Care Home: Symonds House

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What the care home does well People living at Symonds House told us that they were very happy with the service they receive here and "the staff are wonderful", "we are able to make choices of what we do or don`t do". Two activity co-ordinators are employed who take on responsibility for organising a full and varied programme which is organised with the residents choices and preferences taken into account. There is a stable and committed staff team which has provided a consistent approach to the care that the residents receive. As part of the providers quality assessment process an annual survey is completed to examine the outcomes for people living in the home and if any improvements can made to the service. Residents told us that the staff are always looking at ways to improve the service and are always willing to listen to their views and act upon them. What has improved since the last inspection? The residents told us that they felt that they are listened to and felt more involved in decision making through talking with staff and the residents meetings. The manager has made improvements to the environment in line with the redecoration programme and residents told us that they have been involved in the choice of colours and furniture, this has improved the loom and feel of the home. The residents told us that the number of week day activities have increased and they have been involved in the decision making of what they would like to do. The residents also told us that they receive good health care and that any issues are dealt with promptly. What the care home could do better: Information contained in the care plans should be more person centred and ensure that they detail what each person is able to do for themselves and what support the staff need to give to ensure all health and personnel care needs are met. Staff need to remember that where a risk has been identified that a risk assessment is completed and that control measures are included in the assessment. The manager told us there is a need to recruit a nurse to provide a full staff compliment and the recruitment process has begun. Key inspection report Care homes for adults (18-65 years) Name: Address: Symonds House 2 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB     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: Alison Butler     Date: 2 9 0 3 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 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) © 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 Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Symonds House 2 Lavender Fields Lucas Lane Hitchin Hertfordshire SG5 2JB 01462452460 01462440186 jennifer.alder@lc-uk.org www.lcdisability.org Leonard Cheshire Disability Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability terminally ill Additional conditions: Date of last inspection Brief description of the care home Symonds House is a purpose built establishment providing specialist support and personal care to twenty people with who have physical disabilities. The building is situated in the heart of the residential area of Hitchin, close to the town centre. It is a two storey property with the main living and residential areas all on the lower floor, and staffing facilities and a training suite available on the first floor. The building is surrounded by landscaped gardens with all areas accessible for wheelchair users. There is a large car park to the front of the building providing ample parking for staff ,visitors and the homes vehicles. For information on the fees for the home contact should be made with the manager. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 20 0 20 20 Brief description of the care home Information about the home and the service it offers is contained in the Statement of Purpose and the Service User Guide. A copy of these and the most recent inspection report are available in the home. Care Homes for Adults (18-65 years) 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 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: The last inspection of this service took place on 27 April 2007, we have also conducted yearly Annual Service Reviews (ASR). An ASR is a report that we write for good or excellent services that have not had a key inspection in the last year. It does not routinely include a visit to your service. When completing an ASR we use the information received and make a judgement on the outcomes for the service. The ASR shows how we assure ourselves and the public that the quality of the service has not changed since the last key inspection. This unannounced inspection was carried out by one inspector representing the Care Quality Commission. However for the purpose of this report this will be shown as we. The inspection started early morning and provided us with the opportunity to observe staff interacting with residents and the daily routines. We conducted a tour of the home, examined personnel and care records. Comments we have received either through responses to our surveys we sent out prior to the inspection, or during the inspection have been included throughout the report. Care Homes for Adults (18-65 years) Page 6 of 27 Information received by us was reviewed and this included the Annual Quality Assessment (AQAA). This is a self assessment document that focuses on how the home meets the outcomes for the residents and also provides some statistical data. Care Homes for Adults (18-65 years) 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. 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 8 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 9 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. People who live at Symonds House can be assured that they have their needs fully assessed prior to admission and are given the appropriate information to make an informed choice. Evidence: Information from the surveys we received from the people who use the service, with the exception of two, stated they had been involved with choosing and deciding to move into Symonds House. During the inspection we spoke to the residents who had stated in the surveys, they had not been involved in choosing the home, in these cases we found that their families had made the decision on their behalf. The residents told us that it had been a good decision and they were very happy with the care and support they received from the staff at the home. Assessments seen provided sufficient information on each persons personal care and health care needs, and this information is used to form the basis of the individuals support plan (ISP). The manager told us that a review of the paperwork is taking place to see if they can adapt the initial assessment document to work alongside the ISPs for each person instead of being a separate document, the manager hopes it will be used for all new Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: admissions in the future. Care Homes for Adults (18-65 years) Page 11 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. People who live at Symonds House can be assured that they are actively involved in their own care planning and are consulted on every aspect of community life to live an active and fulfilling life. Residents are supported to take risk as part of an individual lifestyle. Evidence: Three care plans were examined, they showed additional work should be carried out to ensure they