Care Home: Willow Court

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What the care home does well The home provides prospective residents with whatever length of time they need to decide if they wish to live at the home. The environment is very well maintained and well decorated for the benefit of people living at the home. Detailed information is collected about a new resident to help ensure staff can provide the necessary levels of care and support to the person. There are good arrangements for people to maintain contact with their family and friends. People have the opportunity to follow their religion if they wish to. There is a very good standard of record keeping. There is a varied programme of activities for people living at the home to become involved with if they wish. There is a good level of staff training to help staff provide more individual care to people living at the home. What has improved since the last inspection? There is an on going programme of decoration and refurbishment around the home. The environment has been designed and decorated for people with dementia in order to maintain their independence. Some bedrooms have been decorated. Carpets have been replaced in some bedrooms and the communal areas. Curtains and bedding have been replaced. The standard of care planning has improved to record the care and support needs of people living at the home. Life Story books have been created for each person living at the home detailing their interests and some past experiences. Some records used by people living at the home are available in other than the written word for people with visual impairment or reading difficulties. The level of staff training continues to improve to ensure staff have some understanding of the specialist needs of people requiring care and support. The programme of activities and entertainment available to people living at the home is becoming more varied. There is more of an ethos of involvement of service users in decisions about their daily living requirements and in the running of the home. What the care home could do better: Care plans should include guide lines about the care and support provided to people with behaviour that might be difficult to work with. Individual accounts should be provided for service user`s money that may be held by the home. Key inspection report Care homes for older people Name: Address: Willow Court Osborne Gardens North Shields Tyne & Wear NE29 8AT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Karena Reed     Date: 0 7 0 9 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 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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 27 Information about the care home Name of care home: Address: Willow Court Osborne Gardens North Shields Tyne & Wear NE29 8AT 01912965411 01912964568 Willow.Court@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cotswold Spa Retirement Hotels Limited (wholly owned subsidiary of Four Seasons Healthcare Ltd) care home 48 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: One named resident is under the age of 65 years. Should this resident leave the home the Commission for Social Care Inspection must be notified. One service user is category DE. No further admissions to take place in this category without prior agreement of CSCI. Date of last inspection Brief description of the care home Willow Court is a purpose-built care home. The home provides both nursing and personal care for people with dementia care needs and a small number of people with mental health needs. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is owned and managed by Four Seasons Healthcare Ltd, which is a large national provider of care services. Willow Court is a modern two-storey building that provides 48 bedrooms, all of which Care Homes for Older People Page 4 of 27 Over 65 45 3 0 0 2 9 0 9 2 0 0 8 Brief description of the care home have en-suite facilities. There are lounges, dining rooms and bathrooms on both floors. The home has its own kitchen and laundry room. Access into the home is level and a passenger lift provides access to the first floor. At the rear of the home there is an enclosed garden. The home is situated in a residential area of North Shields close to local shops and good public transport links. A Statement of Purpose and service user guide are avilable at the home. The guide describes the services and facilities provided by the home and how staff are trained to meet residents care and support needs. CQC inspection reports are also available at the home detailing the quality of care provided. The weekly fees for care range from 455.89 to 602.19 (depending if self-funded). Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home 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 2 star. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out. Before the visit: We looked at information we have received since the last inspection, how the service Care Homes for Older People Page 6 of 27 dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people and the views of people who use the service and their relatives, staff and other professionals. The Visit: An unannounced visit was made on September 7th 2009. During the visit we talked with people who use the service and staff. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for,looked around the building to make sure it was clean,safe and comfortable and checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? There is an on going programme of decoration and refurbishment around the home. The environment has been designed and decorated for people with dementia in order to maintain their independence. Some bedrooms have been decorated. Carpets have been replaced in some bedrooms and the communal areas. Curtains and bedding have been replaced. The standard of care planning has improved to record the care and support needs of people living at the home. Life Story books have been created for each person living at the home detailing their interests and some past experiences. Some records used by people living at the home are available in other than the written word for people with visual impairment or reading difficulties. The level of staff training continues to improve to ensure staff have some understanding of the specialist needs of people requiring care and support. The programme of activities and entertainment available to people living at the home Care Homes for Older People Page 8 of 27 is becoming more varied. There is more of an ethos of involvement of service users in decisions about their daily living requirements and in the running of the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 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 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them 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. Assessments of people who are to use the service are carried out before they move into the home to ensure all needs can be met. Evidence: The Statement of Purpose and service user guide were examined. The statement of purpose is a pre-printed document which requires the provider to input individual information about the service. It contained the necessary information as required by the Care Homes Regulations 2001.They were available in a different format for people who had difficulty seeing the written version. The documents contain a lot of important information that will help people to make an informed choice about the home. In surveys received people who live at the home and their relatives felt that they got enough information from the home and other agencies to make a decision about whether to use this home. Records for four