Care Home: Avalon Nursing Home

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What the care home does well Avalon provides residents with a comfortable and homely environment, with an attractive garden to the rear for them to enjoy when the weather permits. residents and visitors spoke positively about the staff, saying they offer the support that is needed, and communication between residents, visitors and staff was noted to be relaxed and friendly. What has improved since the last inspection? The requirements concerning the pre-admission assessment procedures, safeguarding policies and hot water have been addressed since the last inspection. A number of changes have been made to the homes environment following the purchase of the building next door, which has been rebuilt and now contains 13 single rooms with a combined lounge, dining room and conservatory. The buildings are connected by corridors on the ground and first floor. What the care home could do better: Concerns regarding the Statement of Purpose, the care planning system, staff training and meeting residents individual needs were raised during the inspection. Although no requirements have been made as the providers and manager said they would address the issues as they were raised, they have been included in the report. Key inspection report Care homes for older people Name: Address: Avalon Nursing Home 5 Nevill Avenue Hampden Park Eastbourne East Sussex BN22 9PR     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: Kathy Flynn     Date: 2 4 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Avalon Nursing Home 5 Nevill Avenue Hampden Park Eastbourne East Sussex BN22 9PR 01323502487 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: lynnvq@aol.com Elderly Care Home Ltd care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accomodated is 34 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: Old age, not falling within any other category (OP) Dementia (DE) Date of last inspection Brief description of the care home Avalon nursing home is registered with the Commission for Social Care to provide nursing care for up to 34 people over 65 years of age. 21 people who need nursing in the original building and 13 people with a diagnosis of dementia in the new extension. The home is made up of an original building and a new extension linked by corridors on the ground and first floor, and is situated in Hampden Park on the outskirts of Eastbourne. Care Homes for Older People Page 4 of 26 Over 65 0 21 13 0 2 0 0 1 2 0 0 9 Brief description of the care home Situated near an attractive park it is within walking distance of the village, with easy access to shops, public transport, GPs and dental surgeries. There are 26 single and four double rooms on two floors, with a large lounge/dining room on the ground floor in the original building and a combined lounge, dining room and coservatory in the new unit. There is sufficient space for group activities. A small seating near the office in the original building looks out onto the internal patio area, that is accessible to wheelchairs through the lounge and gardens to the rear that are used by residents when the weather permits. Assisted bathrooms and toilets are available, with a shaft lift in the original building, and a chair lift in the extension, enabling residents to access to the rest of the each unit. Care Homes for Older People Page 5 of 26 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 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The reader should be aware that the Care Standards Act 2000 and the Care Homes Regulations Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Avalon will be referred to as residents. This was a key inspection that included an unannounced visit to the home. A range of documentation was reviewed including care plans, medication charts, recruitment files, and the menus. The providers, manager, deputy manager, care staff and cook were happy to discuss the support they provide. They were all very positive and felt they could meet the Care Homes for Older People Page 6 of 26 residents needs. The Annual Quality Assurance Assessment (AQAA) was completed within the required timescale, and identified areas where improvements have been made. Care Homes for Older People Page 7 of 26 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 26 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 26 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. The home provides information about the two units at Avalon, which may enable people who wish to move in to the home, and their representatives, decide if the home can meet their needs. Prospective residents are assessed, before they are offered a place, to ensure that their specific needs can be met. Evidence: The homes Statement of Purpose has been reviewed and updated, and identifies that there are now two units at the home. The original building is described as for nursing, and the new unit is for people with a dementia type illness who require nursing care. The providers stated that this is to enable people to decide if the home can meet their specific needs, and service user guides are kept in each of the residents rooms for them to refer to if they wish. The providers and manager explained that people with a diagnosis of dementia are admitted to the new wing, while people with nursing needs are offered rooms in the Care Homes for Older People Page 10 of 26 Evidence: original building. However recent admissions to the dementia unit have included people who do not have a diagnosis of dementia, including someone who was placed there while a room in the original building was being decorated, and who was then transferred. There are also people living in the nursing unit who have cognitive difficulties but have not been medically diagnosed with a dementia type illness. The decision to admit people to each part of the home is therefore not clear or consistent, it is difficult to assess if