Care Home: Grace Muriel House

What the care home does well "The care staff are always there to help me" was a very typical comment made about the experience of care by a person living in the home that we spoke to. The standard of care seen throughout this visit was very high and comments from people living in the home, frequent visitors and visiting health care professionals spoken to confirmed that this is always the case. The home is very well managed and the management process is well resourced by the management board. This provides an effective and efficient service for people who live in the home and provides a high level of training and other support to care staff who work in the home. "We have very good access to training" was one typical comment by a member of care staff. The high standard of care experienced by people living in the home which is recognised in this report is a tribute to all members of the management and staff team, including ancillary and administrative staff, supported by the managing board. What has improved since the last inspection? The one requirement made during the previous report was met before that inspection visit ended and no requirements or recommendations are made on this occasion. People living in the home have benefited from the redecoration of some areas of the home including the replacement of some carpets and soft furnishings. There have also been improvements in the training for staff, including an increased number with national vocational qualifications (NVQs) Additional opportunities for people living in the home to become involved in the decision making process of the home, for example in respect of menu planning have been introduced. What the care home could do better: One of the most positive findings of this inspection is the robust quality assurance process that is in place. This indicates that the organisation at all levels is committed to taking a proactive approach to improving care outcomes for people living in the home. This can give confidence to people living in the home and those responsible for them that not only will the current high standard of care be sustained but that efforts will continue to be made to improve and develop care. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Grace Muriel House Tavistock Avenue St. Albans Hertfordshire AL1 2NW     The quality rating for this care home is:   three star excellent 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: Jeffrey Orange     Date: 0 2 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 28 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 28 Information about the care home Name of care home: Address: Grace Muriel House Tavistock Avenue St. Albans Hertfordshire AL1 2NW 01727863327 01727812402 post@abbeyfieldstalbans.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Abbeyfield St. Albans Society Limited Name of registered manager (if applicable) Mrs Annette Gibbons Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Grace Muriel House is a residential care home for older people situated on the outskirts of St Albans. It is owned by The Abbeyfield St Albans Society Ltd, which is a voluntary organisation. The home accommodates up to 37 residents. All rooms are single and 17 have en-suite facilities. Two adjoining rooms with a partition door can be opened to accommodate couples. The home is furnished with individual pieces offering a comfortable, homely environment. There is a large lounge and separate dining room on the lower floor and a further lounge with a small dining area. On the upper floor there is one lounge and an activity room/hairdressers. There are two passenger lifts. There is safe access to the garden from the ground floor lounge. The garden is very well maintained and offers a tranquil area for residents to relax, with plenty of shaded areas. There is a Care Homes for Older People Page 4 of 28 0 Over 65 37 care home 37 Brief description of the care home pond with a fountain and a summerhouse surrounded by tidy lawns and flowerbeds. The front of the home has ample off road parking. All prospective residents are provided with a comprehensive pack of information which includes full details of fees clearly indicating what is included in the standard fee and what is not. Copies of the latest report from the Commission for Social Care Inspection (CSCI) are also included. Current fees start at £604 per week for non-ensuite rooms and £658 per week for ensuite rooms. Additional charges apply where care needs are assessed as follows; Low dependency £35 per month, medium dependency £70 per month and high dependency £130 per month. These fees were current at January 2009. Care Homes for Older People Page 5 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: three star excellent 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 last key inspection on this service was completed on 20th March 2007. This inspection was conducted by one inspector, where this reports refers to we it recognises that it is written on behalf of the CSCI. The inspection started early in the morning as the handover from the night to day staff was taking place. This enabled the early morning routine of the home to be observed as people who live in the home were getting ready for the day ahead. During this inspection we spoke to people who live in the home, members of the care, ancillary and administrative staff, together with visiting friends, relatives and health care professionals. We had useful discussions with the registered manager and were able to look at some key records, including those for staff recruitment, care plans and medication administration. We have also sent surveys to both staff and people living in the home and where these have already been Care Homes for Older People Page 6 of 28 returned we have drawn on them in writing this report. Any surveys received after this report is written will be recorded and assessed and used to determine the future regulation of the home. We have also made use of the information provided to us by the home in their Annual Quality Assurance Assessment or AQAA. The AQAA is a self assessment document which assesses the care outcomes for people living in Grace Muriel House, it also includes some useful statistical information for example on complaints and staff training. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 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 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are only admitted to Grace Muriel House after a thorough and detailed assessment process has established that their individual needs can be fully and appropriately met. People considering Grace Muriel House as their home are provided with an excellent level of explicit and detailed information about fees and facilities and are encouraged to visit the home to help them make a well-informed decision. Evidence: When we looked at the information provided for people who may be considering Grace Muriel House as a home for themselves or someone for whom they are responsible, we found that it was very comprehensive and clear, was presented in a format that is attractive and informative and included exceptionally detailed information about fees. Care Homes for Older People Page 10 of 28 Evidence: The information was seen to include a breakdown summary of the cost elements of the home and how these affect fees. Where additional costs are charged for people falling within different assessed need categories, these are clearly detailed and explained. We noted that among the information included for people considering a move to Grace Muriel House are contact details for organisations who can advise on the financial implications of care and alternative ways to fund care. The potential for unnecessary upheaval and distress where people have to move from one residential care setting to another when they can no longer afford the fees that apply was discussed with the manager. This followed a conversation we had during this inspection with people currently in the process of moving from the home. The manager assured us that every care is taken to explain the fee structure and the homes policies about charges before people are admitted in order to ensure that longterm sustainable funding is in place. The manager indicated that where this unfortunately proves not to be the case, the home make every effort to ensure that the process of selection of a new home and the move from Grace Muriel will be carried out in such a way as to minimise any distress to those concerned. As noted above, the information provided by the home about fees and charges is unusually open and detailed and includes a declaration for sponsors and residents to sign which sets out quite explicitly the policy of the home in respect of Local Authority payments and fees and the requirements in respect of third-party top ups. When we looked at the web-site for the home, we saw that it was informative and included a list of frequently asked questions, together with contact details for the home and identified some organisations that could assist in providing information about social care, including the Commission for Social Care Inspection, Hertfordshire County Council and Age Concern. When we looked at assessments of the care needs completed for people being considered for admission to Grace Muriel House we found that they were comprehensive and included the information required to ensure that only those people whose care needs can be met in a way that takes full account of their individual circumstances, preferences and life history are admitted into the home. When we spoke to relatives of people living in the home, they told us that they had been able to visit the home before any decision was made about the admission of their relatives and that they had been provided with information and advice to help them in that decision. Care Homes for Older People Page 11 of 28 Care Homes for Older People Page 12 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Grace Muriel House can be confident that they will receive effective health and personal care support,that they will be treated with respect and as an individual and that systems and records for medication are accurate and efficient. Evidence: When we spoke to people living in Grace Muriel House they told us that they were well cared for. They are always so very helpful to me was one comment received. Relatives of people living in the home told us; Staff know what is going on with residents socially and health, staff are always available to talk to and My relative is always well-dressed and looks well cared for. When we looked at the detail of the homes own quality assurance survey of people living in the home we saw that all of the responses received to the question are you happy with the care you receive? were very positive. All of those people who responded to our own surveys about the standard of care experienced in Grace Muriel were very positive about the care staff and the way that their care is given. Care Homes for Older People Page 13 of 28 Evidence: When we looked at care plans of people who live in Grace Muriel House we found that they were clear and comprehensive, setting out their individual health care needs and how they were to be met in line with their own preferences and choices. They included evidence of the full involvement of individuals in the review and evaluation of their care plans. Throughout this inspection whenever we saw staff helping people who live in the home, when they were talking to them or referring to them they always did so with appropriate respect and courtesy. When we spoke to a general practitioner visiting the home, we were told that the surgery had a very positive relationship with the home, that the standard of care and documentation observed was good and that care staff have a very good awareness of the individual people that live in the home and their care needs. We were also told that the nurse practitioner from the practice regularly calls on the home to undertake medication reviews, this helps ensure that the health care needs of people living in the home continue to be met appropriately. When we looked at medication records and talked to the member of staff with principal responsibility for the administration and recording of medication to those people living in the home who require assistance, we found a very high standard of medication administration, records and hygiene. There were no gaps found in records, all totals checked agreed and importantly there was good evidence that where people are able to self-medicate they are encouraged to do so within a risk assessment framework to ensure that they can do so safely and effectively. Care Homes for Older People Page 14 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Grace Muriel House can be confident that they will be encouraged and helped to exercise choice and control over their lives including their daily activities and meals and that they will be able to maintain contact with the community, family and friends. Evidence: When we spoke to people who live in Grace Muriel House they told us that they often take part in the activities