Care Home: The Shrubbery

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What the care home does well Admissions are well managed. Care plans are clear and updated as needs change. Health care needs are addressed. Staff mandatory training is undertaken and there is good access to National Vocational Qualifications. People are aware of the complaints procedures People living at the home were very satisfied with their accommodation. What has improved since the last inspection? A controlled medication cabinet has been installed in a locked storage area to comply with new legal requirements. Carers were aware of changes to emergency exit procedures and routes during the refurbishment. An assisted bathing area has been provided to meet the identified needs of people resident at the home. Formal supervision is now provided for all staff. Care staff are undertaking dementia care What the care home could do better: The Registered Manager had submitted a management plan of how the refurbishment within the home is completed, that shows how people using the service are to be supported during the period of the work and what steps are being taken to minimise the disruption for them. However an immediate requirement was made to protect people using the service from accessing the building areas where it was unsafe due to trip hazards and building tools left unsecured after the builders had left the home for the night. The Registered Manager needs to seek advice and approval from the Fire Safety and Environmental Officers regarding the temporary arrangements for access to the home and that facilities are safe. This was a requirement made at the last inspection. Activities need to be based on individual personal preferences, social histories and be person centred. The support needs of several people using the service would benefit from staff training in behavioural management. Communication between management and relatives could be improved. Key inspection report Care homes for older people Name: Address: The Shrubbery 66 College Street Higham Ferrers Northants NN10 8DZ     The quality rating for this care home is:   one star adequate 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: Judith Roan     Date: 2 7 0 4 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: The Shrubbery 66 College Street Higham Ferrers Northants NN10 8DZ 01933317380 01933317380 claire@rochmills.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Rochmills Limited care home 45 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Service users accommodated within the MD(E) category should only be admitted to the Churchill Wing of The Shrubbery. The maximum number of persons to be accommodated at The Shrubbery is 45. The Shrubbery care home is registered to provide personal care for male and female service users whose primary needs fall within the following categories: Old age, not falling within any other category (OP) 18 Dementia - over the age of 65 years DE(E) 8 Physical disability - over the age of 65 years PD(E) 6 Mental disorder - excluding learning disability and dementia - over the age of 65 years MD(E) 13 Date of last inspection Brief description of the care home The Shrubbery situated in Higham Ferrers is near to local facilities and amenities including shops. There are public transport links to the neighbouring towns of Rushden and Wellingborough. The home provides personal care for up to 45 people over the Care Homes for Older People Page 4 of 28 Over 65 0 31 6 8 0 0 1 1 0 9 2 0 0 8 Brief description of the care home age of 65 years; within this they are registered to provide care for up to 8 residents who have dementia or a history of mental health and 6 with a physical disability. Accommodation is provided over two floors with a passenger lift and staircase for access to the first floor bedrooms. On the ground floor there are several communal rooms including two dining rooms, three lounge areas and a conservatory. There are gardens and level access to the main entrance with ample car parking for visitors. There are 33 single rooms of which 29 have ensuite facilities and 6 double rooms with 3 of these being ensuite. Information about the home can be found in their Statement of Purpose and Service User Guide. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is adequate 1 star. This means the people who use this service experience adequate quality outcomes. The focus of inspections undertaken by the Quality Care Commission (CQC) is upon outcomes for people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was case tracking which involved selecting four people who use the service and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. This inspection involved an expert by experience. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it Care Homes for Older People Page 6 of 28 is like to live in or use the service. The views and experiences of people who use services are central to helping us make a judgement about the quality of a service so they should be fully involved in the inspection process. We use information from experts by experience to help us triangulate evidence and verify any issues. We also received surveys completed by seven people using the service, two relatives and four staff member. The questionnaires provided good feedback on the quality of the care service. The homes registered manager also completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required to be completed by CQC. The inspection was unannounced and was undertaken during the morning and afternoon lasting 7.5 Hours. People using the service said:- They received enough information to help them decide if the home was the right place for them That they had a written Contract We know how to make a complaint That the home is usually fresh & clean They make you feel at home Happy her better than I thought Staff said;- The home provides a friendly and caring environment There needs to be more stimulation we do