Care Home: Elmhurst

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What the care home does well The home has good systems in place and staff are well trained in assessing people`s needs and preferences about the care and support they require. Based on the assessments, person centred care plans have been agreed with people or their representitives that give the reader an insight and understanding about the person and significant relationships and events in their life. They also record in detail what is important to them in their daily lives so that the care and support they receive is appropriate for them. Risk assessments and specialist needs assessments are also completed such as manual handling risk assessments, nutrition assessments and mental health assesments. These help to make sure people are safe and well cared for. All the records we examined were detailed and kept up to date with regular reviews taking place. Improvements have been made to the environment with all areas of the home being decorated and furnished to a good standard and well maintained. Furnishings and decor have been thoughtfully chosen in line with good practice guidelines with regard to Dementia care. Photographs are used on people`s bedroom doors as well as name plates to help people move around the home independently. Staff receive regular training including specialist courses and regular refresher courses that keep them up to date with current good practice. A good example of this is some staff who have completed the `Liverpool Pathway` training in relation to Palliative care that has had some positive results. The manager provides clear leadership and works closely with the supervisory team to support and guide staff with regular supervision and team meetings taking place. Based on feedback from relatives there is a high level of satisfaction with the service provided, as the following comments reflect, "very happy with the care my relative is receiving", "very happy with the support from staff". What has improved since the last inspection? All the files examined contained a signed contract of terms and conditions explaining the rules about living in the home and what services are provided. All fire exits were clear and accessible leading onto pathways that were free from hazards so that people can evacuate the building safely in an emergency. Care plans have been looked at and improved making them more meaningful to the person by recording more detail about a person`s life history and significant events and relationships in their lives. Flooring throughout the home has been replaced with a suitable alternative that is attractive to look at and is easy to clean and keep free from malodours and stains. Photographs or pictues are being used effectively in the home to help people find their way around more easily and therefore maintaining their independence. Photograph albums have also been put together for some people, which have proved a useful tool to engage people in conversation and share their life experiences. Staff are receiving suitable training when needs are identified, with clear records maintained and available for inspection. This has included safeguarding training with staff now having a good knowledge of how to identify and report abuse. What the care home could do better: When recording PRN (as and when required) medication that has been administeredstaff should record the number of tablets administered on each occasion. This will ensure an accurate record of medication is maintained at all times. When new medication is being checked into the home`s system, the contents of all packets should be checked to make sure the amount inside corresponds with the label. This will ensure stock records are accurate and people are given the correct medication. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Elmhurst Priory Road Ulverston Cumbria LA12 9HU     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: Ray Mowat     Date: 2 7 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. 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. 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 27 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 27 Information about the care home Name of care home: Address: Elmhurst Priory Road Ulverston Cumbria LA12 9HU 01229894115 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cumbria Care Name of registered manager (if applicable) Mrs Jayne Allonby Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 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: Old age, not falling within any other category - Code OP (maximum number of places: 40) Dementia ? Code DE (maximum number of places: 40) The maximum number of service users who can be accommodated is: 40 Date of last inspection Brief description of the care home Elmhurst is a purpose built local authority care home. Cumbria County Council own the home, which is operated by Cumbria Care. Mrs Jayne Allonby is the registered manager. Elmhurst is a single storey building situated 15 minutes walk from Ulverston town centre but with local amenities nearby. It is divided into four units of 10 bedrooms. Each unit has its own lounge and dining area with kitchen, two bathrooms and a toilet. Care Homes for Older People Page 4 of 27 40 0 Over 65 0 40 care home 40 Brief description of the care home There are four bedrooms with an en-suite bathroom. Three of the units cater for people with dementia, and the other unit is for people with physical frailty. The three-dementia care units have open access within the home, but all exterior doors are key pad activated or alarmed. The grounds are well kept and provide a pleasant secure garden area for people to enjoy when the weather allows. The weekly fees ranged from £375.00 to £455.00 according to individual needs. The home has information for current and prospective residents and their families in the form of a statement of purpose and service users guide. A copy of the latest inspection report is also available in the home. Care Homes for Older People 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: 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: The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. During the visit the lead inspector Ray Mowat was accompanied by an expert by experience. An expert by experience is someone who has either used services themselves or knows what it is like to need a service and what the service should provide to people. We met with people living in the home, visitors and relatives as well as spending time with the manager and supervisory staff on duty. We also met with care staff individually