Care Home: Camellia House Nursing Home Ltd

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What the care home does well There are good admission procedures in place that would ensure that only people whose needs can be met are admitted to the home. Everyone living at the home has a care plan. Staff respect the privacy and dignity of the individual and they were aware of the needs of the individuals and said that they were keen to do a good job. Staff told us via surveys that they thought the home `provides a relaxed atmosphere for residents and staff`. Visitors to the home told us that they were always made to feel welcome, they were very happy with the care given, and were kept well informed about their relatives health. One relative commented on a survey form, that the home `has a positive family atmosphere and makes all visitors, clients and staff feel like they are part of the same team`. What has improved since the last inspection? The home is now safer for people who live there. Equipment is being maintained and staff are receiving regular training. Staffing levels are now sufficient to meet the needs of people living at the home and recruitment procedures are now more robust and protect people from being at risk from people who may be unsuitable to work with vulnerable adults. Medication procedures have improved and medication is now stored securely. The overall decor and cleanliness of the building has been improved and a new `wet room` enables people to easily access toilet and shower facilities on the ground floor. We received many positive comments from visitors to the home who were pleased with the improvements they saw being made, including `there are improvements with all aspects of the home and communication is so much better`. What the care home could do better: The situation in relation to the home home being in administration and the lack of a registered manager needs to be resolved as quickly as possible. The improvements seen at this visit need to be continued, for example the refurbishment programme and the staff training programme. Care plans need to be completed more consistently, they need to be more specific to the individual and provide more details about the person`s social history. Social interaction and stimulation for people living at the home needs to be increased. There needs to be a formal quality assurance system in place that ensures people are consulted about the quality of care provided at the home. The AQAA submitted by the home stated that they were well aware of improvements that needed to be made, but that this was difficult due to the uncertainty of the home`s future due to it being in administration. Key inspection report Care homes for older people Name: Address: Camellia House Nursing Home Ltd Elm Grove Road 5 Oak Park Villas Dawlish Devon EX7 0DE     The quality rating for this care home is:   one star adequate 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: Sue Dewis     Date: 1 6 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Camellia House Nursing Home Ltd Elm Grove Road 5 Oak Park Villas Dawlish Devon EX7 0DE 01626864272 01626867217 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Camellia House Nursing Home Ltd care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Dementia - over 65 years of age (DE(E)) 30 Mental Disorder, excluding learning disability or dementia - over 65 years of age (MD(E)) 30 Old Age, not falling within any other category (OP) 30 Physical Disability - over 65 years of age PD(E)) 30 Date of last inspection Brief description of the care home Camellia House is a Care Home that is registered to provide Personal and Nursing Care for up to 30 people. The house is a large Victorian villa built on level ground with an Care Homes for Older People Page 4 of 28 Over 65 30 30 30 30 0 0 0 0 Brief description of the care home extensive walled garden. The home is in a quiet residential area, within one mile of the seaside town of Dawlish. The accommodation is over two floors with a passenger lift, and ramps to reach mezzanine floors. There is a large lounge and separate dining room. The home has been adapted to meet the needs of people living there and grab rails and specialist equipment has been installed, including accessible bathing facilities. There is no registered manager at present. The current manager is supported by a team of registered nurses and care staff, who provide 24 hour care. The inspection report is available on request from the office. Current fees range from £391 to £415 per week, depending on the room and the level of care needed. Fees do not include hairdressing, chiropody, physiotherapy, newspapers and taxis. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at httpwww.oft.gov.uk. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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 unannounced visit took place over 6 hours, one day in the middle of December 2009. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. Although only one inspector undertook this inspection, throughout the report there will be reference to what we found and what we were told. This is because the report is written on behalf of the Care Quality Commission (CQC). During the inspection 3 people were case tracked. This involves looking at peoples Care Homes for Older People Page 6 of 28 individual plans of care, and, where possible speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process CQC likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to some people living at the home, and some staff. At the time of writing the report, responses had been received from 3 staff and 7 people living at the home, all of which had been completed with help from relatives. Their comments and views have been included in this report and helped us to make a judgement about the service provided. During the inspection we spoke with several people living at the home in a group setting, 2 relatives, 2 staff and the manager. A