on offer in the home and that the activity staff are very good. We were given a copy of the Christmas activity pack that had been provided for everyone living in the home, this included seasonal cracker jokes, puzzles and quizzes for people to complete over the Christmas period. The December newsletter included details of some of the preparations for Christmas that the people living in the home had helped with, this included making Christmas cakes, mincemeat, Christmas puddings, decorations and cards. This enabled those people who would otherwise have missed the hands-on preparations that they were used to make at this time of year to maintain their involvement and interest. Care Homes for Older People Page 15 of 28 Evidence: The home has a well-resourced and resourceful activities team, currently offering 35 hours a week from the activities team with additional one to one activities being provided through the care staff team. The home belongs to a national association that promotes good practice in the provision of activities within care homes and as part of that took part in a fresh air week earlier in the year, making use of the homes well laid out grounds and gardens. During this inspection it was noticeable how many residents went into the garden for some exercise and some also went into the community for a walk. We spoke to one person who lives in the home who helps staff by taking the early post to the post box each morning on his daily walk. When we spoke to activities staff and care staff we found that they are making efforts to provide one to one activities for those people who prefer that at times, and also that they are trying to develop a pattern of activities being available for people living in the home throughout the day on an individual basis. The homes AQAA identifies the need for additional staff training to facilitate this and this indicates that the homes manager and staff are taking a proactive approach to providing individualised, person-centred activities for all the people who live in the home. Whilst we were visiting the home we encountered an almost constant flow of visitors. We were able to speak to some of these visitors who were full of praise for the standard of care that they observed. When we observed the mealtime routine in the home we saw that it was a sociable experience for people who live in the home. We have commented previously on the attractive way that tables are laid and the way that the mealtime experience has been enhanced and certainly when we spoke to people living in the home about the food they were very positive about the quality, quantity and choice on offer. When we observed some of the people who need assistance with their meals, we found that help was given respectfully and sensitively, with good staff interaction making sure that the person concerned was not rushed or made to feel hurried over their meal. We saw the results of the homes own surveys of people living in the home and these confirmed the comments made to us. The home have identified in their AQAA plans to involve people living in the home in a two monthly meeting to discuss menus and mealtimes in general. This is further positive evidence of the homes management and staff seeking to continually improve the care experience of people who live in Grace Muriel House. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Grace Muriel House can be assured that they are able to make a complaint if they wish to do so and that it will be dealt with appropriately without any adverse repercussions for them. They can also be confident that they will be protected from any form of abuse and that if it were seen or suspected action would be taken to address it. Evidence: The homes complaints policy and procedure is included in the material provided to all people living in the home and is also clearly displayed in the home. When we spoke to people living in the home or received survey responses from them they told us that they knew how to make a complaint if they needed to. This was also the result when the home asked a similar question in their recent quality assurance questionnaire. The homes AQAA tells us that there were 4 complaints in the preceding 12 months of which 3 were upheld and all were dealt with within 28 days. In their AQAA the homes manager states an intention to continue to look for ways to minimise any complaints and to encourage residents to feel comfortable in making their views known. The manager also indicates that staff training would be put in place to address any areas of performance where a need for improvement has been identified. Care Homes for Older People Page 18 of 28 Evidence: When we spoke to staff and looked at staff training records we found that they were familiar with the concept of safeguarding vulnerable adults from abuse and that they felt confident they knew what to do if any form of abuse was seen or suspected. When we spoke to the homes administrator they were able to confirm that they would take appropriate action to protect the financial interests of any person living in the home if it appeared that they were being deprived of the financial resources to which they were entitled. This should provide all those who live in the home and those responsible for them with confidence that they or their relatives are being protected from any form of abuse and that if it were seen or suspected robust and appropriate action would be taken. Care Homes for Older People 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, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and working in Grace Muriel House can be assured that the environment is safe, comfortable, clean and well-maintained and will meet their needs. Evidence: When we walked around the home and with their permission went into the bedrooms of people living in the home, we found that the standard of cleanliness was very high and this view has been borne out in survey responses received as well as in the homes own quality assurance questionnaires. The home does not smell, which is excellent was one comment received from a relative. When we spoke to the laundry staff, we were impressed by their enthusiasm and commitment to provide a good service to people living in the home and again this view was endorsed by people living in the home and those responsible for them. My relatives clothes are always clean and well looked after was a comment made. Those bedrooms seen were personalised by the individuals concerned and included pictures, ornaments and photographs reflecting their interests, personal tastes and the things that