and talked to them as they went about their duties. The manager completed a self assessment questionnaire called an Annual Quality Care Homes for Older People Page 6 of 27 Assurance Assessment (AQAA) and sent it to us before the inspection visit. This provided us with information about how the home is run and the managers views on what the home does well, where they have improved and plans for the future. There is also information about the people who live in the home and the staff working there. Surveys were sent out as part of this inspection to people living in the home, staff and other professionals with their views being used to formulate the judgements in this report. We also examined records relating to the running of the home that are required by legislation, which included care plan files that guide staff in supporting people to achieve their goals and lead independent lives. We examined staff files and records relating to the maintenance and safety of the home. What the care home does well: What has improved since the last inspection? What they could do better: When recording PRN (as and when required) medication that has been administered Care Homes for Older People Page 8 of 27 staff should record the number of tablets administered on each occasion. This will ensure an accurate record of medication is maintained at all times. When new medication is being checked into the homes system, the contents of all packets should be checked to make sure the amount inside corresponds with the label. This will ensure stock records are accurate and people are given the correct medication. 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 9 of 27 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 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 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. Detailed needs assessments are completed before a person moves into the home making sure the home is a suitable place for them to live. Evidence: We examined three peoples personal files, which all included a signed contract of terms and conditions. This provided them or their representitive with relevant information about all aspects of home life including the care and services provided and the fees charged. Pre admission assessments were also in place, these are completed by one of the supervisory staff before a person moves into the home. It provides a detailed assessment of the persons personal and healthcare needs, in addition to giving staff an insight to the persons personality and the daily routines that are important to them. Reports and assessments from other agencies were also recorded such as Occupational Therapy assessments, which ensure the persons needs can be safely met in the home environment and they have appropriate equipment and Care Homes for Older People Page 11 of 27 Evidence: resources to promote the persons independence. Emotional and social care needs were also assessed and recorded such as religious and cultural beliefs, social interests and hobbies and important relationships. On the day of the inspection a person was visiting the home from an intermediate care unit to enable staff to complete a full assessment of their needs in the home environment, as they had some complex mobility issues. This was taking place over two days with the involvement of the Occupational Therapist, who was making sure the persons room was suitable for manual handling procedures and that suitable equipment was in place. This level of pre admission assessment is good practice and ensures the home is able to meet peoples assessed needs, including specialist needs, when they move into the home. Care Homes for Older People Page 12 of 27 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. Detailed and personalised care plans ensure peoples needs and aspirations are recorded and staff can provide appropriate support, with all aspects of their health, personal and social care needs. Evidence: Person centred care plans have been developed for each person living in the home. This meant that staff knew exactly what they needed to do to help the person to meet their needs in the way they preferred. The way the plans were written encouraged staff to respect peoples dignity and abilities, therefore promoting their independence. Link workers have been identified from the staff team, who take a lead role in working with the person, their family or representitive and a named supervisor to develop the person centred plan and coordinate their package of care. The plans we examined were very detailed and reflected the persons individuality and personal preferences about how they like to live their lives. This included real attention to detail about everyday things that were prescious to the person such as likes and dislikes, favourite music, colours, smells,what makes them happy or sad. Care Homes for Older People Page 13 of 27 Evidence: Personal care needs and healthcare needs were also recorded in detail including specialist support from other agencies. Examples included dietary assessments, mental health assessments as well as more routine healthcare input. This provides clear guidance for staff in how to respond to sometimes challenging and complex situations relating to emotional support and challenging behaviour. Risk assessments were also in place when potential hazards were identified to ensure the safety of the person and the staff at all times. These included comprehensive manual handling assessments that support and guide good practice. Assessments and care plans were under constant review ensuring they were up to date and accurate and reflected any changing needs, which were signed and dated when they were recorded. The all about me section of the care plan really brings the plan to life and gives the reader a real sense of who the person is and as one staff said what makes them tick. This section included valuable information that due to their condition the person may not have been able to share with staff, such as their work history, family history and significant relationships and events in their lives. Very personal information was also recorded including religious and cultural beliefs and daily routines and rituals. A good example of this was a section recording what the person feels is a good day and what they feel is a bad day. Recording this level of detail and type of information is good practice and is invaluable to staff when supporting and caring for someone in a person centred way. We examined the medical records and contents of the medication cabinet in one of the units. The medical record sheets (MAR charts) included a photograph of the person