Care Home: Nazareth House Nursing Home

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What the care home does well There is a friendly and welcoming atmosphere at Nazareth House and all of the staff we met were pleasant and helpful. Many of them have worked at Nazareth House for a considerable length of time. More than 90% of the care staff have a national vocational qualification in care. Visitors we spoke with said that they are always made welcome and are offered refreshments. Visitors are encouraged to join in social events at the home. One of the visitors told us `Its a very, very good home, I can`t speak too highly, couldn`t ask for more. There is always something going on`. People living at the home are afforded dignity and respect and in a recent questionnaire one person commented `it makes me feel special to be treated with such respect, and no matter how rushed the staff are they always knock`. A letter from relatives stated `Nazareth House is a truly special place to have such very considerate and loving staff`. During our visit a resident we spoke with said `Its wonderful here, we`re very well looked after`. Nazareth House employs a full-time activities co-ordinator working from Monday to Friday and a varied programme of twice daily activities is provided. The home has its own minibus and people have regular trips out. The home has its own chapel and chaplain and a daily Mass is held. This is open to people who live in the local community and to relatives. Ministers of other faiths also visit regularly and have their service in residents` bedrooms or in the chapel. Visits by GPs and other healthcare professionals are recorded. We spoke with a nurse assessor who said she loves visiting this home `It`s top of the range across the Wirral and I`m very impressed with the care of the person I have come to see, who is now walking and eating.` Residents` medicines are well managed. A good standard of catering is provided and people are always offered a choice of meals. There is a well-equipped satellite kitchen on each floor where light meals, drinks and snacks can be made at any time. All areas are spacious and there is a good choice of sitting areas. There are pleasant gardens that are accessible for residents to enjoy. A maintenance manager is employed to ensure that repairs can be dealt with without delay. When we visited, all parts of the home were clean and there were no unpleasant odours. There are always enough staff on duty to ensure that the needs of the people living at the home can be met. The manager consults with staff, residents and relatives though questionnaires and meetings to ensure that they have opportunities to express their views about the service. A monthly health and safety audit is carried out by the manager and regular checks are carried out to ensure that equipment is safe. What has improved since the last inspection? The home`s brochure has been reviewed and updated to make sure that people interested in going to live there have the information they need.An on-going programme of redecoration and refurbishment has continued to ensure that people have a comfortable and pleasant environment. The manager has introduced changes to ensure the financial viability of the service. All staff have been issued with new contracts of employment and they have had an individual supervision meeting with the manager. What the care home could do better: Make sure that pre-admission assessments are completed in full so that staff have information about the needs of people coming to live at the home. Provide training and support for the senior care staff to that they can compile care plans for new residents and keep existing care plans up to date. Whenever possible obtain an employer reference from the most recent employer of people applying to work at the home. Provide training updates for all staff in moving and handling, fire safety, safeguarding and any other identified health and safety subjects, to ensure that they continue to work safely. Review the arrangements for administration and record keeping so that the manager has full control of the day to day running of the home and storage of records. Key inspection report Care homes for older people Name: Address: Nazareth House Nursing Home Manor Hill Claughton Birkenhead Wirral CH43 1UG     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: Wendy Smith     Date: 1 2 1 1 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 24 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 24 Information about the care home Name of care home: Address: Nazareth House Nursing Home Manor Hill Claughton Birkenhead Wirral CH43 1UG 01516527811 01516530816 ellen_curran@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): The Congregation of the Sisters of Nazareth Name of registered manager (if applicable) Type of registration: Number of places registered: care home 47 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with nursing - Code N 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 The maximum number of service users who can be accommodated is: 47 Date of last inspection Brief description of the care home Nazareth House is a purpose built care home attached to an older main building. The home is set in it own grounds in the Claughton district of Birkenhead. It is part of the non-profit making organisation The Congregation of the Sisters of Nazareth, based in London. The home accommodates up to 47 older people who have nursing or personal care needs. Care Homes for Older People Page 4 of 24 Over 65 47 0 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 quality rating for this service is two stars. This means that the people who use this service experience good quality outcomes. We (the Care Quality Commission) visited Nazareth House unannounced on 12 November 2009 as part of this inspection. During the visit we spoke with residents, staff and visitors. We walked round the building to see all the communal areas and some of the bedrooms. We checked records kept at