Care Home: Saxilby House Residential Care Home

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What the care home does well Saxilby House provides a pleasant and homely environment for people to live in. There are good assessments and care plans in place to make sure that people`s needs are identified and met in the way they want them to be. Staff were seen to treat people with respect and the member of staff spoken to had a good understanding of people`s needs and they were observed helping people to be as independent as they could be. There are good systems in place to make sure that staff are recruited safely and staff are being given opportunities to access training to help them carry out their roles. Leadership in the home is generally good and staff feel they are supported by the acting manager. People told us they feel safe living here and feel confident to raise any issues with the manager. People told us that they are satisfied with the care they receive at the home, one person told us he `loves it here`. What has improved since the last inspection? At the last inspection we said that care plans must be in more detail to ensure that people`s needs are met and show how people are helped to make decisions about their lives. We also said that people`s privacy and dignity must be met at all times and we found that action has been taken to address these requirements. Staff have received training about the new laws around decision making and about privacy and dignity. People living at the home told us they felt they received the right care and support and said `it`s the next best thing to home here` and ` I`m quite happy, I like to stay in my room, I have everything I need in here`. We also said that people should have opportunities to take part in activities and leisure interests of their choice and we found that the manager is addressing this requirement. She is currently writing life histories about people to make sure the activity programme will take into account individual interests and she is advertising for the position of activity co-ordinator. We said that staff must have sufficient knowledge about safeguarding adults and how to report any concerns and we found that three staff have completed training in this subject and a date has been arranged for the rest of the staff to complete it. We also said that there must be sufficient staff on duty at all times to meet people`s needs and found that this has been addressed and rotas showed appropriate cover throughout the day and night. We recommended that regular meetings should be held to enable people to have their say about the running of the home and the manager told us that she has found individual discussions work better and records are being kept of these discussions. What the care home could do better: The acting manager must submit her application for registration to us as soon as all the relevant documents have been received. People should be given the opportunity to read and sign their risk assessments showing their agreement. Key inspection report Care homes for older people Name: Address: Saxilby House Residential Care Home Highfield Road Saxilby Lincoln Lincolnshire LN1 2QP     The quality rating for this care home is:   one star adequate 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: Elisabeth Pinder     Date: 2 0 0 1 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 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: Saxilby House Residential Care Home Highfield Road Saxilby Lincoln Lincolnshire LN1 2QP 01522704025 01522704025 triskelion@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Colin Roy Hayes care home 10 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: The Home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Old Age, not falling within any other category (OP) - 10 Physical disability (PD) - 1 Dementia - Over 65 years of age (DE(E) -2 The maximum number of service users to be accommodated is 10 Date of last inspection Brief description of the care home Saxilby House cares for older people in a family environment in a detached property situated in the village of Saxilby. The home is approximately six miles from the historic city of Lincoln. Facilities include a post office, pubs, shops, a chemist and a village hall. The home is a two-storey converted farmhouse standing in its own grounds and gardens with car parking facilities to the rear. There is a stair lift to the bedrooms on Care Homes for Older People Page 4 of 27 Over 65 2 10 0 0 0 1 Brief description of the care home the first floor and there are adaptations and aids around the building to allow residents to move around the home more independently. All of the bedrooms are single. There are five communal toilets and two communal bathrooms. On the day of our visit eight people were living in the home. The current scale of charges at this home is from GBP360.00 to GBP427.00. Additional costs are made for hairdressing, chiropody, transport to personal appointments other than hospital or doctors and personal toiletries. These are all private arrangements and costs are met by the individual. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means that people who use the service receive adequate quality outcomes. This was an unannounced visit and it formed part of a key inspection. It focused on key standards which have the potential to affect the health, safety and welfare of people who use the service. The visit lasted approximately five hours and took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since our last visit. After our last visit the provider was asked to send us an improvement plan detailing the action he was taking to meet the requirements given during the key inspection in September 2009. Other information considered was taken from the Annual Quality Assurance Care Homes for Older People Page 6 of 27 Assessment (AQAA) completed by the acting manager in June 2009. This told us about their own assessment of how well they feel they are meeting standards and their plans to improve aspects of the service. