Care Home: High Lea House

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What the care home does well People who are thinking about moving in are assessed to make sure that the home can meet their wishes and needs. People consulted as part of the inspection process told us they receive good care and support from a caring staff group who treat them with dignity and respect. The home has a robust recruitment procedure in place. Care staff are supervised, and receive training to help them do their job and to understand the needs and wishes of the people they care and support. People are protected from potential abuse by the systems in place to protect their finances and health and safety. The home is managed in the best interest of the people living at the High Lea House by an experienced manager who has the required qualifications and regularly updates her knowledge and skills. What has improved since the last inspection? All bedrooms have en suite facilities and the conservatory has been refurbished. There have been more activities arranged for people to enjoy and in response to listening to people who live at the home meal times have been made more flexible to give people the opportunity to eat when the dining room is less busy. People who live at the home have been encouraged to complete life history information which gives staff a fuller picture of people`s lives before they moved into the home. There have been increased training opportunities for staff, including dementia and person centred care training being completed by some staff. What the care home could do better: Care plans could be further developed to include more information about how the person they relate to prefers their care or support to be provided. People who choose to administer their own medication should be supported to do so following the homes risk assessment framework. Medication should be stored in a lockable cabinet which could be a lockable draw in their own room. Key inspection report Care homes for older people Name: Address: High Lea House Llanforda Rise Oswestry Shropshire SY11 1SY     The quality rating for this care home is:   three star excellent 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: Karen Powell     Date: 1 8 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: High Lea House Llanforda Rise Oswestry Shropshire SY11 1SY 01691654090 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): yvonnej.wakefield@virgin.net Miss Yvonne Wakefield Name of registered manager (if applicable) Provider in day to day control Type of registration: Number of places registered: care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 29 Date of last inspection Brief description of the care home High Lea House is a privately owned residential home providing personal care for up to twenty-nine older people. The registered proprietor and manager is Miss Yvonne Wakefield who has managed the home since 1984. Miss Wakefield and her partner Mr Edwards own the cottage opposite the home and provide on call support as well as having active roles in the running of the home. High Lea House is an impressive house, which has been converted and extended. It is set in it s own grounds in a quiet Care Homes for Older People Page 4 of 27 Over 65 29 0 Brief description of the care home residential area but within easy reach of the centre of Oswestry. The home benefits from its raised position, with a number of rooms having extensive views across Shropshire and the pleasant gardens of the home. The home provides single and double accommodation all rooms having en-suite facilities. There is a large lounge, a pleasant conservatory, a dining room and a quiet room offering people who live at the home a choice as to where they wish to spend their time. The first floor is accessed by a shaft lift and all areas of the accommodation are accessible. Visitors to the home are frequent, good links with the local community are maintained by the home. The home makes their services known to people considering moving into the home in the statement of purpose. The inspection report is mentioned in this document and is given out on request. Fees are reviewed annually and readers wishing to know more about the fees should contact the manager directly. Additional charges are made for toiletries, hairdressing and newspapers. This is clearly laid out in the terms and conditions. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection of the service was unannounced and took place on 18th March 2010 by one inspector over a period of approximately five hours. A range of evidence was used to make judgements about this service to include discussions with people using the service, the senior carer in charge at the time of the inspection as the owner was on holiday when we did our visit and staff. We also examined a number of records to include care records of people living at the home, staff training, staff recruitment and health and safety records. We issued surveys to people who live at the home, relatives and staff. Nine people who live at the home completed the surveys and returned them to us, along with one relative and eight staff surveys. Some of their feedback is contained within the report. Two people who live in the home were case tracked this involves establishing individuals experience of living in the care home by meeting them, discussing their Care Homes for Older People Page 6 of 27 care with staff, looking at care files and focusing on outcomes. Tracking peoples care helps us understand the experiences of people who use the service. An Annual Quality Assurance Assessment (AQAA) document was posted to High Lea House for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an opportunity for them to share with us areas that they believe they are doing well. By law they must complete this and return it to us within a given timescale. The registered manager completed this, and some of the information is included in the report. The purpose of the inspection was to assess all 22 Key National Minimum Standards for Care Homes for older people and any further standards necessary. Information to produce this report was gathered from the findings on the day and also by review of information received by CQC prior to the inspection date. A quality rating is provided throughout the report based on each outcome area for the people who use the service. These ratings are described as excellent/good/adequate or poor based on findings of the inspection. Care Homes for Older People Page 7 of 27 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. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information and encouraged to make informed decisions about the home before moving in. Pre placement assessments ensure that individual needs are met. Evidence: The completed AQAA told us Prior to admission, residents, and their families, are able to find out as much information as possible about the home in any way which suits them best, and the prospective resident is offered the opportunity to experience how it might feel to live in the home. Prospective residents are also encouraged to have trial periods in the home before making any decisions, and to view other homes in order to better understand what is available to them. Prior to admission, careful assessment is carried out to assess whether or not our home can meet the residents needs, and immediately after admission, a detailed care plan is developed. During the whole of this process the resident, their families and, where appropriate, social workers, doctors or other relevant professionals are involved. Care Homes for Older People Page 10 of 27 Evidence: People are provided with a statement of purpose which gives them information about the home. The home has introduced a welcome/Information Folder which is located in each bedroom. All people consulted as part of the inspection told us they received enough information to help them decide if the home was the right place for them before they moved in. The Registered Manager carries out a pre admission assessment of need to make sure the home can meet the needs of the person. People are invited to visit the home and meet staff and people who live at the home prior to moving in. We met someone who had been at the home a week for a period of respite. This means they are on a short stay and will return to their own home. We spoke to the person who was happy to tell us about their experience of choosing High Lea House. They lived local to the home and knew other people who lived there. Before entering for their stay they visited the home where they met people, toured round and discussed their needs with the manager. The home does not provide intermediate care. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in place, however further detail could be included to ensure staff have all the information about the person they are providing care or support for. People have access to health care professionals, and are treated with respect and dignity at all times. Evidence: The completed AQAA told us care plans are devised with the individual or their family. We looked at three care plans during our visit. Each care plan contained a photograph and the persons preferred terms of address. Care plans contained information about the persons needs but could be further developed by more information for example, in one care plan it stated the person was allergic/sensitive but did not say as to what they were allergic to. In another instance it stated the person needed help with bathing but did not say as to what level of help or how, the same with someone who needed help with dressing. Care Homes for Older People Page 12 of 27 Evidence: In one instance where the person self medicated there was no evidence that a risk assessment and check on the persons competency to safely manage their own medication had been carried out by the home. We discussed this with the senior carer who assisted us at the inspection who agreed that this had not been done. When we discussed storage of medication with the person concerned it was evident that they were using the locked draw provided by the home but were not actually using the lock provided to keep their medication safe at all times. The home must follow safe working practices where people wish to self medicate at all times. Care plans contained a useful social history which provided staff with a short description of the persons life before entering High Lea House. Staff spoken to said they found these useful. Although there are some shortfalls in the information recorded in the care plans this does not seem to affect the outcomes for the people receiving the service. Staff, relatives and the people who use the service have positively complimented the care being provided. All of the people spoken with at the time of the visit indicated they are happy with the service and that they receive the care and support they need. All people who returned completed surveys to us told us that staff are available when they need them and that staff listen and act on what they say. People told us; I would be happy to return for further stays What I like about High Lea is the privacy of having my own toilet. We are lucky to be in such a nice place. They give good care looking after welfare, health and well being of my mother. Laundry is always clean. Food is good. They have a wonderful open policy. Everyone seems happy and all are treated well. The staff are very caring and friendly. I am very glad we managed to place my mother at High Lea. I would recommend it to anyone. Care plans evidence that people have access to other health care professionals, these include opticians, chiropodists, GPs and district nurses. Where possible people are taken to see the GP at the surgery, enabling them to get out and to maintain their independence. Care plans were seen to be reviewed regularly and incorporated updates to peoples changing needs. Feedback from all respondents told us that the Care Homes for Older People Page 13 of 27 Evidence: home makes sure they get the medical care they need. It was stated on the completed AQAA that the home has policies and procedures in place for the safe handling of medication. We looked at the medication administration records and storage of medication and found that medication had been signed for when medication had been given indicating that medication had been given as prescribed. Storage is secure, with the exception of the self medicating individual. The home has a system of recording and maintaining medication in and out of the home. Direct and indirect observation showed that staff spoke to people who live at the home in a kindly manner that respects them. Any assistance was given in a discreet way and staff were seen to knock on doors before entering. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience 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 the home are provided with opportunities to experience a meaningful lifestyle that ensures self esteem and well being. People are provided with healthy, well presented meals according to their dietary requirements and choice. Evidence: The completed AQAA told us Residents live a varied lifestyle at High Lea, to suit their needs, wishes and interests. Daily routines are very flexible and the people living in the home are encouraged to have their say in the daily life in the home. People told us there are meetings that take place on a regular basis where they can have their say. We saw minutes of the meetings. People maintain contact with family, friends and the local community. A trip to the garden centre had been arranged for the week after our visit, people were looking forward to this. People living at the home told us that they can take part in the activities if they wish. Weekly car rides take place, along with regular exercise classes. One person entertains friends on a weekly bridge afternoon. Care Homes for Older People Page 15 of 27 Evidence: Everyone who completed and returned questionnaires and who we asked at the inspection told us the home arrange activities that they can take part in if they want to. We saw the daily menu on display in the hall way. People living at the home and those that completed questionnaires told us the food was good and that there is always a choice. The lunch served at the time of the visit looked appetising with good portions. Tables were laid nicely with clean linen and cutlery. We saw refreshments being served during our visit. One staff member commented when we asked the question what does the service do well? We care for the clients every need, including helping with personal hygiene if needed. Also serving a good nutritional diet and keeping clients motivated through games and entertainment and listening what the clients have to say. Someone living at the home told us Staff are very good and helpful. Food is good and enjoyable. High Lea is a very nice place to live if you cannot take care of yourself. People are able to exercise choice over their lives. People spoken to confirm that they can get up and go to bed as they wish. It is evident from speaking to the people and staff in the home that choice and preferences are promoted. A person living in the home comments: The home tries to let me keep my independence. I like my bedroom, I can come and go as I please Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaints procedure which is accessible so that people who use the service have information of how to make a complaint about the home if they need to. Training is provided so that people who use the service are protected from abuse and have their legal rights protected. Evidence: There is a complaints procedure in place which is contained within the service user guide. The procedure does not specify a timescale by which the complaint will be dealt with. The home should include this in the information provided. It was stated on the completed AQAA and confirmed by the senior carer that there has been one complaint since our last visit. There have been no complaints to the Care Quality Commission. We examined the complaints book and saw that details of the complaint had been logged, along with the investigation that had taken place, the outcome of the investigation and action taken by the home to address the concerns raised. People told us the registered manager talks with people who live at the home on a daily basis so that they have the opportunity to raise any concerns. Everyone we asked knew how to make a complaint if they were not happy with the service. People we spoke to were complimentary about the service provided by the staff. Care Homes for Older People Page 17 of 27 Evidence: All staff are trained in adult protection, and some staff have attended the deprivation of liberties training and mental capacity act training. We saw evidence of training certificates on staff training files. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience 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 the home are provided with a clean and homely place to live, which is equipped to meet their individual needs and makes them feel safe and secure. Evidence: We took a tour of the home and found it to be clean and tidy. There is a spacious and light conservatory, an attractive TV room and a cosy small lounge for people to choose where they wish to spend their time. The environment is comfortable and homely and people moving in are encouraged to personalise their rooms. Welcome packs are available in each persons room, these contain useful information about the home. Large gardens with several patio areas, a veranda and walkways offer access to the pleasant grounds. There are raised flower beds, which people living at the home enjoy planting and watering flowers. An infection control audit carried out by the primary care trust infection control officer in June 2009 was good with positive comments about infection control standards at the home. The home put together an action plan in response to their visit, which has been fully implemented. The laundry was clean and tidy. All people consulted as part of the inspection told us the home is always fresh and clean. Care Homes for Older People Page 19 of 27 Evidence: Staff spoken to confirmed that they have undertaken infection control training, we also saw evidence of certificates on staff training files. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The arrangement for staffing, their support and development ensures that the needs of the people living at the home are met. People have confidence in the staff at the home because checks are done to make sure that they are able to care for them. Evidence: It was stated on the completed AQQA When recruiting staff, the priority at our home is to select only people who can help us maintain a warm and friendly environment in which residents feel safe, valued, and well cared for. We are therefore extremely selective, accepting only people who are warm, caring, honest and conscientious. As a result, we receive many positive comments about our staff group, from residents, their relatives and visiting professionals. We follow a thorough recruitment procedure , and no staff are allowed to work in the home until all checks having been completed (e.g. references, CRB). Potential staff are introduced to residents at the time of interview. We looked at the file of one staff member employed since our last inspection to make sure that pre employment checks had been undertaken. This was so that we could see the home are checking staff as being suitable to work with vulnerable adults. The file was well organised and contained all the checks required under regulation. Care Homes for Older People Page 21 of 27 Evidence: All completed staff questionnaires told us that the home carried out checks, including criminal records bureau check and references before they started work. All people consulted as part of the inspection told us that the staff treat them well and that they are happy with the care and support they receive. Observing staff during the visit demonstrated that staff knew their roles and worked in an organised and structured way, thus ensuring they responded to peoples needs. Training for the staff is good. We looked at training completed by staff and saw the relevant training certificates on staff files. Records showed that staff received regular update training on mandatory subjects and extra training included subjects such as person centred care and dementia. The manager stated in the completed AQAA that all care staff have obtained a nationally recognised care qualification (NVQ) at level 2 and above. This exceeds national minimum standards. Staff spoken to said they felt well supported by the manager of the home, and feedback in completed questionnaires supported this. All staff stated there are enough staff on duty to meet the individual needs of all the people living at the home. The homes induction process, consistent with Skills for Care expectations, is thorough and conducted over a period of time. We saw evidence of completed work books. All staff who completed a survey told us that the induction covered everything they needed to know to do the job when they started. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the home because it is effectively managed in the best interests of the people living and working there. Evidence: The Registered Manager has the qualifications and experience to make sure that the people who live in the home receive a high standard of care. She is the owner/manager and speaks to the people on a daily basis to make sure the home is running well. The Registered Manager is aware of what needs to be improved in the home and has a business plan in place to address any issues. The people who live at High Lea House, staff and relatives made complimentary comments about her commitment to the service. Miss Wakefield is consistently in the home supporting the staff and knows the people who live there well, encouraging and supporting them to have their say in how the Care Homes for Older People Page 23 of 27 Evidence: home is run. This ensures that people living at the home receive consistent care and support of a good standard. The home hold the Investors in People Award. It was stated on the completed AQAA that there is a policy in place for the management of service users money and financial affairs. Currently the home do not hold any monies or valuables for people who live there. All checks required such as of the fire safety systems; lifting equipment and electricity are in place. People are protected through regular maintenance of systems and equipment and records to show this are well organised. Even though the hot water taps are fitted with thermostatic valves the current thermometers are not suitable for use. The home should acquire thermometers where the actual temperature can be read in degrees centigrade to ensure they get an accurate reading when testing the hot water that people living at the home have access to. An environmental health visit took place on 21 January 2010 which noted the home follow good hygiene practices. The people in the home are aware that their views and suggestions will be taken into consideration in the day to day running of the home. They told us that there are regular meetings so that they have a chance to discuss any issues. Minutes from the last few meetings were seen, where a number of topics had been discussed including suggestions for future trips. We saw a letter of thanks that the home has received, comments included; Thank you for your kindness. My mother has been so happy at High Lea, made many friends and enjoyed a high level of professional care from you and your staff. Other comments about the home we received included What I like about High Lea is the privacy of having my own toilet. We are lucky to be in such a nice place. Wed go along way to beat it. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Care plans would benefit from having more detail about the individuals preference as to how they wish their care to be delivered and the level of care and support they require. To ensure that staff are given detailed information about individual care/support requirements to of each person. 2 9 People who choose to self medicate should be supported through the homes risk assessment process and be regularly checked to ensure they are still competent to self administer their medication. This is to ensure safe working practices are followed and the individual is fully supported through proper risk assement of their ability to safely administer their medication. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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