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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 104 Highlands Road 104 Highlands Road Fareham Hampshire PO15 6JG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Chris Johnson     Date: 0 5 0 2 2 0 0 9 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. 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. 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. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: 104 Highlands Road 104 Highlands Road Fareham Hampshire PO15 6JG 01329849399 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Proactive Care Providers Ltd care home 10 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home 10 10 104 Highlands Road opened in December 2006. It is a purpose built residence for ten people with learning disabilities. There are four flats on the first floor and two en suite single bedrooms. The ground floor provides accommodation for 8 people in single en suite bedrooms. The flats have their own shared access or can accessed via the main home. Therefore people living in the flats can be independent, or involved in the life of the main home as appropriate to their needs and wishes. There is an enclosed garden. The home is close to local shops and a doctors surgery. We do not have the current fees. Anyone requiring this information should contact the provider directly. Care Homes for Adults (18-65 years) Page 4 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of this inspection was to assess how well the home is doing in the meeting of all key National Minimum Standards, compliance with regulations, previous requirements and to assess what the outcomes are for people who live at his home. The findings of this report are based on a number of different sources of evidence. These included: An unannounced visit to the home, which was carried out over one day on 5th February 2009, whereby we looked at all key standards and followed up on requirements that were outstanding from previous inspections. All regulatory activity since the last inspection was reviewed and taken into account including any notifications sent to the Commission for Social Care. The person managing the home completed an Annual Quality Assurance Assessment (AQAA) prior to this inspection. Care Homes for Adults (18-65 years) Page 5 of 29 Information recorded in that document was taken into account and forms some of the evidence for this report. During this visit we looked at the physical environment including, peoples flats and all communal areas of the home. Staff and care records were inspected. Some members of staff were spoken with and others were observed during their day to day interactions with those living at the home. We examined records, policies and procedures. We spoke briefly with the people living at the home. The person managing the home was present throughout the visit to answer questions and discuss issues. 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. 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 –03000 616161. Care Homes for Adults (18-65 years) Page 7 of 29 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 Care Homes for Adults (18-65 years) Page 8 of 29 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. Peoples needs are assessed prior to admission so that the individual and the home can be sure that the home is right for them and will meet the persons needs. Evidence: The last time that we visited this home we were unable to fully assess this outcome area as there was not anyone living at the home. At the time of carrying out this inspection there were three people living at the home. We looked at the assessment information obtained by the home and the homes assessment process in respect of the most recent admission to the home. We saw that the person had been assessed by the staff team from 104 Highlands Road and that as part of the assessment process staff from the home had visited the person at their last place of residence on several occasions. The assessment material and documentation used by the home was comprehensive and covered subject areas such as; the persons personal history and their social, educational, spiritual, personal and care needs. The assessment had taken into account any risks involved in meeting the Care Homes for Adults (18-65 years) Page 9 of 29 Evidence: persons needs and the level and type of staff support needed to address their needs and associated risks. The person had been able to visit Highlands Road in order for them to assess and decide if the home was right for them. Discussion with the person managing the service, discussion with staff and documentation demonstrated that the process had not been rushed and that the assessment had been thorough. Care Homes for Adults (18-65 years) Page 10 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Improvements are being made to the content recorded in care plans. This means that staff have better guidance to follow to support people in a way that takes into account peoples preferences. It would be of further benefit for people if the plans were produced in a format suitable to their needs. Risks to people living at the home and or others are identified and systems are in place to minimise them. People living at the home are supported to take risks as part of their everyday lives. Evidence: The last time that we visited this home on 5th February 2008 we were unable to fully assess this outcome area as there was not anyone living at the home. At a previous Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: inspection carried out on 28th June 2007 we found that the home relied on the plan the person living at the home brought with them, rather than develop their own. It was also found that care plans were not being reviewed regularly or that there was not enough guidance for staff about how to manage aggressive behaviour or what action they needed to take to support people when they became aggressive. During this visit to the home we examined all three peoples care plans. The person managing the home explained that care plans were being developed