Care Home: 8 Haslerig Close

What the care home does well Potential service users receive a thorough needs assessment to ensure the home can meet the care needs of the service users. Detailed care plans have been produced for all people who use the service, and these inform the care staff what they must do to meet the needs of the individual. There is a motivated and established staff team that consists of care staff, who respond to service users in a respectful and appropriate manner. Communication between people who use the service and staff was observed to be positive and open. Service users are encouraged and supported to prepare their own meals. There is a good range of policies and procedures, providing staff with relevant information about all aspects of care and the home/organisation. Health and Safety procedures are thorough and records are well maintained. The evidence seen and comments received indicate that this service meets the diverse needs e.g. religious, racial, cultural, disability of individuals within the limits of its Statement of Purpose. What has improved since the last inspection? Care plans have been improved and contain up to date information about service users needs. Excess information which is not relevant to users current needs has been removed from files. Improvements have been made to the environment to improve the quality of the home which ensure that users live in a comfortable and safe home. What the care home could do better: The care plans must contain evidence of regular nutritional screening, including a record of peoples weights. Key inspection report Care homes for adults (18-65 years) Name: Address: 8 Haslerig Close Harvey Road Aylesbury Buckinghamshire HP21 9PH     The quality rating for this care home is:   two star good 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: Barbara Mulligan     Date: 1 3 0 4 2 0 1 0 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 Adults (18-65 years) Page 2 of 27 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 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 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 8 Haslerig Close Harvey Road Aylesbury Buckinghamshire HP21 9PH 01296331381 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): haslerigclose-londoneast@maca.org.uk www.together-uk.org Together Working for Wellbeing Name of registered manager (if applicable) Miss Zoe Michelle Collins Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 8. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home Haslerig Close 8 is a detached house in a quiet cul-de-sac on the outskirts of Aylesbury with good access to local amenities and public transport. The home seems well integrated into the local community. The home provides twenty-four hour care for up to eight persons with a mental health problem. Accommodation is domestic in style and each service user has their own bedroom. The home is run by Together Working for Wellbeing formerly known as the Mental Aftercare Association MACA. There is an Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 8 Brief description of the care home established staff team which is supported by relief staff. The staff team liaise with health professionals and other services in the community to ensure that residents receive appropriate care and support. Care Homes for Adults (18-65 years) Page 5 of 27 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: This unannounced key inspection was conducted over the course of a day and covered all the key National Minimum Standards for Younger Adults. Prior to the visit, a detailed self-assessment questionnaire was sent to the registered manager for completion. This was received by the time it was requested and contained some numerical information about the home. Twelve Care Quality Commission surveys were sent to the home for completion but none had been received by the time the inspection report was completed. Further information received by or about the home was also taken into account. The Regulation inspector was Barbara Mulligan. The Registered Manager was not available to assist with this inspection. The visit consisted of discussion with senior staff for the home, discussion with other staff, opportunities to meet with some people who use the service, examination of some of the homes required records, observation of practice and a tour of the premises. Care Homes for Adults (18-65 years) Page 6 of 27 A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the senior staff member who assisted with the key inspection. The staff in the home and service users are thanked for their cooperation and hospitality during this unannounced visit. Care Homes for Adults (18-65 years) Page 7 of 27 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 Adults (18-65 years) Page 8 of 27 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 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The assessment process works well and potential residents and their families have information about the home to help them decide whether their needs can be met, before they decide to move permanently. Evidence: There have not been any new admissions to the service since 2007 according to information supplied prior to the inspection. At the last inspection, documents relating to the most recently admitted service users were examined and found to be in good order with a detailed and comprehensive needs assessment which indicates that people had been involved in the process. The home does not take emergency admissions and is not registered to provide intermediate care. Care Homes for Adults (18-65 years) Page 10 of 27 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. Service user plans are in place, which outlines service users needs and ensures that service users needs can be met. The way service users make choices and the management of risks promote continuity of care and service users well being. Evidence: At the previous inspection it was identified that care plans contained a lot of excess information which was not directly relevant to the persons current support needs and there were notable deficits in the recording of the care plans. A requirement was issued for care plans to be kept up to date in line with service users changing needs. The care of three residents and their care plans were examined. Care plans were up to date and contained sufficient detail for staff to learn about residents they support. Specific needs have been identified within the care plans and there is a detailed action plan in place to provide staff with the details of how these needs are to be managed and fully met. Individual preferences, likes and dislikes and reference to end of life care are recorded in care plans and describes how these will be met. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Visual observations of people using this service showed that people were smartly dressed including jewelery, make up and nail varnish, people were seen to be wearing the aids needed, for example hearing aids and clean glasses. The care plans show that that service users, family members or representatives are included in the care planning process. Daily notes are detailed and informative. Service users are given opportunities to make decisions about their lives, with assistance as needed. This includes help to make decisions regarding their choice of activity, daily routines, menu planning and preferred daily routines. Menu planning is carried out on a weekly basis and service users take part in the homes shopping. Regular house meetings are held and minutes kept. The minutes show that service users are involved in the running of the home and concerns raised by service users are dealt with appropriately. Within each service users plan of care are risk assessments detailing any risks and how these risks are to be minimised, whilst retaining each users independence. Examples of risk assessments seen include personal care, medical and health support needs and financial risk assessments. Missing person procedures were in place in the event of anyone being absent from the home without notice and for staff to refer to, if need be. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have a varied and active lifestyle, which reflects their interests, and are supported to maintain family links and friendships inside and outside the home. Evidence: Three people using this service regularly attend a day centre in Aylesbury and two users go to a day centre in Princes Risborough. People using this service are supported to pursue their leisure interests with activities such meals out, shopping, swimming and using the gymnasium. The home has its own transport and people who use the service can access taxis, buses and other forms of public transport if they wish. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: In the home people can read, chat with others, watch TV or a DVD, or listen to music or the radio. Friday evenings is a social occasion and, after a supper of fish and chips, staff and users play board games or other entertainment. The home has introduced an in-house programme of activities. On the day of the visit service users were being supported to paint pebbles which are going to be placed in the garden. A copy of the activities programme was on display in the home and further activities for the week include bingo, gardening and scrap books. The home has its own transport which users and staff use for outings. Recent trips have included the local garden centre and the zoo. Further outings are to be planned with users. Service users are supported in maintaining links with family and friends as required. The amount of contact varies from person to person. Users and staff plan menus and do some of the house shopping together. Service users are supported to make their own meals. Supper is the main meal of the day and consists of a two course meal. Drinks and snacks are available at all times. Care Homes for Adults (18-65 years) Page 14 of 27 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. The physical, emotional and health care needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. Evidence of regular nutritional screening should be maintained in the service users care plans. Evidence: Staff respect users wishes with regard to their personal preferences, in particular each persons daily routine. These are outlined in individual support plans. Each user of the service is registered with a local GP. The home is in contact with two GP surgeries. A care manager, a health or social care professional is responsible for monitoring the implementation of the Care Programme Approach care plan. This incorporates the support provided by the home. Evidence of contact with GPs, Psychiatrists, CPNs (Community Psychiatric Nurses), Podiatrists and other specialist health services was noted in care plans. One area of concern identified in the care plans was the nutritional screening for some people. In one file examined it states that the service user should be weighed monthly, however the last recorded weight was 09/01/2009. This was identified at the previous Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: inspection but has not been improved since then. Daily food diaries are maintained for each person. The inspector was informed that all service users who are on Clozapine treatment are weighed monthly and other individuals have a six monthly visit to the Gp where people are weighed. However the files do not reflect this and a requirement is issued for improvement in this area. The procedures for the administration of medicines were examined during this inspection. At this visit we looked at the medication administration record (MAR) charts, medication supplies and care plans for the four people whose care was being looked at as part of this inspection, and at the MAR charts for the rest of the people using the service. The home works closely with the local surgery and pharmacy to ensure an effective and safe medication administration system is operational. The pharmacist visits the home to look at medication storage and administration procedures. Copies of these visits are kept in the home. The MAR charts show several hand written entries. When it is necessary to handwrite on a medication administration record chart in the home, the member of staff writing the chart should sign and date the chart and a second carer should check the entry for accuracy and then initial the chart. In addition the entry should include a reference to where this information was sourced,such as the prescribers name. All handwritten entires must be legible. There are detailed guidelines for as required (PRN) medicines. However, for a small number of as required (PRN) medicines there were no guidelines in place and the home should address this. Training records for staff expected to administer medicines were examined and it was noted that they have completed training within the last three years. The Medication Administration Records show no gaps or omissions. Arrangements for the storage of medicines were satisfactory. Most medicines are dispensed in a Monitored Dosage System. Liquid medicines are stored in a separate shelf in the medicines trolley. Care Homes for Adults (18-65 years) Page 16 of 27 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. Procedures for managing complaints and adult protection are in place ensuring people who use the service are listened to, kept safe and protected from abuse. Evidence: The inspector examined the homes complaints procedure which illustrates timescales for responding to complaints. This is clear and accessible to service users and is displayed on the notice board in the dining room, for people using the service. The AQAA tells us that the home has not received any complaints since the last inspection and the homes complaints log confirms this. The information notice on complaints also gives contact details for the advocacy organisation (Aylesbury Vale Advocates), local social services, the housing association (who is mainly responsible for the building), and the Care Quality Commission. Procedures are in place for safeguarding vulnerable adults (SOVA) and staff have access to a whistle blowing policy. The home has a copy of the local authority SOVA policy. Training records demonstrate that staff have completed Safeguarding training and this is regularly updated. The Annual Quality Assurance Assessment tells us that there have not been any safe guarding referrals in the previous twelve months. Care Homes for Adults (18-65 years) Page 17 of 27 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 standard of the environment within the home is good, providing people who use the service with an attractive and homely place to live. Evidence: The home is a