Care Home: The Springs Community

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What the care home does well The assessment process for anyone wishing to move in is thorough. This ensures that the Springs only offers places to people whose needs can be fully met and to people who are compatible with existing residents. The care planning system ensures that personal goals and aspirations are recorded and supported. People have achieved goals like moving onto more independent living. There are good opportunities for people to take part in a range of activities and peoples hobbies are supported. Staff are trained in areas related to peoples needs so staff have the skills and competencies needed to give good support. The manager reviews the staffing levels monthly to ensure that there are enough staff to meet service users current needs. The same manager is in post as at the last inspection and she has been managing the home for several years. The manager has an in depth knowledge of peoples needs and keeps up to date with best practice. A service user said the food is good and the home provides sports and big spaces. One person said they love taking part in the garden and growing vegetables. Medication control is comprehensive and records are clear and well maintained. What has improved since the last inspection? The AQAA shows that there have been lots of improvements since the last inspection with further improvements planned. The environment has been significantly improved which enhances service users lives. There has been lots of alterations and redecoration with purchases of new furniture and equipment. There are plans to improve the information about the home with updated text and photographs. What the care home could do better: We made one requirement relating to medication practice. The documented policies and procedures for the control of medication would benefit from being reviewed and updated. In all cases where the prescribers printed directions require further guidance, detailed directions are to be documented for reference. Key inspection report Care homes for adults (18-65 years) Name: Address: The Springs Community Coast Drive St Mary`s Bay Romney Marsh Kent TN29 0HN     The quality rating for this care home is:   three star excellent 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: Kim Rogers     Date: 0 7 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 29 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: The Springs Community Coast Drive St Mary`s Bay Romney Marsh Kent TN29 0HN 01797363550 01797361040 elizabethscanlan@cygnethealth.co.uk www.cygnethealth.co.uk Cygnet Healthcare Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Elizabeth Scanlan Type of registration: Number of places registered: care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 29 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Mental Disorder, excluding learning disability or dementia - MD Date of last inspection Brief description of the care home The Springs Community provides accommodation, personal care, and developmental support for people who have been diagnosed with Autistic Spectrum disorders including Aspergers Syndrome. Ownership of the home changed in May 2006, and it is now owned by Cygnet Healthcare Ltd. It continues to be managed by Mrs Elizabeth Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 0 29 29 Brief description of the care home Scanlan, and the core body of the staff team remain as they did under previous ownership. The main residential site is situated on Coast Drive, in St Marys Bay. Accommodation is provided in small clusters, and one home is situated in the local community, away from the site. Every individual has a full en-suite facility for their exclusive use. Staff are provided with a full induction programme which focuses on people who have autistic spectrum conditions. The numbers of staff are provided in direct relation to the assessed needs and interests of the service users. There is a wide variety of facilities including two squash courts, outdoor tennis courts, covered, heated, swimming pool, relaxation room, training kitchen, library, bicycles and tricycles, and multiple lounge areas. A community gym is used with professional tutors. Qualified tutors visit the home for a variety of individual lessons including art and craft, sports and fitness and special needs. Qualified therapists such as masseurs and reflexology are available in-house. Previous inspection reports are available from the home. The weekly fee for this service starts at £1950. For more information please contact the provider. Please note for general enquiries and a prompt response use the email address autism@thespringscommunity.co.uk The homes own website can be found at www.thespringscommunity.co.uk Care Homes for Adults (18-65 years) Page 5 of 29 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: three star excellent 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 was a key inspection of the service and included two site visits. We carried out the inspection over two days. We went to the home on a Friday, 26/03/10, and spent the day from 09.00 to 16.40 talking to service users, the manager and staff and observing what was going on. We sampled records and had a look around parts of the home. There was a relaxed atmosphere with people choosing how to spend their day. We gave the manager a couple of days notice so she could let service users know we were coming. This is because some people may be upset and stressed when strangers arrive with no warning. A pharmacist inspector then visited the home on 7/04/10 to look at medication systems and practice. The findings from this are included within this report. An expert