and put into a different format due to the fact that the person managing the home recognised that there were shortfalls in the old format. Some parts of the care plans had been transfered to the new format. It was noted that information recorded in the new format was more detailed and comprehensive than the old format. The results of staff surveys were that two members of staff responded that they were always given up to date information about the needs of the people that they supported and one responded usually. One person commented, Both the manager and senior manager try to listen to all staff concerns about the service users. The care plans looked at demonstrated that people were encouraged and supported to take risks as part of their everyday lives. Their care needs had recently been reviewed and we saw evidence that people were involved in planning their care and setting their own goals. Within the care plans there were specific and detailed guidance for staff to use when supporting people with their personal care needs. Risk assessments had been completed for a variety of different activities and detailed written management plans were recorded where necessary. These provided evidence that the activity had been thoroughly assessed and thought through and that steps had been taken to minimise any harm to the person or others. Care plans looked at provided guidance for staff in the event of aggressive behaviours and included the triggers and signs of someone putting themselves or others at risk. Information recorded in the Annual Quality Assurance Assessment (AQAA) told us that the home were planning to introduce weekly meetings for people living at the home, To discuss weekly events and any changes or ideas for change regarding the service. The AQAA also stated that they were planning to introduce a key worker system, Where service users will have a specific person allocated to them. Key workers will advocate on behalf of service users and assist them to express their views and opinions. We were informed during our visit to the home that neither of these had yet been implemented. The person managing the home said that the meetings needed to be implemented and that they did not intend to introduce the key worker system until Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: they were fully established. Evidence seen during the visit, observation and brief conversations with people living at the home provided sufficient evidence that people are supported and encouraged to make decisions about their lives. The home does however need to ensure that the care plans are produced in a format that is suitable to the individual needs of each person living at the home. As currently this is not the case. Care Homes for Adults (18-65 years) Page 13 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are able to make choices about their life style and are supported to develop life skills. People are supported to engage in activities and to keep in contact with friends and family. Evidence: When we inspected the home on 5th February 2008 we could not fully assess these standards as there was no one living at the home. However the inspection carried out on 28th June 2007 found this outcome area to be good. On the day of this visit one person had just returned from going swimming with a member of staff. At other points in the day people were either engaged in their own activities, spent time in their rooms or were engaged in activities directly with staff. An Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: example of this being that one person baked a cake with staff. The home maintains a daily record system and from an examination of these we saw that over a three day period one person had undertaken the following activities with staff support; used public transport with staff to see a 1970s display at a museum, went shopping for a new mobile phone, visited a cafe, went to shops, received a visit from family, listened to a staff member playing guitar, watched television, made and received telephone phone calls, sent emails from the homes office computer, took part in boardgames, went bowling with staff and other residents, went out for lunch, did arts and crafts and went swimming. Peoples care plans identified their interests and goals. We confirmed through examination of information recorded in care plans and other records held at the home that people are supported to pursue these interests and try new activities. We also saw evidence that while people are encouraged to do things, they do so of their own free will and choice and their right to change their mind or decline an activity was respected. Evidence was seen that each person does different things according to their needs and preferences and in a manner that is suited to their needs. In discussion with one person living at the home they told us that they were supported and encouraged to take part in activities inside and outside of the home and that this included household and other daily living activities. The person spoken with had recently joined staff on a fire training and awareness course and was due to undertake a food hygiene course with staff. The person managing the home said that wherever appropriate people living at the home were being encouraged to take part in training. The home has a visitors policy and people can receive visitors at any time. Staff support people to keep in touch with their friends and family. We looked at examples of menus for people living at the home. Each person has an individual menu based on their own needs and preferences. The menu for one person looked at had been produced in pictorial format and was specific to the person. Examination of menus demonstrated that people had two choices each day for each meal. The person concerned had downloaded pictures from the Internet with staff support of their chosen menu items and meals and these had been inputed onto the menu. We reported at previous inspections that the kitchen door was kept locked thus restricting access. The kitchen was found to be accessible on this visit and people were observed