Care Home: Hollie Hill Care Home

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they can make an informed decision. The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up detailed plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. The home stores medicines safely, and administers them correctly and safely. Service users say that staff treat them well and treat them with respect. The home is working hard to provide a stimulating atmosphere in the home, with appropriate social activities for service users. Service users are encouraged to keep in regular contact with family and friends, who say they are always made welcome in the home. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users are very complimentary about the food, and there is a balanced diet, with a choice included. Complaints and concerns are taken very seriously and are responded to properly. The home is kept clean, hygienic and free from odours. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing very positive leadership to the home. Service users finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. What has improved since the last inspection? The requirement and recommendations identified at the last key inspection visit have been met. The service continues to make improvements to the environment, and this provides a safe and comfortable place to live for service users. What the care home could do better: The service must at all times keep staffing numbers under review, the ratio of staff must always take into consideration the assessed needs of the service users and their dependency levels. The number of staff on duty must always be able to meet the holistic needs of the service users, this will ensure the health, social and personal needs are being met. Service user life story books have been completed, some of this information should now be used to implement more detailed social care plans. Key inspection report Care homes for older people Name: Address: Hollie Hill Care Home Durham Road Stanley Durham DH9 6QZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jim Lamb     Date: 1 1 0 1 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Hollie Hill Care Home Durham Road Stanley Durham DH9 6QZ 01207280948 01207280946 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.fshc.co.uk Tamaris Healthcare (England) Ltd Name of registered manager (if applicable) Mrs Jacqueline Coulson Type of registration: Number of places registered: care home 62 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: People with dementia over the age of 65 years of age to be accommodated within the 32 bedded unit for older people with dementia. These beds are not registered for the provision of continuous nursing care. The home may accommodate two service users under the age of 65 with a Physical Disability to reside in the general older persons unit. Date of last inspection Brief description of the care home Hollie Hill is a purpose built home that was opened in July 1996. Built to a high specification, it provides each resident with an individual room with its own en suite toilet and hand wash facility. The home is tastefully decorated throughout and residents are encouraged to bring their own pictures and small pieces of furniture to Care Homes for Older People Page 4 of 28 0 6 0 2 2 0 0 9 0 0 2 Over 65 32 30 0 Brief description of the care home make their rooms more homely. Each section of the home has its own dining facilities and separate lounge. Bathrooms, showers and additional toilets are located throughout the building and all are fitted with special aids. The philosophy of care is based on 6 key principles: privacy, dignity, independence, choice, rights and fulfilment. The home is registered primarily for two groups of service users: 30 Older people with or without nursing care needs, and 32 people over 65 with dementia who do not need nursing care. These two groups are accommodated in two separate units. Hollie Hill aims to ensure that service users will receive the level of care that their own situation requires, to satisfy physical, personal, social, spiritual and emotional needs. 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements 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 services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Older People Page 6 of 28 people who use the service and their relatives, staff and other professionals. During the visit we talked with people who use the service, relatives, staff, the manager, and visitors, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, and checked what improvements had been made since the last visit. We told the manager/provider what we found. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: The service must at all times keep staffing numbers under review, the ratio of staff Care Homes for Older People Page 8 of 28 must always take into consideration the assessed needs of the service users and their dependency levels. The number of staff on duty must always be able to meet the holistic needs of the service users, this will ensure the health, social and personal needs are being met. Service user life story books have been completed, some of this information should now be used to implement more detailed social care plans. 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 9 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 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make an informed choice about whether this is where they want to live. Evidence: People who come to stay here are given an information pack, called a Service Users Guide, which includes useful information about what they can expect from the service. Everyone is encouraged to come and have a look around the home before making a decision. In this way people have good information to make a decision about whether to move to this home. There are clear records to show that the needs of the service users were assessed before they moved in so that the home knows whether those needs can be met here. Care managers of the Social Services Department carry out most assessments and Care Homes for Older People Page 11 of 28 Evidence: these are provided to the home. The manager also carries out assessments of prospective new service users, to make sure that the home can meet their individual needs. The assessments are holistic and also include details of peoples spiritual and social care needs so that the home can plan to support them in these areas. All are provided with a detailed contract that fully explains the terms and conditions of the service, and the fees to be paid. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: Service users felt that their health and social care needs were well known by staff and were being fully met. Care plans confirmed that health and social care assessments and treatments/interventions were being carried out, with input from staff, local doctors, community nurses for the residential service users, and social workers. Service users said that the community nurse or doctor would see them whenever required and they were satisfied with the quality of service they received. Each persons personal, social and health care needs were well known, understood and respected by the staff team. The service users said that they felt they were treated with respect and with sensitivity. Typical comments included: Staff always listen and act on what I say. I always receive the medical support I need. Care Homes for Older People Page 13 of 28 Evidence: The staff are very kind and helpful, nothing is to much for them Care plans and risk assessments were detailed and comprehensive about service users health and social care needs, providing clear guidance to staff. They were subject to regular review and evaluation, involving service users, relatives and social workers where appropriate. The visiting District Nurse said, The care here is exceptional, the whole staff team are dedicated and extremely caring. It is always a pleasure coming here, standards are always high. Body mapping is used, and for one person who was admitted with severe necrotic feet, there was photographic evidence of this, and clear evidence of treatment and wound assessments. For this person, the Tissue viability Nurse is involved in her care/treatment. Detailed risk assessments were in place for those assessed as needing cot sides, and these are regularly reviewed. With support and guidance from mental health professionals, the home also uses the Cornell scale assessment tool. This assessment tool helps to identify signs of depression in people with dementia. The tool uses several methods to assess a person, these include: mood related signs, behavioural disturbance, physical signs, cyclic functions that looks at various symptoms that may occur during various time of the day, and self esteem issues such as, feelings of failure, pessimism, signs of delusions, illness etc. The aim is to maintain the health and wellbeing of those service users who are unable to express/describe their feelings. Staff training, such as National Vocational Qualifications (NVQ) level 2 or above, includes the important issues of privacy and dignity and a high percentage of permanent care staff (over 84 ) have achieved NVQ level 2/3 in care. The visiting NVQ assessor said, The staff here are always very enthusiastic and are always keen to learn. There are good arrangements for the safe administration of medicines. All qualified staff responsible for the administration of medicine have completed Safe Handling of Medicines courses. There is good support from a local Pharmacist who supplies medication in Monitored Dosage form (in blister packs with the medication clearly identified for the individual service user). There are adequate storage systems and care staff check all medication when it is received into the home. Medication is kept Care Homes for Older People Page 14 of 28 Evidence: securely in lockable cabinets and trolleys. Service users may attend to their own medication, but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are returned promptly to the Pharmacist and the home is careful not to stockpile large quantities. The manager carries out regular medicine audits routinely. It is good that a photograph of the service user is kept next to their Medicine Administration Record, this ensures that the right medication is given to each individual. Care Homes for Older People Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: The home draws up a detailed social history for each person, including hobbies and interests, likes and dislikes, social networks, spiritual needs etc, and there was evidence in the care plans that individual interests are catered for. The manager has plans to display a whole range activities and events in the home. Activities include favourites such as reminiscence sessions, bingo, carpet skittles, quizzes, crafts, baking, dominos and cards. There is a weekly film show and weekly pamper days such as hairdressing and manicures. Life story books have been completed for each person, and information will be used to develop the social care plans further. The usual range of festivals and other significant days are celebrated. These include Valentines Day, Shrove Tuesday (pancake tossing), Burns night, Halloween etc. with photos taken and displayed in the home. Care Homes for Older People Page 16 of 28 Evidence: There are occasional trips out to local places of interest. The home has a mini bus for outings. There are no visiting restrictions. Care assessments and care plans showed that service users are encouraged and supported to be as independent as possible. They are free to choose their daily living patterns, in terms of when they get up and go to bed, what to wear, when to bathe, what to eat and when. (The kitchen is never locked). They are assisted to vote, if they so choose. All are also encouraged to comment on the running of the home in their meetings. The menus promote healthy eating. Alternative choices are available for every mealtime, there is provision for individual choice of, omelette, jacket potatoes, soup etc, on request. The menus were drawn up with the help of the service users. Snacks are available at all times, day and night. Specialist diets will be catered for, but, at the time of the inspection, only diabetic and soft diets were required by service users. There is a suitable budget for the catering staff to work to. The service users said that they always like the meals and confirmed that they are always offered a choice. One service user said, I love the food, there is always a great choice to eat. 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. The complaints management is effective, and this results in the service users being protected from harm and abuse. Evidence: Information about complaints is displayed on notice boards around the home and in the homes Statement of Purpose and Service Users Guide. The people spoken to by the inspector confirmed they were aware of how to raise any concerns or complaints. Although nobody spoken to had any cause for complaint, all expressed confidence that any complaints they might have would be taken seriously. Service users and families views are obtained through regular contact and an open door policy. Service users and family meetings are held, which provide an additional forum to discuss any concerns or potential difficulties. Staff meetings are also held. One person spoken to said, I have never had to make a complaint, but if there was a problem I speak to the staff or the manager. The policy and procedure documents relating to adult protection provide information and guidance to staff. A copy of the Durham Adult Protection Committee Inter-Agency Adult Protection Policy and Procedures on abuse and the protection of vulnerable adults is available in the home. The home also has a copy of the Department of Care Homes for Older People Page 18 of 28 Evidence: Healths NO SECRETS. Additional staff training about abuse and the protection of vulnerable adults has taken place for all staff staff during the last 12 months. 