Care Home: Palm Lodge

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What the care home does well "I think the home is very well managed and overall I am very happy here" was the comment of one person who lives in the home, whilst one of the health and social care professionals who contacted us said; "The home provides good support and encouragement" (to the people who live there). The care outcomes achieved are generally good and the home has adapted well to the admission of two new people, who have indicated to us that they have integrated well into the home. The standard of care planning and risk assessments seen was good and included ample evidence of the involvement of a range of professionals with the care of people living in the home. More importantly, the people living in the home are fully involved in the care planning and review process themselves. The staff team under the manager and responsible individual are very experienced mental health care workers and the home provides a stable and safe environment in which care can be provided. What has improved since the last inspection? Palm Lodge is still a relatively new service and has done well to maintain the standards recorded at its first inspections as the level of occupancy has increased. It is understood that the manager has made it clear to people who live in the home that they are able to personalise their own rooms without unreasonable restrictions. (This was a requirement made following the last inspection). The standard of recruitment documentation has been improved since the last inspection and this improved standard needs to be maintained in order to continue to protect people living in the home from the employment of unsuitable people. What the care home could do better: Palm Lodge is a separately registered care service with the CQC and has its own manager who has been registered with the CQC as a fit person to manage that home. Palm Lodge is closely allied to another registered service, managed by the responsible individual for Palm Lodge and whilst there are some obvious benefits to the close working relationship and systems in place between the two homes, it is significant that anyone asked during this inspection process wrongly identified the responsible individual as the manager of Palm Lodge. This includes people who live in the home as well as health and social care professionals associated with it. This situation is not helped when the responsible individual completes the AQAA and describes himself as the manager. It is important that the roles of manager and responsible individual do not become blurred and indistinct to people either living in the home or who have dealings with it and active steps must be taken to address this. The overwhelming balance of comments received about Palm Lodge was very positive, recognising the good care outcomes achieved for people who live there. There was however some concern raised, following the inspection visit, about the need to offer even more practical encouragement to people who may have lived in residential care for some time to enable them to gain the confidence they need to move on to more independent living settings and to have access to a more varied and stimulating range of daytime activities. This does not detract from other positive comments made and indeed in their AQAA the home state under `what we could do better` "We would encourage service users to discus new changing needs and new goals in our 1 to 1 meetings to be incorporated in their individual care plans". In the summary of their comments in the AQAA they state; "We are continually going to support our residents to improve so that they can move to more independent living." This realistic and positive approach is welcome and suggests that Palm Lodge can continue to achieve good care outcomes for the people who currently live there and others who may move into the home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Palm Lodge Palm Lodge 59 Kings Road London Colney Hertfordshire AL2 1ES     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jeffrey Orange     Date: 0 9 0 9 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Palm Lodge Palm Lodge 59 Kings Road London Colney Hertfordshire AL2 1ES 07759402987 Telephone number: Fax number: Email address: Provider web address: bowmanslodge@btconnect.com Name of registered provider(s): Type of registration: Number of places registered: Bowmans Lodge Limited care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 past or present alcohol dependence past or present drug dependence learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Palm Lodge is a privately owned and run care home, registered to provide care and accommodation for up to five adults between the age of 18 -65 who have had a past drug or alcohol dependency and /or have a learning disability or a mental health disorder. The home aims to offer a supportive environment, to enable service users to gain or regain skills and to recover the confidence necessary for them to be able to move on Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 0 0 0 5 5 5 5 Brief description of the care home and live even more independently within the community. The home is situated in a residential area of London Colney, with accommodation over two floors, including communal areas and office/sleep-in provision for staff. The home has a rear garden which is accessible to service users. There is limited parking available to the front of the home with additional on street parking subject to availability. There are good local public transport links and local shops and the home is also close to a large retail park. The home has a statement of purpose and service user guide, which includes contact details for the Care Quality Commission (CQC) and copies of the latest inspection report by the CQC are available in the home. Current fees are in the range £700-£823 per week. Care Homes for Adults (18-65 years) 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last key inspection of Palm Lodge took place in