Care Home: Wilmington Manor Nursing Home

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What the care home does well The staff are very good at welcoming people into the home, especially enquirers and people visiting for the first time. They promote a friendly and relaxed atmosphere. Care plans are overseen by named nurses, and were seen to be well completed, with good content and sufficient details. Residents reported that the food is good, and they have plenty of choice. Staff training is well managed, with systems in place to ensure that all staff keep up to date with mandatory training; and with opportunities to carry out additional training if wished. What has improved since the last inspection? Residents said that the activities are "much better than they used to be"; and "the activities are good". They appreciate the appointment of a dedicated activities organiser. Requirements given at the last inspection visit have been met in regards to improving toileting and bathing/showering facilities. A number of alterations have been made to assist staff with meeting residents` needs in this respect. There have been ongoing improvements to the decor and maintenance of the building, which has improved some communal rooms and bedrooms. Additional equipment has been purchased, such as more profiling beds and pressurerelieving mattresses. What the care home could do better: The clinical room on the ground floor needs new worktops as they are damaged and cannot be properly cleaned for promoting good infection control. There is a requirement to address this. The whole of the clinical room would benefit from refurbishment. The maintenance staff work hard to keep the general decor of the building in a reasonable state. However, the whole building would benefit from refurbishment, as many areas are beginning to look very worn. This is particularly noticeable in the tea and coffee making area adjacent to the kitchen; and this area should be considered a priority for replacing damaged cupboards and work surfaces. Key inspection report Care homes for older people Name: Address: Wilmington Manor Nursing Home Common Lane Wilmington Dartford Kent DA2 7BA     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: Susan Hall     Date: 1 8 0 5 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 Older People Page 2 of 25 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) © 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: Wilmington Manor Nursing Home Common Lane Wilmington Dartford Kent DA2 7BA 01322288746 01322284403 bazeleym@bupa.com www.bupa.co.uk BUPA Care Homes (CFC Homes) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Mary Margaret Bazeley Type of registration: Number of places registered: care home 50 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 50. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Wilmington Manor is a large detached property, which has been extended and altered during the 1990s to provide additional facilities. It is owned by BUPA, who are well known providers for delivering care. Accommodation is provided on the ground, first and second floors, with two large passenger lifts providing access between floors. All Care Homes for Older People Page 4 of 25 Over 65 50 0 Brief description of the care home bedrooms are for single use, and have small en-suite toilet facilities. The home is provided with two lounges and two dining rooms, one of which overlooks the rear gardens. Front and rear gardens have been designed to enable people in wheelchairs to get around easily, and are pleasantly set out, and well maintained. The home is located adjacent to Dartford Heath, about one mile from the A2. The setting is quite rural, and there are limited places to access locally, as there are few suitable pavement areas for wheelchair users. Public transport is limited. Dartford and Bexley town centres are approximately two and three miles away respectively. The current fee levels range from £577.00 to £1,100.00 per week, and are assessed according to residents individual needs and the room available. Additional charges are payable in respect of hairdressing, newspapers, chiropody and escorting residents to appointments. Care Homes for Older People Page 5 of 25 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 home is assessed as having a rating of Good, 2 stars. This was a key inspection, which includes assessing all of the information obtained by the Commission since the previous inspection, as well as a visit to the home. Information is obtained from phone calls and letters about the service; legal notifications which the home is required to send in; any complaints or safeguarding issues in which we are involved; and an Annual Quality Assurance Assessment (AQAA) provided by the home. This is a comprehensive document which the home is required to complete each year, telling us about ongoing developments in the home, and any changes. The AQAA was well completed by the manager, and was returned to the Commission within the required timescale. We received seventeen completed CQC survey forms, which contained very helpful information about peoples views of the home. Ten of these had been completed by Care Homes for Older People Page 6 of 25 residents or relatives; and seven had been completed by staff. All of the surveys contained positive comments, particularly about the caring attitudes of the staff. The inspection visit commenced at 09:45, and finished at 15.45. During this time, we (i.e. CQC) viewed all areas of the home; talked with eleven staff, four residents and one relative; observed interaction between staff and residents; and inspected documentation such as care plans, medication charts, staff recruitment files, and maintenance files. The manager was on duty throughout the visit, and co-operated fully with the inspection. The home had several safeguarding alerts raised between November 2009 and April 2010. These were investigated by the Social Services Safeguarding team, and have been resolved, except for one issue which is in the process of being addressed. The manager stated that staff are working well together as a team, and this was evident from our observations. Several issues involved moving and handling of residents, and this training has been further emphasised to the staff. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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. The home provides comprehensive information for enquirers and new residents. Evidence: The statement of purpose and the service users guide contain all the required information. The manager stated that she is in the process of updating this information to ensure that it is all relevant and in the best possible format. People enquiring about the home are always made welcome by the staff, and shown round the home. Two groups of enquirers visited on the day of the inspection visit, and were very well cared for by the staff on duty. The manager aims to meet and spend time with enquirers if she is available. Information is also provided in regards to other BUPA homes in the area. All residents have a pre-admission assessment, and these are carried out by the manager either in the persons own home or in hospital. A further assesment is carried Care Homes for Older People Page 10 of 25 Evidence: out on admission, to check if there have been any changes in the meantime, and to clarify details. BUPA have set documentation (known as Quest) for this purpose, and we viewed four pre-admission and admission assessments. These cover all aspects of daily living, such as communication needs, personal hygiene care, medication, mobility, nutrition, continence care, and social preferences. The assessments were seen to be well completed and to contain detailed information. All residents are provided with a contract, which specifies the terms and conditions of residency. Care Homes for Older People Page 11 of 25 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. Care planning is well managed, and demonstrates that residents personal care and health needs are met by the staff. Evidence: Care plans are discussed and agreed with residents or their representatives on admission, and at monthly intervals. Named nurses are responsible for keeping these up to date. We viewed four care plans and found them to be well completed with comprehensive information. Residents have detailed assessments for care needs such as moving and handling, risk of falls, nutrition, continence and pain; and care plans are written for each aspect of care identified. There are additional risk assessments for items such as safe use of wheelchair, safe bathing, and use of hoisting equipment; and there are detailed assessments and consent for the use of bed rails. We viewed two care plans which included wound care, and these records showed that each wound is identified and assessed separately; and there are ongoing records for each change of dressing. These were very clear records. The nursing staff access help and support from the community Tissue Viability Nurse as needed. Care Homes for Older People Page 12 of 25 Evidence: The home has a GP who visits weekly, and most residents choose to register with this GP Practice. Referrals are made for input from other health professionals such as dietitian, speech therapist and physiotherapist where indicated. Medication is administered mostly via a monitored dosage system. The monthly ordering and receipt of medication is carried out by two nurses working together, and there are good systems in place to prevent and deal with medication errors. Internal medication is stored separately from external medication. The room temperature and drugs fridge temperatures are recorded daily. There are two medication trolleys for separate administration of medication on different floors; and these are kept chained to the wall of the clinical room when not in use. We viewed the Medication Administration Records (MAR charts) for the ground floor, and these were well completed, with no gaps in signatures. Allergies are clearly highlighted. Residents who wish to self-medicate have a detailed assessment to ensure that they are able to carry this out safely and effectively. Medication storage is in a designated clinical room. The clinical room is generally in a poor state of decor, and broken edges on the work surfaces heighten the risks of impaired infection control. This matter is referred to in the section on Environment. Residents said that the staff look after them very well, and treat them with respect, and with attention to their privacy. We received comments on survey forms such as all the staff are lovely and conscientious and caring; and staff are generally very concerned about patient welfare. We observed staff attending to residents with gentle and caring attitudes. Care plans are in place for end of life care, showing where residents feel able to discuss this subject and are willing to do so. The care plans also show if residents have the mental capacity to discuss issues and make their own decisions, or if they have an advocate to speak on their behalf. The home has good links with a local hospice for further advice and support when needed. Care Homes for Older People Page 13 of 25 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. Residents enjoy a range of stimulating activities. Food is well prepared and provides a nutritious