Care Home: Hemlington Hall

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What the care home does well People living at Hemlington Hall live in a home that puts them very much at the centre of it and clearly supports people to be as independent as possible. They are supported to live fulfilling lives with very good opportunities to pursue personal hobbies and interests. Care records are comprehensive, with details assessments and care/support plans. They are individual and set out the level of support needed for people within a risk managed way that has been agreed. People who lived at the home were well aware of the care plans and said that they could access them if they wanted to. They said that the information was accurate and that they had been involved in discussion about their needs and how they were to be supported. People have their keyworker who they work closely with and they said that they enjoy the 1:1 time they have. One person said, "My keyworker supports me and helps me", they confirmed that their care plan had been discussed with them. A relative said, "I am extremely pleased with the support that is given, they are definitely looked upon as individuals and are able to make decisions and have choices". The home is a good place for people to live, there is a positive atmosphere and clearly very good relationships. Staff are well trained, have the necessary knowledge and skill for their job roles and are very positive about the work they do. Staffing levels are very good, flexible and sufficient to support with their care and lifestyle needs. Staff spoke knowledgeably about the people they support. One person said, "We support them in their choices and the decisions they make about their life, it has been good to see the progress that people have made". Another member of staff said, "Everyone is an individual with individual values and choices". What has improved since the last inspection? There were no requirements or recommendations made at the last inspection. What the care home could do better: It is commendable that of the areas looked at during this inspection, little has been identified as in need of improvement. The AQAA details areas that the manager, people living at the home and staff think could be improved as part of the continuous improvement of the service. Two recommendations have been made, which will strengthen the medication system. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hemlington Hall Nuneaton Drive Hemlington Middlesbrough TS8 9DA     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: Jacqueline Herring     Date: 2 5 0 2 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 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 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 Adults (18-65 years) 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.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: Hemlington Hall Nuneaton Drive Hemlington Middlesbrough TS8 9DA 01642594751 01642594745 Telephone number: Fax number: Email address: Provider web address: www.milburycare.com Name of registered provider(s): Type of registration: Number of places registered: Milbury Care Services Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Hemlington Hall is a Georgian house set in its own spacious gardens. The house has been adapted to provide accommodation for six persons in single bedrooms, all with an en-suite facility comprising wash hand basin, w.c. bath or shower. Communal facilities available to residents are: lounge, dining room, and kitchen, quiet-room. In addition to the main house two self-contained single person bungalows have been built in the grounds each comprising lounge with kitchenette, bathroom and private patio area. The home has two people carriers to enable residents to visit places of interest and friends and family. Hemlington Hall is registered to provide care for 8 adults with a learning disability. Current fees are 1500 pounds per week. 8 Over 65 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: three star excellent 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: The quality rating for this service is three stars. This means the people who use this service experience excellent quality outcomes. This Key Inspection was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use the services, and that it does what the Care Standards regulations say it must. This inspection was conducted in one inspection day. During the inspection, a number of records were looked at, including records of people who use the service, along with staff recruitment and training records. The medication systems was also looked at. Discussion also took place with the people living at Hemlington Hall, the manager and Care Homes for Adults (18-65 years) Page 5 of 28 staff as well as one relative. The manager has completed the Annual Quality Assurance Assessment (AQAA), the services self-assessment of how well they think they are meeting standards. This was received prior to the inspection and some of information has been reflected within the report to support the judgements made. The AQAA was well completed. We have reviewed our practise when making requirement to improve national consistency. Some regulations from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the services are not being put at risk or harm. In future if a requirement is repeated it is likely that enforcement action will be taken. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Adults (18-65 years) Page 7 of 28 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. People have their needs fully assessed prior to moving to Hemlington Hall, ensuring their needs can be met. Evidence: The AQAA detailed the assessment process, it stated, We identify the needs of the individuals from assessment of need and continually review this assessment ensuring individual aspirations and needs are assessed. It also details involvement of the family and introductory visits to the home. Two sets of care records of people living at Hemlington Hall were looked at. They contained full assessment information along with information from other care professionals who had been involved in peoples care, such as care manager and psychiatrists. This ensures that their needs are able to met by the service. A thorough and detailed process of assessment is undertaken, which is dependant upon the individual. There was also evidence of ongoing reviews showing that the service was supporting people in the way they wanted and that they were satisfied Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: with the support and care provided. A relative spoken to said that they came to look around initially to determine if Hemlington Hall would a suitable place for their loved one. A copy of the service users guide was looked at, which was pictorial and easy read. There was also a copy of the local authority agreement and contract along with other supporting information. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Hemlington Hall have a detailed plan of care which give staff the information needed to show how their needs are to met and how they are to be supported and are able to make decisions. Records detailing how personal care is to be delivered are detailed and clearly identify individual needs. Evidence: People have their needs assessed and have a range of plans in place showing how they are supported. Throughout the records looked at there was evidence that the individual people whose records they were, had been involved in the assessment and care planning process. The care records were extremely detailed, there was good and clear information flow and they were clearly person centred. Examples included, My preferred daily routine, Description of Me, My personal Details, all with very specific information and supported with photographs throughout. They specified both short term and long term goals. Risks had been assessed and staff support people to be as independent as Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: possible in a safe and planned way. The manager said that the care records had recently been reviewed and new documentation introduced. People who lived at the home were well aware of the care plans and said that they could access them if they wanted to. They said that the information was accurate and that they had been involved in discussion about their needs and how they were to be supported. People have their keyworker who they work closely with and they said that they enjoy the 1:1 time they have. One person said, My keyworker supports me and helps me, they confirmed that their care plan had been discussed with them. Both of the care files looked at were up to date and the level of detail was excellent. People living at the home had a range of needs, some more complex than others but regardless, it is clear that people are cared for and supported as individuals and in ways that work for them. Observations throughout the inspection showed the good relationships existed between people living at Hemlington Hall and the staff who worked there. There was a positive atmosphere, people were relaxed and friendly and it was clear that people were treated with respect and as individuals. A relative said, I am extremely pleased with the support that is given, they are definitely looked upon as individuals and are able to make decisions and have choices. Staff spoke knowledgeably about the people they support. One person said, We support them in their choices and the decisions they make about their life, it has been good to see the progress that people have made. Another member of staff said, Everyone is an individual with individual values and choices. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to take control of their lives by being able to make decisions about their lives. There are good opportunities to pursue social and recreational interests. People benefit from maintaining where possible personal relationships and have their right respected. Meals are provided to a high standard within a suitable environment. Evidence: Everyone who lives at Hemlington Hall has opportunities for recreational and social activities, which promote active lifestyles. These are very much based upon the individual and a lot of the activities that take place are on a 1:1 basis. Many of the activities take place outside of the home and are planned around the individual persons interests and preferences. Examples of this included people being involved in drama groups, arts and crafts, horse riding as well as visit to the local Gateway Club as well as going shopping , out for meals and coffee. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: In the past people have had the opportunity to be involved in further education at the local college, however the way in which these courses are run has been changed, meaning there are less opportunities for this. The manager and staff are however mindful of this and are seeking alternatives to this. It was good to see some of the meal preparation that was taking place, with people going into the kitchen to make their own breakfast of choice with the support of staff. Meals are planned and agreed with people but there is also alternatives available if people want. Two people who live at the home said how much they enjoyed going out for meals, which they did at least on a weekly basis, to a restaurant of their choice. One person particularly liked Chinese meals, while another liked their parmo, chips and garlic sauce. Life within Hemlington Hall in without doubt flexible and very much promotes individual decision making. A member of staff spoke of how consultative life was at Hemlington Hall and talked about monthly residents meetings, individual keyworker meetings and the way in which the menu is planned. Another member of staff talked about the freedom people living at the home had, they said, They can freely go into the kitchen to make drinks and snacks, we are there to support and enable and assist in developing their skills. 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 who use the service have their healthcare and personal care needs are met by staff who provide support in a sensitive and flexible manner. Medication systems and records are good and only staff who have received the appropriate training have any involvement with medication. Evidence: The AQAA states, Individual care/support plans contain information bout the service users general health, dietary requirements and details of any specific ailments and medical conditions. Constant monitoring of health is undertaken. Evidence of this was seen within the care records looked at. The records looked at detailed involvement of GP, Consultant Psychiatrists, Care Programme Approach reviews and all health related matters. Staff said the home works closely with external professionals and specialists for advice and support to help the service user and the homes staff. People who live at the home confirmed that both their physical and mental health needs were well met within the home. It was clear that good and effective relationships have been developed with other key Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: health and social care professionals involved in supporting people at Hemlington Hall. One member of staff spoken to said, We network with other professionals, it is very much partnership working. At this inspection, none of the people who live at Hemlington Hall manage their own medication, this is ordered, stored and administered by staff who have been trained to do so. The way in which medication is managed within the home was discussed in detail. Good systems were described from the ordering of medication and appropriate storage. Only staff who have completed the required training are involved in the administration of medication and there is an annual competency assessment. Records and storage was looked at. The medication administration records were well recorded, with no gaps. It was recommended that when a certain range of medication are prescribed, there is the need to have additional records and storage. It was also recommended that when medication is handwritten on the MAR sheet, that this be checked and signed by a second person. Good additional information was in place for individuals medication along with protocols for the use of PRN and homely remedies. 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. People who live at the home are confident their complaints would be listened to, taken seriously and acted upon, although the full procedure needed to made available. People who live at the home are protected from abuse by the homes policies and procedures. Evidence: The AQAA detailed that there had been no complaints since the last inspection. It detailed about complaints, Provision of an accessible version of letting you know what you think policy and Pova Policy. It details that there are individual service user guide that inform people about how to make a complaint. There is a clear complaints procedure in place, which tell people what to do if they need to raise concerns or make a complaint. This tells people who would deal with their complaint and what the timescales are and what to do if they are not satisfied. People spoken to said that if they had any concerns they would speak to staff. They said, I feel safe here, the staff support me in the right way, they respect you and I get on with them. When asked what they thought Helmington Hall did well, one member of staff said, We listen to people, take on board what they say, whether it is negative or positive and act upon it. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: It was confirmed that staff have received training in protection of vulnerable adults and would know what to do if there was the need. There is a clear procedure in place for dealing with allegations and since the last inspection the manager has taken the appropriate steps to deal with an incident and liaise with the appropriate authorities. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides an environment that is appropriate to the specific needs of the people who live there, it is extremely well maintained, homely and comfortable. People are able to personalise their bedrooms and the home is warm, clean and comfortable. Evidence: Hemlington Hall is situated close to the lake at Hemlington and is set in its own grounds, with pleasing gardens. It is fairly close to local shops and recreational facilities and also public transport. The main house is a spacious, clean, well maintained and tastefully decorated home. There is a good amount of communal space as well as very good personal space. There is a spacious, airy lounge/dining room with views over the garden. There is a further two lounges. Furnishing and decor is to a high quality and the home had a homely but modern feel to it. All communal rooms within the house are accessible to all of the people who live there. People living at the home have decided on the furnishings and decor of their own rooms, they are extremely personalised, with evidence of hobbies and interests, they had their photographs and electronic equipment such as TVs, DVD players and music Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: systems. People took pride in showing their rooms to the inspector. They all had locks on their doors with their own key for privacy. People are supported to clean their rooms and keep them tidy. All of the rooms were of a good size with ensuite bath and shower. In addition to the main house, there are two semi detached self contained bungalows. Each is equipped in accordance with the needs of the people living in each of them, ensuring that the environment is both safe and suitable. 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 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 at the home have their needs were met by the numbers and skill mix of staff who were trained and competent to care for people who live at the home. People are protected by the homes recruitment procedures. Evidence: Staffing levels were discussed and considered appropriate to meet the needs of people living at Hemlington Hall. One member of staff said, Staffing ratios are high, it is definitely needed and it works. We are effective dealing with challenging behaviour. Another member of staff also said, Definitely sufficient staff with a good gender mix. It is an experiences staff team and knowledge is passed on. Staff also said that due to the staffing levels, there had not been the need to use temporary agency staff, as such there was good continuity of care. When asked what they thought Hemlington Hall did well, one member of staff said, Individualised care along with staff being trained to a hight standard. Staff files were looked at during the inspection, one of a newer member of staff and one who had been in post for some time. They contained all of the information such as references and Criminal Record Bureau checks needed to show that recruitment was good. Staff are fully aware of the roles and that they comply with The General and Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Social Care Council Code of Practise. There was evidence of induction and the duty rota also showed that new staff are supernumerary for the first week of employment, where they work in a shadowing capacity and do not work on a 1:1 basis with people. 80 of the permanent care staff are trained to NVQ level 2 in care or above. Training records were looked at, there was an annual training plan as well as a matrix of courses and the attendance. There was evidence of ongoing mandatory, health and safety training as well as client specific training. This included, epilepsy, non violent crisis interventions along with first aid and administration of medication. The AQAA detailed, Training certificates/induction/LDAF/training and developments plans to demonstrate that staff are qualified to meet service users needs. The manager also said that some of the training is being delivered electronically through the EL Box (remote learning scheme). There was evidence of regular supervisions taking place and staff spoken to confirmed this. 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 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 at Hemlington Hall are assured that their home is very well run. It is well managed and run in the best interests of the people who use the service. The health, safety and welfare of people who live at the home and staff was promoted and protected. Evidence: The manager is registered with CSCI and has substantial experience in this field of care. They are highly competent to run the home and meets its stated aims and objectives. They have considerable knowledge, experience, qualification and skill to manage Hemlington Hall effectively. Staff also spoke highly of their personal development and the development of management skills, having completed NVQ Level 3 and 4 and completing a recent inhouse management development programme. Senior staff were very clear about their roles. Positive comments were made by people who live at the home. They said, I like living Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: here and cant think of any changes to make it better. Staff also said of Hemlington Hall, I am happy working here and I feel supported. Quality assurance systems are in place within the home. A monthly review of the service takes place, there are regular keyworker meetings, along with group meetings and staff meetings. People living at the home are able to give their views about the home and the support they are provided with. Regular auditing of systems takes place including accidents and incidents. The service is also in the process of Investors in People. The AQAA was completed to a very good level with lots of detailed information. This along with discussions that took place showed that Hemlington Hall was being very well managed but that the manager and staff were being proactive in always looking at what they could do better and definitely looking for continuous improvements. A range of systems are in place to ensure that the environment is safe and well maintained. The AQAA detailed that the servicing of equipment such as fire alarms were up to date. A sample of these records was looked at and it was confirmed that weekly fire checks are carried out, there are regular fire rills and there has been a recent visit from the fire service. 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 is handwritten on the MAR sheet this should be checked and signed by a second person. When certain medication is prescribed there is the need for additional recording and storage. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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