs are considered and a plan of care identified instructing staff on how the needs are to be met. Care plans demonstrate that each aspect of the persons daily routine is considered and made known to staff in order that they may assist them correctly and provide specialist support where needed. Care records are well organised, consistent and rational with each assessed need being followed by an action plan. Each aspect of the care plans are reviewed regularly to ensure any changes to the residents health are identified and made known to staff. Helen Holden, registered manager confirmed that in addition to written care plans, residents needs and how these are to be met Care Homes for Older People Page 13 of 26 Evidence: throughout the day are also identified to staff daily at each shift handover where discussions take place concerning residents progress and general well being. Staff record daily the care they have provided and although sometimes brief, this record demonstrates that each area of the care plan has been implemented. The record also identifies any other significant events for the resident such as appointments, visitors, social activity etc. It was evident that residents and their representatives are party to the ongoing assessment and care planning processes and are kept informed of changes to care programmes necessitated by changing needs. Medication systems were examined, locked storage facilities are used to hold medicines securely. Storage of medicine stocks were noted to be in order with records supporting the use of the monitored dosage system. The monitored dosage system is used for most medications although where medicines are not suited to this type of packaging, they are issued in boxed or bottled containers; these had not been dated on opening and did not all audit with records of medicines held and administered for residents. The registered nurse spoken with confirmed that an audit system was in the process of being established although had yet to be finalised. It is recommended that an audit of medicines is undertaken at scheduled intervals to ensure all medicines are used and stored accordingly. Residents spoken with said that they were treated well and that staff were kind, friendly and respectful and were available when needed, three residents spoken with were confused and unable to comment. Staff were seen to treat residents with courtesy, patience, kindness and diligence. Of five returned questionnaires, the question Do you receive the care and support you need? had been answered usually by three and sometimes by two service users. All five respondents confirmed that staff listen and act on what they say, three confirmed that they always receive the medical support they need and two answered that they usually do. Care Homes for Older People Page 14 of 26 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 able to enjoy a fulfilling programme of activity either individually determined or group activities as far as their individual abilities allow with a variety of resident focussed options to choose from. The home has sought the views of residents and considered their varied interests and abilities when planning the routines of daily living and arranging activities. Routines are flexible and residents are encouraged to make informed choices. An activities coordinator is responsible for creating meaningful activities for groups of residents or individuals. Visitors are welcome at any time. Food is considered to be highly important and the cook in the home is an important member of the care team who is aware of the dietary and needs of each resident. The menu is varied, balanced and nutritious and includes choices with a vegetarian option. Food is served to meet the needs of residents including those who have swallowing or chewing difficulty. Staff give assistance to those service users who need help to eat. Evidence: Care files examined evidenced that each residents social care and recreational needs are taken into consideration through assessment to care planning. Those residents spoken with during this inspection that were able to comment confirmed that their social needs and expectations were met. Records held relating to residents daily lives Care Homes for Older People Page 15 of 26 Evidence: in the home confirmed that they maintain contact with their friends and family and visitors are welcomed to the home. An activities coordinator is employed who arranges suitable activities; on the day of inspection, a game of Bingo was being played in the lounge, 13 residents and one relative were either participating or listening and the manager assisted one resident to play. The returned AQAA (Annual Quality Assurance Assessment) completed prior to this inspection identified that social care could be further improved by the provision of more outings. The AQAA identifies how over the last year, residents have been more involved in planning their recreational activity through use of Activities Questionnaires. Visitors are welcome at any time, one spoken with said they are always made to feel welcome and that staff are supportive and helpful. Residents are provided with three meals a day, breakfast by individual choice, the main midday meal and supper from a menu offering choices and providing a variety of nutritious and appetising dishes. Residents can take their meals in the homes dining area or in their rooms. The home has two chefs who work shifts over each weekly period. The cook spoken with during the inspection was enthusiastic and keen to provide a good service and was knowledgeable about residents dietary requirements. Residents spoken with without exception highly complimented the provision of meals in the home. In June 2008, St James received 5 stars following their Environmental Health food standards inspection. Four returned questionnaires confirmed that they usually enjoy the meals in the home whilst one responded that they always do. Care Homes for Older People Page 16 of 26 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. Policies, procedures and staff training programmes are in place to protect the residents living at the home. Residents can be assured that they can express any concerns they may have and that any incidents will be managed appropriately Evidence: Residents and their representatives are provided with a copy of the homes complaints procedure, this is also included in the Service User Guide. No complaints have been received by the Commission for Social Care Inspection, a record held detailed that one complaint that had been received by the home had been managed effectively and within the time scales laid down in the complaints procedure, it was evident that the complaint had been resolved to a satisfactory conclusion. Of five residents who responded to questionnaires, all confirmed that they would usually know who to speak to if they were unhappy and four stated that they would know how to make a complaint, one did not know. Adult protection procedures are in place detailing the correct action to be taken should any concerns or allegations be made. The home holds a copy of local authority and Department of Health guidance on adult protection matters and all care staff have received training in adult protection and recognising abuse. One referral investigated since the last inspection has been concluded and no further action is required. Care Homes for Older People Page 17 of 26 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 are encouraged to see the home as their own