tour of the communal areas of the building was made and a sample of records were looked at, including medications, care plans, the fire log book and staff files. All key standards were inspected. Some people living at the home have limited verbal communication skills, and as we are not skilled in their other methods of communication it was difficult for us to have any meaningful communication with these people. However, the interaction between the people living at the home and those who care for them was closely observed. A number of concerns have been raised with the Commission over the previous 2 years and the home has been included in our improvement strategy. The home has recently gone into administration and is currently being overseen by a management company appointed by the bank. There has been no registered manager at the home for some time and the previous manager has left since our last visit. The person currently with management responsibility for the home was appointed by the management company. Devon County Council have now lifted their ban on admissions to the home as they feel many improvements have been made by the management company. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The situation in relation to the home home being in administration and the lack of a registered manager needs to be resolved as quickly as possible. The improvements seen at this visit need to be continued, for example the refurbishment programme and the staff training programme. Care plans need to be completed more consistently, they need to be more specific to the individual and provide more details about the persons social history. Social interaction and stimulation for people living at the home needs to be increased. There needs to be a formal quality assurance system in place that ensures people are consulted about the quality of care provided at the home. The AQAA submitted by the home stated that they were well aware of improvements that needed to be made, but that this was difficult due to the uncertainty of the homes future due to it being in administration. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedure would ensure that there is a proper assessment prior to people moving into the home, and that they can be assured their care needs can be met. Evidence: There is a Statement of Purpose, Service User Guide and Brochure available to people thinking of moving into the home. There have been no changes made to either document since our last visit. There have been no new admissions to the home since the last visit. However, we were assured that the homes stated admission policy and procedure will be followed when any new referrals are received. The homes stated procedure includes sending out information about the home, inviting the person to visit the home and then visiting them to complete a pre-admission assessment. Care Homes for Older People Page 11 of 28 Evidence: The home does not provide intermediate care. Care Homes for Older People Page 12 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans do not always provide staff with clear individualised information. This could lead to inconsistent care being given. The management of medication is good. Evidence: All people living at the home have an individual plan of care and we saw some evidence that peoples relatives had been involved in regularly reviewing the plans. We looked at the care plans for three people. There have been some changes to the care planning system, and the manager told us that a new care plan system was in the process of being introduced. However, the system still remains very confusing, with much information missing from the various documents. This means that care staff did not have the information they needed, in an easily accessible format, in order to provide consistent care to fully meet peoples complex care needs. Where we did see directions to staff (Planned Delivery of Care) they were generic, and were not specific to the individual or in any way person centred. This gives the Care Homes for Older People Page 13 of 28 Evidence: impression that the behaviour rather than the individual has been focused on, and that everyone can be cared for in the same manner. We saw one care plan that had had the assessment section completed, but then there were no directions to staff about the persons care, except for some brief notes in the daily records. Daily records were generally fairly descriptive, but they did not always evidence where peoples identified needs had been met. We have consistently been assured that the care planning system was being addressed and that the new systems would soon be in place. Yet another new system is being introduced, and there is little evidence that this is being consistently implemented in order to ensure there is evidence of of peoples needs being thoroughly assessed and met in a consistent manner. However, staff that we spoke with clearly had a good knowledge of peoples care needs and how to meet peoples individual needs. They described peoples personal preferences and how people liked to be cared for. We spoke with 2 relatives who were visiting the home and they praised the standard of care received by their relatives. They told us that although they had had some concerns about the home in the past they had never had any concerns over the standard of care received by their relatives. These positive comments were echoed by relatives who had completed surveys. Information about visits from and to health care professionals had been recorded in individual care plans, showing clear evidence that people are supported to maintain access to specialist medical services including dentists and GPs. Medication administration is now well managed and policies and procedures relating to this area were in place. We were told, and records show that staff who administer medications have received training that tested their competency. Staff were seen administering medication