Care Home: St George`s Nursing Home

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What the care home does well All people that wish to use the service benefit from a thorough pre-admission assessment and the care plans are then generated from this initial assessment. The pre-admission assessment is kept in the person`s individual care plan folder. The care plans and risk assessments contained enough information about the people using the service to allow staff to care for them appropriately. The plans contained clear instructions for staff regarding skin integrity, wound care and nutritional status. All food provided at the home is freshly prepared using fresh fruit and vegetables. The chef offers multiple choices at lunchtime and the manager and chef plan the menus taking into account the preferences of the people using the service. Staff spoken to on the day were knowledgeable about the care needs of the people using the service and told us they were supported well by the senior management team. Activities take place everyday and the home benefits from an activity organiser and assistants. Large group activities can take place but also one to one sessions and outside entertainers attend the home. Regular training takes place and this includes the NVQ (National Vocational Qualification) which all staff have access to. The registered manager and the staff spoken to demonstrated a clear understanding of safeguarding policies and procedures. Documentation evidenced that complaints that are received by the manager are investigated appropriately within the timescales set by BUPA. There are clear lines of managerial responsibility within the organisation. The manager told us she felt supported by her operations manager and fellow managers within the area. What has improved since the last inspection? The last key inspection for the home was in April 2007 and no requirements were made at this time. The manager told us that she is constantly looking a new ways to improve the service. Monthly quality audits are carried out in the home by either the registered manager, another local manager or the operations manager. Shortfalls that are identified are acted upon quickly. What the care home could do better: No requirements were made as a result of this key inspection. Key inspection report Care homes for older people Name: Address: St George`s Nursing Home 5 Byfleet Road Cobham Surrey KT11 1DS     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lesley Garrett     Date: 0 6 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for 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) © 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 27 Information about the care home Name of care home: Address: St George`s Nursing Home 5 Byfleet Road Cobham Surrey KT11 1DS 01932-868111 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): fessere@bupa.com www.bupa.com BUPA Care Homes (BNH) Ltd Name of registered manager (if applicable) Mrs Carol Dione Purdy Type of registration: Number of places registered: care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 60 The registered person may provide the following category of service: 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 category : Mental disorder, excluding learning disability or dementia (MD) Dementia (DE) Date of last inspection Brief description of the care home St. Georges Nursing Home (one of the BUPA homes) is situated in a rural setting on the outskirts of Cobham, close to the renowned Wisley Gardens. St. Georges is a single storey, purposed built home designed specifically to provide safe and secure environment for service users requiring dementia nursing care. The carefully planned layout of the home provides a safe environment for service users to walk around Care Homes for Older People Page 4 of 27 Over 65 0 0 60 60 Brief description of the care home freely. St Georges has a number of reception rooms, providing a central meeting place where service users can get together to chat, watch television or read. A feature of the home is the pleasant central secure courtyard garden, where service users can spend time strolling or relaxing on the patios. Modern safety features fitted in each bedroom include 24- hour nurse call system. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the care home was an unannounced Key Inspection. Mrs Lesley Garrett, Regulation Inspector, carried out the inspection and the registered manager represented the service. We arrived at the service at 09:40 and were in the home for seven hours. It was a thorough look at how well the home is performing. It took into account information provided by the home and any information that the Care Quality Commission (CQC) has received about the service. The registered manager for the service supplied CQC with an AQAA (Annual Quality Assurance Assessment) and this document was used to assist with the inspection. We sent surveys to the home for completion by the people using the service. We sent younger adult surveys in error and the home did not receive replacements in time for this inspection. We spent time talking with and observing some of the people using the service and staff members. Care Homes for Older People Page 6 of 27 We looked at how well the service was meeting the key national minimum standards and complying with the regulations and have in this report made judgements about the standard of the service. Documents sampled during the inspection included the homes care plans, daily records and risk assessments, staff files, training records, and the homes safeguarding and complaints policies and procedures. From the evidence seen by us and comments received, we consider that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. 