are person centred. The plans need to show what the resident is able to do for themselves and then what support the staff need to provide, in order for all their health and care needs to be fully met at all times. Staff spoken to were clear about the support that individuals require to ensure that their needs are fully met. The manager told us that a review of the ISP paperwork is taking place throughout the organisation and we were assured that additional training will take place to ensure the staff are clear on how to make the plans person centred for all residents. A resident spoke we spoke to explained that they are able to leave the home and visit the local community as they wish and were clear that they must inform the staff they Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: were leaving the home. Although we were unable to find a risk assessment for this in the care plan. We were assured by the manager that one would be put in place as a matter of urgency. Staff were seen to always ask residents what they wanted prior to assisting them. Staff spoken to were clear that every person is able to make their views known even if it takes several attempts to understand them due to communication difficulties. Residents confirmed they have a monthly meeting where they are able to discuss items of concern, they are given information of up and coming events and an update from the previous meeting as necessary. We saw copies of the minutes of these meetings and residents confirmed they also have access to a copy. There is a good team of volunteers who provide support to the residents in activities of their choice and/or befriending individuals who would like this to happen. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Symonds House can be assured that they will be encouraged to live full and active lives which meets their needs and wishes. Evidence: We joined the residents in the activities room where they were taking part in a quiz on gardening, this was a change to the published programme as unfortunately the person who runs the gardening club was off duty. The residents were being supported by a volunteer and a member of staff. Residents taking part were enjoying it and some of the answers created a lively discussion especially around the various names of the plants and flowers. Another resident was being supported by a volunteer who was advising them on the type of brush stroke to use, whilst they were a painting a picture of a landscape. Again they said that they very much enjoyed painting and having support in getting it right. A detailed programme of activities is in place which included both the morning and Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: afternoons every week day. Comments we received from the surveys told us they would like to see more evening and weekend activities. Staff told us that although activities are not arranged on a regular basis they do have some weekend activities arranged for example they have a fete coming up and all families and friends are invited. A volunteer comes to the home to support residents on a one to one basis with the opportunity to do some cooking, those residents who choose to take part in cooking told us they very much enjoy it. The manager has purchased a voice activated programme for the computer which provides access for more residents to use e-mail and the Internet to contact families or get information on local events. The residents told us that trying to get the computer program to understand their voice was difficult but they were enjoying it. Staff were seen to encourage residents to take part in the activities, whilst one said they were not very good at quizzes but did enjoy meeting with the other residents and therefore went along to the session. We joined the residents at lunchtime, where we found the lunch was nicely presented and a choice is offered which, included a vegetarian option. Those residents spoken to said they have never been hungry and that they have always enjoyed their mealtimes. The mealtime was unhurried and relaxed and residents were seen to be supported in a caring and patient way. The manager told us that they had received some money which had been used to purchase a more suitable table for one of the dining rooms to accommodate the high number of specialist wheelchairs that were being used. This has provided more space, making the environment a lot less busy. We spent time with a resident who told us about their life prior to coming to Symonds House, they were very happy here and told us this place is marvellous and would not want to go anywhere else. They told us that they have support from their family who visit them regularly. They also have access to the Internet and are able to purchase goods on line. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Symonds House can be assured that staff understand their personal and health care needs and how they prefer them to be met. Evidence: Residents told us that the staff meet their needs in a caring and supportive way. Staff were seen to have a good relationship with the people who live at Symonds House and were seen to support and encouraged them to be as independent as possible. The manager told us that they have a good rapport with the GP practises they use, which provide the residents with good health care support and includes access to other appropriate health care and community care services. The home provides an in-house physiotherapist who supports the residents on a one to one basis, the physiotherapist provides a plan giving staff instructions on how to support the residents appropriately if required when they are not on duty. Should a resident require an out patient appointment or be admitted to hospital the manager told us that a member of staff would accompany them if a family member were not available, this ensures the resident is supported at all times by someone who knows what and how to meet their care and support needs. The medication and storage were generally found to be well managed, with the Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: exception of one person who self medicates. We found for one one of their prescribed medications no risk assessment to minimise the risk both to the person or the other people who live in the home. A thermometer is available in the room where the medication is stored. Although we were told staff check the temperature a record is not made. The care manager assured us that both of these issues would be addressed immediately. The temperature of the medication fridge is recorded. The care manager told us that if the temperature was seen to be outside of the required limits this would be reported, and appropriate action would be taken to ensure the medication does not deteriorate and loose its effect. Care Homes for Adults (18-65 years) Page 17 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 who live at Symonds House can be assured that their views and any concerns they have will be listened to and acted upon. Robust policies and procedures are in place to protect them from abuse. Evidence: Information from the surveys and the residents spoken to told us who they would speak to if they had any concerns about their care and felt confident that they would be listened to and any action would be taken. There is a clear procedure in place for reporting of complaints. The compliments, concerns and complaints folder was examined. There is a form that is used for recording