the home and spent time talking with the manager. We also looked at any information that we had received about Nazareth House since our last inspection there. Before the visit, the manager was asked to complete a questionnaire to give us up to date information about the service. Care Homes for Older People Page 5 of 24 What the care home does well: What has improved since the last inspection? The homes brochure has been reviewed and updated to make sure that people interested in going to live there have the information they need. Care Homes for Older People Page 6 of 24 An on-going programme of redecoration and refurbishment has continued to ensure that people have a comfortable and pleasant environment. The manager has introduced changes to ensure the financial viability of the service. All staff have been issued with new contracts of employment and they have had an individual supervision meeting with the manager. 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 7 of 24 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 8 of 24 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. Information is provided to help people decide if this is the right home for them. Peoples needs are assessed before they move to the home to ensure their needs can be met. Evidence: Nazareth House is part of a group of 13 non-profit making homes owned by the Congregation of the Sisters of Nazareth, an international order of Catholic nuns based in London. Houses are open to people of any faith or none, but a central feature in every house is a chapel in which Catholic priests celebrate Mass daily. Although there are no longer any sisters working in this home as part of the direct care team, they still have an input into the service in a pastoral capacity. The ground floor has 25 places for people requiring nursing care and the first floor has 22 places for personal care. The manager told us that occupancy is always high with a considerable waiting list. All of the people living at the home are older people. The Care Homes for Older People Page 9 of 24 Evidence: home is not registered to provide specialist care for people with dementia and the manager confirmed that, although some of the residents are confused, there is no-one at present who requires specialist care in order to meet their needs. Information about the accommodation, the philosophy of the home, activities within the home and the fees is provided for people interested in going to live there. The brochure has recently been reviewed and updated. People are encouraged to visit the home before they make a decision. In the annual quality assurance assessment (AQAA), the manager told us that Before any resident is admitted to Nazareth House a detailed needs assessment is undertaken by the manager, deputy manager or an experienced person either in their home or during a hospital visit to ensure that the home can meet their needs. If Social Services are involved its report is obtained. Also where possible, family and other health care professionals contribute to this assessment procedure. We looked at the assessments for some people who had come to live at Nazareth House in recent months. One of the forms had been fully completed in detail, but others did not provide much information about individual needs and preferences and they were not always signed or dated. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and care needs of the people living at the home are met in a way that respects their privacy and dignity. Evidence: There is a care plan for each person living at the home, except for the most recent person to come and live on the first floor. The care plans for people living on the first floor were all written by the previous manager and this was done using a computer programme which none of the care staff know how to use. Also, the computer required for writing the care plans is not readily available for them. The senior care staff are writing regular reviews of the care plans and are keeping progress records for each person, but they are not able to update the computerised plans. The manager told us that a new care planning system is due to be introduced in 2010 and staff will have training so that they know how to use it. The personal care unit has its own manager and senior care staff and they are keen to learn and develop their skills. The senior nurse on the ground floor is responsible for writing care plans for the residents receiving nursing care and these are also electronic records. The nurses are Care Homes for Older People Page 11 of 24 Evidence: able to access the records but only on one computer. The standard of the record keeping was good, but the senior nurse told us that there is no flexibility in the system for updating and amending care plans as peoples needs change, and it is a timeconsuming process. The care plans we looked at contained a series of risk assessments detailing any identified risks to the health, safety and well-being of each person. They were updated monthly and detailed evaluations had been recorded each month. Due to the short-comings of the care plan system, a large file is kept containing written records pertaining to each resident. This includes wound care records and monthly monitoring of weight. Visits by GPs and other healthcare professionals are recorded. Residents have a choice of GP and where possible they continue with their own GP. We spoke with a nurse assessor who said she loves visiting this home Its top of the range across the Wirral and Im very impressed with the care of the person I have come to see, who is now walking and eating. The home has policies and procedures for the safe receipt, recording, storage, handling, administration and disposal of medicines. The manager told us that if any of the people living at the home wish to look after their own medicines, a risk assessment is carried out and documented, and they are supported to self-medicate. We looked at the storage and recording of medicines on the ground and first floors and found that they were well managed. Care staff who give out medication on the first floor have all received appropriate training. We observed that the people living at the home were afforded dignity and respect. In a recent questionnaire one person commented it makes me feel special to be treated with such respect, and no matter how rushed the staff are they always knock. A letter from relatives stated Nazareth House is a truly special place to have such very considerate and loving staff. During our visit a resident we spoke with said Its wonderful here, were very well looked after. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can choose how and where they spend their time and a range of social activities is provided for people who wish to join in. Visitors are made welcome and there is a very good meals service. Evidence: Nazareth House employs a full-time activities co-ordinator working from Monday to Friday. There is a varied programme of twice daily activities and an individual record is kept to show what activities people have joined in. There are regular weekly activities such as bingo on a Monday, and occasional events such as a clothes party. On the day we visited, students from a local high school gave a music concert during the afternoon and this was well attended. There are celebrations for residents birthdays and other theme days such as Halloween and Saints days. The home has its own minibus and people have regular trips out. People can choose whether they sit in one of the main lounges and join in the activities or stay in their own room or one of the quieter lounges. There is a 50 screen television in each of the main lounges. There is a small library for residents to use. The home has its own chapel and chaplain and a daily Mass is held. This is open to people who live in the local community and to relatives. Ministers of other faiths Care Homes for Older People Page 13 of 24 Evidence: also visit regularly and have their service in residents bedrooms or in the chapel. There was a friendly and welcoming atmosphere and all of the staff we spoke with were pleasant and helpful. Many of them have worked at Nazareth House for a considerable length of time. Visitors we spoke with said that they are always made welcome and are offered refreshments. Visitors are encouraged to join in social events at the home. One of these visitors said Its a very, very good home, I cant speak too highly, couldnt ask for more. There is always something going on. People are encouraged to personalise their bedrooms and we saw that one person had her own piano in her bedroom. We spoke with the chef who said that he always tries to maintain a high standard of meals, with a good choice of healthy food. Menus are provided on each table and are presented in large print to make it easier for people with poor vision. New crockery and place settings have been purchased. People are encouraged to make suggestions about what they would like on the menu and the manager told us that some spicier foods have been included on the menu as requested by a resident. There is a well-equipped satellite kitchen on each floor where light meals and snacks can be made. There is a member of staff working in each of the satellite kitchens during the day and the people we spoke with said that they have a good choice of meals and can have a drink or a snack at any time. We saw the lunch being served out from one of the satellite kitchens and it looked nicely cooked and presented. The staff serving out the meal made sure that each person get exactly what they wanted. Care Homes for Older People Page 14 of 24 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. People living at the home are protected from abuse. Evidence: The home has a complaints procedure and a copy is included in the information folder in each bedroom. It is also displayed in the home for relatives, visitors and staff. The complaints procedure gives the name of the home manager and of another person who can be contacted if people have any concerns or complaints. However it did not say what the role of the second person is or how he can be contacted. The manager told us that this is the regional manager and he agreed to amend the complaints procedure so that people are informed how they can contact the regional manager. The manager has set up a complaints file to record any complaints or concerns received. One issue had been recorded and there was a copy of the full written reply that had been sent to the complainant. The manager told us that all staff are familiar with the Wirral No Secrets policies and procedures. The deputy manager has provided some recent training about safeguarding, but the records suggested that some staff need to update their training. Care Homes for Older People Page 15 of 24 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. Nazareth House provides a comfortable, safe and well-equipped environment for people to live and work in. Evidence: Nazareth House is a modern building attached to an original large family house. It was purpose-built as a care home joined to the convent where the nursing sisters lived. All areas are spacious and there is a good choice of sitting areas. There is a main lounge and dining room on each of the two floors and the ground floor also has two conservatories. Furniture and furnishings are domestic in style. There are plenty of bathrooms, shower rooms and WCs to ensure that peoples needs can be met. Mobility aids, hoists, and adjustable beds are provided to meet individual needs. A maintenance manager is employed to ensure that repairs can be dealt with without delay. The manager told us that a building surveyor from Nazareth Care will be visiting during November to assess what building maintenance work is required. There are pleasant gardens that are accessible for residents and are maintained by contractors. CCTV is in use for outside security but there are no cameras inside the home. When we visited, all parts of the home were clean and there were no