Care Home: Abbey Care Complex

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What the care home does well The health, personal and social care needs of individuals are set out in their care plans and are generally being met. Residents spoken to were highly complimentary about the home and stated that staff were very helpful. Residents live in a pleasant, bright and homely environment that is suited to their needs. A comprehensive range of policies and procedures are in place and systems to ensure the service is well delivered. The home is focused on providing an individualised service provided by well trained and supported staff. The home is managed by an experienced and competent manager who is committed to the wellbeing of residents and ensuring the home meets its objectives. What has improved since the last inspection? Not applicable. What the care home could do better: The service needs to ensure more effective liaison with doctors prescribing medication to ensure that all individuals who need their medication receive it on time as prescribed. Safe medication practises must be observed at all times. Further recommendations have been given. Key inspection report Care homes for older people Name: Address: Abbey Care Complex 23-29 Abbey Road Ilford Essex IG2 7NE     The quality rating for this care home is:   three star excellent 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: Nurcan Culleton     Date: 2 8 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Abbey Care Complex 23-29 Abbey Road Ilford Essex IG2 7NE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Mary Apps Type of registration: Number of places registered: care home 40 Abbey Care Complex Limited Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category of service only: Care Home with nursing - Code N to service users of the following gender: Either whose primary needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home 40 0 Over 65 40 40 Care Homes for Older People Page 4 of 24 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: This is the first inspection to this newly registered service which took place on 29th July 2009. The inspector spoke with the registered manager, responsible individual throughout the day, as well as staff and residents, making observations whilst touring the premises. We examined a sample of files of people using the service including their care plans, assessments and daily records made by nurses and care staff. We also looked at staff files to examine recruitment proceedures. The home is registered to accommodated 40 people but were not yet up to full capacity at the time of the inspection. Care Homes for Older People Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 6 of 24 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 7 of 24 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. Good quality pre-admission assessments are conducted to identify needs and ensure that only those people whose needs the service is able to meet are admitted. The service demonstrates its capacity to meet the needs of people who live in the home. Evidence: The Statement of Purpose and Service Users Guide. Both documents include all the relevant information about the home for prospective users about the service. They also need to include the new regionalised contact details for the Care Quality Commission under the section for complaints. See standard 8 for a further recommendation to be included in these documents. Currently all people using the service have a contract with the local authority. Prior to individuals admission to the home, the referring authority send their assessments of need to the home prior to the homes manager doing completing their assessment. The manager informed that this occurred in the majority of cases, however in all cases Care Homes for Older People Page 8 of 24 Evidence: each person has a needs assessment completed. A sample of the homes pre-admission assessment forms were examined. They were fully completed including basic information such as key contact details and current medication as well as showing descending severity of needs and individual wishes. Comments were noted against identified needs. The assessments were thought to comprehensively identify needs that were personal to the individual. Whilst completing these assessments the manager was shown to have been pro-active in challenging previously unproven diagnosis stated in local authority assessments. This the manager informed was to ensure that individuals moving into the home recieved care and support that was appropriate to their needs. Files also contained specialist assessments such as a psychogeriatric assessments where these were necessary. The service showed their ability to be part of the assessment process for an individual under the Mental Capacity Act deprivation of liberty safeguards procedures in a carefully considered way that resulted in a positive outcome for the individual concerned. It is clear that the home has the capacity to meet individuals needs once admitted to the home. The skills and abilities of staff are a major consideration in the decision as to whether or not to admit someone to the home. The manager has taken the view for example that staff cannot support individuals requiring an End of Life service or terminal care until they have received appropriate training and have demonstrated their competence to do so. This training had been planned to take place shortly after the inspection. In another example there are currently two individuals with little English and two staff members have been recruited to care for them who can speak their own language. The manager informed another staff member who can also speak their language is also actively being recruited. The policy for the home is that individuals may visit the home and have lunch and tea to help them decide if they wish to move into the home. Care Homes for Older People Page 9 of 24 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. Good quality care plans inform staff how best to support individualsneeds to ensure that identified outcomes for each individual are achieved. Evidence: A sample of files were examined, including care plans to see how well the service completes these plans in response