Care Home: Ashcroft House

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What the care home does well As identified in this report some progress has been made. Good progress has been made with activities with both group sessions and more individual needs being catered for. This principally remains with the leisure therapists as care staff are still committed to task orientated care support. A relative we spoke to praised the activities. A service user told us that she preferred to spend time in her room and staff supported her to do this. Observations during the day showed that overall staff were kind and caring and related well with individual service users. Busy times, such as the lunch period, resulted in staff rushing tasks and not having the time to listen to individual people. Care plans now contain more information and are being reviewed on a regular basis. However, care staff access and involvement with care planning is limited. A more pro-active approach has been undertaken to address healthcare needs including assisting people to access the dentist. The registered manager told us at the time of our visit that none of the people living in the dementia unit had seen a dentist for a least a year prior to this. We spoke with a visitor who was positive about the home and said the manager had `sorted a lot of things out for their relative`. What the care home could do better: Despite the evidence of some progress in place. There continues to be a lack of continuity in care practice. The home has still to ensure that care is delivered in a manner that fully safeguards the service users and promotes their safety and quality of life. Poor record keeping, lack of staff access, and involvement with, care planning and a lack of support provided to staff to understand the policies and procedures still impacts adversely on the quality of care. The care planning process still requires improvement with more service user, advocate and staff involvement. Shortfalls and inaccuracies with record keeping were identified. Record keeping should be accordance with the Care Homes Regulations 2001 and current good practice with regards to the NMC guidelines and be contemporaneous and accurate. There should be a more pro-active approach made by the management group. When shortfalls were pointed out during the inspection the management took immediate stepsto address, but did so without giving enough time to ensure the implications were fully understood. For example records were altered without due consideration to the consequences including the change to a careplan without prior care review. There was a lack of understanding about key areas of regulation. Despite assurances given at the start of the inspection, evidence failed to be produced to support all these claims. This lack of evidence showed that the home continues to fail to meet their own deadlines and embed their own procedures into daily care practices. The implementation of recruitment procedures remains a cause for concern as the home has again failed to meet regulations. The registered provider has failed to support the home to introduce robust recruitment procedures. The registered provider produced the improvement plan referred to in this report and has provided assurances that the plan has been actioned. However, the evidence found that the new policies and procedures have not been fully implemented and that care staff had not been supported to adopt them into their daily practices. The management has not monitored the progress and effectiveness of their new ways of working. Random inspection report Care homes for older people Name: Address: Ashcroft House Wilderness Hill Fairview Close Cliftonville CT9 2QE zero star poor service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Anne Butts Date: 2 2 0 7 2 0 1 0 Information about the care home Name of care home: Address: Ashcroft House Wilderness Hill Fairview Close Cliftonville CT9 2QE 01843296626 01843571551 Manager.ashcroft@regalcarehomes.com www.regalcarehomes.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Gregg Type of registration: Number of places registered: Conditions of registration: Category(ies) : Regal Care Homes (Margate) Ltd care home 88 Number of places (if applicable): Under 65 Over 65 0 88 dementia old age, not falling within any other category Conditions of registration: 88 0 The maximum number of service users to be accommodated is 88. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Ashcroft House is an exceptionally large detached property, that was previously a hospital. The service is set out over three floor. The top floor is currently closed and Care Homes for Older People Page 2 of 18 0 1 0 2 2 0 1 0 Brief description of the care home not in use. The middle floor caters for people with dementia and the ground floor caters for people with nursing and residential needs. The home is situated within walking distance of local amenities. There is a shaft lift to access the upper levels. The home has its own secure garden area. There is limited parking for cars available. There are additional costs for items such as hairdressing, chiropody, newspapers and taxis. Information about fees at this home can be obtained from the registered provider. Care Homes for Older People Page 3 of 18 What we found: This was a random inspection which was carried out by two compliance inspectors over the course of two days. We (the Care Quality Commission) visited the service on 20 and 22 July 2010. Time was spent looking at a selection of records including care plans, monitoring records for the well being of people living in the home, staff records and a selection of policies and procedures. We also looked around the home and observed staff interactions and the daily living experiences of people living in the home. We spoke to six service users and eleven members of staff, including healthcare assistants, senior healthcare staff, activity therapists, ancillary staff and the deputy managers during the course of our visit. We