Care Home: Chatting Independently Ltd

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What the care home does well The philosophy of the manager and staff to enable people living in the home to communicate and live a more independent life is excellent. People who live in the home praised most of the staff. People said they made choices for themselves. There is a well maintained hydrotherapy pool available on site. What has improved since the last inspection? Although no staff have been employed since the last random inspection, the manager is aware of the checks that need to be in place before someone commences employment. What the care home could do better: Staff on duty must have the necessary training to enable them to carry out specific medical procedures. Food kept in the fridge must be covered, and must have the date it was opened recorded. Care plans must be updated so that changes in a person`s needs are evident. Where a different number of tablets can be given staff must record the actual number given so that there is an audit trail. Staff must recieve regular supervision to ensure best practice in the home. A Quality Assurance system must be put in place so the service can be improved. Key inspection report Care homes for adults (18-65 years) Name: Address: Chatting Independently Ltd 3 Rectory Drive March Cambridgeshire PE15 9QR     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alison Hilton     Date: 0 5 1 0 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 27 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 27 Information about the care home Name of care home: Address: Chatting Independently Ltd 3 Rectory Drive March Cambridgeshire PE15 9QR 01354650767 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: david@chattingindependently.co.uk Chatting Independently Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category/ies of service only: Care home only Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Physical Disability Code PD Date of last inspection Brief description of the care home Chatting Independently Ltd. is situated in a converted bungalow at 3 Rectory Drive, which is a private road near to March town centre. The service is designed to cater for 6 people with a physical disability, who will learn how to use AAC (Augmentative Alternative Communication), which is an electronic device to assist people with speech communication problems. There are six single bedrooms and people living in the home share the kitchen/dining area, bathroom and lounge facilities. There is a well equipped physiotherapy room and hydrotherapy pool available on site. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 6 Brief description of the care home There are gardens to the rear of the property. There is an office and sleeping-in facilities for the staff. A copy of the last inspection report was in the office and available to residents and families. The fee levels vary depending on the needs of individuals accommodated and information can be gained directly from the home. The last key inspection was undertaken on 12th November 2007. A random inspection took place on 4th June 2009 as the result of a complaint, but no evidence was found to substantiate this. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home 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: We, the Care Quality Commission (CQC) carried out a key unannounced inspection on Monday 5th October 2009 at 07:50 hrs using the Commissions methodology described below. This report makes judgements about the service based on the evidence we have gathered. Staff, (including night staff), people who live in the home, the manager and responsible person were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission prior to this inspection. Surveys were sent out to staff and people living in the home. Two surveys were returned by those living in the home and seven staff surveys were returned. Information they provided will be in the body of the report. A number of records were seen, together with two files for people living in the home and three staff files. Care Homes for Adults (18-65 years) Page 6 of 27 There were two people in the home during the inspection and three staff. Two people from this home and one from another Chatting Independently home went on holiday the morning of the inspection. Care Homes for Adults (18-65 years) Page 7 of 27 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 27 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 27 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. People are expected to visit the home to ensure their suitability and that the home and staff can meet their needs. Evidence: The AQAA showed that people have a 3-day assessment and a report is written at the end of that time. There was evidence on file of a comprehensive assessment completed during a four day stay at Chatting Independently for one person new to the home. The person had also had a report completed by a physiotherapist. This meant that staff had enough information to decide if they could meet the needs of the person, and the person had got to know the staff and the home giving them the information to decide if they wished to live at Chatting Independently. There is a comprehensive Statement of Purpose and Service User Guide available. Care Homes for Adults (18-65 years) Page 10 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information in the care plans does not reflect the change in peoples needs, therefore their needs may not be met. Evidence: Details in the AQAA showed that people living in the home are encouraged to ask for the help they need so that they are free from another persons control and accept the consequences of the decision made. Two files for people living in the home were seen as part of the inspection. The newest person admitted to the home had additional disabilities. This persons behaviour means other people in the home remove themselves from rooms that that person enters. There was no documentation on the file that showed other people living in the home were consulted about the person recently admitted, although they are all able to speak their minds using different means of communication. The person has caused major disruption to the lives of those already living in the home, although it has been very positive for the person admitted. A review took place during the inspection and Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: the Social Worker for the person is pleased with their placement and the improvement in behaviour in such a short space of time. The care plan for the other person had not been updated since they were discharged from hospital on 10/08/09. There had also been another hospital admission for this person (prior to 10/08/09) and no updated care plan was completed then either. A file was found by staff that showed changes made after a review on 07/09/09, but these had not been put on the care plan, which means the person may not have received the appropriate care since discharge from hospital. There was evidence on file that people are encouraged to take part in a variety of activities both in the home and externally. Risks are assessed to minimise hazards but allow a person to take part in what they want. The detail in the care plan for one person showed they required 2-1 care 10am-10pm. There were two staff in the