our best but do not have enough time We sometimes are understaffed when people are off on leave or sick. Relatives said:- The staff are very pleasant and responsive. They try to provide a home from home atmosphere and generally do so They could provide more activities They look after my Mum well The expert by experience summarised their visit by saying on the whole I liked what I saw, staff were open, friendly and happy to help without interfering. I sensed a nice atmosphere and I felt further improvements will come along when the building work is completed and residents and staff can move about without restrictions because of builders. Care Homes for Older People Page 7 of 28 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 Care Homes for Older People Page 8 of 28 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 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. People admitted into the home can be assured that their needs will be fully assessed. Evidence: The statement of purpose and service users guide provides clear information about the support available at the service. Copies are available in reception has been reviewed and updated to ensure that information remains current. The documents tell the reader clearly about the service available. People who replied in the surveys confirmed that they receive a service users guide. The AQAA states that All service users are given a copy of our service user guide prior to admission- this is written and reviewed by head office. A copy of the statement of purpose and service users guide can normally be found in the reception area at the home. However during refurbishment this has been difficult to achieve. People who use the service and relatives are given a choice of rooms available when Care Homes for Older People Page 11 of 28 Evidence: they are admitted. Relatives are aware they are able to visit at any reasonable time to view. Assessments are completed prior to admission and carers were mostly aware of the needs of new people being admitted to the home. Carers stated that they were not always well informed and prepared when a new person is admitted. The surveys supported this view. In reviewing files it was clear that assessments had been completed and that all people using the service had a contract. The terms and conditions of residing at the home are contained in the contract that is issued to all residents and their families. 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. Individual personal and health care needs are well recorded and consistently met. Evidence: Care plans viewed showed that all required information to meet the needs of people who use the service was evident. Plans are consistently updated and reviews are taking place. The new team leader is responsible in maintaining the quality in this outcome area. The AQAA states that we have encouraged our service users and their representatives to participate in compiling there care plans. All risk assessments applicable like nutritional, manual handling & pressure area care are completed on the day of admission. All care plans are now up to date and reviewed monthly, a copy of reviews and comments is kept for auditing purposes. All care plans had risk assessments in place to support areas of identified need. It was evident that manual handling assessments had been completed and in use for those people case tracked. Nutritional and fall assessments were seen to be in place and ensure that protections are in place to minimise risks. The Expert by Experience who witnessed one person being verbally abusive to another resident raised one concern Care Homes for Older People Page 13 of 28 Evidence: and made the following comments. I observed one gentleman being very abusive to various residents and particularly to a lady with an accent. He started to distress other people sitting in the lounge, once a member of the staff recognised what he was doing she removed the lady he was verbally attacking. I felt this was an issue and that if he is behaving like this a plan of action would have to be put in place to deal with him. The individual does have a behavioural strategy and the local community team for people with mental health needs are involved. In discussion with the manager they confirmed that regular support and monitoring is being carried out. The incident will however be discussed on how to ensure that the strategy is working in protecting others living at the home. Essential documents relating to the discharge of a mental health patient admitted on a section 117 leave were not held in the file of one person case tracked. The manager contacted the Mental Health Professional responsible and the paperwork arrived later in the day. During the inspection the inspector observed carers to be respectful and responsive to the needs of residents in the home. The Expert by Experience noted that the Registered manager on the tour of the building knocked on the door respecting the privacy of the resident. Carers communicate well with people using the service and maintain communication links about the well being with relatives. The Expert by Experience made the following observations I then went off on my own to chat to residents and staff. I chatted to most of the people sitting in the lounge individually and everyone told me how happy they were with the home, I asked what would make their lives better and not one single person had anything to add. Most were nicely dressed although one or two ladies didnt look as if they had had their hair combed today. One lady had had her nails varnished which she was very proud of and when I asked who had done it for her she said the staff. During my visit the Staff weighed everyone it was made to be a fun event, which I liked. Administration of medication within the home is safe. On the files viewed profiles were evident and indicated the reasons for the medication. The storage of controlled drugs now meets the new