by experience accompanied us for part of the inspection. An expert by experience is a person who has experience of residential services for people with a learning disability. The expert spoke to people and had a look around and gave us feedback which has been included in this report. Care Homes for Adults (18-65 years) Page 6 of 29 We looked at the Annual Quality Assurance Assessment or AQAA that the manager completed. This is very well completed and gives detailed information about what the home does well, what could be better and how they intend to improve. We looked at other information we have received about the home including any concerns, complaints and notifications about incidents or accidents. We sent surveys to staff and service users so they can tell us what they think about the service. We received 4 surveys back from staff and 12 back from service users. The key minimum standards were assessed. The previous key inspection was carried on 16/04/07. This inspection was positive with one requirement for improvement made relating to medication practice. We have carried out two Annual Service Reviews since the last inspection. This is how we monitor services. The home is rated as excellent and we found that the home continues to provide an excellent service to the people who live there. Previous reports can be viewed on our website. For more information please contact the home on autism@thespringscommunity.co.uk or see www.thespringscommunity.co.uk Care Homes for Adults (18-65 years) Page 7 of 29 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 Care Homes for Adults (18-65 years) Page 8 of 29 order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 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 10 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Full and detailed assessments are carried out before a person moves in. There is information about the service to help people make a decision about moving in. Evidence: The manager meets with prospective service users and carries out a detailed pre admission assessment with them so she knows about the persons needs and goals. She gets this detail so she can make a judgement about the suitability of the Springs. The manager said that compatibility with current service users is very important due to their needs. The manager thinks carefully about each person to ensure that the Springs is the right place for any one wishing to move in. Anyone thinking of moving in is offered trial stays and visits and any move into the home is planned around the persons needs. Family and friends are fully involved in this process. There is information about the service to help people make a decision about moving in. They plan to update the information and the website with more recent photographs of the home. Care Homes for Adults (18-65 years) Page 11 of 29 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 know that their needs and personal goals will be supported. Risks are supported and managed and people have the support they need to make decisions and choices. Evidence: Each person has a support plan that they and their families have been fully involved in developing. The plan sets out a persons needs and personal goals clearly. The action that staff need to take to support people is also recorded clearly and in detail. We heard examples of people having the right support to achieve their goals. Staff spoken to knew about details in support plans so they know about peoples needs. Any potential risks to people are identified by way of a checklist. When a risk is identified an assessment is carried out to manage and reduce the risk to people. Plans as well as risk assessments are reviewed on a monthly basis to make sure that any changes are picked up and acted on. More formal reviews are held every six months. The AQAA shows that they plan to involve service users more in their review Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: meetings. Support people need with communication is recorded in individual plans. This shows how people prefer to communicate so staff know about peoples preferred methods of communication like using sign language or behaviours. We saw staff communicating with service users effectively. The environment supports communication. For example, the meal choices of the day are displayed as well as photographs of staff. Care Homes for Adults (18-65 years) Page 13 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from the opportunity to take part in a range of activities. People have the support they need to learn new skills and develop existing skills. Meals are wholesome and nutritious and relationships are supported. Evidence: Service users continue to have support to enjoy a range of activities while at home and in the community. Each person has an activity planner covering Monday to Sunday. This means that there is a plan of activities in place and people know what they will be doing. Some people attend college courses and some people have jobs. Hobbies are supported. One person showed us the vegetable garden that they have been fully involved in. Another person returned home during our visit from a golf session. The staff rota is planned around people needs and there is a shift plan in place so one to one activities can be supported. Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: A range of tutors come into the home to teach people skills with money, literacy and numbers and life skills. This support has lead to some people moving onto more independent living. Everyone is involved in the day to day running of the home with people having support to do their laundry and cleaning. Everyone has a say about what is included in the menu. This has lead to a healthier menu with more suggestions by service users being included. The training kitchen in the main house has been refurbished. This enables people to learn new cooking skills and develop existing skills. There are various leisure and sporting facilities available to service users including a swimming pool, tennis court, squash courts and astro turf football pitch. There is a recreation room used for parties and visiting entertainers. There is also a quiet lounge separate from the main lounge so people can have quiet time if they wish. Visits to see family and friends are supported so that people can stay in touch. There are private telephone facilities for service users to use. One staff told us, everyday there is something going on. There is never a dull moment here. Service users said, the food is good. I like my room, the dinners and everything here. The home provides sports and big spaces. Care Homes for Adults (18-65 years) Page 15 of 29 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 know that their health and personal care needs are supported. Safeguards have been introduced to ensure that medication practice is safe. Evidence: The support people need with personal care is recorded in individual plans. This ensures that staff have the information they need to support people in the way they prefer. Each persons individual styles and taste is supported. People have their own en suite facilities with additional communal facilities to use including a sensory room and recently refurbished Jacuzzi and shower room. Peoples health needs and the action that staff need to take to ensure people remain well and healthy is recorded in support plans. Records of the outcomes from health appointments are kept and any information transferred to support plans. Plans are reviewed monthly so that any changes in peoples health can be picked up early and acted on. Staff work with health care professionals and seek advice when needed. Service users have been involved in updating the menus which are now healthier in that healthier alternatives have been added. Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: A pharmacy inspector checked medication practice and found that medication control is comprehensive and records are clear and well maintained. Secure storage is provided both centrally and in peoples rooms with storage appropriately divided according to use to provide additional safeguards. Sources of medicine information are varied and up to date, including medicine manufacturers leaflets and the British National Formulary or BNF. The documented policies and procedures for the control of medication would benefit from being reviewed and updated. In all cases where the prescribers printed directions require further guidance, detailed directions are to be documented for reference. We made one requirement and two recommendations to further improve medication practice. The manager has taken steps to retrain staff and improve systems following some recent medication errors. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know their complaints will be listened to and acted on. People are safeguarded from harm and abuse. Evidence: There is a complaints procedure that people can use if they wish to make a complaint. Four service users we spoke to said they would talk to staff if they have a problem and staff would sort it out for them. Service users also said in the twelve surveys we received that they know who to complain to. There have been changes to the service based on service users views and opinions. For example a partition wall was built to ensure that people have privacy when using the telephone in one house. There has been one complaint to the home since our last review. This complaint was recorded and acted on. For more information please contact the provider. Staff have training in how to recognise and respond to abuse. There are policies and procedures in place for staff to follow showing how they safeguard people from harm and abuse. They have improved systems to safeguard peoples money. Staff told us about this saying that regular checks ensure that any mistake is picked up quickly. Staff have training in how to respond to problem behaviours in a positive non aggressive way. This ensures that people are safe and support is as proactive as possible. We observed staff noticing when a service user was becoming anxious and the staff took action to support the person. Details about problem behaviours are Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: recorded in peoples support plans setting out what staff should look out for, triggers etc. Guidelines show staff what they should do to keep the person and others safe and calm. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained, clean and suits peoples needs. Evidence: There have been substantial improvements to the environment since the last inspection. This includes the purchase of new sofas and armchairs, new flooring and the redecoration and updating of most parts of the home. Service users have had a say about colours and styles of the redecoration. Furniture and fittings are of good quality and suit peoples needs. Pictures and paintings have been purchased that people have had a say about. For example paintings of the local area and attractions that mean something to the residents. There are different areas available for example, a large lounge as well as a separate quiet lounge, library and recreation room so people can spend time on their own if they wish. All bedrooms are single and have en suite facilities. There are further toilets, bathrooms and a Jacuzzi room available for everyone to use. The garden can be assessed from different parts of the home and has patio and