the concern or complaint and includes detailing the action that has been taken and the outcome. The manager told us that a quarterly return is also completed and sent to head office detailing any concerns or complaints and these are fed into the quality assurance process. The manager told us that recent concerns that have been raised, have been dealt with on an informal basis as there is an open door policy in the home. Residents confirmed that they were able to go and speak to any member of the management team at any time. There are appropriate procedures in place for safeguarding vulnerable people. Staff spoken to were clear and aware of the safeguarding procedures, and their responsibility to report appropriately. The manager told us that all the management team will have training in Mental Capacity and the Deprivation of Liberty to ensure they fully understand the process. This will the be cascaded down to all staff over the Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: coming year. Care Homes for Adults (18-65 years) Page 19 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 who live at Symmonds House can be assured that they live in a welcoming, warm, clean and well maintained environment that meet their needs. Evidence: A tour of the home was conducted and we saw cleaning staff working throughout the home. We found all areas to be clean and fresh. To maintain the decoration an on going redecoration plan is in place. Residents told us they are involved in the choice of colours for both the communal areas and their own bedrooms if they are to be redecorated. Throughout the home there is overhead tracking to support both residents and staff in safe moving and handling tasks. The entire home is wheelchair accessible with all residents facilities being on the ground floor. There is a guest bedroom on the first floor for families and friends if they wish to stay at the home. The kitchen has been awarded five stars from the food standards agency which means that there are good practises in maintaining the food hygiene standards. Policies and procedures are in place for the control of infection which includes the Department of Health essential steps guidance and audit process. Care Homes for Adults (18-65 years) 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, 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Symonds House can be assured that a robust recruitment procedure is in place to keep them safe and there are sufficient competent staff on duty to meet their needs. Evidence: An examination of two staff files showed that all the required information and checks had been carried out prior to them commencing their employment at the home. The home have a stable and consistent staff team and staff told us it is a lovely place to work, we have a very good team and are well supported, we have regular staff meetings, we receive regular training. Staff were seen to be very happy in their work and offer support in a caring and patient manner. Robust recruitment procedures are in place and a resident is part of the recruitment panel. We spoke to a resident who has been part of the recruitment process and they told us that they very much enjoyed the experience and felt that they had had an input in to the choice of staff to work with them. Examination of the rotas showed that the staffing levels at Symonds House are appropriate to meet the needs of the residents. The manager told us that they have a low sickness rate and have not used agency in the last 5 years. The organisation has in place it own team of bank workers who they can call on at short notice if required. The manager told us they are in the process of recruiting for a nurse. During the inspection a telephone call was received with somebody interested Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: in the role and was arranging a visit to the service. The information we received indicated that just under half of the care workers have achieved an NVQ award of level 2 or above. We examined the training matrix, which highlights when staff are due to attend training thus allowing the manager to cover the rota appropriately. Training is offered in specific subjects that relate to the needs of the residents such as multiple sclerosis, and behaviour management, therefore improving the staff knowledge and understanding. On the first floor a training room is available alongside staff changing facilities and a staff room. The company have introduced an on line induction programme which works alongside new staff shadowing members of staff and this can continue until the person feels confident in working alone. There is a list of volunteers who support the residents and they follow the same recruitment procedure as paid members of staff. This area of recruitment has been delegated to a volunteer co-ordinator who is employed by Leonard Cheshire and the manager has overall responsibility. Care Homes for Adults (18-65 years) Page 22 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. People who live at Symonds House can be assured that the home is run in their best interest and that their health, safety and welfare is protected through a series of checks. Evidence: The manager has been in post since November 2009 and has applied to the Care Quality Commission for registration, she is waiting to be notified to attend a fit person interview. Staff and residents confirmed that there is an open door policy and that they feel able to go to any member of the management team if they have any concerns or ideas for improving the service. Residents were seen to regularly speak with the manager and there appeared to be a good relationship between them. Regular meetings are held for residents and the different groups of staff, minutes seen confirmed this. Discussion with residents and staff showed us that the home belongs to the residents and they have a lot of say in how it is run and what improvements need to be made. A quality assurance system is in place with monthly monitoring visits taking place a report sent to the home which was available for inspection. Leonard Cheshire carry Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: out an annual survey and a report is completed on the findings and an action plan formulated which looks at ways to improve the service. The results from this years survey were yet to be finalised. There are comprehensive policies and procedures in place to ensure staff are working and supporting residents safely. The manager completes a monthly accident/incident audit which looks for trends or additional support that may be required for individual residents. Equality and diversity issues are understood by staff and they are addressed within the care plans, which appropriately describes how a residents needs are to be met. Fire safety records which is the responsibility of the maintenance person were checked and were well maintained, a records is made of any issues or problems and they arrange for them to be put right. The manager completed the AQAA within the given timescales and it gave us the information required. Care Homes for Adults (18-65 years) 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 Adults (18-65 years) 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 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. If you would like a summary in a different format or language please contact our helpline or go to our website. 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