Care Home: Holmwood

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What the care home does well The residents who we spoke with said they enjoyed the food and they were offered choices of what to eat. One resident said "food is OK" whilst another said "I like the food and we get to choose what we want". One resident told us that sometimes they go out to lunch at a local hotel. Six residents said the staff are caring and kind and made comments such as "the staff are very kind" and another said "I like living here". The administration of medicines is managed well. What has improved since the last inspection? Many areas around the home have been re furbished and the outside has been tidied up. Staffing ratios have been increased since our last visit. The process for recruitment has been made more robust. Since the employment of a domestic assistant the home is much cleaner. Privacy screens have now been provided in shared rooms. What the care home could do better: The system for assessing resident`s needs must be improved to ensure that all needs can be met before admission and records maintained for this purpose. The care plans do not reflect the current needs of the residents or what therapeutic interventions are being carried out. Staff training records needs to be updated to include meeting specific needs of the individuals who use the service. Continue to provide a well maintained environment. Ensure a suitable system in place for accounting resident`s monies so accurate records are made of all transactions. Some issues highlighted in this report suggest a more robust monitoring and oversight of the management of the home is required for its safer management. Ensure that those residents who are prescribed prn (as required) have care plans to justify continued use. The home must ensure that risk assessments and risk strategies are in place. Provide more opportunities for meaningful activities. Key inspection report Care homes for adults (18-65 years) Name: Address: Holmwood 11 Harvey Lane Norwich Norfolk NR7 0BW     The quality rating for this care home is:   one star adequate 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: Marilyn Fellingham     Date: 1 0 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © 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 Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Holmwood 11 Harvey Lane Norwich Norfolk NR7 0BW Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Robert Dunton Buttifant Type of registration: Number of places registered: care home 32 Baytree Community Care (London) Limited info@careholm.co.uk Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Holmwood is a care home registered to accommodate a maximum of 32 people. Of these places 26 are for people who fall within the category of Mental Disorder, with 4 places offered to people who have a learning disability. The premises occupy a sloped site in a residential eastern area of Norwich. There is a small parade of shops, pubs and access to the riverbank all within walking distance. There is a bus service into Norwich that passes close by. The main house is a former period residence, with accommodation for 24 people on 3 floors. A purpose built annex, known as the Lodge, was added some years ago and offers 6 en suite single rooms with an adjoining kitchenette, lounge and bathroom. There are two lounges in the main house along with Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 28 4 28 0 9 0 2 2 0 0 9 Brief description of the care home a dining room. There is a small terrace with a seating area. The main house is approached by a sloped driveway leading to a small car park to the side of it. Information about the home, including the last inspection report, is available from the manager. There were extra charges for hairdressing, newspapers, chiropody and toiletries. People were also charged for transport to health care appointments. Fees are £325 to £480 per week. Care Homes for Adults (18-65 years) Page 5 of 29 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection that took place over eight hours. The key inspection for this service has been carried out using information from previous inspections, information from some residents and people who work in the home. The main method of inspection used was case tracking. This involved selecting individual care plans and information available about people who live in the home and tracking their experience as a result of the support provided. During our visit a tour of the premises was undertaken and the residents records and staff files looked at. Care Homes for Adults (18-65 years) Page 6 of 29 What the care home does well: What has improved since the last inspection? What they could do better: The system for assessing residents needs must be improved to ensure that all needs can be met before admission and records maintained for this purpose. The care plans do not reflect the current needs of the residents or what therapeutic interventions are being carried out. Staff training records needs to be updated to include meeting specific needs of the individuals who use the service. Continue to provide a well maintained environment. Ensure a suitable system in place for accounting residents monies so accurate records are made of all transactions. Some issues highlighted in this report suggest a more robust monitoring and oversight of the management of the home is required for its safer management. Ensure that those residents who are prescribed prn (as required) have care plans to justify continued use. The home must ensure that risk assessments and risk strategies are in place. Provide more opportunities for meaningful activities. Care Homes for Adults (18-65 years) Page 