Care Home: Attlee Court

What the care home does well In their surveys people told us that the staff are kind toward the people in their care. The views of the people living at the home are sought about things like what activities they would like to have available to them and what they would like to see on the menus. Staff receive the training they need to enable them to meet people`s needs. What has improved since the last inspection? The manager and staff have worked hard to comply with the requirements and recommendations made at the last inspection. Care plans and risk assessments are improved, the medication system is improved and the cleanliness is improved generally. What the care home could do better: There is a need to review the way the home is managed and resourced to make sure that standards are further improved and to give the manager more time to manage the home, rather than undertaking administrative tasks. The standard of the floor coverings need to improve in most shared areas, to reduce the risk of cross infection and to make the home a more pleasant place to live. More work needs to be done to make sure that care plans and risk assessments are kept up to date as people`s needs change. Medication systems need to be audited more thoroughly, to make sure they are completely safe. Key inspection report Care homes for older people Name: Address: Attlee Court Attlee Street Normanton Wakefield West Yorks WF6 1DL     The quality rating for this care home is:   one star adequate 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: Caroline Mitchell     Date: 1 3 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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) © 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 Older People Page 3 of 27 Information about the care home Name of care home: Address: Attlee Court Attlee Street Normanton Wakefield West Yorks WF6 1DL 01924891144 01924897755 attleecourt@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Minster Care Management Limited Name of registered manager (if applicable) Mrs Lynne Notley Type of registration: Number of places registered: care home 66 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 66 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 care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP; Dementia - Code DE; Mental Disorder, excluding learning disability or dementia - Code MD; Physical Disability - Code PD. Date of last inspection Care Homes for Older People 1 3 0 5 2 0 0 9 66 66 0 66 Over 65 0 0 66 0 Page 4 of 27 Brief description of the care home Attlee Court is a purpose built 66-bedded care home on two levels, which opened in July 2000. Minster Care Management took over the ownership of the home in October 2007. The ground floor is designed to accommodate older people who require either residential or nursing care. The upper floor is designed to accommodate older people who have a diagnosed dementia type illness and who require residential or nursing care. The home is situated in Normanton within walking distance of the local shops. The town centre is a short distance by car or local transport. The home has a statement of purpose that explains the aims, objectives and philosophy. The most recent inspection report is made available to anyone who wishes to see it upon request from the homes manager and can also be found on our website www.cqc.org.uk. The residential care fees at the time of the visit in April 2010 were £396 to £450 per week, and nursing fees are individually assessed. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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: We went to the home without telling them we were going to visit. The purpose of the visit was to make sure that the home is operating and being managed in the best interests of people living there. Information has been used from various sources for this report. These sources include reviewing information that has been received about the home since the last inspection visit and information provided to us by the manager of the home in their Annual Quality Assurance Assessment (AQAA) We sent out surveys to people living at the home and several were returned. During the visit we spent time talking to people who live at the home, relatives and staff. We also had a look around the home. The manager was available throughout the visit and the findings were discussed with her and the operational manager during and at the end of the inspection. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 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 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. The home does not provide intermediate care. Evidence: We saw the written records for two people who live in the home and there were needs assessments for each person. A senior member of staff goes to visit people who wishes to move into the home to make an assessment of their needs. These assessments help the staff at the home in making a decision about whether they can provide the care and the environment the person needs. We also spoke to several peoples relatives. They said that people had an assessment before they moved into the home. Care Homes for Older People Page 10 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are mostly met. However, some shortfalls in risk assessment and medication procedures could put people at risk. Evidence: At the last inspection the registered person was required to make sure that where assessments suggest that a person may be at risk, care plans are in place to instruct staff on how to manage these risks. At this inspection we saw evidence that lots of work had been done to make sure people had care plans around each area of risk. The care plans do give detail of how staff should support people and how the person likes to receive support. However, we found two instances where these had not being kept up to date. In one persons file the care plan did not reflect that they had a lesion on their back, although this was noted to some extent