Care Home: Lynwood

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What the care home does well Lynwood presents as a warm, caring and friendly care home and residents appeared relaxed and comfortable with the staff. It was evident through interviews, general observations and discussions that staff had a good knowledge of the residents` individual care needs and the level of support required. During our visit staff were observed spending time with residents, either on an individual basis or within a group. Care was seen to be given in a discrete, sensitive manner and staff were patient in their approach. Feedback from residents was very good; residents said that the staff had a "kind and considerate manner" and that the staff spoke to them in a courteous way. Prior to admission the manager assesses residents` health and social needs. Information collected is then used to form the basis for the plan of care. Assessment documentation seen had been completed to a good standard and included key areas regarding the residents` health and general well being. Care files were organised, the information easy to read and identified the relevant care and support required. Attention is paid to recording basic needs such as dental, optical, hearing and foot care. The home has an experienced and enthusiastic team of staff who work well together and enjoy taking part in training and development sessions. The staff are motivated and keen to ensure that residents receive high standards of care. Seven staff were spoken with and comments included were:"The manager gives us the opportunity to attend training" "We make sure we look after the residents well" and "We feel we provide really good individual care for each resident." The manager was experienced and ran the home well. She made sure she checked out staff before they started working at the home and gave them training and support to make sure they did the job to the best of their ability. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of good practice, particularly in relation to continuous improvement, staff training, resident satisfaction and quality assurance. What has improved since the last inspection? All of the requirements made at the last key inspection and the follow up random inspection have been met. Record keeping has improved a lot. The manager can now demonstrate more clearly to us the care provided at the home. Care plans are well ordered and easy to read. This makes it a lot easier for staff to keep up to date with residents` changing needs. Particular attention is paid to risk assessments which are reviewed and updated and the action needed to address the risks, are transferred to each person`s care plan. Attention is given to pressure sores, weight loss and infections. This ensures that each resident has a plan in place, which makes sure the risks are lessened and the right care given. New records are being used to check that residents with poor appetites are checked regularly and the staff take any action needed. What the care home could do better: The writing down of medicines on the recording sheets should be signed by two members of staff to avoid a mistake being made. The provision of activities inside the home should be further developed and consideration given to the possibility of employing a member of staff with responsibility for this, so that the social needs of residents can be better met. There are not enough staff available to meet the residents` needs during the breakfast period on the Dementia Unit. The manager must consider how staff are deployed in the home during this time to ensure that residents are properly cared for. The manager has a good understanding of the areas in which the home could further improve. Planning was in place and set out how these improvements are to be resourced and managed. Signage could be improved to help residents identify toilets and bathrooms. Key inspection report Care homes for older people Name: Address: Lynwood Lynwood 57 Mersey Road Heaton Mersey Stockport Cheshire SK4 3DJ     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: Bernard Tracey     Date: 2 7 0 8 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 27 Information about the care home Name of care home: Address: Lynwood Lynwood 57 Mersey Road Heaton Mersey Stockport Cheshire SK4 3DJ 01614327590 01616130633 lynwoodresthome@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr. Mohsin Munif,Mrs. Anne Munif care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 23 Date of last inspection Brief description of the care home Lynwood is a large Victorian detached house that has been converted into a care home and is set in its own extensive grounds. The accommodation consists of 21 single rooms and one shared room, which are spread over three floors. Three of the single Care Homes for Older People Page 4 of 27 Over 65 0 0 23 23 23 0 3 0 0 4 2 0 0 9 Brief description of the care home rooms and the one shared room have en-suite facilities. There is one large dining room, which has a small seating area overlooking the garden, two further lounges and a conservatory. The home is owned by Mr and Mrs Munif and is managed on a day-to-day basis by one of the registered providers, Mrs Munif. Lynwood is registered to care for 23 older people. The registration also allows for up to ten service users who are suffering from a dementia type illness and three service users who may have a mental health problem. The home is located in the Heaton Mersey area of Stockport and is close to local shops and other amenities. Stockport town centre, motorway network and public transport are easily accessible. The fee structure at the home ranges from £408-£418. The previous CSCI inspection report was available on request. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 (the Commission of Social Care Inspection) undertook a key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. The previous key Inspection took place on the 18th June 2008, and we completed a further random inspection on the 30th April 2009 to look at the administration and storage of medicines. Some weeks before our planned visit the manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. This helps us to determine if the management of the home see the service they provide the same way that we do. We felt this form was filled in honestly and that a lot of time and effort had been given to filling it in. Where appropriate, the comments have been included in the report. Care Homes for Older People Page 6 of 27 We spent over five hours at the home over one day. During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. We spent time speaking to six residents and one relative who was there during our visit, as well as speaking to five staff, the manager and the owner. We have not received any complaints about the service since our last inspection but, in discussion with the manager and owner, issues of concern that have been raised with the manager have been recorded and details of how these matters had been resolved were examined. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? All of the requirements made at the last key inspection and the follow up random inspection have been met. Record keeping has improved a lot. The manager can now demonstrate more clearly to us the care provided at the home. Care plans are well ordered and easy to read. This makes it a lot easier for staff to keep up to date with residents changing needs. Particular attention is paid to risk assessments which are reviewed and updated and the action needed to address the risks, are transferred to each persons care plan. Attention is given to pressure sores, weight loss and infections. This ensures that each resident has a plan in place, which makes sure the risks are lessened and the right care given. New records are being used to check that residents with poor appetites are checked regularly and the staff take any action needed. Care Homes for Older People Page 8 of 27 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they are admitted to the home and this gives an assurance to everybody, that a person is only admitted if the home can meet their needs Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. Care files contain relevant paperwork, including social work assessments and reports from health care professionals prior to a person choosing to stay at the home. The manager also carries out an assessment, which includes a visit to see the person in his or her own home or while in hospital. These measures ensure that admissions to the home only take place if the service is confident staff have the skills and ability and qualifications to meet the assessed needs of the prospective resident. One resident told us that she felt very comfortable and safe coming to the home A relative interviewed when we visited told us that the manager provided her with ample information and opportunity to visit the home prior Care Homes for Older People Page 11 of 27 Evidence: to my husbands admission and this was very reassuring Standard 6 does not apply. The home does not provide Intermediate Care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal care needs are being met and are addressed in detailed care plans. Evidence: Four care plans were examined, two of which related to residents who had lived at the home for a relatively short time. Each resident in the home had a detailed, up to date and individual plan of care, covering all personal, health and social care needs. Any areas of risk for the resident were highlighted, along with the planned action to reduce that risk. Care plans demonstrated that residents personal choices and preferences had been taken into account by staff. We spent time talking with care staff who were working in the home, they were able to demonstrate knowledge, skill and a caring manner in carrying out their specific tasks. They were also supported by the District Nurses from the local surgery who give support and advice for the residents living in the home. Care Homes for Older People Page 13 of 27 Evidence: All care plans had been regularly reviewed by staff on a monthly basis. Evidence of resident or relative involvement was seen on two of the care plans, one of which had recently been reviewed with relatives. The care plans of the two residents who had moved in recently had been signed or agreed with them or their representative. Care plans clearly recorded GP, District Nurse,and care management involvement. Residents spoken with said these health professionals were contacted when necessary. One resident described the care as really goodand other residents spoken with were satisfied with the overall care provided at the home. . Healthcare arrangements were also good. Residents had good access to their local doctors, dentist and optician and some were also under the care of a district nurse. A resident told us that the The carers really look after us There is an efficient Medication Policy supported by practice guidelines. Staff follow robust systems to make sure that medication records are fully completed, contain required entries and are signed by appropriate staff. We discussed some aspects of the prescribing of medicines that are only given when required and suggested that the manager should contact the doctor to review these medicines when the resident feels they need them or they are being given on a regular basis Personal care was provided privately in bedrooms or bathrooms, and door locks or engaged signs were used. Residents wore their own clothes and were dressed appropriately for the weather and their activity. A relative spoken with during our visit stated My husband is really well looked after. The staff are very approachable if I need to ask them for anything. He is quite content here and all the residents seem to be well cared for personally and individually. It is a really good home Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities provide daily variation and interest for people living in the home. The dietary needs of the residents were well catered for with a balanced and varied selection of food being served. Evidence: The residents involvement in social activities varies greatly according to their abilities and needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching the television. The home has a very pleasant friendly atmosphere. The activities person has given thought to arranging social activities to suit individual needs and preferences. Social needs are assessed in detail when a resident is admitted and residents spoken with were pleased with the home programme of social events. Staff work hard to ensure social interests are stimulating and it was evident through discussion with a number of residents that they enjoy a full lifestyle. A discussion with the residents and care staff confirmed that the residents were able to receive visitors in private and that they were able to choose whom they see and do not see. Visitors can be seen in the privacy of the residents bedroom although many choose to sit in one of the communal areas. Residents are encouraged to bring personal possessions into the home. Many of their Care Homes for Older People Page 15 of 27 Evidence: bedrooms were highly personalised with small pieces of their own furniture, pictures, photographs and ornaments etc. We did not dine with the residents but observed breakfast and lunch being served in the dining rooms. The meals served were of ample portion and looked appetising. The tables were nicely set with napkins, cruets and cold drinks. Staff discreetly assisted some residents to eat. There was always a choice of meal at lunchtime and evening. The menus were inspected and they looked varied and nutritious. Mid-morning and mid-afternoon drinks were served and milky drinks were provided at supper time. A discussion with the residents showed that they were very happy with the choice and quality of the food provided. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear complaints procedure and residents and their families know action will be taken to resolve their concerns. Staff have a good knowledge and understanding of Adult Protection issues which safeguards residents from abuse. Evidence: The home has a complaints procedure, which was displayed on the notice board in the entrance area and included in the Service User Guide. Staff interviewed were familiar with the procedure. Residents knew who to speak to if they had a complaint but said that matters were usually dealt with straight away so there was no need to complain. The complaint log was seen and complaints recorded. All of these complaints appeared to have been dealt with satisfactorily The Care Quality Commission has not received any complaints about the home. The policy and procedure used by the home for the Protection of Vulnerable Adults (POVA) was the Stockport Inter- agency procedure. A whistle-blowing procedure was also in place and staff interviewed showed their understanding of it. The manager knew and understood the reporting procedure, which she had appropriately used in the past. Some staff had received POVA training and dates have been confirmed for the remainder. The owner and two senior staff have attended the training provided by the Local Authority in relation to the Mental Capacity Act and the Deprivation of Liberty. The owner is aware of his responsibilities and confirmed that there had been no applications made in respect of the deprivation of liberty of any individual living at the Care Homes for Older People Page 17 of 27 Evidence: home Questionnaires had been distributed to relatives and residents, collected and evaluated to help improve the service. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in pleasant, safe, comfortable and well-maintained surroundings. Evidence: The accommodation is provided on three levels. It is fully accessible to people who are physically disabled and is fitted with aids and adaptations to promote independence. The main entrance hall is spacious and there is ample information available regarding the home and the service it provides. A partial tour of the building was undertaken, two bathrooms, a shower room and six bedrooms were viewed. The bathrooms were clean and tidy and hot water temperatures are recorded each month to ensure the hot water is delivered to a safe temperature. Improved signage for toilets and bathrooms would help residents more easily identify these facilities. Bedrooms viewed had individual items and were homely. A resident said, I have everything I need, including some of my own furniture. Bedrooms have door locks and storage space for valuable items. Bedrooms have a call system with a hand held buzzer to call for assistance. The call system on the First and second floor needs to be re connected to the main panel following the upgrade of the system Care Homes for Older People Page 19 of 27 Evidence: The home is equipped with comfortable furniture, fittings and electrical equipment, including televisions and CD. players. . There is a well equipped laundry and there was evidence of gloves and aprons for staff use. Infection control training is given to staff and infection control policies are available. Residents commented on the good laundry. There are sufficient domestic staff and on the day of this visit the home was clean, fresh and hygienic. Policies and procedures are in place to promote a high standard of cleanliness and hygiene. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are appropriately trained and experienced care staff employed so that residents feel supported and that their needs are understood and met. The recruitment policy is generally robust to protect the residents. Evidence: The manager had provided details of the staffing arrangements in the home prior to the inspection, the details of which were checked during the visit. Staffing levels within the home were seen to meet the needs of residents but consideration should be made with regard to the deployment of care staff on the night shift. It has been the custom to have a sleeping night staff between 12 midnight and 06:00 hours. This was discussed with the manager and she assured us that she will look into this and provide a solution. Residents confirmed that staff were always respectful and met their needs competently. In the main, residents were satisfied with the support they were given and described staff as OK, nice people, alright, find time to listen and good. Sufficient ancillary staff were employed e.g. domestics, laundry and kitchen Staff were in the main knowledgeable about the needs of residents and demonstrated that they understood their own role. Care Homes for Older People Page 21 of 27 Evidence: Staff files demonstrated that a robust recruitment process is in place, with all appropriate checks being undertaken prior to working in the home. These include criminal record bureau disclosures, application forms and references with one from the previous employer always obtained. New staff undertake a full induction programme that is followed by further in house training. Several staff are presently undertaking National Vocational Qualifications in care at Level Two. The home has an ongoing training programme that staff can apply for. Since the last inspection several staff have received training in abuse awareness and more are booked to attend in the future. Staff spoken with showed that their knowledge had increased since the training and that they were more aware and confident in reporting concerns. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 run in the best interests of the residents. Evidence: Throughout the inspection the inspector was able to evidence the professional, capable and approachable manner in which the manager undertook her role when dealing with residents, staff and visitors. Staff and residents said she was easily accessible and welcomed her open door policy as well as providing structure and a sense of direction through more formal meetings. Residents said she made sure she spoke to them on her arrival at the home each day to check out how they were feeling. The manager operates a quality assurance programme made up of audits and satisfaction surveys to gain feedback on the quality of the service offered at the home. The responses to the latest survey had not been collated as yet but showed that respondents were very happy with the care provided. Care Homes for Older People Page 23 of 27 Evidence: A set of management audits was used to monitor the standard of care planning, medication records, upkeep of the building and provision of meals. The manager also sees every accident/incident report and is therefore able to implement any newly identified safety measures accordingly. The manager holds small amounts of spending money of behalf of some residents. Any spending was accounted for with receipts and the records were open to scrutiny by residents or their advocates. There is a sound system in place for promoting the health, safety and welfare of staff and residents. All services and equipment for the building were under contract for regular testing and repair and the appropriate documentation to support this was available for examination. There was information on, and staff had received training in, fire safety, safe moving and handling, and the safe use of chemicals, food hygiene and first aid. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 19 The manager should consider improving the signage to the bathrooms and toilets to assist residents in better identifying these facilities The call bell system on the upper floors requires re connection to the main board following the recent upgrade of the system. This is to ensure that staff throughout the home are able to respond to calls on on floors. Sufficient care staff should be available to support the residents during the night period. 2 19 3 27 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. 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