Care Home: St Mark`s Road Care Home - Block B

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What the care home does well The staff at St Marks Road Care Home Block B have a good understanding of the needs of the people they support. Two care files examined contained detailed assessment of needs, which focused on the individual needs of the people using the service. Confidential information including staff files and care files were kept securely. The communal areas of the home were clean and well maintained. People living at the service are supported to access social activities within the community. What has improved since the last inspection? The following improvements have been made since our last visit: A cabinet has been obtained and installed to ensure that any controlled drugs prescribed for people in the home are stored safely. The service have also purchased a refrigerator which has a lock and there is a thermometer for recording the fridge temperature. The staffing rota and training matrix showed that there is a member of staff on duty at all times who is trained to administer medicines. What the care home could do better: The registered person must ensure that all people with complex needs including epilepsy have an appropriate risk assessment in place. This will ensure people`s needs in respect of health and welfare are met. The registered person must ensure that all staff are trained to administer medicines. The registered person must ensure all staff receive training in safeguarding adults, to prevent people being placed at risk of abuse. All of the staff team must undertake training to support people with moving and handling. This is to ensure that all staff can support people safely. Key inspection report Care homes for adults (18-65 years) Name: Address: St Mark`s Road Care Home - Block B 26 St Mark`s Road Derby DE21 6AH     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: Rehana Rashid     Date: 0 1 1 0 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 Adults (18-65 years) 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 Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: St Mark`s Road Care Home - Block B 26 St Mark`s Road Derby DE21 6AH 01332294466 01332242449 26stmarksroad@robinia.co.uk www.robinia.co.uk The Robinia Group PLC Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Yolande Dionne Yates Type of registration: Number of places registered: care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Robinia Care Group is the registered provider for 26 St Marks Road. The home is located on the same site as another home owned by this organisation. The home was purpose built to a high standard in 2005, to provide personal care and accommodation for up to 8 people in the category of learning disability, aged between 18 and 65 years of age. The home is situated in Chaddesden, just outside Derby City centre, and is close to local amenities. A car park is available at the front of the premises and a garden at the rear. The home provides a spacious environment with all rooms being single with en-suite shower facilities. The home has a vehicle to help promote activities outside of the home. At this inspection the weekly fees were between £1564.21 to £1834.24. Information about the home and inspection reports are avaliable from the service. 1 0 0 6 2 0 0 9 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection carried out by one inspector on 1 October 2009 which took place over six hours. The main method of inspection was case tracking, which involved sampling two people and examine their care records. Case tracking is used to establish if the needs of the people living at the home are being appropriately assessed and their needs are being catered for. Due to people living at the service having limited verbal communication, they were unable to express their views about the service. Observations of staff with people using the service were made throughout the inspection visit. The deputy manager was present during the inspection visit. Discussions were held with two staff members about the care provided to people living at the service and the Care Homes for Adults (18-65 years) Page 5 of 27 support and training they receive. Two staff recruitment files were examined. A partial tour of the building was carried out which included viewing communal areas. Before the visit the registered manager submitted an Annual Quality Assurance Assessment (AQAA), which is a self assessment detailing what the home was doing well, what has improved since the last inspection and any plans for improving the service over the next twelve months. Information from the AQAA was used within this inspection report. We also sent out eight surveys asking for views about the care and support people receive at the home. Ten surveys were sent out to members of staff working at St Marks Road Care Home Block B. We received no surveys back from people who use the service and we had three completed surveys back from staff. Prior to this inspection visit time was spent looking at information we had received since the last key inspection which was undertaken 13 October 2008. A further inspection visit was made to the service 10 June 2009 to check the progress made on addressing the requirements made at the last key inspection. To assist with planning the AQAA, notifications from the provider and any other information received about the service were also examined. Care Homes for Adults (18-65 years) Page 6 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. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are in place prior to admission to ensure peoples needs can be met by the service. Evidence: Information about the service was available including a service user guide and statement of purpose. The service user guide did need to be updated to include the address change of the regulator, which the deputy manager agreed to do. In the annual quality assurance assessment (AQAA) questionnaire completed by the service they told us that through pre-placement assessments are completed prior to people being accepted to the service. We looked at the care files for two people living at St Marks Road Care Home Block B. Records for both of these people demonstrated that pre-placement assessments had been undertaken before these individuals came to live at the service. As part of the admissions process people, families, carers and their representatives Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: are encouraged to visit the service. This enables people to make an informed decision about the service. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in place ensuring that staff are able to meet the needs of the people who use the service. Evidence: The registered manager told us in the information about the service that people are monitored so that they can identify any changes in their individual needs. At the inspection we looked at two care files, both contained support plans which had been completed by the service. The support plans covered their social, physical, health and personal care needs. These were person centred and in pictorial format. The two support plans viewed were detailed, providing information for the staff team on the level and type of support needed to meet the individuals needs of the two peoples care records we looked. Both support plans had been reviewed which ensured that any changes in the support required by the individuals were identified. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: In the staff surveys we received two members of staff responded that they are always given up to date information about the needs of the people they support. A range of risk assessments had been completed, which largely focused on keeping people safe. Risk assessments were in place for key areas of support which included finances and moving and handling. In one persons care file viewed the service was not able to locate a risk assessment for a specific medical need (epilepsy). In one of the care files we viewed there was evidence which confirmed that the person had been supported by advocacy services and there was a mental capacity assessment on file. Staff spoken with told us how they supported people to make decisions. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with appropriate activities and maintain family relationships. This ensures their social care needs are met by the service. Evidence: In the information supplied to us about the service the registered manager told us that they offer a varied range of activities to meet the individual needs of people. College placements are in place and people are supported to take holidays of their own choice and if necessary consultation also takes place with families. They also told us that families are encouraged to visit the home. On the day of the inspection three people were supported at home and another three people were being supported by staff to attend a local college. People are encouraged to use local amenities, shops and college. Care plans viewed showed that people living at the home are involved in meaningful activities of their own choice within the Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: community as well as in the home. Visiting arrangements were flexible, family and friends were able to visit when they wished. People are able to continue to maintain and develop relationships with family and friends. Observations during the visit confirmed that daily routines at the service were flexible. In the written information the registered manager also told us that a menu plan has been developed to meet the needs and preferences of each individual person. We looked at the menu which takes into account the dislikes and likes of the people living at the service. The menu viewed showed that a varied and balanced diet is offered. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health and personal care needs were well managed, ensuring that their health needs are generally met. Evidence: In the Annual Quality Assurance Assessment (AQAA) it stated that all people at the service have a Health Action Plan, which outlines their preferences to be supported and that all people at the service are treated with respect and dignity at all times. We looked at the care files for two people. These contained essential information as to how their health care needs are to be met. Information about support received from health care professionals was recorded which included assessments from Speech and Language Therapists (SALT) and GP visits. In the AQAA the registered manager told us that people living at the service have regular chiropodist treatment and annual well-man and well-woman checks. Observations demonstrated that support was being provided to people at the service in a respectful and dignified manner. Staff interaction was polite and friendly. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Examination of the arrangements in place for storage and administration of medicines were found to be satisfactory. We looked at the medication administration record (MAR) charts for the two people case tracked, all entries were completed accurately. During the random inspection we were told that staff on duty at night are not trained to administer medicines. In the AQAA the service told us that medication is only administered by staff who have received the appropriate training. Evidence at this inspection supported that there is at least one member of staff on duty at all times who is trained to administer medicines. The training matrix showed that most of members of staff had received medication training. In the surveys returned to the Care Quality Commission staff told us that they receive training which gives them enough knowledge about health care and medication. At the random inspection the pharmacy inspector looked at the homes arrangements for storing and recording medicines. It was found that the home did not have a cupboard for storing controlled drugs should these be prescribed for a person living at the home. The refrigerator that was available for storing medicines had no lock or thermometer for recording the fridge temperature over a 24 hour period. We found evidence at this inspection which confirmed that these requirements had been complied with by the service. A controlled drugs cabinet has now been obtained and installed at the home. The service have also purchased a refrigerator which has a lock and there is a thermometer for recording the fridge temperature. Evidence was seen which supported that the fridge temperature was recorded when medication was being stored in the refrigerator. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are generally protected by the homes safeguarding and complaints procedures. Evidence: In the written information supplied by service they told us that all people at the home have access to a clear complaints procedure in a format that is accessible. They also told us that all complaints are responded to within 28 days and the results are documented in the complaints folder. We saw a copy of the complaints procedure in peoples files this was produced in pictorial format making it accessible for people at the service. We looked at the complaints record and this indicated that since the random inspection in June 2009 the service has received three complaints. The records viewed showed that the issues had been satisfactorily resolved and responded to appropriately. At the random inspection a requirement was made that all staff receive training in how to receive and record complaints ensuring they are responded to appropriately. At this inspection we viewed the staff meeting minutes for August 2009, this showed that the registered manager had addressed this issue with staff. The minutes stated that discussion took place regarding the complaints procedure, dealing and recording complaints. In the information we received from the service we were told that one safeguarding Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: adults referral has been made and investigated during the last 12 months. We checked the records regarding this incident and the information showed that the service investigated the issue and took appropriate action. They shared the outcome of the investigation with the local authority. The service has a policy on safeguarding adults and they also had information from the local authority about safeguarding adults policy and procedures. In the information we received from the service they told us that all staff have access to relevant policies including whistle blowing and safeguarding adults policy. Two staff members were spoken with both demonstrated an