Care Home: Elmsmead

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What the care home does well People told us they are very happy living at the home. Comments included `I think Elmsmead is good fun, laughter and happiness. I love living at Elmsmead` and `it is good living in this home`. Each person has a team of keyworkers to support them to follow their interests. People who live at the home have opportunities to take part in a range of activities. People who live at the home told us that because of the support they have received, their independence has increased during the time they have lived at the home. People who live at the home benefit from a friendly, experienced and stable staff team. Staff have good training opportunities which gives them the skills and knowledge they need to meet peoples` needs. People who live at the home told us `staff are friendly, helpful, easy to approach and relaxed`. Staff told us they are passionate about their work and keen to obtain the best outcomes for the people they support. Care plans contain a good level of detail and are person centred. The home ensures that people have the opportunity to take part in the development of their care plan. What has improved since the last inspection? The home has employed a manager. The Expert reported "One resident said the new manager was `really nice, he`s amazing!`" The Expert said "I think that talking to the new manager and the two residents that the home is going in the right direction and that residents lives will get better. Regular residents meetings have been reintroduced so that people who live at the home can become more involved in the running of the home. Regular staff meetings have been reintroduced. Staff told us they were pleased that communication has improved in the home. A suggestion box has been introduced. Further improvements including redecoration and refurbishment have been made to the home. The manager confirmed there are plans for further work to continue to improve the environment. Voyage has employed a Regional Quality Assurance Manager to monitor quality. What the care home could do better: When Medication Administration Record Sheets are written by hand, these should be checked, signed and dated by two members of staff to confirm the entry is correct. Key inspection report Care homes for adults (18-65 years) Name: Address: Elmsmead 82 South Road Taunton Somerset TA1 3EA     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: Alison Philpott     Date: 0 8 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 Adults (18-65 years) Page 2 of 28 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 28 Information about the care home Name of care home: Address: Elmsmead 82 South Road Taunton Somerset TA1 3EA 01823333529 01823327559 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Home First & Foremost Ltd care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Registered for 12 persons in categories LD and PD. Date of last inspection Brief description of the care home Elmsmead provides care and support for up to 12 people who have a learning disability and physical impairments. Elmsmead is located on a bus route and within walking distance of Taunton town centre. The home consists of a two storey detached property which was previously extended and adapted. The people living at Elmsmead have access to secure enclosed grounds to the front and rear of the property. There is also an indoor swimming pool on site. The manager told us that the current fees are held by Voyage. Please contact the provider for further information. 12 12 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 28 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 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: This was an unannounced inspection which took place over 6 3/4 hours on 8th July 2009. Throughout the report the term we will be used as it is written on behalf of the Commission. On the day of the inspection, twelve people were living at the home. As part of this inspection we received eleven completed surveys from people who live at the home, and one completed staff survey. The home sent us their Annual Quality Assurance Assessment (AQAA) after the inspection. During the inspection we observed care practice, and spoke with people who live at the home, management and staff. As part of the inspection process, CQC are using Experts by Experience to help inspectors get a picture of what it is like to live in a social care setting. The term Expert by Experience used in this report describes the people who also visited the home during the inspection and who have knowledge about social care. The Expert reported We talked to two residents. We could not talk to other residents because some did not Care Homes for Adults (18-65 years) Page 5 of 28 want to see us and some did not use words and have behaviour that could put me at risk. We viewed the accommodation and facilities at the home. We looked at three individual care plans, and looked at records relating to medication, finance and health & safety. The focus of this inspection visit was to inspect the relevant key standards under the CSCI Inspecting for Better Lives 2 framework. This focusses on outcomes for people living at the home. The quality of the service is measured under four ratings. These are excellent, good, adequate and poor. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Care Homes for Adults (18-65 years) Page 6 of 28 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. Care Homes for Adults (18-65 years) Page 7 of 28 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 28 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 28 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. The home provides a range of information including its Statement of Purpose and Service Users Guide to people before they move into the home so that they can make an informed decision that it is the right place for them. The home carries out comprehensive pre admission assessments to ensure that it can meet the needs of the prospective person. People are invited to visit the home and spend some time there. Evidence: The home has a service users guide which is available in an accessible format. The home told us on their AQAA where possible all relevant documents are shared and explained to service users. We looked at the information that the home had obtained about a new person living at the home. The home had carried out a pre admission assessment to identify the persons needs. Information had also been obtained from the placing authority. The home had used a transition planner to assist in the move. The manager had met the Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: person. They were then invited to visit the home to look around and see the bedroom. They were able to meet staff and people who live at the home and stay for lunch. Care Homes for Adults (18-65 years) Page 11 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are person centred and contain good detail. People are involved in the development of their care plans. People are encouraged to make their own decisions and choices wherever possible. Risk assessments are carried out to support people to take responsible risks and increase independence. Evidence: We looked at three care plans. These contained a good level of detail and were person centred. They provide good information and guidance for