Care Home: Bridge House

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What the care home does well There is a good management system. This has enabled the service to run well by, for example, addressing any issues or concerns without delay. The home has a quality assurance system that enables the people who use the service to have a say in how the service should be managed and improved. The home`s efforts to encourage and support the residents to be as independent as possible are commendable. The residents have an opportunity to eat food that meets their cultural, dietary and medical needs. The home listens to the residents and deals with their complaints. The staff are committed to their work which means that the residents receive care that meets their needs. What has improved since the last inspection? This is the first inspection since the home has been opened. What the care home could do better: Even though each resident has a care plan and risk assessment in their files, we are not sure if these have been done with residents` involvement. There is a need for the home to ensure that care plans and risk assessments are regularly reviewed, dated and signed by all the people who took part in them. Care staff must be confident in their experience and knowledge of supporting people with mental health needs. The home must provide training and support for the staff to enable them to meet the residents` needs. It is important for the home to ensure that newly recruited staff have relevant experience and knowledge in the service the home provides. Key inspection report Care homes for adults (18-65 years) Name: Address: Bridge House 679-681 Lea Bridge Road London London E10 6AL     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: Teferi Degeneh     Date: 1 2 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Bridge House 679-681 Lea Bridge Road London London E10 6AL 02085481539 02082577810 eshan@leytonhouse.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leyton House Community Care Name of registered manager (if applicable) Mr Sunnilduth Kuppan Type of registration: Number of places registered: care home 13 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 13 The registered person may provide the following category 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: Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection Brief description of the care home Bridge House has been recently registered with the Care Quality Commission to provide care for thirteen people whose primary care needs on admission to the home are within the categories of mental disorder, excluding learning disability and dementia. The home is owned by Leyton House Community Care Ltd (L.H.C.C Ltd), a company which also has four similar homes in Waltham Forest and one other in Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 13 13 Brief description of the care home Newham. The homes statement of purpose explains the aims and philosophy of the service as being to provide the people who use the service and who suffer from severe and enduring mental health problems, a place to live, for as long as required, in a comfortable home with the opportunity of enhancing their quality of life. The home is located within walking distance of local shops, cafes, restaurants, post office and banks. Leyton and Walthamstow Central underground stations can be reached by a number of London buses which run close to the home. Each person who uses the service has a single room with en suite facilities. A small fridge is also provided in each room for the residents to keep food items that they individually buy. The home gives each resident a weekly allowance of twenty pounds which they use for shopping. This is in addition to the communal food items and Sunday meals the home provides. The weekly fees range from £850 to £1,350 depending on the needs of the people who use the service. More information about the home including the service users guide and a copy of the inspection report can be requested from the manager. Care Homes for Adults (18-65 years) 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 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: The home was not told in advance that we were visiting. We arrived at the home at 8:30 am and left approximately after 3 pm. We also went back to the home on 12/03/2010, three days after the inspection, to check things that were not on place when we first visited. Our second visit lasted for two hours. The manager was present throughout the inspection on both days. The owner present on the second day and we had a good conversation with him. Before our visit to do this inspection, we had received a self assessment form known as the annual quality assurance assessment (AQAA) from the home. An AQAA is a form which we request from care homes every year to complete and send back to us. It gives care homes an opportunity to tell us how they are planning to improve the service. The AQAA we received from the home was clear and gave us all the information that we asked for. Care Homes for Adults (18-65 years) Page 6 of 26 The other activities we carried out on the day of this inspection included a tour of the building, the examination of the residents files including care records, the examination of health and safety records, the viewing of staff rotas and discussions with and observation of people who use the service, care staff and the homes management. We have also considered all the other information that we have about the home. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 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 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, 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. New residents can be confident that their admission to the home is based on the outcome of their assessment and the ability of the home providing services that meet their needs. Evidence: We checked the files of five residents and spoke to the manager. The manager told us that eight of the current nine residents have been transferred from another home owned by the same provider. He said that the residents, their families and social workers had been consulted to ensure that this home meets the residents needs. The manager said the reason for the residents to move to this home is to allow the other home to be refurnished. He said the residents will be offered a choice of staying at this home permanently or moving back once the work on the other home is completed. The file of a new resident showed that the home has received a referral from a social worker. The manager confirmed that all new residents are assessed before admission to ensure that the service meets their needs. The AQAA completed by the home gives details of the homes admission procedure. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: The AQAA reads: We provide comprehensive information to all prospective residents, including information about the accommodation in the home, the communal facilities, local amenities, the philosophy of the home, activities within the home and a breakdown of the fees and services provided. Visiting the home prior to admission is very important. We understand how a new resident may feel when looking at moving into care, therefore we ensure that we always encourage new residents to visit the home prior to admission to get the feel of the place and out contacts with residents allow them to have a trial period if they wish. We spoke to three residents. Each of these residents told us that they are happy at the home. Care Homes for Adults (18-65 years) Page 11 of 26 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. The people who use the service can be sure that the home can meet their needs through its detailed care planning and risk assessment systems. The residents can be more satisfied if they know that they and their representatives are always involved in their care planning and risk assessments. Evidence: We examined five residents file. Risk assessments and care plans have been completed for all these residents. The manager told us that each resident has a key worker who updates the care plans and risk assessments. While it was evident that the care plans are detailed and reflect the assessed needs of the residents, we were not confident that they are regularly updated with the involvement of the service users. This is because some of the care plans have not been dated or signed by both the staff and the people who use the service. We discussed this with the manager and asked him to make sure that the care plans and risk assessments are dated and signed by all the people who take part in developing them. It was clear in the file that the home works closely with health and social care professionals. Records showed that Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: the residents have seen their psychiatrists, community psychiatric nurses and social workers. We saw a community psychiatric nurse who was visiting a resident at the home while this inspection was taking. As the nurse was in a hurry we were not able to talk in detail about the home but we were reassured that they are satisfied with their observation of the care given at the home. The three residents we talked to told us that they are happy with the services they receive. In one of the risk assessments we noted that a resident has an idea of committing suicide. In discussions with the manager we were informed that the risk has been managed very well and the person was no more at risk of committing suicide. While this was a good progress, we still suggested that the home regularly monitors the persons needs and take proactive steps such as providing window restrictors and properly training staff (please see below under premises and staffing). Care Homes for Adults (18-65 years) Page 13 of 26 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. The residents have good opportunities to choose their food and day activities. This means that the residents aare engaged and decide what and when to eat. Evidence: From a discussion with the manager and veiwing of the residents files it is clear that some residents are engaged by either going to a college or doing activities of their choice. We noticed during the inspection that a resident was able to go to and return from the community independently. The manager said the homes aim is to encourage the residents to be confident and do things for themselves so that in future they can move on to live in the community with a minimum support. From the files we noted that two residents have no planned or unplanned activity. However, the manager said that the two residents who do not go out on their own are supported by the staff to go to the shops and the post office. We asked one of the residents who does not go out on their own and were told that they are happy living at the home. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: The homes visitors book indicated to us that some residents are visited at the home by their friends and families. It was also clear from discussions with the manager and residents that some residents visit their families. On the day of the inspection one resident was away visiting their family. The residents we spoke to confirmed that they are free to access all communal areas. The manager and the residents we talked to told us that all residents have keys for their rooms. We were informed that some residents have their mobile telephones while others are allowed to use the homes telephone. The residents are able to attend and discuss common issues in their meeting. Copies of the residents meeting were available for inspection. The kitchen was inspected and was found to be clean. Each resident has a fridge in which they keep their food items in their bedroom. The manager told us that the home gives each resident £20.00 (twenty pounds) a week so that they can buy main meals of their choice. The AQAA also states: Staff support service users to devise healthy balance diet according to their cultural needs. Items such as milk, bread, cheese, vegetables and cereals are provided by the home and are not part of what each person is required to buy. Sunday lunch is provided for all the residents by the home. The manager confirmed that each residents dietary and religious needs are taken into consideration when preparing Sunday lunch. The residents we spoke to said they are satisfied with the current food arrangement. The manager told us that each resident has their own bank account but are supported by the staff with budgeting and applying for benefits. Some personal allowance money, records and receipts were kept in a separate cash tin for each resident. We checked a sample and found the records and the receipts to be correct but the money, in a few cases, was more than what the residents should have. The manager said this was because the resident was yet to take and sign for extra the amount. Care Homes for Adults (18-65 years) Page 15 of 26 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. There are good systems to ensure that the healthcare needs of the people who use the service are met. Evidence: The AQAA confirms that the home works closely with the residents General Practitioners (GPs), psychiatrists, community psychiatric nurses (CPN) and social workers. We have mentioned above that a CPN was visiting the home to see a resident while the inspection was taking place. It was evident in the residents files that healthcare appointments were recorded and the residents were supported to see healthcare professionals. Care plans and risk assessments give details of the residents health care needs. The manager told us that each resident has had dental and eye check. From discussions with the manager and some residents it was evident that all of them are able to do their personal care independently. On the day of the inspection the residents looked well and relaxed. The administration and recording of medication were examined. The home has the Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: required policy and procedure. Medication was stored in locked cupboards in a separate room. Many of the residents self administer their medication. The staff monitor to ensure that these residents take their medication as prescribed by their doctors. The medicines and the medication administration record sheets (MARS) that we checked were all in order. We were informed by the manager that the staff who administer medication have all had appropriate training and are experienced. However, we were not able to see certificates to confirm that all staff had certificates from appropriate organisation able to provided training and certificate. We also felt that the temperature of the room where the medicines were kept was high during our visit. Even though the home had a thermometre, it had not started monitoring the temperature in the medication room. We were satisfied to note on the day of our visit and on a follow-up visit that the manager has implemented a procedure of recording the room temperature where the medicines are stored. We noted in the MARS we checked that the