also had the opportunity to speak to a visiting relative. The manager, who is registered with the Commission, was available throughout the inspection as well as a senior member of Regal Care Homes (Margate) Ltd. The responsible individual was also present for part of the visit on the second day. Judgements have been made based on records viewed, observations made and verbal responses given by those people who were spoken with. A random inspection does not change the star rating of a service and as such the judgement made in November remains at this time. Previous full inspection reports are available on our website at www.cqc.org.uk A key inspection in November 2009 found evidence that the home had failed to meet requirements and improve upon breaches of regulation found in July 2009. Eight statutory requirement notices were served in January 2010. A random visit carried out in February 2010 evidenced a continued failure to meet these requirements. We, the Care Quality Commission, have served an enforcement notice on the registered provider, Regal Care Homes (Margate) Ltd. In March the service conducted an audit of the home and developed an improvement plan from this. Information from this has been used to measure the service provided against the requirements made on the home. At this visit we have found continued shortfalls and requirements at the end of this report reflect our findings. The registered provider has made a voluntary agreement not to admit people and the local authority has suspended new placements at the home. A requirement which has previously been made with regards to the assessment of new people moving into the home, has therefore, not been assessed at this visit. Since our last visit, in February 2010, there has been a change in the management of the home. The home has been supported on a temporary basis by a quality assurance manager for the larger organisation. The registered provider has employed a new manager, who has been in post since April 2010 and became registered with us in June 2010. Two deputy manager posts have been created and staff employed to fill these roles. We looked at the Statement of Purpose, and saw that this had been reviewed since our Care Homes for Older People Page 4 of 18 last visit. Information contained within this document, though, still is not fully reflective of the service provided within the home. Previous visits to the home had evidenced serious concerns about how people were supported with their nutritional and fluid needs. At this visit we looked at what progress the home had made in order to support people with their assessed need. The registered manager told us that only people who have been assessed as being at risk of poor nutrition and/or dehydration have daily monitoring records of their food and fluid intake. We looked at two records for people in relation to their fluid and nutritional monitoring in conjunction with their care plans. We also looked at a third record for fluid monitoring to consolidate our findings. The two care plans we looked at identified that these people often refuse drinks, only take limited amount of fluids and have poor appetites. The care plans were not supported by robust and consistent recording. Staff do not always complete the records in a timely manner and on the first day of inspection were seen to fill in fluid charts at a later time. We asked a member of staff about this and we were told that the records are now kept in the office and they (staff) do not always have time to go to the office to record at the time when drinks were given out. This has the potential for inaccurate monitoring in accordance with assessed need. We found evidence that there is not a consistent approach to how the fluid and nutritional records are completed. A prescribed nutritional supplement and portions of jelly were being recorded on either the food or the fluid charts and in some instances the same entry was duplicated on both charts. The registered manager explained that this was in order to ensure that they could fully monitor all fluid intake. However as it was dependent on the member of staff completing the record there was no uniformity to where the entry was made. This means that there is no robust way to identify if service users have adequate support in respect of their food and fluid intake in accordance with their identified needs. The registered manager told us that weekly monitoring and auditing of fluid charts had been introduced over a month ago. However, she told us that she believed this had failed to become set in practice due to introduction of other paperwork. She told us that the records had been re-introduced during the week of our visit. The improvement plan presented to us in March 2010 stated, in regards to the fluid charts that with immediate effect the nurse in charge of the ground floor and senior in charge of the first floor must sign off the charts at the end of each shift, and follow up any gaps. At the time of our visit this was not embedded into daily practice. There were nutritional assessments in place and the MUST tool was being used. There was evidence to show that people were being referred to a dietician where a need has been identified. The records for two people showed that they were at risk of malnutrition. The nutritional monitoring records of these two people failed to show how their needs were being fully met with regards to this as the monitoring and recording were not robust. Quantities of food recorded were not measured. Charts viewed stated that meals were either all or half eaten, for example it was recorded that a person had weetabix for breakfast and ate all, but did not state how many. Records also stated liquidised supper ate all and liquidised meal - ate half. There were no records seen to show what they ate or the size of the portion. Care Homes for Older People Page 5 of 18 There is now a record of accidents and incidents in place. Evidence showed that these are audited and action taken to follow up on individual