seating areas. A service user showed us the vegetable plot and poly tunnel where they grow fresh vegetables and soft fruits. The service user said they enjoy helping in the garden. There is a swimming pool; squash courts, tennis court and astro turf football Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: pitch that everyone can use. The home was clean and smells fresh. Care Homes for Adults (18-65 years) Page 21 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough trained staff to meet peoples needs and this is kept under review. Recruitment checks are robust protecting service users. Evidence: The home is fully staffed with some longstanding members of staff who know service users well. Staff are of various ages and backgrounds so can bring different skills and attributes to the service. We received four surveys back from staff. We asked if staff think that there are enough staff on duty. One said never, one said sometimes and two said usually. Two staff spoken to during our visit said they thought that there is enough staff on duty. We spoke to the manager about this. The manager uses a recognised tool to work out how many staff are needed based on peoples needs. She reviews this each month to make sure people have enough staff to meet their needs. The manager adds about an extra 90 hours a month on top of the basic staffing hours needed to ensure that people have the staff support they need to lead the lives they want. The manager ensures that staff are up to date with mandatory training including fire awareness, food safety and first aid. Staff also attend training related to peoples needs including Autism and Aspergers awareness. All four staff surveys said that they have the training they need to understand and meet individuals needs. Most of the Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: staff have a National Vocational Qualification in care. Staff have the opportunity to have a one to one meeting with a line manager on a regular basis, the manager said they plan to hold more regular staff meetings. The AQAA shows that recruitment checks are carried out before a person starts working at the home. Staff confirmed this saying they had a Criminal Records Bureau check and had to give references. Everyone we spoke had good things to say about the staff. Staff said, The Springs provides us with lots of different training and opportunity to say if we have any gaps in our knowledge. It is a friendly place. I feel the home provides good support to all our clients and their individual needs. We would benefit from employing more male staff. Communication between management, team leaders and staff could be better. Service users access lots of varied activities. The home has fantastic sports facilities. A service user said I have the people I need here. Surveys from service users said that staff are kind and they listen. Care Homes for Adults (18-65 years) Page 23 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and managed in service users best interests. People know that their health and safety is protected. Evidence: The same manager is in post as at the last inspection. The manager has been in charge of the home for eleven years and has the skills and experience needed. The manager is registered with us so she has passed the fit person process. The manager spoke with knowledge and understanding of peoples needs. The manager attends regular conferences and training to make sure she is up to date with best practice. All four staff surveys say that the manager is supportive. The manager completed the Annual Quality Assurance Assessment or AQAA. This must be completed and sent to us every year. The AQAA is well completed and has lots of information about what the home does well and how they intend to improve in the future. The AQAA shows an understanding of issues relating to equality and diversity and gives evidence of how the home is good value for money. The manager has identified in the AQAA some barriers to improvement and has ideas about overcoming these barriers so that the service continues to improve. Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: There are quality assurance systems in place that monitor and audit the service. People are asked for their views about the service by way of annual surveys and questionnaires. We heard about lots of changes being made based on peoples views including the redecoration and improvement of the environment. The AQAA shows that checks are carried out on the building and equipment to make sure that they are safe. Staff are trained in areas relating to health and safety. They continue to let us know about any incidents or accidents. Care Homes for Adults (18-65 years) Page 25 of 29 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 26 of 29 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 To ensure the safe use of 21/04/2010 medication, documented detailed directions are required for reference where the prescribers printed directions require further guidance. This will ensure that service users are safe and receiving the right amount of medication at the right time by the right route. 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 20 To retain the primary medication administration record (MAR) chart in the home, including when medication is administered at other locations such as a GP surgery To record the maximum/minimum temperatures of the medicines fridge, in addition to the single current temperature, to improve assurance of correct storage temperature 2 20 Care Homes for Adults (18-65 years) Page 27 of 29 Care Homes for Adults (18-65 years) Page 28 of 29 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. 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