Care Home: Acorns

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What the care home does well Acorns provides a homely, comfortable and safe environment for the people who live there and people told us that they were happy living in the home. People`s individual needs and wishes are assessed and recorded in a plan of care and these are being kept under regular review. People access their local community, they attend colleges and day care facilities and can see their friends and families. There is a robust staff recruitment process in place and staff receive a structured induction and training. What has improved since the last inspection? A new, experienced manager has been registered. The activities and outing that are provided for people have been improved and each person has a daily activities plan in place. The home has gained advice form a nutritional expert and the quality of food provided has been improved. All accidents and incidents occurring to service users are recorded and monitored and relevant healthcare support is requested as appropriate. The system for the administration of service user`s medication has been reviewed and records are current and in good order. The staff team have received updated training and regular supervision in order to improve staff practice and ensure they are familiar with policies and procedures for preventing people from risk of abuse or harm. There is a safe system in place for keeping service user`s bedroom doors open if they wish to do so and automatic closures have been fitted. Improvement have been made to the environment by redecoration of the home and the replacement of some furnishings and fittings. There is a system in place to monitor accidents and incidents and these are reported to the Commission as appropriate. What the care home could do better: The service should continue to sustain the improvements made to the running of the home. The registered provider must ensure that monthly Regulation 26, registered provider`s visits are carried out and recorded in order to monitor the home and support the new manager. Key inspection report Care homes for adults (18-65 years) Name: Address: Acorns Walton Heath Pound Hill Crawley West Sussex RH10 3UE     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: Annie Taggart     Date: 2 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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 28 Information about the care home Name of care home: Address: Acorns Walton Heath Pound Hill Crawley West Sussex RH10 3UE 01293885331 P/F01293885331 acorns@ilg.co.uk springmeadow@ilg.co.uk Evesleigh Care Homes Ltd (ILIACE Group) Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Patricia Hyland Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 5. The registered person may provide the following category 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: Learning disability - (LD). Date of last inspection Brief description of the care home Acorns is a care home registered to accommodate up to five people with learning disabilities. The Registered Provider is Evesleigh Care Homes Ltd (ILIACE Group) part of the Independent Living Group. The registered manager is Miss Patricia Hyland The home is a detached property situated in a small cul-de-sac on the outskirts of Crawley, West Sussex. There is easy access to all community facilities including a local rail and bus station. Limited parking is available to the front of the house. Accommodation is Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 5 1 3 1 0 2 0 0 9 Brief description of the care home provided over two floors. People have their own en suite bedroom, located on the first and ground floors. On the ground floor there is a comfortable living room with a large T.V. a good size kitchen, a utility room, a dining room, an office and a staff toilet. The garden is accessed via the kitchen door at the rear of the property. There is a large balcony area with decking and steps leading to a small enclosed garden. Current fees are from 1100.00 to 1750.00 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: In order to plan for this key inspection an annual quality assurance assessment (AQAA) was sent to the manager of the home for completion and surveys were sent to service users and staff. We looked at any other information that we have received and this included an improvement plan provided by the home following the last key inspection and information gained from safeguarding meetings concerning the home. The completed AQAA was returned within the given timescales and this contained clear information about the home. Three service user, three staff and two family surveys were returned. All made positive comments about the home. The unannounced visit was carried out at 9.30am on Friday 23rd April and the visit lasted for three and a half hours. During the visit we spent time with the four service users currently living in the home Care Homes for Adults (18-65 years) Page 6 of 28 both in communal areas and in their private bedrooms, we spoke to the two staff members on duty and we observed staff practice. Three care plans and all supporting documents such as risk assessments, daily records and food records were tracked and we saw how peoples healthcare needs and medication was being managed. The recruitment files for three members of staff were seen and they contained all of the required documentation. Training records, a training matrix and evidence of staff supervision and appraisal were also seen. Records for the running of the business were seen and these included Regulation 26 , registered providers visits, fire records, service users money management, quality assurance processes and incident and accident reporting. The registered manager Ms Hyland was away on a training day and feedback was given to the senior carer on duty. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The service should continue to sustain the improvements made to the running of the home. The registered provider must ensure that monthly Regulation 26, registered providers visits are carried out and recorded in order to monitor the home and support the new manager. Care Homes for Adults (18-65 years) Page 8 of 28 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 9 of 28 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 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, 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. People have their individual needs and wishes assessed and recorded. Families and service users are involved in the process and contracts of terms and conditions of residency have been agreed and signed. Evidence: There is information about the home available and each service user has a copy of the Service User Guide in their individual file. From looking at records we saw that people have had their individual needs and wishes re-assessed and recorded and service users and their families have been involved in the process. Contracts of terms and conditions of residency are in place and we saw that these had been signed by service users and their representatives. No new service users have been admitted since the last inspection Care Homes for Adults (18-65 years) Page 11 of 28 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. The people living in the home have their individual needs and wishes recorded in a detailed plan of care. Risks are identified and assessed to ensure that people are being safely supported and service users and their families are involved in the process. Evidence: The people living in the home