staff to follow so that they know how to best support people. There was evidence that care plans had been explained to people and they had been involved in the process. People had also signed their care plans. Care plans included peoples likes and dislikes and their preferred daily routine. One plan was due to be reviewed as it was dated April 2008. The Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: manager confirmed that all care plans are being reviewed. One care plan that had been reviewed contained good detail and was person centred. The person told us that they had enjoyed writing their care plan with their key worker. The home told us on their AQAA for service users who need extra support with their emotions and behaviours they also have available an in depth behaviour care and support plan this is written with the support of the service user, psychology and advice from psychiatry where needed. We looked at one persons behaviour management guidelines. These contained good detail for staff to follow. The Expert said The two residents said they had lots of choice and control, but they werent sure if it was the same for people who cant talk. The home told us on their AQAA for those service users who are not able to express their wishes we support these people by having ..reviews so we are able to listen to the people who know them well including care managers, parents and staff. The manager has re-introduced regular meetings for people who live at the home. We looked at the minutes of the last two meetings where items discussed included food preferences, any issues, activities, and holiday plans. One person who lives at the home told the Expert there are residents meetings to decide things like menus, activities and holidays. The manager told us that he has plans to provide feedback in formats that each person will understand. One person we spoke with told us that they had taken part in the interviews and selection for the managers post. The home had carried out detailed risk assessments where a risk had been identified. We looked at risk assessments relating to traffic and behaviour. Care Homes for Adults (18-65 years) Page 13 of 28 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 are offered a wide range of activities. The home is developing individual activities for each person who lives there. People are supported to maintain contact with family and friends. Staff support people to meet their goals. The home encourages people to be as independent as possible. People are involved in planning menus. People enjoy their food at the home. Evidence: We spoke with one person who works as a volunteer two days a week. The person told us how much they enjoy their work and the responsibility. The home is looking into opportunities at college for other people. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The Expert said they told us residents are supported to go out to the pub or bowling etc in the evenings and there are weekend activities. On the day of the inspection, one person had been to the library to collect some books, other activities included bowling, watching television. We found individual activity planners in peoples care plans. The manager showed us work that had recently been undertaken to identify activity choices and options to meet each persons needs so that individual activities can be developed and their quality of life continues to improve. The Expert reported they said they were supported to keep in regular contact with their families. The Expert found that individuals relationships are respected and the staff are supportive of these. We found contact lists for family and friends in peoples care plans. One person showed us their phone in their bedroom. Another person told us they have a mobile phone. Some of the people who live at the home are supported to visit family on a regular basis. Bedrooms have key code access to gain access. We observed people who live at the home using the code to go into their bedrooms. The Expert spoke with two people Both lead very independent lifestyles and are supported in budgeting, cooking and going out and about and Another resident said Staff dont push me and make me to do things Im not ready to do. Its good...at my own pace. They also said, I love it here. I get nervous about moving on. They felt supported in this. One person told us they enjoy preparing foods in the kitchen but couldnt do it in the past. They explained how they had become more independent with the support of the staff. After consulting with people who live at the home, the main meal is now served in the evening. The manager told us this is to improve peoples quality of life so that they can go out during the day. One person who lives at the home told us the food is brilliant and its a lot better having the meal in the evening because I can do more throughout the day. One person showed us they have facilities in their bedroom to make their own hot drinks. Care Homes for Adults (18-65 years) Page 15 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported in their preferred way. People are supported to access a range of health professionals. Individual health plans are being developed. The homes medication policies and procedures protect people from risk of harm. Evidence: People who live at the home told us the staff support them in their preferred way. These preferences were recorded in peoples care plans. Each person who lives at the home has a team of key workers who support them. This means if one key worker is on leave there is always another key worker available. One person who lives at the home said sometimes I have a bad day and the staff are here to listen. We looked at a letter recently received from a relative complimenting the home on the support they are providing. The Expert said We talked to the new manager who said lots of things were being done around being person centred and also about making health action plans. I had a Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: good feeling about the manager. He seemed to really want to change things to make the residents have good lives. People have access to a range of health professionals including doctor, dentist, epilepsy nurse, optician, behavioural therapist and psychiatrist. The home is currently introducing individual health folders. We looked at a detailed health plan for one person. This included my condition; how it might affect me; and support I may need. Senior staff and management currently administer medication for everyone who lives at the home. We looked at the homes medication and records. All medicines are stored securely. The home uses a Monitored Dosage System. We looked at the Medication Adminstration Sheets (MAR). There were no gaps in these. Where two MAR Sheets had been hand written, they were not signed or dated. The home does not have any controlled drugs. Medication Audits are carried out as part of the homes quality assurance system. Weekly checks are carried out to check stocks of medicines that are taken as required. Care Homes for Adults (18-65 years) Page 17 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes has a complaints policy. The homes policies relating to abuse and whistleblowing protect people from the risk of harm. Evidence: The home has a complaints procedure. Any concerns or issues can also be discussed in the meetings for people who live at the home. The Expert