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: 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. Care Homes for Older People Page 8 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service benefit from a pre-admission assessment from a suitably trained person from the home to ensure that the home can meet their needs. Evidence: We looked at the service user guide and statement of purpose and they contained all the information required. People wishing to use the service are able to make an informed choice about living at the home. All people who wish to use the service benefit from a pre-admission assessment. This assessment is carried out by the senior nurse. The assessments that were sampled on the day were thorough and take into account past medical history, details of next of kin and the persons mental capacity and details regarding lasting power of attorney. These assessments enable the nurses at the home to begin to generate care plans for Care Homes for Older People Page 11 of 27 Evidence: the person. A further assessment also takes place on admission to ensure that there have been no changes since the original assessment. The manager also told us that the home offers a pop-in service to people who may wish to use the service. This enables them to sample the home before committing to long term care. Respite care can also be offered and prior to admission an assessment takes place to ensure the home can meet their needs also. The home does not offer intermediate care. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans were well written with enough information available to allow staff to care appropriately for the people using the service. Evidence: The care plans contained detailed risk assessments, for example, the skin integrity of the people using the service, nutrition and moving and handling. These had all been reviewed monthly and updated where necessary. Equipment, including hoists and height adjustable beds, is provided to encourage independence for the people using the service. There are specialist mattresses available for those people who are at risk from pressure sores. The QUEST system for care plans is in use throughout the BUPA care homes (and this system was developed by BUPA for their use). All relevant assessments within the care plans had been fully completed for those that were sampled. There had been some documents added into the system one being an environmental risk assessment for each bedroom. In two of the care plans areas of concern had been identified but these had not been signed when the task had been completed. Other documentation and a look into the bedrooms demonstrated the work Care Homes for Older People Page 13 of 27 Evidence: had been done. The manager was informed and she will ensure that this documentation is now fully completed. The senior nurse said that people who use the service are registered with a local GP. He visits the home once a week to review all those people who are unwell but will also review those people using the service that have not seen the GP for six months. The senior nurse told us that the GP will also do medication reviews regularly. People using the service can retain their own GP if their surgery agree and they are in the homes catchment area. The senior nurse also said that the home has support from other health care professionals and they include chiropodist, optician and specialist nurses including the tissue viability nurse. All people who use the service have access to their local hospital and NHS services. People using the service are supported by the staff to attend any out patient appointment and specialist clinics. The psychiatrist will also visit the home for reviews regularly for their patients. The senior nurse stated that a large chain pharmacy is used for the supply of medications to the home and they are delivered in blister packs. The homes policy and procedures for the safe handling of medicines was sampled and staff have access to this documentation. All nurses are undertaking medication training which has been developed in conjunction with a college and will give the nurses a competency certificate at the completion of the course.The home also undertakes through audits of the medication procedures and practises. This is carried out every month by the operations manager for the home or another local BUPA home manager. During a tour of the building it was observed that staff were speaking appropriately to the people using the service and using their preferred name which had been documented in their care plan. All people were dressed in clothes appropriate for the weather with hair well groomed and nails clean. 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 excellent 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 are able to take part in social and recreational activities and are able to exercise choice in their daily lives. The standard and quality of the meals are good which means nutritional needs should be met. Evidence: The manager employs an activity organiser and two helpers who between them organise the social programme Monday to Sunday. It was observed that the home has a varied programme of activities and social preferences are documented in their individual care plans. On the day of the visit some of the people who use the service were in the activity room and others visiting the hairdresser. A variety of activities are available including group meetings and one to one interaction. The home has the use of a minibus so trips outside of the home are also available. The AQAA advised that during the last year activities have expanded to include a debating club and pet management club. A local girl guide group have also established a pen pal club. They will write to any of the people using the service that would like to receive regular letters from them. The manager told us that visitors are welcome in the home at any time and the home Care