Care Home: Windsor Lodge

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What the care home does well There is information available and the opportunity to visit the home to help prospective service users decide whether they wish to move to the home. An assessment is undertaken of prospective service users to ensure that needs are identified and that the home is able to meet these needs. Service users` care needs are recorded in a care plan which is updated regularly ensuring that needs are identified and can be met by staff. Their privacy and dignity are upheld ensuring that care is provided sensitively and appropriately. Service users can choose how they spend their day and are supported to take part in activities in the home if they wish. The standard of food is good and meets service users` nutritional needs. There are effective complaints procedures in place and information is available to service users about local advocacy services. Staff have been trained in adult protection and whistle blowing procedures to ensure that the risk of harm to service users is reduced. The home is in a good state of repair, clean, safe and all bedrooms are single occupancy . The lounge is comfortable and homely. Measures to minimise the risk of acquired infection are in place. Service users receive care from kind, well trained staff who can meet their diverse needs. Recruitment procedures are thorough to ensure that only staff that are suitable to work with vulnerable people are employed. The home is well organised and there is effective management to ensure continuity and it is run in the best interests of service users. Service users who we spoke to and those who completed a survey were positive about the care offered at Windsor Lodge. Comments included"the home provides a very warm and caring environment. All the staff are very friendly and patient. The meals are always very appetising and well presented. Visitors are always made to feel welcome." "It treats the residents with respect and dignity, it demonstrates care and compassion, it proactively carries out entertainment events, residents` birthday treats and professionally treats the residents like members of the family, everything they do is high quality." Positive comments were received from health care professionals about the care offered at Windsor Lodge. Comments included "calm caring comfortable environment for staff and residents always welcoming." "supportive caring environment appropriate to individual needs." "Provides caring comfortable environment which is very similar to living in own home." What has improved since the last inspection? The manager reflected in the annual quality assurance self assessment that the home continues to place the needs of service users at the forefront of care. The quality of the care plans and risk assessments have improved to ensure that service users` diverse health and personal care needs are adequately met. Service users are encouraged to promote autonomy. The home has a new website to enable potential service users and their family to obtain the necessary information to help make a decision about moving into the home. The indoor activities programme has improved to ensure service users are provided with individualised and meaningful activities. What the care home could do better: The AQAA outlined where the home still needs to make improvements and how it was going to do this. Consideration must be made for the exposed hot water pipe and towel rails in the bathrooms to be risk assessed for the risk they present to service users and action taken to minimise any identified risk. Key inspection report Care homes for older people Name: Address: Windsor Lodge Windsor Road Gerrards Cross Bucks SL9 8SS     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: Joan Browne     Date: 2 8 0 1 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 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: Windsor Lodge Windsor Road Gerrards Cross Bucks SL9 8SS 01753662342 01753662342 windsor_lodge_ch@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Thomas Glynn,Mrs Margaret Glynn care home 9 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 who can be accommodated is: 9 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: Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Windsor Lodge is a small residential home for eight elderly people but is registered to provide care for up to nine persons to accommodate a couple who may wish to share accommodation. The home is privately owned and managed. The home is the family home of the proprietors who live on the premises. It is a large dormer style bungalow set within large landscaped grounds. Accommodation for service users is on the ground floor while the proprietors have accommodation on the first floor. The home is situated in a semi rural area on the edge of Gerrards Cross. All bedrooms provide single room accommodation unless a couple choose to share the one double room. Two bedrooms Care Homes for Older People Page 4 of 27 Over 65 9 0 Brief description of the care home have en suites and there are additional toilets and an assisted bathroom and shower area. The home is accessed by electronic gates that are activated through a CCTV intercommunication system. The drive takes the visitor through the landscaped garden to car parking areas adjacent to the home. 