Care Home: The Orchards

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What the care home does well The home provides information and completes assessments before people move in so that people know that their needs will be met when they move in. People have access to a range of Health and Social care professionals and this ensures that health care needs are met. People receive their medication in a safe manner and as prescribed. There are a variety of activities offered so that people have something to do if they want to take part. There is a choice of meals, which meet any dietary, cultural needs or preferences so that people have food that they like. People are provided with a homely and comfortable environment in which to live where privacy is maintained. The home maintains a core group of staff so that people know who will help them to meet their needs. Small amounts of personal money can be held safely by the home. People told us: `This home was my first choice and I am happy here` `Its marvellous here` `I feel I get 100% care` `Staff provide practical care to a high standard` `Visits to the shops are very popular as are the concerts` `There are always activities but I choose to stay in my room` `I am a vegetarian and the kitchen have provided me with a range of meals` `My questions have always been acted upon` `I like the staff and I like living at The Orchards` What has improved since the last inspection? The home has started to introduce new care plans so that staff have detailed information about how people would like to have their needs met. The home has introduced trips outside of the home so that people can maintain linkswith the local community. A rolling programme of refurbishment and decoration is in place so that people live in a homely environment. A number of carpets have been replaced and communal areas decorated. Staff training continues to improve to ensure that staff are up to date with current practise and know how to meet peoples needs. What the care home could do better: The home should continue to introduce the new care plans so that staff have information available to help them meet peoples needs in a way they prefer. Mealtimes should be reviewed so that people receive their meals in a timelier manner. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Orchards 164 Shard End Crescent Shard End Birmingham West Midlands B34 7BP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lisa Evitts     Date: 1 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: The Orchards 164 Shard End Crescent Shard End Birmingham West Midlands B34 7BP 01217302040 01217301655 theorchards@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Colette Mary Rooney Type of registration: Number of places registered: Southern Cross Care Homes No 2 Ltd care home 72 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 72 The registered person may provide the following category of service only: Care Home with Nursing (Code N) 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 (OP) 72 Dementia (DE) 72 Date of last inspection Brief description of the care home The Orchards is a modern purpose built care home first registered in 1998 and situated in a residential area close to local shops and public transport links. The home provides 24 hour nursing, residential and respite care for a maximum of 72 older people. This includes the provision of transitional care for up to sixteen older people who are in Care Homes for Older People Page 4 of 28 Over 65 0 72 72 0 Brief description of the care home need of short-term care arranged by two Primary Care Trusts. The home can also provide care to people with Dementia. Accommodation is available over two floors and each bedroom is for single occupancy with an en suite facility. Provision can be made for two companion bedrooms if required, subject to availability. There are two goodsized lounges and one dining room on each floor. The first floor is serviced by two passenger lifts. Corridors are wide and spacious and have handrails to enable people to move freely around the home with any mobility aids they may require. The home has a hair salon. There are four assisted bathrooms and two assisted shower rooms, which meet the needs of the people living at the home. There is a pleasant enclosed courtyard with a variety of attractive features and with easy access for disabled people. There are three disabled parking spaces and limited parking spaces available at the front of the home however there is ample space to the rear of the building. CCTV is unobtrusively installed to cover the exterior of the home for security purposes. There are a number of notice boards in the reception area, which provide relevant information about the home and forthcoming events, and the last inspection report which may be of interest to people. The current scale of charges for the home are between three hundred and forty nine pounds to six hundred and eighty five pounds per week, depending on needs and type of room. Fee rates are exclusive of the registered nursing care contribution. Additional costs include, hairdressing, toiletries, chiropody and newspapers. Care Homes for Older People Page 5 of 28 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 focus of our inspections is upon outcomes for people who live in the home and their views of the service provided. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provisions that need further development. A pharmacy inspector carried out a visit to the home over three hours on one day. The following day two inspectors undertook this fieldwork visit to the home, over seven and a half hours. The manager was present for the morning and the Operations Manager assisted us for the rest of the day. The home did not know that we were visiting on that day. There were 65 people living at the home on the day of the visit and two people were receiving hospital treatment. Care Homes for Older People Page 6 of 28 Information was gathered from speaking to and observing people who lived at the home. Five people were case tracked and this involves discovering their experiences of living at the home by meeting or observing them, looking at medication and care files and reviewing areas of the home relevant to these people, in order to focus on outcomes. Case tracking helps us to understand the experiences of people who use the service. Staff files, training records and health and safety files were also reviewed. Random questionnaires were sent out to 18 people who live at the home and 5 staff in order to gain their views about the service. 