to be able to access the kitchen to make drinks and snacks. Care Homes for Adults (18-65 years) Page 15 of 29 Care Homes for Adults (18-65 years) Page 16 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the appropriate level of assistance with their health and personal care needs. Evidence: From evidence recorded in the care plans and from observations and discussion it was evident that people were receiving support with their personal care needs in line with their needs and preferences. Care plans and associated documents provided us with enough information to demonstrate that health care needs were being met and that people had access to a range of health and social care support. Each person had a health care plan entitled, My health care plan. The home had been liaising with family members as well as other agencies to compile a family medical history. The health care plans seen during the visit were person centred and provided details and information such as, When Im unwell this is what Im like, This is how I say I Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: am in pain, fed up happy etc. Care plans clearly explained the level and type of support needed with healthcare appointments. The medication administration records were checked for two people during the visit. From examination of these records it was evident that staff were following correct administration recording procedures. The home has a written medication policy and clear procedures. The Annual Quality Assurance Assessment (AQAA) stated that the home was, Promoting self medication for one service user (with support), who is also recording when he is involved with preparing his own medication. During our visit we saw evidence to support this. The home has a policy that staff must speak to a senior manager before administering any as needed (PRN) medication. What they do need to do however is produce written guidance for staff detailing how and in what circumstances PRN medication can be given. This needs to specific to the individual as each persons PRN medication needs will differ. It was also noted that while all staff had signed the medication file, there was no evidence of them having received medication training. It has since been confirmed to us by the Responsible Individual that all staff involved in the administration of medication had received training at the time of this visit. Care Homes for Adults (18-65 years) Page 18 of 29 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. The home has procedures to protect people from harm and abuse. Evidence: No complaints regarding the home have been reported to the Commission for Social Care Inspection since the last inspection. Data recorded in Annual quality Assurance Assessment (AQAA) told us that none had been received by the home either. The AQAA stated that Our view of complaints is positive, and will help us to review our service, deliver and make changes where necessary. The home has a complaints procedure and people living at the home are made aware of this. The AQAA also told us that the home plans to make improvements to the complaints process by changing the procedure into a more appropriate format. When we asked staff in the surveys sent to them whether they knew what to do if a person living at the home, relative, advocate or friend had concerns about the home, two responded that they did and one that they did not. This is something that the person managing the home will need to address. The home has the facility to looks after peoples money. We looked at the procedures for looking after peoples money and checked the records for people living at the home. All transactions had been recorded and receipted as per the homes policy and Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: the storage facilities were safe and secure. We reported at the last inspection of the home that the provider said that they intended to provide staff with safeguarding training during their induction. We saw from looking at the files of three members of staff recruited since the last inspection that this had been carried out. Care Homes for Adults (18-65 years) Page 20 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well furnished, comfortable and homely. The home is clean and tidy and good standards of hygiene are maintained throughout the home. Peoples individual living space is decorated, furnished and arranged to suit their individual preferences and needs. Evidence: We looked at all areas of the home during our visit. The home was found to be clean and tidy and homely. From observation people were relaxed and at home in their environment and were able to pursue their own leisure interests as they chose. A person living at the home assisted in showing us around and this included their own personal flat. Each persons flat was individually decorated and reflected their individual tastes and needs. People had been able to personalise their flats with pictures, belongings, televisions and audio equipment etc. In discussion with one person living at the home they told us that they had been able to choose the decor and furnishings for their own flat and the home. We saw evidence that the general upkeep of the building is maintained and that furnishings and decor are replaced as necessary. The AQAA identified the Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: improvements that had been made and that were planned for the future. The home plans to convert all remaining rooms into flats. Whilst this will will reduce the number of people that the home can accommodate it will mean that each person has their own individual living space within the home. The person managing the home stated in the AQAA, By having individual flats within a residential care home we are able to ensure that immediate environments are suitable for the individual and are flexible to meet changing needs. Care Homes for Adults (18-65 years) Page 22 of 29 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 are employed in sufficient numbers to meet peoples needs. They receive training appropriate to meet the needs of those living at the