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: three star excellent 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: This unannounced key inspection was carried out on the 28 January 2010 and covered all of the key National Minimum Standards for older people. The inspection lasted for approximately six hours. commencing at 09:30 am and concluding at 15:30 pm. The last key inspection on this service was completed on 20 March 2007. Prior to the inspection a detailed self assessment questionnaire known as the annual quality assurance assessment (AQAA) was sent to the manager for completion and surveys were sent to service users, staff and visiting professionals. The AQAA was returned by the due date and contained detailed information demonstrating how the home had listened to service users and their relatives and recognising the areas that it still needs to improve in and how it was planning to do this. Eight service users, seven staff members and four health care professionals completed surveys and their replies have helped to form judgments about the service. The manager, owners, service users, three staff members, one health care professional and one relative were also involved Care Homes for Older People Page 6 of 27 in the inspection process and their responses and views of the home have been incorporated into the report. Further information was gained by observing staffs practice, examination of care plan documentation, staffs records, health and safety records and a tour of the premises. Feedback was given to the manager and owners on the inspection findings. There were no requirements made on this visit. We (the Commission) would like to thank service users and staff who made the visit so productive and pleasant on the day. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? The manager reflected in the annual quality assurance self assessment that the home continues to place the needs of service users at the forefront of care. The quality of the care plans and risk assessments have improved to ensure that service users diverse health and personal care needs are adequately met. Service users are encouraged to Care Homes for Older People Page 8 of 27 promote autonomy. The home has a new website to enable potential service users and their family to obtain the necessary information to help make a decision about moving into the home. The indoor activities programme has improved to ensure service users are provided with individualised and meaningful activities. 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. Service users needs and wishes are assessed before they move to the home. This is to ensure that the home is able to meet the identified needs. Evidence: The care files of three service users were examined. All had been visited by the manager before they moved to the home and a comprehensive assessment of their care needs and wishes had been undertaken. This formed the basis of their initial care plan which was developed when they moved to the home. Two service users and a family member were asked about their experience when they moved to the home. They all said that they had visited the home prior to being admitted and had spent sometime and were made to feel welcome. Eight service users who returned a survey to us said that they had been given enough information about the home. They also confirmed that they had been issued with contracts, which were seen in the three files examined. The following additional comments were noted from a service user respondent: we had personal information on the reputation of this care home which Care Homes for Older People Page 11 of 27 Evidence: was extremely good. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users diverse personal, health and medication needs are met in a manner which protects their dignity and maintains their wellbeing. Evidence: The care of three service users was followed through. All had care plans which had been updated regularly. The care plans were signed by service users or their relatives to confirm their involvement.There were records of risk assessments relating to tissue damage, falls and nutrition which were being appropriately maintained. Individuals weights were being closely monitored. It was noted that one service user who was at risk of being malnourished had gained a significant amount of weight. The AQAA stated that services users had been provided with advanced care plans incorporating the gold standards framework. We saw evidence of the care plans in the care files examined which were signed by service users and their relatives. We were told that the plans were reviewed regularly by the general practitioner. The care files demonstrated that service users see a general practitioner and other members of the local primary health care team regularly and are supported to visit Care Homes for Older People Page 13 of 27 Evidence: hospital outpatient departments when necessary. Four health care professionals who returned comment cards said that the home always ensure that service users social and health care needs were properly monitored, reviewed and met. They said that the staff team aways have the appropriate skills and experience to support service users and that medication was appropriately managed. A district nurse commented, this is a very good home. l will be happy to put a relative here. The service users are well looked after. Staff respect their privacy and dignity. The following additional comments were noted from health care professionals: patients are content and comfortable. I am never called out inappropriately. Instructions/treatments are always followed. As the GP for residents I have a good working relationship with Windsor Lodge. Service users spoken to confirmed that their health care needs were being adequately met. One person commented, before coming here I had no appetite. Since living here I have gained weight and feel stronger. A second person commented, I came here a total wreck and in terrible pain and hardly able to walk or move. With great help from the owners and staff and my medication corrected I gradually improved. I am now able to walk properly with a frame and my mind is now functioning as the pain has gone. There are medication policies and procedure in place and the staff spoken to were aware of these. Service users medication administration record (MAR) sheets were completed in full and appropriate steps were taken to ensure that supplies were received fully. One service user was partly managing their medication and the appropriate risk assessment was in place to support this activity. None of the service users were in receipt of controlled medication. A discussion was held with the manager during the inspection. She was advised to seek professional advice from the homes pharmacist regarding storage of controlled medication to ensure that the homes facility meets the current regulation and best practice guidelines. Staffs training records demonstrated that staff had been trained in the safe handling and administration of medication. Service users are supported to maintain their personal hygiene and to wear clothing of their choice. Individuals were appropriately dressed in colour co-ordinating clothes that had been ironed neatly. Some had been enabled to wear jewelery and their hair and nails had received good attention to promote positive self-image. Those who returned a survey to us said that staff respected their privacy and dignity. Staff were observed speaking to service users politely and having a joke in a respectful manner. 