Care Home: The Heathers

What the care home does well The service offers an extensive care package to the people who use this service in order to meet their complex care needs in a way that promotes their individual choice. Care plans and records are detailed and provide staff with all the information required to meet the needs of people who use this service. The service is to be commended for the quality of information and guidance available to staff, enabling them to provide excellent care and support to the people who live in the home. People are protected from harm through good risk management systems. Detailed risk assessments are in place to support staff in promoting the health and welfare of the people who use this service. People who use the service can be confident their health care needs are well met and their personal care is provided in a way that promotes their privacy and dignity and enhances their well being. People are protected through safe systems for handling of medication. They are listened to and protected form abuse. People who live in this home benefit from the comfortable, good standard of accommodation and the clean and safe environment. Suitable adaptations and equipment ensure people`s needs and lifestyles are well supported. They further benefit from the excellent support and friendly atmosphere provided by the enthusiastic, well trained and committed staff and management team. People who live in this home can be confident the service is being well managed in their best interests. Effective quality assurance systems ensure excellent standards of care are maintained and further opportunities for improvement are identified. The health, safety and welfare of people who live and work in this service are protected and promoted. What has improved since the last inspection? This was the first inspection carried out in the home since the new service provider took over the home in August 2009. What the care home could do better: The home must ensure there are sufficient numbers of suitably qualified and competent staff to meet the needs of people who live in the home. To ensure they are able to access all their programmed activities, maintain a presence in the community and enjoy regular outings. Key inspection report Care homes for adults (18-65 years) Name: Address: The Heathers 36 Green Lane Lower Kingswood Tadworth Surrey KT20 6TL     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: Ruth Burnham     Date: 0 4 0 1 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 25 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 25 Information about the care home Name of care home: Address: The Heathers 36 Green Lane Lower Kingswood Tadworth Surrey KT20 6TL 01737833985 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): veronica.goder@sabp.nhs.uk Leonard Cheshire Disability Name of registered manager (if applicable) Ms Veronica Albertha Goder Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6. The registered person may provide the following category/ies of registration only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home The Heathers is a large detached property situated in a pleasant residential area of Lower Kingswood, Surrey. It is currently registered to provide residential care for up to 6 adults with learning & physical disabilities and sensory impairment. The accommodation for the people who use the service is provided on two floors, with an elevator to reach the first floor. The communal space provided is a large dining room, a comfortable lounge and one room equipped with appropriate sensory equipment to Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 6 Brief description of the care home provide stimulation for the people who use the service. The people who use the service have access to a large enclosed garden, which is laid out in lawns with an area of enclosed trees at the rear boundary. The home has limited parking space to the front with an additional space provided for the homes minibus. The current fees charged are £1,717 per week. Care Homes for Adults (18-65 years) Page 5 of 25 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: The unannounced site visit, which forms part of the homes key inspection was undertaken on 4 January 2010. We were in the home for three hours 08:45 to 11:45. We asked the owner to complete and return the Annual Quality Assurance Audit (AQAA) before our visit. This was returned to us and contained all the information we asked for. Evidence for some of the information provided was looked at during our visit. There are 6 people currently living in the home. They all have profound multiple disabilities and were unable to communicate with us verbally or complete surveys. our judgement is therefore based on observation during our visit. We also spoke to 2 members of staff and the registered manager. We looked at most areas of the premises. We also examined a number of records including staff employment records, daily records, incident records, risk assessments, reviews and care plans. This is our Care Homes for Adults (18-65 years) Page 6 of 25 first visit to the home since change of ownership in August 2009. Before the visit we sent surveys to people who live in the home; their advocates; members of staff; health professionals and care managers. 12 surveys were returned: 6 from members of staff, 3 from health professionals and 2 from Community Support workers. Responses were largely positive. There is one required development at the end of this report. Care Homes for Adults (18-65 years) Page 7 of 25 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 25 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 25 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. The homes admission and assessment procedures ensure that the needs of the people who use this service are appropriately identified and met. Evidence: People who live in the home have done so for a number of years. There has been no change in staff or registered home manager since the change of ownership in August 2009 and no new residents have moved in since that time. The manager demonstrated the knowledge and ability to ensure that the homes admission and assessment procedure would be implemented for any person who wanted to move to the home to determine that the care home could meet their needs. The organisation has policies and procedures in place and provides helpful information to anyone who may consider moving into the home in the future. Care Homes for Adults (18-65 years) Page 10 of 25 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 use this service can be confident their individual needs are understood and can be met. They are supported to make decisions about their lives with assistance from the well trained and committed staff team. Excellent care planning and risk management systems ensure people the wellbeing of people who live in the home is promoted and they are protected from harm. Evidence: People who live in this home have complex needs which make it impossible for them to be enabled to have control over their lives. Each person has a detailed communication profile within their Person Centred Plan which highlights their likes and dislikes and the level of support required. Information provided in the Annual Quality Assurance Audit and obtained in surveys, in conjunction with direct observation during our visit, shows that staff are committed to providing appropriate levels of support, to promote some form of individual independence no matter how