falls, for example. We saw that where a person had been identified as having more than one fall in a month they had been referred to the falls clinic. There were records maintained in files of any bruising or monitoring of pressure area care. The improvement audit carried out by the home in March 2010 identified that there was key documentation missing from care plans and that areas of the care plans needed improvement in their content. We looked at four care plans, two of which we assessed in depth. We saw evidence that there had been progress with the care plans in that they now contained more detail and the guidance for staff primarily reflected the associated risk assessments. Evidence showed that the Homes management team continue to have concerns about how care plans are written. There were records of audits taking place in July where shortfalls in the care plans were identified and amendments needed, despite the improvement audit stating that care plans would be improved by 31 May 2010. We spoke to three healthcare assistants who all told us that they did not have any involvement in writing and reviewing of the care plans. Two told us that they would look at care plans if they had a spare five minutes and another said I look at care plans if I have a couple of minutes. We asked one of the management team about the procedures for staff reading the care plans. We were told that staff are not expected to read them all every day, but when they have a spare five minutes, they should be looking at them. We asked staff about their understanding of the needs of individual service users. Comments included I talk to other members of staff to find out about what people need and I pick up bits and pieces as I go along. Staff were able to describe the needs of people who they cared for on a regular basis, but demonstrated limited knowledge of the needs of other service users. They stated that, if they had time, they would then look at the care plan. Not all of the guidance given in the care plans was translated into daily care practice. Observations showed that a service user was not fed in accordance with their assessed and described need. We discussed this at the time of our visit. Following this the care plan and risk assessment were re-written and we were told that the original care plan was not accurate. Therefore the care plan had not been reviewed and updated when the persons needs had changed. One of the care plans contained contradictory information about a service users ability to communicate, which did not provide clear guidance. For example in one section of the care plan it stated that the service user was able to communicate well verbally and in another section, of this individuals care plan, it described significant communication difficulties. All healthcare assistants we spoke to said that they did not make a contribution to the daily records and that this was the responsibility of the senior members of staff. A healthcare assistant told us I dont even get chance to tell the seniors what has happened. Senior members of staff on both floors confirmed that they were responsible Care Homes for Older People Page 6 of 18 for writing the daily notes. This means that the records are not concurrent for all care given by healthcare assistants and have the potential to be heresay, and are not in accordance with current NMC guidelines. We looked at the daily records for two people and saw that the information in these was brief and not reflective of the actual care described in the care plans. This does not support the home in ensuring that people received their care and support in accordance with their needs. The home has a system, whereby service users are supported by key workers. The improvement plan stated that it had been recognised that staff did not understand this role and that a meaningful policy would be in place by June 2010. We asked to see this policy and were given a copy of a document entitled Key Worker System. This expanded upon the role of the key worker and identified designated tasks including supporting people with voicing any concerns and that staff are to record their key worker support in the new key worker files. We spoke to staff about their understanding of their key worker role. Staff told us that they thought the key worker role was to make sure that people had enough toiletries and clothes and help them purchase them. Two members of staff were unsure as to all the people for whom they were the key worker and another member of staff said it had just changed again. All members of staff spoke to said they had not seen a key worker policy, although one person said they thought there was something about this on the notice board. None of the staff we spoke to said that they had to make any records of their key workers activities. The records for a service user contained two different sets of dependency level assessments. We saw that the dependency levels identified varied between the two assessments with one assessment saying that the person had medium needs and the other saying that the person had very high needs. These assessments were carried out within three days of each other. When we asked about this we were told that one of the assessments was obsolete paperwork and shouldnt be in the file, yet it was also in place on another file we viewed. This is reflective of findings at previous inspections. The risk assessment culture within the home concentrates on reducing known primary risks in relation to moving and handling, falls and nutrition for example. The guidance within these assessments was clearer and were primarily individual to the person. We saw that on one record there was a risk assessment in place that was not individual to the person and had not been reviewed in accordance with this persons needs. Less obvious areas of risk continue to remain unidentified. For example it had been identified in a care plan that one of the service users had a tendency to display verbally aggressive behaviour on