reported The two residents said staff were really good if they had a problem and people knew who to talk to with a complaint. They also knew about the man in head office to speak to if they needed to. The home had received one complaint. The home had responded to the complainant and action had been taken. We found that staff recruitment files contained all of the required checks to protect people from risk of abuse. The home has a whistleblowing policy and staff spoken with knew what to do if they suspected or witnessed abuse. The home holds small amounts of monies for people who live at the home. These are stored individually. We checked the balance of one persons monies and this was Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: found to be correct. Two signatures had been obtained for most of the financial transactions. Care Homes for Adults (18-65 years) Page 19 of 28 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 environment is homely, comfortable and safe. Some areas of the home show signs of wear and tear. The home has ongoing plans for maintenance including redecoration and refurbishment. Peoples bedrooms are personalised to reflect their individual tastes and interests. Evidence: Elmsmead is an older building which has been refurbished and has an ongoing maintenance programme. The home has twelve bedrooms; five bedrooms on the ground floor and seven bedrooms on the first floor. All rooms benefit from en-suite facilities. Communal areas include two lounges, a dining room and dining area, and a kitchen which can be used with support. We viewed the premises. On the day of the inspection, the lounge was being redecorated. Some other areas are in need of redecoration and would benefit from new floor coverings. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The Expert The home has got beautiful gardens at the front. When you go in, the house needs to be decorated as it is a bit dark and tatty. We talked to the manager who is new and he said he knows the house needs to be done up and is working on that. The home told us on their AQAA that they will continually improve the environment based on service users needs. The manager told us that there are plans to develop the games room which also has a computer, stereo and television. Bedrooms were personalised with items to reflect peoples interests and tastes. One person who lives at the home was supported by staff to paint their bedroom in the colour of their favourite football team. Windows in bedrooms were restricted with the exception of two of the bedrooms. The manager confirmed that this had been risk assessed for the people who currently live in these rooms, and that the doors are always locked to prevent other people accessing the bedrooms. The home has an attractive indoor swimming pool with showering facilities. People who live at other Voyage homes visit to use the pool. On the day of the inspection the pool was not in use due to maintenance issues. The home told us it will be ready to use in a few days. The home was clean and hygienic on the day of inspection. We observed that liquid soap and paper hand towels were available. Care Homes for Adults (18-65 years) Page 21 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have a good knowlege of the people they support. Recruitment procedures are robust to ensure that residents benefit from good staff support. The home provides a comprehensive training and development programme for staff to ensure they are able to meet peoples needs. Evidence: On the day of the inspection, there were 6 support staff on duty in the morning; 7 support staff in the afternoon; and 2 waking and 1 sleeping staff overnight. One member of staff commented that it would be nice to have more staff on duty but there is generally enough staff to enable people to go out. People who live at the home told us staff are friendly, helpful, easy to approach and relaxed. We observed good interactions between staff and people who live at the home. We spoke with staff who had a good knowledge of the people they support. Staff told us they are passionate about their work and keen to obtain the best outcomes for the people they support. The manager has re-introduced staff meetings and plans to hold these on a regular Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: basis. We looked at three staff files. These contained all of the required checks. We looked at staff training records. Training is provided in the following areas; Protection of vulnerable adults; food hygiene; health & safety; first aid; fire training and drills; manual handling; medication; infection control; and non violent crisis intervention. On the day of the inspection, staff were taking part in fire training at the home. Staff told us they are pleased with the training opportunities they receive. 16 of the 27 staff who work at the home have completed an National Vocational Qualification (NVQ) at level 2 or above. Care Homes for Adults (18-65 years) Page 23 of 28 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well managed home. The home has quality assurance systems in place. The homes health & safety policies and procedures protect peoples health, safety and welfare. Evidence: A new manager started working at the home in April 2009. He has fourteen years experience of working with people with learning disabilities and mental health needs. He is in the process of registering with the Commission. The Expert reported One resident said the new manager was really nice, hes amazing! The Expert said I think that talking to the new manager and the two residents that the home is going in the right direction and that residents lives will get better. I think staff work in a person centred way. Staff told us they find the manager approachable, communication has improved and they think it will be better. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The home has introduced a suggestion box. There is a monthly audit programme in place so that the home can check it is continuing to meet the National Minimum Standards. The manager advised that the homes AQAA had been completed but had not yet been forwarded to the Commission. We received the AQAA after the inspection on 10th July 2009. A senior manager from Voyage visits the home every month to speak to staff and people who live at the home. They write a report of what they find. Voyage has employed a Regional Quality Assurance Manager to monitor quality. The home carries out weekly health & safety checks including checking hot water temperatures. We looked at health & safety records for portable appliance testing, electrical installation, fire systems, lifting equipment and gas safety. The gas safety certificate was out of date. The home confirmed that this years check had been carried out and they were awaiting the paperwork. Accidents and incidents are recorded. A monthly return is sent to Voyage head office. The home has been awarded a 5 star rating by Environmental Health for its kitchen. They have introduced the Safer Food, Better Business paperwork. Chemicals were stored securely. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 20 When Medication Administration Record Sheets are written by hand, these should be checked, signed and dated by two members of staff to confirm the entry is correct. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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