the home has the capacity to meet their needs and is not supported by the information in the Statement of Purpose. Since the inspection the provider and manager have stated that they are reviewing the Statement of Purpose to ensure that it reflects accurately the capacity of the home to meet peoples needs. A requirement therefore has not been made at this time. The pre admission assessment process has been reviewed, additional information is now recorded to ensure a full picture of the needs of prospective residents is obtained. The manager confirmed that there are now sufficient registered nurses in the home to enable her to meet with and assess people who have requested a place. A letter is then sent to the prospective residents, or their representatives, to confirm that the home can meet their needs and a place is available. Residents and relatives spoken with said that they had been given information about the home, some had visited to look at the rooms, and all were visited and assessed before they were offered a place. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system provides staff with some information about the nursing and care needs of the people living in the home, although additional information is required to ensure a complete picture of their needs is available. Policies and procedures are in place for the ordering, storage and administration of medication, however these are not always followed which may put residents at risk. Evidence: The care planning system used at Avalon has been reviewed and the home has recently decided to change the care plan format, including the recording of support offered by the care staff. Four new care plans were viewed and these included risk assessments, moving and handling assessments, Waterlow scores and night care plans. However they were difficult to read, with contradictory information regarding mobility for one resident; a pre-admission assessment had been carried out prior to admission for another resident but a care plan had not been completed, therefore there was no guidance for staff to follow when offering support and care; residents were not all weighed on Care Homes for Older People Page 12 of 26 Evidence: admission and concerns regarding the diet for one resident were noted during the inspection, staff would be unable to assess if this resident had lost weight since admission without a baseline measurement. Two of the original care plans were also viewed and were found to contain appropriate information regarding residents care needs. Although one resident whose room is on the first floor, who walks around the home and may be confused at times, did not have an appropriate risk assessment in place. The manager confirmed that she would do this. Since the inspection the manager has advised that the new care plan format will only be used for people admitted to the EMI unit, and will be monitored to ensure that the information recorded reflects the needs of people living there, including evidence that the care plans have been reviewed with the involvement of the residents and their representatives. Training for staff regarding completing care plans has also been arranged in the new year. Therefore a requirement has not been made at this time. Risk assessments are carried out by the nurses employed at the home, however they have not attended a risk assessment course and the expectation is that only people qualified to do so carry out these assessments. The manager contacted training providers during the inspection and will be arranging appropriate training. A communication book is used by the registered nurses to record any changes in residents needs, and the information is discussed at handover. However it was found that some of the information recorded was not the same as that in the care plans, therefore staff were unaware of the changes in the needs of people living at the home, and would be unable to offer appropriate support. The manager stated that the communication book should reflect any changes in behaviour or residents needs, and she will be addressing this immediately with the nurses. The support offered to residents is recorded by the care staff on forms kept in the residents rooms, and this is supported by daily records in the care plans. On viewing these it was noted that some staff record very little information, and comments like all care given and no change do not reflect how the needs of the residents are met. Daily records, when well written, help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review, and to record that they are following the assessment of needs. Residents involved in the inspection said that the staff are very good, although they also said that they are busy and do not have a lot of time to spend with them unless they are providing personal care. Observations during the inspection support this, Care Homes for Older People Page 13 of 26 Evidence: there were very few instances of staff sitting and chatting to people living in the home, unless they were assisting them or giving out drinks and meals. Staff were noted to treat residents with respect, and protect their dignity when offering support and care. The home has policies and procedures in place for the ordering, storage and administration of medicines, and the manager confirmed that staff have attended relevant training. The fan in the clinical room has been repaired, which has resolved the issue regarding the temperature of the room being above the optimum for the storage of medication, and photos of residents are being placed at the front of their charts. It was noted that the medicine trolley was left on the ground floor while the nurse was administering medicines on the first floor, this meant that although the cupboard was locked, people could access medicines that are kept on the shelf below it. One of the residents is responsible for administering one of their own medicines and the manager confirmed that a risk assessment has been completed. A tick box system to show that staff are checking that the medicine is being taken is in place, however the forms viewed clearly showed that not all nurses and completing this. The manager advised that she would be immediately addressing the issues regarding staff failing to follow the homes policies and procedures. The home provides end of life care and there are links with the Macmillan Nurses. The manager is planning to start training in the Liverpool Care Pathway in the latter part of 2010, and introduce the Gold Standard Framework following this to support people whose health deteriorates. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a range of activities for residents to participate in if they wish, and the meals at the home are good, choices are offered, including pureed meals with staff assisting if required. Evidence: An experienced activity organiser and two part time staff have recently been employed to develop a programme of activities for residents in both units of the home. The organiser explained that she is working with residents and relatives at the moment to understand how they like to spend their time and if they have any particular interests. Her aim is to offer a range of group and individual activities that would also involve other staff at the home, so that there are activities throughout the week. She confirmed that she has experience of providing appropriate activities for people with a dementia type illness, and plans to develop a programme that will enable residents from each unit to participate in activities together if they wish. Residents were making Christmas crackers in the new unit on the first day of the Care Homes for Older People Page 15 of 26 Evidence: inspection and on the second day an external entertainer provided a motivational music session in the nursing unit. Residents noted to be participating in activities were clearly enjoying themselves. The residents involved in the inspection said that they decide how they spend their time, with some remaining in their own rooms while others sit in the lounge for most of the day. They were positive about the support offered by the staff. Visitors are welcome at any time, those spoken with said that the staff look after everyone very well, although they are very busy. Relatives and friends are encouraged to be involved in the development of the services offered at the home, and the manager has an open door policy which encourages them to talk to her or the providers at any time. Communication between residents, visitors and staff was relaxed and friendly, and it was clear throughout the inspection that they are happy to talk to the manager and providers. The food at the home is good, choices are offered at each meal, pureed meals are provided if required and staff help residents who need assistance. On the first day of the inspection the chef made a number of meals based on the residents preferences. He explained that they can have anything they want as long as it is available, and if it isnt then we can get it and make them their meal later that week. Residents involved in the inspection said the food is very good, we are offered choices and the puddings are very nice. It was noted that staff left residents plates on trays with lids rather than place them on their individual tables, and residents were not using the dining room tables. The manager confirmed that she had addressed the issue regarding ensuring residents meals are appropriately placed for their benefit during the inspection. Care Homes for Older People Page 16 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies and procedures are in place to enable people to raise any concerns they may have, training in protecting vulnerable adults if provided for staff to protect residents. Evidence: Details of the complaints procedure is included in the homes Statement of Purpose and Service Users Guide, and these are available to all residents and their visitors. Residents involved in the inspection said that we do not have anything to complain about although they can talk to the manager and providers if I want something and they sort it out. Visitors also said that they did not have any concerns, and if they did they felt they could talk to the manager. Training in protecting vulnerable adults is provided for staff, those spoken with said they have attended the training and were able to demonstrate an understanding of abuse and what action they would take if they have any concerns. The manager and providers confirmed that the requirement made at the last inspection has been met, she has attended appropriate training, and there is information in the home regarding the multi agency procedures for staff to refer to and follow. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides residents with an attractive living environment, and staff have attended training in the control of infection to protect residents. Evidence: Avalon Nursing Home has been extended with a new unit of 13 rooms designed to meet the needs of people with a diagnosis of dementia. It is accessible through keypad doors along corridors from the original building on the ground and first floor. There is a combined lounge, dining room and conservatory, with single rooms on each floor, that have en suite facilities of sink or shower and toilet. Access to the each floor for residents is by using a stair lift, and the manager stated that risk assessments have been completed for all the residents who use this. However feedback from staff during the inspection was that residents can become upset and distressed when sitting on the stair lift, as it is noisy and does not move smoothly. The company who fitted the lift have been asked to return to the home a number of times to address concerns and since the inspection the manager confirmed that they have reduced the noise and ensured that it moves more easily. In addition the provider has been looking at installing a shaft lift