occasions. There was no risk assessment in place for this and no action in place to reduce the risk to other service users. One member of staff told us that they had witnessed occasional aggressive outbursts and a couple of incidents. However when we asked another member of staff about the lack of risk assessment for supporting the service user and protecting other service users, we were told that there was no need for this because if this person gets annoyed they usually just goes to their room Previous inspections have highlighted serious concerns about how the home supports people with maintaining their dignity and respect. At the start of the inspection we spoke to the manager about what had been put place to improve these outcomes for people living in the home. She told us that a member of staff had been allocated as a Dignity Champion for the home and that this person was taking the lead. We asked to speak to this person, but they were unavailable at the time of inspection. Care Homes for Older People Page 7 of 18 We spoke to members of staff on duty about their understanding of the dignity challenges and staff were unsure. A member of staff told us that there was a notice up for people to show interest, but thought that this was something that needed to be done in their spare time. When we asked the registered manager about the promotion of the dignity challenges she told us that they had not concentrated on this and it was not fully up and running yet. As previously noted in this report the registered manager had told us about the Dignity Champions initiative and her belief that this was embedded in practice in the home. Observations and conversations with staff did not support this. We looked around the home and saw that some attempt had been made to provide better support with regards to privacy and dignity for service users. For example the home has fitted strip curtains to be placed on the bedroom doors for some people; this is so they can keep their doors open and maintain some privacy. A new system had been introduced whereby discreet signs were placed on bedroom doors when staff are delivering personal care. However, effective use of these was not transferred into daily care practice. Some examples of this were signs were being left up once personal care had been completed and signs not being put up when personal care was being given. We knocked on the bedroom door of one service user, which did not have a sign up. A member of staff answered the door and said that they were in the middle of providing personal care. We observed the lunch time on both floors. Observations on the first floor (which is the dementia unit) showed that people were asked if they wanted the use of an apron whilst they were eating, we observed where a person did not answer they were given one anyway. Earlier in the inspection we were told by a senior representative of Regal Care Homes (Margate) Ltd that special wipes had been provided in the dining room so that people who wished could cleanse their hands before eating. The records of a staff meeting reminded staff that these wipes were available for people. We saw that the dispensers for wipes were available in the dining room but did not observe staff offering these to service users. The majority of people remained in their wheelchairs and staff stated that this was service user choice. However the height of the tables meant not all wheelchairs could not fit under the table, resulting in some people not being able to easily reach their plates which led to some people dropping food. The improvement plan produced in March 2010 identified that staff need to assist people to eat in a dignified manner. Staff are to be seated when they help residents eat. The staff meeting notes from April 2010 reminded staff to sit beside a service user when assisting with their meals, however there were no spare chairs set aside for staff to use. We observed members of staff assisting people with their meals. One member of staff was assisting two people with their meals who were sitting on different tables. For one service user the staff member used additional cutlery to assist them to eat. When they walked away to assist another person with their meal, they left all three items on the side of the plate. We observed that this caused the service user to become upset and agitated by having the extra cutlery. We observed that the service user slammed the extra cutlery down on the table and made no further attempt to finish the meal. When this person was asked if they wanted any additional help to finish their meal they replied yes. The member of staff then walked away without giving assistance to this individual and began to help another service user with their meal. Care Homes for Older People Page 8 of 18 Progress had been made in the range and scope of social activities. There is a leisure therapist based on each floor and they are beginning to promote more individualised activities. For example the home had arranged for one person to have internet access and additional space for a workshop which allowed them to pursue their interests and hobbies. Service users who spend the majority of their time in bed are now being supported to get up if they wish. We saw evidence that two people are now being assisted to get up more frequently. Staff told us that one person had been outside for the first time in two years and another person had been encouraged to join in some activities for the first time. A sensory garden is being developed and there is a residents gardening committee. A relative told us that there are a range of activities available including bingo and regular exercise sessions. Special occasions have been celebrated including recent V E Day events and people were supported to watch the world cup. At the time of our visit service users were preparing for the annual strawberry tea. We observed people making decorations and getting ready for the event. Previous visits to the home evidenced serious shortfalls in the