Care Home: Chalkmead Resource Centre

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What the care home does well People who are considering moving into the home are given detailed information about what life is like there to help them decide if the home will be suitable for them. They can be confident their needs will be thoroughly assessed before a place is offered. People who live in the home can be confident their personal and healthcare needs will be met in a way which promotes their privacy and dignity and protects them from harm. People are supported and encouraged to maintain their independence and choose how they want to live their lives. They have opportunity to take part in a range of activities, which is increasing with the appointment of an additional activities coordinator. Mealtimes are relaxed; food is served in pleasant surroundings with plenty of choice available. People are listened to and protected from abuse. People who live in the home benefit from the spacious and well designed premises. They can be confident there are sufficient staff on duty at all times who have been trained to understand their needs and provide appropriate support. People can be confident the home is managed efficiently and in their best interests. Their health and safety is promoted through safe working practices. What has improved since the last inspection? All the requirements from the last inspection have been met in that care plans have been updated to ensure they contain sufficient detail to enable staff to understand people`s individual needs and provide appropriate support. People can be confident staff training is a priority and the organisation and monitoring of training programmes has improved. Shortfalls in recruitment records have also been addressed. Record keeping in relation to the administration of medication has improved, as has the recording of individual risk assessments to protect people from harm. An additional activities coordinator has been appointed to ensure people have more opportunity to take part in activities. Outside areas are attractive and well maintained. Additional refurbishment work is currently taking place in the home to further improve facilities for the people who live there. What the care home could do better: People who have dementia should not be disadvantaged in that independent access to outside space should not be restricted. The first floor location of units for people with dementia should be reviewed. CARE HOMES FOR OLDER PEOPLE Chalkmead Resource Centre Deans Road Merstham Surrey RH1 3HE Lead Inspector Ruth Burnham Unannounced Inspection 13th May 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chalkmead Resource Centre Address Deans Road Merstham Surrey RH1 3HE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01737 644831 edith.mpatila@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust Care Home 50 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (50), of places Physical disability over 65 years of age (12) Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may be admitted in the categories OP (Older people) of whom 20 may fall into the category DE(E) Up to 12 people with physical disability over the age of 65 years may be accommodated PD(E) 21st May 2007 Date of last inspection Brief Description of the Service: Chalkmead is situated in Merstham, Surrey in a quiet residential area and is home to 50 older people. It is conveniently located for the local shops and not far from Redhill town centre. The home has five living areas with eight to 12 single bedrooms in each one. Each area has a lounge and dining room with a kitchenette. Main meals are cooked in the central kitchen and served in the dining room using heated trolleys. Chalkmead is on two floors and the upper floor can be accessed by a lift. The home is set around a nicely established courtyard with seating for residents. The home runs a welfare shop and money raised is used to provide outings and entertainment for service users. There is private parking to the front of the building. The registered provider is the Anchor Trust. The current range of fees are £470.10 - £669.50 per person per week. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 08.45 and was in the Service for 5 hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Service’s owner or manager and any information that CSCI has received about the Service since the last inspection. We spoke to the manager, 2 staff members and 3 people who live in the home. We observed interaction and care practices and looked at records and documents, including 3 people’s care plans and the home’s service user guide. Surveys were sent to residents, health and social care professionals and staff as part of the inspection. Responses were largely positive and examples have been used in the report. The manager completed the Annual Quality Assurance Audit for the Commission; information provided in this document is also included within the report. There is one Required Development at the end of this Report. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Commission for Social Care Inspection would like to thank the residents, relatives, manager and staff for their hospitality, assistance and co-operation with this inspection. What the service does well: People who are considering moving into the home are given detailed information about what life is like there to help them decide if the home will be suitable for them. They can be confident their needs will be thoroughly assessed before a place is offered. People who live in the home can be confident their personal and healthcare needs will be met in a way which promotes their privacy and dignity and protects them from harm. People are supported and encouraged to maintain their independence and choose how they want to live their lives. They have opportunity to take part in a range of activities, which is increasing with the appointment of an additional activities coordinator. Mealtimes are relaxed; food is served in pleasant surroundings with plenty of choice available. People are listened to and protected from abuse. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 6 People who live in the home benefit from the spacious and well designed premises. They can be confident there are sufficient staff on duty at all times who have been trained to understand their needs and provide appropriate support. People can be confident the home is managed efficiently and in their best interests. Their health and safety is promoted through safe working practices. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&3 People who use the service experience good outcomes in this area. People who are considering moving into the home are given detailed information about what life is like there to help them decide if the home will be suitable for them. They can be confident their needs will be thoroughly assessed before a place is offered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who are considering moving into the home are given detailed information about what life is like there to help them decide if the home will be suitable for them. The information is contained in the Statement of Purpose and Service User Guide. These documents have both been updated to include information about the new manager, they are presented in a user friendly format and consist of a standard Anchor folder, with specific information about Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 9 Chalkmead, including services and facilities, staffing and the complaints procedure. Copies of the service user guide are placed in each resident’s room. People who are thinking about moving into the home can be confident their needs will be thoroughly assessed to ensure the home will be able to provide appropriate care and support for them. The assessment process and relevant documentation relating to a new resident were examined and found to be satisfactory. The home carries out a thorough assessment of need when people express a wish to move into the home to ensure their needs can be met. People are encouraged to visit the home wherever possible to meet staff and other residents so they can experience what life is like there before deciding to move in. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 10 People who use the service experience good outcomes in this area. People who live in the home can be confident their personal and healthcare needs will be met in a way which promotes their privacy and dignity and protects them from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home can be confident their personal and healthcare needs are understood. Three care plans were examined, the format has been recently updated and there was good evidence that residents are involved in drawing up and reviewing these plans. The plans contain detailed information about individual needs, and aspirations including clear guidance for staff about how to provide care in line with the wishes of each person. Care plans are kept in locked cabinets on each unit so they are accessible for staff. whilst protecting residents’ privacy. People are protected from harm through good Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 11 risk management processes, records seen showed risk assessments relating to people’s individual need and lifestyle. Some discussion took place about the frequency of night checks. Currently each person chooses how often they wish to be checked at night and their wishes are respected. However, some people are experiencing dementia and have been identified as at risk of falling. The manager agreed to complete an additional risk assessment and review the frequency of checks for those people. People can be confident their healthcare needs will be met. People who were spoken said they are supported with hospital and doctor’s appointments. They said health professionals are called in when needed, for example the GPs and district nurses. There are no pressure sores at this home and the home works closely with continence services to ensure that residents are correctly assessed and supported in this area. People are protected form harm through the safe handling of medication. There is secure storage for medication on each unit. The community pharmacist visits regularly to advise the home and report on medication handling. Each person is individually assessed and those who are able to manage their own medication are supported to do so within a risk management framework. Records seen were well maintained and up to date. Staff who administer medication have received appropriate training. People can be confident their privacy and dignity will be respected. Staff were observed to knock on residents’ doors before entering bedrooms, personal information is stored securely and is available solely to authorised and appropriate people. Interaction observed between staff and residents was warm, friendly and respectful. A number of residents responded to surveys sent out before the inspection and they were full of praise for staff. Comments included: ‘I am satisfied with the care and assistance received from staff and the home in general. I find the staff helpful and they take time to listen;’ ‘I am very pleased to be here, I am very comfortable. I am very happy with the way I’m treated.’ Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 People who use the service experience good outcomes in this area. People are supported and encouraged to maintain their independence and choose how they want to live their lives. They have opportunity to take part in a range of activities which is increasing with the appointment of an additional activities coordinator. Mealtimes are relaxed, food is served in pleasant surroundings with plenty of choice available. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are able to choose how to live their lives. Routines are flexible and relevant. The home employs a part time activities co-ordinator and has just recruited an additional full time worker to this position. During the visit t people were involved in a variety of activities; a game of dominoes was in progress; some people were enjoying the sunshine in the garden; others were watching TV; listening to music; knitting or reading magazines and newspapers. The atmosphere in the home was relaxed. There is an outline plan of activities however this is flexible to take into account of what residents want to do on the day and also the individual abilities of residents. In addition to in house activities, outings are arranged and outside entertainers come into Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 13 the home. Chalkmead is also home to Chalkie the cat who is popular with staff and residents alike. People who live in the home benefit from the policy of open visiting times. They can be confident about their security, as the door is only accessible with a coded keypad, staff know who is coming in and out. People are supported to maintain contact with family and friends, relatives and friends are encouraged to stay and have a meal or snack at the home, facilities can be provided when possible if relatives wish to stay overnight. People are encouraged to continue to attend the clubs and day centres they attended before admission, currently one service user attends a day centre every Tuesday and Friday each week. The local church visit the home regularly to provide church services and one to one support as required. People are supported and encouraged to maintain their independence and to exercise choice and control over their lives as far as they are able. People are encouraged to personalise their bedrooms and bring in some of their own personal possessions to make it feel like home. A list of advocacy services is available in the home for residents who do not have contact with friends or relatives. People who were spoken to enjoyed the food in the home. Meals are provided in pleasant surroundings, each unit has it’s own dining room and kitchenette where snacks and drinks are available throughout the day and night. People choose their meals from a range of options; menus are displayed in the home. Choice is presented to people in accordance with their abilities. It was good to see two different meals plated up at lunch time on the unit for people who are experiencing dementia so they were able to see each different dish and make a choice there and then. The food is generally homemade with a few special diets, for example for diabetics. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good outcomes in this area. People who live in the home are listened to and protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are listened to and are encouraged to offer comment or complaint. All complaints are recorded and dealt with promptly. The Commission has received two complaints since the last inspection; these were passed to the management of the home for investigation and dealt with satisfactorily. The home has a complaints procedure, a user-friendly version of which is available inside the front door for visitors. Each resident is also provided with a copy of the complaints procedure, which is also available on audiotape. People who live in the home are protected from abuse. There is an in-house policy for the protection of vulnerable adults and the majority of staff have had training on this issue. Staff are given a booklet on rights and responsibilities which covers safeguarding matters in some detail. All staff are checked through the Criminal Records Bureau before they start working in the home. The Trust has appointed a Care Specialist to ensure a consistent approach to safeguarding people throughout the organisation. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 – 26 People who use the service experience adequate outcomes in this area. People who live in the home benefit from the spacious and well designed premises. It is unfortunate that access to outside space is restricted for people who are suffering from dementia. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the modern design and accessible layout of the building. The home is arranged in five units, each with its own lounge, dining room and kitchenette. The premises are generally well decorated and maintained, work is currently underway to refurbish areas of the home and provide additional facilities for people such as an activities room. All areas are pleasantly furnished and attractive. There is an inner courtyard with chairs, tables, pots and bird feeders, which is safe, and secure for residents, this area was being well used during the visit. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 16 People who were spoken to were pleased with the accommodation. All bedrooms are sizable single rooms with hand basins, one with an en-suite toilet. There is a television point, telephone point and call bell in each room. All areas of the home seen during the visit were clean and fresh, there were no unpleasant odours. Bathrooms and toilets were all clean and tidy and some had some nice homely touches including blinds, plants and pictures. It was good to see a number of water coolers around the home for residents and staff to enjoy chilled water, these were being well used on such a hot day. People who are accommodated on the ground floor can enjoy the outside space whenever they choose. There is a passenger lift between floors and the premises are accessible for those with impairments – the inner courtyard is secure to enable those with dementia to move around freely although it is unfortunate that people with dementia are accommodated on the first floor and can therefore only access outside space when staff are available to escort them to and fro. Access to and from the first floor is secured by a coded keypad system to keep residents safe. People can be confident their clothes and linens will be laundered with care. The home employs domestic staff for the general cleaning in the home and a laundry worker on five mornings per week; care staff help out on other occasions. The laundry is well equipped, well organised, clean and tidy. Each resident’s laundry is washed individually and they each have their own laundry bins and baskets to keep their clothes separate and ensure that their own clothes are returned to them. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 – 30 People who use the service experience good outcomes in this area. People who live in the home can be confident there are sufficient staff on duty at all times who have been trained to understand their needs and provide appropriate support. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the support of the committed and well trained staff team. On the day of the visit there were sufficient numbers of staff on duty to meet peoples’ needs. Staff are deployed throughout the units according to dependency levels with staff numbers based on people’s assessed needs. People who responded to surveys sent out as part of the inspection had only positive things to say about staff. Comments included, ‘Staff are always kind and helpful’, ‘They take time to listen to me’.. People can be confident staff are well trained. There is a commitment to staff training, staff are encouraged to undertake at least NVQ Level 2 qualification or above. People are protected through robust recruitment policies, which include checks through the criminal records bureau for all staff and taking up 2 references prior to appointment. Recruitment files were examined at the last inspection when they were found to be generally well maintained and up to date. There is an equal opportunities policy in regard to recruitment. All staff Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 18 who are involved in the recruitment process have now been trained in correct recruitment procedures, with regard to the Care Homes Regulations 2001 (as amended) and in particular Schedule 2. There is a good level of training activity at this home. All new staff undergo induction training. Training records were examined in detail at the last inspection and found to be in order. The manager confirmed that requirements made in relation to staffing issues following the last inspection have all been met. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience good outcomes in this area. People can be confident the home is managed efficiently and in their best interests. Their health and safety is promoted through safe working practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People can be confident the home is managed in their best interests. A new manager has been appointed since the last inspection, she has been in post for 3 months and has 9 years experience in the provision of care to older people. The new manager has a Diploma in Management, is working towards completion of the Registered Managers Award and will be applying for registration shortly. There are clear lines of accountability within the home and externally with Anchor Trust; requirements made following the last inspection have all been met. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 20 People are involved in decisions about how the home is run in a variety of ways. These include day-to-day contact with the manager or their keyworker, quarterly residents’ meetings and regular unit meetings. Positive responses were received from health and social care professionals to surveys sent out as part of the inspection. These included: ‘We always find the home to be a caring and friendly place to visit. They take on board our recommendations and support the clients to help them maintain the best possible quality of life’. ‘They are always welcoming and always there when I need to be taken to the next patient. I enjoy my visits to this particular care service.’ The manager completed the Annual Quality Assurance Audit for the home, which has been used as part of the inspection. This shows the home has an effective quality assurance system, which demonstrates year on year improvement in the service. An audit was carried out at the last inspection where the home acts on behalf of residents in relation to their finances. It was found then that the homes policies, procedures and good record keeping protect people from financial abuse. People can be confident their health and safety is promoted. Staff receive appropriate training in safe working practices. The Trust conducts an annual health and safety audit. Water temperatures are monitored regularly; there is an annual inspection of the water system. Regular safety checks are carried out on all equipment and installations. Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP20 Regulation 12(1)(a) Requirement The registered person shall ensure that the care home is conducted so as to promote and make proper provision for the health and welfare of service users; In that people who have dementia should not be disadvantaged in respect of independent access to outside space. The first floor location of units for people with dementia should be reviewed. Timescale for action 30/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Chalkmead Resource Centre DS0000013591.V363211.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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