or a wheelchair lift to enable staff to transfer residents without distressing them. Care Homes for Older People Page 18 of 26 Evidence: A new bathroom has been installed with a bath that can be raised and lowered to meet the needs of staff. However residents may not be able to use it as they would need to climb in and out with limited assistance from staff, and during the inspection it was being used as a storage room. The provider is considering replacing the bath with one that residents are able to utilise. The homes housekeeping and management systems including the laundry, kitchen, staff room and office remain in the original building, and staff have to leave the new unit to obtain clean laundry, drinks, care plans, or contact the manager or providers. The providers have been reviewing this and a sideboard was delivered during the inspection, to enable staff to make residents drinks in the unit. They confirmed that the unit has not been open long, and they are making improvements as and when they are identified through observation and discussions with residents, visitors and staff. The original building has been refurbished, with some residents involved in choosing the paint colours used. A new boiler has been installed, to ensure that hot water is provided at a safe temperature for residents, which addresses the requirement made at the last inspection. The home has appropriate moving and handling aids, including hoists, stand aids, assisted baths in the original building and individual mobility aids as required by the residents. Control of infection training has been provided for staff, those spoken with have attended and were able to demonstrate a clear understanding of the correct use of gloves and aprons. Care Homes for Older People Page 19 of 26 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. Robust recruitment procedures are used to protect residents, and an ongoing training programme is in place to ensure staff offer people living in the home the care they need. Evidence: The providers advised that the staffing levels at Avalon have been reviewed and increased to ensure there are sufficient numbers working in each of the units, to meet the residents needs. Staff involved in the inspection said that they have completed or are working through the induction programme provided, which the manager said is in line with Skills for Care, and two are working towards National Vocational Qualifications NVQs level 3. A mandatory training programme is in place, and attendance is recorded on a training matrix to ensure that all staff are up to date. Additional training concerning the Mental Capacity Act and dementia has also been provided, and the expectation is that all training is provided by people who are qualified to teach the particular subject involved. Feedback from staff about the training was positive, they are encouraged to work Care Homes for Older People Page 20 of 26 Evidence: towards NVQs by the homes management, and most agreed that more training is needed to support people who have a dementia type illness. In particular to ensure that all the staff regard residents at the home as people needing care and support, rather than people who have a diagnosis of dementia. The manager and provider confirmed that all residents at the home should receive an appropriate level of care irrespective of their diagnosis or individual needs, and they will be addressing this. Robust recruitment procedures are followed and the four staff files viewed contained relevant information including application forms, two references and Criminal Records Bureau CRB and Protection of Vulnerable Adults POVA checks. Care Homes for Older People Page 21 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management style encourages the involvement of residents, relatives and staff in the development of services at the home. The health and safety of residents are protected through assessment of the homes facilities. Evidence: The manager at Avalon is a registered nurse and has been responsible for the day to day running of the home for over 2 years. She has considerable experience of providing care for older people and is currently working towards a Leadership and Management qualification, and the expectation is that she will register with the Commission within the next few months. The management structure at the home has been reviewed, a deputy manager has been appointed and staff supervision has been allocated to registered nurses, to enable the manager to manage the home. The providers discussed the quality assurance and monitoring system that is in place, Care Homes for Older People Page 22 of 26 Evidence: which includes ongoing face to face feedback from residents and visitors as the providers are available at the home several days a week, regular meetings, questionnaires and Regulation 26 unannounced visits to review services provided. The providers confirmed that the information they receive is used to assess the support and care the home provides and make changes if appropriate. However an effective quality assurance system would have identified the difficulties with the changes in care plans, and also the need for extra staff training with regard to supporting people with cognitive difficulties. Feedback from residents and visitors during the inspection was positive with all saying the staff are very good, although some also said that staff did not always have much time to spend with them. The manager confirmed that the home does not take responsibility for the residents finances. A number of consultants have been used to ensure that the health and safety of residents, staff and visitors is protected. The providers confirmed that appropriate checks are carried out and the necessary certificates are in place. Care Homes for Older People Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 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. 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