Care Home: Roman House

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What the care home does well The home provides a good service to residents who are consulted about their needs by a staff group who all receive regular training and supervision from a new but committed management team who are committed to improve the service currently provided. What has improved since the last inspection? Since the last inspection general standards had slipped as reported in our Annual Service Review (ASR) in March 2009. However under the new manager previous issues of concern as detailed in the main body of this report, have or are being addressed. The registration of a new manager is almost complete. The carpeting in the main communal area has been replaced and a plan is in hand to redecorate all of the communal areas. What the care home could do better: Whilst there are no requirements or recommendations made, the managers action plan to bring the home back to its previous excellent state should be accelerated. Areas that require attention, include redecoration of all of the communal areas, improving details in the care plans and ensuring all plans and menus are available in a format that all residents can understand. Key inspection report Care homes for adults (18-65 years) Name: Address: Roman House Winklebury Way Basingstoke Hampshire RG23 8BJ     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: Peter McNeillie     Date: 0 7 0 4 2 0 1 0 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 Adults (18-65 years) Page 2 of 29 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 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 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Roman House Winklebury Way Basingstoke Hampshire RG23 8BJ 01256328329 01256328340 laura.christian@scope.org.uk www.scope.org.uk SCOPE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users to be accomodated is 26 The registered person may provide the following catergory of service only: Care Home only -(PC) to service users of the following gender :Either Whose primary care needs on admission to the home are within the following category: Physical disability (PD) Date of last inspection Brief description of the care home Roman House is a care home owned and managed by Scope, a national disability charity. The service provides accommodation, care and support for up to twenty six adults with cerebral palsy and associated disabilities. The service is set in its own large grounds which are situated in a residential area in the North Hampshire town of Basingstoke within close proximity to local amenities, the town centre, public transport,and a major a leisure facility. The home consists of the main building, which Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 26 Brief description of the care home provides accommodation for eighteen residents and two bungalows housing four residents each. On site parking is available in the front of the property. Care Homes for Adults (18-65 years) Page 5 of 29 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: This report was written after taking into consideration a number of sources of information and evidence including a site visit, previous reports, examining resident and staff records, talking with residents , staff, management,visiting health care professionals and responses to a pre inspection CQC satisfaction survey by residents and staff. Additional information was provided by the Manager in her responses in the homes pre inspection Annual Quality Assurance Assessment. (A.Q.A.A.) During this inspection which took place on 07/04/2010 between the hours of 9.00am and 3.15pm all of the designated key standards for younger adults were inspected. As a result of this visit no requirements or recommendations have been made. Care Homes for Adults (18-65 years) Page 6 of 29 The results and findings contained in this report will determine the frequency and type of future inspections. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? 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 Adults (18-65 years) Page 8 of 29 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 9 of 29 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. The home has a well-developed system of assessing and identifying residents needs which ensures residents safety and assessed needs can be met. Evidence: There have been no admissions since the last inspection at which time we reported No one is admitted to the home without a care needs assessment to ensure the home can meet their care needs. It was confirmed by the manager during this visit and in the AQAA, admissions would be carried out in accordance with an admissions policy that requires visiting the prospective resident in their own home or current placement and the prospective resident visiting the service. During these visits assessment of residents needs and risks would be carried out overseen by the manager or a member of senior staff. External health and social care professionals family members and if appropriate independent advocates also contribute to the assessment which is reviewed on a regular basis. Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: As no admissions have taken place since we last visited we see no reason to change our previous judgment. Care Homes for Adults (18-65 years) Page 11 of 29 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. There is a clear and consistent care planning system in place, which ensures residents needs are met within a risk management policy that involves residents in decisions that affect them. Evidence: As part of our inspection plan, we viewed a sample of three residents care plans. chosen at random. All of the care plans looked at had been reviewed at least monthly and were based on pre admission and ongoing assessments which identified what help, support and personal care individuals needed whilst taking into consideration their wishes, choices aspirations and any attendant risks. (The previous section of this report; standards 16 refers). In discussion with the manager we highlighted ,whilst the care plans seen met the current standards, they could be improved with the inclusion of more detail in some Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: sections and the format in which they were available. An example of this is, the section that covered the residents previous history which would be improved with the inclusion of the names of people important to the resident i.e. brother or sister which were not always available. However some sections were very detailed e.g. how to get the resident up in the morning and assist them to get ready for their day. Currently all plans are only produces in a written format. Standard 6.7 requires the care plan is Available in a language and format the resident can understand. The manager acknowledged this deficit and gave a verbal undertaking as part of her personal action plan she would review the manner in which care plans were produced. Any action taken would be in addition to a new project which is about to start. This involves an individual copy of the care plan being downloaded onto a memory stick which would then be then updated by the resident with assistance from their