Care Home: Chandos House

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What the care home does well The home provides a pleasant, homely and clean environment for people who live there. people gave positive comments about their care and services received, comments included,` the staff are good and all very pleasant` and `couldn`t find a better place`. The visiting nurse told us she `finds the home very good`,matters are referred to her appropriately and staff always complete any tasks given. People are able to take part in various recreational activities and maintain contact with family and friends as they wish, activities include, games, hand massage, one to one time and outings. Leadership in the home is good and quality monitoring systems are in place to ensure the home is run in the best interest of people living there. What has improved since the last inspection? The Statement of Purpose and Resident Guide have been updated and include a copy of our report and information about the current fee rates. Six bedrooms have been refurbished and another fourteen re-decorated. A room has been designated as a `medical room` giving the visiting nursing team an area to work from. The garden patio area has been extended and a raised garden made, a large flat screen television has been purchased for one of the lounges and the car park has been re-surfaced. The organisation has taken action to address the previous requirement to ensure staff receive regular supervision, however, records available showed that this is not to the recommended level of six times a year and the manager told us she would ensure this is done. What the care home could do better: Peoples needs, identified as part of the assessment process, must be reflected in their plan of care so they can be appropriately supported and receive the right care they need. Care plans could be improved further by including the action staff need to take to show that the mental capacity of people has been considered. They should also clearly give staff guidance regarding the action they should take to meet specific needs and show that they are regularly looked at and necessary changes made. Additional activities should be provided to ensure people have the right level of stimulation to meet their needs. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Chandos House Gorse Road Grantham Lincs NG31 9LH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Elisabeth Pinder     Date: 1 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Chandos House Gorse Road Grantham Lincs NG31 9LH 01476562393 Telephone number: Fax number: Email address: Provider web address: manager.chandos@osjctlincs.co.uk Name of registered provider(s): Type of registration: Number of places registered: The Orders Of St John Care Trust care home 31 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category:- Old age, not falling within any other category (OP) - 31 The maximum number of service users to be accommodated is 31 Date of last inspection Brief description of the care home Chandos House is a purpose-built home, providing personal care for older people. Formerly owned by the local Authority, the home is now owned by the Orders of St. John Care Trust, which manage a group of 16 homes across the county. The care home is situated in a quiet residential area to the north east of the town of Grantham. There are limited local amenities available in the area. The town centre is not within walking distance but there are various forms of transport available for easy access. The home was purpose built to meet the needs of older people and has large landscaped gardens and on-site car parking. Residential accommodation is provided on both the ground floor and first floor. The first floor is reached by stairs or the shaft lift. The home provides accommodation for up to 31 older people and at the time of the inspection, 28 people were living there. The current fee range is from £397 to £463 Care Homes for Older People Page 4 of 26 Over 65 31 0 Brief description of the care home per week, additional charges are made for hairdressing, chiropody, newspapers and personal toiletries. Information about these costs, as well as the day-to-day operation of the home, including a copy of the last inspection report, is available in the reception area or from the office. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit and it formed part of a key inspection, focusing on key standards which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection (CSCI). The visit lasted seven hours and took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since our last visit. Before we made our visit the manager had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent out surveys to people living at the home and to staff before we visited and these are Care Homes for Older People Page 6 of 26 mentioned throughout the report. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of people through their care records and assessing their care. We spoke to people who use the service and saw rooms of those who said we could and to two members of staff, one visitor and a registered general nurse (RGN) who was attending to meet the health needs of people. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 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 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. People coming into this service have access to a range of information to help them make a decision about moving into the home. The admission procedure includes an initial assessment which helps to make sure that it can meet the needs of people admitted to the home. Evidence: Information sent to us prior to the inspection told us that people have access to a range of information about the service and this was confirmed during our visit. The Statement of Purpose and Resident Guide have recently been updated and include a copy of the last inspection report and information about the current fee rates. They also tell people how differing needs, such as religion and culture will be met and how the service considers the Mental Capacity Act. People living in the home