Care Home: St Catherine's Nursing Home

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What the care home does well The residents appeared well cared for. The residents and visitors interviewed gave positive feedback about the care and service provided. The following report from the expert by experience summarises the service and care provided by the management and staff working at St Catherine`s Nursing home. "The ground floor has a sitting/waiting area with a reception desk. This area has a fresh welcoming atmosphere about it and I was given a warm welcome, offered a hot drink, and asked if I would like to be shown round. There is also a cool water dispenser in this area with single use beakers available. Opening from this area is the spacious conservatory which is used as a lounge. Both these areas have been newly carpeted and furnished. There is also a dining room on this floor that is awaiting tables and dining chairs which will make mealtimes more of a social occasion. At the moment there is one table and other residents eat from individual bedside tables. The residents all looked clean and well cared for. The whole place has a homely atmosphere about it although it is rather `tired looking` in places. I was able to chat to quite a few people, including staff and a visitor. Most of the staff were observed to be enjoying their work and treated the residents with dignity. They explained what they were doing especially when using the hoists. They knocked on the bedroom doors before entering. The residents were observed to have `call bells` within reach when they are in their rooms. Some of the comments made by residents and visitors were: "I am well looked after here." "The girls are very kind and helpful." "I have just had a lovely shower and had my hair washed." "The staff are very friendly and come for a chat when they have a spare moment." "The food is very nice. We have a good cook." "We have a choice at lunchtime but if I don`t like it I can always ask for something different." One lady said "The meals are rather large and I can`t always manage to eat it all." Another "I am a bit worried about the weight I`m putting on." When asked if she had mentioned this to anyone she said "I didn`t think about it." When asked if he had enough choice one gentleman said "Nobody can choose what they want all the time. There has to be routine." He also said how grateful he was to be given lunch when he visited his wife each day. The sister of another lady also echoed this. She added "I don`t even have to pay!" The meals all looked appetising and when taken to the rooms had covers over them so they kept hot. The soup that I had was very acceptable. Although the activity co-ordinator had recently left some of the residents spoke of activities that they enjoy a sing-along, bingo, and music bingo among them. A hairdresser visits a couple of times a week for those that would like this service and a chiropodist visits regularly. One gentleman pops to the local shops as and when he wants and explained that the shopkeepers look out for him even offering him a chair so that he can catch his breath. The expert continued "I would like to thank the owner, the manager and the staff for making me welcome and to wish them well as they seek to make this place a real home for those who live here." What has improved since the last inspection? This section is not applicable as this is the first inspection since the change of provider. What the care home could do better: Since registration in May 2009, the new provider has completed the first phase of the refurbishment work to the ground floor to ensure that residents reside in a more comfortable and homely environment. A risk assessment was carried out prior to refurbishment work to ensure that residents are safe at all times. The new management continue to find ways of improving the care and the social environment for the benefit of the people living in the home. Under new management, a risk assessment is being carried out to ensure that residents who needed to be nursed on a profiling or nursing bed will be provided with one. Key inspection report Care homes for older people Name: Address: St Catherines Nursing Home Spring Road Letchworth Garden City Herts SG6 3PR     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: Yoke-Lan Jackson     Date: 0 2 1 1 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 25 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 25 Information about the care home Name of care home: Address: St Catherines Nursing Home Spring Road Letchworth Garden City Herts SG6 3PR Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Marion Mason Type of registration: Number of places registered: care home 39 Grovewell Estates Ltd Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home St. Catherines Nursing Home, provided by Grovewell Estates Ltd, is a residential care home for 39 people in the Old Age category, some of whom may have physical disabilities and require nursing. The building is a large extended house situated in a quiet residential area of Letchworth. There are parking facilities in front of the building. The ground floor comprises an entrance hall, a small waiting area/sitting room, a large conservatory/lounge with a dining area and a kitchen. Accommodation is provided on two floors with assisted bathroom and toilet facilities nearby. A passenger lift gives access to the first floor, which comprises a lounge/dining room, two shared bedrooms and sixteen single bedrooms. Care Homes for Older People Page 4 of 25 Over 65 39 0 Brief description of the care home The managers and administrative office and two staff rooms are on the second floor which is not accessible to residents. The home has an enclosed garden with seating. The external grounds are wheelchair-accessible. The home charges £400 - £675 per week. Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Guide. A copy of these and the most recent CQC inspection report are available in the home. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: St Catherines Nursing Home was inspected on 2/11/2009 for the first time since its registration following the change of provider on 18/05/2009. One of the two directors and the new home manager were present. There are 38 people in residence. The inspection included a tour of the premises and general observation of activities and the interaction of staff with residents. It also included lunchtime observation. Staff, residents and some visitors were spoken to and key documents were examined. The inspection ended with a thorough discussion with the management team. The inspection included a visit by an expert by experience. The expert from the organisation, Help the Aged, spent three hours in the home speaking to residents. An expert by experience is a person who, because of their shared experience of older people, contributes to providing a better picture of what it is like to live in or use a service such as St Catherines Nursing Home. The use of an expert by experience was Care Homes for Older People Page 6 of 25 arranged by us. The information and feedback received from the expert by experience are incorporated into this inspection report. Survey questionnaires were sent to the residents and relatives and their responses and other information received by us were reviewed. On this occasion, we have not requested that the service submit an Annual Quality and Assurance Assessment (AQAA) which providers of registered services are required to complete annually. The AQAA focuses on how the outcomes are being met for the people using the service and also provides us with statistical data. Care Homes for Older People Page 7 of 25 What the care home does well: The residents appeared well cared for. The residents and visitors interviewed gave positive feedback about the care and service provided. The following report from the expert by experience summarises the service and care provided by the management and staff working at St Catherines Nursing home. The ground floor has a sitting/waiting area with a reception desk. This area has a fresh welcoming atmosphere about it and I was given a warm welcome, offered a hot drink, and asked if I would like to be shown round. There is also a cool water dispenser in this area with single use beakers available. Opening from this area is the spacious conservatory which is used as a lounge. Both these areas have been newly carpeted and furnished. There is also a dining room on this floor that is awaiting tables and dining chairs which will make mealtimes more of a social occasion. At the moment there is one table and other residents eat from individual bedside tables. The residents all looked clean and well cared for. The whole place has a homely atmosphere about it although it is rather tired looking in places. I was able to chat to quite a few people, including staff and a visitor. Most of the staff were observed to be enjoying their work and treated the residents with dignity. They explained what they were doing especially when using the hoists. They knocked on the bedroom doors before entering. The residents were observed to have call bells within reach when they are in their rooms. Some of the comments made by residents and visitors were: I am well looked after here. The girls are very kind and helpful. I have just had a lovely shower and had my hair washed. The staff are very friendly and come for a chat when they have a spare moment. The food is very nice. We have a good cook. We have a choice at lunchtime but if I dont like it I can always ask for something different. One lady said The meals are rather large and I cant always manage to eat it all. Another I am a bit worried about the weight Im putting on. When asked if she had mentioned this to anyone she said I didnt think about it. When asked if he had enough choice one gentleman said Nobody can choose what they want all the time. There has to be routine. He also said how grateful he was to Care Homes for Older People Page 8 of 25 be given lunch when he visited his wife each day. The sister of another lady also echoed this. She added I dont even have to pay! The meals all looked appetising and when taken to the rooms had covers over them so they kept hot. The soup that I had was very acceptable. Although the activity co-ordinator had recently left some of the residents spoke of activities that they enjoy a sing-along, bingo, and music bingo among them. A hairdresser visits a couple of times a week for those that would like this service and a chiropodist visits regularly. One gentleman pops to the local shops as and when he wants and explained that the shopkeepers look out for him even offering him a chair so that he can catch his breath. The expert continued I would like to thank the owner, the manager and the staff for making me welcome and to wish them well as they seek to make this place a real home for those who live here. 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 Older People Page 9 of 25 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 25 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. Prospective residents can be assured that a comprehensive pre-admission assessment will be carried out before they are admitted to ensure that the home can meet all their care needs. They have the information they need to make an informed choice. Evidence: The service has a Statement of Purpose, a copy of which was submitted to us at registration. Each resident is given a Service User Guide on admission. The pre-admission documents for two new residents were examined and they were found to be detailed and informative. The assessment process was carried out by the home manager. The residents seemed settled in their new home. The home will only admit a prospective client whose care needs can be met. There is a trial period of six weeks before the contract is finalised. Care