Care Home: Breck Lodge

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What the care home does well The owners have led the continued development of the environment and the standard of care provided to the people who live at Breck Lodge. They have both recently achieved the required qualification for managers of care homes, the Registered Managers Award, and have a good understanding of what `best practice` is. They make sure staff left in charge of the home when they are not there are experienced and capable, and the senior at the home has achieved National Vocational Qualification (NVQ) Level 4 in care. 80% of the care staff have NVQ qualifications. "The owners are always available when you need them, for staff, residents and relatives", commented a staff member, "It makes you confident in their support, and a good staff team has developed". Many of the staff are long term, and have attended various training courses, "There`s continual training on one thing or another, I`ve got certificates for all of mine", said another staff member. Assessments and care plans are very clear and detailed, for staff to know how best to look after each individual. Individual preferences are taken into consideration. Daily records made by staff give a good picture of the life of each resident in the home. The home has a relaxed and friendly atmosphere, and the furnishings are very homely and comfortable. Bedrooms are attractive, with matching fabrics and cosy features. The addition of personal belongings makes them all individual. Staff at the home were friendly and approachable, and had a good understanding of each residents` care needs. We saw good interaction between the staff and the residents living at the home. An activities coordinator is employed to try and provide interest, activity and stimulation for residents most days. Visiting entertainers call twice a month, and trips out in a coach take place every three weeks. A dedicated cook plans and prepares the meals, which were praised by the residents. "The food is excellent. There is always fresh produce, varied menus, and alternatives are offered", said a resident. What has improved since the last inspection? Care plans are reviewed monthly by staff, and the residents` keyworkers record an overview of the previous month, with any changes or notable events. Any changes to the care required are made on the care plan, dated and signed by staff and the resident. Staff told us that they are aware that the keys to the medication cabinet should be kept securely at all times, and at this visit were held by a staff member. They confirmed with us that sometimes they are held in an unlocked cupboard. Staff must ensure they follow the correct procedure. What the care home could do better: The staff should ensure the key to the medication cupboard is held securely at all times, in order to minimise the risk of any tampering with medication stocks. The owners should continue to address the need for people to have a choice on whether they can lock their bedroom door, so as to have full privacy of their belongings, by fitting appropriate locks. Staff should receive appropriate one to one supervision with their manager, in order to monitor their work performance and assess any training needs. This develops the workforce and so the quality of the service provision. To show that the quality of the service is monitored, there should be evidence of any audits made in the home, for example, a manager`s signature to show records have been checked as correct. A system should be developed to obtain and record feedback about the service provision from residents, relatives, and other interested parties, such as advocates and health care staff. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Breck Lodge 78/80 Breck Road Poulton le Fylde Lancashire FY6 7HT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jennifer Hughes     Date: 0 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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: Breck Lodge 78/80 Breck Road Poulton le Fylde Lancashire FY6 7HT 01253894567 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): chrisbrecklodge@btinternet.com Mr Simon Dickinson,Mrs Christine Dickinson Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 15 Number of places (if applicable): Under 65 Over 65 15 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 15 Date of last inspection Brief description of the care home Breck Lodge is a residential home that provides personal care for 15 people aged 65 and over. The home is situated near to Poulton and is within easy reach of local shops and amenities. There is a main bus route near the home. Breck Lodge is a large detached property with a parking area at the side of the home. There are pleasant garden areas at the rear of the home, which are accessible to the people who live there. There are three lounges and a dining room. Accommodation is provided in 15 single rooms all of which have en-suite facilities. A chairlift provides access to first floor Care Homes for Older People Page 4 of 26 Brief description of the care home areas. The home is owned and managed by Mr Simon Dickinson and Mrs Christine Dickinson. As at January 2009 the fees for care at the home ranged from £430 to £450 per week, with added expenses for hairdressing, chiropody and newspapers. 