Homes for Older People Page 15 of 27 Evidence: promotes open visiting. On the day of inspection it was observed that people using the service had visitors during the day in individual bedrooms and in the communal areas. The visitors spoken to were helping their relatives with drinks and told us they were able to visit everyday if they chose to. The manager told us that since the last inspection the quality and presentation of the meals had improved. The manager and chef have devised new menus taking into account preferences of the people using the service and the type of diet they require. On the day of inspection there was seven different main courses on the lunch menu. People who use the service are offered a choice for lunch and supper the day before so the chef has an idea of how much to cook of each meal. The manger told us that on the day people using the service will often change their minds about their selection but this does not cause a problem for the chef. The manager told us he is very flexible. For those people using the service that are on special diets the manager told us the chef can meet their needs and for example soft and liquidised food, diabetic diets and a grazing diet is all available . Platters of fruit are available during the day and afternoon tea has home made cakes always available. Part of the lunchtime service was observed and it was noted that staff were available to help those people using the service that required this. Tables were laid with tablecloths, napkins and drinks were available. 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. People who use the service can be confident that their complaints are listened to and acted upon. Staff showed awareness of the safeguarding adult procedures which should protect the people using the service from abuse. Evidence: The home has a complaints procedure in place a copy is available at the reception and is also in the homes service user guide. Most of the people using the service would have to rely on relatives, friends or advocates to implement these procedures on their behalf. The manager told us that they had only received one complaint in the last year. Complaints are kept in a folder and this was seen. It allowed us to see that the complaint had been taken seriously, investigated and responses all recorded.There is one ongoing complaint at the home which is also a safeguarding alert. CQC are aware of this complaint and are copied in to the letters sent to the home and social services. There have been two safeguarding alerts which had been referred to the local authority for investigation during the last twelve months. One has been resolved but the other as mentioned earlier is ongoing. CQC have been made aware of the alerts by Regulation 37 notifications. The home has an internal safeguarding policy and procedure which matches that of the local authority. The manager had a copy of the local authoritys multi agency procedures but this was the 2005 copy. During the inspection she printed the 2008 copy from the Surrey County Council web site. Care Homes for Older People Page 17 of 27 Evidence: The manager told us that BUPA provide specialist training for managers and senior staff who work in or manage dementia care homes. It is a four day course and the focus is on people with dementia and how to recognise safeguarding adult issues. The manager then cascades this training to all staff at the home. When sampling records it became clear that staff did not routinely receive safeguarding adult training. Some members of staff had not received formal training since 2006. We discussed this with the manager who was not aware that staff should receive regular training in this subject. The manager told us she would discuss this with BUPA. Following the inspection the manager telephoned CQC to say that BUPA would now ensure that this training is now available every year for all staff and the manager has already placed dates in the calendar to start the staff training. We spoke to staff during this inspection and found they had knowledge of what the term abuse meant and what they would do if they witnessed an incident in the home. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home enables people who use the service to live in a safe and comfortable environment who will benefit from a newly refurbished home this year. Evidence: The layout and design of the home is suitable for the people using the service. The communal accommodation has been arranged to allow people who use the service the opportunity to walk freely around the home. There are various lounge and dining areas.The manager told us that the home is about to undergo a full refurbishment. This will include new carpets, curtains and other soft furnishings. The bedrooms and communal areas will be decorated. During a tour of the building it was observed that the interior is dark and tired. Some wall paper was peeling and paint work needed refreshing. The dining room tables and chairs are also old and worn. All these areas will be addressed during the refurbishment the manager is just waiting for confirmation of the date. The bedrooms have patio doors and can open into the garden and benefit from adjustable beds and bed-rails (if required). It was observed that equipment to aid manual handling, including hoists, was readily available and that new wheelchairs had recently been purchased. Care Homes for Older People Page 19 of 27 Evidence: The home has a housekeeping team who work seven days a week. On the day of inspection it was observed that some of the carpets in the bedrooms and communal areas needed to be vacuumed. The senior nurse told us that one housekeeper had called in sick that morning so they were a little behind in their schedule.Soap dispensers and paper towels were available in the communal areas which assist with infection control within the home. Records showed that staff have also received infection control training. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers at the home on the day of inspection were sufficient to meet the assessed needs of the people using the service. NVQ training for the care staff continues to ensure a good skill mix of staff on duty. Evidence: The manager writes the rotas and these were sampled. On the day of inspection the number and skill mix of staff on duty was sufficient to meet the individual needs of the people using the service. Staff are allocated to units according to the assessed needs of the people using the service on the day. We spoke to home visitors on the day of inspection. One person told us I come in every day and the staff are always welcoming and look after my wife very well. Another told us nothing appears too much trouble. Good interaction was observed between the staff and people using the service. All staff had a good knowledge of the care needs of the people they were caring for. Staff have access to National Vocational Qualification (NVQ) training. The manager told us that most staff have achieved this qualification and the training is on going for all new staff following an induction programme. The induction for all new staff is linked to skills for care a national programme of induction. Care Homes for Older People Page 21 of 27 Evidence: Two staff employment folders were sampled and were found to have the necessary paper work to enable the home to safely employ those people. This ensures that the people who use the service are protected by the homes recruitment procedures. The home employs a training coordinator who is responsible for ensuring that all training necessary for staff takes place. Individual training files for the staff were viewed. This showed us that staff at the home have access to a variety of training to meet the needs of the people using the service. Mandatory training by the home is carried out yearly or when the certificate has expired. This includes moving and handling, fire awareness, infection control and food hygiene. The training coordinator told us that specialist training is also available depending on the needs of the people using the service. The manager delivers dementia training for all staff and also the Mental Capacity Act and Deprivation of Liberty. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements at the home ensures the staff team is adequately supported and there are clear lines of managerial accountability. Quality assurance systems are in place which improve the quality of care offered to the people who use the service. Evidence: On the day of inspection the manager was on duty and was supported by two senior nurses together with another nurse and carers. There are clear lines of managerial responsibilities and there was good communication observed between the team on duty. The manager has over forty-two years experience in nursing and is a dementia care specialist. Her office is situated in the reception area and visitors to the home are able to see her and stop to chat whenever they visit. The manager has obtained several awards from BUPA for her good practise. The pop in service that she introduced to the home is still operating. This allows a limited number of people who may wish to use the service in the future the opportunity to have some respite care at the home. This can be anything from a couple of hours to twenty-four hours to allow Care Homes for Older People Page 23 of 27 Evidence: their carers some free time. The submitted AQAA was very brief and some areas was not fully completed. The manager told us that we had sent her the wrong version for completion and it then had to be completed in a rush. During the day we spoke in length about the home and the service she provides and it was clear the she and her team are always looking at ways that they can improve the service that is provided to the people who use the service. The home is supported by a national team of quality and compliance officers within BUPA whose role includes supporting quality issues within the home. The manager has to report monthly to BUPA on the completed audits regarding medication, pressure sores, complaints and safeguarding issues. Audits are carried out by the operations manager, other registered managers within the group and the home manager. The manager told us that yearly surveys are sent to the people using the service and their relatives or representatives. Results of these surveys are sent to the home and the manager then has to write an action plan to address any issues raised. The operations manager also visits the home every month unannounced to carry out the Regulation 26 visits. These reports are available in the home and were sampled on the day of inspection. The home employs an administrator and part of that persons role is to manage the personal allowance accounts for the people using the service. This system was not inspected during this visit but the manager told us that BUPA have clear guidelines to follow when using this account. The home does not act as an appointee for any person using the service. The health, safety and welfare of the people using the service are promoted. There are a wide range of health and safety policies and procedures in place. The training coordinator arranges for staff to be made aware of these policies when they are available or updated by BUPA. The maintenance department oversees routines checks within the home, for example; fire alarm testing and equipment checks, water temperature recordings and emergency call bell systems. Documents sampled demonstrated that the home has the necessary health and safety certificates in place. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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