home for this person on the day of inspection. Further details in the care plan and risk assessments were sufficient for staff to be able to care for this person in a positive and consistent way. Care Homes for Adults (18-65 years) Page 12 of 27 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 have the opportunity to take part in activties that develop their social, communication and educational skills. Evidence: Details in the AQAA showed that people are encouraged to take courses at college and there are two staff who provide learning support, which allows people to discuss educational options more freely. Each person is given £40 per week food budget and they are expected (with support) to purchase their own food and to have staff cook it. Each person has a key to the front door so that they can come and go as they wish. It was evident that one person was quite disruptive and the other person in the home, during the inspection, would leave the room and go to their bedroom to avoid the noise made by that person. Staff said all other people living in the home left the room when this one person entered as they could not cope with the noise. This means that Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: those living in the home are restricted in their time together because of this behaviour. People in the home are encouraged to maintain links with their families and one person said they wanted to ring their mother and staff said they would arrange this later in the day. Staff said they accompany people to local facilities as well as on holidays. Two people from the home had gone on holiday as we arrived to do the inspection. The ethos of the home is to encorage people living there to be as independent as possible, so that on leaving the home they can direct people they employ to undertake the tasks required. They receive support from staff to decide what they want for meals. to purchase the food and then get staff to cook it. One person chose to eat when the other person in the home was not in the kitchen so the meal was peaceful. We observed the other person having their meal and it was a noisy time but staff handled it well. Care Homes for Adults (18-65 years) Page 14 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Medication must be administered by trained staff and the details recorded accurately in the medication administration records to ensure the health and wellbeing of people in the home. Evidence: Information provided in the AQAA showed that people living in the home are encouraged to ask for their medication when required and staff administer this. It also gave details that a member of staff had been appointed to be responsible for the ordering, checking and auditing of medication, but this is not the case at the moment. Details of the personal support required by people in the home is in their care plans. There are issues about information not being updated on discharge from hospital when significant changes to some areas such as moving and handling are evident. We discussed this with the manager who agreed significant changes had occured and should have been updated in the plan. People in the home are encouraged to be as independent as possible so they can live in the community at some point in the future. People spoken to said they did make Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: choices in all areas of their lives but sometimes staff did not respond as they would like, but did not know what to do about it. (See complaints) People have the necessary equipment to enable them to be as independent as possible including specialist wheelchairs, communication aids (augmentative alternative communication) and other aids and adaptations in the home. There was evidence on file that specialist health professionals such as physiotherapists were involved with the care of those in the home. However on one file it was noted that the person should be stretched twice a day to ensure their limbs remained flexible, but staff said this was not always done. Where this type of action has been requested by a health professional it must be provided to ensure the health and wellbeing of the person. Massage of the legs and hips was last noted on 13/09/09. The manager was informed of this. The medication administration records (MAR) were seen for the two people in the home. There was consistency in the way medication offered but refused was recorded and the numbers of tablets in the home was correct. One person should have Conotrane cream applied three times a day but there were very few days that this had been done. Where a different number of tablets can be given, the actual number given must be recorded so that an audit trail can be seen. This was in relation to Senna tablets 7.5mgs 2-4 at night, where only 2 entries had details of the actual number given. The manager was spoken to about this and will ensure this is done in the future. Staff said they had received medication training. Some people in the home require staff to be trained to administer rectal diazepam. Only 50 of staff have received this training and it was noted that there were some night shifts where neither person on duty (sleep in nor waking night) had received this training, putting people at risk. The manager was spoken to and he stated he would ensure that someone with the appropriate training was on duty at all times. He also said that there would be training for the remaining staff on 21/10/09. Care Homes for Adults (18-65 years) Page 16 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People did not feel their views were listened to but were aware of the complaints procedure. Evidence: The Commission has not received any complaints about the service. Details in the AQAA show the manager has received no complaints and there have been no safeguarding issues, but people spoken to during the inspection felt their concerns were not listened to by management. No specific examples were given. There is a clear complaints procedure in the home and people in the home, their relative and staff have signed to say they have received a copy and understood them. Details in the AQAA showed that the manager believes people feel free to speak of concerns and know they will be listened to and will have a response within the agreed time frame. This was not what those living in the home said. Care Homes for Adults (18-65 years) Page 17 of 27 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 home is a safe environment for people to live in. Evidence: Details in the AQAA showed a caretaker has been appointed who is responsible for the maintenance of the premises, vehicles and hydrotherapy pool. One person in the home had chosen the colours for the communal rooms and shared ideas with the others who live there. They had all agreed on the colour scheme and the kitchen was being painted on the day of inspection. Further improvements to the environment were being made whilst two people who live in the home were on holiday meaning less disruption. The lounge was to be decorated and new vinyl flooring put down in place of the stained carpet currently laid. Overall the home is adequate and meets the needs of those living and working there. People have their own bedrooms that they decorate as they wish. The hydrotherapy pool is a real asset to the home and allows people regular access to this specialist facility. People have specialist beds, communication systems, wheelchairs and other equipment necessary for them to have a reasonable quality of life. Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: There were no unpleasant odours anywhere in the home. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff morale is low resulting in some staff turnover that affects the consistency of care to people living in the home. Evidence: Details in the AQAA show that staff go through two interviews and a practical where they shadow a member of staff and person living in the home for a day. There is a discussion between the manager, staff member and person living in the home to get their views before making an employment decision. The manager is using a new HR company to complete the contracts and other specialist areas of employment. There is a 5.5 day induction where all the statutory courses are completed plus input from the company speech and language therapist and physiotherapist. Staff are then encouraged to undertake a National Vocational Qualification (NVQ) within three months of their probationary period. Staff confirmed this during the inspection. Surveys received from staff show that 4 out of 7 felt the training does not keep them up to date with new ways of working or give them enough knowledge about healthcare and medication. We found that 50 of staff had not yet received training in administering rectal Diazepam (see also personal and healthcare support). Only one person said their induction covered everything they needed to know and two indicated Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: not at all. The manager needs to ensure staff complete an induction that provides them with the expertise to keep those in their care safe and well. Further evidence from staff on the day of inspection was that they had not completed safeguarding training, no training on how to assist someone to eat and do not get regular supervision. Further evidence was found that not all staff had received rectal diazepam training, and on two night shifts on the rota (prior to arranged training) were covered by untrained staff. These issues were discussed with the manager who stated that staff get training from speech and language therapist in relation to feeding someone. He agreed that supervision had not been given regularly but was going to put this in place as soon as possible. He agreed that the staff on the night shifts in question would be altered so that at least one person had received the training, thus ensuring the safety of people living in the home. Staff surveys showed that although staff were enthusiastic about their work morale was low because of staff turnover. Staff on duty said that because they try to cover shifts when others are sick or on leave to maintain consistency for people living in the home, it could be very stressful. Staff do not have regular staff meetings where they could raise issues or concerns. Chatting Independently owns this home and another across the road. Both homes use the same staff group and although each person living in the home is supposed to have a dedicated staff member each shift (called a facilitator) when one home is short or needs a driver, staff from the other home are called upon to fill the gaps. Staff also said that when there are no female staff in the other home the female person who lives there is brought across to Wimblington Road for the female staff there to care for her. The responsible person said that no-one new had started at the home since the last random inspection on 4th June 2009, when elements in the process for employing people had not been on file. He stated that there were some people waiting to start but the manager was aware that no-one can start work without at least a PoVA First, references and full interview. Care Homes for Adults (18-65 years) Page 21 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The ethos of the home is excellent but the management structure does not underpin it to make sure people feel supported. Evidence: The philosophy of the home and the staff undertsanding of it cannot be faulted, however people living in the home expressed concern at the leadership and management ethos, which they felt was not clear. Some staff echoed the comments made to us during the inspection. The AQAA showed that the manager is well qualified and has managed his own staff from the age of 18years. He has the same physical and communication issues as those living in the home, and can empathise and understand things from a similar viewpoint. He has City and Guilds Registered Manager of a Care Home and is about to start his NVQ Level 4. The AQAA showed that policies and procedures have been reviewed in June this year. Copies of some were inspected and they cover the necssary information for staff. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: A new caretaker has been employed to oversee both homes. We spoke to him during the inspection and he demonstrated a comprehensive understanding of his role and was able to supply us with all the necessary checks and documentation. There were details of fire drills that had taken place but not of the people who had been part of them. This information would allow the manager to ensure all staff and those resident in the home had taken part in a recent drill for their safety and wellbeing. Details in the AQAA showed that the manager believes a better quality assurance system could be in place which is more transparent. We discussed the lack of an effective quality assurance system and the manager stated that someone from outside started that and we need to pull it together and I had given myself until the end of October because a lot came up together. Care Homes for Adults (18-65 years) Page 23 of 27 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 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 6 15 Care plans must be updated and reviewed when there is a change in the needs of a person living in the home. This well ensure the current needs of people in the home are detailed 16/10/2009 2 18 12 Staff must provide the treatment detailed in the care plan. This is to ensure the continued health and wellbeing of the person in the home. 06/10/2009 3 20 13 Arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines must be made. This is to ensure the health and wellbeing of those living in the home. 06/10/2009 Care Homes for Adults (18-65 years) Page 25 of 27 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 4 32 19 Staff must have the qualifications and skills necessary to care for people in the home. This is to ensure the health and safety of those living in the home. 30/10/2009 5 36 18 Staff must receive appropriate supervision. This is to ensure staff are supported and best practice is maintained. 30/10/2009 6 39 24 The manager must establish and maintain a system for reviewing and improving care in the home. This is to ensure the quality of care is improved in consultation with people who live in the home. 07/12/2009 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 22 The relationship between the manager, staff and people who live in the home should be maintained to ensure concerns can be raised. Care Homes for Adults (18-65 years) Page 26 of 27 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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