18 people who live at the home and 2 staff returned questionnaires. These contained positive comments about the service provided and are included within this report. Ms C White, an expert by experience was present for part of this visit. An expert by experience is a person who, because of their shared experience of using services, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Feedback was given on the day of the visit to the Operations Manager and is included within this report. Prior to the inspection the manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us some information about how the home think they are performing. It also gives us some information about the staff and people who live there, improvements and plans for further improvements, which was taken into consideration. What the care home does well: What has improved since the last inspection? The home has started to introduce new care plans so that staff have detailed information about how people would like to have their needs met. The home has introduced trips outside of the home so that people can maintain links Care Homes for Older People Page 8 of 28 with the local community. A rolling programme of refurbishment and decoration is in place so that people live in a homely environment. A number of carpets have been replaced and communal areas decorated. Staff training continues to improve to ensure that staff are up to date with current practise and know how to meet peoples needs. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 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 10 of 28 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. Suitable arrangements are in place so that people can be confident that their needs will be met on admission to the home. Evidence: The organisation has produced a comprehensive service user guide and statement of purpose. Both of these documents were on display in the reception area of the home, which ensures that the information is available to people if they choose to read it. The documents are also available on audiocassette so that people with visual impairments can access the information. The certificate of registration and public liability insurance certificate are on display and a copy of the previous inspection report is displayed so that people have access to this information. Care Homes for Older People Page 11 of 28 Evidence: Comprehensive pre admission assessments are undertaken prior to people coming to live at the home. This should ensure that peoples individual needs can be met when moving into the home. People told us: I received plenty of information This home was my first choice and I am happy here Its marvellous here Care Homes for Older People Page 12 of 28 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. New care plans provide staff with specific details to assist people to meet their needs in a way they prefer. The management of medication ensures that people receive their medication safely and as prescribed. Evidence: Each person had a written care plan. This is an individualised plan about what the person is able to do independently and states what assistance is required from staff in order for the person to meet their needs. We looked at five people care plans and the pharmacy inspector looked at care plans for people whos medication was reviewed. The home was in the process of introducing person centred planning and this means that peoples likes, dislikes and preferences are recorded in detail. We found that the care plans on the ground floor were very detailed with likes and dislikes and included specific information to enable staff to assist people to meet their needs. For example I prefer to have a shower. This should mean that people receive their care in a way they prefer. The care plans on the first floor were not person centred and did not Care Homes for Older People Page 13 of 28 Evidence: provide such clear guidance for staff. Some people did not have care plans written for specific needs such as care of their feeding tube. These plans were discussed with the Operations Manager at the time of the visit and we were informed that these would be addressed. Due to the home being in the process of introducing the new care plans we believe that they will continue to put these plans in place and that once this has been completed, people will have very detailed plans for staff to follow. Therefore we will review this at the next visit to the home. Staff complete a number of risk assessments to ensure that any changes in care needs are identified and acted upon. These include nutrition, sore skin and moving and handling needs. Plans had been updated as peoples needs changed so that they reflected the current needs of the person. There was evidence of people receiving visits from external healthcare professionals including General Practitioners, tissue viability nurse, dietician, speech and language therapists and the falls coordinator. People told us: I feel I get 100 care The nursing staff responsible for medical support are excellent Staff provide practical care to a high standard The pharmacy inspector visited the home on the previous day to review medication management. Medication was stored safely and at the correct temperature. All controlled drugs were stored correctly and records were accurate. The home has installed a good system to check the prescriptions prior to dispensing and to check the medicines and charts received into the home for accuracy. One discrepancy was identified and this was immediately addressed with the persons doctor. Hand written medicine charts were well written and recorded all the relevant details required. Audits indicated that the majority of medicines had been administered as prescribed. A few mistakes were seen where staff had failed to record that they had administered a dose by signing the medicine chart. Medicines prescribed on a when required basis were sometimes dispensed in a monitored dosage system to help the nursing staff Care Homes for Older People Page 14 of 28 Evidence: administer these. This had resulted in some medicines only being offered at set times a day instead of when the person actually needed them. Other medicines, such as inhalers prescribed to be used only when required were often administered routinely. There were no supporting protocols detailing their use for nursing staff to follow. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. We observed good interactions between staff and people who live at the home. People told us that they were able to get up and go to bed at times to suit them. Care Homes for Older People Page 15 of 28 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 are able to choose the activities that they participate in which promotes their individuality and independence. People are offered a choice of meals to meet their dietary, cultural needs or preferences. Evidence: The home has two dedicated activities coordinators and this means that someone is available every day to support people with their interests. There is an in house activity programme which runs over four weeks and includes cinema, music, chats, ball therapy, bowling and arts and crafts. External entertainers visit the home each fortnight and a show had been booked for Christmas. There were photographs displayed in the home of events that had been held. People are able to have newspapers delivered and this means that they can continue to keep up with articles of interest to them. The hairdresser visits each week so that people can have their hair dressed in a way they prefer. Staff bring in their pets so that people can still enjoy and maintain an interest in animals if they choose to. People are able to continue with their chosen religion, as the home will arrange for a priest or vicar to come to the home. Care Homes for Older People Page 16 of 28 Evidence: Since our last visit the home have commenced outings outside of the home, so that people have access to the local community. The home has a driver and they take different people out on shopping trips and for pub lunches. They are now planning for trips out to places like Stratford for those people who wish to go. Residents meetings are held and minutes of these meetings were on display on the notice board so that people could read them if they wanted to. People told us: Visits to the shops are very popular as are the concerts There are always activities but I choose to stay in my room I prefer the girls to come and have a chat which they do often There is an open visiting policy, which means that people can see their visitors as they choose and maintain relationships that are important to them. The home has a four-week rolling menu and these identified a range of meals. The lunchtime meal has two hot choices and in the evening there are choices of sandwiches or a hot snack. There are snacks available throughout the day. The expert by experience joined people for lunch where she was offered a choice of main meal and sweet. She noted that people were brought into the dinning room for lunch at 12 noon and while the food was ready to be served from the heated trolley, staff first went to assist people in their rooms. This meant that people in the dining room did not get their meals served until round 12:30 and were sat waiting. This was discussed with the Operations Manager on the day of the visit and it is recommended that this is reviewed. The home is able to cater for peoples personal preferences and provide meals for cultural and medical reasons. People told us: I am a vegetarian and the kitchen have provided me with a range of meals I enjoy the meals now that the staff give me sandwiches at lunch instead of hot dinners Care Homes for Older People Page 17 of 28 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. The complaints procedure is comprehensive and is accessible to people should they want to make a complaint. The home has policies, procedures and staff training, which should safeguard people from harm. Evidence: The complaints procedure is displayed in the home and is included in the statement of purpose and service user guide so that people know how to make a complaint if they need to. Since our last visit we have received four complaints in relation to the manager, staff attitude and ability, people being woken up early and medication administration. These were referred back to the providers to investigate using their own complaints procedure. The home had recorded eight complaints this year and records of actions taken and outcomes were recorded. One person has told us that they feel that the home has taken too long to resolve a complaint, which was still outstanding at the time of the visit. We found a complaint regarding food being cold in the minutes of a meeting but this had not been transferred into the complaints book. We discussed this with the Operations Manager on the day of the visit and it is recommended that a grumbles book is implemented to monitor low level concerns for any trends. This will enable the Care Homes for Older People Page 18 of 28 Evidence: manager to take action before the concerns escalate into a complaint. One person told us I know exactly how to make a complaint The home has an adult protection policy, which incorporates the Department of Healths, No secrets policy, and the home has copies of local Multi Agency Guidelines so that staff have guidelines to follow in the event of an allegation of abuse. This should safeguard people from harm. There had been five incidents, which were raised as adult protections. These had been raised by the home and from external professionals. All had been closed with the exception of one, which was being investigated, by social care and health. The home informs us about things that have happened by a report called a notification. Staff have received training in the Protection Of Vulnerable Adults, dementia awareness and challenging behaviour, which should ensure that staff have the knowledge and skills to act appropriately to safeguard people from harm. Care Homes for Older People Page 19 of 28 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 are provided with a homely, clean and comfortable environment, in which to live that meets their individual needs. Evidence: We looked at areas of the home which were relevant to the people we case tracked. There was a nice atmosphere throughout the home and staff were observed to interact well with the people living in the home. Chairs in lounges were arranged to promote social interaction and some people stayed in their rooms, as they preferred. During the afternoon we sat in the lounge were the curtains had been