Care Home: The Firs Residential Home

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What the care home does well The Firs is very homely, with a relaxed and friendly atmosphere. Efforts are made to ensure people living at the home have choice, and that their wishes are met. The activities on offer, involve people coming into the home to entertain and socialise, and also people going out to activities and functions away from the home in the local community. The food is of a good quality, with efforts made to provide fresh home cooked food, and give people a good range and choice. What has improved since the last inspection? At the last key inspection, seven statutory requirements were made relating to: Medication administration records, social activities, safeguarding training for the staff, decorating the outside of the home, recruitment of staff, information given to staff about the eneral Social Care Council code of conduct, and producing an annual development plan. Evidence was seen at this key inspection that all of these statutory requirements had been met. In addition: The home has new kitchen tops, new dining chairs, the linen cupboard upstairs has been enclosed, the outside wall at the front of the building has been rendered, new bed linen has been purchased, the plumbing has been tested, new fire exit signs have been fitrted, and some fire doors have been fitted with new closers and seals. What the care home could do better: No Statutory requirements have been made as a result of this key inspection visit. However three good practice recommendations have been made relating to: Recording people`s wishes for the time of their death, ensuring that every member of staff has two written references, and that these are available for inspection, and ensuring that all members of staff receive a minimum of six formal supervision sessions per year. Key inspection report Care homes for older people Name: Address: The Firs Residential Home 9 Stevens Lane Breaston Derby Derbyshire DE72 3BU     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: Rob Cooper     Date: 2 3 0 6 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: The Firs Residential Home 9 Stevens Lane Breaston Derby Derbyshire DE72 3BU 01332872535 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Firs Care Home Ltd care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 20 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home The Firs Residential Care Home provides accommodation for 20 Older People. The building was originally a large Victorian family home that has been extended to its current size. The Home is situated in the village of Breaston, located almost midway between Derby and Nottingham. Two stair lifts, and three staircases, provide access to the first floor. The Home has two lounges, and a seating area in the large reception area of the Home. There is a front conservatory that exits on to a patio and garden area, which people staying in the Care Homes for Older People Page 4 of 26 Over 65 20 0 Brief description of the care home Home regularly use. There is a call system, which operates in all areas of the Home. Relatives and visitors can call to visit Residents at any time. The Home is run by the Registered Provider, who is also the Manager. The charge made for a room at The Firs Care Home ranged from 380.00 to £400.00 a week. The difference in fee relates to the size of room chosen by the individual, and whether it is a shared room. Details of previous inspection reports can be found in the Home, or on the Care Quality Commissions website: www.cqc.org.uk Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit as part of the key inspection process, so that no one at the Firs knew that the inspection visit was going to take place. The visit took approximately five hours through the middle of the day, with one inspector present. In preparing for this inspection, the information that the Commission holds about this care home was reviewed, this included looking at the last inspection report, the inspection record, considering any complaints or concerns that have been made about the service, and reviewing any notifications made relating to incidents that affect the well being of people living at the Firs. The methods used during this key inspection and visit were to visit the Firs, where a Care Homes for Older People Page 6 of 26 process called case tracking was used; this involved identifying four people who live at the care home and looking at their individual files and making a judgement about the quality of care they are receiving, and if their needs are being met. This was followed by a partial tour of the Firs, looking at the activities on offer, and talking to three people who live there, plus two relatives and three members of staff about the quality of the service, and their experiences of living and working at the Firs. We also sent out an Annual Quality Assurance Assessment (known as an AQAA), which allowed the Firs to carry out a self assessment; and provide a range of information relating to their service. Information provided by the home helped to form the judgements in this report. We also sent out five surveys asking for views and information to people who live at the home, five to relatives and five to staff. Of these we have so far received none back, so they were not available to help with the judgements that we made. The registered manager Yvonne Pelosi is also the registered provider and she supplied much of the information during this key inspection visit. On the day of this inspection visit there were nineteen people living at the Firs. People who might want to live at the Firs can obtain information about the home direct from them, and this would include seeing previous inspection reports prepared by the Care Quality Commission. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to detailed information about the services on offer. They have contracts or a service agreement and they receive a comprehensive assessment of their needs, which allows them to make an informed decision about whether the home can meet their needs. Evidence: Both the statement of purpose and service user guide were seen during the inspection visit. These documents contained a great deal of useful information about the care home. Currently both documents are being reviewed and updated, although the current information that is available would allow people living at the care home, and those who might wish to in the future, to make an informed choice about living at the Firs. Copies of the Service User Guide were seen in bedrooms during the visit. As part of the case tracking process four people who live at the care home were identified, and their files were seen, each one contained either an agreement from Care Homes for Older People Page 10 of 26 Evidence: Social Services to fund their placement, or a private contract, together with a copy of the terms and conditions of residence, which had in some cases been signed by the individual. Each of the four files that were seen contained a formal assessment of need. The assessments had all been completed in house, and covered areas such as: the risk of falls, continence, dependency, and nutrition. The evidence showed that the information provided by these assessments had been used to draw up the care plans, having been completed prior to admission. The Firs does not offer intermediate care, and therefore this National Minimum Standard was not assessed. Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care given in a professional and caring manner by the staff, which means that individuals are having their care needs met. Evidence: Each of the four files that were seen contained a plan of care, which identified personal goals and identified peoples needs and how to meet them. Evidence was seen that care plans were being reviewed regularly, and there were daily entries by care staff, to record progress and any issues relating to individuals care. The manager said that the care plan format is in need of review, and that she will be addressing this in the coming months. All of the files that were seen contained health care plans. The plans included information relating to health care professionals such as visits to the doctor, or by the nurse, and any hospital visits. A mobile optician (Vision Call) provides a service to people living at the home, and a mobile dentist (Concept Clinic) provides a dental service, although some people prefer to use the local dentist. There is a local doctors surgery in the village which the manager said provides a very good service, as well as Care Homes for Older People Page 12 of 26 Evidence: practices in Long Eaton, so that people living at the home have a range of choice with regard to their health care. With the care home being close to the county border, hospital services in both Derbyshire and Nottinghamshire are used, again with some element of choice. Two people were asked about seeing the doctor, and they all said that the staff would get them a doctor if they were unwell, and if they needed one. Health related care plans in the files captured health care information. A local chemist provides the Firs with their medication. An inspection of the medication systems showed that medication is handled safely. Administration records were seen and found to be complete. No one living at the home currently self medicates. All aspects of the medication procedures that were seen showed a clear audit trail for medication, and indicated that people living at the care home were safe. Staff training records showed that staff had been trained in medication, with training being provided by Derby City Primary Care Trust and Derbyshire College. The chemist last carried out an audit of the medication, and provided staff training in March 2009. Discussions with three people who live at the Firs, and observation of the staff working with people generally showed that the staff treated them with respect and dignity. There was a relaxed friendly atmosphere throughout the home, and staff were observed being gentle and supportive. People living at the home were having conversations between themselves and there was good communication with the staff. Observations also showed staff knocking on peoples doors before entering, and speaking in a respectful manner. Each persons file had details for an end of life care plan. However the details were in many cases brief, or made sweeping general statements that would give staff little guidance in the event of the persons death. Basic information such as the wish to be buried or cremated was also missing in many instances. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a lifestyle that reflects their cultural, social and religious interests, and needs, and there is clear evidence that their social care needs are being met. Evidence: Evidence was seen in documents, files and posters that a programme of activities is organised at the home, and this includes Quizzes, a physical movement group who come in to do exercises, which is according to two people who were spoken with very good, and very popular. A petting service occasionally visit the home with a dog, so that people can stroke and fuss the animal. A local school send pupils in for work experience, and there is a church service held at the home on the first Friday of every month. The home employs an activity co-ordinator who works with individuals on a one to one basis, and as well as organising group activities. In addition there are trips out into the local community, shopping and for lunch at local pubs and cafes. In addition some people attend Evergreens