7 of 29 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 Adults (18-65 years) Page 8 of 29 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 29 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service does not have an appropriate procedure in place to ensure adequate assessments are undertaken. Evidence: We looked at the records for two residents that had been admitted since our last visit to the home; one resident who had been admitted in October had no records in place to indicate that their needs had been assessed before admission to the home, although the manager told us he had undertaken the assessment himself he could not find any records pertaining to this activity. The AQAA (Annual Quality Assurance Assessment) states that prospective residents undergo a a rigorous assessment of their needs to ascertain if their needs can be met by the service. This information in the AQAA is contradictory to what actually happened in the case of this resident. The second residents notes we looked at also lacked detail and evidence of how their needs were assessed prior to admission; there were no notes to reflect what medication they were taking or what challenging behaviour they presented with. We also could not evidence that these two residents were given sufficient information to make an informed choice about living in the home. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: The manager did show us some new documentation for assessing new residents, however this had not yet been used. Care Homes for Adults (18-65 years) Page 11 of 29 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information in the care plans is not sufficient to ensure that the residents needs are met in a consistent way. Evidence: We case tracked four residents who all had a different format for their care plans. The directions on the care plans were not detailed sufficiently to ensure that the staff were providing a consistent approach to care that met the needs of these residents. We noted that none of the care plans we looked at had any evidence of the resident being involved in their care planning. Two of these residents records we looked at had daily notes in place that were informative and gave information about occurrences that had taken place and any activities that the residents had been involved with; however the other two residents had no daily notes at all. The care plans we looked at had no consistent evaluation of the care which had been prescribed, it was very haphazard and could lead to changes in care being missed and needs not being met. Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: We saw no evidence in the care plans to help the residents maintain suitable hygiene and cleanliness of their rooms. Two of the records we looked at had no risk assessments in place, so for these residents no indication was given to reflect what risk they were to themselves or to other people. We found no evidence when looking at records that the residents are involved with aspects of the running of the home although we did see some minutes for residents meetings. Those residents we spoke with confirmed that they made decisions about what they did every day; one said I get to do what I want whilst another said I am happy here and I choose what I do, another added I go out when I want to. We did note however that this resident did not have a risk assessment in place for this activity. The manager had previously informed us in an AQAA that he was planning to establish a residents committee to have some input into the running of the home, however we saw no evidence for this to suggest that this has happened. Care Homes for Adults (18-65 years) Page 13 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are not supported to take part in meaningful activities on a regular basis and are only helped to exercise choice and control in a number of issues affecting their lives. The variety of choices for menus suited most of the residents. Evidence: We spoke with six residents who told us that they organised themselves and did what they to do, however there are residents who are unable and do not have the ability to do this. We noted that there were no entries in these residents records to confirm that some form of activity had been facilitated for them. There was little evidence to show us that the residents were offered meaningful activities on a regular basis. The residents told us that they enjoyed Peter Pipers visits and he did visit the home every two weeks; the manager told us that the sitting room was always full of Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: residents on these visits and that they loved playing the different instruments that Peter brought with him. One resident told us he goes out every day usually into the city, we observed him returning to the home with a bag of shopping. Another resident told us that they enjoyed having a flutter on the horses. One person had been supervised cooking his meals in order for them to increase their independence, however this had not been recorded in their notes. We observed staff interacting with the residents, they were respectful to the residents and treated them with dignity. Two staff members we spoke with told us that they always knock on residents doors before entering. There was a happy atmosphere in the home with a lot of laughter with the residents and those staff on duty. The manager told us that mealtimes had been re organised and also the dining room. Residents go to the dining room for breakfast when they wished and there is always a choice of hot or cold breakfasts. There is also a choice of food for the main meals; on our visit the residents had a choice of eggs and bacon