drawn and people were watching a movie. The home has spacious corridors with handrails and this enables people to move freely around the home with the use of any mobility aids they require. The home told us in their Annual Quality Assurance Assessment that they have a rolling programme of redecoration and refurbishment. Some of the bedrooms have had new carpets and areas of the home have been redecorated. This means that people live in a homely environment. Bedrooms seen were personalised and reflected individual tastes, gender and cultural Care Homes for Older People Page 20 of 28 Evidence: preferences. People are encouraged to bring in their own possessions in order to have familiar items around them to make their rooms as homely as possible. People told us: I am more than happy with the cleanliness of my room and the home Its very clean and tidy The expert by experience said the cleaning staff were very active on my visit, bins were emptied and bathrooms cleaned Care Homes for Older People Page 21 of 28 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. People are supported by staff who receive training to ensure that they have the knowledge to meet individual needs. The recruitment procedure ensures that people are safeguarded from harm. Evidence: There are four trained nurses on duty in the morning, three in the afternoon and two at night. There are six carers on each floor in the morning, five in the afternoon and four at night. The home has a full compliment of nursing staff and had few care staff vacancies. The home maintains a core group of staff so that people know who will be assisting them to meet their needs. In addition to nursing and care staff the home also employs maintenance, domestic, kitchen and administrative staff to meet all the needs of the people living at the home. All of the staff have completed a National Vocational Qualification level 2. New staff who have been recruited have been enrolled onto a training programme for this qualification and this should ensure that a knowledgeable and skilled workforce can meet peoples needs individually and collectively. People told us: Care Homes for Older People Page 22 of 28 Evidence: My questions have always been acted upon I like the staff The expert by experience told us that she observed staff interacting well with people and no concerns were brought to her attention when she was talking to people who live at the home. Three staff files were reviewed and these contained all the required information to ensure that people were safe from harm. Two recent employees did not have identity photographs and this was brought to the attention of the manager at the time. There was evidence that people receive an induction into the home so that they are aware of their responsibilities. The home has a detailed training matrix, which enables the home to plan future training. There is a dedicated in house trainer who coordinates training across the home. Staff have received training in customer care, pressure care (sore skin), challenging behaviour, dementia awareness, bed rail safety, fire safety, food hygiene, moving and handling, health and safety, infection control, nutrition and abuse. Care Homes for Older People Page 23 of 28 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. The home is run in the best interests of people who live there. Evidence: The manager is now registered with us and this shows a commitment to the running of the home. She is a Registered Nurse and has experience of managing care homes. The manager has a City and Guilds advanced management in care qualification and continues to attend study courses in order to ensure that her knowledge is up to date in order to lead the care team. External managers visit the home to monitor the quality of the service being offered and they write a report about this each month. The organisation has a number of audits in place to monitor the service provided and sends out satisfaction surveys every three months to get peoples opinions about the home. Prior to the inspection the manager had completed an Annual Quality Assurance Care Homes for Older People Page 24 of 28 Evidence: Assessment (AQAA) and returned it to us. This gave us some information about how the home think they are performing. It also told us about staff and people who live there, improvements and plans for further improvements, which were taken into consideration. The manager holds a surgery each Wednesday so that people can come and discuss their needs with her and their relatives. The manager holds meetings with different groups of staff and residents and relatives meetings are held so that people are given the opportunity to discuss ideas or share concerns. The home is able to hold small amounts of peoples personal money for safekeeping. The home has a computerised system, which generates individual accounts and provides details of money coming into and out of the account. Each person receives interest on the money held. Health and safety and maintenance checks had been undertaken in the home to ensure that the equipment was in safe and full working order. Maintenance checks are completed on the fire system and equipment and staff receive fire training and drills so that people should be safe in the event of a fire occurring. One person who lives at the home told us The Orchards has a very good maintenance team, they work above from expected duties and are very helpful and supportive to us. Accident records are audited each month and any trends are identified and acted upon to try and reduce the incidence of the same accident happening again. Care Homes for Older People Page 25 of 28 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 26 of 28 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 2 7 9 All care plans should provide specific information so that peoples needs can be met in a way that they prefer. It is advised that all medicines prescribed to be administered on a when required basis have a supporting protocol detailing its use for nursing staff to follow. Arrangements for mealtimes should be reviewed so that people receive their meals in a timley manner. Arrangements should be made to record and monitor low level concerns so that they can be addressed. 3 4 15 16 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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. 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