regulations that came into force in 2007. The annual medication inspection audit carried out by the supplying pharmacist reported that the home has no requirements Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Not all activities are person centred for people using the service. Evidence: There is a range of activities at the home but it is recognised and stated within the AQAA that more could be achieved. The home has an activities person who works four days per week 1.30-5.30(helps with tea from 4), she needs to attend training to develop her skills, especially to work with clients with profound dementia. In discussion with and in observation by the expert by experience they supported the above view. Their report made the following comments I asked about activities and some people where interested but others did not wish to participate. Activities are usually done twice a week with an activities co-ordinator and the staff said they also did some. I felt that this area still needed a greater input, certainly some of the residents need a one to one to stimulate them. Most residents said that they were assisted to make choices during their day and felt that their preferences were respected. The menu has choices and individuals are consulted each day as to their choice from the menu. People who had difficulty with eating were supported individually. At Care Homes for Older People Page 15 of 28 Evidence: teatime there is a choice of sandwiches or a hot option. The expert by experience observed the meal and spoke with people in the dining room. They made the following observation. I visited the dining room as lunch was being served, the tables looked nicely set out and one table had a flower arrangement that made it look extremely nice. Normally food is served directly from a hot trolley but today the trolley had lost a wheel so food was being brought from the kitchen. Salad was the main meal but people had a choice early this morning, some had a hot meal. It would have been nice to see perhaps some food, potatoes or bread, that the residents could help themselves to on the table. Salad is not always easy to eat and some could have done with the food being cut up smaller. I noticed one meal being delivered to a resident in their room and asked to feel the plate; it was hot so that meant the resident would get a warm meal. The plate had no cover on and it would be more hygienic if it had. Families are made to feel welcome at the home and are always kept up to date with changes in needs of their family member. There are no restrictions on times that families/friends can visit. The expert by experience noted that Throughout the day visitors kept arriving to see family and there was a nice atmosphere between the staff and families. Care Homes for Older People Page 16 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 adequate 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 are not fully protected by the practices at the home. Evidence: Residents and their relatives are fully aware of how to have their concerns and complaints addressed. Relatives completing the surveys confirmed that they would be confident that concerns would be addressed. CQC have received one complaint about the service relating to the environment whilst the refurbishment is being completed. The provider has investigated and replied direct to the complainant and taken action to resolve those issue upheld. A further twelve complaints have been received by the Provider of which five have been upheld and acted upon. Carers have undertaken safeguarding training and knew the whistle blowing procedures if a person using the service was at risk or being harmed. The recruitment practices at the home ensure that all staff have a valid Criminal Records Bureau (CRB) check and that references are taken up. The environment seen during the inspection placed people using the service at risk. See Environment outcome area for full details and actions taken to make people safe. Care Homes for Older People Page 17 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 poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The refurbishment programme at the home does not ensure that safety is maintained to an acceptable standard. Evidence: The parts of the home that have been refurbished were found to be clean tidy and rooms seen by the expert by experience were personalised. In their report they made the following comments from their tour of the building. I noticed that all the rooms were bright and had no smells whatsoever. The toilets in the en suite were clean. The residents are allowed to bring whatever they like from their own homes so each room was very different. To accommodate one resident a carpenter was erecting further shelves so that she could store more of her belongings. Later in the inspection they noted The toilets downstairs had a rush just after lunch and more staff needed to be involved for safeties sake. I think it would be a good idea to have a cleaner to check them out at this time. Considering that lots of building works are going on the home was kept very clean with just the odd piece of dusty equipment. One wheelchair had a faulty brake and it would suggest that it should be taken out of service and the others checked for any faults. The home continues to operate under difficult conditions whilst managing the refurbishment programme. After the last inspection the Registered manager submitted a plan of how the remainder of the work was to be completed to ensure that the Care Homes for Older People Page 18 of 28 Evidence: safety of people using the service is maintained. Unfortunately the area under construction was found to be accessible to all people using the service and staff. We found tools lying around that could cause an accident and the floors presented serious slip and fall hazards. An immediate requirement was made for the area to be made safe before the end of the inspection. A further letter was