recruitment procedures. In that the home had failed to recruit managers and staff in line with the Care Home Regulations (2001). We looked at a selection of recruitment records including those for management. There was evidence on the files that staff are subject to checks through the Independent Safeguarding Authoritys (ISA) vetting and barring scheme and the criminal records bureau. The ISA checks were in place prior to staff starting work in the home. We looked at the recruitment procedures for two members of the management team in depth. There was little evidence to show that these procedures were robust and had been carried out in an impartial manner. For example on the first day of our inspection neither file had a reference in place from an independent source, such as their previous employer. When we returned for the second day of inspection we saw evidence that the responsible individual had requested and received additional references from the previous employer after the first inspection day. One reference from this source showed a discrepancy in dates of employment with those provided on the application form. There was no evidence to show that this had been discussed and explored. On one file we saw on the second day of inspection (22 July 2010) that there was also another additional reference in place for the member of staff dated 15 July 2010. However when we spoke to the registered manager on 20 July 2010 she had informed us that they had not applied for a reference from this source. There are interview notes in place which allow for the interviewer to make records of the interview including assessing the person under a scoring system for their suitability for the role. Of the two records we viewed neither of the scoring systems had been completed. There was a discrepancy between the dates on the record of interview and letter of offer to a senior member of staff. In that the letter of offer and returned acceptance letter was dated two days prior to the date recorded for the interview having taken place. The registered manager told us that this was a recording error on the interview notes. There Care Homes for Older People Page 9 of 18 were no further records maintained in either the home or at the head office to evidence the actual date of interview. On the second day of inspection, recruitment records had additional comments which had been added to the files where discrepancies in dates had been identified on the first day of our inspection. The information added was misleading. For example an interview record dated 17/5/10 had a comment added that stated Date written in error and signed. The date of 14/05/10 was added underneath the signature. This entry was written between the dates of the 20 July and 22 July (which were the dates of our visits) and we were told that this was when the entry had been made. Failure to correctly date records is misleading. Previous inspections at the home had evidenced serious failings in the recruitment procedures in particular those related to the recruitment of management. At this visit we found that recruitment procedures still failed to meet with regulations. We looked at induction and training. We looked at two induction records and saw that these were not robust. For example there was a discrepancy on the dates entered on one of the records with additional comments which were misleading as to the actual date of entry. All of the induction had been signed off on one day. For example a Skills for Care Certificate of Completion had been dated as started and completed on the same day. The record showed that the inductee had been observed in a number of situations including taking action on a clinical emergency, be involved in training other members of staff and being able to implement the homes operational policies and procedures amongst others on the first day in post. The registered manager told us that it was completed over a period of time. Therefore records need to reflect this. Certificates which were used as evidence for the induction process were gained by inductees prior to their employment at Ashcroft House. However, in one case this included the corporate induction programme from another employer which was not relevant to Ashcroft House. A training certificate for safeguarding vulnerable adults was also used as part of the induction evidence, but this was from a course completed in August 2005. We looked at the staff training matrix and spoke to staff about training opportunities. All of the staff we spoke to said that they had received regular training and this had improved. They told us that they no longer watched training videos and, had more face to face training and that there was generally more training available. The training matrix evidenced that staff had completed training in fire safety, manual handling, infection control, adult protection and health and safety. There were still members of staff who had not completed all of the training, including; food hygiene, nutrition, mental capacity and deprivation of liberty. Some staff who are primarily based in the ground floor also work on the dementia care floor on occasions, particularly during the night shift. There was no evidence on the training matrix to show that these members of staff had received training in dementia care or managing challenging behaviour. We asked staff about their understanding of whistle blowing policies and procedures. There was a mixed response from staff. Everyone we spoke to said they understood the Care Homes for Older People Page 10 of 18 principles of reporting concerns, both about staff and service users. Some members of staff told us they are not confident to report concerns because the management group are all friends or related. At the end of our visit on the second day we spoke to the responsible individual about whistle-blowing procedures. He said that he believed that the whistle blowing procedures made provision for staff to report concerns for when family members were involved. What the