are important to them. Care Homes for Older People Page 20 of 28 Evidence: The grounds of the home are well laid out and kept and were seen to be being used, even on what was quite a cold day, by people living in the home for exercise. The AQAA informs us that the home have invested in additional adjustable beds to enhance the comfort and care experience of people living in the home and have also upgraded the kitchen cleaning regime in line with the Better Food Safer Business Guidelines This suggests that the management of the home are responsive to the needs of those people living in the home and are proactive in seeking ways to enhance the environment in which care is provided. Care Homes for Older People 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 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. People who live in Grace Muriel House can be assured that they are protected by the recruitment policies and procedures followed by the home and that there are sufficient numbers of care staff with the training and skills required to meet their care needs. Evidence: Staff know what is going on with residents socially and health wise, Staff are always available to talk to My relative is very well cared for. They are always so helpful to me and They are so nice are only some of the many positive comments received during this inspection about the care staff in Grace Muriel House. When we received comments from people who live in the home in our own surveys and when we saw the responses to the homes own quality assurance questionnaire we found this positive view endorsed and confirmed. When we looked at staff recruitment files we found that all the checks required to protect people who live in the home from the recruitment of unsuitable care staff were in place and that recruitment policies and procedures were followed robustly. When we talked to staff or received surveys from them they told us that they are provided with excellent opportunities for training. The home gives good training Care Homes for Older People Page 22 of 28 Evidence: opportunities and Our training co-ordinator is always keeping us updated and giving us information and handouts were some of the comments received. When we looked at training records we found that they were full and provided an effective management tool to enable immediate access to information about regular and specialised training undertaken or due. The training co-ordinator post, which is referred to positively by staff, demonstrates that the management of the home is supported at board level,recognises the critical importance of staff training and is prepared to resource it in order to improve and sustain a high level of care within the home. In general the surveys received and the results of the homes quality assurance process that we saw indicates that there are sufficient staff available to meet the care needs of people living in the home appropriately. We spoke to one member of an agency working in the home and they were able to confirm that they had received a thorough induction and that they were familiar with the policies and procedures of the home and indeed with the individual residents and their needs. Throughout this inspection we observed a high standard of care and very good and effective interaction by care staff with people living in the home. When we spoke to care staff and looked at the schedule for completed and planned supervisions we found that they received regular supervision and were given the support they need to consistently provide a high standard of person centred, individualised care. Supervisions and appraisals are done regularly, we can also see our manager who has an open door for all of us was the typical comment of one staff member. Care Homes for Older People Page 23 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Grace Muriel House is well managed and has an effective administrative and management support infrastructure in place which helps ensure that people who live in the home receive a high level of care within a safe environment provided by well trained and motivated staff. Evidence: When we spoke to care staff, people living in the home, relatives, visitors and visiting health care professionals they were all positive about the way the home is run and managed and also about the manager and her team. We found that the management of the home is well-resourced and that the manager is given the support and assistance she requires by the managing board to help her direct the activities and development of the home effectively. In particular the home benefits from the significant contribution of the Head of Care and the Training CoCare Homes for Older People Page 24 of 28 Evidence: ordinator. The manager herself is both well-qualified and also committed to a process of development of the home to sustain and take forward its operation in line with the very best care practice. She is familiar with national care practice developments and issues and leads the home in taking account of current best practice. When we spoke with the administrator responsible for dealing with the financial records of people living in the home we found that she had a good understanding of the safeguarding implications of her role and we found that there was a robust, wellaudited system in place to protect the financial interests of people living in the home. We found that the AQAA was not only very well completed but was also a realistic assessment, borne out by what we saw and were told during our visit and provides confidence that the home is genuinely seeking to improve all the time. The Board take an active role in monitoring standards within the home and there is a robust system of quality assurance and self-appraisal in place. The AQAA informed us that the Investors in People key strength summary found that staff felt valued, recognised and supported in their work and training and that they are given opportunity for personal development. When we looked at the process of risk assessment in place we found that it is thorough, comprehensive and subject to regular review in order to make sure that it remains relevant and up to date and continues to protect people who live in the home from avoidable risks whilst maintaining their independence and autonomy. Care Homes for Older People 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 Older People 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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. Care Homes for Older People Page 28 of 28 - 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!