Care Home: Laurel Mount

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What the care home does well The home has a friendly, warm and relaxed atmosphere and people told us that they find the manager and staff approachable and helpful. The information provided about the service is good and helps people decide if the home can meet their needs. People are invited to visit the home before admission to see at first hand the facilities provided, meet the staff and other people living there and stay for a meal if they wish to do so. People are also able to move in to the home for a trial period if they are still undecided. People are offered the opportunity to take part in a range of social and leisure activities and are encouraged to make choices and decisions about how they spend their time while living at the home. People told us that the food is always good and that they were always offered an alternative if they did not want what was on the menu. The home is clean and comfortable and people are encouraged to furnish their rooms with personal possessions to make them feel more homely What has improved since the last inspection? A new care planning system is currently being implemented, which covers all aspects of people`s personal, health and social care needs, however, work is still required before it is fully operational. There has been an increase in the number of care staff achieving a National Vocational Qualification (NVQ) at level two or above, which shows that the home is commited to making sure people are being cared for by a skilled and experienced staff team. Internally improvements have been made to the environment and there is an ongoing programme of refurbishnment and renewal. Externally the Pavillion, has been fully renovated and a water feature has been installed in the garden to add interest. The home has also improved disabled access to the garden by building another ramp to the rear of of the building. What the care home could do better: Qualified nursing staff must be more vigilant when administering and recording controlled drugs so that people living at the home can be confident that their medication is being given as prescribed. Staff need to make sure that if any significant changes in people`s needs are identified, their care plan is amended so that it accurately reflects the level of care and support they require. Formal one-to-one staff supervision must be carried out at regular intervals so that the home can demonstrate that staff receive the support they need to carry out their roles effectively and in the best interest of people using the service. Monthly reports on the conduct of the home completed by the registered providers or their representaive must be made available for inspection as required under Regulation 26 of the Care Homes Regulations 2001. Key inspection report Care homes for older people Name: Address: Laurel Mount Woodville Road Keighley West Yorkshire BD20 6HP     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: Stephen Marsh     Date: 1 7 0 7 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 Older People Page 2 of 26 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 26 Information about the care home Name of care home: Address: Laurel Mount Woodville Road Keighley West Yorkshire BD20 6HP 01535667482 01535604366 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Christopher Bolland,Mrs Catherine Bolland care home 34 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: The category of PD is specifically for the service user named in the variation application dated 21 May 2004. The places for DE are specifically for the service users identified on 2.4.4 Date of last inspection Brief description of the care home Laurel Mount is a converted property in a residential area in Keighley, close to public transport routes. The home is registered to provide nursing care for up to 34 older people, some of whom may be suffering from dementia. Accommodation is provided in single and double rooms, two of the single rooms have en suite facilities. People living at the home have a choice of several lounges and a dining room, which are all located on the ground floor of the premises. The home is situated in extensive and attractive gardens to which there is level access from the home. There is a car park to Care Homes for Older People Page 4 of 26 Over 65 0 34 0 9 0 1 Brief description of the care home the front of the building. Care Homes for Older People Page 5 of 26 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: The last inspection of this service was the 18 July 2007. Since then we have improved our practice when making requirements to improve national consistency. Some requirements from previous inspections may have been deleted or carried forward as recommendations, but only when it is considered that people that use the service 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 inspection process included looking at information we have received about the service since the last key inspection, as well as this unannounced visit to the home, which was carried out between 09:30 and 17:00 hrs. The methods we used included looking at records, observing staff at work, talking to people living at the home and visitors, talking to the manager and staff and looking around the property. On this occasion we did not send any survey questionnaires to Care Homes for Older People Page 6 of 26 people using the service. The home had also completed and returned their Annual Quality Assurance Assessment (AQAA) form and the information provided has also been used as evidence in the body of the report. The AQAA is a self assessment form that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The purpose of the visit was to assess what progress the home had made in meeting the requirements made in the last inspection report and the impact of any changes in the quality of life experienced by people living at the home. Feedback was given to the manager at the end of the visit. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Qualified nursing staff must be more vigilant when administering and recording controlled drugs so that people living at the home can be confident that their medication is being given as prescribed. Staff need to make sure that if any significant changes in peoples needs are identified, their care plan is amended so that it accurately reflects the level of care and support they require. Formal one-to-one staff supervision must be carried out at regular intervals so that the home can demonstrate that staff receive the support they need to carry out their roles effectively and in the best interest of people using the service. Monthly reports on the conduct of the home completed by the registered providers or Care Homes for Older People Page 8 of 26 their representaive must be made available for inspection as required under Regulation 26 of the Care Homes Regulations 2001. 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 26 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 26 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. The admission process is thorough and people will not be admitted unless staff are able to meet their needs. People are provided with good information about the service and are encouraged to visit and see the facilities at first hand before deciding if the home is right for them Evidence: The service has produced a service user guide, which is made available to all people considering moving into the home. The service user guide provides people with good information and can be published in different languages or formats on request. Records show that peoples needs are always assessed before they move into Laurel Mount either in their own home or temporary place of residence. Needs identified during this pre-admission assessment visit form the basis for the initial care plan, which is completed within the first week of admission. We looked at the pre-admission Care Homes for Older People Page 11 of 26 Evidence: assessment for the last admission to the home and found that it provided staff with good information about the persons health, personal and social care needs. People are invited to visit the home before admission to see at first hand the facilities provided, meet the staff and other people living there and stay for a full day if they wish to do so. People are also able to move in to the home on a trial period if they are still undecided. This is good practice and shows that people are supported through the admission process. Feedback from people shows that they feel the information they received about the home before admission was very good and the initial visit was helpful and informative. The relatives of one person recently admitted said that they had chosen the home because of its reputation locally for providing good quality care and facilities. Feedback from relatives also shows that they feel there is a good mix of skills within the staff team and staff had a good understanding of their needs. Comments included all the staff I have dealt with appear caring and professional and I have no doubt that staff have the skills, training and experience to care for my mother appropriately. Care Homes for Older People Page 12 of 26 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 and support is delivered in a manner that respects peoples privacy and dignity although how this is achieved is not always reflected in the care plans in place. Evidence: A new care planning system is currently being implemented, which covers all aspects of peoples personal, health and social care needs. Care plans are drawn up with the involvement of the person using the service and/or their relatives and forms the basis for the care to be provided. The care plans we looked at were generally completed to a good standard and provided staff with clear guidance on how care and support was to be provided. However, in some instances we found that information that should have been in the care plan had actually been recorded in the daily report or other supporting documentation. For example the daily report for one person clearly showed there had been a recent significant deterioration in their general health. However, the care plan had not been changed to reflect this and therefore did not give staff guidance on how they should now provide care and support. On discussing the matter with the manager Care Homes for Older People Page 13 of 26 Evidence: it is apparent that care plans are only being reviewed and amended at the end of every month and are not being changed at the actual time significant events occur. This is unsafe practice, which may lead to people not receiving the level of care and support they require. The manager confirmed that she would review all the care plans in place and make sure that they accurately reflected peoples present circumstances. Moving and handling and nutritional assessments are routinely carried out for all new admissions and risk assessments are completed where areas of potential risk to peoples general health and welfare are identified. All people living at the home are registered with a general practitioner and are supported in having access to the full range of NHS services. The input of other health care professionals is clearly recorded in the documentation available. This shows that staff are seeking advice if they have concerns about peoples health. During the course of the visit we were able to speak briefly with a general practitioner who said that he always found the staff to be very professional and knowledgeable about the people in their care. He also said that the home never requested a doctor to visit unless there was a genuine need and that the manager had established a good working relationship with other healthcare professionals working in the local community. People confirmed that they were happy with the care and support they received and said that staff always treated them with kindness and respect. Comments included we are very well cared for and the staff will do anything to help you and staff look after us very well -- I have no complaints at all about care provided. Feedback from relatives shows that they are also pleased with the standard of care and facilities provided and were always kept informed of any significant changes in peoples general health. We reviewed the medication system in place and found that generally medicines are managed safely. However, when we checked the medication held in the controlled drugs cabinet against the register we found two discrepancies in the stock control figures. Qualified nursing staff must therefore be more vigilant when administering and recording controlled drugs so that people living