September 2007, in September 2008 we conducted an annual service review, which was based upon any information received about the home in the intervening period including the homes annual quality assurance assessment or AQAA. (The AQAA is a self assessment document that assesses how well care outcomes are being achieved for the people who live in Palm Lodge and also includes some useful statistical information for example about staff training and complaints) This inspection was unannounced and began early in the morning in order to give us an opportunity to speak to people living in the home before they left for any daytime activities. The inspection was carried out by one inspector, where the report refers to we it Care Homes for Adults (18-65 years) Page 6 of 28 recognises that it is written on behalf of the Care Quality Commission (CQC). We were able to talk to people living in the home and to the homes management team. Following the inspection visit we were able to talk to some of the health and social care professionals associated with people living in the home. We also sent surveys to people living in the home, to care staff and to health and social care professionals. Where these have been returned to us, they are used and taken into account in drawing up this report. Whilst at the home we took the opportunity to look at some key records including those for care planning, medication, staff recruitment and staff training. The home also provided us with their new AQAA (see above) and this has also been used to inform the report. What the care home does well: What has improved since the last inspection? What they could do better: Palm Lodge is a separately registered care service with the CQC and has its own manager who has been registered with the CQC as a fit person to manage that home. Palm Lodge is closely allied to another registered service, managed by the responsible individual for Palm Lodge and whilst there are some obvious benefits to the close working relationship and systems in place between the two homes, it is significant that anyone asked during this inspection process wrongly identified the responsible individual as the manager of Palm Lodge. This includes people who live in the home as well as health and social care professionals associated with it. This situation is not helped when the responsible individual completes the AQAA and describes himself as the manager. It is important that the roles of manager and responsible individual do not become blurred and indistinct to people either living in the home or who have dealings with it and active steps must be taken to address this. The overwhelming balance of comments received about Palm Lodge was very positive, recognising the good care outcomes achieved for people who live there. There was however some concern raised, following the inspection visit, about the need to offer even more practical encouragement to people who may have lived in residential care Care Homes for Adults (18-65 years) Page 8 of 28 for some time to enable them to gain the confidence they need to move on to more independent living settings and to have access to a more varied and stimulating range of daytime activities. This does not detract from other positive comments made and indeed in their AQAA the home state under what we could do better We would encourage service users to discus new changing needs and new goals in our 1 to 1 meetings to be incorporated in their individual care plans. In the summary of their comments in the AQAA they state; We are continually going to support our residents to improve so that they can move to more independent living. This realistic and positive approach is welcome and suggests that Palm Lodge can continue to achieve good care outcomes for the people who currently live there and others who may move into the home. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering Palm Lodge as their home can be assured that they will only be admitted once their needs have been fully assessed and are able to be met. They can be certain that they will have an opportunity to visit the home and meet the people and staff who already live or work there so that they can decide if they think they will be happy there. Evidence: When we received surveys from people who live in the home, they all told us that they thought they had enough information about it before hand so that they could decide if it was the right place for them. When we spoke to one of the people who has recently moved into Palm Lodge and asked them about the experience they told us that it had been very positive and that they were satisfied with the process of assessment. They also confirmed that they had been able to visit the home in order to meet the people who were already living there so that they could judge if they would get on. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: When we looked at the pre-admission documentation for the person who has most recently moved into Palm Lodge we found that it was thorough and comprehensive and included input from a range of health and social care professionals who had been part of the process. When talking to the manager she indicated that the home has on some occasions decided not to admit someone referred to them because they did not feel that they would fit in with the existing group of people living in the home. It was agreed with the manager and the responsible individual that the information sent to people about Palm Lodge would be updated as soon as possible to include the new contact details for the Care Quality Commission. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Palm Lodge can be confident that they will be involved in decisions about their lives and care and that this will include consideration and management of any identified risks. Evidence: When we received surveys from three of the people currently living in Palm Lodge they agreed that they were involved in decisions about what they do each day and that they are able to do what they want during the day, the evening and at weekends. When we talked to people who live in the home they told us that they felt able to discuss issues with the manager and confirmed that they were broadly able to do what they want to. Some of the people we spoke to indicated that they would like to move into more independent living settings and it is expected that the manager and staff will support this process actively, in line with commitments made during the inspection. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: The home provides support and encouragement was the assessment of one health and social care professional who returned a survey to us. When we looked at the homes care plan documentation we found that each person living in Palm Lodge has a care plan that they have agreed and that this is subject to review and updating with their contribution and agreement. The care plan includes details of risk assessments, annual review under the Care programme approach (CPA) involving health and social care professionals involved in the care of the people concerned. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Palm Lodge can be assured that they will be able to develop interests, build relationships and life skills and pursue leisure activities both in the home and community. Evidence: I think the home is very well managed and overall I am happy here was the assessment of one person living in Palm Lodge. One person was involved with countryside management on the day of the inspection and when we talked to others people who live in the home and saw their care plans, we found evidence of a range of different activities throughout the week. When we looked at the pattern of daytime activities and compared them over the period of several years, we found that they were quite conservative and consistent. Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: This however appears to be what the people concerned want or are at least comfortable with. We spoke to two people living in the home who expressed an intention and desire to move into more independent accommodation and in one case this was thought to be relatively imminent. This would be a positive step and is one that the manager and her staff should be, and indicate in their AQAA and in conversations during the inspection that they are, encouraging and supporting. This is because it fulfils the role of services such as Palm Lodge to develop,support and encourage the building of life skills for people living there to the point where they can consider moving on to more independent living settings. The people living in Palm Lodge were seen to be able to access and make use of community services quite independently. This has included day centres and spending weekends away from the home with family and friends. We saw photographs of a recent barbecue that had taken place in the homes garden and included relatives of people living in the two associated homes. People living in the home are involved in shopping and menus or choices of what food they prepare. It is clearly important that in order to have the capacity to live more independently, people living in Palm Lodge should be specifically encouraged to manage food, medication and money so that they will have the life skills necessary to make this a realistic possibility. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Palm Lodge can be confident that they will be encouraged and supported to maintain their health, including compliance with their medication and building the capacity to self-medicate to the greatest possible extent that can be safely achieved. They can also be confident that they will have access to the community health care services they need. Evidence: When we spoke to or surveyed health and social care professionals about the standard of care received by the people in the home they are involved with, they were generally very supportive and positive. When we looked at medication records and practice, including that for encouraging and supporting self-medication, we found that changes had been made in order to remedy shortcomings identified in a jointly managed associated service and that therefore at the time of this inspection these were satisfactory in respect of Palm Lodge. Ways of improving the carrying forward of medication records from one period to the next were discussed in order to make it easier for totals to be monitored, audited and agreed. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: Care plans included a good level of risk assessment and documentation to support varying degrees and levels of self-medication. When we looked at care plans, and in particular at the process of reviews, we found that there was substantial evidence of the involvement in this process of not only the person living in the home, but also their health and social care professional support workers. We observed that people are prompted and enabled to maintain a good standard of personal hygiene where this may have been an issue for them in the past. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Palm Lodge can be confident that they are protected from abuse and that they have the capacity and opportunity to raise any concerns or complaints they may have either within the home or outside of it. Evidence: All of the people living in the home who returned surveys to us told us that they knew how to make a complaint. Policies, procedures and planned training schedules for care staff that we saw, should, provided they are adhered to, ensure that the identification and reporting of any abuse is prompt and appropriate in th event that it takes place or is suspected. We were able to talk to three of the people living in the home and they were each well capable of making any concerns they might have known and are all involved quite independently outside of the home with people with whom they could share any concerns they might have. The CQC have not received any complaints about Palm Lodge since the last key inspection and are not aware of any incidents or safeguarding matters which might raise concerns about the safety or