Care Home: Chelfham House

Similar services:

• Fairfields Country Rest Home
• Queensmount
• Poldhu
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well Chelfam House provides people with a safe clean and homely environment. Individuals are encouraged to personalise their rooms are are able to bring in their own items of furniture. Care and support is well planned and provided by a staff group that understand the needs of frail elderly and confused people. Individuals who live at the home said ``Staff are lovely, I don`t think you could ask for any better.`` ``We think the staff are excellent`` ``We are well looked after, would recommend this place.`` The staff are definitely good``. Health care professionals who returned surveys also gave positive feedback about the care and support provided. The home endeavors to provide a stimulating environment and activities that suit peoples needs and wishes. They try hard to ensure that people are given opportunities to go out on trips once a month, and also have regular paid entertainers. The management of the home is open and inclusive and they actively seek ways of ensuring that people who live in the home and their families and carers have opportunities to have their say about how the home is run. What has improved since the last inspection? Individuals who need to be seen by health care professionals have treatment in their own rooms or in the staff office using a privacy sign. This is to ensure that individuals privacy and dignity is respected at all times. Since the last inspection the registered manager has completed train the trainer course in dementia care, so that she can deliver training to staff in respect of caring for people with dementia. Staff have worked hard to ensure plans of care include good information and risk assessments to enable care and support to be delivered in a person centered way. What the care home could do better: Plans of care could be further enhanced by building on the information in the life history page and by including more detail about the individuals preferred daily routines and how staff honour these. This would evidence that care and support is delivered in a person cantered way. The medication system is safe but could be made more robust with some minor improvements. Staff are reminded that any handwritten entries or alterations to the medication records should be double signed to prevent errors. We also recommend that any as needed (PRN) medications have clear instructions written in individuals plans of care, as to if and when PRN is considered. Some of the outside areas could do with a tidy up. Individuals who are unable or do not wish to leave their room, should have reasonable views. Some people looked out onto untidy and unkempt garden areas. These could be vastly improved with a little effort.The home needs to ensure that there is a robust audit trail for dealing with individuals personal finances. The induction programme for new staff should follow national guidelines as set by Skills For care. Key inspection report Care homes for older people Name: Address: Chelfham House Chelfham Barnstaple Devon EX31 4RP     The quality rating for this care home is:   two star good 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: Joanne Walsh     Date: 2 2 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Chelfham House Chelfham Barnstaple Devon EX31 4RP 01271850373 01271850814 hammond.m@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Karen Jane Hammond,Mr Mark James Hammond care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 38. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, Not falling within any other category (Code OP) Dementia aged 65 years or over on admission (Code DE(E)) Date of last inspection Brief description of the care home Chelfham House is a privately owned care home registered to provide care for up to 38 residents over 65 years of age. The homes service is for people whose needs may relate to old age, a dementia-related illness, a mental disorder, a physical disability or a sensory impairment. The home is situated in a small rural hamlet, on the outskirts of Barnstaple in North Devon. The two storey detached property stands in its own large grounds, with commanding countryside views from many aspects of the building. The Care Homes for Older People Page 4 of 26 Over 65 38 38 0 0 Brief description of the care home home was not purpose built as a care home, but has been adapted over the years to meet the needs of service users to provide 30 single bedrooms and 4 double rooms. Most of the bedrooms have en suite facilities. There is a newer ground floor extension, which was completed in 2000, and also a single-storey extension to provide a further 10 bedrooms. There is a passenger lift to all floors and a call bell system is installed throughout the home. The cost of care at this time ranges from £330 to £430 per week depending on individual needs. Additional costs, not covered in the fees, include hairdressing, newspapers, toiletries, chiropody and some leisure trips. Current information about the service, including CQC reports, is available to prospective residents, relatives and others who may have an interest such as care managers. 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 inspection took place during a week day in July and lasted approximately 6.5 hours. During this time we spoke to 8 people about their experiences of living at Chelfam House. We also spoke to three care staff, the activities coordinator, the manager and the cook. We looked at some of the key documents including plans of care, pre admission assessment information, staff recruitment and training files, records relating to medication and individuals monies. This helps us to understand how well the home is run and managed. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. Care Homes for Older People Page 6 of 26 During the inspection 3 people were case tracked. This involves looking at peoples individual plans of care, and speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process we try ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to people living at the home; representatives, health and social care professionals (including GPs and care managers) and staff. At the time of writing the report, responses had been received from 4 people living at the home, and from 4 staff. We also received 4 surveys from social and health care professionals. Their comments and views have been included in this report and helped us to make a judgment about the service provided. A Random inspection was completed on the 18th July 2008, as a result of a complaint we had received in respect of the use of overseas staff. We did not find any evidence to substantiate the complaint issues and we did not make any new requirements as a result of completing this random inspection. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Plans of care could be further enhanced by building on the information in the life history page and by including more detail about the individuals preferred daily routines and how staff honour these. This would evidence that care and support is delivered in a person cantered way. The medication system is safe but could be made more robust with some minor improvements. Staff are reminded that any handwritten entries or alterations to the medication records should be double signed to prevent errors. We also recommend that any as needed (PRN) medications have clear instructions written in individuals plans of care, as to if and when PRN is considered. Some of the outside areas could do with a tidy up. Individuals who are unable or do not wish to leave their room, should have reasonable views. Some people looked out onto untidy and unkempt garden areas. These could be vastly improved with a little effort. Care Homes for Older People Page 8 of 26 The home needs to ensure that there is a robust audit trail for dealing with individuals personal finances. The induction programme for new staff should follow national guidelines as set by Skills For care. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 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 10 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. New people are only admitted once an assessment of need has been obtained, to ensure that the home can meet identified needs. Evidence: The pre admission assessment information for the two newest people to the service was looked at and discussed with the registered manager. Where possible the manager says she will visit the person in their own home or where they are currently being cared for. She will speak with the individual and their carer givers as well as any other health care professional involved such as CPN or GP. This helps the home to assess the individuals needs and make a decision about whether Chelfam House can meet these needs. Where individuals are funded by the Local Authority the care management assessment and care plan is also obtained so that this information can be used to better understand the individuals needs. One person we spoke with said that they remembered the manager visiting them prior Care Homes for Older People Page 11 of 26 Evidence: to moving in, but that their family came to view the home, and thought it was the best one for them. Staff spoken to confirmed that they are usually given information about new individuals prior to them moving in so that they can plan for care and support. Care Homes for Older People Page 12 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. Individuals personal and health care needs are well planned and well met. Evidence: During this inspection we looked at four peoples plans of care in detail and where possible spoke with them to gain their views on how well they are cared for and what it is like living in the home. We also spoke to staff about their knowledge and experience of working with and supporting these individuals and we observed care practices at different times of the day. This all helps us to understand how well individuals needs are being met. Plans of care are well organised and clearly the home have spent a good deal of time making sure that they have good information on each person so that staff can provide consistent support to people. Plans include sections on life story page gaining where possible details of the individuals life story, who are important to them and where they lived etc, safety section including risk assessments for falls, use of bed rails. Sections on communication, breathing, eating and drinking, continence, mobility, including a moving and handling assessment, personal hygiene, sexuality and spirituality, Care Homes for Older People Page 13 of 26 Evidence: sleeping, skin condition and pain, pressure sore risk assessment and social interests. Plans also now include a two stage capacity test in respect of defining individuals mental capacity. Daily records are kept separate to the plans of care and staff record how they are monitoring individuals personal, health and emotional well being. They also record what other health care professional support they have asked for such as doctor visits, community nurses and CPN advice. We spoke with one person and their relative who was visiting. They said that the person had come in with bedsores and that these were all healed now. They both described the staff as Excellent, cant fault them. This person was admitted as an emergency so it was not initially the home of their choice, but both the individual living at the home and their relative said