Care Home: St Dominic`s Nursing Home

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What the care home does well There is a detailed and informative Statement of Purpose and Service Users Guide that gives prospective residents the information required to enable them to make an informed choice about where they live. Some residents were able to confirm that they were visited by the someone prior to admission to the home and said they were involved in the admission process. The menus evidence a well thought out balanced diet with a varied choice of food in line with resident`s preferences. comments received included, ` good choice of food`, `Lovely`. Quality assurance systems are in place which enables the service to monitor and improve their service and ensure that the home is run in the best interests of residents. There is an open-house policy which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard resident`s finances. Staff provision is well maintained with a robust recruitment practice being followed and appropriate numbers of suitably qualified staff working in the home. The atmosphere of the home is pleasant with good interaction seen between residents and staff. The Comments received from visitors and families regarding the care received included:`I like it here, the staff are very nice`. Comments from residents regarding life in the home were generally positive and included: ` My room is fine`, ` comfortable and clean` `Look after us well`. What has improved since the last inspection? The care documentation has been improved and demonstrates that a full needs assessment is undertaken and provides a clear person centred plan of action for staff to follow to meet the individual care needs. This will ensure that residents needs are met in a clear, safe and consistent manner. The residents now benefit from a programme of activities that meets their social and recreational interests and needs. What the care home could do better: The care plans and risk assessments have been improved, however there are areas that do still need to be developed to ensure staff are kept informed of the changing needs of the residents. The staffing levels need to be reviewed regularly to ensure that the residents needs are met. The call bell system in the home needs to be reviewed with robust risk assessments to ensure that they are accessible and suitable for the residents living in the home. This will ensure that the residents safety and well being is promoted. The management team are committed to improving the service and the improvements seen were in conjunction with the action plan received by the CQC. Verbal and written reports from other health care professionals confirmed that the shortfalls identified have been actioned satisfactorily. Key inspection report Care homes for older people Name: Address: St Dominic`s Nursing Home 71 Filsham Road St Leonards On Sea East Sussex TN38 0PG     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: Deborah Calveley     Date: 2 1 0 6 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 26 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) © 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 Older People Page 3 of 26 Information about the care home Name of care home: Address: St Dominic`s Nursing Home 71 Filsham Road St Leonards On Sea East Sussex TN38 0PG 01424-436140 01424460767 stdominics@asterhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): St Dominic`s Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 91 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 maximum number of service users to be accommodated is 91. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Physical disability (PD) Dementia (DE). Date of last inspection Brief description of the care home St. Dominics Care Home is a large property in a residential area of St. Leonards-OnSea. It is registered to provide personal and nursing care for up to ninety-one older people, including those with physical disabilities and dementia. Care Homes for Older People Page 4 of 26 Over 65 0 91 0 91 0 91 1 5 0 9 2 0 0 9 Brief description of the care home The home is arranged over four floors. A large passenger lift enables access to all floors. The residents accommodation is currently arranged over the upper three floors and each floor has its own lounge. Many of the rooms have lovely views, either towards the sea or over the surrounding countryside. Outside there are parking facilities to the front of the home and a large garden to the rear. There are plans to landscape the gardens so as to improve access for the more physically frail people who use the service. Fees are based on the assessed needs of the prospective resident. The fees do not include items such as hairdressing, newspapers and telephones in the rooms of residents. The range of fees is available on request. Further information in respect of fees can be obtained from the home on request. Care Homes for Older People Page 5 of 26 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at St Dominics will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over 5 hours on the 21 June 2010. There were 40 residents living in the home on the day of which six were case tracked and spoken with. During the visit ten other residents, both male and female were also spoken with. Care Homes for Older People Page 6 of 26 The purpose of the inspection was to inspect all key standards and talk to the people who use the service. A range of documentation was viewed including the Service Users Guide, Statement of Purpose, care plans medication records and recruitment files. Four members of care staff, two registered nurses and the cook were spoken with in addition to discussion with the appointed manager and the Head of Care. Telephone contact was made with visiting professionals following the visit and three relatives were spoken with during the inspection visit. The information received verbally has been incorporated into this report. An Annual Quality Assurance Assessment (AQAA) was received completed competently and in full prior in December 2009. The information received in the AQAA was measured against the information gathered on the site visit. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: The care plans and risk assessments have been improved, however there are areas that do still need to be developed to ensure staff are kept informed of the changing needs of the residents. The staffing levels need to be reviewed regularly to ensure that the residents needs are met. The call bell system in the home needs to be reviewed with robust risk assessments to Care Homes for Older People Page 8 of 26 ensure that they are accessible and suitable for the residents living in the home. This will ensure that the residents safety and well being is promoted. The management team are committed to improving the service and the improvements seen were in conjunction with the action plan received by the CQC. Verbal and written reports from other health care professionals confirmed that the shortfalls identified have been actioned satisfactorily. 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 26 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 26 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. The home provides prospective residents and relatives with a good level of information about the home its facilities services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission however little information is documented thus not evidencing their needs can be met Evidence: There is a comprehensive Statement of Purpose and Service Users Guide which contains clear information about the home the facilities and the services it provides. These are given to prospective residents and a copy is available from the reception and also in the residents bedrooms. These documents give prospective residents and their families the information they Care Homes for Older People Page 11 of 26 Evidence: need to make an informed choice about where to live. The documents have been updated since the last key inspection. It was confirmed whilst talking to four residents that the contract arrangements were clear and understood. A review of the care documentation confirmed that pre-admission assessments are completed by the appointed manager or senior nurse. The format of the pre-admission document was seen to be relevant however more information could be recorded, which will inform the inspection process and ensure that the home can meet the identified needs. The prospective residents are seen either in their home or hospital before admission and it was confirmed that wherever possible the family or representatives are involved. One visitor confirmed that they were involved in the whole admission process. The appointed manager was able to verbally demonstrate his knowledge and awareness of the different needs of the residents that live in the home. He has ensured that all staff employed have attended the relevant courses to deal with the needs of the elderly and those with a dementia type illness. Trial visits to the home can be arranged. It was confirmed that residents are invited to a trial period to ensure suitability of the home. This is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Intermediate or rehabilitative care is not provided at St Dominics Care Home. Care Homes for Older People Page 12 of 26 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. Comprehensive care plans are needed to enable staff to meet the assessed needs of residents in a structured and consistent manner. Residents are protected by the homes medication policies and procedures. They are treated with respect and dignity. Evidence: The care documentation pertaining to eight residents were reviewed as part of the inspection process. These residents were also visited and spoken with. The standard of the care documentation was found to be improved and evidenced that a lot of work has been undertaken since the last key inspection. The management team is auditing the care plans and the shortfalls identified during the site visit were acknowledged and it was confirmed that work is on-going to ensure a person centred approach. The home use risk assessment tools for various health and safety needs and these did evidence monthly review but not all were correct in relation to moving and handling Care Homes for Older People Page 13 of 26 Evidence: needs and nutrition. New forms are currently being introduced and will address the shortfalls identified. The staff spoken with demonstrated an understanding of the individual residents they care for and questions that arose from reviewing the care documentation were answered with insight and from knowing the resident well. Relatives and residents spoken with were satisfied with the care provided at the home, comments received included: Very caring and helpful, They try very hard . There are policies and procedures in place for staff to refer to regarding the safe administration, storage disposal and recording of medication. The systems for recording and checking controlled drugs were found to be thorough. Medication Administration Charts were found to be in the main competently completed. The medication round observed demonstrated that staff were aware of the homes policies and residents are protected by safe medication practices. All the trained staff at the home have received medication training as a result of a safeguarding investigation that highlighted poor practice in November 2009. The management team also audit the medication administration charts on a daily basis to monitor practice and identify any irregularities. Staff were seen to be respectful and considerate to all residents and visitors whilst attending to their needs. Each of the residents were addressed by their preferred term and dressed