or gammon with mixed vegetables and creamed potatoes. The person who does the cooking does not fulfill any caring duties during their kitchen shift. The residents spoke with us about the meals and made comments such as food is alright and there is always a choice. The tables in the dining room looked very pleasant with individual teapots, milk jugs and sugar bowls. One resident told us that sometimes they go out to a local hotel for lunch. Care Homes for Adults (18-65 years) Page 15 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and health care needs of the residents could be met in a more consistent manner. Medication is managed well. Evidence: As previously mentioned in this report, the care plans we looked at are not detailed enough about the residents personal and health care needs, including mental health needs; they also do not reflect the support needed or the residents preferred choices of care. There were insufficient instructions relating to the support needed in relation to diabetes and high cholesterol levels. We noted that there were records in place for visits to the GP, dentist and other health care professionals; we also noted that records were kept of visits to the home by the community nurses. We carried out a spot audit of medicines, the medicine record charts were in good order and all medicines in use tallied with those signed for as being given. All medicines were stored correctly and at the recommended temperatures, there had Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: been daily temperature checks for the fridge which was used to house some medicines. Some residents who had been prescribed prn (as required) medicines did not have care plans to justify the continued use of these medicines. Training records evidenced that those members of staff who administered medicines had received training related to this. None of the residents self medicate. Care Homes for Adults (18-65 years) Page 17 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents feel that their views are listened to. Staff have been provided with the information in relation to issues relating to abuse, however this needs to be extended to encompass risk management. Evidence: The home does have a complaints procedure, however it does need revising and updating with relevant information, we also noted that the procedure for safeguarding also needs to be revised to contain directions for reporting incidents of abuse. We spoke with six residents who all knew how to air their concerns and who to go to and told us that they could easily do this and would not hesitate if they had any complaints. The home has not received any complaints since our last visit and neither has the Commission. The manager does keep a record of small issues raised by relatives, residents and staff and these show how the areas of concern have been dealt with. The residents we spoke with felt that all staff members listened to them. All staff have done SOVA training, this was done by distance learning, we shared with the manager that it might be useful to have an outside facilitator to talk about abuse and add to the knowledge that the staff already have. We spoke with three staff members who were conversant with issues relating to the abuse of adults. We know from looking at residents records that one resident has a history of verbal and aggressive behaviour however no risk assessments were in place or guidelines to support staff to how to deal with this and therefore could be risk to others and Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: themselves. Care Homes for Adults (18-65 years) Page 19 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is in a better state of repair compared with our last visit, however more work is needed to enhance it completely. Evidence: We undertook a tour of the premises and it was evident that a number of areas around the home have been enhanced. Some building repairs have taken place and a ramp for wheel chair use has been added to the front of the house leading up to the front door. Some of the residents rooms have been re furnished and re carpeted, one resident was anxious because their new carpet had burn holes in and they shared with us that they thought the owner would be cross with me. We spoke with the manager about this so that the residents concern could be allayed. The hall, lounge and stairs have been re carpeted and the front hall re painted. The kithen floor has been replaced, a new stove has been purchased along with a microwave and freezer; the kitchen boiler has also been replaced. New furniture has been provided in the lodge and some beds have been replaced. There are still areas around the home that need re decorating and the manager explained that there was a plan for this to happen. We noted that some areas outside had been cleared of greenery and was beginning to look tidy. Care Homes for Adults (18-65 years) Page 20 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The resident are supported by adequate numbers of staff; however lack of suitable training may compromise the care of people using the service. The residents are protected by the homes recruitment practices. Evidence: Records for newly appointed staff were looked at, there had been two new members of staff employed since our last visit. Those records were seen to reflect a robust checking system before staff are employed. This was also confirmed by new members of staff we spoke with who also told us that they had received a thorough induction which covered all mandatory subjects; we saw records that confirmed this. Three staff members we spoke with told us that they had had training in food hygiene, safeguarding adults, medicine training