to meeting the health, personal and social care needs of individuals. Care plans were found to be comprehensively recorded and person centred, making clear the individuals needs and wishes and stating clearly how the carer should support the individual. For example one care plan outlined an individuals preferred clothing during the day, their preferred style of washing and in which room, advising against long converstations with the individual stating reasons why. In addition to the care plans including the needs and wishes of the individual they also identify existing skills and abilities of the individual and the goals and outcomes expected from their care plan. These outcomes are reviewed and updated on a monthly basis. The manager showed the care plan audit sheet used on every floor to help ensure the care plan audits are adequately completed. It is recommended that the care plans are also signed by the individual or their family or representative. Care Homes for Older People Page 10 of 24 Evidence: The home was able to demonstrate the adequate use of charts and assessment tools to monitor the health and wellbeing of individuals in their care. These included charts for assessing the risk of developing pressure sores and a system (the Standex System) of recording and monitoring the weight, skin type, continence, mobility, nutritional risk and other special risk factors to the individual. These were found to be consistently well recorded. These including the moving and handling assessments were reviewed on a monthly basis. Risk assessments linked in with needs identified in previous assessments and care plans, for example, a moving and handling assessment showing a high scoring against psychological issues in relation to an individual being moved was previously identified and well addressed in their care plan. Risk factor scores were added producing overall scores used by the service to dictate the number of care hours to be allocated to each individual. There are good connections with the community health services, for example, with district nurses for people requiring wound dressings or for diabetics needing injections. Staff or families who are able or who choose may escort people to their hospital or clinic appointments if needed. Local GP practises are used though there is no GP assigned to the home. We were advised that currently the organisation has the benefit of having two consultant geriatricians employed or sub-contracted to them. Other services such as chiropodists, opticians and dentists are available to individuals in the home. The home were recommended to state whether there are additional costs to the individual for these community services in the homes Statement of Purpose and Service Users Guide. One area requiring discussion with the service was around medication. Generally the medication recording practises were very good. At the time of inspection however the medication room was too hot for the safe storage of medicines at the time of inspection. When pointed out this was remedied on the same day when a portable air conditioner was delievered by the end of the inspection. Secondly a record against one individuals medication in their medication record sheet showed that the individuals medication was not available. When the senior nurse was questioned about this it was explained that the request for the repeat medication had been given in time to the doctor, however despite repeated requests the prescription had not yet been produced by the doctor. The Responsible Individual showed suitable alarm at this occurence and informed that they would be taking appropriate action to address this. The medication was obtained for the individual again during the course of the inspection. We acknowledged with the service that this was not a problem that was directly their Care Homes for Older People Page 11 of 24 Evidence: responsiblity. However where shortfalls in the provision of other services arise, the importance of the home of asserting the health needs of individuals with other professionals was stressed, particularly when those shortfalls may have an impact on the health of an individual and where they also have an impact on the homes ability to deliver and meet national minimum standards of care. During the course of the inspection we spoke with people living in the home, all of whom commented that the staff were pleasant,available to them when needed and that they were treated with dignity and respect. Staff were seen to interact positively with individuals on the day, engaging in conversation and assisting people as needed. A bright, relaxed and pleasant atmosphere was observed between staff and residents. Care Homes for Older People Page 12 of 24 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. Individuals in the home benefit from a range of social activities. Individuals enjoy varied and nutritious meals that suit their meal choices and cultural or special needs. Evidence: A range of social activities currently take place in the home, however as a new service, the home is still in the process of developing further social activities to benefit people in the home. The manager informed that they were planning to have a social activities folder for each person in the home with containing their life story, profiles of key people in their lives and prior hobbies so that activities are built around individual interests. An activities person has been employed and there is currently one volunteer. The manager has been asking family members for photographs and potted histories of individuals past to help with the development of the folders. Significant contacts with relatives and friends are maintained and relatives were seen visiting the home at the time of the inspection. A communication sheet was seen in individual files recording contact and important communications with family. It was apparent during the inspection that importance is placed on delivering a service that is person-centred and policies and procedures available reflected this, for Care Homes for Older People Page 13 of 24 Evidence: example, policies on individuals opening their personal mail, respect and support for their type and place of worship (currently there are ministers currently coming