Care Home: Birch House

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What the care home does well They make sure that residents know all about the home and what is expected of them when they move in. Each resident has their own individual guide that is written especially for them, with pictures and photos, so that they can understand it. One service users said that she liked her guide because it had pictures she recognised and said things about what she was hoping to achieve. Residents are encouraged and supported to make choices about their daily routines and what they want to do with their lives. They are helped to develop their daily living skills and social skills, so that they can live their lives as independently as they want, knowing that staff are there to offer encouragement and support when they need it. They have the opportunity to have time with their key worker. That is a staff member that they have been linked to that they can rely on to provide support. This helps to make sure that they can talk about any worries they may have. Staff are good listeners and make sure that any thing raised is acted upon. Residents go out into the community and pursue their own chosen leisure activities. They can go out to lots of different places of interest and they go on holidays to places that they have chosen for themselves. Staff make sure that residents receive good healthcare. The home is well managed with residents best interests at the heart of whatever they do What has improved since the last inspection? At our last inspection we saw that they had established generally good standards and there were not many things that needed improvement. The manager completed the homes AQAA and told us that most of the house had now been redecorated and new carpets laid. She also said that contacts had been made and clearer plans are now in place for daily activities and holidays. Service users now have more one to one times with their keyworker. The requirement from the last inspection has beeen addressed. Records were seen which evidence the occurence of monthly visits and reports of the visit, in line with Regulation 26. What the care home could do better: The manager felt that the turnover of staff, at times, has an undermining effect on the morale and motivation of others. It is hoped that , by improving the environment, training and practise, a positive regime and outcomes will be established along with a settled and long term staff group. The acting manager needs to complete the process of application to be registered. Service user views need to be taken into account when planning improvements to the bathroom. Key inspection report Care homes for adults (18-65 years) Name: Address: Birch House The Street Appledore Kent TN26 2AF     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: Geoffrey Senior     Date: 2 8 0 9 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 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 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 27 Information about the care home Name of care home: Address: Birch House The Street Appledore Kent TN26 2AF 01233758527 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Michael John Rogers,Mrs Sylvia Margaret Rogers,Mrs Sharon Ann Colton,Ms Joanne Clare Rogers,Mr Al care home 3 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disabilities (LD) Date of last inspection Brief description of the care home Birch House is a large, detached property situated in the village of Appledore, on the edge of Romney Marsh. The providers operate as Nexus Direct and the home is managed on a day-to-day basis by a currently un registered manager. Set in its own spacious grounds, access to local facilities such as the village shop and post office, pub and recreation ground are minutes walk away. There is a train station situated a brisk 20 minutes walk from the home and an infrequent public bus service is available. The home has access to a dedicated vehicle and is able to have access to a second Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 0 9 0 1 2 0 0 9 Brief description of the care home company vehicle if required. The home offers accommodation to a maximum of 3 people who have learning disabilities. The house offers a large communal lounge / diner, kitchen, laundry, WC and spacious lobby on the ground floor. All bedrooms and the office are situated on the first floor, with easy access to an additional WC and large bathroom. Service users with staff support manage the garden and are currently developing a vegetable plot at the back of the garden. Copies of inspection reports can be viewed at the home on request. The basic fee for this service for a 12 week assessment is approximately 2000 pounds per week. A confirmed placement could be contracted at a lower price than the assessment or in some cases at a higher price should assessment prove the necessity of additional input being required. Details can be obtained directly from the Providers. Care Homes for Adults (18-65 years) 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: 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 report takes into account information gathered since the last key inspection on 09.01.2009 and includes a visit to the home. The visit to the service was an unannounced Key Inspection which took place over one day. We arrived at 12 noon on the 28.09. 2009 and stayed for about three and a half hours. The homes acting manager, three members of staff and the three service users were involved in the inspection. We received the homes annual quality assurance assessment, known as an AQAA, when we asked for it. This is a document that all homes have to send us once a year to tell us how they think they are meeting the national standards, how they have improved in the previous year, what they aim to do and lets us know when they have completed important environmental safety checks. Prior to the visit we sent survey questionnaires to the home to be distributed to the service users, members of staff and care professionals. Most were completed and returned to us. The responses were noted and contribute to this report. At the time of the visit there were three service users living at the home. We spoke with two of them and had discussions with the manager Care Homes for Adults (18-65 years) Page 6 of 27 and the staff on duty. We observed how staff interacted with service users during the day when offering care support. We looked at some of the service users individual support plans and risk assessments. We also looked at and discussed the training records and quality assurance arrangements. Care Homes for Adults (18-65 years) 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. Care Homes for Adults (18-65 years) Page 8 of 27 You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be sure that a thorough assessment of their needs will be carried out with them. There is good information about the home to help people decide about moving in Evidence: People can find out about the home from the service users guide that tells them all about Birch House and what to expect if they decide to move in. There is a general guide available but each service user has, or will have one that has been put together specifically for them in a way that they can understand. The guide includes words, pictures and photos of various areas inside and outside the home and garden. It tells the person about the staff, what support they can expect, their rights, things they are responsible for and explains the homess routines. The manager told us she is exploring ways of producing the service user guide in different formats, to meet the needs of service users with impaired