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: This was an unannounced visit to the home, in that the owners were not aware that it was to take place. The site visit was part of the key inspection of the home. A key inspection takes place over a period of time, and involves gathering and analysing written information, as well as visiting the home. The length of the visit was for 6 and a half hours. Every year the registered persons are asked to provide us (Commission for Social Care Inspection, CSCI) with written information about the quality of the service they provide. We use this information, in part, to focus our assessment activity. This document is called the Annual Quality Assurance Assessment (AQAA). Care Homes for Older People Page 6 of 26 Surveys were sent and received from residents and staff of the home. During the site visit staff records and resident care records were viewed, alongside policies and procedures of the home. One of the owners, residents, and care staff were spoken to, along with any visitors who called during the day. Their responses are reflected in the body of this report. A tour of the home was made, viewing lounges, dining rooms, bedrooms and bathrooms. Everyone was friendly and cooperative during the visit. What the care home does well: What has improved since the last inspection? Care plans are reviewed monthly by staff, and the residents keyworkers record an overview of the previous month, with any changes or notable events. Any changes to the care required are made on the care plan, dated and signed by staff and the resident. Staff told us that they are aware that the keys to the medication cabinet should be kept securely at all times, and at this visit were held by a staff member. They confirmed with us that sometimes they are held in an unlocked cupboard. Staff must ensure they follow the correct procedure. Care Homes for Older People Page 8 of 26 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 set out 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 9 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 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear information is provided, which enables people to make an informed decision about the home. The comprehensive assessment that is carried out for all residents means that a service is provided that is tailored to an individuals needs and preferences. Evidence: The home provides very clear information about the service it provides in the form of a Statement of Purpose and Service User Guide that clearly details who owns and manages the home, and what services the home provides. There is detail on what people who live there can expect from the day to day running of the home, and the staff who will look after them. There is also a handy leaflet with a brief overview of what the homes aims and objectives are, and what the service provides, with contact details. Care Homes for Older People Page 11 of 26 Evidence: Residents told us that they were given information about the home before they moved in, and one said I came previously on respite and liked it, and another told us I didnt hear a lot about it, but relatives looked at many homes and thought this was the best. There is a set procedure for admitting someone to the home, and we looked at the pre-admission assessments for three residents. We found that the assessments had been fully completed, and held very detailed information about all aspects of the physical, social and psychological care of the individuals. The assessments made sure that the individual needs were identified, and the home could meet those needs. They were carried out by one of the the owners, Mrs Dickinson, with the prospective residents, and their family if needed. One resident had been admitted in an emergency, and we saw that the owner had made sure she had full information about their care needs prior to admission. Staff told us that they are always given up to date information about the care needs of people they support, and are able to view the assessments the owner has made for more information. They were able to tell us about the needs of residents, and how to meet those needs. The same assessment tool was used for all residents, promoting equality of assessment and care provision. Care Homes for Older People Page 12 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 health and personal care needs of residents are well met in this home. Evidence: Care plans are written records that describe the care that is given to each resident. We viewed two of the residents care plans, which we found clearly identified the areas of need for each person, with clear instructions for staff on what they must do to meet that need. The plans were person centred, individual and informative. We saw that the care plans were reviewed every month, with any changes in need clearly recorded. The reviews gave a detailed overview of each residents care needs. Daily records are made three times a day for each resident, and we saw that these gave a good picture of the daily events in each persons life. These also prompt contact with other professionals, such as GPs or district nurses, or occupational therapists, when needed. Records are held of the visits by healthcare professionals, and what care Care Homes for Older People Page 13 of 26 Evidence: they provided. A visiting district nurse said Its a nice, homely place. Yes, its good here. Residents surveys indicated that they received the care and support they needed, and staff surveys told us that they were always kept up to date with information about residents needs. Staff said I think because we are a small home you know the residents so well. Also we work closely together all of the time, and are a good staff team, so constantly communicate and support each other. The manager is very teamwork minded, and encourages us all to think and work as a team. Its good. We all get on very well. Staff care for people with diverse needs, for example, different dietary needs. Clear information is held on specific conditions of individuals, and how staff can provide the best care. Appropriate aids and adaptations are assessed for by professionals, and available in the home for those residents who need them. Residents are allocated a named key-worker. They have responsibility for more individual needs, and they are someone the resident can feel a closer relationship with. All of the staff knew who they were a key-worker for, and most of the residents we spoke to knew the name of their key-worker, although some did not have a full understanding of the role. This system helps to provide more person centred care to individuals. They do everything for you, theyre all very good said a resident. All staff are very competent in their work. They ensure residents have all they need and are always very friendly with residents and visitors, commented a relative. We saw residents being treated with respect, and heard staff chatting with residents who clearly felt able to say how they felt and what they wanted. We looked at a sample of medication records and stock, and found that they were correct and up to date. Medication is stored securely in locked cupboards within a locked room. Usually the keys to the medication room are held by a staff member on duty, but staff confirmed they are occasionally stored in an unlocked cupboard. They must always be kept secure. 