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of people through their care records and assessing their care. We spoke to people who use the service, one members of staff, the acting manager and one visitor. We did not request questionnaires from people using the service or staff as these had been completed in September 2009. 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 acting manager must submit her application for registration to us as soon as all Care Homes for Older People Page 8 of 27 the relevant documents have been received. People should be given the opportunity to read and sign their risk assessments showing their agreement. 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. People are assured that their needs can be met due to a clear introduction and assessment process. Evidence: Information sent to us in June 2009 told us that people have access to a range of information about the service including the current fee rates and they are able to visit the home and spend time there before making a decision about moving in. A copy of the report dated August 2008 was available in the home and the manager informed us that she had not yet received the final version of our last report from September 2009. Since the last inspection no one had been admitted into the home but we looked at the documents which would be used to assess peoples needs prior to their admission. These showed that all aspects of care would be considered and details would be recorded to give staff information about how the person wanted their care to be delivered, including how they are able to make decisions and choices and the action needed if they are not able. Care Homes for Older People Page 11 of 27 Evidence: One person told us they had lived in the home for a number of years and loves it here. However, another person told us he wanted to move to another home and the manager agreed to contact the persons social worker and request a visit. The service does not cater for people with intermediate care needs. 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 health and personal care needs of people are being met in a safe and respectful way. Evidence: During the previous inspection two requirements had been given, one that care plans must be in more detail to make sure peoples needs are met and take into consideration the Mental Capacity Act. Second, the privacy and dignity of people living in the home must be respected at all times. We looked at three care plans and these showed that improvements have been made. Care plans gave clear information for staff to follow, they were signed and dated by the individual where able and made reference to the new laws about how people make decisions. Clear risk assessments had been written for things such as mobility, smoking, alcohol and health risks such as diabetes and records were being kept of visits by healthcare professionals such as district nurses and community psychiatric nurses. However, some assessments had only been signed by the manager and when this was discussed the manager agreed to talk with people and offer the opportunity to sign showing their agreement. During our previous visit the manager had told us she had received a training pack from Care Homes for Older People Page 13 of 27 Evidence: Lincolnshire County Council which includes a CD and workbook and she was planning to make sure all staff worked through this programme. On the day of our visit this has not been actioned, however, we have since received information that this training was completed on 23rd and 25th January 2010. During our visit staff were seen to respect the privacy and dignity of people they were caring for and were observed wearing gloves and aprons when necessary. Since our last visit a male carer has been employed and a discussion was held with regards to asking people about their preference of a male or female carer and documenting this in their care records and the manager agreed to do this. We spoke to five people living at the home and one relative and they were all satisfied with the care and support they were receiving. They told us its the next best thing to home here and Im quite happy, I like to stay in my room, I have everything I need in here. Another person told us it was her birthday and she was having a birthday cake made and was going to watch a movie that had been a present. The relative spoken to told us that she sometimes felt there was not enough staff on duty but said she is always able to discuss things with the manager. She said she is usually informed of changes in her mothers care but had not been informed of a recent illness, however, she was satisfied that the right action had been taken and did not wish to pursue this. Staff told us that medication is only given by designated staff who have completed relevant training and we looked at records verifying this. Staff told us they have information about the side effects of medicines and have a good relationship with GPs (General Practitioners) and district nurses. Records of when people receive their medication were up to date. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The limited range of social and cultural opportunites may not meet individuals needs. Meals provided are well balanced and take into account personal preferences and dietary requirements. Evidence: A requirement was given during the previous inspection that appropriate activities and leisure opportunities must be provided to meet individual needs. During this visit people told us that some activities had begun, they had enjoyed fireworks on bonfire night and records showed movie nights, arts and crafts and nail and beauty days. The manager told us she has started the process to recruit an activity co-ordinator and she is currently writing life histories about people to make sure the activity programme will take into account indivdual interests. One person told us he is able to go out when he wants on his scooter, another person said they liked to go to the pub each day after their lunch and another person told us she enjoys doing puzzles with a staff member. The manager told us that she has tried to have a resident meeting but feels individual discussions work better and records are being kept of these discussions. People told us they receive regular visitors and that they are always welcomed into the home and Care Homes for Older People Page 15 of 27 Evidence: offered a drink. However, not everyone has visitors and the manager told us she is currently arranging advocacy for people. People told us that the food is very good, the cook has been working in the home for many years and has a good understanding of peoples likes and dislikes. Menus showed that a varied, nutritious diet is offered and we saw people being asked what they wanted for lunch. 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. There are satisfactory policies and procedures in place to make sure that staff know what to do to keep people safe and protected. Evidence: During the previous inspection a requirement had been given that all staff must have sufficient knowledge about safeguarding adults and how to report any concerns to prevent people from being placed at risk of harm or abuse. We looked at training records and spoke to the manager and one carer and found that action has begun to address this. Three staff have undertaken training in protection of vulnerable adults and another four staff are due to do this late January. The carer spoken to had a good understanding of what abuse is and her responsibilities to report any concerns. We spoke to four people living at the home who all told us that they feel safe living here and they felt confident to raise any issues with the manager. The home has a copy of the Local Authority guidance on safeguarding adults and we know from our records that since our last inspection there has not been any alerts made to the Local Authority Safeguarding Adults Team Care Homes for Older People Page 17 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. People live in a well-maintained, clean, comfortable and homely environment. Evidence: During our visit one concern was raised about the stair lift in the home and when this was discussed with the manager we were told that it has recently been serviced and is working safely, however, the controls on the arms have been altered and people are no longer able to use this independently. The manager told us she is currently waiting for a quote to install a new one. People told us they were happy with their rooms, they were kept clean and people had been able to personalise them as they wished with pictures, photographs and ornaments. One person showed us their room and we saw that they had their own kettle to make a hot drink as required and was able to smoke in the room. We looked at their records and these showed that assessments had been written identifying the risks associated with these and the action needed to minimise the risk. Jugs of water or juice and baskets of sweets and fruit were available in the lounge and emergency call bells were within reach. Since our last visit the home had been visited by Lincolnshire County Council who carried out a health and safety audit and the manager told us that no issues were Care Homes for Older People Page 18 of 27 Evidence: raised. We were also told that an action plan is in place for infection control and the manager is developing an action plan for redecoration and refurbishment of the home. The service received a 5 star award for food safety from the Environmental Health Officer in January 2009. Staff were observed wearing protective aprons and gloves where needed. Care Homes for Older People Page 19 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. People are protected by robust recruitment procedures and adequate staffing levels. Training has begun to make sure people are cared for by well trained staff. Evidence: During the previous inspection two requirements had been given, one that there must be sufficient staff on duty at all times and the second, that all staff must be trained to ensure the needs of people living at the home are met. On the day of our visit there were eight people living at the home and we looked at staffing rotas for the month of January and saw that two staff were on duty at all times. However, the managers hours continue to show that on numerous occasions she is on the rota to work from 3pm until 7am the following morning. She told us that she is planning to cover some of these shifts using existing staff who want to work additional hours. The rota shows that there is one wakeful night staff and another person on call. This is usually covered by the manager or her partner who live on the premises but on occasions it is covered by a staff member living in the village who can be in the home within five to ten minutes. The carer spoken with told us she felt that there were usually enough staff on duty to meet peoples needs and she was able to complete tasks without rushing. People told us that staff were usually available, although there are times when they have to wait for assistance. However, they said that staff always check whether it is an emergency Care Homes for Older People Page 20 of 27 Evidence: and always come to them as soon as possible. One new member of staff has been employed since our last visit and