appropriately. There is a no homely remedies policy for the home as only medications prescribed by a GP are administered. Hand written entries on the MAR (Medication Administration Record) sheets from when extra medication had been prescribed had been signed by two members of staff, which is good practice. The MAR sheets showed that several people had been prescribed creams and ointments and staff now sign MAR sheets when these topical creams and ointments Care Homes for Older People Page 14 of 28 Evidence: have been applied. Containers are now marked with the date of opening, which reduces the risk of people having creams applied that are past their expiry date and therefore ineffective. All of the people seen during this visit were treated with respect by the staff and their right to privacy was upheld. Personal care was offered in a discreet manner. Staff told us how they respect peoples privacy when helping them with personal care needs. We heard staff speaking with people in a kindly, friendly way. Visitors that we spoke with confirmed that staff always treated their relatives with respect. Care Homes for Older People Page 15 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social interaction and activities are not readily available and there is little daily variation and stimulation for people living in the home. Evidence: There is no activities organiser employed and care staff provide activities as and when they are able, which tends to be sporadically in the afternoons. Visitors told us that their relatives very much missed the previous activities organiser who had begun a regular programme of social interaction both in a group setting and on a 1:1 basis. There is very little information relating to peoples interests and preferences recorded in their care plans, which means that staff do not have information with which to engage people in conversation or activities relevant to their likes and dislikes even if they have the time. We were told by the manager that they still had some of this type of information for some people that had collected by the previous activities organiser, but there was little evidence that this was being used. However, the manager is trying to improve the level of stimulation available to people and has begun to produce a regular newsletter to let people know what is going on in the home. They also told us that they are continually trying to encourage staff to sit Care Homes for Older People Page 16 of 28 Evidence: and chat with people and that everyone had recently enjoyed an afternoon themed about World War 2. On the afternoon of the visit several visitors, staff and people living at the home were enjoying a birthday party for one individual, everyone was having a good time eating cakes and sweets. Visitors told us that they were always made welcome and that they could visit at any time. Staff told us that they always tried to offer as much choice as possible, including what time people got up and went to bed. Care plans do not show any evidence of when choices are offered. We were told by staff that menus have improved since our last visit and that people are able to have much more choice. The manager told us basically they can have what they want. People are asked throughout they day about what they want for the next meal. Menus were balanced and offered plenty of choices. Care Homes for Older People Page 17 of 28 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. There is a good complaints procedure in place and people are confident that their concerns will be listened to. Procedures are in place to ensure that people are protected from abuse. Evidence: There is a clear and simple complaints procedure that is displayed in the front hallway. A file of any complaints is kept, with each complaint being recorded separately and the outcomes of the investigation clearly recorded.The manager told us that they had not received any complaints since our last visit as they try to deal with any moans and groans straight away. The Commission has not received any complaints since our last visit. The people who were spoken with during this visit were not able to tell us whether they knew about the homes complaint procedure or whether they would feel comfortable making a complaint. However, their visitors were clear about who they would speak with if they were unhappy about anything and felt sure that their concerns would be dealt with by the new manager. Records show, and staff told us that they had received training in Safeguarding Adults. Both staff that we spoke with were able to discuss different forms of abuse and said that they would report any suspicions they had to the acting manager. They were also Care Homes for Older People Page 18 of 28 Evidence: able to tell us who they would report any concerns to, outside of the home, if necessary. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is now providing a more comfortable and safe environment for those living in, working at and visiting the home. Evidence: A full tour of all the communal areas of the home and some of the individual bedrooms were looked at. All areas of the home were clean and fresh smelling. Some areas of the home have been refurbished and people told us that they thought the environment was much improved. Although some areas of the home are still shabby there are signs that it is being maintained to a higher standard. A wet room has been created on the ground floor giving people easy access to toilet and shower facilities. One person commented on a survey form that they would like a separate quiet lounge as the main lounge sometimes gets very noisy. The manager told us that equipment was now being serviced as required and that the lift had recently been fully serviced. The laundry area was clean and tidy and has an impervious floor covering that helps prevent cross contamination from soiled articles. Washing machines have the ability to Care Homes for Older People Page 20 of 28 Evidence: meet disinfection standards and sluice machines are provided for disposal of bodily waste and cleaning commode pots. Staff confirmed that disposable gloves and aprons were available to them in order to minimise the risk of cross infection and we saw them being used and disposed of appropriately. Staff also confirmed and records show that they have received training in this area. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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. A good range of training is provided and the skill mix of staff on duty is sufficient to meet the needs of people currently living at the home. People are protected by recruitment procedures that ensure people who may be unsuitable to work with vulnerable people are not employed at the home. Evidence: On the day of the visit there were 12 people living at the home. On duty during this time were the manager, a registered nurse, 3 care staff and 3 ancillary staff (kitchen staff, laundry and maintenance). Staff told us that they felt that these levels were currently adequate because of the low numbers of people living at the home. Staff were praised by visitors to the home when we spoke with them and positive comments via survey forms were received, which included staff are friendly and helpful, The staff are very caring and The staff are very good at individualised care and attention. Staff that we spoke with demonstrated a good awareness and understanding of peoples needs. They were able to describe peoples personal preferences in the way they received care as well as displaying a good knowledge of their individual needs. Records show and staff confirmed that there has been an increase in staff training and Care Homes for Older People Page 22 of 28 Evidence: staff have recently received training in moving and handling, Safeguarding Adults, first aid and the Mental Capacity Act. New staff also confirmed that they have received a full induction in line with Skills for Care recommendations. The Red-Crier in-house training system is also now being used. There has also been an improvement in the area of staff recruitment. Three staff files were looked at. Each file contained all the required information including satisfactory CRB (Criminal Records Bureau) checks, two written references and proof of identity. This robust recruitment practice now ensures that people are protected from the risk of harm by people who may be unsuitable to work with vulnerable adults. Care Homes for Older People Page 23 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is no registered manager for the home. However, people are living in an adequately managed home, which is generally safe and has begun to be run in the best interests of the people living there. Evidence: The home is currently in administration and there has been no-one registered with the Commission as manager of the home for some time. We were unable to determine the fitness of the new manager to run the home effectively, as we have not received an application to register them with the Commission. This means that police and reference checks have not be obtained and the suitability of the person to work with vulnerable people has not been explored by the Commission. The manager told us that they have a range of experience and skills in working in care homes and care settings. Staff and visitors told us that they thought the home had Care Homes for Older People Page 24 of 28 Evidence: improved significantly since the new manager came to the home and were confident that they had the skills to run the home effectively. The manager told us that there was no-one living at the home that is subject to a deprivation of liberty authorisation. We saw no evidence to show that anyone living at the home is having their liberty deprived without an authorisation. There is no formal quality assurance system in place at the home that shows that people have been consulted about the quality of care provided by the home. We were told by the manager that the management company continue to support them, but do not regularly visit the home monthly or write a report when they do visit. No money is managed by the home on behalf of people living there. The AQAA (Annual Quality Assurance Assessment) provided evidence that Camellia House complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. The record of fire safety training and accident and incident records were found to be accurate and up to date. Policies and procedures are not always inspected during the visit but the information provided on the AQAA helps us form a judgement as to whether the home has the correct policies to keep people living and working at the home safe. Information provided by the home, evidenced that policies and procedures are in place and along with risk assessments are reviewed regularly and updated where necessary, to ensure they remain appropriate and reduce risks to people living and working at the home. So that the risk of burning from hot surfaces is minimised, radiators within the home are covered. All windows above ground floor level are fitted with restrictors, in order to minimise the risk of anyone falling from these windows, and so that the risk of burning from hot water is minimised temperature controls are fitted to bath taps. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 7 7 7 Care plans should provide evidence of when individuals are offered choices. Care plans should show more details of the individuals social history. Care plans should be consistently completed, giving staff specific directions on meeting individuals needs and they should provide evidence of when these needs are met. Social stimulation and interaction should be improved for people on a day to day basis. The programme of refurbishment should be continued. A formal quality assurance system should be put into place. 4 5 6 12 19 33 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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