have had their individual needs and wishes re-assessed and these have been recorded in a detailed plan of care called an Essential Lifestyles Plan. We tracked three of the plans and found that they had recently been reviewed and updated and were signed by service users and their families or representative. The plans gave very detailed information for the staff team to follow concerning how each people wishes to be supported. Areas detailed included personal care preferences, behaviour management plans, health plans, community involvement and communication. Risk assessments have been completed to ensure that people are safely supported Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: both in the home and out in the community and we saw that people are being supported to make individual choices and be as independent as possible. At the last visit we found that records such as monthly reviews by key workers were not up to date and care plans and records were in large loose leaf files and difficult to follow. The new manager told us that she was going to review and update the records and care plans. At this visit we found that there were clear and concise records in a format that was easily accessed by the staff team, regular reviews had been carried out and recorded and families had been involved in developing the care plans and providing information. Care Homes for Adults (18-65 years) Page 13 of 28 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. In order to ensure that the people living in the home are provided with interest and stimulation, there is a programme of activities and outings in place. People are offered choices and are supported to be as independent as possible and there is a varied menu on offer. Evidence: At the last inspection visit we saw that some of the people living in the home did not have a programme of activities to offer them interest and stimulation and a Requirement was made for this to be addressed. Evidence seen at this visit showed that service users all have an individual programme of activities both inside the home and in the community and this includes the use of local colleges and day care facilities. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: From looking at daily records we saw that people are involved in caring for their home and cooking and cleaning, some people go swimming, have reflexology and make up sessions and visit the shops and go to see their families. There are clear preferences forms in place that detail what people would like to do both during the week and at week ends. From service user meeting minutes we saw that structured outings are arranged, people had asked to go to Madame Tussuads and to the cinema and this had been completed. Annuals holidays are also being arranged and service users and their families are involved in the planning. For one person there are still few outside activities such as college or opportunities for personal development in place. We saw that the manager and staff team are exploring options for this person and had developed a number of in house activities to offer the person interest and stimulation. At the last visit we saw that people were not being offered a healthy choice of meals and that most meals were fast food or carbohydrate heavy meals. At this visit we saw that the home had sought advice from a dietician and that there was a choice of fresh, home cooked meals on the menu. Some people have a healthy eating plan in place and have their own individual menus. We saw that people are offered choices and during the visit we saw one person go to the food cupboard and show that staff what she would like for lunch. The staff on duty at the time of the visit were respectful and friendly in their dealings with service users and there was a good rapport between them. People were being supported to be independent as possible and being encouraged to walk and when the door bell rang a service user answered it each time. Care Homes for Adults (18-65 years) Page 15 of 28 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. There are clear and detailed plans in place regarding both the physical and emotional healthcare needs of people, the home is working with other healthcare professionals and medication is well managed. Evidence: For each person living in the home there is a Health Action Plan in place that details individual physical and emotional healthcare needs. We saw that the plans contained clear and concise information and had recently been reviewed and updated. From looking at records we saw that people have access to a local doctor and all service users had recently received an annual healthcare check. People attend the dentist and optician services and we saw that some people had been assessed by an occupational therapist and speech and language therapist. Some of the people living in the home can sometimes become distressed and upset and this exhibits as challenging behaviours. There are clear behavioural plans in place for the staff team to follow and the staff team have been trained in dealing with challenging behaviour through a system known as Strategies for Crisis Intervention Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: and Prevention (SCIP). As the last visit we found that incidents and accidents occurring to service users were not being recorded and referred to the relevant healthcare professionals. At this visit we found that there were clear health plans in place, accidents and incidents are recorded and monitored by the manager and incidents to service users have decreased. There are plans in place for end of life wishes and we saw that peoples families had been involved in this process. Medication in the home was being well managed, there were policies and procedures in place and staff had received training. No gaps were found in the signing of medication recording sheets (MAR) and the drugs cabinet was clean and well organised. We asked the senior carer on duty what they would do if service users refused their medication and she said that they would record this and refer this to the doctor for advice. Care Homes for Adults (18-65 years) Page 17 of 28 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. Complaints are recorded and acted upon and the homes policies procedures and staff training are designed to protect people from risk of abuse or harm. Evidence: The home has a complaints procedure a copy of which is included in the Statement of Purpose and Service User Guide. There is also a user friendly version for service users in signs and symbols and the procedures have been updated to reflect the address of the Commission. Records showed us that complaints are recorded and acted upon and outcomes fed back to complainants. At the last inspection visit a Requirement was made for the staff team to receive updated safeguarding training as there were incident forms and daily records that showed us that there was a lack of understanding in the staff team as to what constitutes abuse. At this visit we saw that the staff team had received updated safeguarding training and certificates were on file to support this. We also looked at the minutes of staff meetings that showed us that there is an ongoing theme of staff practice discussed at each meeting and the manager, Ms Hyland is very clear about how service users are to be supported and that high levels of competence and compliance are required from the staff team. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: We spoke to the to the staff on duty who both said that they would report any suspected abuse straight away and one person said, the new manager is just the best, she makes sure you know what your job is and that you carry it out properly and she addresses any concerns in supervision and at staff meetings. Safeguarding issues that were under investigation by the West Sussex Safeguarding team have now been completed with no further action required. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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. Acorns provides a safe, homely and comfortable environment for the people who live there and the home is clean and well maintained Evidence: Acorns provides a homely and comfortable environment for the people who live there. The home has recently been redecorated and carpets cleaned and the office has been completely re-fitted and re-organised. There is a large lounge with comfortable furniture and large television in place. One of the sofas needs replacing as it has torn arms, the senior staff member on duty said that this was being addressed. Peoples private bedrooms are homely and attractive and and have been personalised to meet peoples individual needs and hobbies. Each bedroom has an en-suite bathroom and these were well equipped and accessible. There is a well maintained garden with a large decking area and during the visit we saw people sitting out and enjoying the good weather. At the last visit a Requirement was made for the home to seek advice from the fire department as the three upstairs bedroom doors had been propped open with furniture, causing a risk to service users. At this visit we saw that all bedroom door Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: had working automatic closures in place and there was a recent fire report on file. The home was clean and hygienic throughout, there were cleaning schedules in place that included the involvement of service users, staff had attended health and safety training and cleaning liquids and equipment was safely locked away. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, 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. The staff team receive the training and supervision they need to ensure that service users are safely supported and there are robust staff recruitment and induction processes in place. Evidence: Staffing rotas and shift records showed us that there are usually two staff and the manager on the early shift during the day. The manager was away on training and there were two staff one of whom is the senior carer on duty to care for four people. From looking at recruitment records we saw that a robust recruitment process is carried out and in the four records we saw, all had the required documentation including a current Criminal Bureau Check (CRB) and two references. New staff complete the Learning Disability Qualification (LDQ) induction pack and a number of people who had not done this have recently completed the work books and they are on their personal files. There is a programme of training and development in place and this includes mandatory training such as infection control and moving and handling. Certificates are kept on file and we saw that there is a central training matrix held at the head office and people are put on updated training when required. Records show that post-course Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: evaluations are held with the manager to ensure that people have understood how to put training into practice. At the last inspection visit a Requirement was made for the staff team to receive regular supervision and support. At this visit we saw that since the new manager has been in post, staff have received monthly supervision and this is recorded. There have also been regular staff meetings held that clearly address performance management issues and the introduction of shift planning means that each staff member is held accountable for their work each day. A staff member told us, things are so much better with the new manager, she is approachable and works as part of the team and is very straightforward in giving us advice and feedback. Care Homes for Adults (18-65 years) Page 23 of 28 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 well managed, records are up to date and in good order and health and safety issues are recorded and addressed. In order to monitor the home, monthly Regulation 26 visits need to be carried out. Evidence: The new manager has a number of years experience in working with people with a learning disability and transferred six months ago from another home in the ILG group. Ms Hyland has been registered for Acorns since 5th April 2010. The staff on duty were very complimentary about the positive changes brought about by Ms Hyland and in a survey returned from a family member we are told that although the person still thinks there are areas for improvement they say, Pat (the manager) has made a good deal of difference and she is working hard to initiate improvements. The new manager is so helpful and I will be very happy for my daughter to remain at Acorns if the improvements continue. There are Regulation 26 visits carried out to monitor the service being provided but Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: these have not been being carried out monthly as required. There was a full compliance visit carried out 14/4/2010 and a Regulation 26 in February 2010 but a number of records of the visits for other months were missing. The senior carer said that this was perhaps because there had recently been a change in area management. Following the inspection the link inspector for the home spoke to the regional manager for ILG 0n 28/4/2010 who confirmed that there is now a new regional and area management team in place, the company is committed to ensuring that Regulation 26 visits are carried out monthly, that managers are well supported and that an annual quality assurance process is undertaken and reported. We saw that the quality assurance process was out of date and the senior carer showed us evidence that surveys have recently been sent to service users, their families and other professionals. Outcomes from this process will be assessed at the next inspection visit. We checked the system for managing service users monies and found that this was robust with a safety tagging numbered system in place for peoples money wallets and records and receipts are kept on file. Two peoples records were checked and were correct. From looking at health and safety records we saw that regular fire checks and staff fire training is carried out, there are systems in place for checking and recording hot water temperatures and equipment and vehicle checks are regularly undertaken and recorded. Regulation 37 incident and accident reporting is now being reported to the Commission as required. This inspection showed that a number of positive improvements have been made to the running of Acorns and we will be assessing that these are sustained over time. The registered providers must ensure that regular Regulation 26, providers visits are carried out in order to monitor the home and support the registered manager. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 41 26 26. (1) and (2) The registered provider must ensure that monthly Regulation 26 visits are carried out and recorded. This is to ensure that there is a system for monitoring the home and supporting the manager. 30/05/2010 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 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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