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. The home has an activity programme in place. This means that individualised and meaningful activities are provided to service users. Meals provided are of a high standard and served in pleasing surroundings. Evidence: The activity programme was displayed in the home to enable service users and their relatives to be aware of what was on offer. The AQAA informed that service users were involved in planning the activity programme. Service users who returned a survey told us that the home arrange activities that they can take part in if they want to either always (7) or usually (1). Activities provided included board games, various crafts, knitting, baking and relaxation therapy. One visitor who was spoken to confirmed that family and friends were encouraged to join in planned activity events such as, parties, barbecues and outings. Service users were observed during the inspection assisting with folding the laundry, making cards and setting the table for lunch. We were told that birthdays were celebrated. One particular service user was looking forward to celebrating their birthday with family and friends. Some service users were looking forwarding to taking part in the Royal Society for the Protection of Birds annual bird watch which was taking place in the home. A quarterly newsletter is produced for the home to update service users and relatives on events. Care Homes for Older People Page 15 of 27 Evidence: The home does not have any restrictions on visiting. Family and friends can visit at any time within reason. Service users can entertain their visitors in their bedrooms in private or in the communal lounge. A visitor spoken to during the inspection confirmed that the homes staff always made them feel welcome and provided refreshments. Service users are made aware of their entitlement to bring personal possessions with them if they wished to. Some rooms seen were personalised with family photographs, televisions, and small pieces of furniture. One service user told us that she was delighted she was able to have her own telephone, bed and bed linen. Three meals are provided daily and hot and cold drinks and snacks were available at regular intervals. We noted that fresh fruits and sweets were available in the lounge for service users to help themselves if they wished to. During this visit lunch was sampled. The food was pleasantly prepared and presented. The meal consisted of two different options served with fresh vegetables. A choice of desserts was on offer. Service users told us that if they did not like what was on offer an alternative would be provided. Staff were sensitive to the needs of those service users who had difficulty with eating and provided assistance. A relative spoken to said that the meals provided were of a high standard. Service users who returned a survey said that they enjoyed their meals. The following additional comments were noted: we have lovely fresh home cooked meals, roast dinners, Yorkshire puddings, roast potatoes and lovely little fresh new potatoes, vegetables and puddings. The home provides good breakfast of porridge or cereal, tea and toast. 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 safeguarding policy in place. This should ensure that service users will be protected from abuse or exploitation and any complaints they may have would be dealt with appropriately. Evidence: There was a copy of the complaints procedure displayed in the home and it was included in the service users guide. Service users who returned a survey said that they knew who to speak to informally if they had a concern and that they knew how to make a formal complaint. Records are kept of complaints which showed that they were responded to promptly and that action was taken to address the concern. One service user specifically identified the manager as a good listener, approachable and available to talk over any problems that may arise. The following additional comments were noted from a service user respondent: I cant find any reason to complain we are waited on hand and foot. From tea first thing in the morning to a soothing drink last thing at night. A visitor spoken to said that she has never had any reason to make a complaint. However, she was confident if she did raise a concern it would be dealt with appropriately. Services users who were asked told us that they felt safe living at the home. Staff confirmed that they had received training in the safeguarding of vulnerable adults and training records examined verified that all staff had undertaken updated training. Seven staff who returned a survey said that they knew what to do in the event of a Care Homes for Older People Page 17 of 27 Evidence: concern or allegation of abuse. Those spoken to were aware of the whistleblowing expectations.The AQAA informed that there have not been any safeguarding referrals or investigation and the Commission has not been made aware of any safeguarding referrals in connection with the home. 