people who live at the home showed that when they were admitted to Care Homes for Older People Page 11 of 27 Evidence: Willow Court an assessment of their care needs had been carried out before their admission by a social worker or health care professional. This assessment is forwarded to the home for the manager to look at to determine if the needs of the person can be met. The manager or senior staff carry out a pre-admission assessment to ensure that the staff can meet each individuals needs. The person living at the home and relevant people are involved in the assessment.These initial assessments are used to create care plans. The manager said that any person interested or needing to use the service or relatives are encouraged to visit the home to have a look round and meet the staff. People have the opportunity to visit the home as often as they need in order to decide if they want to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people who live at the home at a pace suitable to the individual. A relative commented :We looked around before the decision was made to move into the home. The home does not provide intermediate care. Care Homes for Older People Page 12 of 27 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. There are good arrangements in place to ensure the health and personal care needs of people living at the home are met by staff. Evidence: The care files of four people that use the service were looked at during the visit. Files contained a detailed assessment of needs for the person, evidence of nutritional screening, moving and handling assessments and a history of the person including interests, family details and other important and useful information. Following assessment of the person care plans are developed. One of the care plans examined did not show enough detail about the care and support that was provided to a person who had behaviour that was difficult to work with, one of the staff members spoken to had an excellent knowledge of how she supported this person if they were upset, other staff could use the same techniques if they were written down as part of the care plan. People who use the service looked cared for and staff showed respect in their actions and in the way they spoke to people they were attending to. Care Homes for Older People Page 13 of 27 Evidence: There is clear evidence of the involvement of GPs, District Nurses and other health care professionals such as chiropodists. People living at the home confirmed that if they were feeling unwell, the GP would be called. Some people that use the service were spoken to during the visit. People were happy with care received. People spoken to and observation confirmed that their privacy and dignity was respected. During the inspection arrangements for receiving, storing, administering, recording and disposing of medication were observed and examined. Examination of medication records and observation of a medication round took place. Appropriate records of medication coming into the home and those that are destroyed are kept. An audit of current medication in stock and records showed that medication was signed for and given appropriately. Care Homes for Older People Page 14 of 27 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. Appropriate and enjoyable activities do take place at the home and people are able to exercise choice and control.Food provided is enjoyed, providing people that use the service with a varied and well balanced diet. Evidence: Residents files contained personal histories and entries about their likes and dislikes and preferences regarding daily life. A short history of each person was framed and well illustrated and hung on the corridor outside their bedroom. The home employs an activity coordinator to plan, arrange and take part in activities at the home for people that use the service. The programme of activities include:art,reminiscence,bingo,gardening,memory games, newspaper quizzes, videos,old time music, sing a long, pat a dog, hairdressing and pamper sessions, a minister also visits.People also enjoy entertainment such as Northumbrian Pipers, Scottish Pipers and themed evenings such as Chinese and Spanish food and music. A regular newsletter is published for people living at the home and their relatives and staff to keep them informed of events taking place and matters of interest. Seasonal activities and entertainment also takes place such as Carlin Sunday, May Day Easter egg competitions, summer fayres, Burns Night Supper, Halloween and Christmas Care Homes for Older People Page 15 of 27 Evidence: parties. Entertainers such as accordionists,comedians and singers also visit. People also enjoy trips to the coast and other places of interest and go out for pub meals. Staff ask each person about their wishes, interests and choices. Staff have had training about memory loss. This training should help to ensure that people living at the home are given more choice in order to keep some control in their lives. Visitors are welcomed to the home and staff encourage and provide support to people living at the home to maintain contact with relatives. The manager stated he was planning to build upon involvement with the local community for the benefit of people living at the home. A four weekly menu is used in the home. The home does provide for special diets e.g pureed and diabetic. A substantial alternative is served at main meals. On the day of inspection lunch served was;chicken and mushroom pie or Cornish pasty,beans,potatoes and carrots followed by jelly and cream. Tea was to be fish and chips or corned beef salad,soup and sandwiches and chocolate buns. The dining rooms are bright and tables are well set with table cloths,condiments and glasses. A menu is available in large print in each dining room showing the meal selection available. A luncheon club is also available in a separate area for a small group of more independent people living at the home. Care Homes for Older People Page 16 of 27 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 home has a complaints and protection system, which helps to protect people who live at the home. Evidence: The homes complaints procedure is given to new people as they move into the home. The procedure assists and supports them and their relatives to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within the home. The complaints procedure is available on cassette or cd for people who have visual impairment or reading difficulties. There is a complaints procedure on display within the home for the use of people living at the home and their relatives. The home keeps a record of complaints. One complaint has been received about the home since the last inspection. There have been no safe guarding incidents using the council safeguarding strategy. Surveys returned stated people living at the home or their relatives knew how to complain if they needed to. The home has a copy of the local authorities Vulnerable Adults procedure. This provides staff with clear guidance on how to deal with adult protection concerns. Relatives commented:I have always found my mother happy Care Homes for Older People Page 17 of 27 Evidence: and cheerful when I visit so I dont think it comes up very often, if at all, about speaking to someone if were not happy. I have no complaints about my mothers treatment and have not found any reason to worry when I am not present. Staff have received training about safeguarding vulnerable adults , this is multiagency strategy training, which describes the procedures to be followed by staff when allegations of abuse are made about a person. Staff have also received training about whistle blowing which shows the procedure for staff to follow to report if there were ever concerns about bad practice to people living at the home. Staff have received training about dementia care,Yesterday,Today,Tomorrow to give staff more insight into the needs of people with memory loss. Staff have also received training about how to work with behaviour that may be difficult to work with. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home is excellent providing people that live there with a homely and comfortable place to live and at the same time trying to ensure their independence . Evidence: The home is accessible and placed in the centre of a local community in a residential area. There are some shops and pubs quite nearby. There is an ongoing programme of decoration and refurbishment around the home. Since the last inspection a large amount of work has been done to ensure the environment is appropriate and user friendly for people with dementia in order to help people retain some independence and move freely around the home. The lighting has been altered so corridors and public areas are brighter. Carpets have been replaced in corridors and other public areas to colours which are restful and therapeutic for people with dementia. Decoration has also taken place around the home using guidance to ensure the colours are appropriate for people with dementia and to help maintain independence e.g door colours, hand rails depicted against the walls,etc. There is appropriate signage around the home to show different areas this will help maintain a persons independence for as long as possible. All people living at the home enjoy their own bedrooms. As stated an illustrated Care Homes for Older People Page 19 of 27 Evidence: personal history of each person was mounted outside their bedroom door. Bedrooms observed were comfortable and well decorated and personalized with belongings and some items of furniture of people living at the home. Furniture and fittings were domestic in design and the home was well decorated and comfortably furnished. The home has an appropriate amount of sitting, recreational and dining space. There was emergency lighting around the home. The washing machines have the specified programme to meet disinfection standards. The home was observed to be clean and odour free. There was a plentiful supply of protective clothing which included plastic pinnies and gloves to help to prevent the spread of infection. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent 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. The homes recruitment procedure is robust, which helps to ensure that people are protected, there are currently sufficient staff to meet the needs of people living at the home. Evidence: At the time of the inspection there were thirty three people using the service. The homes duty roster and discussion with the manager showed that there was one nurse on duty and six care staff during the day and evening. On night duty there was one nurse and three care staff. These numbers do not include the manager. There is a senior staff member on each shift when the manager is not on duty. Other members of staff are employed for duties such as cleaning,gardening,organizing activities, administration and food preparation. A sample of staff files were examined.The necessary checks are carried out before a person is appointed to work at the home. Two written references were available on staff files examined. Care Homes for Older People Page 21 of 27 Evidence: An application form had been completed for each staff member. Employment histories were available. CRB checks are carried out before a person is appointed. Staff photographs were available on staff files examined. There are currently two vacancies which are in the process of being filled for a deputy manager and a qualified RMN, registered mental nurse. Comments include: More domestics are needed as there are only 2 and this is not enough for this home to be kept clean. More domestics are required. Cleaners need to be more than two. The laundry is also an issue. There is a good level of staff training. 7 of the 14 carers have achieved a National Vocational Qualification(NVQ) at level 2 or 3. As the home provides nursing care for people with dementia, specialist nurses with mental health qualifications are employed. A staff member commented:training is constantly being up dated. Staff have received the necessary statutory training and developmental training is carried out to help ensure that staff can meet specialist needs of people.Training carried out includes: infection control,moving and handling, first aid, health and safety, food hygiene, tissue viability,diabetes,dementia care,continence, equality and diversity,cross infection, safe handling of medication person centred care planning. A relative commented:My husbands care at Willow Court is about the best that can be expected due to his condition. I too get moral support from the home which is a great help at a difficult time. Care Homes for Older People Page 22 of 27 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. People living at the home live in a home that is run in their interests and where the welfare of all is promoted. Evidence: It was good to see the continued changes to the home especially to the environment to ensure the home was appropriate to its status as a service for people with dementia.The manager has the relevant qualifications for managing the home. He is a qualified nurse and has several years of experience managing homes providing nursing and personal care. The manager is creating an ethos of involving staff and residents in the running of the home. Residents are also becoming more involved in decision making in their daily living and in the running of the home. Staff meetings take place and resident and relatives meetings. The meetings enable the home to inform people of important information, discuss future events, discuss any concerns and talk openly about the home. Care Homes for Older People Page 23 of 27 Evidence: Supervisions take place every two months with each staff member,as well as an annual appraisal when staff will help identify their training needs. There was a good standard of record keeping and documents detailing fire safety and other statutory records were all up to date. A random sample of health and safety records were examined. Records were available to confirm that the fire alarms, gas boilers and hoists had been serviced within the last twelve months. Lockable facilities are available for residents to keep their own money if they wish. Inspection of some personal allowance records showed that individual accounts were not maintained for people whose monies the home and Company held but rather a communal account. Staff training relating to health and safety was up to date. Independent auditing is carried out on a yearly basis to ensure that the home is run in the best interests of people that use the service. The home carry out their own quality assurance exercise in which they send questionnaires out to people that use the service to see if they are happy with the care provided. Weekly tests of the fire alarm service were recorded. Records were available to confirm that water temperatures were taken and recorded monthly Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 7 The care plan discussed should contain more detail of the action taken by staff to support the person whose behaviour might be challenging. Individual records and accounts should be kept of any monies held on behalf of people living at the home. 2 35 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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. 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