diet for the residents. Evidence: A programme of daily and weekly activities is displayed in the entrance hall, and at other key areas around the home. An activities co-ordinator oversees the programme and discusses ideas for forthcoming events with the residents. Ongoing activities include items such as quizzes, art, and pamper days (hairdressing and manicures); and events include items such as entertainers, a visiting clothes shop, and themed days. Outings are arranged for four to five residents at a time, and include visits to seaside resorts such as Herne Bay, pub outings, and local parks and places of interest. On the day of the inspection, four residents attended a special event at another local BUPA care home. Residents are attended by a nurse or qualified first-aider for outings. Attention is paid to meeting residents spiritual needs, and visiting ministers or church leaders are welcome to visit. Residents are assisted to attend churches or places of worship if they are well enough to do so; and communion and other church services Care Homes for Older People Page 14 of 25 Evidence: are held in the home. The catering is overseen by a head chef, who draws up the menus. These are then checked by a BUPA nutritionist to ensure that they provide a well-balanced and nutritious diet. Residents spoke positively about the food, with comments such as the food is well cooked and there are good choices. A cooked breakfast is available every day; and snacks and a night bite menu are always available. There is a choice for each course at meal times, and residents are able to choose where they wish to sit for meals. We viewed the kitchens and talked with the chef. The kitchens were seen to be clean and generally well organised. There is a tea and coffee area outside the main kitchens which is available for staff and visitors to make hot and cold drinks. This area would benefit from some refurbishment. Care Homes for Older People Page 15 of 25 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. Residents are confident that their concerns will be listened to and addressed appropriately. There are robust systems in place for reporting any suspicions of abuse. Evidence: Residents and relatives are informed of how to make a complaint as part of the admission process. The complaints log shows that even minor complaints are taken seriously and are addressed appropriately. The manager responds in writing or with face to face discussions whenever possible. Residents are confident that any issues they raise will be dealt with; and appreciate that the manager has a daily presence in the home so that she is accessible to them. The manager also has an open door policy for anyone with concerns. All staff are trained in the recognition and prevention of different types of abuse, and staff training records confirmed this. There were several Safeguarding alerts between November 2009 and April 2010, and these were investigated by the Social Services Safeguarding team and/or police as applicable. One investigation was due to a staff member acting as a whistle blower, and this shows that the systems for expressing concerns work in practice. There is currently one matter which is still being dealt with, but all others have been resolved. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises provide a comfortable and homely environment, but would benefit from refurbishment in the near future. Evidence: The home is situated in its own grounds, with pleasant gardens to the front and the rear of the property. There are two communal lounges, and two dining rooms for residents use. All of the bedrooms have small en-suite toilet facilities which can only be accessed by a small number of residents. Changes have been made to the premises since the last inspection visit, and this includes alterations to bathing and showering facilities, which are now much improved. However, a shower room on the second (mezzanine) floor is out of use as a part needs to be replaced. There is still a limited number of toilet facilities for residents who need the use of a hoist for toileting purposes. The home has a full time maintenance person who improves the decor on an ongoing basis, within the limits of one maintenance staff for a large building. Several bedrooms have been redecorated to a good standard over the past few months. However, the general decor of the home is tired, with scuffed skirting boards, and damaged doors; and the building generally would benefit from refurbishment. Some of the furniture is functional, but is old and unattractive and could be replaced. The clinical room has Care Homes for Older People Page 17 of 25 Evidence: already been mentioned in the section on Health and Personal Care, and this room needs to be refurbished as soon as possible so as to aid good standards of infection control, and to ensure that medication cupboards meet all the future storage needs for when the home is fully occupied. There is a requirement to replace damaged work surfaces, which are an infection control hazard. The home has suitable hoisting facilities, with two full hoists, two stand aids, and a small hoist. However, the staff state that another hoist would considerably improve the management of moving and handling, and this is currently being considered. The manager ensures that all necessary equipment is in place prior to admitting new residents. This includes pressure-relieving mattresses, bed rails and padded sides and hoist slings. The home has a mixture of hospital beds, divan beds and profiling beds, and these are according to residents nursing needs. Bedrooms were seen to be personalised according to residents wishes; and residents can bring in