small. Individual needs and personal goals of the people who use this service are clearly recorded, these have been carefully developed using peoples known likes and dislikes and in consultation Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: with, families and other professionals involved in their care. The service operates a key worker system to ensure each person has a designated member of staff to oversee their care and wellbeing. Records seen show that individual care review meetings take place regularly to identify any changes and ensure appropriate adjustments are made to the persons plan of care in order to continue to meet their needs. As the people who live in this home cannot verbally discuss their health and well-being issues and concerns, the service has developed individual communication strategies to ensure all staff understand and know how to support the choices people make. People are protected from harm through good risk management processes. Each person has individual risk assessments relating to all aspects of their day to day lives and activities. Clear guidance is provided to enable staff to support people to participate safely in a variety of areas. Care Homes for Adults (18-65 years) Page 12 of 25 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 who use this service are provided with appropriate activities and engage in a range of leisure activities, however this is restricted due to the difficulties in arranging transport. The rights and responsibilities of people who use this service are respected and safeguarded. People who use the service are provided with a well-balanced and nutritious diet. Evidence: The service offers the people who live there a range of activities. Activities are tailored to suit individual needs and preferences. Each person has an individual activity programme. There has been some difficulty in accessing activities outside the home due to the lack of staff who can drive the homes minibus. This has had an adverse effect on people who live in the home in that they have been unable to attend all their day service activities, there has also been limited opportunity to access the local community or enjoy outings. The manager told us they also use alternative transport Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: wherever possible and the possibility of using volunteer drivers is also being explored. The home also uses a transport service Buses 4 Us when this is available. The service organises a in house music sessions which is held on a once a week basis by US IN A BUS, which is a charitable funded organisation catering for people with profound needs. They were visiting the home on the morning of our visit. People who use this service also benefit from aromatherapy sessions that are held once a week and tailored to meet the needs of each individual. There is a well equipped sensory Room in the home where people benefit from the opportunity to enjoy relaxation and physiotherapy exercises. The returned AQAA provides information about the types of community activities that are encouraged for the people who use this service, they include shopping, local hairdresser, visits to the theatre, day trips to various places of interest and visits to the coast as the availability of drivers permits. Records of activities seen however show that there have been limited opportunities for people to go out and about since September. Contact with friends and relatives is encouraged and the people who use this service are fully supported to maintain contact with their friends and families. Not all the people who live in the home have relatives who visit, the manager told us every effort has been made to find independent advocates for these people but this has proved unsuccessful to date. All the people who live in the home require some support with eating and drinking. The menu shows that healthy meals are provided. The dining room is well equipped, spacious and provides a pleasant environment where people can enjoy their meals. Support is provided discreetly in a way that promotes dignity and choice. Specialist advice had been sought to assist the home with specific dietary needs. Care Homes for Adults (18-65 years) Page 14 of 25 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. People who use the service can be confident their health care needs are well met and their personal care is provided in a way that promotes their privacy and dignity and enhances their well being. People are protected through safe systems for handling of medication. Evidence: Everyone who lives at The Heathers requires high levels of support with their personal care. Observations during our visit show that this is provided in a way that promotes peoples privacy and dignity. Interaction between staff, the manager and residents observed during our visit were friendly and respectful at all times. The good humour, patience and kindness of staff ensure an up beat atmosphere which residents clearly enjoy and benefit from. Each person has an up to date Health Action Plan (HAP) to meet their personal health needs, Two plans were examined in detail. These documents consist of previously known medical histories, current medication information, dietary requirements, blood tests and vaccination history. The HAPs are developed in consultation with health care professionals who have input into the health needs of each person. health professional Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: involvement includes the physiotherapist, optician, dietitian, dentist and other relevant specialists. A health professional who responded to our survey commented: The home has a very good understanding of residents needs. People who live in the home are protected through the safe handling of medication. All medication is stored in a locked cupboard. The home operates a monitored dosage system. Training is provided by the pharmaceutical supplier who also provides advice and monitors regularly. All medication administered in the home is recorded. Protocols are in place for service users receiving As required medication. The home has a copy of the Royal Society Pharmaceutical Guidelines. Care Homes for Adults (18-65 years) Page 16 of 25 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 in the home are listened to and protected form abuse. Evidence: Although people who live in the home have limited verbal communication skills, staff know them well and are able to interpret when they are unhappy. Excellent communication profiles enable staff to understand how each person communicates and ensure they are listened to and appropriate action is taken to promote their well being. There is a complaints procedure, this has been produced in a pictorial format. The manager informed us there have been no complaints made since the last inspection. People who live in the home are protected from abuse. There is a clearly written safeguarding adults procedure and a copy of the local authority safeguarding adults from abuse policy is available. All staff have attended training in safe guarding adults. Care Homes for Adults (18-65 years) Page 17 of 25 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 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 in this home benefit from the comfortable, high standard of accommodation and the clean and safe environment. Suitable adaptations and equipment ensure peoples needs and lifestyles are well supported. Evidence: People who live in this home benefit from the pleasant, homely and comfortable