sent requiring the provider to make arrangement for the area to have a partition erected that could be locked when the builders were not in the building. The Registered Manager has also not sought the views of the Fire and environmental officers about safety in the home as required after the last inspection. An appointment has now been made for this advice with the fire officer who is visiting later in the week. The environmental health officer has also visited at the request of CQC to give advice. The provider has confirmed that the required work has been achieved to protect people living at the home. The provider has now addressed the requirement made at the last inspection in providing an operational bathroom offering lifting equipment to support people who wish to have a bath. Care Homes for Older People Page 19 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. A trained and committed staff team support people using the service. Evidence: Staff files were reviewed and demonstrated that recruitment procedures are in place and the required checks have been completed to protect people using Files contained applicationforms with employment histories, references and criminal record bureau (CRB) disclosures. Protection of Vulnerable adults confirmation is included within the CRB process. Mandatory staff training is maintained and staff files reviewed contained evidence that they had completed their in house training. Staff spoken with indicated that induction and basic training is completed. Staff surveys in the main confirmed that training is undertaken and that they are supported. The AQAA confirms that further training is promoted and that of a care team of thirty sixteen staff have completed NVQ 2 or above. Remaining carers are completing this training at present. All carers have completed infection control training and a further ten are taking a course in dementia care Keeping staff up to date with all the emergency arrangements in a constantly changing environment has been achieved. Staff surveys were in the main positive. They all however felt that more time is Care Homes for Older People Page 20 of 28 Evidence: required for activities. This is also identified by the Expert by Experience and by the Registered Manager within the AQAA. Staff also said that they would like more staff meeting to discuss issues affecting them and the service. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is not always managed in the best interests of people using the service. Evidence: People who use the service and their relatives are surveyed on an annual basis and is one part of the quality assurance system in place at the home. An external provider who visits the home monthly carries out the regulation 26 reports. Issues are discussed and form part of discussion with the provider. The results being reflected in a development plan for the service. Surveys received from relatives confirm that they are normally consulted and kept informed. Information is also gained from service user meetings held regularly throughout the year. People spoken to during the inspection were able to confirm this and were happy that their views were being listened too. One survey however expressed concern that information was not forthcoming. The issues regarding poor communication have been sent to the provider to investigate. Relatives mainly support the people who use the service with their finances. In a few Care Homes for Older People Page 22 of 28 Evidence: situation the homes administrator keeps valuables. There is a good recording system to protect people who use the service. The manager failed in their duty to ensure that other people working in the home are working safely and that their actions do not compromise the safety of people who use the service. Health and safety checks are maintained and full records are kept. A system of staff supervision has been set and most staff confirmed that they are now being supported. Care Homes for Older People Page 23 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 24 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 1 19 13 You must by 18:00 29th April 27/04/2009 2009 ensure that the area has a physical barrier to prevent people using the service and staff access to the area whilst workmen are working in the building. This barrier must be lockable at night. This is to make the home safe for people using the service. 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 7 12 Documentation must be in place relating to the admission of people on a Mental Health section 117 leave prior to their admission and continuation residency. This is to ensure that the the legal status is clearly defined. 30/06/2009 2 12 16 Activities need to be person centred and meet the identified social and activity needs of people using the service. 31/07/2009 Care Homes for Older People Page 25 of 28 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 This is to ensure that staff have adequate time to support people with activities. 3 12 16 Activities need to be based on individual personal preferences, social histories and be person centred. Activities need to be based on individual personal preferences, social histories and be person centred. 4 18 13 The environment must be safe and free from hazards. This is to ensure that people using the service are protected. 5 30 18 Staff must receive training in Mental Health care and behavioral management Staff to be competent in meeting the needs of residents cared for at the home. 6 38 23 External contractors working 30/06/2009 at the home must in dicussion with the provider agree to safe working practices at the home. This is to ensure that the safety of people using the service is maintained. 30/09/2009 30/06/2009 31/07/2009 Care Homes for Older People Page 26 of 28 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 Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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