vision.The manager said that there is a company wide procedure for introduction, assessment and admission for people who are interested in living at the home. They are visited at their current address by the home manager, and the supervisory manager, who undertake an initial assessment and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: then, if all agree, they arrange for the person to to visit, meet the existing service users and staff, look at the accommodation and find out about the routine and lifestyle they could expect at Birch House. There are three people living at Birch House. One has lived there for 3 years. The other two moved to Birch House from another home within the organisation that closed just before Christmas 2008. The Manager told us that she had met with the two service users at the other home and talked to them about the possible move to Birch House. They already knew the home and the person living there through social events and holidays. The service users told us that they were invited to visit and stay overnight to find out more about the home before deciding whether it was where they wanted to live. This also gave the manager opportunity to assess what support needs they have and decide whether the staff skills and experience were enough to properly look after them. People we spoke to said that they were glad to have moved in as they liked the house and it is nearer shops and the pub than where they were before. They said they felt happy to live at the home and settled in quickly. In our surveys both people who answeerd said that yes they had been asked if they wanted to move into the home and had received enough information about the home to help them decide. Social care professionals who use the service commented in the survey forms we sent them that the continuity of care has enabled the client to build confidence and feel more settled. Another said that the home manages to provide satisfactory care to individuals by recognising their ability, or inability, to carry out daily living tasks and offering support in areas of need. Care Homes for Adults (18-65 years) Page 12 of 27 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. Service users benefit from having their own individual plan of care that shows their assessed needs and wishes. Staff and service users work together to ensure that these are met. Service users are encouraged to make their own decisions and choices, they are supported to take reasonable risks and develop their life experiences. Evidence: Staff have got to know each person well and have found out and recorded what support they need and how they like it to be offered. Some routines have been estblished and guidelines have been written for staff in the support plans so that everyone should be doing the same thing. We looked at two of the files and saw that they covered areas that are important to the individual, such as, their daily routines, what they need reminding about; where they need encouragement and things they need support with. They cover religion and culture and make sure that any related things are known and that plans are put in place to make sure that the persons wishes are respected. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Risk assessments are included as part of the plan. This is so that if people want to do something they are not stopped because it is thought to be unsafe. Instead, staff work out what is needed to make it as safe as possible. We spoke to some of the service users about their daily lives. They told us how they make choices about the things that they want to do with their lives, such as where to go and what to do. We saw them deciding with staff what to have to eat, as well as helping prepare the food. They also told us about other things they are able to have a say in. The people who live there chose the colours for the redecoration of the communal rooms as well as the bedrooms. They spoke about being given a choice of holidays, whether to go as a small house group to Centreparcs or as part of a large group from all the homes going to an activities camp where they had been before. Care Homes for Adults (18-65 years) Page 14 of 27 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 are helped and encouraged to live fulfilling lifestyles within and outside birch house. They are supported to experience activities that enrich their lives and to maintain contact with family and friends. They are supported to plan and prepare their own meals so that they enjoy a balanced diet. Evidence: Each persons support plan is tailored to their development and what they would like to do with their lives. They are encouraged and supported to develop their daily living skills according to their needs and wishes. Everyone is expected to contribute, to some extent, to the group living and running of the home. Access to the kitchen is unrestricted and people may make drinks and snacks as they wish. Service users have a say in the menu and, with guidance around making healthy choices, can choose and Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: prepare what they want to eat. Service users take turns to choose the menu for the week. The example we saw showed the choices that had been made by the individual but at the same time considered the dietry needs and preferences of their fellow service users. We were told that people living at the home choose their occupational and educational activities. We saw that each service user decides with their keyworker what they want to do then puts it on a wekly planner. This is so that everybody knows who is doing what and when and what level of support is needed. One service user was keen to tell us of recent events regarding his goal of living independently. Contact has been made with people who can teach him to read Braille and he also now has his own front door key. This he saw as an important milestone. Everyone is involved in household chores around the home and look after their own rooms with staff support as necessary. A care professional commented in the survey form that the small household allows for more one to one work between staff and service user. The service iusers are supported to keep in contact with their family and friends via phone calls and visits Care Homes for Adults (18-65 years) Page 16 of 27 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 are encouraged and supported by staff to ensure that their personal and health care needs are met. There are systems in place for the safe storage and administration of medications. Evidence: Each persons file contains details about their health needs and the support they require. There is information and monitoring charts for the people who have specific conditions so that details are available if the specialist or GP need them. People are supported to access community and specialist health care services and appointments. Staff told us that they are currently trying to encourage service users to make the appointments and talk for themselves rather than staff talking for them. Staff were able to talk in detail about the current health of the service users and how it is monitored as part of the support plan review process. Any changes can then be noted and acted upon with minimum delay. One service user used to manage their own medication but now chooses not to. All service users do however play a part in the administration in that they are encouraged to remind staff when medication is due, help with dispensing and then countersign receipt of their medication. The records relating to medication administration were Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: seen to be complete and up to date. There