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. Residents daily lives and social activities are generally catered for, and people benefit from living in a home that tries to continually develop to provide people with opportunities to live lives that are fulfilled. Evidence: The individual care plans we saw included information on each persons life history, their religious needs, and what hobbies and activities they preferred. The residents we spoke to told us about the entertainment in the home. I like to watch television - I like Coronation Street. We sometimes get outside entertainers in doing some singing, and sometimes get out in the coach. You dont want to be doing something all of the time though - I like to have a bit of peace and quiet. Oh yes, visitors are calling in all the time. We saw future plans advertised in the hallway, with entertainers calling twice a month, and trips out every third Wednesday. Care Homes for Older People Page 15 of 26 Evidence: The owners told us that there is a designated activities coordinator, who provides some entertainment each afternoon. Residents confirmed this, and talked about the gentle games and exercise sessions they could join in with if they wished. Comments were I dont wish to take part, and I dont join in, and staff said they try to motivate the residents as much as possible. The owners told us they had acquired a memory and reminiscence pack, and how residents enjoyed sharing memories with staff and each other. We noted the good relationships and interactions the staff had with the residents during the day. The hairdresser was attending to several residents. Visitors called in and sat with their relatives chatting. They told us they were happy with the care, and always felt welcome when they called. The meals are served in a homely and attractive dining room, with well set tables. Staff serve the food efficiently in a pleasant, friendly and unhurried atmosphere. The home caters for those residents who may prefer, or need to have, their meals in their own room. There is a full choice of breakfast and morning tea or coffee with biscuits. The midday meal sampled was fish and chips, followed by butterscotch mousse. This was well made by the cook, and tasty, and all of the residents finished their meals, commenting on how they enjoyed it. The main course is set from a three week menu plan, but residents are provided with a choice if they wish. Any special diets are catered for, such as diabetic or vegetarian needs. The evening meal also offers choices, with afternoon tea and suppers provided. Lovely food, said a resident. 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. The residents are confident their concerns will be listened to and acted upon. Staff have an understanding of Safeguarding issues, which protect residents from abuse. Evidence: There is a complaints procedure in place, and a file in which to record any complaints which come to the owners attention. There have been no complaints received by the home or by the Commission for Social Care Inspection since our last visit. All of the residents we spoke to said that they knew how to make a complaint, and what they would do. Id tell any of the girls if I didnt like something, said one resident, but Im quite happy. A visitor told us that they would tell the staff or the owners if they had a concern, and they felt the communication was good in the home. We saw that staff had attended training about safeguarding procedures. These are procedures all homes must have in place, and that must be followed if it is suspected that a resident has been the victim of any kind of abuse. We spoke to staff on duty, and found they had a good understanding of the procedures. Advocacy services are well advertised in the home. 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 has a well maintained environment, which provides aids and equipment to meet the care needs of the residents. It is a pleasant, safe and homely place to live. Evidence: The home has an attractive exterior, with a large garden at the rear which is made accessible for residents so that they can use the seating area in the warmer weather. It is a pleasant and maintained area. We sit out there and have cups of tea and cakes, but its too cold at the moment, commented a resident. We toured the home, and saw that all of the home was clean, tidy and fresh. The home was kept comfortably warm. Domestic staff have set routines to follow to keep the home to a good standard of hygiene, and they were at work during our visit. Surveys returned from residents told us that the home is always fresh and clean. There is equal access to all areas of the home for residents and visitors with mobility problems, in that there are wheelchair ramps and a stairlift in place. Aids and adaptations are also in place to help with toileting and bathing needs. The bedrooms we saw were personalised with residents own belongings, such as pictures, ornaments, and small pieces of furniture. All of the residents said that they Care Homes for Older People Page 18 of 26 Evidence: were happy with their rooms, and that they were kept clean. The owner said that residents can choose on admission whether, following a risk assessment, they would like a key to their room, to have full privacy, and one would be fitted if needed. Those residents we spoke to said that they did not wish to hold a key to their room, but knew they could ask the owners if they felt they would like one. We saw residents moving between the lounges in the home, of which there are three, which allows for when more privacy or quiet is preferred. Televisions were in the lounges, and one of them held a variety of board games for residents to freely use. The laundry area was clean and tidy, and we saw set procedures and routines being followed. Policies are in place for the prevention of cross infection, and we saw that staff had attended infection control training. 