basic understanding of safeguarding adults and their responsibility to alert the manager of any disclosure or suspicion of abuse. One staff member commented that they had not received training in safeguarding adults. Staff training records viewed showed that some members of staff had not received training in safeguarding adults. Financial records were examined for two people living at the service and were found to be satisfactory. Receipts are kept to show each transaction made and their cash was stored securely. Individual records are held for each person providing detailed information regarding expenditure and balance remaining. Care Homes for Adults (18-65 years) 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, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean environment which has sufficient facilities which suits their needs. Evidence: In the information supplied to the Commission by the service they told us that the home is purpose built to meet the needs of people with complex physical needs. At this inspection the communal areas were clean and tidy. One bathroom was viewed which had aids and adaptations to assist people. One persons bedroom was seen this was furnished according to the individuals needs and was personalized. The laundry facilities were seen and were satisfactory. These were appropriate for the needs of the people using the service. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Training practices did not ensure that all staff had the skills to care for the people at the service. Evidence: In the written information about the service supplied to the Commission the service told us that the staff rota is done to ensure that the people living at the service are supported to carry out activities of their choice. We spoke to two members of staff, one told us that sometimes there are not enough staff on duty. They stated that this was usually more likely when staff were supporting people to access the community. In the three staff surveys we received, staff told us usually there are enough staff to meet the individual needs of the people who use the service. Staff comments included there are not enough staff to support people at the service and few of the people require 1:1 support, we are not able to give them the support they need. We examined the recruitment records for two of the most recently appointed members of staff. Each of the files we looked contained most of the information required by the Care Homes Regulation 2001. Both members of staff commenced employment upon receipt of the Protection of Vulnerable Adults (POVA) first check. One member of staff Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: is still waiting to receive a satisfactory Criminal Records Bureau (CRB) check, whilst the second member of staff received their satisfactory CRB check few weeks after they had commenced employment. We were told that the member of staff who has not received their CRB clearance is being supervised when they are working at the service. At the random inspection 10 June 2009 there was no evidence to support that any of the staff had undertaken training in moving and handling techniques. Following the random inspection we were told that staff had been booked on this training. At this inspection we found that not all of the current staff team had undertaken training in this area. All of the people living at the service have a physical disability and require support with transfers. All staff need to receive training in moving and handling techniques so that they can support people safely. In the written information supplied by the service they stated that four members of staff had achieved National Vocational Qualification (NVQ) level 2 or above. Two members of staff told us that they had either started NVQ level 2 or were waiting to be enrolled on to the course. Staff spoken with stated the training provided was good and in the three staff surveys received were told that relevant training was provided by the service. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed in the best interest of people living there. Evidence: In the written information supplied to the Commission the service told us that the manager has completed National Vocational Qualification level 4 and the registered managers award. Since the last key inspection the service has recruited a manager who is in post and is registered with the Care Quality Commission. The registered manager is also supported by a Deputy Manager who has recently been appointed. Two members of staff were complimentary about the management at the home. Staff told us that they are benefiting from management support. In one staff survey we were told that since the appointment of the current manager staff tend to feel more settled. Comments from two members of staff included things have improved since the registered manager has been in post and its better now that we have managers in post. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: Records viewed showed that monthly monitoring visits by the provider have been undertaken, a sample of these reports were seen at the inspection. The deputy manager confirmed that there is a quality assurance system in place at the service. We were told that quality assurance takes places annually, which enables people using the service and their family and representatives to express their views about the service. It was observed at this inspection that the laundry room door was wedged open for a period of time. This was addressed by the service immediately, the laundry basket was removed from the door and the door was shut. Information on the annual quality assurance assessment supplied to us showed that the required health and safety practices and maintenance had been undertaken regularly. Records seen at the service confirmed that portable electrical equipment had been tested February 2009 and gas was serviced May 2009. Care Homes for Adults (18-65 years) Page 23 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 Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The registered person must ensure complex needs including epilepsy have an appropriate risk assessment in place. As to how the persons needs in respect of health and welfare are to be met This will ensure people are safe and their health care needs are met. 16/11/2009 2 20 18 The registered person must ensure that all staff are trained to administer medicines. This will ensure the health and safety of people living at the home 16/11/2009 3 23 3 The registered person must ensure all staff receive training in safeguarding adults. The registered person must ensure all staff receive 30/11/2009 Care Homes for Adults (18-65 years) Page 25 of 27 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action training in safeguarding adults, to prevent people being placed at risk of abuse. 4 35 35 The registered person must ensure that all staff have completed training in moving and handling. This is to ensure that staff working in the service can support people safely. 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 12/11/2009 1 32 The registered person should ensure that there are adequate numbers of staff on duty to meet the needs of the people living at the service. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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