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. The home provides a comfortable and safe environment for those living there. Evidence: The home was clean, well decorated and well maintained. The grounds were attractive, tidy, safe, and accessible. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. During the last twelve months, there has been some significant improvements made to the environment, there is new flooring in the EMI unit, new flooring in the ground floor entrance/corridor, several profiling beds have been purchased, several bedrooms have new furniture and most have recently been decorated, and new crockery has been purchased. More improvements are planned for this year. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. All bedrooms have got en-suite facilities. Some bedrooms had freestanding wardrobes, these were not secured to the wall. These could easily topple over and cause injury. The manager will ensure these are Care Homes for Older People Page 20 of 28 Evidence: secured to the wall. The lighting in the EMI lounge needs to be improved, the manager said that this is already being addressed. All doors have privacy locks and room sizes exceed the required standards. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. Service users bedrooms have opening windows and restrictors are in place. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There are several attractive garden areas that have been landscaped, and service users have easy access to these areas. The home recently won a regional garden award. There was emergency lighting throughout the home. The kitchen was spotlessly clean and very well organised. Water is stored at over 60C. Valves at water outlets ensure water is provided close to 43C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are very well organised. The washing machines have the specified programme to meet disinfection standards. 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. There is now enough staff employed to meet the needs of service users and safeguard their welfare. Staffing levels must be kept under review. Evidence: The home currently has 40 service users. There were not enough staff employed to meet the service users needs on the nursing unit. Currently there are 16 service users on this unit, the majority have high dependency needs: 3 are bedfast, 6 require a PEG feed, and 4 others require assistance to eat. The staffing levels on this unit on the day of the inspection were: from 8am to 2pm there is 1 qualified nurse and 3 care staff on duty. From 2pm, the care staff reduced from 3 to 2 until 8pm. The inspector contacted the Area manager for the home regarding the staffing levels, she immediately agreed to increase the care staff levels from 2pm to 3 staff. The manager then immediately arranged additional cover to commence that afternoon. The elderly mentally infirm unit currently has 24 service users. Currently there is 1 senior and 3 care staff on duty. Should the number of service users increase, even by 1, then the staffing levels must be reviewed. Care Homes for Older People Page 22 of 28 Evidence: The manager confirmed that personnel record all contain completed application forms, the dates of employment, making it easy to follow a clear employment audit trail. The manager also completes an audit check list and this ensures that all the necessary checks have been completed prior to commencing employment. The company always obtains two work references, (crb) criminal record bureau check, documentary evidence of identity, induction and training and development information. The organisation employs a training and development officer, and all staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as control of infection and Adult Protection. Individual staff members have his or her individual training needs analysis on their personal file. These have recently been revised to cover developmental as well as mandatory and core training. The inspector spoke to the NVQ external assessor, she said that she was very impressed with the staff team and their ongoing enthusiasm for learning and development. To date 84 have achieved NVQ level 2/3. The manager said that, mental capacity and deprivation of liberty training will be arranged during the next 12 months. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The manager is well qualified and experienced in senior roles within social care settings. Service users, relatives and staff described her as being approachable and caring. She has the Registered Managers Award at National Vocational Qualification (NVQ) level 4. She confirmed that all staff will be regularly supervised (bimonthly) and have an annual appraisal. Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving service users personal monies, such as pocket monies, clear individual accounts and records are maintained. Service users have ready access to their money, even at short notice. Comments received from staff and Care Homes for Older People Page 24 of 28 Evidence: management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of service users and staff. All relevant staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered providers written policies on Health and Safety. Health and Safety issues are also discussed at staff meetings. The manager receives regular support from her regional manager. Service users and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. For example, all service users and relatives commented that the home was always fresh and clean. Service users and staff said they enjoyed living and working at the home and believed the home was safe and run in the best interests of the service users. The manager said she will routinely invite comments and suggestions for improvements from both service users and visitors to the home, via regular meetings, surveys and consultations. She also maintains a detailed annual development plan. The maintenance records for the home are very well organised, and information was easily accessible. 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 1 12 The home should use the information gleaned from the service users life story books to implement even more detailed social care plans. This will ensure that each persons holistic social needs are fully met. 2 27 The home must keep the staffing numbers under review. The ratios of staff to service users must be determined according to the assessed needs of service users, and not dependent solely on numbers. This will ensure that the assessed needs of the service users can be properly met at all times. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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. 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