with their name and date of birth. PRN (As and when required medication) guidelines were also in place for each person that make sure all staff are aware of how, when and why the medication is required. A stock book is used to record all medication coming into or leaving the home, with an audit taking place monthly to reconcile the stock held and the medication administered. However when we audited one persons medication against the records there were two discrepencies. The MAR chart stated one or two paracetomol tablets to be administered when required, however when staff had signed the chart to record the fact they had administered the medication, the number of tablets given was not recorded. Also it became evident that the stock record for a prescribed medication was not accurate. This was due to the fact that staff checking in the medication had presumed the number of tablets recorded on the outside of the box was accurate, when in fact one of the boxes had been part used prior to admission. Two good practice recommendations have been made to address these shortfalls. There was evidence the home has provided good quality end of life care to people, with staff receiving relevant training and support to guide their practice and deal with issues with sensitivity and respect. The manager has adopted the use of the Liverpool Pathway, which a is recognised good practice tool when dealing with terminal illness. Care plans also record peoples wishes and preferences with regard to death and Care Homes for Older People Page 14 of 27 Evidence: dying. The following quote from a family member of someone who had died whilst staying in the home reflects the level of care provided. My relative always seemed happy and settled when we visited. They were always kept clean and comfortable with regular checks on their needs. They were offered exemplary palliative care. Care Homes for Older People Page 15 of 27 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. A good range of social activities are provided that enable people to lead a full and active life and pursue their individual interests and hobbies. Evidence: A member of staff has been identified to take a lead role in coordinating activities. A two week activity rota has been developed that is displayed on the notice board in each of the units. The rota included a planned activity for each morning and afternoon, with a member of staff identified to coordinate the activity. There was a good range of activities provided including both sedentary and non sedentry activities taking place in the home and in the local community. These included theraputic and social activities such as armchair exercises, reminiscence, a sing along, bingo, manicures and hairdressing, ball games and arts and crafts. Staff provide 1-1 support to people such as hand massages or manicures and the home is also visited by PAT dogs, which people find have a calming effect and are always popular. Alternatively for the more active people they go for walks around the garden or to visit the local shops or amenities. There are also bus trips taking place twice a week, going to local places of interest that are proving very popular. In addition to the formal activity sessions described staff are skilled at supporting Care Homes for Older People Page 16 of 27 Evidence: people spontaneously on a more informal basis, a good example of this happened during the inspection with people enjoying a sing-a-long in one of the units. We also observed people who liked to get involved with household tasks being encouraged and supported by staff to do this in a meaningful way. Photograph albums or local history books were used to instigate a conversation with individuals and small groups of people also some people enjoyed a daily paper that staff also used to help orientate people to the day and date and what was happening locally and nationally. Cultural and religious needs are respected and there is a church service each Friday and a Communion each Sunday in the home. There is a four week rolling menu that is displayed in each unit, which staff use to find out a persons meal choices. These provided at least two choices at each meal and a selection of snacks and drinks that are available at any time. We joined different groups of people for a meal at lunch time and found staff were attentive in making sure people had a suitable meal and drinks and their choices were respected, with alternatives being provided when they changed their meal selection on seeing the meals being served. Staff did not eat with people but were on hand to provide varying levels of unobtrusive support to help people eat their meal. Plate guards were also used to help promote peoples independence and dignity at mealtimes. Care Homes for Older People Page 17 of 27 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. Policies and procedures are in place, which help to ensure that people raising concerns are listened to and their concerns are taken seriously and acted upon. Evidence: Information about how to complin and who to complain to is displayed in the home as well as being issued to people and their represenntitives when they move in. Feedback from the surveys sent out as part of this inspection confirmed that staff are aware of their responsibility in relation to supporting peope to raise concerns. All complaints and their investigation are clearly recorded and responded to in a timely manner. The manager described how they had made a referral to the IMCA (Independent Mental Capacity Advocate) on two occasions to make sure the persons best interests were being aknowledged and taken into account during decision making. There was evidence the manager has dealt effectively with a recent adult protection (safeguarding) concern when issues had been identified. Timely referrals have been made to the appropriate agencies and the people involved have been safeguarded during the investigation process. Staff have received relevant training and based on discussions with them, have a good understanding about what is abuse and how to report allegations or incidents of abuse. They also confirmed they had access to up to date and relevant policies and procedures to guide their practice. Care Homes for Older People Page 18 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, 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. Improvements have been made to the decor and furnishings making the home a comfortable and safe place to live. Evidence: Improvements have been made to the home environment since the last inspection visit, which included the fitting of new laminate effect flooring and carpets in the