in the treatment plan for a pressure sore on their foot. For another person there was a risk assessment that indicated that they used bed rails to prevent them falling out of bed, but we were told by the nurse on duty that this was not current as the bed rails were no longer being used for this person. A requirement is made about making sure that the assessments and plans about risk are kept up to date, to make sure that people are kept safe. Care Homes for Older People Page 11 of 27 Evidence: At the last inspection the registered person was required to make sure that medication is administered as prescribed. Again, there was evidence that work had been done to make sure that the policies and procedures for medication are followed so that people get the correct medication. However, a recent incident where an Agency Nurse administered a medication to someone when it was no longer prescribed, revealed shortfalls in this instance, in recording and disposal of controlled drugs and the standard of monitoring by senior nurses. Requirements are made about this issue. It was previously recommended that staff make sure that they take action to meet peoples needs in terms of their dignity. At this inspection we saw staff approach people with consideration and respect and people were appropriately dressed. However, we did see some people who had food stains on their clothes and a recommendation is made about this. Care Homes for Older People Page 12 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care home supports people to follow personal interests and activities. Further work is needed to make sure that the care home is responsive to peoples particular disabilities. People are able to keep in touch with family, friends and representatives. People have nutritious and attractive meals. Evidence: We visited one person in their room. They have a kettle and mini fridge so they can make their own hot drinks. They told us that a lady from Age Concern visits them regularly. They told us that they are Baptist and that the Baptist Minister has been to visit. At the last inspection it was recommended that all people living in the home should have access to social and leisure activities appropriate to their choice and ability. There was evidence that a lot of work had been put into this area. We saw the snoozalum and the staff told us that it is used every day. The activities coordinator was very enthusiastic and there was evidence that she is creative and active in encouraging people to participate in activities. However, there is still room for improvement. We saw a small number of people who were sitting quietly or asleep, Care Homes for Older People Page 13 of 27 Evidence: who received little or no interaction from staff. Another person told us that they dont join in with the activities because they feel handicapped by their visual impairment. Recommendations are made about these issues. We talked to one persons visitors. They said that they come every day. The person has not been in the home long, but they were very happy with the home. Their visitors comments included, Good home, good food, the bedrooms are very nice. They said that their relative is well looked after and sees a Doctor if they need to. They were using sing a long song book to sing some songs with the people sitting in the lounge. They said people do lots of craft sessions such as making Easter cards and making pictures. They praised the staff saying that they come around regularly, talking to people or asking people if they are OK and offering drinks and snacks. We sat with two ladies at lunch. They said that they had a choice of two meals at meal times. They said that some people choose to eat in their rooms. They told us that lunch is the lighter meal with the main meal being served at around 4.30 to 5pm. I like the lunch better than the evening meal because I sometimes have trouble chewing the meat. Whereas the other person said that they preferred the evening meal. They told us that the food had improved a lot. saying We were always having what they called casseroles, so we let them know that we were fed up of that and they changed the menu. We recommended that drinks and snack foods like crisps, biscuits and sweets be made easily available to people. Several staff told us that this was something that was already under discussion. Care Homes for Older People Page 14 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that their concerns are listened to. However, some people have asked for more information about what is done to address the issues that they raise. The care home has responded positively to recent safeguarding issues, providing improvement plans to make sure that people are better protected in the future. Evidence: No complaints have been recorded in the home. When asked who they would complain to one person said, You speak to a nurse, theres always a nurse. Two people told us that they are they are disturbed during the night on a regular basis, by another person shouting out for staff attention. During this conversation another person chipped in saying, Wherever you are you are bound to hear things at night, when people are working. Another person also came to the defense of the home saying, Ive not been to any other homes but Id say youd go a long way to find a better home. The complainants said, Fair comment. and Yes, the carers are generally very good. We noticed that those people who live in the home who were able to express an opinion were doing so freely. When we commented on their confidence to give their view, one person said That is generally encouraged. When we raised the issue of noise at night with the manager, she told us that one Care Homes for Older People Page 15 of 27 Evidence: person has raised the issue with her, but that they were very clear that they did not want their concern written down as a complaint. A recommendation is made about the home looking at ways to manage noise at night better. We spoke with the manager about two recent issues that had occurred