their records were looked at and showed that an application form, criminal record bureau check, identification and written references had been obtained. Records also showed that induction training had commenced based on nationally recognised standards. As already highlighted action has begun to meet the requirement given regarding staff training. Some staff have completed safeguarding adults training and a seminar on diabetes. All staff have received training from Lincolnshire County Council regarding the new laws around helping people with decision making and the manager has obtained a copy of the Code of Practice for this legislation. Over 50 of staff hold a nationally recognised care qualification and the manager told us she is arranging further training to a higher level. Fire training records showed that staff have not received any fire training or drills since 2008 and the manager confirmed that she is contacting their fire training officer to arrange training and also review and update their fire risk assessment. The two staff files looked at did not show that staff had first aid training and this was also discussed with the manager who agreed to look into this. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This service is generally being managed in the best interests of the people living at the home. Some systems are in place to obtain the views of people the service supports but people are not always clear about them or who is in charge of the home. Evidence: During the previous visit the timescale for two requirements had been extended as they had been met in part and one additional requirement had been made. Please refer to the requirement section of this report. During this visit we found that action has been taken to address all three requirements although none had been completely met. The manager told us that she is currently waiting for her criminal record bureau check to be returned, she has obtained all the other relevant information required for registration with us and will be submitting these as soon as possible. During our visit no concerns were raised about the manager, people told us they liked Care Homes for Older People Page 22 of 27 Evidence: her and felt she was caring, always around and spoke with them everyday. Staff told us they felt the manager was supportive to them and they could raise any issues with her. During the previous inspection an incident occurred relating to privacy and dignity and the manager told us that the provider has addressed this issue through supervision and training. Concerns were raised by one person regarding the ownership of the home and this was brought to the attention of the manager who agreed to discuss this with the providers representative. Since our last visit staff supervision has commenced, however, no arrangements have been put in place for supervising staff where there may be a conflict of interest, for example, where staff may be related or connected to the manager. The manager told us that she has regular discussions with a representative for the provider but these are not recorded to show she receives regular formal supervision. A staff meeting was held on the 3rd January 2010 and topics of discussion included a key worker system, training and health and safety. A representative for the provider had visited the home once a month to monitor and evaluate how the home is running and reports were available of their findings. However, these did not indicate the overall outcomes for people. The manager told us that quality assurance questionnaires are ready to be sent out to people living at the home and their relatives. She is currently writing questionnaires for GPs (general practitioners), district nurses and social workers and once all of these have been sent out and returned a report will be written detailing peoples views about the care and support people receive. The AQAA told us that there are a range of policies and procedures and the majority of these had been reviewed and updated in July 2008. We were also told of equipment maintenance and service date. Health and safety audits are carried out by an external company and their certificate of compliance was on display. The manager told us that no money or valuables are currently held for anyone living at the home. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 12 16 Appropriate activities and leisure opportunities for residents to participate in must be provided to meet individual needs. This requirement has been met in part, a further timescale is given for compliance. The provider must appoint a manager who must register with the Commission. All staff must be appropriately supervised to ensure they have the necessary skills to care for residents. This requirement has been met in part, a further timescale is given for compliance. 01/11/2009 2 31 8 01/11/2009 3 36 18 01/11/2009 Care Homes for Older People Page 24 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 1 12 16 Approprate activities and leisure opportunities must be provided. To meet individual needs. This requirement has been met in part, a further timescale is give for full compliance. 31/03/2010 2 31 8 The provider must appoint a manager who must register with the Commission This requirement has been met in part, a further timescale is given for full compliance. 31/03/2010 3 36 18 All staff must be appropriately supervised. To ensure they have the necessary skills to care for residents. This requirement has been met in part, a further 31/03/2010 Care Homes for Older People Page 25 of 27 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 timescale is given for full compliance. 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 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. 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