Care Home: Oakland Care Centre (Moston)

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What the care home does well They provide enough information for people to make an informed decision about moving in. This was in the form of a service user guide and statement of purpose. They carried out a pre-admission assessment of people`s needs. This was to make sure that the person`s individual needs could be met. Staff and people living at the home had a good relationship. This means that people were comfortable with staff they could express concerns and be sure that they would be listened to. There were no set visiting times. This means that people`s relatives and friends were welcomed at any time. The home had a robust recruitment procedure. This means that they carried out thorough checks to make sure new staff were safe to work with vulnerable people. They had appointed a new activity organiser. This means that people had the opportunity to take part in activities if they chose to. We saw that the manager held regular meetings with people living at the home and staff. This means that people were consulted about the day to day running of the home and that staff were kept up to date with new policies and working practices. They use `Choices` to help people who have difficulty communicating their needs and preferences to staff. `Choices` is a selection of photographs of every day items and foods. Staff use the cards to develop a picture board to help the person communicate their wishes and needs. The home is clean and free from unpleasant odours. This means that people have a pleasant and comfortable place to live. They use the `Nutmeg` menu planning system. `Nutmeg` is based on the nutritional value of various foods and is used to make sure people with poor appetites are getting a balanced diet. What has improved since the last inspection? They have employed a new activity organiser. This means that when planning the activity programme people`s likes and dislikes will be discussed and included. There was an ongoing maintenance programme and a number of areas had been redecorated since the last key inspection. They had addressed the requirement made at the last key inspection. This means they listen to and act on what we say. They have introduced the `Choices` system. This means that every person living at the home regardless of their communication difficulties were encouraged to make choices about their day to day lives. What the care home could do better: During the recruitment process they take copies of documents to check a person`s identity. This could be further improved by signing and dating the copies to show that they originals have been seen. They could make the care plans more person centred. This means that the care plan reads as though it has been written by the person them self. Key inspection report Care homes for older people Name: Address: Oakland Care Centre (Moston) 130 Kenyon Lane Moston Manchester M40 9DH     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: Susan Jennings     Date: 0 1 0 9 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 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Oakland Care Centre (Moston) 130 Kenyon Lane Moston Manchester M40 9DH 01616825554 01616827775 oakland-moston@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Home Properties Limited care home 54 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: 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: 54. Date of last inspection Brief description of the care home Oakland Care Centre (Moston) is a large purpose built provision set in its own grounds and located in the North of the City. The home is owned by Southern Cross Health Care and is registered to offer accommodation to 54 older people. There are carparking facilities to the front and rear of the building and well maintained gardens with a seating area for residents and their visitors. There is a ramp to the homes main entrance and a passenger lift that enables access to all levels of the home. The home offers lounges and dining rooms on both floors. All bedrooms are for single use and have en-suite facilities. The home is equipped to meet the needs of those with mobility difficulties and who may require additional space. The charges for fees range from Care Homes for Older People Page 4 of 28 0 Over 65 54 Brief description of the care home £390.54 - £585.20 Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This visit was undertaken as part of a key inspection, which includes an analysis of any information received by us (the Care Quality Commission)in relation to this service prior to our visit. We also looked at other information we had about the service. Before our visit the manager was asked to complete an Annual Quality Assurance Assessment (AQAA) to provide up to date information. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. At this inspection an Expert by Experience (expert) was used. This means that an Care Homes for Older People Page 6 of 28 independent volunteer who has experience of receiving care and health services was used to provide a picture of the home and services from the viewpoint of the people living in the home. Comments from the report produced by the expert are, where appropriate, included within this report. The visit was unannounced and took place over the course of 7.5 hours on Tuesday 1st September 2009. During the course of the site visit we spent time talking to people living at the home, the manager, visitors and 3 members of staff to find out their views of the service. Time was spent examining maintenance records, peoples care plans and the staff files . We also spoke to people to ask them what they thought about the service they received. There was evidence to show that the unit managers and staff continued to work hard to develop and improve the service. Health and Safety checks take place to make sure people are kept safe and good records are kept of these. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? They have employed a new activity organiser. This means that when planning the activity programme peoples likes and dislikes will be discussed and included. There was an ongoing maintenance programme and a number of areas had been redecorated since the last key inspection. They had addressed the requirement made at the last key inspection. This means they listen to and act on what we say. They have introduced the Choices system. This means that every person living at the home regardless of their communication difficulties were encouraged to make choices about their day to day lives. Care Homes for Older People Page 8 of 28 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had their needs assessed before moving in and there was enough information available for them to make an informed decision about moving into the home. Evidence: They had a statement of purpose and a service user guide. The documents had been updated to give the details of the new manager. These gave people enough information about the home for them to make a decision about whether it was the right home for them. We saw that people had a pre-admission assessment before they moved into the home. This was to make sure that the home could meet peoples care needs. We also saw that where people had a care manager, copies of the care managers needs assessment were also on file. People who live at the home told us that they had received enough information before Care Homes for Older People Page 11 of 28 Evidence: they moved in. People are able to visit the home and look around, have a meal and view a room before making any decisions about their future. This was so that people could see what the home was like, speak to other people about the care and were familiar with the home if they decided to move in. This home did not provide an intermediate care service. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs were identified and met and each person had a written care plan. Evidence: We saw that each person living at the home had a written care plan in place. We looked at a sample of care plans and saw that they were up to date and detailed peoples physical care needs. We saw that care plans were not person centred and did not give details of peoples preferences about how they would like the care to be given. The manager told us that they are looking at reviewing the care plans to make them more person-centred. They told us that the new activities coordinator will be taking a life history from each person including details of their likes and dislikes. They will then incorporate this information into the care plans to give as much information as possible about the person, their likes, dislikes and preferences. This means that care plans will give staff as much information about the person as possible so that all aspects of their health and social care needs can be met. Care Homes for Older People Page 13 of 28 Evidence: We saw that people have their individual needs assessed and risk assessments were also in place where there is an identified need. We saw that each person is registered with a local GP. Health care records detailed when people had received GP visits medical treatment and any other support from health care professionals. Staff told us they receive and have access to peoples care plans and are involved in completing records. One staff member told us about their role as a key worker and said we fill up the daily reports every time we are on a shift. People who live at the home told us that they felt they had their care needs met and that there were always enough staff around to support them. This means that people are confident that their needs can be met. People told us they have access to their GP and receive their medication as prescribed. We looked at the medication systems. Medication administration records were completed correctly with no gaps in the records and standards for administration were maintained. We saw that medication was given out by the qualified nurse on duty. We saw that regular audits of the medication systems were carried out and any errors identified quickly and discussed with qualified staff. The expert spoke to people living at the home. One person told us that they were sometimes unable to reach the emergency call bell during the night. Staff should make sure that people are able to access the emergency call system at all times. This is to make sure that people have access to the support they need when they need it. The expert told us that one person looked unkempt, they were unshaven and wearing stained clothes. The manager explained that this person was generally self caring and reluctant to accept help. They told us that a relative visited as often as they could and offered support with personal care and grooming. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were offered a varied diet and were encouraged to make choices about their day-to-day activities. Evidence: During our visit the expert spoke with people living at the home about their daily routines. People told us they were happy with the support they received from the care staff. They also told us that staff generally listened to and acted on what they said. During the course of our visit the expert spoke to one person who had difficulty hearing what was said and the person did not appear to have a hearing aid. We looked at the persons care plan and saw that they had been seen by an audiologist but expressed a preference not to have a hearing aid. The care plan advised staff that they should speak clearly and appropriately so that the person could understand what they were saying. This is so that the person can understand what is being said to them. They told us that a new activities coordinator had recently joined the team. We spoke to the activities coordinator who told us that she is meeting people who live at the home and their relatives. This is so that she can develop an