Care Home: Rivermead

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What the care home does well Admissions were not made until a full assessment of needs had been carried out so that prospective residents and their representatives could be sure their needs would be met. The staff included residents and relatives in the care planning process if appropriate. The home provided care with a person centred approach, with the best interests of the residents being a central focus. Medication records were generally in order, contained the required entries and had been signed appropriately by staff. This home had a complaints policy, which was easily accessible to residents and visitors to the home. It detailed expected timescales for responses, and guidance for any complainant that remained dissatisfied with investigatory outcomes. Safeguarding was addressed with staff in this home through the induction process, and was also included in the mandatory training schedule. The home provided a clean, comfortable and safe home, which was well maintained, for the people who live here. Observations of staff and residents interactions indicated that there was a familial, relaxed and friendly atmosphere, and generally the staff were confident and competent in their roles. This service recognised the importance of training and delivered a robust training programme. The manager effectively ran the home and supported the staff team. What has improved since the last inspection? There were no requirements made at the last inspection but both the current and the previous manager worked to make improvements. For example liquidised meals looked more appealing as now the portions were not been mixed together. Staff had been made aware of the homes protection procedures, whistle blowing policy and the need to report allegations of abuse promptly, so that people living in the home were protected from the risk of abuse. What the care home could do better: The home should maintain and improve on the findings from this inspection. Some recommendations made include: Care must be taken that medications are carried forward at the end of the month to allow an easier method of auditing medication. Carpets that have been identified as needing to be replaced should be replaced as soon as possible andConsideration should be given to describing the menu to those people who are not able to read text. Key inspection report Care homes for older people Name: Address: Rivermead Halsey Road Kempston Bedfordshire MK42 8AU     The quality rating for this care home is:   three star excellent 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: Sally Snelson     Date: 0 7 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Rivermead Halsey Road Kempston Bedfordshire MK42 8AU 01234851573 01234843643 westfies@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: BUPA Care Homes (Bedfordshire) Ltd care home 33 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Rivermead is operated by BUPA Care Homes (Bedfordshire) Ltd. The service is registered to provide for older people who may also have dementia and/or physical disabilities. People living in the home at this inspection had some form of cognitive impairment. The home is situated a short distance from the local centre which has a group of shops, church and public houses. On same site as the home is a day centre that is used by some of the people living in the home. A health centre with dentist and chiropodist are located in an adjacent building. The premise had been was purpose built on two levels that were accessed by a shaft lift and staircases. The home is divided into three units that each have a combined lounge/dining area and kitchenette facilities. This division is more of an operational nature, as people loving in the home use the entire building, regardless of the unit where they are accommodated. Weekly Care Homes for Older People Page 4 of 27 0 0 0 Over 65 33 33 33 Brief description of the care home fees for accommodation were between £665.00 per week Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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: This inspection was carried out in accordance with the Care Quality Commissions (CQC) policy and methodologies, which requires review of the key standards for the provision of a care home for older people that takes account of residents views and information received about the service since the last inspection. Information from the home, through written evidence in the form of an Annual Quality Assurance Assessment (AQAA) has also been used to assess the outcomes within each standard. Evidence used and judgments made within the main body of the report include information from this visit. This inspection followed a random inspection earlier in the year and information from the random inspection is included within this report. The home manager Mr Peter Hodges was present for the majority of the visit and he and other staff members assisted with any required information. Verbal feedback was Care Homes for Older People Page 6 of 27 given periodically throughout the inspection and at the end of the visit. During the inspection the care of four people, including the most recent admission to the home, were case tracked. This involved reading their records and comparing what was documented to the care that was being provided. Documentation relating to: staff recruitment, training and supervision and medication administration, complaints, quality assurance and health and safety in the home were also examined. We also spent some time in the communal areas of the home, talking to the residents and observing the care practices and interventions that were carried out during this five and a half hour inspection. We would like to thank everyone involved for their support and assistance during this visit to the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The home should maintain and improve on the findings from this inspection. Some recommendations made include: Care must be taken that medications are carried forward at the end of the month to allow an easier method of auditing medication. Carpets that have been identified as needing to be replaced should be replaced as soon as possible and Care Homes for Older People Page 8 of 27 Consideration should be given to describing the menu to those people who are not able to read text. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each resident was provided with a Service User Guide that gave full details of the home, including information about what was provided. This meant that residents, and prospective residents, knew what they could expect from living at Rivermead. Evidence: A Statement of Purpose was available in the home. The document provided information on the staffing, accommodation and services available at the home including how to make a complaint. On admission each resident was given a Service Users Guide that gave them similar information in a simplier form. The documents had been reviewed within the last month and amended to include the recent changes in details for the Care Quality Commission (CQC). Residents surveys, and talking to visiting relatives, confirmed that people had been given sufficient information about the home prior to moving in. Where possible the manager encouraged prospective residents to visit before deciding to move in. The Care Homes for Older People Page 11 of 27 Evidence: contract gave people using the service an initial trail period. One visiting relative told us, I moved my mum here from another home and this is so much nicer for her. We looked at the care files of four people living at the home. All had the relevant preadmission assessment information. Information from other agencies had also been secured, for example, the assessment of the persons needs by a representative from Social Services. Information from all these assessments was used to formulate the initial care plans. All of the residents, despite how they were funded, had a contract. Intermediate care was not provided at the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care and support that the staff provided was flexible and altered as needs changed. On the whole medication practices were good and medication was administered by staff who were competent to handle, record and administer medication. Evidence: Each of the files that we viewed had a number of care plans. These plans covered all the areas of care provided, were written in detail and had been regularly reviewed. We noted that people had short term plans for care that would not be on-going, such as wound healing. Each care plan had any associated risk assessments and guides. For example if a person using the service needed help with eating and drinking there was clear instructions as to how this help should be given, plus a nutritional risk assessment and other assessments, such as tissue viability (prevention of pressure areas). The risk assessments also resulted in appropriate equipment being sought for people, such as pressure relieving mattresses and hoists. During the inspection we witnessed staff moving and handling people correctly. One of files for a person whose care we tracked showed how, despite a reluctance to eat and drink, community staff Care Homes for Older People Page 13 of 27 Evidence: had worked with the staff in the home to heal pressure sores. Staff reported a good relationship with the local GP surgery who would visit weekly and in between as necessary. The home also secured the support of other health professionals, such as a community specialist Parkinsons nurse. In June we had carried out a random inspection as the result of anonymous information we had received. We were told that residents did not have an adequate supply of incontinence pads. At that inspection the manager showed us the supply list for all the pads that were delivered and and told us that because of storage issues pads were stored centrally in an out-building and bought into the home on a needs basis. We were told that pads were changed regularly, and if a residents personal supply ran out, the home would order and pay for additional pads. We did not see any evidence of continence pads not being available. During this inspection we examined the Medication Administration Record (MAR) sheets for a sample of residents. The files were tidy and well completed with signature and the correct omission codes where necessary. All the medication dispensed in blister packs, and the medication prescribed on a regular basis and dispensed in boxes monthly reconciled correctly. However for some of the as required medication such as paracetamol, it was not always clear how many tablets had been carried forward from month to month, and therefore was sometimes difficult to reconcile. We discussed this matter with the manager and senior staff and it was apparent that this was a recent error as it had been happening in the past. We had no reason to suspect that people living at the home were not receiving the correct medication at the correct time. We observed a medication round. This was completed diligently and we noted that the carer spent time with each resident and interacted with them. We witnessed People in this home being treated with kindness and respect. A visitor said the staff are so kind to all the residents and they treat the visitors well as well. The care plans included information about a residents and/or a relatives wishes for end of life. These had been sensitively completed and one relative said, I understand why they have to ask those sort of questions. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were able to continue to have contact with those who were important to them. Meals were well well cooked and well balanced and staff were sensitive to the needs of people who found it difficult to eat unaided. Evidence: The manager was aware that recently there had not been as large a range of activities as he would have wanted because there was no designated staff member to coordinate the activities. On the day of the inspection a new person had joined the team to fulfill this role and was spending time getting to know the residents and their interests. Despite not having an activity co-ordnator in post ,on both visits to the home, staff had been encouraging people to participate in activities such as dominoes and board games. One visitor said, staff always seem to be doing something with or for my mum, it helps keep her alert. Between the random and the key inspection the home had undertaken a cruise, this involved parts of the home being decorated like a ship and different days being themed to different destinations. This had been successful and residents were keen to talk about it and repeat the experience. Care Homes for Older People Page 15 of 27 Evidence: It was apparent that staff supported the residents to maintain contact with families and friends and where appropriate involve them in their care. There were no restrictions on visiting within waking hours. One relative told us he visited every day and looked forward to seeing the staff. The home had recently made a family room, in which a resident could entertain in private. Visitors were welcomed to join their friend or relative for a meal. Information seen within the care records contained entries and information to show that residents continued to make decisions in their lives, examples included personal financial matters and the preferred gender of the staff member providing care. We started our inspection at 06.45 hours and it was apparent that people were able to get up as and when they wished. Once awake, either in the lounge or in their bedrooms they were offered a cup of tea. The home employed a full-time cook and catering assistants. Residents were offered a cooked breakfast every day. The home was divided into smaller residential areas and people could chose to stay in these areas or move around the home. People took their meals in the smaller areas. In addition to cooking breakfasts and the main meals, the kitchen staff prepared cakes for afternoon tea. One resident had a birthday on the day of the inspection and she had made a request for a Victoria Sandwich, which the cook had produced for her. The dining areas of the home were appropriately presented and menu were on tables and displayed throughout the home. We believed that some of the residents would benefit from picture menus. Staff were very attentive at mealtimes and provided support appropriately. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had an open cultured which allowed residents and their visitors to express their views and concerns in a safe environment. The staff team receive regular training in safeguarding and have policies that reflect the training. Evidence: The home had a complaints policy, which was easily accessible to residents and visitors to the home. It detailed expected timescales for responses, and guidance for any complainant that remained dissatisfied with investigatory outcomes. We viewed the complaints and compliment files. The home had not received any complaints since the previous inspection. There were however numerous cards of thanks. As already referred to we had received information that we looked into at a random inspection. Evidence from the random inspection has been included throughout this report in the appropriate areas. We did not uphold any of the concerns passed to us. The Safeguarding of Vulnerable Adults (SOVA) was addressed with staff through the induction process, and was also included in the mandatory training schedule. The training matrix indicated that all the staff had attended this training. The manager told us he was able to liaise with the safeguarding team and CQC when appropriate. The manager stated that at all staff meetings staff were reminded of the importance of reporting incidents and of the whistle blowing policy. Care Homes for Older People Page 17 of 27 Evidence: The training matrix also indicated to us that the Mental Capacity Act (MCA) and the Deprivation of Liberty (DOLS) were being addressed with staff through training. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rivermead provided an environment that was appropriate to the specific needs of the people who lived there. Evidence: There had been no major structural changes to the environment of the home. It was clean and tidy. An area, in which an offensive odour was identified at the random inspection was now odour free. A team of ancillary staff were responsible for the cleaning and the laundry. The manager had a plan of refurbishment and at both inspections we met the maintenance person who was working through the painting and decorating that needed to be undertaken. We were told that some of the care staff who were allocated to the smaller units took a pride in their unit and had decorated some of the areas and had chosen colour schemes and curtains with the residents. These actions had been recognised by the company as part of their personal best awards scheme. This home had single bedrooms, all of which were decorated individually to meet with each persons preferences. The residents could identify their rooms both by door numbers and memory boxes containing photographs and pictures which were significant to them. The rooms were furnished with personal assets, ornaments and photographs that reflect the lifestyle and personal history of each resident. Care Homes for Older People Page 19 of 27 Evidence: A random inspection was instigated following an anonymous informant who told us that often bedrooms in the home did not have hot running water. We were told which rooms to look at in particular, and also which residents to speak to about their concerns. We asked the