well-being of people living there. It is understood that key staff have received training on the Mental Capacity Act and Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: are therefore able to ensure its provisions are followed when and if they apply to anyone living in the home. People living in the home retain full control over their own finances although the manager may help with budgeting if requested to do so. When we looked at staff recruitment practice in the home, we found that the necessary checks are carried out to protect people living in the home from the appointment of unsuitable people to provide them support or care. Care Homes for Adults (18-65 years) Page 20 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, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Palm Lodge provides a safe, clean, homely and comfortable environment for the people who live there. Evidence: When we looked around the home during the inspection we found that it was clean, tidy and was essentially homely, not institutional and met the needs of the people who live there. We spoke to people living in the home whilst they were sitting in the garden having a smoke under a loggia that has been provided for them. People who live in the home told us that they took some responsibility for the cleaning of the home and routine household tasks. This is important if they are to build and retain some of the basic skills required if they were to move to a more independent setting. Care Homes for Adults (18-65 years) 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, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Palm Lodge can be confident that they are supported by a staff team who have the skills required to do so safely and appropriately and that the recruitment of new care staff is done in a way that protects their safety and wellbeing. Evidence: When we spoke to people who live in Palm Lodge and when they returned surveys to us, they said that they were always treated well by care staff and that care staff always listen to and act on what they say. When we spoke to or received survey responses from social and health care professionals associated with the home, they were in general very positive about the quality of staff and the support provided. In answer to the question what does the home do well? one health care professional said; Provides support, provides encouragement, monitors mental state of people living there, ensures the home is maintained at a high standard and encourages socialisation. When care staff returned surveys to us they told us; The home is well managed and the residents are well cared for and The manager runs the home very well and I receive the support and help I ned to carry out my duties Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Care staff also told us that they had been subject to a rigorous recruitment process and that they receive training and supervision support to ensure their skills are maintained and developed. Issues around training records had recently been raised at the inspection of an associated home, which shares a number of care staff with Palm Lodge. These had been addressed and satisfactory basic training records were seen which will, if fully carried out, ensure care staff receive the training they require to provide care in line with current best practice. When we looked at the recruitment file for the most recently recruited member of care staff we found that it included the checks and documentation required in order to protect people living in the home from the employment of unsuitable people. The majority of care staff work part time and are also employed in other mental health care settings, where they also receive relevant training and supervision. We saw some evidence of joint staff meetings between the two associated homes and also some supervision records and annual appraisals. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although people living in Palm Lodge experience good care outcomes and can be confident the home is well-managed, there is considerable potential for confusion as to the respective roles of the registered manager and responsible individual which is neither helpful nor desirable. Evidence: When we spoke to health care professionals about the home and talked to people living in the home, they all identified the responsible individual as the homes manager. It was the responsible individual who completed the AQAA and identified himself in that as the homes manager. The AQAA also says in one place; The home has two qualified managers. This is not factually correct as only one person is registered as manager of Palm Lodge. Whilst the most important thing is that the home is well-managed, which it is, this confusion in practice as to who is in day to day control of the home and is ultimately responsible to the CQC for how it is run remains, as has been noted before, unsatisfactory and could cause confusion as to roles and responsibilities. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: I think the home is very well managed is the comment of one person who lives in the home and this was borne out by the standard of records seen and the good standard of care outcomes achieved for the people who live in Palm Lodge. Possible improvements to medication records and issues raised at the associated home in respect of staff training records and team meeting records were discussed very openly and positively. When we looked at care plans, we found a good standard of risk assessment and care plan reviews indicated that the health, safety and well-being of the people living in Palm Lodge is of paramount importance to the way the home is operated. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 20 The way that medication is recorded when being carried forward from one recording period to the next should be reviewed and improved to make it easier for accurate monitoring and auditing of medication to be accomplished. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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