in the home and that have been investigated through the Councils safeguarding procedure. One incident was regarding the way the home dealt with the sudden death of a person who was living in the home. The manager said that the safeguards that that have been put in place to make sure things are dealt with better in the future include all staff having updates to their first aid training, updating the policy regarding dealing with emergency situations and staff being made clear about the policy. The second issue was about a person being given a Controlled Drug that they were no longer prescribed. The manager told us that safeguards that have been put in place to make sure that this doesnt happen again. These include tighter auditing arrangements being introduced. The manager said that weekly since employing a new unit manager, recently there have been improvements made in the way the first floor is managed. Care Homes for Older People Page 16 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People stay in a safe and well-maintained home that is generally reasonably clean. However, the carpets in the shared areas need to be replaced. Evidence: The home is accessible for people who use wheel chairs and has a lift. Bedrooms have en-suite facilities and there are sufficient assisted baths and showers and toilets in the home. The home provides appropriate communal accommodation with each floor having separate communal facilities. Occupants of both floors share the garden area. It is not as easy for the people on the top floor to gain access to the garden, an area has been created indoors, on the first floor that is devoted to gardening, where people are encouraged to grow and look after plants. . At the last inspection the registered person was required to make sure that the home is clean and hygienic and as far as possible, the risk of cross infection eliminated. At this inspection we saw evidence that work has been done to address this issue. However, we could smell urine in some of the shared areas. The managers of the home said that they wish to replace the carpets as they believe that this is the source of the problem. The floor coverings in the bathrooms also need to be replaced. A requirement is made about these issues. It was previously recommended that the manager introduce an system to audit the Care Homes for Older People Page 17 of 27 Evidence: standard of cleanliness in the home. We saw that this had been done. The home scored 5 stars in June 2009 for the Councils Scores on the Doors system for cleanliness in the kitchen. In the surveys that we got back from people, five said that the home was clean all of the time and one said most of the time. We saw that lots of work has been done to make the environment stimulating for people with dementia on the first floor. Another good use of memorabilia and reminiscence materials is the boxes that are placed outside each persons room, with pictures and other items showing something about each person, whether it is something they like something of their background. The handyman showed us the plan he was drawing, as he was going to make a wooden cover for a radiator that one person, who lives on the first floor, sometimes lifts from the wall. We saw the handyman replacing wall paper. He said that because some people like to peel it off, he has a good supply so that he can replace it regularly. We visited one person in their room and they said they are very happy with their room. They also told us that there are nice wide corridors in the home so they can get around. The bedrooms that we saw were personalised to suit the tastes of the occupants, with pictures, photographs and ornaments. Care Homes for Older People Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home are supported by staff who have some training. However, there is a need to review the way that staff are deployed, to make sure that staff are available in sufficient numbers to meet peoples needs. Evidence: At the time of the inspection there was a group of several staff having an update to their first aid training. We saw a good induction format, that the manager has developed to support staff during their induction. The manager said that all new staff follow the common induction standards along with the induction to the home. The manager told us that the home is using agency nurses at night to cover vacancies for two nurses. For the sake of consistency, they try to use the same workers. The manager said that the vacancy for the nurses was being advertised. A nurse who usually works at night has moved to daytime work to cover one of the vacant posts. People who live at the home said that they think there are enough staff available to meet their needs and that they usually respond when called. However, independently of each other, three people said that they have to wait longer at night. Another person said that sometimes staff say they are busy and will come back later, and they dont come back. Two staff members who returned surveys to us also said that they thought Care Homes for Older People Page 19 of 27 Evidence: there is a need to increase staffing levels. A requirement is made for a review of staffing to make sure that staff are deployed effectively, particularly at night. Observations during the visit were that staff have an easy, but respectful relationship with the people who live at the home. Staff were observed supporting people with their needs in a kind and friendly manner. Some care staff told us that they are supported to follow the national vocational qualification (NVQ) training in care. We saw the training matrix that shows the training that staff have had and this shows that generally, staff are receiving a good range of relevant training on a regular basis. We looked at two staff files during this inspection. Information was available in the files to show that appropriate checks and clearances had been done before people started work at the home. Care Homes for Older People Page 20 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a