Homes for Older People Page 11 of 25 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. People who use the service can be assured that their healthcare and personal care needs will be positively met. They can be assured that their rights to privacy will be respected and that they will be protected by the homes medication policy and procedure. Evidence: Each resident has a written care plan which is not person-centred. The newly appointed home manager said that all care plans will be reviewed in the coming months and both nurses and care workers will be undergoing training on personcentred care planning. The nurses interviewed said that each care plan is reviewed monthly and any changing needs are reflected in the care plans. The care plans examined were detailed and reflected the nursing, personal and social care needs of the residents being cared for. A detailed care plan ensures that those who are looking after the residents have the required information to deliver the personal, social and healthcare needs of the people living in the home. Relevant risk assessments were seen in the care plans examined. Care Homes for Older People Page 12 of 25 Evidence: There are a high number of residents who require hoisting and the members of staff interviewed have the knowledge and skills to care for these residents. Both the nurses and care workers have had manual handling training. It was noted that one resident who was resting in bed seemed comfortable lying on an air mattress in a profiling bed. The nurse said that the resident has no pressure sores. However, there was a recent admission who was placed in a bedroom that has no profiling or nursing bed. The resident seemed comfortable resting in an armchair at the time of the visit. The home manager confirmed later that a nursing bed will be provided for this resident sometime during the day as one becomes available. The new home manager said that risk assessments will be carried out during the week and arrangements will be made to ensure that those who require a nursing bed will be provided with one. There is also a yearly review of care needs that involves the resident, their next of kin and the relevant social and healthcare professionals. Appropriate records are kept. Each resident is registered with a local general practitioner of their own choice. Residents have access to appropriate specialist professionals for advice and assistance, including medical, dental and chiropody services according to their healthcare needs. A trained nurse administers the medication. Medicines that are in use are securely stored in medication trolleys, one for each floor. All controlled drugs are stored in the controlled drug cupboard in the storage room on the ground floor by the nurses station. The medication administration record (MAR) charts were examined and they were found to be correctly filled in. No gaps were found. The deputy manager audits medication regularly to ensure that good practice in the administration of medication is well maintained and that medication errors are avoided. Care Homes for Older People Page 13 of 25 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 who use the service can be assured that they will be given the opportunity to make everyday choices and that their wishes and preferences will be respected. They will be encouraged to participate in social activities and to maintain links with their friends and families. A healthy diet will be promoted. Evidence: On the day of the site visit, the home was without a care co-ordinator who had resigned the same day. The home manager said that the vacant post will be advertised immediately. Meantime, care workers continue to assist residents with group activities and one-to-one attention. The daily routine in the home and the activities provided are flexible and varied to suit individual expectations and preferences. The manager said that a group activity will be organised later in the afternoon when the afternoon shift comes on. Group activities offered include outside entertainers, bingo, art and craft. Residents are offered a choice of menu which is reviewed regularly by the chef to ensure that the residents choices and preferences are taken into consideration. An expert by experience assisted with the inspection of the service and the following Care Homes for Older People Page 14 of 25 Evidence: comments were made. There is also a dining room on this floor that is awaiting tables and dining chairs which will make mealtimes more of a social occasion. At the moment there is one table and other residents eat from individual bedside tables. The expert noted that on the second floor The television was on, and rather loud, even though no one appeared to be watching it, so it was not conducive to conversation. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the home has a robust Complaints Policy and Procedure and can be assured that they will be listened to and any concerns raised will be investigated and appropriate action taken. Evidence: Residents and relatives are aware of the homes Complaints Policy and Procedure which is included in the Service User Guide. The management handles any issues raised promptly and positive changes are made for the benefit of the resident. The new provider held a relatives meeting and the feedback from the relatives about the service and care provided has been very positive. The home manager confirmed that all members of staff received training on safeguarding issues and the Whistle-Blowing Policy. The service follows the Hertfordshire County Council Joint Safeguarding Procedure. There has been no safeguarding referral made since registration. Care Homes for Older People Page 16 of 25 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 who use the service can be assured that they live in a safe environment and that the management is working towards making the place more comfortable and more homely to live in. Evidence: The premises appeared clean and tidy on the day of the site visit. The first stage of the refurbishment programme has been completed since registration. The entrance hall, the reception area, the dining room and all the corridors on the ground floor have been redecorated and new carpet laid. The conservatory where most of the residents spend their daytime appeared homely and comfortable with new carpet and furniture. A risk assessment was carried out prior to refurbishment work to ensure that residents are safe at all times. The residents bedrooms have been decorated as they become vacant. The residents interviewed said that they are quite satisfied with their bedrooms which have personal items on display to reflect their lifestyle. All equipment for the use of the residents, including hoists and slings and wheelchairs have been well maintained. Under the new management a risk assessment is being carried out to ensure that residents who need to be nursed on a profiling or nursing bed will be provided with one. More refurbishment work will be carried out in the Care Homes for Older People Page 17 of 25 Evidence: coming months. The manager said that a dining table and chairs have been purchased for the lounge on the first floor to make it into a lounge-diner. At the present time, residents have their lunch using individual bedside tables. The expert by experienced described the lounge as quite long and appeared rather dark. There are plans to refurbish this lounge and create a dining area at one end. Care Homes for Older People Page 18 of 25 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 who use the service can be assured that the new management will follow the homes recruitment policy and procedures when employing new staff to ensure people who use the service are safely cared for. They can be assured that staff will have the appropriate training to enable them to meet the care needs of people living in the home. Evidence: The home has an effective team of nurses, care workers and domestic workers. On the day of the site visit, a member of the nursing team was sick and the deputy manager later came on shift to help out. Members of staff are adjusting to the change in management since the change of provider. The care co-ordinator had resigned on the day of the site visit and the new manager said that the post will be advertised and assured us that the care workers will carry on with activities in the meantime. The number of care workers on the first floor has been reduced by one for the afternoon shift in recent weeks. Currently there are one nurse and three care workers per shift except for the first floor. The new management said that the care needs on the first floor was reviewed to ensure that residents are not affected by the reduced staff number. The director and manager assured us that the staffing level will be maintained according to the care needs of the residents. Care Homes for Older People Page 19 of 25 Evidence: The home follows the Skills for Care training programme. Staff interviewed confirmed that they have had training by an external organisation. Recent training covers Challenging Behaviour, Moving and Handling, the Mental Capacity Act, Health and Safety, Infection Control and Safeguarding. All new staff receive mandatory training within 6 weeks of commencement of employment. Members of staff interviewed confirmed that they have been vetted and that they commenced work only when the Criminal Record Bureau checks and the Protection of Vulnerable Adults (POVA) checks had been cleared. All staff records have been updated. In a recent survey by us, a resident commented, The staff are lovely, nothing is too much trouble for them. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be assured that the care and service provided will continue to improve under the new management and that their health, welfare and safety are promoted and protected. Evidence: This is the first key inspection under the new provider, Grovewell Estates Ltd. The service has appointed a new home manager in September 2009. The new manager is a trained nurse and has managing experience over the years of working in residential care homes. The home manager has yet to register with us. The management confirmed that the service has an annual quality assurance and monitoring system in place. This involves sending out survey questionnaires to all stakeholders. The first batch of survey forms have been sent out and the management said that stakeholders feedback will be taken seriously and appropriate changes will be made to improve the service further. Care Homes for Older People Page 21 of 25 Evidence: The directors held a meeting with all the relatives for the first time since taking over the service. They said that the relatives gave positive feedback about the staff, the service and the care provided. The management assured us that any issues raised by residents, relatives and other stakeholders will be taken seriously and acted upon to ensure residents are well cared for. In a recent survey by us, a respondent commented that the home is excellent and would recommend it to anybody. There is an effective system in place for managing monies for those people who are unable to do so themselves. The management ensures that all records required by regulation are well maintained and kept up to date and all records, including staff records and servicing records are kept secure and are used in accordance with the Data Protection Act 1998. Care Homes for Older People Page 22 of 25 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 23 of 25 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 24 It is recommended that a risk assessment be carried out to ensure that an adjustable bed is provided for any resident receiving nursing care. Care Homes for Older People Page 24 of 25 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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