home and the home follows safe recruitment procedures. Evidence: During the visit to the home staff rotas were examined. These confirmed the rota to be a true reflection of actual staffing levels. Rotas had been planned in advance for the forthcoming month and provided evidence that cover is provided in the event of a member of staff being unavailable due to sickness or leave. Staff told us in the surveys that Criminal Records Bureau checks and references had been undertaken before they were able to start work at the home and that they considered that their induction had covered everything they needed to know to do the job when they started. One person commented that they had been, Very well informed. We looked the recruitment records of three members of staff all of whom had been recruited to work at the home since the last inspection. These confirmed that an appropriate recruitment process had been followed and that this included; the Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: submission of an application form, an interview, the receipt of two written references and that both Criminal Records Bureau and Protection of Vulnerable Adults checks had all been completed prior to the person commencing work at the home. The file of the first person showed that they had commenced working at the home in October 2008 and that they had completed induction training that was linked to the Skills for Care induction standards. Areas covered in the induction included, values, confidentiality, person centred- approach, risk assessment, health and safety, communication, abuse, food hygiene and moving and handling. The two other files looked at were of staff who had only been working at the home since January 2009. Evidence was seen that both were undertaking induction training and that they had been supernumerary for the first two to three weeks. All staff who returned a survey told us that they were receiving training that was relevant to their role, helped them meet and understand the individual needs of people living at the home and kept them up to date with new ways of working. Data recorded in the Annual Quality Assurance Assessment (AQAA) told us that six of the eleven permanent care staff held an NVQ level 2 or above. We saw the homes training schedule for the forthcoming months and saw that several courses had been arranged. The staff members whose files we looked at had been booked to attend a range of different training courses. Care Homes for Adults (18-65 years) Page 24 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being safely managed. The appointment of a manager has helped this. However the person managing the home needs to apply to be registered in order that they can demonstrate their fitness. There is a need to improve the systems for monitoring the quality of the service. Evidence: At the last inspection of the home carried out on 5th February 2008 the home was without a manager. Previously to this the home has had three different managers since opening in December 2006. The home has not had a registered manager in post since March 2007. The person currently managing the home has been in post since the 17th November 2008. At the time of this inspection the Commission for Social Care Inspection had not received an application to register a manager. However the person managing the home and the Responsible Individual have confirmed that this will be submitted as soon as all the pre- registration documentation has been completed. Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: The home had recently employed an outside consultant to undertake a complete audit of the home against all National Minimum Standards. They informed us that they were using the findings of the audit to identify areas of good practice and areas for improvement. At the time of this inspection the home had only just received the report and were therefore still analysing the findings. Previously to this the Responsible Individual for the service had carried out an audit of the home in October 2008. Where the provider of the service does not actually manage it on a day to day basis they or their appropriate representative are required by regulation to visit at least once a month and prepare a written report on the conduct of the service. The Responsible Individual explained that as he was based at the home on a daily basis he had previously been advised that he did not need to carry out these reports. It was explained that these visits must be completed monthly and that the organisation would need to make arrangements for someone to carry this out. The Responsible Individual has since confirmed that they have changed their base and have commenced monthly visits and reports. Data in the Annual Quality Assurance Assessment (AQAA) told us that regular servicing of the homes equipment was carried out. We saw documented evidence during our visit to substantiate this. Examination of the fire logbook confirmed that weekly fire alarm checks are undertaken. We saw recorded evidence that regular fire drills take place. People living at the home have the opportunity to join in with fire training and other health and safety training such as food hygiene and this is seen as good practice. The home had been visited by the fire authority on 8th January 2009 whereby it was identified that the fire risk assessment had not been reviewed. The person managing the home showed us evidence that this had now been completed. This inspection did not raise any concerns as to health and safety within the home. Care Homes for Adults (18-65 years) Page 26 of 29 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 Adults (18-65 years) Page 27 of 29 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 37 8 The registered person must ensure that the appointed manager submits an application to the Commission for Social Care Inspection to be registered. The home has been without a registered manager since March 2007. 05/05/2009 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 Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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