environment. Each person has their own bedroom. The rooms have been furnished and personalised to a high standard to meet their individual needs with their own furniture and pictures. Specialist hydraulic beds and individually designed arm chairs are provided. Ceiling tracking hoists are fitted in each bathroom and two mobile hoists are available to assist with safe moving and handling. There is a lift that enables access the bedrooms and therapy room on the first floor. The home is clean and hygienic with adequate hand washing facilities available throughout premises. There is a well equipped laundry and kitchen. All areas of the home are well maintained. Care Homes for Adults (18-65 years) Page 18 of 25 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 in the home benefit from the care and support of the committed, well trained and caring staff team. The impact of the reduction in staffing levels since the change of ownership is being carefully monitored, it is unclear whether the difficulties with accessing external activities relate directly to reduced staffing levels or lack of transport. People are protected through robust recruitment procedures. Evidence: People who live in the home benefit from the care and support of the enthusiastic, committed and stable staff team. Staff work well as a team and their goo d humour, enthusiasm and patience has helped create a happy and beneficial atmosphere for the people who live there. The home has ten permanent staff who all transferred with the residents when the ownership of the home changed. In response to our survey a local Health Trust community support worker commented: All staff know the clients very well. Good communication. A health care professional who responded to our survey said: Staffing is a long term problem as the home finds it difficult to recruit due to location. This impacts on the amount of social activities that can be accessed. Since the transfer of ownership numbers of staff on the morning shift have reduced from 4 to 3. The impact on residents of this reduction is being monitored by the manager and provider. The manager told us she is confident there has been no impact on the level of care people are receiving. High levels of agency staff are being used to cover shifts, Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: the manager said these are regular agency staff who know the people who live there well. It is proving difficult to ensure a full programme of activities. This is also exacerbated by the fact that only 2 staff are able to drive the minibus. The manager is aware of these problems and is actively seeking to find solutions. Five members of staff responded to our survey. Their comments are largely positive, the only areas they felt the home could do better related to difficulties with transport. Comments included: The home uses the buses 4U as an alternative if there is no driver in the home. In this way the service users are able to integrate themselves in the community and maintain their social being. Good team work between staff and general relaxed atmosphere. Clients are well cared for from all aspects. Provides a comfortable environment for the 6 service users by adhering to choice privacy dignity and maintaining community presence. lack of outings for service users due to the lack of drivers and staff numbers. The home could do better if we had more drivers at the home in order that the service users can go out more, driving the weekend rather than staying indoors. The home requires more drivers. Currently there are only 2 drivers and this limits the activities. There are no shops nearby and so rely on drivers for all trips. The home could do better by enabling the service users to access the community activities more frequently than present. People who live in the home are supported by well trained and competent staff. During the inspection the manager was working on the floor with the two other members of staff on duty. A number of staff have completed National Vocational Qualifications (level 2) or above. Each member of staff has their own training record in place and it was evident that staff have received mandatory training in safeguarding adults, fire, food handling, food hygiene, manual handling, health and safety, first aid and managing medication. People who live in the home are protected through robust recruitment procedures. Staff records were sampled. Records are well maintained in good order and contain all the required information. All staff are checked through the Criminal Records Bureau before appointment; POVA first checks are carried out and enhanced police checks are completed. Care Homes for Adults (18-65 years) Page 20 of 25 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 in this home can be confident the service is being well managed in their best interests. Effective quality assurance systems ensure excellent standards of care are maintained and further opportunities for improvement are identified. The health, safety and welfare of people who live and work in this service are protected and promoted. Evidence: The home manager transferred with staff and residents when the ownership of the home changed. This has ensured stability for staff and people who live in the home and the maintenance of excellent standards of care. The quality of the management of the home is reflected in the happy and relaxed atmosphere and the enthusiasm and commitment of the staff team to providing an excellent service where people who live in the home come first. We were not able to hear from residents directly about the service they receive as the nature of their disabilities meant that conversation was restricted and surveys were Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: not able to be completed. Judgements throughout this report therefore rely on observation, examination of documents, conversation with staff, information from healthcare professionals and community support workers and the information supplied by the manager in the Annual Quality Assurance Assessment. All this information confirms that the home provides an excellent service. The only areas where we have identified a need for improvement is in the high use of agency staff and restricted implementation of residents activity programmes and access to the community. The manager is aware of these issues and is working with the provider to find solutions. Observation throughout our visit indicates that people who live in the home are happy and very well cared for. People who live and work in the home are protected from harm through safe working practices. Substances hazardous to health (COSHH) are stored securely and appropriately. Health and safety checks are completed and recorded regularly including fire prevention records, fridge and water temperatures. The manager provided information to indicate that records and certificates and identified systems are in place for routine service and maintenance arrangements for all equipment and installations. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 32 18 The home must ensure there 28/02/2010 are sufficient numbers of suitably qualified and competent staff to meet the needs of people who live in the home. To ensure they are able to access all their programmed activities, maintain a presence in the community and enjoy regular outings. 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 24 of 25 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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