small items of furniture if they fit the room and are safe to use. The home has two lifts, and all bedrooms can be accessed via one of these lifts. There are good processes in place for carrying out safety checks, such as those for fire prevention, hot water safety, and window restrictors. Radiators have low surface temperatures, and there are individual thermostats for hot water outlets. The laundry is on the lower ground floor, and has been considerably improved with new flooring since the last inspection visit. There are two washing machines and two tumble dryers; and there are dedicated laundry staff on duty each day for the management of the laundry. There are usually two to three housekeepers on duty each day, and the home was seen to be kept clean in all areas. Care Homes for Older People Page 18 of 25 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. Residents are cared for by a competent and caring staff team. Evidence: The home maintains good levels of nursing and care staff, which is essential in a such a large building. There are two nurses on duty throughout the twenty-four hours, who share the responsibility for the different floors. The nurse on the ground floor takes overall responsibility for nursing care on that day. The nurses are supported by eight care staff in the mornings, and six care staff in the afternoons and evenings, although these numbers may sometimes vary according to the current dependency levels in the home. There are three care staff at night times, as well as two nurses on duty. There are currently approximately forty per cent of care staff who have completed NVQ 2 or 3 training. BUPA enables care staff to carry out this training, and other care staff are working towards this. We viewed two recruitment files, and noted that there are robust recruitment procedures in place. These include two written references; a full employment history; CRB and ISA checks (police and safeguarding checks); proof of identity, and an interview record. All employees complete a health check questionnaire, and are required to provide proof of training. Nurses PIN numbers are checked with the Nursing and Midwifery Council. Care Homes for Older People Page 19 of 25 Evidence: The home employs a trainer for all mandatory and other training in the home. This includes a comprehensive twelve-week Skills for Care induction course; and training in mandatory subjects such as infection control, basic food hygiene and moving and handling. Other BUPA training is also provided, such as understanding dementia, and safe use of bed rails. Nursing staff are encouraged to keep their skills and competencies up to date, and training is held at different BUPA venues throughout the country. This includes subjects such as diabetes awareness and use of syringe driver. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by a caring and efficient manager. There are good processes in place for promoting the health and safety of the staff and residents. Evidence: The manager is suitably trained and experienced in the nursing care of older people, and keeps her own skills and training updated with relevant courses. She provides a clear sense of direction and practical leadership to the staff. Residents and relatives appreciate her daily presence in the home, and her awareness of their day to day concerns. She is currently recruiting for the post of deputy manager. Staff meetings are usually held once per month and this enables staff to share ideas as well as keeping up to date with changes in the home. Residents and relatives meetings are held two to three times per year. BUPA carry out an annual customer satisfaction survey, and the results for 2009 showed positive results. For example, 90 per cent of residents who responded felt that staff treat them as individuals; and 95 per cent were happy with the level of activities in the home. There was an eighty per Care Homes for Older People Page 21 of 25 Evidence: cent response rate to the questionnaires; and the survey results can be viewed in the home. Monthly visits are carried out by a regional manager, and there are good support systems in place from other senior BUPA management staff. The manager and staff do not manage any residents monies. Residents either look after their own finances or have an appointed representative. Additional charges (e.g.for hairdressing) are invoiced monthly. The home has a system in place for one to one staff supervision sessions. The manager said that this was currently behind schedule, but that she was working to catch up with this, and looking to delegate some of this to department heads in the future. Policies and procedures are checked on an annual basis, and staff are informed of any amendments or new policies during the year. There are good systems in place for health and safety checks. This includes individual bedroom checks; and routine weekly and monthly checks for items such as water testing for legionella and fire equipment checks. Other regular checks include PAT testing, and servicing for the lifts and hoists. Details of chemicals used (COSHH details) are kept in the laundry room where they are easily accessible. Accidents and incidents are reliably recorded, and ongoing audits are carried out. Care Homes for Older People Page 22 of 25 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 23 of 25 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 19 13 Damaged work surfaces in the clinical room must be replaced, to aid good infection control. The providers must make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home. 18/08/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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