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. The home is properly staffed, which means that the residents are supported by sufficient numbers of trained staff. Evidence: Three staff files were selected, and we saw there is a recruitment procedure in place showing that the necessary recruitment checks are carried out to ensure the protection of residents. References and Criminal Records Bureau disclosures had been carried out for all staff prior to them starting work at the home. All new staff follow a comprehensive induction programme, which they sign to confirm they have understood the content. All of the staff surveys returned commented that it covered all they needed to know very well. Staff are given a staff handbook, which gives guidance on working practices in the home. The owners said that they also considered how new staff would fit into the staff team, and they encouraged existing staff to have some input during the recruitment process. Residents feedback was also considered. Care Homes for Older People Page 20 of 26 Evidence: A training matrix shows what courses staff have attended, and all of the staff team have attended various courses between them, including; food hygiene, first aid, challenging behaviour, continence care, diabetes care, dementia awareness, fire prevention, infection control, moving and handling, and safeguarding. Weve been on lots of training courses, theres always something going on, said one staff member. Information the owners sent us told us that 80 of staff hold National Vocational Qualifications in care, with more attending the training. Part of this includes Equality and Diversity training, encouraging care provision from staff which meets the individuals choices and preferences. The staff rota showed us that there are appropriate staff on duty at all times, to meet the needs of the residents. Staff meetings occasionally take place with the owners, when there is a specific topic to be discussed. The owners said that due to the small size of the staff team, communication takes place constantly. Staff said that information is freely passed among the staff team. The home holds the Investors In People Award, which demonstrates a commitment to developing staff. 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 owners are qualified and committed, and have a good understanding of the improvements that can be made to further enhance the quality of life for residents. Evidence: Both of the owners of the home have achieved the Registered Managers Award, and have over 20 years experience in the care industry. They informed us that the senior carer has achieved the National Vocational Qualification (NVQ) Level 4 in care. The owners told us that the management approach is open, and they try to encourage staff to discuss issues, and residents to chat freely and express opinions. Staff said Its a really good team, we all get on well. Simon and Christine (the owners) are always available to speak to and to discuss things with. We are really well supported. We see Simon all the time. He takes you to appointments in his car. Its very good, commented a resident. Care Homes for Older People Page 22 of 26 Evidence: A communication book for staff to pass on daily information about residents, and a shift handover session, ensures all staff on duty are up to date with events in the home. All staff members should have the opportunity to meet their manager on a one to one basis through the year, to discuss areas such as training, personal development, or procedures in the home, for example. This is generally referred to as supervision, and is known to have a positive effect on the workforce, improving staff performance and retention. Due to the ease of communication in this home, one to one supervisions have not been regular for staff and should take place at appropriate intervals, with records kept. The owners told us they monitor records all the time to ensure they are up to date, which we saw they generally were. Some evidence of this monitoring, such as a signature when it is done, would give an audit trail of when the quality of the service was being checked. Some residents told us that they are asked for their opinions about their care, and a visitor said that they were very happy with the care their relative received, and they felt very comfortable speaking to anyone at the home about any queries they had about it. The owners said that as the home was small, they had constant feedback and communication with residents and relatives, giving them a picture of how the service was operating. We saw numerous written compliments of the service from relatives and residents. There needs to be a system to record this feedback, for evidence of the quality of service provided, and that the owners are proactive in addressing any improvements that need to be made. Clear records were kept of residents spending money left in the home, and this was securely held in a safe. We viewed a selection of maintenance records of equipment and safety certificates, which were up to date. 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 1 2 9 24 The key to the medication cupboard should always be held securely. The manager should continue to address the need for people to have a choice on whether they can lock their bedroom door so as to have full privacy of their belongings, by fitting appropriate locks to the doors. Quality monitoring and feedback should be held in written records as evidence the service is continuing to seek residents opinions, operating to a good standard, and any improvements needed are being addressed. Care staff should be appropriately supervised to monitor performance and to guide self development. 3 33 4 36 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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