key worker. This would also have the advantage of an up to date copy of the care plan always being available if the resident had to leave the home for any length of time i.e. a hospital admission. Staff who had a good understanding of the contents of the care plans and risk assessments was able to explain to us how the care plans were put into day-to-day practise. All of the residents spoken with confirmed they were very satisfied with the care and support they received. They advised us they were contented, liked the staff and management were treated with respect, that their individual privacy was respected and that staff always knock on their bedroom door and wait before entering. When asked what the home did well, responses included: Regular visits during hospital stays,Good support when choosing new personal equipment.Good in house activities. When asked what the home could do better the following responses were received:Nothing, Have more space, More sensory equipment,Build more bungalows,More day trips. The home takes issues of equality and diversity seriously. In their AQAA the manager told us, they operate a robust opportunities policy designed to achieving equality for persons with disabilities. This is done by: Treating all persons including residents and Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: staff with respect and dignity irrespective of their race, gender, ability, sexual orientation age, or cultural beliefs, mandatory staff training, monitoring staffs attitude and language, reserving posts for disabled candidates, and providing additional training to target and challenge poor practise and barriers that effect the services ability to respond to individual needs and aspirations. Care Homes for Adults (18-65 years) Page 14 of 29 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. The social activities, family contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: All decision that affects individuals takes into consideration their choices, wishes, aspirations and independence. To assist with this an activities programme organised by activity organisers both in the home and in the community was available. Residents expressed how important the activities were and how much they enjoyed them in particular accessing the local community. All confirmed that participation was up to the individual and no one was forced to join in. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: Currently the in house activities programme include life skills training, sensory room crafts, computers,gardening and any other activity residents request. Community activities include, shopping, restaurants, church, social clubs, theatres, cinemas. In addition two residents attend a local disability forum, one is in paid employment, one in voluntary employment and two attending local college courses. Through out the home there were photographs and photo collages of events that had taken place such as birthdays and Christmas etc. As a number of the residents have mobility problems access to community based facilities is frequently made using the home adapted unmarked vehicles. Monthly Residents meetings where any matters that affect living in or the running of the home are discussed. These could include an individuals conduct to other residents, food, staff and staff attitudes, group activities, and arrangements for special times of the year such as Christmas. No subject is taboo as long as all of the residents agree. Residents and the homes staff informed us visitors were encouraged and were welcome at any time and can be entertained in a private family room if the resident does not wish to use their own accommodation. The quality, quantity, presentation and choice of food including special diets served came in for particular praise from the residents. A written daily menu based on residents likes and dislikes was displayed. We highlighted to the manager who agreed with our observations, for the need to ensure that the menu was displayed in format that all residents would understand. This is of prime importance for persons who have difficulty in understanding text and would be beneficial to understanding the daily menu and when making meaningful choices on what they wished to eat. The manager gave us a verbal undertaking she would as a matter of urgency ensure that in future menus were available in a format that all residents could understand. Care Homes for Adults (18-65 years) Page 16 of 29 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. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. Evidence: The AQAA informed us the great majority of residents require assistance with washing, dressing and personal care. Staff informed this would always be delivered in private in a manner that respected the individuals dignity, gender and wishes, this was confirmed by residents. Residents informed us were able to see the doctor of their choice or any other health and social care professional when they needed to. The records viewed indicated that in addition to doctors, district nurses, physiotherapists, occupational therapists, dieticians and the local community disability team, other specialists would be consulted as required. Records were kept of appointments with GPs, dentist, optician, chiropodist and any other external health and social care professional and included details of any advice Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: and treatment given. Since the last inspection we had been informed under regulation 37 notifications of errors made when administering residents medication. The manager informed us that all staff responsible for the administration of medication had received training and if an error arose when administering medication the staff concerned would be suspended from medication tasks until their training and knowledge had been reviewed. All drugs are which securely stored are administered, recorded and disposed of by trained staff in accordance with an in house and corporate medication policy and procedure. Currently residents living in the bungalows have their medication stored in secure locked individual facilities. The manager informed us she was evaluating the possibility of all residents medication being stored in a similar fashion. This would further reduce the possibility of medication errors in the future. Records of administration and disposal of unwanted drugs and medicines viewed were complete and accurate. A policy and procedure is in place that allows residents to assume responsibility for their own medication. Currently one resident was self-medicating following a risk assessment. Care Homes for Adults (18-65 years) Page 18 of 29 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. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse. Evidence: The complaints procedure, which is also included in the service users guide included information on how to contact The Care Quality Commission (CQC) was seen, as was the record of complaints. No complaints have been received by CQC since the last inspection however there has recently been concerns raised regarding a residents equipment and moving and handling by a residents relative. These matters are currently being dealt with under the Hampshire County Council safeguarding protocol. All members of staff spoken with of stated they felt confident in discussing any concerns, complaints with management either in house or external on behalf of any resident and were confident any issues raised would be dealt with promptly and fairly. The homes corporate adult protection policy was available and is designed to work in tandem with the multi agency procedure circulated by Hampshire County Council which is based on National Guidelines,the document No Secrets and is designed to safeguard residents from abuse. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: Records viewed,management and staff spoken with confirmed they had all received training in recognising various types of abuse and were able to demonstrate they knew the procedure to follow should they witness or suspect the abuse of any resident. Care Homes for Adults (18-65 years) Page 20 of 29 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. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. Evidence: The home which comprises a large purpose built two storey building and two bungalows is situated in a residential area close to Basingstoke town centre. There is easy access to public transport, local shops and other community facilities such as a large sports centre, cinemas and a shopping centre. All areas of the home were clean and free from unpleasant odors and obvious hazards. Residents told us the home was always clean and smells fresh and had improved a lot lately. Furniture was comfortable, homely and in a good state of repair in keeping with the decor and met residents individual and collective needs. In the week prior to our visit a new carpet had been laid throughout the main corridor, the first of many improvements the manager informed us she had budgeted to make including decoration all of the ground floor public areas including the many doors that were showing considerable damage following collisions with wheelchairs. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: In the main corridor a fire door had received damage that might have impaired its integrity to keep out smoke. The manager gave us a verbal undertaking she would contact the local fire safety officer. We have since been informed The Hampshire Fire and Rescue Service have arranged to undertake a full fire safety audit on the home. All communal areas were accessible by residents including the well-tended established and safe garden. Residents in their responses to our satisfaction survey commented how satisfied they were with the accommodation (especially those in the bungalows) apart from the fact they were to small. An infection control policy and procedure was in place as were disposal aprons, gloves, antiseptic hand soap and a washing machine fitted with a high temperature and sluice programmed. On site parking is available on the front of the property. Care Homes for Adults (18-65 years) Page 22 of 29 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. Residents needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. Evidence: At the time of our visit staff numbers and their deployment was sufficient to meet the residents needs. This view was confirmed by residents who told us there was always staff available when they needed them. The manager informed us that a review of the current staffing structure had just been completed and was likely to produce a new way of working that would increase staff time available with individual residents In the AQAA the manager informed us that all staff had been recruited in accordance with a robust equal opportunities recruitment and selection policy and procedure. To test this statement and as part of our inspection plan we viewed a sample of three staff files chosen at random. All files viewed confirmed the above statement that staff were employed in a manner designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) and reference checks. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Following their appointment, records seen confirmed that all staff are subject to a Skills for Care induction and a training programme that include first aid, handling medication, food handling, moving and handling, safeguarding and infection control much of which is overseen by Salisbury College. All staff training needs are assessed at regular one to one supervision sessions. Following completion of their induction programme, all staff are expected to undertake a National Vocational Qualification N .V. Q.) Course. Information provided in the AQAA indicated that 50 of care staff had been trained to at least NVQ level two with a further 10 about to commence a course. Care Homes for Adults (18-65 years) Page 24 of 29 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. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. Evidence: Since our last visit,we had been informed there had been a management change. The current managers application for registration is currently being processed by CQC. In talking with the manager it was clear to us she has a clear vision for the future of the home and has developed an action plan for ongoing improvement. Having worked in the home prior to becoming manager she is aware of previous issues around medication, safeguarding and staff training and the general decline in standards as described in our annual service review in March 2009 and has a taken steps to address these concerns. Residents confirmed the home was getting better. Comments made by residents confirmed they can speak to the manager and all care staff at any time and they are always willing to listen and give them time. This view was also echoed by the staff who described the manager as available and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: approachable. Staff told us that there was a clearly defined management structure and that the operate an open door policy, and encouraged them to share any concerns or ideas they have for the betterment of the service. It was also evident the staff team were aware of there responsibilities, worked within clear lines of accountability and guidelines and recognized and promoted the ability of the individual residents not the disability. As part of the homes quality monitoring system, residents, residents representatives and health and social care professionals staff and social care professionals are invited to participate in satisfaction surveys in line with comments made following the last inspection. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future development of this service. Records viewed confirmed a health and safety policy was in place as were records of weekly health and safety checks, the servicing of equipment, staff training in the techniques of moving and handling, first aid, health and safety, the procedures to follow in the event of fire (including evacuation) and accidents. We were informed that the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all hot pipes and where appropriate radiators were covered to protect residents from burning. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 Care Homes for Adults (18-65 years) Page 28 of 29 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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