care home does well: What they could do better: Despite the evidence of some progress in place. There continues to be a lack of continuity in care practice. The home has still to ensure that care is delivered in a manner that fully safeguards the service users and promotes their safety and quality of life. Poor record keeping, lack of staff access, and involvement with, care planning and a lack of support provided to staff to understand the policies and procedures still impacts adversely on the quality of care. The care planning process still requires improvement with more service user, advocate and staff involvement. Shortfalls and inaccuracies with record keeping were identified. Record keeping should be accordance with the Care Homes Regulations 2001 and current good practice with regards to the NMC guidelines and be contemporaneous and accurate. There should be a more pro-active approach made by the management group. When shortfalls were pointed out during the inspection the management took immediate steps Care Homes for Older People Page 11 of 18 to address, but did so without giving enough time to ensure the implications were fully understood. For example records were altered without due consideration to the consequences including the change to a careplan without prior care review. There was a lack of understanding about key areas of regulation. Despite assurances given at the start of the inspection, evidence failed to be produced to support all these claims. This lack of evidence showed that the home continues to fail to meet their own deadlines and embed their own procedures into daily care practices. The implementation of recruitment procedures remains a cause for concern as the home has again failed to meet regulations. The registered provider has failed to support the home to introduce robust recruitment procedures. The registered provider produced the improvement plan referred to in this report and has provided assurances that the plan has been actioned. However, the evidence found that the new policies and procedures have not been fully implemented and that care staff had not been supported to adopt them into their daily practices. The management has not monitored the progress and effectiveness of their new ways of working. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 12 of 18 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The registered person shall 31/01/2010 compile in relation to the care home a written statement The Statement of Purpose. In that the current statement of purpose and service users guide are reviewed and give accurate, un-contradictory and factual information about the services which are to be provided. The registered provider shall 31/01/2010 ensure that all parts of the home are free from hazards. This is so that people are not subject to any risks. 2 19 13 (4) (a) Care Homes for Older People Page 13 of 18 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, 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 7 17 The registered person shall 20/09/2010 ensure that records are maintained in respect of each service user so that they reflect the care and support provided. So that records evidence that peoples needs are being met and are reflective of the actual care provided. 2 7 15 The registered person shall have a system in place that ensures the regular review and updating of written care plans. This is so that changing needs are identified and revised in the care plan and staff are supported to use the care plans in order to meet the needs of the service user. 20/09/2010 3 7 13 The registered person shall 20/09/2010 ensure that unnecessary risks to the health or safety of service users are identified and so far as possible Page 14 of 18 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 eliminated. In that all risks are identified and there are clear action plans in place to ensure that service users are protected from risk of harm. 4 8 17 The registered person shall 20/09/2010 maintain in the care home the records specified in schedule 4. In that records are maintained of food and fluid intake for service users. The home to maintain accurate and contemporaneous records so that service users can be confident that their nutritional, including special dietary needs and fluid needs will be monitored and met. 5 10 12 The registered person shall 20/09/2010 make suitable arrangements to ensure that the care home is conducted in a manner which respects the privacy and dignity of service users; This is so that people are fully supported at all times in respect of their privacy and dignity the homes policies and procedures are implemented into everyday care practice. 6 29 19 The registered person shall 20/09/2010 only employ a person to work at the care home in line with regulation 19 and Schedule 2 of the Care Home Page 15 of 18 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 Regulations (2001). This is so service users can be confident that they are safeguarded by the recruitment procedures. 7 30 18 The registered person shall 20/09/2010 ensure that persons employed to work at the care home receive training (including structured induction training) appropriate to the work they are to perform. This is so service users can be confident that they are cared for by staff who are competent to meet their needs. 8 33 24 The registered person shall 20/09/2010 have a system in place that monitors quality of service provided that ensures staff support service users. This must ensure the best outcomes for people living in the home. The registered person shall ensure that policies and procedures are fully implemented and staff are supported to adopt them into daily care practices. Care Homes for Older People Page 16 of 18 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 Older People Page 17 of 18 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. Care Homes for Older People Page 18 of 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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