Care Home: Chace Dene

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What the care home does well The home makes sure that it has written down how people will be helped in the way that they prefer (plans of care). It looks at the paperwork quite often to make sure that they can still help people and they are still doing it in the best way. The home write down how to help people do as much as they can for themselves, as safely as possible. Staff make sure that people stay as happy and healthy as possible. They have good ways of helping people to behave in a way that does not upset them or others. The home make sure that people get the right care from Doctors and nurses, if they need it and work very hard to make sure that it is not too upsetting for them. The house looks very nice and is comfortable and a good place to live. There are lots of staff around, during the day so that people can go out and do things if they want and there is always someone there to help them, if they need it. Staff listen to people and are good at finding out what people think, even if they cannot talk about it, so that they can do something about anything that people aren`t happy with. The manager makes sure that it is the people who live there that are important when she decides how the home will be run. What has improved since the last inspection? The Fire Officer is happy with the arrangements that the home has to try to make sure that there is not a fire, that puts anyone in danger, in the home. What the care home could do better: The home could think about whether it needs extra paperwork about when to give medicine that the Doctor says should be taken, when necessary. The home could think carefully about whether it is safe for one staff member to help people, physically, with behaviour that may upset or be dangerous to themselves or others. The manager could think about whether it would be useful to have some paper that says what they are going to do to try to make things better in the future. Key inspection report Care homes for adults (18-65 years) Name: Address: Chace Dene 4 Heath Road Southend Bradfield Berkshire RG7 6HQ     The quality rating for this care home is:   three star excellent 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: Kerry Kingston     Date: 1 5 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 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Chace Dene 4 Heath Road Southend Bradfield Berkshire RG7 6HQ 01189745062 01189745074 chacedene@apt-ltd.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Atlas Project Team Ltd care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accomodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home Atlas Project Team Ltd are the registered provider for Chace Dene, and provide care and accommodation for three young adults aged 18 to 65, who have a learning disability with associated behaviour difficulties. Chace Dene is an extended detached three-bedroom bungalow owned by Housing Solutions; the maintenance of the home is undertaken by the landlord as reported to them by the Atlas project team. The home has a large garden with table and seating provided. Chace Dene is situated within a semi-rural residential area within the village of Southend Bradfield. Limited off-road parking is available at the front of the house and village shops are within walking distance. The home has its own transport and the towns of Newbury and Reading are Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 Brief description of the care home within a 20 to 30 minute drive from the home. The current fees are from £1,876.38 to £2,210.31 per week dependant on individuals assessed needs. 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: three star excellent 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 last inspection on this service was completed on the 5th March 2007. This is a report for the key inspection, which included a routine unannounced site visit to the service. This took place between 10.00 and and 3.00 pm on the the 15th December 2009. The information was collected from an Annual Quality Assurance Assessment, a document sent to the service from the Care Quality Commission and completed by the service manager. One surveywas returned to us by a person who uses the service, staff of the home helped them to complete them but because of peoples communication difficulties. Discussions with the registered manager, the proprietor and one other staff member took place. People who use the service have difficulty communicating with people who do not know them so observation of people and their interactions with staff took place during the visit to the home, which included a meal time. Care Homes for Adults (18-65 years) Page 6 of 26 Reviewing records of the people who use the service and other records and procedures was also used to collect information on the day of the visit. All information received by the Commission since the last inspection, about this service was also taken into account when producing this inspection report. 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. The home ensures that people are properly assessed so that they can be sure that they can meet their needs. Evidence: The home has had no new admissions, since the last inspection. The three people who use the service have been resident for the past 12 years. The home has a detailed admissions policy and procedure. The registered manager confirmed that the Statement of purpose is up to date. The home regularly review the needs of the people who use the service to ensure they are still able to meet those needs. Care Homes for Adults (18-65 years) Page 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their assessed and changing needs, make as many decisions as possible about their lives and are helped to be as independent as they are able. Evidence: Plans of care for all three residents were seen. They are produced after lengthy specific assessments for different areas of need. They are very detailed and cover all areas of care including personal care, daily living activities and behaviour. Plans of care are reviewed monthly in a Therapy Planning Meeting and are also reviewed annually by the local authority. People are involved, as much as possible, in care planning and reviews of the plans. Communication methods are recorded, so that people who are not always able to clearly verbally communicate their views and feelings can be understood by staff. People often let staff know if they have something to say by a change in behaviour, either more positive or negative. Two of the three people who live in the home,have close family contacts to advocate on their behalf, should it ever be necessary and the other person is able to make his own feelings known, however he does not have an external advocate or contact. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: People have detailed risk assessments, as appropriate, these are up-to-date and were last reviewed on the 9th December 2009, by the manager. Residents and staff were observed to be interacting positively although the people who live in the home were somewhat constrained because of the number of people in the home, they appeared to be very comfortable with the staff. Care Homes for Adults (18-65 years) Page 12 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. People are given opportunities to take part in interesting and rewarding activities and are assisted to take part in the community as appropriate and according to their needs. They are offered balanced and nutritional meals that they are fully involved in choosing and preparing. Evidence: People do not have set activity programmes as they are unable to cope with routines and forward planning. Their special needs are such that they can only access activities when their moods and behaviours allow. Residential staff provide all the activities, they have a list of suitable activities and choose those that suit the persons mood and behaviour and what they would like to do on the day. People said that they go the local pub they also use the local leisure centre, go the cinema, shopping and access other local facilities. People participate in many and varied activities when they are Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: able to. The home has its own transport which enable staff to access local towns and communities, which are not within walking distance of the small village where the home is situated. The home work hard to support people to keep contact with their families, they provide transport and escorts, as necessary. The routines of the house are flexible and alter on a daily basis to suit the choices,preferences, needs and moods of individuals. People are given as many choices as possible, they were observed choosing their lunch, drinks and activities. People have unrestricted access to the home, they were seen going to spend time in their bedrooms, as they chose. People are encouraged to participate in the household chores and activities and these are often used as part of development programme. Menus seen were well balanced, healthy and nutritious. People choose their own menus at a get together on a Sunday night and choose their own breakfast and lunch everyday. The home promote healthy eating , nutritional information is included in care plans and weight charts are kept, if necessary/appropriate. Care Homes for Adults (18-65 years) Page 14 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home meet the personal care, health and emotional needs of the people who live there very well. They ensure that medication is administered as safely as possible Evidence: Plans of care are detailed and included peoples choices and preferences, how they should be supported with their personal care, details of their family and friends and the activities they liked to do. They also include behavioural guidelines and how people must be supported to behave in an appropriate way. The plans of care are reviewed monthly at the therapy planning meetings and a summary of the months events and the individuals well being is completed by key workers. The plans of care are amended as a result of the monthly meetings and summaries. The monthly and annual reviews also include goal setting exercises so that peoples progress can be easily charted and it is easily identified if the therapy plans are working to enhance peoples lifestyle.There are several methods of recording development and behaviour such as star charts, adaptive behaviour scales and full assessments, which are completed annually. Staff survey comments included the home constantly moves clients forward , reduces behaviours so that they have a better quality of life whilst Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: experiencing new things, we meet the needs of service users and we give the service users the best quality of life by taking needs, likes and dislikes into consideration. The Service user survey completed was positive. Plans of care also included detailed review notes, the last annual review for all the people resident, in the home was in October 2009. Care managers were satisfied with the care people had received and the progress made. People do not have specific health care plans unless they need to, but there was evidence that if people need specialist care the home work very hard to ensure that they get the best possible care from the Health Service and that they are able to accept the treatment offered. One person had a serious health issue approximately two years ago and the manager instigated a staff intensive desensitisation programme to enable them to access the necessary services. Records of how the issue was managed, including a meeting with the local Community Team for People with Learning Disabilities to discuss consent evidenced very good practise. Detailed notes of any health appointments are kept on file and those seen included, psychiatrists visits, dental check ups, eye appointments and hearing consultations. Plans of care also include a description of how people present pain if they cannot verbalise it and how staff can recognise that it may be pain causing disturbed behaviours. Medication is kept in a locked cupboard in the staff office, they use the BOOTs monitored dosage system and only staff who have received medication administration training can administer medication. The local Primary Care Trust looked at medication in the home in May 2009, they made no recommendations as a result of their visit. The records seen on the day of the visit were accurate and the registered manager confirmed that there had been no medication errors this year. Some people have medication prescribed by the G.P to be taken as required, to help them to control their behaviour but this is used very infrequently and only with the express permission of a senior member of staff. There was a discussion about the home not having specific individual guidelines for the use of as necessary/required medication and although the registered manager and provider said they would give this some consideration they did not feel that they were necessary as their use was always sanctioned by a senior staff member who knows the people very well. Care Homes for Adults (18-65 years) Page 16 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 home has a comprehensive complaints procedure and listens to people if they have complaints or concerns. Staff know how to protect people from all forms of abuse. Evidence: The home has a comprehensive complaints procedure that is also produced in a simple format so that people may be better able to understand it. There are no recorded complaints since the last inspection and the manager confirmed that she had not received any. The home have recorded four compliments about the home and the care they offered since January 2009. The registered manager described how staff would recognise that someone was making a complaint or was not happy by observing their behaviours and looking for the triggers for any unusual behaviours or agitations. All staff receive Protection of Vulnerable Adults (Safeguarding ) training. A staff member spoken to confirmed this and was very clear about what her duties were with regard to the protection of the people in her care, she knew who to approach external to the organisation if she did not think they had taken any or appropriate action but was also confident that her manager would take firm action, if necessary, to protect people. The Commission has received no information about complaints or safeguarding issues in relation to this home, since the last inspection. Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: People have very detailed and specific behavioural plans to help staff to support them to control any behaviours that can be dangerous or distressing for them or others. The behaviour plans are written and/or approved by senior staff members who have completed behavioural therapy training. All staff are trained in physical restraint techniques which are used, quite frequently in the home, however the incidents of physical restraint use has dropped from 43 in 2007 to 2008 to 23 in 2008 to 2009, it is calculated that it will have dropped again to approximately 13 for the year 2009 to 2010. There have been no incidents recorded at the home since 1st November 2009. Staff make detailed recordings of all behaviour incidents and they are reviewed at the monthly therapy planning meetings to see if any changes need to be made. There was one incidence of a staff member using physical restraint techniques on her own, the manager said that this was not usual as generally two staff employ the techniques. There followed a discussion about the safety of this practise, as the physical restraint involved the individual being taken to the floor. The technique had been used safely and effectively on the occasion noted. The registered manager was advised to review safety of both staff and people who use the service when the above technique is used by one staff member rather than two. Following a telephone conversation prior to the inspection report being finalised the registered manager advised that she had completed a review of the safety of one instead of two staff using restraint techniques generally used by two.She is confident that restraint techniques are always used safely and would only be used by one staff in emergency situations to minimise the risk of harm to the individual or others. The registered manager described the financial systems used to safeguard peoples money. A person from head office acts as the appointee for all residents in all the services provided by the organisation and everyone has their own bank account, an administrator and senior manager are counter signatories on peoples accounts and the administrator accesses cash for them, when they require it. Cash is kept in individual locked tins and receipts and records are kept of all expenditure. One record seen was accurate. The manager audits the accounts monthly and an internal auditor audits accounts on occasion throughout the year, they are also seen at the monthly visits made on behalf of the proprietor. 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 house is kept to a good standard of hygiene, is comfortable and is a pleasant environment to live in. It meets the needs of the individuals and the group of people who live there. Evidence: The home is well kept, clean and homely. It is small but people appeared to be comfortable and made use of their private space, as appropriate. The home is well maintained and has all the necessary facilities. 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 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 competent staff team, in sufficient numbers to meet the needs of the people who live there. The staff team has stabilised and qualification training is undertaken as soon as possible for all staff. Evidence: The home has a total of six staff with two vacancies, one for a deputy manager. From 2008 to 2009, eight staff left the service, the registered manager explained that these were either because people were not suited to work in the home or for other valid reasons, such as moving home or transferring to other homes within the company. The staff team has now settled and several staff have been in post for over a year, there are two staff who have just started. There are a minimum of two staff per shift during day time hours and one person sleeps in the home. Once people are in bed they, generally, do not rise until morning. Because of the special needs of the people who live in the home, they do not use agency staff, any shortfalls of staff is covered by using bank staff or by staffing working extra hours. Recruitment records for the two newest staff were seen, they contained all the necessary information to ensure, as far as possible, the suitability and safety of the applicants, to work with vulnerable people. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: All staff receive the standard health and safety training and up-dates, as necessary. Two of the six staff have an NVQ level 2 or above and one is completing her NVQ 3. Training records showed that staff have opportunities to participate in other training that will benefit the people in their care such as behavioural therapy and understanding autism. A staff member spoken to confirmed that they are offered good training opportunities. 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 service is well managed, in the best interests of the people who live there. The home has ways of looking at the quality of care it offers and keeps people as safe as possible. Evidence: The manager, Donna Morley, has been registered to manage the home since 2007. She has several years experience in care, has worked in the home for five years and has an NVQ 3 and 4 in care and a B Tech 1st Diploma in Care. She does not have a registered Managers award but has completed the organisations trainee manager training programme. A staff member described her as a good manager who is always willing to help and you are happy to ask for advice from her. The home receive regular regulation 26 visits, (visits that the proprietor or someone he appoints must make every month)and a copy of their findings is kept in the home and sent to the Commission. The manager and proprietor were advised that they no longer needed to send a copy to the Commission although they must remain available in the home, to be seen if necessary. The home sends out annual surveys to all Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: interested parties which are returned to and collated at head office, quality of care also forms a significant part of the annual review of individuals plans of care and any comments or concerns are recorded in the appropriate places. The registered manager has various places where she notes any changes or developments that she is going to make in the home but she did not have a collated annual development plan available, she agreed that she would consider producing one so that she is able to more easily track progress and completions. A small sample of Health and Safety maintenance schedules and records were seen, all were up to date and safety checks are completed in a timely way. The Fire Officer from the local fire authority visited in October 2009, he was satisfied with the fire safety arrangements and made no requirements or recommendations. Accident forms are completed and kept confidentially. 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 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 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). 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. 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