that they would not want to move now. The relative said that even though it was in an out of the way location, the registered manager or staff helped them by offering lifts several times a week. They said they go that extra mile for people, you dont often get that these days. One person we spoke to said Staff are lovely, I dont think they could be any better for what they have to put up with. Its like being at home here, you can have a pet if you want. I dont see what they could do to improve it. Another person said We are well looked after here, would recommend this place. We received four surveys back from health care professionals and comments included A good kindly homely tolerant residential home with cheerful and caring staff. Always seem very caring when I visit They seem to manage quite demanding residents well. Only one less positive comment was received in answer to what could the service do better, one health care professional said perhaps need to call in other agencies sooner rather than later when issues arise. We could not find evidence to support this. From looking at records and plans of care it would appear that the home called in advice and support from health care professionals in a timely manner. Most of the practice we observed was kind and respectful, carers were busy during the morning, but did listen to people and spend time talking to individuals, guiding some people who were wandering or appeared distressed. One incident of poor practice was observed, this was minor but should still be addressed. One person was bought into the lounge and left in their wheelchair facing the wall. The carer did not explain that they were going back to get someone to help them to safely transfer them into a chair. Carers need to be mindful to always explain what they are doing with and to an individual. Care Homes for Older People Page 14 of 26 Evidence: We looked at the medication storage and records relating to administration of medications. These appeared well maintained. We noted that hand written entries were not always double signed. This helps to prevent any errors occurring. Any Creams that have been prescribed should also be recorded when they are administered. The home should also make sure that any medications that are prescribed as needed PRN, instructions as to how and when PRN is considered should be clearly identified as part of the persons plan of care. Care Homes for Older People Page 15 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. Individuals social and diverse needs are reasonably well met. Evidence: The routines of the home appear reasonably flexible with people being able to make choices about when they are assisted to get up and go to bed, what they wear and where they spend their time. People spoken to said that they got up at a time that suited them. One person said staff are very good, if I am not ready, they say they will pop back and even though they are busy, they do try to come quick when I ring my call bell. We observed people being assisted to get up at different times, some were having a late breakfast and others were up and about and were getting involved in activities set up by the activities coordinator. The home try to offer a range of activities and outings and have an activities coordinator who works four mornings and during the afternoons care staff try to engage people in games and puzzles. The home also have paid entertainers in on a weekly basis and endeavor to having outings on monthly basis. These include trips to Exmoor Zoo, local garden centers, and places of local interest. Outings and activities are usually discussed at regular residents meetings so that people have an opportunity to have say if they are able, about what sorts of things they would like to do. Care Homes for Older People Page 16 of 26 Evidence: We discussed how individuals who are not able to or choose not to leave their room are encouraged to be involved and engaged in activities. The staff said that where possible they do regular checks on individuals who remain in their room and that the activities coordinator visited people in their room on a regular basis to see if they needed anything, or to sit and chat. One person told us that visitors were made welcome and one visitor said that they were always made welcome and that staff helped them with transport to get to the home. The home offers a good range and choice of meals. The main meal of the day is served at lunch time and individuals can choose where they would like to dine. We saw people being assisted with kindness and dignity during meal times and people were generally very positive about the food. Comments includedMeals here are smashing, we get plenty, There is always lots to eat and I enjoy what they give me. Meals are absolutely good The cook told us that they can cater for special diets and they are aware of individuals likes and dislikes and menus are planned around these. He said that people were always being asked about menu choices and he and the staff tried hard to vary the menu to suit tastes. Care Homes for Older People Page 17 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. Individuals views are listened to and acted upon. Evidence: The home have a stated complaint process and keep records of all complaint and concerns and evidence how these are investigated and resolved. People we spoke to during the inspection said they could speak to the manager or senior staff about any concerns they have and were confident these would be dealt with. Everyone who returned a survey said the knew how to make a complaint. Since the last key inspection we received an anonymous complaint about the use of overseas workers. A random inspection was completed on the 16th July 2008. We did not find any evidence to substantiate the complaint. The home was complying with all requirements in relation to employing overseas workers, and we did not make any requirements as a result of this random inspection. We received notification from the home of two safeguarding issues, which were not referred onto the safeguarding team or the Police as they should have been. Since then the home have had further training in the safeguarding processes, and we are confident that they now follow the correct pathways in ensuring possible safeguarding issues are referred to appropriate bodies. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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. The home provides people with a well maintained homely environment. Evidence: Chelfam House is reasonably well maintained and provides people with a homely safe environment. People we spoke to said that the home was kept clean and there was no evidence of odour in the building. The home employ three cleaner who work each morning are are commended for keeping the home fresh smelling and clean. People said that their rooms were cleaned on a regular basis. The registered manager said that she also tries to get the relative support group to be involved in having a say about the decor and homeliness of the home during their monthly residents meetings. The home has policies and procedures in place for infection control and should add to this what their response will be to Swine flu. Staff were observed to sue clothes and protective clothing and staff said that they had access to cleaning materials. Some of the outside areas are looking a little neglected and would benefit from a tidy up and some weeding. This was particularly noticeable in those bedrooms where people are not able to get out. The raised flower beds in one area outside a bedroom only had weeds and grass growing in it. 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. Staff are well trained and supported to do their job. Evidence: The staffing levels for the home are sufficient for the number and needs of the current group of people living at the home. There are normally 5 carers on each shift, plus an activities coordinator who works four days per week from 8.30 until 2 pm, 3 cleaners who work mornings, a cook and a kitchen assistant. There are three waking night staff to cover the night time and early morning periods. The staff recruitment files were looked at for the two newest members of staff. They evidenced that checks and references were obtained to ensure workers were fit to work with vulnerable people prior to being employed. One file also gave information about one to one staff supervision, to ensure that support and training had been given to this worker. Staff we spoke to and those who returned surveys said that they were given good opportunities to receive training. One staff member said The basic principles of caring, treating people with respect and the skills of good communication remain as vital as ever. The company has rules about safety, fire and cross infection, every member of staff must be trained in safety, first aid, moving and handling and protection of vulnerable adults. Another staff member said We have joined NAPA, Care Homes for Older People Page 20 of 26 Evidence: who provide some excellent training course and I am working with the home owner to arrange some in house training, which could possibly involve staff from other homes. 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. The home is well managed and run in the best interests of the people who live there. Evidence: The registered manager is qualified and experienced to run the home. She has completed training in understanding the needs of the people who live at the home as well as the relevant management training. Staff and individuals who live at the home say that the manager has an open and inclusive approach and that both can talk to her about any concerns they have. The home try to involve family and friends of people who live at the home as much as possible, both in formally reviewing the quality of care and support via surveys, but also less formally, with regular relative support group meetings that meet monthly. The home only handle one individuals personal monies. They have tried to involve an independent advocate in this matter as this individual has no family or friends acting for them. Receipts and records are kept for all transactions made on behalf of the Care Homes for Older People Page 22 of 26 Evidence: individual, but the actual monies did not tally with the records when checked. This was a human error, and explained, but currently the home charges the individual for staff one to one time to get the person out for shopping trips. The money is paid direct to the staff member, but it would be better for the home to properly invoice the person for additional staff time used. The AQAA provided us with information about how well the home ensures health and safety is protected via regular servicing of equipment and maintenance of electrical and heating systems. Staff told us that they have updated training in all aspects of health and safety, and the home now needs to ensure that induction training for new staff follows national guidance as specified by The Skills for Care Council. 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 2 9 9 Medication records should be double signed when hand written entries or alteration are made. Clear instructions for staff should be included in individuals plans of care as to if and when any PRN (as needed) medications should be considered. The outside areas should be tidied up and made more attractive Induction training for staff should follow national guidelines as set by Skills For Care. 3 4 19 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!