appropriately in well-laundered clothing and their personal appearance was attended to in a manner that maintained their dignity. Care Homes for Older People Page 14 of 26 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. The lifestyle and meals experienced by residents at this time meets their expectations, choices and preferences. Evidence: The care documentation evidenced some residents past histories and social preferences which are linked to an activity programme. Work is in progress to complete these profiles on all of the people who live in St Dominics. The home have recently employed two activity co-ordinators that work monday through to friday. The mornings are dedicated to one to one sessions with the less able and the afternooons are group sessions which include arts and crafts, cinema, bingo and gentle exercise. Visiting entertainers are invited to the home at certain times of the year and the residents spoken with stated that they enjoyed these sessions. The appointed manager shared his vision for the new sensory garden and specific themes for the residents who have a dementia type illness. At present there is a gap in the activities for those who are less able and the introduction of these will improve the outcomes for the residents. Care Homes for Older People Page 15 of 26 Evidence: The home have a selection of lounges throughout the home and some residents were seen to be quite isolated during the morning, with no company and very little supervision. This is impacted on by staffing levels and residents individual needs and is assessed under the staffing outcomes. It was confirmed by staff that the residents are encouraged to attend facilities away from the home these include shopping trips church services and visits out with their families. It was not clear from documentation how often these take place. From talking to 10 residents and two visitors, it is found that at this time that the lifestyle experienced in the home matches their expectations and preferences and meets their interests and needs. Residents are facilitated to maintain their independence for as long as they are able. There are no restrictions on visiting times as long as consideration is shown to all the residents. Many of the residents have individualised their bedroom with items from home. Residents and relatives spoken with confirmed that they are encouraged to make it homely. It was observed during the inspection that the routines and the flexibility of the daily routines at the home are impacted on negatively by the staffing levels. This was acknowledged and extra staff are to be brought in with immediate effect. The home has an advocacy policy in place and the information regarding this is available to all residents. There are various dining areas throughout the home and some residents eat from small tables from their chairs in lounge areas and their bedrooms. The staff were seen to assist residents with their meal in a discreet and supportive manner. The menus demonstrated that there is a varied and nutritious menu in place which changes seasonally. The meals provided for residents were seen to be nutritious and attractively presented including the pureed meal. However it was noted that staff mix up the pureed food whilst assisting residents to eat, which is not considered good practice. Fresh fruit and vegetables are readily available. The residents comments included, The food is very nice, Good and plenty of it, Not bad but could be hotter. The staff keep fluid/food and stool charts in residents bedrooms, however not all were up to date and correctly completed which then gives an inaccurate picture of their nutritional status. The home staff use a nutritional assessment tool to identify any residents with special dietary needs. Monthly weights are recorded and weight loss/gain is monitored effectively. As previously mentioned an action plan needs to be in place for those whom have been identified as at nutritional risk. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. Evidence: The complaint policy and procedure is clear and uncomplicated and a copy of this is readily available in the home and the Service Users Guide. A system of recording complaints was demonstrated during the site visit and these were seen to have been managed in line with the homes policies and procedures. Residents spoken with confirmed that they were confident that any complaints or concerns that they had would be listened to and responded to effectively. The home has relevant guidelines on the protection of vulnerable adults and staff have received appropriate training. The management team has a clear understanding of adult protection guidelines and are aware of how to initiate an investigation if required. There has been one safeguarding referral since the last key inspection and the home home have worked alongside Social Services to address the concerns satisfactorily. Care Homes for Older People Page 17 of 26 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. St Dominics provides a comfortable, clean and safe environment for those living there and visiting. Residents and their families are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: St Dominics is a large home and is registered for 91 residents. The layout and location of the home is suitable for its stated purpose. The new extension provides single ensuite accommodation for 40 residents, communal areas and a large purpose built laundry. The extension has been built to a good specifications and furnished to a high standard. The older part of the building is at present following a redecoration and refurbishment plan. Specialised equipment is available in the home to encourage independence, e.g handrails in bathrooms, hoists, wheelchairs and lifts to all areas of the home. There is a call bell facility in all areas. However as they are attached to the wall in the lounge areas, residents can