in to see two people in the home) and policies such as choice around waking and retiring to bed. Meals were varied and nutrious and enjoyed by people who were dining on the day of inspection. The cook consults people for their meal choices every night and compiles a four week menu. In addition the home used the Nutmeg System to assist with menu planning, tailoring recipes to reflect the nutritional requirements of that age group. We were informed that there were also some individuals in the home who preferred to eat Asian foods and these were prepared separately for them. It is recommended that special food needs or preferences are included in individual care plans. One person is currently on a peg feed. We were advised that all deserts were low in sugar so that they were suitable for diabetics. Care Homes for Older People Page 14 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A suitable complaints procedure is in place to protect and safeguard the interests of people using the service. Complaints are minimimal and there is a positive approach to dealing with complaints and learning and developing from them. Legal rights and choices are observed and respected. Evidence: Only one complaint had been recieved, recorded and appropriately investigated since the start of the service. The individuals spoken to on each floor of the home informed that they had no complaints and were very satisfied with the service and the care they received by staff, and individuals variably stated that they knew how to complain. The home has relevant polices and procedures to ensure individuals legal rights are respected. The manager demonstrated their involvement including a report produced concerning the Deprivation of Liberty safeguards for one individual prior to their admission to the home. A Best Interest meeting had taken place and relevant professionals were involved. The individuals needs and views were central to the report produced by the home, including for example, their human rights as relevant to this process. An appropriate adult protection policy is in place to safeguard against and respond to allegations of abuse. A whistleblowing policy is in place. Care Homes for Older People Page 15 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a bright, attractive and homely environment that is suitably equipped for meeting the needs of people living there. Evidence: The environment is generally clean, pleasant and well maintained. It is bright, well furnished and ventilated. Pictures adorning the walls throughout the home are carefully selected to evoke memories and to stir interest, helping to provide a more homely and attractive environment. When touring the premises we were shown pictures hanging in the hallway close to one individuals room with images of football, reflecting their personal interest in the game. We observed that individuals have opportunities to personalise their rooms and to use their own furniture. Suitable aids and equipment are available throughout the home and the home is adapted to suit disabled persons. There is an attractive garden at the back of the home planted carefully to provide sensory landscaped features for the benefit of people living in the home. Care Homes for Older People Page 16 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well supported and trained and sufficient in numbers to effectively carry out their duties. A robust recruitment procedure ensures that only suitable persons are employed to protect those living in the home. Evidence: On the day of inspection residents were observed to be supported by sufficient numbers of staff who had developed positive relationships with them, were engaging postively and were supportive of their needs. Most of the staff are registered general nurses in their own country and are therefore suitably skilled and qualified. However are also taking NVQ Level 2, 3, or 4 training to gain further qualifications. At the time of inspection eight staff were receiving literacy and numeracy support. Staff follow the Skills for Care induction programme and a list of staff names were seen to show that they had each undertaken induction. The manager informed that they had found it helpful to carryo out inductions for staff whilst they awaited their Criminal Record Bureau checks so that they were ready to go once their documentation was in place. All staff are provided with employee handbooks including the staff grievance and disciplinary procedure and the whistleblowing policy. We spoke with the training manager for the organisation who explained how they identify training that is suitable to the development needs and interest of individual Care Homes for Older People Page 17 of 24 Evidence: staff, how training needs are identified and sourced. We examined the training schedule that included mandatory training, and additional training that also included Equaliy and Diverstity, slips, trips and falls. The organisation had provided information about external courses to staff who were interested, for example, mental health awareness (undertaken by the manager), and dementia courses, however it was explained that more intensive dementia training could be made available in college or through distance learning. Staff files included certificates of training, including a record of where the certificates were obtained and when their training would expire and refresher courses needed in areas including moving and handling, fire awareness, COSSH, and mental health. All staff had received training in safeguarding adults. After examining a random sample of staff files We were satisfied that staff files contained all mandatory documents such as Criminal Record Bureau checks and references, demonstrating that recruitment procedures were robust and consistently applied to to ensure that all prospective staff are suitably screened, vetted and selected to work in the home. The home benefits from advice and support from the human resources manager employed within the organisation and has access to advice from an external company that supports managers with any matters related to recruitment, including policies and procedures. Care Homes for Older People Page 18 of 24 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. There is effective