detached house in a small close in a residential area. It is just over two miles from Aylesbury town centre. The ground floor accommodation comprises the entrance hall, lounge, dining area, walk-in shower, WC, bedrooms, office, staff sleepin room (with shower and wc), kitchen, laundry, and conservatory. Stairs lead to the first floor where accommodation is comprised of bath and WC, six bedrooms, storage, and a separate WC. None of the bedrooms have en-suite facilities, all have a hand basin. There is a small area of green to the front of the house and a pleasant enclosed garden to the rear. Improvements to the home since the last inspection include replacement of stair and hallway carpets and replacement of the furniture in the conservatory. The lounge and dining area are sufficient in size for present needs. The lounge is Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: comfortable and has a TV, dvd/video, books and magazines. There is an informative notice board in the dining room. The conservatory is the smoking area. At the previous inspection it was identified that this area was in need of thorough refurbishment and the registered manager and area manager both confirmed this room was due to be improved. The furniture has been replaced but no further attempts have been made to improve this area. The home should address this. The kitchen is fitted with domestic standard storage units and is accessible to service users if they wish to assist with meal preparation. The laundry facilities for the home are sited so that soiled washing does not come into contact with the kitchen. Hand washing facilities are sited in the laundry. Policies and procedures were observed by the inspector for the control of infection, which includes the safe handling and disposal of clinical waste. Care Homes for Adults (18-65 years) Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing numbers and skill mix is satisfactory and staff training is sufficient and up to date to ensure that people who use the service benefit from staff who are competent to do their job. Records required for inspection purposes must be readily available to ensure a thorough key inspection can be completed. Relief staff must receive formal staff supervion to ensure they are well supported to carry out their jobs. Evidence: The rotas show adequate numbers of staff are working in the home at any time to meet the needs of the people living in the home. The current staffing of the home provides for a minimum of two staff in the morning and two in the afternoon and evening. The night time staffing arrangements have changed since the last inspection. There are no longer waking staff, and since April there has been one sleeping staff. Feedback from staff was positive about the change of night staffing arrangements to date. Staffing is adjusted to take account of activity. These figures exclude the registered manager. The Annual Quality Assurance Assessment document shows that there are nine permanent staff and three of these have completed National Vocational Qualification Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: level 2 or above. The registered manager was not present during the inspection. Access to staff files was not possible on the day of the visit. The home must implement a system to ensure that in the absence of the registered manager, records can be accessed for inspection purposes. A requirement is issued for improvement in this area. The staff recruitmennt files were examined at the previous inspection and the On the day of the visit the staff files were not accessible and information regarding staff training was provided by the registered manager within forty eight hours after the inspection. However, no recruitment information was available. Staff spoken to said they complete an induction programme that covers the common induction standards for social care. Training records show that staff are up to date with their mandatory training. This includes moving and handling, fire, basic food hygiene and infection control training. There is specialist training available for staff, and an example of this includes Person Centred Approaches, Service Support, Benefits training and service user led training. Staff spoken to said they receive formal staff supervision. The process includes discussion on matters relating to service users, staff issues, and training and development. All staff have an annual appraisal. However, one regular relief staff member said they had not received formal supervision for a long time and a requirement is issued. for improvement. Care Homes for Adults (18-65 years) Page 21 of 27 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 well managed with systems in place to ensure the health and safety of services users and staff is maintained. Evidence: The registered manager has worked in the home for eleven years and has been the manager for three years. The manager is supported by a deputy manager and is accountable to the area manager. The manager was described as approachable and supportive. The ethos of the home seems appropriate for supporting people with serious mental health problems. Staff were seen to be responsive and supportive to people who use the service. There was a pleasant and positive atmosphere in the home throughout the day of inspection. The registered manager is required to complete a monthly internal management report which compares practice against a standard statement. This is submitted to the area manager. The area manager carries out a monthly monitoring visit (to comply Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: with Regulation 26) of the home and completes a report. This includes talking to users and staff. The service conducts an annual service review in which the views of a range of stakeholders are sought through questionnaires. There is a comprehensive Health and Safety policy. Systems are in place for recording accidents and incidents. The home has not had a visit from the local environmental health department since the last inspection. Contracts are in place for the maintenance of such equipment as fire safety equipment, gas appliances, Portable electrical appliances and electrical wiring. Staff have access to training in first aid, food hygiene, manual handling, infection control, fire safety, administration of medicines and safeguarding vulnerable adults. Arrangements for fire safety are satisfactory. A fire risk assessment was completed on 28/03/2010. Weekly fire safety checks are carried out and recorded. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 19 13 Evidence of regular nutritional screening, including weights must be recorded within service user files. To ensure the nutritional needs of service users can be met. 30/05/2010 2 33 17 Recruitmenet records must be made available for inspection purposes To ensure the recruitmenet practices in the home can be fully assessed to protect the people who use the service. 30/04/2010 3 36 18 Relief staff must receive formal supervision from a line manager. To ensure service users benefit from well supported and supervised staff. 30/05/2010 Care Homes for Adults (18-65 years) Page 25 of 27 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 26 of 27 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. 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. 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