Care Home: Ballater House

What the care home does well Care plans are up to date,needs are reviewed regularly and service users have started contributing more to the content of their plans. Health care needs are well met and the home supports service users to maintain links with a range of healthcare professionals. Medication procedures are robust and only trained nurses administer medication. Staff recruitment procedures are thorough and staff receive plenty of training opportunities. What has improved since the last inspection? A new pre admission assessment document has been introduced and the home is looking more closely at the compatibility of service users. Person centred planning has been introduced. There is more awareness of the need to enable service users rather than undertake tasks for them,independence is being promoted more. Service users have been consulted about the introduction of a new menu. There has been more progress on making daily routines more flexible. What the care home could do better: Care plans need to be streamlined so that information is easier to access and health information needs to be in a dedicated section. Daily recording needs to include information on what service users do during the day in terms of activities or socialising and less clinically based. The stated intent to increase the range of activities available needs to be carried out. Communal areas need to be made more homely. Staffing at weekends needs to be increased further so service users have more opportunities to go out if they choose to. Key inspection report Care homes for adults (18-65 years) Name: Address: Ballater House 43 Hollymeoak Road Coulsdon Surrey CR5 3QA     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: Deborah Sullivan     Date: 0 1 0 6 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 Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Ballater House 43 Hollymeoak Road Coulsdon Surrey CR5 3QA 08706003636 01737550368 ballaterhouse@glencare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Gordon Phillips care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 16 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: Learning disability - LD Date of last inspection Brief description of the care home Ballater House is situated in a residential part of Coulsdon and is registered to provide nursing care for up to 16 adults with a learning disability. The service supports people who have a learning disability and challenging behaviour. The accommodation is on two floors of a large modern house and consists of sixteen single bedrooms, however, only some of the bedrooms are being used at present . Some of the bedrooms have en-suite facilities, consisting of either a toilet and sink or a toilet and shower. There is a very large secure garden to the rear of the property. There are ample parking spaces at the front of the house. The base fee for this service is 2,266 pounds per week. Additional charges are made for staff support if people wish to go out for an activity that is over 8 miles away from the care home. Details of this are provided within the Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 16 Brief description of the care home contract. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection of Ballater House took place in the company of the Registered Manager,service users and care and nursing staff.Five service users were at home during the visit,some time was spent with each of them.A range of documentation was read including care plans,staffing files and training records,medication records and health and safety recording. Survey forms completed by service users,staff,health and social and health care professionals and advocates and relatives have also provided information to assist the inspection process and some comments that they made are included in this report. The AQAA (Annual Quality Assurance Assessment) completed by the registered manager has also been used as evidence for this inspection. During the visit staff and service users were were helpful in providing information. Care Homes for Adults (18-65 years) Page 6 of 28 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. Care Homes for Adults (18-65 years) Page 7 of 28 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the service is available for prospective service users and their representatives and visits to the home are welcomed. The needs of prospective service users are assessed before they are offered a place at the home. Evidence: The home has a statement of purpose and service users guide,work is commencing on revising the information so that it gives clearer details about the length of time that service users may be expected to stay at the home, in that it is a rehabilitation service and the expectation is that service users stay at the home for approximately two years before moving on to more independent or long term settings.Screening for new service users is more robust as there have been inappropriate admissions made in the past that have had a negative impact on existing service users. Needs are assessed by the registered manager before a place at the home is Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: offered.Pre assessment information was read on the care plans of the two service users who had been admitted since the last inspection.The assessments include risk assessments,background and personal information,information is also provided by health and social care professionals involved. Introductions to the home are individually planned and can include daytime visits and trial stays.A member of staff said that they shadowed staff at a new service users previous home in order to become familiar with their needs.Following admission an initial review is held within six to eight weeks. Service users have contractual agreements with the service. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each service user has a care plan and care plans have become more person centred with the introduction of person centred planning. Service users receive support to enable them to make choices about their daily lives,opportunities for choice are increasing. Evidence: Each service user has an individual care plan,since the last visit the home has progressed with person centred planning.The care plans of three service users were read,information is held in the person centred plan and a separate file containing assessment,medical and background information,daily recording and the main working plan of care for staff to follow,these were being reviewed monthly and updated if needs changed. The recording on daily notes tended to be based on rather clinical observations such as when service users slept,took medication and their mood during the day,more recording of activities,personal interactions and choices is needed. A Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: number of staff have attended person centered planning training A health professional wrote on a survey that -The information provided is always accurate and includes areas around health and social well being. Service users had contributed to the person centred plans and signed them. There is a large amount of information in the other folders that is not very easily accessible to staff and it is recommended that some information that is not needed or