management, leadership and organisation of the home ensuring the aims and objectives of the service are achieved, enhancing the wellbeing and quality of life of those living in the home. Evidence: The manager was able to demonstrate how her knowledge and awareness of social care issues and her previous nursing and management experience has enabled her to effectively manage and organise the home. In addition the manager applies to the home her understanding of current thoughts in social care good practise with the aim of enhancing the experience of living in the home so that people in the home have a better quality of life. The manager seeks to be kept informed and updated on social care issues through, for example, attendance at care provider forums. The manager is a Registered Nurse with 30 years experience. She has worked predominately in the NHS, and more recently in care homes. She has a City and Guilds qualification in teaching and has a qualification in assessing NVQs in Care. The Care Homes for Older People Page 19 of 24 Evidence: manager also worked as an assessor for Community Learning and Skills Services at the time of inspection, receiving students from all over the borough. She became registered by the Commission for Social Care Inspection as the registered manager of Abbey Care complex in 2008. The home became operational in February 2009. The manager has completed her Registered Managers Award course however was not issued with a certificate due to the business and financial difficulties of the training organisation. As this will not now be forthcoming she has taken a positive step and enrolled on a Level 4 in Management for Care Services course. We examined a folder containing monthly regulation 26 management quality monitoring visits presently being conducted by a member of the senior management team. The last visit took place in July 2009, a month before this inspection. The manager informed how she has monthly to six weekly meetings with the project manager to discuss management issues including the number of care hours needed in the home depending on the outcome of individual risk assessments. We observed positive comments made either directly by people in the home, their family and friends, or recorded following conversation with them, such as in one service user contact stating :I spoke to a husband and wife who came to home for a week, they said they have really enjoyed their stay. They commented that the service they have received from the home is excellent, excellent staff who are very attentive and the food is excellent. One individuals survey recorded in June 2009 stated ... said the home has a very homely and relaxed atmosphere and she likes it. She was very complimentary about the staff and the care she receives. The policies and procedures folder was examined containing a list of appropriate policies and when they were last reviewed. The adult protection policy and procedure need to be updated to include the new contact details of the Commission and to include the need to make a referral to the local authority safeguarding adults team when abuse is suspected. The manager informed that business plans have been produced but were unavailable for inspection as they had been been submitted to another authority as part of a commissioning process. The home holds a folder containing individual accounts. A safe system of Care Homes for Older People Page 20 of 24 Evidence: accountability is in place and all have individual wallets. Currently the home do not have any legal responsibility for managing the money of any persons in the home. The manager openly informed that supervision has been occuring one to one on an ad hoc and open door basis. She acknowledged that supervision needs to be structured, stating that this structure was not yet in place until there were nurses working with carers who were identified as named key workers. Presently the carers were moving between floors though the plan was for this to change once the home is fully occupied. The manager has good understanding and experience of health and safety issues and has gained a certificate following a one year health and safety course. The manager has a role liaising between external health and safety advisers and the company, producing risk assessment proformas which apon the approval of the managing director are used company wide. External specialist consultants check the homes health and safety audits and work with the managers on a twice yearly basis. Other specialists are also involved for example to ensure the quality of nutrition for individuals in the home. On touring the premises we were shown an advanced fire detecting system that can detect faults externally by the maintenance contractor. Weekly fire alarm tests are completed and a fire drill had taken place this year. At the time of the inspection the home had two fire marshalls and more training for additional fire marshalls was being planned. All relevant health and safety records and certificates were available and satisfactory at the time of inspection. Care Homes for Older People Page 21 of 24 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 22 of 24 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 1 It is recommended to state whether there are additional costs to the individual to access health and community services in the homes Statement of Purpose and Service Users Guide. The Statement of Purpose and Service Users Guide to include the contact details of the Care Quality Commission. It is recommended that the care plans are also signed by the individual or their family or representative. The service must take every action to ensure that all individuals have their prescribed medicines when they require them at all times. The service must ensure that the medication storage room does not exceed recommended temperatures in order to ensure that medicines are stored safely for their effective use at all times. It is recommended that staff supervision is arranged on a regular and more structured basis. 2 3 1 7 4 9 5 9 6 36 Care Homes for Older People Page 23 of 24 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. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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