activities programme that Care Homes for Older People Page 15 of 28 Evidence: will meet the needs and preferences of people living at the home. The activity programme will give people the opportunity to join in some activities promoting conversation and improving peoples wellbeing. People told us that their family and friends are encouraged to visit and are made to feel welcome. The manager told us that they encourage family and friends to take part in discussions about improvements in the home. There was a relatives and friends committee in being and there was a meeting arranged for the evening of our visit. This means that people living at the home and their relatives and friends have a say in the day-to-day running of the home. The home has developed its menu to make sure peoples favourite meals are included. Tables were laid with items such as teapots and milk jugs, which support some people to serve themselves and others. People told us that they enjoyed the meals and mealtimes. One person told the expert the food is good and each morning I have a full cooked breakfast. We saw where one person had difficulty communicating their likes and dislikes. They were using a photographic card system called Choices to help communicate with the person. We saw pictures of various foods that the person liked were on a board with a thumbs up photograph. Foods the person disliked were on a board with a thumbs down photograph. These boards were laminated and held in the persons care plan and a copy was also kept in the kitchen. This system was also used for choosing clothing. This means that the person was able to make choices about their day-to-day activities. The expert had lunch with some of the people living at the home. They told us the meal was chicken, mashed potatoes or chips, sprouts and corn on the cob. This was followed by rice pudding and they told us that the meal was very nice and well presented. People are offered a choice of fruit drinks and also a cup of tea or coffee. The expert saw people tucking into their meal and enjoying it. The expert saw one person who was unable to feed them self and throughout the meal they were assisted by one of the carers. This was done in a sensitive manner so that the person could enjoy their meal at their own pace. The manager told us that peoples religious needs were identified and met. They told us that two nuns from the local convent visited people at the home to give them communion. They told us that the Church of England Minister visited regularly and if the need arose they would make arrangements for ministers of other faiths to visit the home. We spoke to people living at the home who told us they received communion Care Homes for Older People Page 16 of 28 Evidence: on a regular basis. This means that peoples spiritual and religious needs are being identified and met. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged to raise concerns and people are protected by the homes policies and procedures. Evidence: They had a written complaint procedure that was included in the service user guide. This gave people details of how to express concerns about the service. We spoke to people living at the home who told us that they would speak to the manager or a member of staff if they had any complaints. We saw that the home had comment cards for people to raise any concerns or complaints and people were aware these cards were available. They told us that they encourage complaints because they can be used to improve the service they provide. The manager told us that they operate an open door policy. This means that people living at the home, their relatives or representatives have access to the manager whenever they need to speak to him. People told us if they had a concern or complaint they would speak to the manager and felt that he would listen and act on what they told him. We saw that they keep a record of all complaints, there had been a number of complaints since the last key inspection in September 2007. The records included the nature of the complaint, the investigations and outcomes. Care Homes for Older People Page 18 of 28 Evidence: We saw that staff received training in the Protection of Vulnerable Adults. They had a copy of the Manchester Multi-Agency policy on the protection of vulnerable adults. We saw that they have corporate safeguarding policies and procedures. They told us that staff received training in how to recognise abuse and what action to take if an allegation is made. We spoke to staff at the home. One member of staff told us I would tell the manager if I saw anything if the manager was not here I would speak to the person in charge another member of staff told us the number for the contact centre is on the notice board. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean, pleasant and comfortable environment for people to live in. Evidence: The expert spent time with people in the lounges and dining areas. The expert commented that the home was completely free of foul odours and was well decorated and corridors were wide. We walked around the home and saw that the home was well maintained both inside and out. Decoration and furniture were of a good standard. This means that people living at the home have a comfortable and pleasant place to live. We spent time in the training room next to the designated smoking area and the smell of cigarette smoke was clearly detected. They told us that a number of the extractor fans were not working. They should make arrangements for the fans to be repaired or replaced as soon as possible so that people can enjoy a smoke free environment. The manager told us that re-decoration and re-refurbishment were ongoing and that day to day maintenance is carried out as and when required. We spoke to the maintenance person who told us that they decorate and carry out repairs as and when needed. The manager told us that where possible people are involved in choosing colours and wall coverings. This means