not easily access them if required. As discussed this needs to be appropriately risk assessed and action taken to ensure the safety and well being of the people who use the service. Care Homes for Older People Page 18 of 26 Evidence: There are suitable pressure relief and preventative equipment for people who have tissue damage or those who have been assessed as being at risk to tissue damage. Polices and procedures for infection control are in place and have been updated. Sluice areas were clean and uncluttered, but some equipment was stained and not fit for use. Good practice by staff was observed during the day in the usage of gloves and aprons and these are stored appropriately to prevent cross infection. The cleanliness of the home was generally good with no malodours. The environmental Health organisation visited the home in January 2010. As yet the work required has not been progressed and as discussed needs to be actioned. Care Homes for Older People Page 19 of 26 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. The Staff training introduced ensures they are aware of their roles and are able to provide the support and care the residents need. Evidence: The staffing rota was viewed and from direct observation during the site visit the staffing levels were not seen to be sufficient to meet the needs of the residents at this time. Residents were left unsupervised for some considerable lengths of time and staff spoken to confirmed that they were rushed and could not give the standard of care they wanted to. This was fully discussed and extra staff were put on the staffing rota to commence the next day. A letter confirming this was received by the CQC the following day with a propose rota evidencing this. As this was addressed a requirement has not been made at this time, but will be assessed in depth at the next key inspection. A selection of staff recruitment files were viewed and demonstrate that a robust recruitment process has been maintained to protect residents and contained all the relevant information required. There is an induction programme in place which is in line with Skills for Care. This has been introduced for all staff. Files seen confirmed this. Care Homes for Older People Page 20 of 26 Evidence: Staff spoken with said that training opportunities at the home are good and they are well supported by the senior staff and the management team. Staff and the training list seen confirmed that training is now in place to enable them to care for the residents competently and safely. The manager has introduced a training matrix which enables the management team to track the training needs. Staff are all encouraged National Vocational Qualification training (NVQ). Care Homes for Older People Page 21 of 26 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. The residents financial interests are safeguarded and the safe working practices of the staff promote their safety. Evidence: The management structure of the home has changed since the last key inspection. The deputy manager is now the appointed manager and is in the process of applying for registration with the CQC. He has been in post since November 2009. He has the necessary qualifications and experience to run the home effectively. He is supported by a new Head of Care, and the responsible individual as well as Mr Jeebun who is the registered provider. The staff spoken with said that they were well supported by this new structure and the training provided. Residents were aware of whom the appointed manager is and of his role in the home. Care Homes for Older People Page 22 of 26 Evidence: There has been considerable work done to meet the outstanding requirements and the introduction of audits has improved the outcomes for residents health, safety and well being. The quality assurance systems in the home include questionnaires sent out to residents and relatives following admission to the home. The formal quality assurance and quality monitoring systems has enabled the management to objectively evaluate the service and ensure it is run in the residents best interests. The quality assurance results have recently been audited and action taken to address any suggestions of improvement. The results are also included in the Statement of Purpose for interested parties. There are no residents at present who are responsible for their own finances. Relatives and solicitors support the majority. The home holds small amounts of residents personal allowances. There are safe procedures in place for managing this which ensures that residents financial interests are safeguarded. Staff supervision was discussed and staff supervision is in place. Staff spoken with confirmed that they receive regular supervision. All staff have received the mandatory training necessary to promote and protect the safety and well being of the residents. The manager confirmed that all staff are appropriately supervised until they have received the necessary training. The accident book was viewed and an audit of accidents and incidents has recently been commenced. In the main good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. However as previously mentioned in the report, the lack of supervision and access to a call bell in the communal areas does impact on the residents safety and well being. Care Homes for Older People Page 23 of 26 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 24 of 26 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 22 16 That the registered person ensures that a suitable call system is available in all areas of the home for service users to access. Or that a suitable risk assessment is in use wih an appropriate action plan. To promote the safety and well being of service users. 30/08/2010 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 25 of 26 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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