an older persons club in the village, and a local sensory impairment group also visit for occasional social activities. Two relatives were spoken with during this inspection visit, both were positive in their comments, and said that they were made to feel welcome, and that the staff were friendly and approachable. One relative who has a more involved role, said that they Care Homes for Older People Page 14 of 26 Evidence: were more than happy with the care their relative was receiving. Discussions with two people who live at the Firs showed that relatives are able to visit anytime, and a number were observed doing so during the inspection visit, and that the staff made people welcome. Staff were observed to see how well they interacted with the people who live at the home, and whether choices were being offered. Many positive choices were seen being offered particularly around drinks and activities. The kitchen staff demonstrated how choices were offered and recorded at meal times. Discussions with three people indicated that they all thought they had control over a lot of things in their lives, and one person said: If I didnt Id soon have something to say about it. On the day of this inspection visit there was a good choice of meal on offer including a vegetarian option if required. The main option being homemade lasagne which was seen being made) discussions with the cook showed that there is often a homemade option on the menu, and the farm shop down the road often supply fresh fruit and vegetables. Information related to peoples likes and dislikes was seen in the kitchen. All of the people spoken with said good things about the food with comments such as: The food is really nice, shes a marvellous cook and Its very nice and I have no complaints about the food whatsoever. Discussions with the cook showed that there is an attempt to accomodate peoples likes and preferences, and this will include trying to provide something other than the menu choice, if an individual says they really only want ... a chip butty. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are safe, as a result of the policies, procedures and systems that are in place, and people living at the care home and their relatives are confident that their complaints will be taken seriously and dealt with. Evidence: The Firs have received seven complaints since the last key inspection in July 2008 (identified in their AQAA). A review of the complaints showed that they had been dealt with in line with the homes complaints procedure, which is on display in the foyer, and also forms part of the service user guide. Discussions with two people who live at the home indicated that they knew who to complain to, and how to complain, although none of them had ever needed to. Discussions with a relative about the complaints procedure identified that they would speak to the manager, and they felt confident that she would deal with the complaint, although so far, this had not been necessary. In their AQAA they said: Complaint forms are available on the notice board in the main hall, we have an open door policy and the Manager is always available. Complaints are taken seriously and are acted on swiftly by the manager. The residents are confident to let staff know if they are not happy and want changes. The manager has informed residents individually of the complaints form. The manager meets residents each morning and residents are aware that they can speak to the manager if they have any issues. A review of the staff training records in relation to safeguarding adults showed that all Care Homes for Older People Page 16 of 26 Evidence: of the staff with the exception of one new member had undertaken this training in the last twelve months, with the last course taking place in January 2009. The training is aimed at raising staff awareness of abuse, and issues around abuse and through raising those issues, offering people greater protection against abusive practice, while also making sure that the staff understand the correct policy and procedure to follow if abusive practice is found. Three members of staff were asked about safeguarding adults training and they said they were aware of the issues, and had undertaken this training. The Firs have not had made any safeguarding adults referrals since the last key inspection. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, clean, well maintained and comfortable home, with their personal possessions around them, this means that people are living in homely surroundings that meet their needs. Evidence: A partial tour of the Firs showed that it was comfortable and well maintained, with good quality fixtures and fittings. Discussions with two people who live at the home showed that they thought it was comfortable and meets their needs. Several bedrooms were seen, and these were well personalised, and homely, all of the people who were spoken with said they felt they had everything they needed, and that they thought their bedrooms were comfortable and the home was well equipped. The gardens are very attractively laid out with different sitting areas, and hanging baskets have been prepared by people living at the home. Staff were seen cleaning in different parts of the home during this inspection visit, and discussions showed that there were systems in place for cleaning, and that there was a good supply of cleaning materials. The building was found to be clean, and smelt fresh. In relation to cleaning they said in their AQAA: Prior to buying The Firs there was a lot of maintenance to do on the home, as it did not meet the standards. We have had a routine maintenance programme, we have re decorated most bedrooms, bought new furnishings, we have enclosed a linen cupboard to meet fire regulations Care Homes for Older People Page 18 of 26 Evidence: the grounds are kept tidy and attractive and we have encouraged residents who love gardening to keep up their hobbies. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have been recruited professionally, and are competent and trained to do their jobs, which means that the people who live at the care home are safe, and have staff who are able to meet their needs. Evidence: The staffing rota was reviewed and this showed that there was enough staff currently employed to meet peoples needs. Staff also sign a sheet to evidence the hours that they have worked. Two people living at the care home were asked about staffing levels, and they said that they thought there were enough staff. Discussions with three members of staff also indicated that there were enough staff, with only one person saying: they thought there could be more staff on nights. In their AQAA they said: Turnover of staff is low. High levels of staffing hours are provided to meet residents needs. The care industry considers National Vocational Qualifications (NVQ) to level II in care to be the basic qualification for staff working in residential care. A review of the staff training records showed that currently there are fifteen care staff (from the AQAA) of whom there are ten staff with NVQ level II, and two with NVQ level III qualifications. In addition there are five staff currently studying for their NVQ level II and three staff studying for their level III qualification. Care Homes for Older People Page 20 of 26 Evidence: The files of four members of staff were seen, to check that they contained all of the information that would show that staff had been recruited in a safe manner, namely that applicants had filled out an application form, provided two written references and had had a Criminal Records Bureau check. The documentation showed that the recruitment policy and procedure had mostly worked to protect the people living there. As references were not present for one member of staff, although the manager said they had been received. Discussions with three members of staff about their recruitment showed that they had gone through all of the pre-employment checks, and had not started working until those checks had been completed. The staff training records showed that there is a training plan for the staff,and staff are receiving mandatory training (fire safety, moving & handling and food safety). The training records showed that staff were receiving the training to help them to do their jobs. Discussions with three staff members provided evidence of the training courses staff had attended. Copies of certificates were seen in staff files. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This is a safe, well managed care home with good systems for ensuring its quality in place, which means that people living at the home have their needs met. Evidence: Yvonne Pelosi is the Registered Manager, and also the owner/ provider. She is suitably qualified and has over thirty years experience. Yvonne has been judged by the Commission to be a fit person to run a care home. Yvonne became the registered manager in 2005. The Firs have a quality assurance system that relies on questionnaires being filled in by people who live at the home, relatives and visitors, and an audit system for key functions such as activities. Copies of these questionnaires were seen together with evaluation of the results, which were on display on a notice board within the home, dated January 2009. A copy of the homes development plan for 2009 was also seen. The home does not hold group meetings for the people who live there, rather the manager speaks to people on an individual basis every day. Care Homes for Older People Page 22 of 26 Evidence: The Firs has a system for peoples small cash needs. This is operated on behalf of some of them by the staff (dependent on individual choice and their ability to manage the money, or relatives involvement). Four peoples finances were checked at random. All of the cash tallied with the records, and receipts were seen, which enabled a clear audit trail of the individuals financial expenditure to be followed. The administrator who manages peoples accounts said that some relatives like to have photocopies of the financial transaction sheets, so they can audit their relatives expenses, and copies of these were seen during the inspection visit. The home has a formal staff supervision system in place, in which staff receive supervision, either with the manager or with one of the other senior members of staff. This is usually in a one to one meeting. Formal supervision offers staff support and guidance in carrying out their work, and is seen as an essential management tool in residential care. The records indicated that staff were being supervised, but the National Minimum Standard of six times a year was not being achieved. Three members of staff were asked about formal supervision, and they all said they were receiving supervision sessions. A range of different health & safety records were seen, including the fire safety records, water temperature checks and the Control of Substances Hazardous to Health (COSHH) records, all were found to be correct and up-to-date, which shows that people are living and working in a safe environment. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 11 End of life care plans should be specific, and include the persons wishes, as well as giving staff clear guidance on who to contact, and what action to take. Two written references should be obtained for all members of staff, and be made ready for inspection. All staff should have a minimum of six formal supervision sessions per year, with the outcome recorded and available for inspection. 2 3 29 36 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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