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 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 appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. Evidence: The home is located on the road that connects Gerrards Cross to Stoke Poges and is set amongst countryside. The management and staff encourage service users to see the home as their own home. The grounds are large and very well maintained. Access to the home is via a security gate with closed circuit television. All bedrooms are single occupancy and some have en suite toilets and wash hand basins. A selection of bedrooms seen were personalised to reflect the characters of individuals. The bathrooms and toilets had been fitted with aids such as raised toilet seats and grab rails to promote independence. There was an exposed hot water pipe in one bathroom which could pose a risk to service users . The hot towel rails that had been fitted in the bathrooms had not been risk assessed. The manager was advised to risk asses the towel rails and hot water pipe for the risk they present to service users and action taken to minimise any identified risk. All areas of the home were presented as clean, tidy and well maintained with no unpleasant odours. Service users and staff who we asked confirmed that this was the usual state of the home. The AQAA stated that the home has a contract with a carpet cleaning company to ensure that stains are removed from carpets quickly and Care Homes for Older People Page 19 of 27 Evidence: professionally. The laundry is separate from the kitchen area and the washing machines have suitable disinfection programmes to wash soiled laundry. The AQAA informed that there was an action plan in place in connection with the prevention and control of infection and that seven staff had received training in the prevention and control 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 number and skills mix of staff on duty promotes the independence and well-being of service users. Recruitment and vetting procedures are effectively applied to minimise the risk to service users of inappropriate staff being employed. Evidence: The staff rota demonstrated that the number of staff on duty to provide care and attention to service users for any twenty-four hour period was suitable to meet their assessed care needs. The manager was not officially on duty but wished to assist with the inspection. Service users who completed a survey said that staff listen to them and were available when needed. The following additional comments were noted: the staff are always helpful and enquire about how I am feeling. All the staff are very kind and thoughtful and we are like a happy family. Were only residents and we are thoroughly spoiled. All the staff are very kind and thoughtful. The AQAA stated that the home has a stable staff team with a low absenteeism rate. The manager said that staff were valued and rewarded for their commitment and provided a high standard of care. Staff spoken to said that the manager keeps them updated on any changes that may arise. Staff records examined indicated that over 50 of the staff team had achieved the national vocation qualification (NVQ) at level 2. The AQAA informed that the home held a ceremony for the two recent staff members who achieved the NVQ at level 2 Care Homes for Older People Page 21 of 27 Evidence: which was attended by service users and family members. The recruitment files for two staff members were examined. Both contained application forms and a photograph to confirm proof of identity. Interview records had been kept and a criminal record bureau disclosure and two references had been obtained before the staff member commenced work. There was evidence in the files that an induction programme had taken place and employment contracts had been issued. The home is part of a local cluster training group this means that there is a planned training programme in place. Staff members are encouraged and enabled to undertake developmental as well as mandatory training. All staff who returned a survey to us confirmed that they had good training opportunities. Those who we spoke to during the visit said that they were able to discuss their future training needs with the manager who was supportive of professional development. 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. The home is effectively managed to ensure continuity and it is run in the best interests of service users and staff to promote and protect their safety. Evidence: The home is managed by an experienced manager who is registered with the Commission. She has been managing the home for nine years and holds the registered managers award. The owners live on site and have active, daily involvement with the care provision and contact with service users. There is a quality assurance programme in place to ensure that service users best interests are promoted. From discussions with service users it was evident that their views were sought and did influence the way in which the home was run. For example, as a result of regular consultation with service users more group activities have been arranged. We saw evidence of regular service users and staff meetings taking place. The home does not manage service users money on their behalf. Family members may leave money to cover expenses such as hairdressing, and chiropody. The homes Care Homes for Older People Page 23 of 27 Evidence: financial procedures ensure that service users money is protected. The home has a comprehensive range of policies and procedures to promote and protect service users and staffs safety. Staff training records indicated that health and safety training was up to date. Accident records showed that five service users had sustained accidents within the year. The home has a system in place to ensure that service users mobility assessment is reviewed if they sustain a fall and if necessary advice is sought from a physiotherapist. The AQAA stated that all routine health and safety maintenance checks were carried out on equipment in the building. 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 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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