need to review the management arrangements in the home to make sure that improvements can be sustained. The environment is safe for people and staff because appropriate health and safety practices are carried out. Evidence: The registered manager is very experienced, having been in the post for many years. She holds a management qualification. The manager conducts annual quality assurance surveys where she seeks feedback and opinions of people who live at the home and their relatives, staff, and other people associated with the home such as health care professionals. She told us that she was in the middle of this process at the time of the visit. The manger had completed and returned to the Commission an annual quality assurance assessment known as an AQAA. This document is for the home to provide the Commission with information about how they think they are doing and any Care Homes for Older People Page 21 of 27 Evidence: improvements they are thinking of making to improve outcomes for people who live at the home. We are aware that a senior manager was engaged through a consultancy, at the end of 2009 to support improvement, but that this arrangement was not a lasting one. There is evidence of progress, but serious shortfalls have been highlighted through the safeguarding investigations that have been undertaken recently. Discussion at this visit and information from the safeguarding investigations indicate that the manager has been struggling to make sure that the home meets the required standards. The current junior management support arrangements within the home are not adequate and past management support from senior managers in the organisation has been spasmodic. Although the requirements from the last inspection are deemed met because of the evidence of the work put into these areas, there is still lots of room for improvement and other areas have also been identified for improvement at this inspection. A requirement is made for the registered person to review the management and staffing arrangement in the home with a view to strengthening the management team, so that improvements are sustained and a more proactive style can be adopted. The manager has no dedicated administrative support and this issue needs to be considered as part of the review. One person said, We do have meetings. They are not very frequent, although I think they are frequent enough. Im told that we are going to have a meeting very soon. Another person said, The matron is there and takes the chair. If anyone brings anything up she says shell look into it, but we dont know if she does. Three people agreed that sometimes they are not sure what has been done about their concerns. A recommendation is made about letting people know what has been done about issues that they raise. The AQAA completed by the manager indicated that servicing and maintenance of equipment used in the home are up to date. At the visit we saw evidence that the temperature of the water in bathrooms is monitored. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The registered person must 30/05/2010 make sure that all documents relating to risk assessment and risk management are dated, and updated as changes occur, to reflect peoples needs or treatment. To make sure that information is up to date about the management of risks associated with each person to make sure that people are kept safe. 2 9 13 The registered person must make sure that regular management audits of the medication practice in the home are undertaken. To make sure that the correct medication procedures are followed, to keep people safe. 30/05/2010 3 9 13 The registered person must make sure that the correct 30/05/2010 Care Homes for Older People Page 24 of 27 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 procedure is followed, for the safe and timely disposal and recording of all medication. To make sure that information is up to date about Controlled Drugs to make sure that people receive the correct medication, as prescribed and are kept safe. 4 26 23 The registered person must 30/05/2010 make sure that an action plan is provided to the Commission for the replacement of the floor coverings in the shared areas and in the assisted bathrooms. This must provide a detailed account of the rooms that are affected and reasonable timescales for completion. To provide a safe and pleasant environment for the people who live and work in the home. 5 31 24 The registered persons must 30/05/2010 conduct a complete review of the management arrangements in the home with a view to strengthening the management team. Care Homes for Older People Page 25 of 27 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 To ensure continued improvement and address shortfalls in the quality of the service. 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 2 10 12 It is recommended that peoples clothing be changed in a more timely manner, if food is spilled on them. It is recommended that further work be undertaken, to make sure that everyone living in the home has regular social interaction and leisure activities that are appropriate to their needs. It is recommended that the home contact the RNIB for support and advice regarding supporting people who are visually impaired. It is recommended that drinks and snack foods, such as crisps, biscuits and sweets be laid out, so that they are easily available to people. It is recommended that the management team review the issue of noise at night and produce management strategies for minimising disturbance to people living in the home. It is recommended that the registered persons conduct a review of the staffing arrangements in the home to make sure that staff are available in sufficient numbers to meet peoples needs, particularly at night. It is recommended that the manager feed back what issues have been addressed, the progress and the outcomes at residents meetings. 3 12 4 14 5 16 6 27 7 32 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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