home. St James is well maintained, safe, comfortable and attractive and has specialist equipment and adaptations needed to meet individual residents need. All staff members are trained in the safe use of aids and equipment. Most of the rooms have en suite facilities and shared bathrooms are accessible which are comfortable, easy to use and well appointed, assisted showers and baths are available. There are a number of toilets placed around the home. There is a selection of communal areas and residents have a choice of place to sit quietly, meet with family and friends or be actively engaged with other residents. The home operates an infection control policy, is kept clean and well maintained. Evidence: Residents spoken with confirmed that they are comfortable in their rooms and are able to bring personal effects to make their space more homely; a tour of the premises viewing some rooms evidenced this and that they were clean, well maintained and homely. Many bedrooms have en suite toilet and wash facilities. Shared bathrooms are available with suitable aids and adaptations to assist residents and toilets are sited conveniently around the home. All bathrooms and toilet areas seen were well equipped and of a good standard. All resident areas have emergency alarm call points should they be needed by residents requiring assistance. Communal areas of the home Care Homes for Older People Page 18 of 26 Evidence: include lounge areas and a dining room, these were noted to be well furnished and decorated, clean and comfortable. The completed AQAA submitted prior to this inspection confirmed that in the past twelve months some new furniture has been purchased to upgrade a small lounge area, the outside patio area has also been upgraded with seating, a mural and new plants. The home was clean and well maintained at the time of inspection. Infection control procedures are in place with suitable hand washing facilities for staff. Residents spoken with confirmed that the laundry systems in the home work well and that their clothing, bedding etc is returned promptly, clean and in good condition. Three of the five returned questionnaires from residents confirmed that the home was always clean and fresh whilst two stated that it usually was. Care Homes for Older People Page 19 of 26 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. Residents have confidence that the staff at the home are able to meet their needs. Rotas show that the home is staffed efficiently and the staffing structure is clearly defined. Management are aware of the benefits of a skilled, trained workforce and invest in training programmes to ensure all staff are up to date. There is a good recruitment procedure that is followed in practice for the protection of residents. Evidence: Staff rotas seen demonstrate that there are sufficient numbers of staff on duty to meet resident needs. Residents confirmed that staff are available when they need them. There are two first level registered nurses on each day shift with 5 or 6 care assistants on duty each morning and 3 or 4 each afternoon. At night there is one first level registered nurse and 2 health care assistants. Staff training files seen demonstrated that each staff member undertakes training and regular up dates in mandatory subjects relating to health and safety such as moving and handling, infection control, food hygiene, first aid, health and safety and fire safety. Additionally, clinical updates are undertaken to ensure that the trained staffs registration remains current and that they continue to meet residents needs. Helen Holden registered manager confirmed that all new staff undertake the induction programme which conforms to Skills for Care induction standards. BUPA Care Homes have also devised their own training programme called Personal Best which forms part Care Homes for Older People Page 20 of 26 Evidence: of the induction and all staff have taken part in. In speaking with staff, this training programme was appreciated with staff commenting that it was a really useful learning tool. Staff files examined also demonstrated that good practice is used when recruiting staff, all mandatory checks are undertaken and pin numbers are verified. No staff member commences employment before a satisfactory POVA check and CRB have been carried out. Staff files hold all the necessary information concerning each staff member as required by the Care Homes Regulations. A recommendation of the last inspection is repeated as the number of staff who have attained NVQ level 2 was not reviewed. The AQAA completed by Mrs Holden prior to this inspection identifies an increase in NVQ training as an area they could do better in. Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that the home is well managed and that systems are in place that centre around their care needs. Management practices and records kept, confirm the health and safety of people in the home. Evidence: Helen Holden, registered manager of St James is a first level registered nurse and a competent manager with a Certificate in Management Studies and NVQ level 4, who is able to efficiently run the home with the support of a cohesive staff team. Residents spoken with confirmed they were happy with the management arrangements stating that Mrs Holden and the staff were available when needed. The Commission for Social Care Inspection send all care homes an AQAA (Annual Quality Assurance Assessment) at the start of the inspection year (April). A completed AQAA which provided detail of the homes intention to continue to monitor and evaluate the quality of service provided was submitted which identifies what the home feels they do well and sets out their plans for improvement over the next twelve Care Homes for Older People Page 22 of 26 Evidence: months. The last inspection reported on the homes ongoing quality assurance processes, these were not reviewed during this visit. For those residents requesting assistance in managing their personal allowances, the home has thorough policies in place providing careful safe management procedures. Sums of money received on behalf of residents are banked in an interest bearing account, monies are available to residents for purchases as required. Staff are trained in all relevant health and safety matters including fire, first aid, moving and handling, infection control and COSHH (Control of Substances Hazardous to Health). Details of equipment servicing and maintenance were examined including the records of regular checks and tests of fire safety equipment and lifting equipment. The last inspection report made the recommendation that a detailed escape plan with reference to residents accommodated was included in the fire risk assessment, Helen Holden confirmed that this is nearly complete although before being finalised they are waiting for confirmation from residents representatives and the fire chief that the escape plan is acceptable given the needs of the current residents. Care Homes for Older People Page 23 of 26 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 24 of 26 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 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 An audit of medicines should be undertaken at scheduled intervals to ensure all medicines are used and stored accordingly At least 50 percent of care staff should be trained to NVQ level 2 or equivalent. 2 28 Care Homes for Older People Page 25 of 26 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. 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