Care Home: The Horizon

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What the care home does well The home has a friendly, relaxed and supportive atmosphere. The independence and rights of the people who use the service are given high priority. People who use the service are encouraged to make decisions about their lives and to take appropriate risks with support from the management and other professionals involved in their care. Detailed needs assessments are carried out prior to anyone moving into the home so that the person receiving the service knows the home can meet their needs. Occupational and leisure interests are encouraged. The manager is professional and ensures the health and safety of both staff and people who use the service. The building is clean and decorated to a very good standard. What has improved since the last inspection? A random inspection of this service was undertaken by the Commission in December 2008. As a result two requirements and one good practice recommendation were issued. The service has now complied with all of these. The medication policy has been reviewed to reflect current professional guidance. Staff have received training in adult protection and protocols within the home have been developed to ensure the safety of people who use the service. The registered provider has ensured that staff have access to training they need to carry out their job properly and safely. What the care home could do better: As a result of this inspection five new requirements have been issued. All medication coming into the home must be recorded so that a detailed audit of medication can take place at any time. All residents` known allergies must be recorded on their medication chart so that staff are aware of any possible problems. Paper towels must be provided for staff and residents in communal toilets so that the risk of cross infection can be reduced. All staff, including night staff need regular training and fire drills so they know what to do in the event of a fire. The home must develop a lone working policy and procedure for the protection and support of staff at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: The Horizon 154 Hedge Lane Palmers Green London N13 5BX     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: David Hastings     Date: 1 2 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: The Horizon 154 Hedge Lane Palmers Green London N13 5BX 02088822663 02088822663 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somerset Villa Care Home Limited care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 4 The Registered Person may provide the following categories 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: Mental Disorder, excluding Learning Disability or Dementia - Code MD Date of last inspection Brief description of the care home The Horizon is a care home registered for four people with a history of mental illness who may also have a forensic background. The home is owned and managed by Mr and Mrs Ghoora who are both qualified mental health nurses. The accommodation in the home is arranged over three floors and all the bedrooms have an en suite shower room. The home is located near to Palmers Green and there is access to local transport and other local amenities. The stated aim of the home is to provide 24 hour care in a safe, homely and Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 4 0 9 1 2 2 0 0 8 Brief description of the care home therapeutic environment to build up the service users confidence and enable them to assume a more independent life in the community by assisting them in every day tasks and decisions and to develop better strategies for coping with stress and disabilities. Fees range from seven hundred and fifty pounds to seven hundred and ninety five pounds per week. Copies of this report can be obtained by the home and on the CQC website. 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This Key unannounced inspection took place on 12th November 2009. In total the inspection lasted 5 hours. We were assisted by the registered manager and provider who were open and helpful throughout the inspection. We spoke with two staff on duty during the inspection. We met all four residents of the home and we spoke with a mental health professional over the phone. We observed the interactions between staff and residents. We inspected the building and examined various care records as well as a number of policies and procedures. The home also prepared a self-assessment (AQAA) and this was submitted to the Commission. This information was used as part of the inspection. Care Homes for Adults (18-65 years) Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. There is also information available to prospective residents to the home about the services and facilities available. Evidence: We examined the homes Statement of purpose and Service user guide. These documents describe the aims and objectives of the home and the facilities available to people coming into the home. These documents also inform social workers looking for placements for people. The documents clearly outlined the aims and objectives of the home and included information about the facilities available for residents. Pre assessments were examined for all four people living at the home. The placing authority had provided detailed information to the home about the prospective residents. This information included risk assessments, Occupational Therapy assessments, mental health assessments and a proposed care plan by the placing Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: authority. The manager told us that they would not assess anyone without these pre assessments being received first. The manager said that he or the registered provider would then carry out their own assessment of the person. Both the manager and provider are qualified mental health nurses. We saw detailed information in these assessments about the individual and their needs. We also saw evidence that people had been involved in their own assessments. This should ensure that people know the home will be able to meet all their needs before they move in. The manager and provider told us that prospective residents would visit the home and possibly stay overnight to get a better feel about the service. We saw evidence that residents had a review of their placement four to six weeks after they moved into the home. This is to make sure that the home is right for them. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service have a detailed plan of care, which is reviewed together with staff and changes made when required. Risks to residents as part of their individual life styles are recorded and reviewed. The management and staff work hard to assist and facilitate residents to make decisions about their life. Evidence: Four peoples care plans were examined. These were detailed and outlined the needs and wishes of the residents with information for staff about how to support residents and meet their assessed needs. Care plans had been signed by the resident to confirm they agreed with the information. One person had not agreed with their plan. The manager told us this was because the individual lacked any insight into their condition. It was clear from discussion with the manager and provider that they were dealing with this conflict in a sensitive and supportive manner. The emphasis in all care plans was around support and rehabilitation. Residents confirmed that they was able to make decisions about their life and staff supported them when needed. The manager and the staff we spoke to were able to give examples of how they support residents to Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: make their own decisions, for example, with regard to food and activities of daily living. Extensive risk assessments were in place for the residents at the home. These included risks associated with medication, illegal drugs, smoking, fire and other activities of daily living. These assessments detailed what action had been taken to reduce these risks while maintaining peoples independence as far as possible. The manager told us that the service does not deal with any of the residents finances. Both risk assessments and care plans were being reviewed on a regular basis and with input from residents and other care professionals. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported to enjoy a range of occupational and leisure activities. These activities are based on their individual interests. They are also supported to eat nutritious meals based on their individual dietary needs. Evidence: Two of the four residents attend day centres. One resident is undertaking a degree course with the Open University. All of the residents we spoke with said they were satisfied with the activities available at the home. We saw the staff interacting and carrying out activities with residents during the inspection. There is a large snooker table in one of the vacant rooms in the home. There is a large outbuilding in the garden which the provider told us would be the new games room after it had been decorated and tidied up. The manager explained that staff were encouraging residents to carry out activities of daily living, however this was a challenge for some residents due to their past history in residential care. Some people we spoke with said that Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: sometimes staff would nag them to do things. However residents did say that they knew the staff had their best interests at heart. The manager told us that all of the residents go out of the home on a regular basis. This was confirmed by residents we spoke with. Although all the residents have family not all are able to visit. The manager told us that the service has an open visiting policy. Residents who do have visitors told us they were made welcome by staff. There are no restrictions on residents going out however the manager said that some residents would be advised not to go out too late for their own safety. Residents that we spoke with told us they had choice around what they did each day and that staff encouraged them to make decisions about their lifestyle. Residents decide what they would like to cook and eat the day before. Staff support residents to cook if they wish and the lunch on the day of the inspection was sausage casserole with rice. One of the residents we spoke with told us that meals are discussed at residents meetings and we saw evidence that the service had responded to requests for changes to the menu. There was evidence that the service had taken into account the cultural needs of residents at the home. The kitchen was clean and food, fridge and freezer temperatures were being monitored as well as what the residents ate each day. Residents we spoke with told us they liked the food at the home. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service receive the care and support they need to maintain their independence. People have good access to health care professionals and their health needs are monitored by the home. There are generally good systems in place to deal with the receipt, administration and disposal of medication at the home. Evidence: None of the residents at the home need support with personal care. Care plans detail how staff are to encourage and prompt people with their personal care needs such as washing and changing their clothes. Residents told us that the staff were friendly and respectful towards them. Residents weight is monitored monthly and there was evidence that people have good access to health and mental health professionals such as doctors, dentists, opticians and chiropodists. The manager told us that in some cases residents have refused health care professional support however the manager would always book dental appointments etc and try and encourage that person to attend. Where there have been concerns about residents health, due to non attendance of medical appointments, the manager has kept the persons doctor informed. Everyone at the home sees their doctor on a regular basis and has regular contact from mental health professionals. All residents have an allocated social worker Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: who works closely with the resident and the service. Records were examined in relation to the receipt, storage, administration and disposal of medication. Records indicated that staff have undertaken medication training and the manager told us that only qualified staff administer medication at the home. The home uses a Dosett pack medication system supplied by a local pharmacist which contains the medication for each individual each week. The amount of medication coming into the home was not being recorded. This needs to be recorded so that an audit of medication can take place at any time. A requirement has been issued in the relevant section of this report. One resident at the home has a known allergy to some medication. Although this was clearly stated in his care plan it should also be recorded on his individual medication record (MAR chart). A requirement has been issued relating to this matter. Medication was being administered, stored and disposed of properly and in accordance with the homes medication procedures. None of the residents self-administer their medication. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. People who use the service are protected from abuse by clear policies and procedures and by a knowledgeable staff team. Evidence: The home has satisfactory policies and procedures in relation to complaints and adult protection. People who use the service told us they had no complaints but knew what to do if they did have a concern. We examined the minutes of the monthly residents meetings. This detailed a minor complaint about the food. There was clear evidence that this matter had been dealt with and the menu choices had improved as a result. The manager was clear about his responsibilities in notifying the appropriate authorities should an allegation of abuse be made at the home. Records indicated that four of the five care staff have undertaken adult protection training and the manager told us that further training has been booked for January 2010. Both the registered provider and manager have attended an adult protection course for managers provided by the local authority. They have also both attended training regarding the Mental Capacity Act which included the Deprivation of Liberty Safeguards. We were able to interview two members of staff during the inspection. They had a good understanding of what adult protection was and their responsibility to report any suspicions of abuse to the manager. Care Homes for Adults (18-65 years) Page 17 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 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 is clean, safe and furnished and decorated to a high standard. Evidence: We looked around the home with the registered provider and visited a residents room with their permission. The home has been recently decorated to a very good standard and was bright and clean throughout. Residents told us they were happy with their rooms and the room we saw had been personalised and included a fridge for drinks and snacks. There are eight rooms in the house for residents. Currently the service is only registered for four people. The manager and provider told us they were going to apply for registration of the other four rooms soon. They told us they did not want to rush this process and wanted the four existing residents to get used to being in the home first. There is adequate communal space including a lounge with a television, a conservatory and seating in the kitchen for meals. One of the vacant rooms on the ground floor has a snooker table in, however the registered provider told us they were Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: planning to use the large building at the end of the garden for a games room in the future. All bedrooms have an on suite toilet and shower. Communal toilets had anti bacterial soap but need paper towels to further limit the risk of cross infection. A requirement has been made. The manager told us that he employs a maintenance person to fix things when needed. The kitchen and laundry areas were both clean and tidy. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: The registered manager works between 9:00am and 5:00 pm during the week. There is also one staff member on shift at all times during the day and night. The registered manager and provider are on call at all times if they are not on duty at the home. There are five male carers on the rota. The manager told us the staffing ratios will increase when the four other rooms are registered. People told us they were happy with the staff team. The manager told us that four of the five staff have completed their NVQ level 2 training or equivalent. We saw written evidence that staff training has been undertaken and the staff members interviewed were positive about the training offered by the home. This training included first aid, health and safety training, infection control and medication training. We saw that further training has been booked for all staff in the coming months. Mental health training is provided by the registered manager and provider who are both qualified mental health nurses. There were records in each staff file to indicate that staff have induction when they Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: first start work in the home and supervision on a monthly basis. Three staff files were examined from staff employed by the home. We checked these files to see if the homes recruitment procedures were being followed so that residents are protected from unsuitable staff working at the home. The files examined contained all the information needed to protect residents including two written references, proof of identity and criminal record checks. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from a well run home and a professional manager. The newly developed quality assurance system should ensure that residents and their representatives have a say in how the service is run. The health, safety and welfare of residents are promoted and protected. Evidence: The registered manager is a qualified mental health nurse and has completed the training required for his management role. Both staff and residents were positive about the manager and the provider of the home and said they were easy to talk to. Staff said the manager was supportive and helpful. We spoke with a mental health care professional who has placed residents at the home. They were positive about the professional approach of the manager and registered provider. As this service is relatively new the quality assurance systems have not yet been fully tested. However there are regular residents meetings so that people can have a say in how the home is run. The manager told us that the service would be sending out quality questionnaires to every resident and other stakeholders every six months. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: Health and safety records including fire records were examined. We noted that staff have not undertaken fire drills yet. Although fire training is given as part of the staff induction process, it is important that staff regularly go through the action they need to take in the event of a fire. The manager told us that this would be addressed in individual supervisions and recorded. A new requirement has been issued. As there are times when staff work alone in the home it would be prudent to develop a lone working policy. This would enable the service to assess the risks associated with lone working and provide staff with information about remaining safe. A new requirement has been issued. There was evidence that the service has the relevant health and safety documentation and certificates needed to run this service. Both the manager, registered provider and staff have attended health and safety training relevant to their job. Further training has been booked for the coming year. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person must 01/01/2010 ensure that any known allergies of residents are recorded on their medication chart. This is to ensure that staff at the home are aware of any allergies residents may have. 2 20 13 The registered person must ensure that all medication coming into the home is recorded. This is to ensure that an audit of medication can take place at any time. 01/01/2010 3 30 13 The registered person must ensure that all communal toilets contain paper hand towels This is to ensure that the risk of cross infection is reduced. 01/01/2010 Care Homes for Adults (18-65 years) Page 25 of 27 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 4 42 13 The registered person must ensure that a lone working policy is developed. This is to ensure the safety of both staff and residents at the home. 01/01/2010 5 42 23 The registered person must ensure that all staff including night staff receive regular fire drills at the home. This is to ensure that all staff including night staff know what action to take in the event of a fire. 01/01/2010 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. 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