current be held elsewhere and all medical information be placed in one section.Risk assessments had been completed for service users individually. With the introduction of person centred planning and progress the home is making on being less restrictive, service users are being offered more opportunities to make decisions about their lives although there still needs to be better recording of choices made especially regarding activities. Service users can choose to manage their own finances totally independently or with some support. The daily routines had become less restrictive when the last inspection took place and this has continued with service users being free to use the kitchen independently or under supervision to prepare their own meals and packed lunches for college.One door into the kitchen is locked but the other is kept unlocked and service users were observed to be entering it.The laundry remains unlocked. Service users who choose to attend a daily meeting each morning at which they can discuss what to do during the day,they choose when to get up and go to bed.One service user got up mid morning and another spoken with confirmed they can choose when to go to bed. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have opportunities to take part in activities at home and in the community,the service needs to continue to expand the range of activities available. Contact with friends and relatives is supported. Meals are healthy and varied and there is choice available. Evidence: Service user have opportunities to take part in activities and the home is making efforts to provide more opportunities for them.Some service users attend college part of the week,go out independently and have more chances to access the community than others although the service has acknowledged that it needs to to improve the breadth of community activities and activities at home. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: On the day of the inspection two service users were at college,another was visited by a relative and was going out with them in the afternoon,two people went out swimming and shopping and others spent time in the main lounge or in their rooms.It was a sunny day so staff encouraged people to spend time outside,two people played netball for a short while for some exercise.One service user had written on a survey form that they go to college and go home on their own and another stated during the visit that they often choose not to take up activities. One person said they liked going out shopping on their own locally another attends church on Sundays. The two people who had been most recently admitted were the least active,spending some time outside, watching TV or sleeping,the manager said that it was difficult to find activities to motivate them,one had progressed as previously they were not happy with being with others in communal areas and now would accept this. Service users share in the domestic tasks of the home and each has a daily task such as laying tables or hoovering. There have been restrictions on opportunities to go out at weekends due to there not being enough staff on duty or sufficient drivers,now additional staffing hours are provided for weekends and the manager organises the rota to accommodate outings and activities although the hours still need to be increased to give more flexibility throughout the whole weekend.The home has its own minibus and service users can access public transport independently or with staff. The manager and staff spoken with confirmed that they are exploring the availability of more community activities,currently service users can go bowling or to the cinema at weekends and other outings can be arranged.Two service users said they liked painting at home and one has started growing vegetables. In 2008 six service users went on a short holiday to Butlins,this was a success the intent is they will return this year,two people choose not to go away. Service users are supported to keep in contact with friends or relatives,one service user said they were going home for the weekend,their relative who was visiting said they were always welcome at the home and they were happy with the service. Service users can have friends to visit and there are activities that take place with other homes in the group such as a mini Olympics day. The menu is healthy and varied and is under review,an outside catering consultant has devised a suggested new menu,service users have been consulted about it and their views recorded,they will be feedback before the menu is finalised.This work is in preparation for the planned employment of a cook for the home, as currently the post is vacant and staff prepare the meals. The main meal is taken in the evening,the lunch was healthy with choice available,as the weather was good two service users chose to take their meal outside, others ate in dining room.Service users spoken with said they liked the meals at the home.One service user is diabetic and staff are aware of their Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: dietary needs. A cookery and baking session takes place once a week for service users who wish to attend,use of the kitchen has become more available for service users. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive the support they need with health and personal care needs and to keep in contact with health professionals. Service users are encouraged to take responsibility for their personal care and health. Thorough medication policies and procedures are in place. Evidence: Health information on care plans includes evidence that service users are supported to keep in contact with specialist health professionals and that routine health checks are kept up to date.Visits to the chiropodist,dentist,GP and for other appointments such as medication reviews and blood tests were recorded.Service users have a variety of healthcare needs some quite complex,records showed that input with health specialists such as community psychiatrists,dietitians and community nurses takes place. Three health and social care professionals who completed and returned survey forms were satisfied overall with the level of care provided.A survey form from a relative said that the home keeps them informed of medical appointments and invited them to attend a hospital appointment and they are kept up to date with the service Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: users condition. Most of the service users are independent with their personal care,two need some support and prompting,personal care support needs are included in care plans.One person who is diabetic monitors their own blood sugar levels with some staff support.Currently no service users self medicate.There is a mix of male and female staff so gender preferences for personal care can be respected as far as possible.A female service user who has a male key worker confirmed they were in agreement with this. Medication procedures are good and the practice of service users lining up for medication has been stopped as this could be a time when friction between service users occurred whilst they were waiting.Medication is stored safely and only staff trained to do so administer it.There is always a qualified nurse on duty who is responsible for giving medication. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A complaints procedure is available for service users and others and complaints are recorded and responded to. Safeguarding policies and procedures are in place and staff are aware of them.The service is demonstrating that it is taking action to improve the protection of service users. Evidence: The home has a complaints procedure,it is on display in the hallway and available for service users.One formal complaint had been recorded during the past year the manager had responded promptly to it in writing.A service user spoken with knew they could go to staff with concerns. Safeguarding procedures are in place and staff have safeguarding training.A staff member spoken with confirmed that they were aware of safeguarding procedures. Recruitment procedures are thorough and all staff are properly vetted. Five safeguarding alerts have been brought to the attention of the local authority in the past year,representatives from the service have attended safeguarding meetings and the organisation is showing that it has taken action and continues to address to address areas of concern. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean,well maintained and hygienic.Service users would benefit from communal areas being made more homely. Individual bedrooms are personalised and reflect the interests of the occupants. Increased access to the laundry and kitchen encourages the development of independence skills. Evidence: The home is clean,hygienic and well maintained,attempts have been made to make it more homely looking,communal areas are still rather bare and would be made more attractive and with the addition of more pictures,ornaments and furniture. A large room that was used as the smoking room has been repainted and the manager stated it was going to be used as the main lounge/activities area to allow for the through lounge dining room to just be used as a dining room,this will be an improvement as it will allow space for activities to take place without any equipment having to be cleared for tables to be used for meals and the current lounge tends to be rather a main thoroughfare.There is now no dedicated smoking room, a shelter has been put up in the garden for service users who wish to smoke. The majority of occupied bedrooms Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: were visited with the permission of the service users,all were personalised to varying degrees,well decorated and clean,some are en suite. One service user has a pet hamster,another has paintings up in their room that they had done,other personal items include photos,music systems and TVs. Service users are either independent with their laundry or receive some support ,one person confirmed they do it themselves and another was doing their laundry during the visit. The kitchen is clean,safe and well equipped and service users now have more access to it. The garden is large well maintained,accessible and secure,there is a patio that was being used during the visit as the weather was good. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are well trained and receive regular supervision. Recruitment procedures are through and help to make sure that service users are protected. Weekend staffing needs further review to allow increased opportunities for service users to access the community at weekends. Evidence: The home is staffed by care and nursing staff,there is always a trained nurse on each shift.There staff on duty were one nurse and two care staff,one of the care staff was a first aider. Three staff files were checked,all were well ordered and contained the required recruitment documentation,throughly completed supervision forms,appraisals and employment contracts.Training records showed that staff attend regular core training and regular core training updates and a variety of other courses.CRBs are being renewed every two years. A staff member said that last year they had attended thirteen courses including core training renewal and topics such as Mental Capacity Act,autism and person centred planning.Another had requested a course on a condition that a service user had and it had been sourced quickly for them. National vocational qualification training is promoted and the majority of care staff have an Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: NVQ in care at level two or above or have nearly completed their NVQ. Staff spoken with said they felt well supported and that it was an improvement that the home was promoting independence more than it used to,one felt it made the work more enjoyable and less task centred. Staff were polite and respectful towards service users and spent some time speaking with them or supporting those needing assistance with activities or domestic tasks.There were periods when staff were just observing people which was rather intrusive, if service users need to be under observation for health or safety reasons methods of making this less obvious should be considered. An additional eight staff hours have been allowed so that there are enough staff at weekends to take people out if they wish to go ,leaving two staff at the home,however this is spread over the whole weekend and needs to increase to give more opportunities for going out.The manager does use the time as flexibly as they can but consideration should be given to further increasing hours at weekends. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to work on becoming more responsive to service users needs and rights and it is clear that investment is being made to develop the service and bring about improvements. Internal quality assurance takes place and the service seeks the views of service users. Policies and procedures are in place to protect the health,safety and welfare of service users and staff. Evidence: The registered manager has gained her RMA and is well established at the home. The atmosphere in the home was friendly and it continues to become a less institutionalised setting than before,at the last inspection it was recorded that some notices that were restrictive had been removed and staff who needed to carry keys did so less obviously. There are still improvements to be made towards making the service a less clinical Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: environment such as making the decor more homely,providing more and different activities and making sure that daily recording is less medically based,this work has started and the provider is showing that they are making a commitment to addressing these issues. Improvements include person centred planning,more focus on promoting independence,a new pre admission assessment document and increased reporting of incidents to the Commission and the local authority the latter is an outcome of safeguarding investigations.Staff awareness of what to report and when to report matters to the Commission and the local authority is improved. Internal quality assurance takes place via Regulation 26 visits,annual service user and stakeholder surveys and there are regular service user meetings as well as the daily meetings to discuss any issues of the day.A monthly house safety and maintenance audit is completed by the manager. Requirements made at the last inspection have been met. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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