also receive a copy of the Trust magazine. Care Homes for Older People Page 10 of 26 Evidence: Care records of two people who had recently been admitted were looked at and these showed that a needs assessment had been carried out. However, one was dated after the persons admission and we were told that the person had initially come into the home for respite care. A discussion was held regarding the need to ensure a full needs assessment is carried out for everyone before they move into the home regardless of their planned length of stay to ensure their needs can be met. Whilst both files contained adequate information to assess if the staff have the skills and ability to meet peoples needs there were gaps in both. For example, in one, no details were recorded regarding death and dying wishes or legal status and in the other, information about the persons hobbies and interests had not been completed. Although assessments had been carried out regarding falls and skin damage and identified the person to be at risk, no risk assessments had been completed. Neither told us who was involved in providing the information or if a letter confirming that the service can or cannot meet their needs had been sent. This was discussed with the manager who agreed to address this and since the visit we have received information telling us what has been done to confirm this. Five surveys returned to us before the visit told us people living in the home had received enough information about the home before moving in, three did not know if they had been given a contract of residency as they had lived in the home for a considerable time, one person confirmed they had and one was left blank. Terms and conditions/contracts of residency were held on both records looked at. During the visit people told us they were happy with the home and the services offered, one person told us she had initially come to stay for a short time but was considering staying, another said couldnt find a better place and a relative told us he was very satisfied with the service so far, the staff are good and all very pleasant. The service does not cater for people with intermediate care needs. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and health care needs are being met by staff who understand their needs and deliver care in a respectful manner. Medication policies are detailed and safe procedures are being followed for the administration, recording and storage of medicines. Evidence: We were told that within the last twelve months care plans have been revised to ensure they are more person centred and have been written as if the person had completed them themselves. We looked at the care records of 4 people living at the home and they did not tell us whether the person had written these or the level of their involvement. This was discussed with the manager who agreed to address the issue and since the visit we have received information telling us about the action the manager has taken. Two care plans looked at were well written and evaluated regularly giving staff clear guidance on the action they should take to meet the persons needs. Daily notes were detailed and showed that they were receiving the correct level of care and support, however, the other two care plans had significant Care Homes for Older People Page 12 of 26 Evidence: gaps and had not been reviewed since August and September 2008. For example, it had been suggested by a persons general practitioner in September 2008 to use an ice-pack twice a day for 5 minutes but this had not been included in their plan of care. Another persons pre-admission assessment identified moderate pain in her leg but no information had been written in their care plan regarding medication or strategies to relieve the pain. A care plan for a person recently admitted had not been started although she told us she was able to tell staff how she liked things done and felt she was being treated with respect and dignity. These issues were discussed with the manager and since our visit we have received information telling us that these care plans have been re-written or reviewed and updated accordingly. Care records looked at did not make reference to whether peoples capacity to make decisions had been considered when drawing up care plans, this is important in view of recent legislation which came into force in October 2007. Staff told us they had received some training and were due additional training in January this year. People were happy with the level of support given and told us they felt their needs were being met. Staff spoken to had a good knowledge of the needs of people who use the service and how to meet them and were observed to be responsive to needs and were respectful and kind. A visiting nurse told us she finds the home very good, matters are referred to her appropriately and staff always complete any tasks given. Information taken from the AQAA told us that policies and procedures concerning the receipt, storage, administration and disposal of medications were available. We looked at medication records of the people whose care was being followed and observed medications being administered at lunchtime, these showed that the people were receiving their medications correctly. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to take part in various recreational activities and maintain contact with family and friends as they wish. Meals provided are well balanced and take into account personal preferences and special dietary requirements. Evidence: People have access to a varied activities programme that has been written by the activity co-ordinator to meet individual needs. The service has a link with a local college and students studying health and social care are able to undertake a placement at Chandos House. The manager told us she finds this very valuable as students are able to give people one to one time and also help with the provision of activities. The activity co-orinator was on annual leave during our visit and records of recent activities/events were unavailable. However, photographs of events over the Christmas period were on display and we saw a group of people playing dominoes, another person was going out with relatives and some other people were having their hair styled. Since the visit records of events and activities that have recently taken place have been sent to us and these tell us that people have had the opportunity to take part in a variety of activities including, hand massage, bingo, ball games, sing-a-longs and outings to a garden centre and carol service. Surveys received prior to the visit Care Homes for Older People Page 14 of 26 Evidence: told us that generally people are satisfied with the activities offered, comments read I enjoy all activities offered up to my capability and I play bingo and like to watch entertainment that is brought into the home. However, one survey read I feel under stimulated at times because I would like something a little more intelligent. Comments were discussed with the manager who told us she would look at this through the homes quality monitoring systems. The service also has two volunteers who help support staff by assisting them with various tasks, for example sitting with people who are receiving end of life care or helping with events. There is also a Friends of Chandos House group who meet regularly and discuss fund raising events and minutes of the last meeting were looked at and these made reference to recent events of soup and sizzle and old time sing along which people felt had been successful. People told us they were able to keep in touch with family and friends and have visitors whenever they choose and this was evident throughout our visit. Meals are served in the dining room and we saw people chatting with each other as they ate. They told us that the menus were varied and a choice offered. Alternatives and specialist diets, such as a diabetic diet were also available. Tables were nicely laid with placemats/napkins and condiments and the meal of the day was sausage and chips or ham and chips and peas. People told us they had enjoyed it and had been offered extra portions if they wanted them. Comments taken from surveys received prior to our visit read, the variety of food is good and is always served and cooked nicely. I sometimes like the meals, they are not to the standard I would have at home and I eat everything that is made for me and enjoy my food. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the procedures in place for handling complaints and allegations of abuse. Staff have received training in these subjects to help them protect the people they support. Evidence: Information taken from the AQAA tells us that a clear complaints procedure is available and is included in the residents guide and this was confirmed during our visit. People told us they feel able to raise issues with their relatives, key worker, care leader or manager and felt these would be taken seriously. Surveys received prior to the visit all indicated people know how to make a complaint and who to speak to if they were unhappy. Specific comments read, I am usually very happy but in the event I am not, there are many care leaders I feel happy to talk to. I know how to make a complaint, I just tell them what I think and I am aware of the complaints procedure but have no complaints. Within the last twelve months no complaints have been received and no referrals made to Lincolnshires Safeguarding Adults team. Training records are held on the computer and the manager looked at these and verified dates staff had undertaken training relating to safeguarding adults. Staff spoken to had a good understanding of the types of abuse and the correct procedures Care Homes for Older People Page 16 of 26 Evidence: to take to report any incidents. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well-maintained, clean, comfortable and homely environment. Evidence: We took a partial tour of the home which included looking at the bedrooms of the people whose care was being followed and some communal areas. Bedrooms had been personalised with photographs, mementos and small items of furniture. Although bedroom doors are lockable we were told that no one has requested their own key, however there was no record of people being asked if they would like this facility and the manager agreed to make this part of the admission checklist staff complete with people. There were no unpleasant odours in the home, communal areas were bright and nicely decorated. Five surveys completed by people living at the home told us that the home is always fresh and clean, specific comments read my bedroom and the toilets are always very clean and tidy and lovely, brilliant, fantastic, I am very happy and content with the service I receive. Information taken from the AQAA told us that within the last twelve months six bedrooms have been re-furbished and another fourteen re-decorated. A room has been designated as a medical room giving the visiting nursing team an area to work from. The garden patio area has been extended and a raised garden made, a large flat screen television has been purchased for one of the lounges and the car park has been re-surfaced. Care Homes for Older People Page 18 of 26 Evidence: Staff told us protective aprons and gloves are always available to use when needed and various pieces of equipment were in use during the visit including hoists, specialist mattresses, raised toilet seats and grab rails. The service has received an excellent for food safety from their district council Environmental Health Officer in October 2008. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is enough staff on duty to meet the needs of the people currently living at the home. People are generally protected by robust staff recruitment procedures and staff have access to training and support to ensure they are knowledgeable and equipped to meet the needs of people living here. Evidence: On the day of the visit 28 people were living at the home. Duty rotas looked at for the past two weeks showed that there were generally three care staff in the morning, two in the afternoon and two throughout the night. In addition to this there is care leader, registered manager and administrator on duty. Surveys received prior to the visit gave a mixed response about the availability of staff. Comments written read, staff are very busy but I know that if I need something they will come when I need it. No complaints about the staff whatsoever, they look after me so well and are available most of the time and they are short of staff. During our visit only positive comments were received from people, these included the staff are all lovely and the staff are very helpful, they are getting to know how I like to be treated. People whose care was being followed told us they felt there was enough staff on duty and if they have to call them they never have to wait long before someone comes. At the moment there is one male carer working in the home and care records state peoples preference for male or female carer. Care Homes for Older People Page 20 of 26 Evidence: The records of two staff recently employed were looked at and these showed that essential checks such as written references and C.R.B. (Criminal Records Bureau) checks were being undertaken. However, there was only one reference for one member of staff and this was brought to the attention of the manager who told us a further request had been made and this person was working under the supervision of a senior member of staff. All staff undertake induction training and complete a probationary period. Prior to our visit we received five surveys from staff and these told us their induction training covered everything they needed to know to do the job and they receive ongoing training relevant to their role. Staff said they felt well trained and supported. The Organisation have a good training programme covering a variety of topics. Training records confirmed that staff had received essential training to meet the needs of the people they support. Training undertaken included, manual handling, first-aid, fire awareness, dementia awareness, health and safety and safeguarding adults from abuse. Awareness of the Mental Capacity Act training had been provided using a computer and staff spoken with confirmed they are to receive further training in January. Information received told us that 97 of care staff have achieved a nationally recognised vocational award, level II in care, care leaders level III and one care leader is currently developing her role as dementia champion. The service is now using ELearning training and further training is planned regarding assessing capacity and familiarisation with the Mental Capacity Act. The manager told us she is looking at involving people who use the service in the recruitment of care staff and is currently establishing which people would like to be involved. Observation of care practises during the visit showed staff caring for people in an appropriate manner. They were visible in communal areas and responded well to peoples needs. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home is well managed and the staff are generally supported and supervised in carrying out their roles. The audit and policy systems ensure that peoples views are listened to and acted upon. Evidence: The registered manager is suitably qualified and experienced to run this home. She has been in post approximately two years and has completed the Registered Managers Award. Surveys received prior to the visit raised no concerns regarding the current management arrangements. Specific comments read The manager is very nice but I know she is busy and I do not like to disturb her if I can help it and manager is very open and approachable, we have regular meetings to discuss our progress. The manager has taken action to address the requirement given during the previous inspection regarding the frequency of staff supervision, however, records for one staff member spoken to were looked at and these showed that the last one had not been signed and dated and the one prior to this was dated 2007. Since the visit we have Care Homes for Older People Page 22 of 26 Evidence: been given information that supports additional dates confirming these are being held regularly. Discussion and records showed that there are various systems in place to monitor the quality of the service being provided. This includes seeking the views of people through meetings and questionnaires. However, minutes could not be located but staff told us they are held regularly and the last meeting was held in October 2008. The service has attained a Quality Award and Investors in People Award by independent companies who audit the homes systems against expected standards. The home also carries out quality monitoring questionnaires and since our visit the results of these have been sent to us and show the action being taken to address issues raised. Information provided in the AQAA told us that there are a range of policies and procedures in place and the majority of these had been reviewed and updated in 2008. We were also told of equipment maintenance and service dates. Building risk assessments are in place and regular health and safety audits are completed. The Department of Health Essential steps is used to assess infection control and records showed staff receive health and safety training. There are satisfactory arrangements in place to ensure any valuables or monies held on behalf of people living in the home are kept safe and we looked at records held for the people whose care was being followed and these were all up to date and accurate. Generally records required by law to be kept about the operation of the service were up-to-date and well maintained. Someone from the Company had visited the home at least once a month and completed a report on their findings which included talking to people living at the home and to staff. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Care plans should clearly state the action staff must take to ensure they show that consideration to the Mental Capacity Act has been given. Additional activities should be available for people who feel they need more stimulation. 2 12 Care Homes for Older People Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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