allergies that residents may have have been recorded. Care Homes for Adults (18-65 years) Page 17 of 26 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 people who use the service can be confident their concerns are listened to and solved by the home. The homes safeguarding procedure makes the residents feel safe in the home. Evidence: There has been one recorded complaint since the home was opened. This complaint has been investigated and addressed by the manager. It was clear from conversations with the manager that all residents and visitors concerns are recorded and taken seriously by the home. The three residents we talked to confirmed that they know that they can talk to the staff or the manager if they have a concern. The AQAA states that the residents are given information about the homes complaints procedure. The AQAA says: We [the home] ensure that new residents are informed on how to log a complaint, and a service user guide containing relevant information is given to them upon admission. The AQAA confirms that all staff have attended training on safeguarding. We were not able to see certificates to confirm this. However, we interviewed three care staff who were able to demonstrate good knowledge of the homes safeguarding procedure and good practice of ensuring the safety and welfare of the people who use the service. We will still ask the manager to make sure that all the staff attend safeguarding training and have certificates in their files. Care Homes for Adults (18-65 years) Page 18 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, 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 location, cleaning and facilities of the home are good and the residents feel safe and comfortable to live in the home. Evidence: The communal areas and the kitchen were clean and tidy. We looked at a few of the bedrooms which we found were clean, spacious and homely. The people who we spoke to said they are happy with their rooms. Each of the residents has their own bedroom with en suite facilities. The residents have also keys for their bedrooms. The home is situated very close to shops and public transport services. During a guided tour of the premises we noted that the windows did not have restrictors and the gate to the back garden was broken. Both these were fixed immediately and we were able to confirm during a second visit after a few days of this inspection. An area next to the lounge is provided for the residents to socialise, play pool or follow interests of their choice. Smoking is not allowed in the home but the residents have access to the back garden where they can smoke. Care Homes for Adults (18-65 years) 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, 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Even though the staff are committed to their work they need more experience and training to provide a high quality of care expected by the people who use the service. Evidence: The staff rota was checked and showed that there are two care staff and the manager during the day and two care staff at evening and night. The deputy manager or a designated care worker leads a shift when the manager is not on shift. The staff files are kept at the Companys head office. We randomly chose five staff names and asked the manager to bring to the home for inspection. All the staff files we checked contained evidence of satisfactory criminal record checks, written references, employment documents including terms and conditions of employment. We interviewed two members of staff who were able to demonstrate their knowledge of supporting the residents by ensuring their privacy, respect and dignity. From observations it was evident that the staff have good understanding of the needs of the people who use the service. The residents we talked to said they are happy with the staff. We were not able to see in the staff files evidence of training provided at the home except the induction programme provided to all new employees. Even though we are Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: satisfied with the commitment of the staff, we are concerned that some members have no relevant training or experience. We ask the manager or the owner of the home to ensure that all staff employed at the home have relevant, qualification, training and experience to meet the needs the needs of the people who use the service. Care Homes for Adults (18-65 years) Page 21 of 26 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 people who use the service benefit from open, forward-looking and committed management system. Evidence: The manager has been registered with the Care Quality Commission. Written evidence supplied to the Commission and discussions with the manager showed that he is a qualified and experienced nurse. The manager also confirmed that he has received training regarding mental health as part of his nursing training. The staff and the residents we spoke to are happy with the way the home is managed. The manager told us that he attends training to update himself with new practices of management of care homes in order to improve the quality of care. The home has introduced a quality assurance system. This includes written questionnaires distributed to the residents to give feedback about the services and facilities. A sample of the questionnaires, which were completed and returned by the residents and seen by the inspector, showed that the residents are generally satisfied. Each resident has also a key worker with whom they regularly share their views of the Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: service. As we mentioned earlier, the residents are able to discuss common issues in their monthly meetings. We stated earlier in this report that risk assessments and care plans have been completed and updated but not always signed by the service users or key workers. We suggested to the manager to ensure that all care plans and risk assessments are reviewed with the involvement of the people who use the service. We also commented that the care plans and risk assessments are dated and signed by all those people who are involved in the reviews. We checked incident/accident books and found that no incident or accident has been recorded since the home opened. The home has been recently registered and many of the facilities and equipment are new. From the AQAA we note that there is a system to check and maintain the facilities. There is evidence to confirm that the home has a fire risk assessment and has been visited by fire safety officers who confirmed that there are no significant failure to comply with regulatory (fire safety) order. The manager confirmed that fire alarms and emergency lights are checked weekly and monthly respectively. The gas boiler and portable electrical appliances were checked a few days after the inspection. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 1 32 18 Experienced and qualified staff must be employed and training given without delay especially in mandatory training areas such as medication, safeguarding, first aid and mental health awareness. These enable the residents to be supported by trained and experienced staff who can meet their needs. 31/05/2010 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 6 Care plans and risk assessments should be reviewed with the involvement of residents. All the care plans and risk assessments should be dated and signed to show that they are reviewed and the residents are involved. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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