unpleasant odours. Procedures are in place to help prevent the spread of infection. Care Homes for Older People Page 16 of 24 Evidence: Care Homes for Older People Page 17 of 24 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. Enough qualified and experienced staff are employed to ensure that peoples needs can be met. Evidence: We looked at the staff rota which showed that there are enough staff on duty at all times to meet the needs of the people living at the home. On the ground floor there is always a registered nurse on duty and in addition the senior nurse works between 9am and 4pm five days a week. There are nine care staff on duty during the day and three at night. Extra staff are brought in for special events and trips out. Most of the staff have worked at the home for a number of years. More than 90 of the care staff have a national vocational qualification in care and some have level 3, which means that there is a well-qualified workforce. We looked at the recruitment records for three staff who started working at Nazareth House in the last year. They had all completed application forms and provided an employment history. Criminal Records Bureau disclosures had been obtained to make sure that they had no convictions which would make them unsuitable to work with vulnerable people. Written references had been received, but these were not from the previous employer. A reference should always be requested from the persons previous/current employer so that the manager is aware if there have been any Care Homes for Older People Page 18 of 24 Evidence: disciplinary issues. New staff have induction training with the senior nurse and this is recorded. The deputy general manager has considerable experience in training and she has put together a matrix to show when each member of staff has attended training in important areas that safeguard the health and safety of the people who live at the home. This has highlighted a need for training updates for most staff in areas such as moving and handling and fire safety. Care Homes for Older People Page 19 of 24 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 undergoing a period of significant change, however the new manager has ensured that it continues to be run in the best interests of the people who live there. Evidence: Since our last visit the home has a new manager who took up post in May 2009. He is a registered general nurse and mental health nurse with many years experience and he is working towards the registered manager award and he has applied for registration with the CQC. Previously, the home has always been managed by one of the nuns who lived on the premises, but Nazareth Care has recognised the need to appoint lay managers due to the declining numbers of Sisters of working age. There is a separately registered special needs unit for people with learning disabilities on the same site and the registered manager of this service has been appointed deputy manager for the whole establishment. The manager has had to introduce changes to ensure the financial viability of the service. More than half of the other homes in the group have closed. This has Care Homes for Older People Page 20 of 24 Evidence: inevitably resulted in feelings of uncertainty and insecurity amongst the staff. All staff have been issued with new contracts of employment and they have had an individual supervision meeting with the manager. A full staff meeting is held every three months and we saw the minutes of the last meeting in September 2009. A staff survey has also been carried out and returned some useful comments. There is also a monthly heads of department meeting. A monthly monitoring visit is carried out by another manager in the organisation and this is documented. One of the nurses takes overall responsibility for the care plans, and another for medicines management. A relatives survey has been sent out recently and the manager told us that he plans to hold a meeting for residents and their relatives when the survey results are finalised. People can bring small amounts of personal spending money into the home and this is kept securely in a large purse for each person. Detailed individual records are kept. The manager said that they do not support any residents with their finances, however other members of staff said that there are appointeeships in place for three people. The homes administrator was on holiday at the time we visited, and another member of staff who deals with fees only works two days a week so we were unable to clarify this. Various records are kept in different offices around the building and a number of people have access to management records. It is important for the manager to rationalise these arrangements and ensure that he has overall control of the management and administration of the service. Unfortunately he did not have a period of hand-over with the previous manager to familiarise him with all of the complex systems that are in place. A monthly health and safety audit is carried out by the manager and this includes an audit of accident reports which is used to identify any reoccurring accidents. The annual quality assurance assessment provided us with dates when all plant and equipment had been tested and serviced. Weekly maintenance tests are carried out and recorded by the homes maintenance manager. A fire risk assessment for the building was done by a professional company in January 2009. Care Homes for Older People Page 21 of 24 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 22 of 24 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 30 19 Ensure that all staff have regular updates of their mandatory training. To ensure that they know how to work safely. 31/03/2010 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 29 Whenever possible an employer reference should be obtained from the current or last employer of any applicants wishing to work at the home. Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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