at the home can be confident that their medication is being given as prescribed. Care Homes for Older People Page 14 of 26 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. People are offered the opportunity to take part in a varied range of social and leisure activities that take account of their preferences and abilities. Evidence: The manager confirmed that people are encouraged to make choices and decisions about how they spend their time whilst living at the home. Peoples personal interests are recorded in their care plan and wherever possible they are supported by staff to follow their own daily routines. The home does not currently employ an activities co-coordinator therefore it is the responsibility of the care staff to arrange in-house activities. There is a list of events displayed on the notice board. For people that dont like to join in group activities, time is made to engage with them on a one-to one basis. Information in the self assessment form shows that the home is taking steps to improve the range of activities available to people by appointing a part-time activities coordinator within the next twelve months. The manager confirmed that people are encouraged to continue to attend their place of worship if they wished to do so and the home is looking to arrange regular multiCare Homes for Older People Page 15 of 26 Evidence: denominational church services in the coming year. People told us that they were generally pleased with the level of activities and outings made available to them although two people said that they would like to have more trips out to places of interest. Comments included I look forward to the weekly exercise class but would like to get out and about more and there is usually something happening within the home on a daily basis but its sometimes depends on how busy the staff are. People spoken with said that they were able to see visitors in their own rooms if they wished to do so and family and friends were always made to feel welcome and offered light refreshments when they visited. We observed the lunchtime meal being served, which looked appetising and was well presented. If people required assistance or prompting to eat their meals this was done in a discreet and sensitive manner so that they were not caused any embarrassment. The home has a dining room although we were told that many people prefer to eat either in one of the lounge areas or in their own room. People told us that the food is always good both in quality and presentation and they are always offered an alternative if they dont like what is on the menu. Comments included there is a good choice at mealtimes and the food is always tasty and well cooked and I have no complaints at all about the quality of meals provided. During the course of the visit we had the opportunity to have a brief discussion with the cook and it was apparent that she was aware of peoples different preferences and dietary needs and catered for them accordingly. Following a kitchen inspection by the Environmental Health Department the home has been awarded a four star rating out of a possible five stars. Care Homes for Older People Page 16 of 26 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. There are suitable systems in place to make sure that complaints are dealt with appropriately and people are protected from any form of abuse Evidence: There is a clear complaints procedure in place and information provided in the self assessment form shows that three complaints have been received in the last year all of which were dealt with appropriately. People living at the home said that they were aware of the complaints procedure and would have no problem at all in approaching the manager or registered provider if they had any concerns about the standard of care being provided. Adult protection (safeguarding) policies and procedures are in place and training records provided by the manager show that all staff receive training in the recognition and reporting of allegations of abuse. The manager confirmed that the home operates a zero tolerance approach when dealing with complaints and safeguarding issues. Feedback from staff indicates that they are aware of the homes policy on whistle blowing and knew what to do if they suspected that people were being abused or working practices at the home were not in the best interest of the people living there. Care Homes for Older People Page 17 of 26 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 people with a pleasant comfortable and safe place to live. Evidence: Laurel Mount is situated in a residential area of Keighley about half a mile from the town centre. Constructed in 1885 the main building is listed and therefore some architectural features cannot be removed or disturbed. The building has over the years been sympathetically adapted and extended to provide accommodation for thirty-four people in both single and double bedroom accomodation. Communal lounges and the dining room are located on the ground floor close to toilet facilities. Both the bedrooms and communal areas are decorated and furnished to a good standard and there is an ongoing programme of refurbishment and renewal. The home was clean and free of unpleasant odours on the day we visited. People living at the home said that they were very satisfied with the standard of accommodation and pleased that they had chosen to live at Laurel Mount. Comments included I feel very at home -- it has such a warm friendly atmosphere and my room is comfortable, well decorated and kept spotlessly clean. Feedback from relatives also shows that they are very pleased with the standard of decor and furnishings. Comments included the home is very comfortable and Care Homes for Older People Page 18 of 26 Evidence: welcoming and the home is well maintained and provides good private and communal facilities. Maintenance issues we brought to the attention of the manager during the visit including fitting locks to some toilet doors were dealt with immediately by the handyman emloyed by the home. Externally the grounds are well maintained and information in the self assessment form shows that the in the last year the providers have renovated the Pavillion and installed a water feature to add interest to the garden. The home has also improved disabled access to the garden by building another ramp to the rear of of the building. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at the home are protected by the staff recruitment and selection procedures in place. The home provides staff with good training opportunities and makes sure that they are clear about their roles and responsibilities. Evidence: The home has a thorough staff recruitment and selection procedure , which includes obtaining at least two written references and a Criminal Record Bureau (CRB) check before new staff start work.This makes sure that people that use the service are cared for and supported by staff that are suitable to work in the caring profession. We looked at the recruitment files for four recently appointed staff and found that generally they were kept in good order. However, the manager was reminded that wherever possible one written reference must be obtained from the applicants last or present employer. The staff rota showed that sufficient care staff are employed on day and night duty to meet peoples needs and the home has a stable staff team and a relatively low staff turnover. The manager confirmed that at times the home has to employ agency staff to maintain staffing levels but wherever possible the same members of staff are employed to make sure people receive continuity of care. Care Homes for Older People Page 20 of 26 Evidence: All new staff receive induction training in line with the Skills for Care Common Induction Standards. These are nationally agreed induction standards designed to help new staff get the skills and knowledge they need to care for people. Following induction there is an expectation that staff will study for a National Vocational Qualification (NVQ) at level two or three above depending on the post they hold. Information provided by the manager shows that currently six care staff have achieved the qualification at level three and two at level two. This shows that the home is committed to making sure that people are cared for by a skilled and experienced staff team. Feedback from the staff spoken with confirmed that they are generally happy with the level and standard of training provided and are encouraged to take up training opportunities. Staff also felt that the training the receive helps them understand the individual needs of people living at the home and keeps them up to date with new ways of working. Care Homes for Older People Page 21 of 26 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 home is well managed and the manager is quick to address matters raised by people living at the home and/or their relatives or highlighted through the inspection process. Evidence: Mrs Judith Helen Wardrope is the registered manager of Laurel Mount Nursing Home. Mrs Wardrope is a qualified nurse, has many years experience in the caring profession and has achieved a recognised management qualification. Mrs Wardrope has a positive attitude to the inspection process and during the course of the inspection showed a willingness to work with us to maintain and improve standards at the home. Feedback from staff and people living at the home shows that the manager is very approachable and operates an open door policy, which means that they are able to speak to her at any time if they have any concerns. Comments from people included the manager is very easy to talk to if you have a problem and the manager is very friendly and always makes sure we are well cared for. Care Homes for Older People Page 22 of 26 Evidence: Unfortunately records show that care staff have not had formal one-to-one supervision with the manager for several months although the staff spoken with confirmed that they were well supported by the manager and qualified nurses. Comments included it is very easy to approach the manager with any problems and the qualified staff provide good leadership and we all work well as a team. The manager confirmed that she is aware that staff supervison does not take place as often as required and is currently taking steps to address this matter so that the home can evidence good proctice. There is a range of quality assurance monitoring measures in place including sending out survey questionnaires to people using the service, their relatives. The questionnaires give people the opportunity to express their views of the service provided and are an important part of the quality assurance monitoring process. As part of the quality assurance monitoring process the registered providers or their representative also visit the home on a monthly basis and complete a written report on the conduct of the service. However, although it is apparent that the visits that are being made no written reports were available for inspection. Following a discussion with the manager she confirmed that this matter would be addressed and reports would be in future made available for inspection as required under Regulation 26 of the Care Homes Regulations 2001. The home holds money in safekeeping for a number of people. Only senior staff deal with peoples personal finances and transaction sheets are available showing income, expenditure and a balance. Receipts are obtained for any items purchased on peoples behalf. We checked the system in place and no concerns were raised therefore people can be confident that the system is safe and well managed. Information provided in the self-assessment form completed by the manager shows that policies and procedures are in place to make sure staff follow safe working practices and all equipment is serviced in line with manufacturers guidelines. People can therefore be sure that their health and safety is not being compromised. Care Homes for Older People Page 23 of 26 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 24 of 26 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 9 13 Qualified nursing staff must be more vigilant when administering and recording controlled drugs. So that people living at the home can be confident that their medication is being given as prescribed. 30/08/2009 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 Staff should make sure that if any significant changes in peoples needs are identified, their care plan is amended so that it accurately reflects the level of care and support they require. Care Homes for Older People Page 25 of 26 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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