manager to show us how water temperatures were checked and we were shown a monthly audit that randomly checked different areas of the home. The areas mentioned had been part of the random checks and it was clear that no problems had been identified at these. We went to the areas concerned and probed the water coming from the tap. It was being delivered at 41.8 degrees which was considered acceptable. We spoke to a resident who confirmed that at times he and staff had to wait for the water to run hot, but he was able to confirm that he had never been expected to use cooler or cold water, and the wait did not unduly bother him. We also spoke to the maintenance person who was responsible for the water checks and for regulating the water temperatures. He was familiar with the recommended temperatures and how these needed to be maintained. We were also advised by our informant that it was practice in the home for shampoos and other personal toiletries to be stored in communal bathrooms. This could be dangerous to those people with dementia who may try to ingest them. We had a full tour of the building and did not see any evidence of poor storage. We repeated our tour at this inspection and found the same outcomes so we continued to believe that people had access to hot water when they wanted it and were not unduly exposed to any harmful chemicals. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Training files showed that all staff received training that was focused on delivering improved outcomes for the residents. Staff had been appropriately appointed and inducted into their roles. Evidence: The usual staffing levels during the day in this home were seven care staff and the manager, supported by cleaning, maintenance and kitchen staff. At night there were three carers on duty. We examined the personal files of three members of staff. All contained fully completed application forms, appropriate references, induction checklists and training records and certificates. Criminal Record Bureau (CRB) checks had been carried out on all staff, and home office paperwork was present where required. All staff had contracts of employment and training records. The staff that we spoke to during this visit was confident and competent in their roles, and were able to talk in depth about individual residents needs and the care that they required. Training records indicated that staff attended a variety of mandatory and specialist training, which the manager ensured was kept updated. The manager was in the process of arranging some dementia training from a dementia consultant for the staff at Rivermead and also for other BUPA staff in the area. The AQAA told us that Care Homes for Older People Page 21 of 27 Evidence: over 60 of staff had achieved NVQ certificates in care at varying levels, and that others were enrolled on the training. All staff undertook a period of induction. Observations of staff and residents interactions indicated that there was a familial, relaxed and friendly atmosphere in this home. The staff were committed to the home and the residents and we saw evidence of staff giving their own time to decorating areas of the home and one staff member who undertook to produce a monthly newsletter for the home. The company celebrated staffs commitment by awarding personal best awards. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager had a clear understanding of the key principles of care. He had a person centered approach which resulted in effective outcomes for people using the service. The AQAA was accurately completed and demonstrated a clear vision of planned improvements Evidence: Peter Hodges had taken over from a previous manager who had been deemed an excellent manager. He had maintained these standards and staff were committed to working with him to continue to make improvements in the home. We received five completed staff surveys (100 ) in advance of our inspection. All were very positive and two commented that they would be happy to place a relative of their own in the home. Three spoke of recent improvements and recognised the need to continually monitor review and plan. The manager told us that he believed the low level of complaints to or about the home Care Homes for Older People Page 23 of 27 Evidence: was because he, or his deputy, made themselves available to staff visitors and residents and acted promptly on any identified concerns. The home had methods to continually audit the quality of the care they provided, including questionnaires, formal and informal opportunities for staff and residents to raise concerns including staff and resident/ relative meetings and monthly visits by the operational manager following which a report was written. The home would keep pocket money on behalf of residents, but also encouraged people who could to keep money available for trips out to the local shops. Any money held by the home was in line with the BUPA policy and receipts were available for incomes and expenditures. We addressed the supervision records for three members of staff, all were receiving regular structured supervision. Health and Safety information provided by the home showed contracts with approved contractors were in place for the maintenance and servicing of equipment. The most recent inspection undertaken by Environmental Health had awarded three stars. Other areas of health and safety were noted to meet all the standards at this and the previous random inspection. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Staff should ensure that any unused medication is either disposed of or a record is kept of what is carried forward to the next month. Some residents may benefit from the introduction of picture menus on the tables and displayed in the home. Carpets that have been identified as in need of replacing should be replaced as soon as possible. 2 3 15 19 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!