is information about what each person is taking and possible side effects to be aware of. The manager said that all staff who are involved in medication have received training and she is satisfied with their competency. Care Homes for Adults (18-65 years) Page 18 of 27 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. The service users are supported and enabled to raise concerns and make complaints. The management and staff make sure complaints are listened to and sorted out. The homes recruitment procedure checks people who come to work at the home to make sure service users are protected from the risk of harm. Evidence: There is a copy of the complaints procedure that each service user has a copy of with their service user guide. This is discussed with them when they first come to live at the home. A general copy is also available for visitors to the home. Both service users and five staff who completed the survey questionnairres said they knew about the complaints procedure and how to raise a concern if they were not happy.. Staff said that they would seek to resolve anything that caused distress and would try to reassure them. Staff have received training in the protection of vulnerable adults and were clear about what to do if they had cause for concern. The AQAA told us that there have been no complaints or safeguarding issues raised in the past twelve months. Care Homes for Adults (18-65 years) Page 19 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, 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. People said they enjoy living in a house that is well maintained, clean and comfortably furnished. Service users enjoy acces to all communal areas and the privacy of their own spaces. Evidence: The Manager told us that the programme of decoration and improvement continues. Several of the communal areas have been painted and papered and new carpets laid. We saw, as we looked round, where improvements had been made and were told about plans for other parts of the home and garden. The first floor bathroom, the only one in the house, is in need of attention as the decor is worn and the fittings old and stained. In discussion with service users a desire was expressed for a walk in shower and separate bath. It was felt that the shower would be particularly beneficial for those with limited mobility or vision. We spoke to two of the service users who said that they liked the home and enjoyed having their own room that they can personalise with their own bits and pieces and choose the decor. They also liked having their own keys for the bedroom and front door. People have worked on the front drive and garden to make a favourable first impression of the home and have developed the rear garden into a pleasant and usable leisure area. Care Homes for Adults (18-65 years) Page 20 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, 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. Service users are supported by trained staff in sufficient numbers. The homes recruitment practices include measures to protect the service users from the risk of harm. Evidence: We talked to the manager about staffing in the home and looked at the duty rotas and staff files. We were told that recruitment and retention of staff is sometimes hindered by the rural location of the home. However, the manager said that they currently have a settled team and are able to maintain appropriate levels of support on each shift. We saw that rotas are worked out to cover for staff training and to support service users activities. There is a mix of youth, experience and qualifications on the staff team. Staff were asked in the surveys if they were being given induction and training that is relevant, helps them understand and meet the needs of people, keeps them up to date with ways of working and gives them knowledge about healthcare and medication. Five answered the questionnairre and all said that they were. The manager told us that, of the ten staff members, six have attained NVQ level 3 qualification. All new staff have to complete initial training to acquaint themselveswith the home and service users and things to ensure safety. They are also required to complete a number of mandatory courses such as,first aid, fire safety, health and safety and safe moving and handling. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Once these are completed staff have opportunities to attend other courses that are specific to supporting people with a learning disability. We looked at staff files and talked to the manager. We found that the organisation has robust recruitment procedures in place to protect service users from the risk of harm. A number of security checks are completed before new staff start working at the home. These include written references and a criminal records check to make sure they are trustworthy and safe to be around service users. we also saw from staff records that they receive individual supervision with the manager every six to eight weeks. This is to monitor performance and discuss training and development needs and achievements. Care Homes for Adults (18-65 years) Page 22 of 27 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. Service users benefit from living in a well managed home where their best interests are safeguarded. There are systems in place to promote the health, safety and welfare of service users, staff and visitors to the home. Service users can be assured that their views will be listened to and may affect changes introduced into the home for their benefit. Evidence: The acting manager has several years experience in a variety of residential care settings and has attended management and care provision training to NVQ level 4 and the Registered Managers Award. She has worked as a manager of a home in another organisation. She told us that she recently resubmitted an application to be registered. Confirmation of receipt has yet to be notified. She told us that there have been a number of changes to both practice and administration in the home. This, she said, is down to initiatives from the organization, herself and from the staff and service users. She feels that the open and approachable management style has helped to make people feel valued and respected. Service users said that they feel they are listened to and can play a part in running the home Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: and staff said they feel their contributions are appreciated. There is good communication between staff and between residents and staff. This means that residents are fully consulted and involved in the daily running of the home and in planning their own individual lifestyles. They have regular residents meetings and staff meetings. Residents have their regular meetings with their key worker and staff have regular supervision meetings with the manager. There is ongoing quality monitoring that includes monthly visits by a representative of the owning organisation. We were told that the home utilizes the review meetings and family visits to obtain feedback,determine how the home is doing and identify areas for future development. The AQAA indicated that safety checks are up to date. Systems are in place to promote the safety and welfare of the service users, staff and visitors to the home. Care Homes for Adults (18-65 years) Page 24 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 Adults (18-65 years) Page 25 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 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 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. 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). 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