lounge/dining areas and some corridors. The laminate type flooring is both attractive to look at but also very practical as it can be effectively cleaned when spillages occur preventing malodours. The manager has researched the best products to use in an environment where Dementia care is provided, which is good practice, with obvious benefits for the people living in the home. In addition to peoples names being on their bedroom doors, photographs have been added, if appropriate for the individual, to help them identify and differentiate between their own bedroom and other rooms in the home. The bathrooms we looked in were clean and tidy and fitted with suitable equipment to promote peoples independence. In addition to the lounges on each unit there is a quiet lounge in the foyer area, where people can go for some time on their own or to meet a visitor. The home manager and accommodation manager had recently completed a building survey to make sure the decor and furnishings are maintained to a good standard. Smaller touches such as the Care Homes for Older People Page 19 of 27 Evidence: purchase of new lamps, pictures and place mats added to the homely and well kept feel of the home. Dedicated domestic staff are deployed throughout the week to ensure the environment is clean and hygienic and free from offensive odours. Care Homes for Older People Page 20 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 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. The home has a well trained and knowledgeable staff team who have developed a good understanding about peoples individual needs and how to support them to lead a fulfilling and independent lifestyle. Evidence: Based on our own observations and discussions with the staff and the manager, there were suitable numbers of care staff and domestic staff on duty to meet the needs of the current group of residents. Over 75 of the staff team have completed their NVQ 2 qualification (National Vocational Qualification), with a further six staff working toward the NVQ 3 award. The organisation has sound recruitment policies and procedures in place that make sure the staff working in the home are both safe and suitable for their role. We examined staff files and met with staff as they went about their work or on a 1-1 basis. Some of the staff we met during the inspection shared with us their experiences of the recruitment and induction process. They said it had been a positive experience with a good, thorough induction including five days training as well as shadowing experienced staff. All necessary checks were completed and copies of relevant information was held on individuals files. Staff confirmed they received a job description and contract and had access to relevant policies and procedures to guide their practice. Care Homes for Older People Page 21 of 27 Evidence: A good range of both mandatory and specialist training was being provided to staff. Training records examined confirmed people were receiving suitable training for their role and refresher training was taking place. Some senior staff had completed training that they were able to pass on to care staff in addition to the home working cloely with other agencies and professionals to make sure staff had adequate skills and knowledge to respond to peoples individual needs and complexities. Care Homes for Older People Page 22 of 27 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 manager is providing good leadership and support and ensures the home is run in the best interests of the people living there. Evidence: The manager is suitably trained and experienced and provides good leadership to the staff team. Based on our discussions with staff and their responses to the staff surveys sent out as part of this inspection, they talked about a suportive management, a good working environment and regular supervision,and felt that we can discuss anything we need to. Others said its a good home, with person centred care based on a persons preferences, its a good well run home, everyone gets on together with regular supervision and team meetings to discuss things. Our own observations and experiences during this visit confirmed these views, with staff providing sensitive support that focussed on the individual and promoted their dignity and independence. The daily handovers and regular supervisions and staff meetings provide people with Care Homes for Older People Page 23 of 27 Evidence: opportunities to raise concerns and contribute to the running of the home. The manager is preparing to send out the annual quality survey, to all the people living in the home and to their families and representitives, with their responses being incorporated into the homes annual business and development plan. The home only holds small amounts of personal finances on behalf of people to pay for sundry personal expenses such as hairdressing and toiletries. We sampled the personal finance records of two people and found these to be in good order with all tansactions clearly recorded and signed for, with all monies securely stored in the safe. The manager and supervisory team provide all staff in the home with regular supervision, which is recorded. There was evidence of appropriate discussions taking place relating to current good practice, policies and procedures and all aspects of the staffs persoanl and development needs. The home was awarded a four star rating by the Environmental Health Department in relation to their catering facilities and management. All other aspects of health and safety are monitored by designated staff, with checklists in place to make sure all routine checks are completed. The fire training matrix was examined and was up to date ensuring all staff were receiving fire training at the appropriate intervals. Equipment servicing and maintenance were being completed and records maintaned. COSHH substances were all securely stored and risk assesments and data sheets were up to date. Care Homes for Older People Page 24 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 Older People Page 25 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 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 9 When recording PRN (as and when required) medication that has been administered staff should record the number of tablets administered on each occasion. When new medication is being checked into the homes system, the contents of all packets should be checked to make sure the amount inside corresponds with the label. 2 9 Care Homes for Older People Page 26 of 27 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. 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