that people are involved in the day-to-day Care Homes for Older People Page 20 of 28 Evidence: running of the home. The expert visited some people in their rooms. They told us that the rooms they saw were all nice and clean and again well decorated. There was a nice large garden attached to the home with seating provided and the expert spent time sitting in the garden along with some of the people living at the home and some of the staff. This means that people can choose to spend time in their bedrooms one of the lounges or the homes well maintained gardens. The expert told us that all in all it is a very nice home where people were happy and staff appeared to work well together. We saw that staff had access to protective clothing such as latex gloves and plastic aprons and that liquid soap and paper towels were used. This means that they are taking precautions to reduce the risks of cross infection. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes recruitment and selection practices protected people living at the home. Evidence: We saw a sample of staff files. We saw that these were well maintained and contained all the necessary checks including Nurses registration being checked with the Nursing and Midwifery Council (NMC). We saw that some application forms did not give a full employment history. Where there are gaps in employment these should be discussed and a record of the responses kept on the recruitment file. All staff have an enhanced Criminal Records Bureau (CRB) check and checks had been made against the Protection of Vulnerable Adults list (POVA). This means that staff employed to work in the home are safe to work with vulnerable people. The manager told us that regular staff supervision was provided and all staff completed an induction period. They told us that staff had been reallocated to work in other areas of the home. This is to make sure that the skill mix and experience of staff is linked to peoples needs. We saw that staff had a structured induction and there were copies of training Care Homes for Older People Page 22 of 28 Evidence: certificates on staff files. This showed us that staff received training and had the skills and knowledge required to meet peoples care needs. We spoke to staff. They told us that they had good access to training. We saw a training matrix that identified the training needs of staff. Staff have received training in safe working practices including, moving and handling, medication administration, safeguarding, first aid and basic food hygiene. The manager told us that further training in relation to infection control medication and dementia care was planned. This is to make sure staff are up to date with the latest training. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed in the best interests of the people living there and there are policies and procedures in place to protect peoples financial interests. Evidence: The manager has a number of years experience of running a care service for older people. Comments from staff about the management of the home included good and the manager is available to speak to at any time. The manager has showed a good understanding of the areas of weakness and how the service can improve. The manager has, in his short time at the home, held a number of meetings to consult with people living at the home staff and relatives and was in the process of familiarising himself with residents and their individual care plans. We saw that a health and safety policy was in place and risk assessments of the premises and safe working practices had been carried out. This was to ensure that people living at the home and staff had relevant information to enable them to live Care Homes for Older People Page 24 of 28 Evidence: and work in a safe environment. Information given in the Annual Quality Assurance Assessment AQAA showed that fixed Gas and Electricity appliances had been regularly maintained. They also carried out a periodic test of portable appliances and lifting equipment. These checks mean that the safety of people living at the home, staff and visitors was given priority. They ask relatives or representatives their opinion about the care people receive. We saw a sample of completed forms and they gave positive comments made about the home. This gives people who live at the home a chance to give their opinion about how well the home is doing and what they could do to improve further. The completed comment cards are sent to the organisations head office and the results discussed with the home manager. The manager is responsible for making sure that any issues raised are addressed. In addition the manager carried out regular audits of the homes systems. This included medication, care planning, regulation 37 reports, accident reports and complaints. This is done to make sure that records are up to date and accurate. We spoke to some of the staff who told us that they feel supported by the manager and the operations manager. They felt they could speak to the manager about any concerns they may have. As stated in the last inspection report Southern Cross have a national agreement in place with CQCs National Provider Relationship manager (NPR) with regard to managing peoples finances. They provided secure facilities for peoples valuables and receipts are kept for any transactions made on behalf of people living at the home. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 3 4 8 19 29 29 Staff should make sure that people are able to access the emergency call system at all times. They should repair or replace the extractor fans to make sure that people have a smoke free environment. It is recommended that that all photocopied documents are signed to indicate that the original had been seen. Where there are gaps in employment these should be discussed and a record of the responses kept on the recruitment file. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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