and fire training. The manager told us that more manual training sessions have been organised. We did note that the training records did not reflect that any training had been carried out in relation to specific needs of the residents including subjects pertaining to mental health; the domestic worker would also benefit from doing an infection control course. The duty rosters were looked at, the amount of staff on duty at any given time has improved since our last visit and staffing ratios are increased depending on whats Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: happening and what visits are taking place, for example visits to clinics and escort duties for those residents who need this. Two staff members we spoke with told us that they loved working in the home, further discussions with them confirmed that they had a clear understanding of their roles. The six residents we spoke with said the staff are very kind and look after us well; whilst on our visit we noted one resident had asked to go into the garden and the carer responded immediately to the request and made sure that they were dressed appropriately for the inclement weather. Supervision records indicate that the staff have received regular supervision from the manager who in turn is supervised by the provider. Care Homes for Adults (18-65 years) Page 22 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are some management shortcomings that could compromise the health, safety and welfare of the people using the service. Evidence: We looked at health and safety related information and records, these showed that there are servicing arrangements for all equipment, these included the two boilers, fire fighting equipment and the oven. Fire training records were in place and up to date as was the PAT test information and certificate. The manager told us that the provider visits every month unannounced, we saw a report of the last visit, it was informative and looked at a number of areas as well as talking with some residents. The staff told us that they are always able to speak with the manager and whilst we were visiting we noted that the manager made himself available to visitors and staff. The manager at times had difficulty in locating some of the files that we needed to look at and in particular the assessment of needs records for new admissions to the home. We looked at the records for transactions residents monies, we found one residents Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: money to be ten pounds over what it should have been according to the records. The manager seemed to be unaware that the care plans lacked detail and that there were some anomalies with the accounting system of residents monies and that it needed to be more robust. He was also vague about the assessment process for new residents and as mentioned previously unable to locate files for this procedure. Care Homes for Adults (18-65 years) Page 24 of 29 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 6 15 People using the service must be provided with opportunities to be involved in drawing up and reviewing their care plans. Plans must include sufficient detail for staff to provide individual care and must be reviewed on a regular basis. In order to promote the health and welfare of people using the service. 31/03/2009 2 9 13 Risk assessments and risk 31/03/2009 management strategies must be clear and relevant. To support people using the service to be more independent and to ensure their safety. 3 19 15 Care plans must contain sufficient directions with regard to health and personal care In order to ensure that staff are able to understand and meet the needs of people using the service 28/02/2009 Care Homes for Adults (18-65 years) Page 25 of 29 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 1 2 14 Prospective residents to the 09/04/2010 home must have appropriate assessment of their needs prior to admission to the home. This will ensure that the service can meet their needs. 2 6 14 The care plans must contain detailed information about individuals care needs. This will ensure that residents needs are met. 09/04/2010 3 9 13 Risk assessments and risk management strategies must be clear and relevant. This will promote independence and ensure safety of those persons whose independence is being promoted 09/04/2010 Care Homes for Adults (18-65 years) Page 26 of 29 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 4 14 16 The views of the residents must be sought about their interests and recorded. This will enable them to take part in meaningful and motivational activities. 09/04/2010 5 32 18 Staff must receive training 12/08/2010 with regard to mental health conditions. This will enable them to meet the needs of the residents. 6 37 24 The manager must ensure that there is a system in place for maintaining all records and have these records available for inspection purposes. This will ensure that the residents benefit from a well run home. 12/04/2010 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 2 23 24 It is recommended that the staff have an outside facilitator to provide more information relating to issues of abuse. It is recommended that the service continues to enhance the environment to ensure that it is homely and comfortable. It is recommended that the domestic does some infection control training. Page 27 of 29 3 32 Care Homes for Adults (18-65 years) 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 4 41 It is recommended that all residents money transactions are sanctioned with two signatures. Care Homes for Adults (18-65 years) Page 28 of 29 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). 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