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Inspection on 08/07/09 for Alexandra House [Poole]

Also see our care home review for Alexandra House [Poole] for more information

This is the latest available inspection report for this service, carried out on 8th July 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Alexandra House provides a service for older people including those with dementia. Staff treat people with dignity and care, respecting their individual choices and preferences and activities are centred around the person`s abilities. There is a varied menu on offer and people are supported to maintain a balanced diet. People should be confident that complaints will be listened to and acted upon. People live in homely, clean and comfortable surroundings. The staff team are well trained and there are sufficient staff on duty to meet the health and social needs of people. Recruitment procedures ensure that only suitable people are employed to work within the home. There is a strong management structure in place. There is good management of peoples finances.

What has improved since the last inspection?

All of the requirements and good practice recommendations issued at the last inspection have been met, so there have been improved outcomes for people living at the home. The standard of assessment and associated record keeping, including care planning, has improved to ensure that staff are aware of the needs and circumstances of each resident, in order that they may reliably provide the correct care. There is evidence that all accidents are properly investigated and appropriate action is taken to minimise future risks. Pre admission assessments have improved. Weighing scales are regularly calibrated to ensure they are accurate. Improvements have been made in the administration, storage and management of medication. Provision has been made for covering activities in any absence of the activities organiser. The policy and procedure for the management of alleged or suspected abuse of vulnerable adults has been reviewed. There is an on going programme of renewal and refurbishment and regular audits of cleaning and infection control procedures. Copies of maintenance records are kept within the home.

What the care home could do better:

At the end of this inspection there are four recommendations: All risk assessments provided for people who choose to self medicate, should be agreed and signed by both the home and the individual. It is recommended that consideration should be given to the layout of the laundry room, to ensure that it provides a comfortable and accessible space for staff to work in and meet necessary infection control procedures. The duty rota should accurately reflect the full names and positions of all people working at the home. It is recommended that annual staff surveys are clearly dated to evidence when they are completed.

Key inspection report Care homes for older people Name: Address: Alexandra House [Poole] Alexandra Road Parkstone Poole Dorset BH14 9EW     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: Joanne Pasker     Date: 1 0 0 7 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: Alexandra House [Poole] Alexandra Road Parkstone Poole Dorset BH14 9EW 01202746640 01202743627 alexandra@care-south.co.uk www.care-south.co.uk Care South Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Dorota Soanes Type of registration: Number of places registered: care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: 39 in the category OP (Old Age) including up to 20 in the category DE(E). One person under the age of 65 may be accommodated, from time to time, to receive care. Date of last inspection Brief description of the care home Alexandra House is a purpose built home; erected in 1965 it transferred from the control of Dorset County Council to the current provider organisation in the early 1990s. The Borough of Poole currently own and lease the property. The home is situated close to a busy shopping area with a range of facilities including banks, a post office, supermarket, public houses, local public transport, etc. Care Homes for Older People Page 4 of 27 0 0 Over 65 20 39 Brief description of the care home Residents accommodation is on the ground and first floors; each floor has lounge/dining areas and a small kitchen, used for preparing drinks, breakfasts and light snacks. On the ground floor is the main lounge and dining room with a central kitchen for preparation of all meals. Bedrooms do not have en suite hygiene facilities but there are numerous toilet and bathroom facilities throughout the home. The fee range quoted in the service user guide at the time of inspection was £495 to £695 per person per week. Up to date fee information may be obtained from the service. Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk 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 stars. This means that people who use this service experience GOOD quality outcomes. This was a statutory unannounced inspection required in accordance with the Care Standards Act. We looked at information sent by the home before we visited. We spoke to people who live in the home as well as people who work in the home. We also spoke to people who visit the home. Surveys were distributed by the manager to people who live at the home, health/social care professionals and staff. Nine surveys from people and their relatives, two health/social care professionals and three staff surveys were returned. The findings of these surveys have been included in the report. During the site visit we looked at a variety of care records to find out how people were Care Homes for Older People Page 6 of 27 being supported, we also observed care in the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? All of the requirements and good practice recommendations issued at the last inspection have been met, so there have been improved outcomes for people living at the home. The standard of assessment and associated record keeping, including care planning, has improved to ensure that staff are aware of the needs and circumstances of each resident, in order that they may reliably provide the correct care. There is evidence that all accidents are properly investigated and appropriate action is taken to minimise future risks. Pre admission assessments have improved. Weighing scales are regularly calibrated to ensure they are accurate. Improvements have been made in the administration, storage and management of medication. Provision has been made for covering activities in any absence of the activities organiser. The policy and procedure for the management of alleged or suspected abuse of vulnerable adults has been reviewed. There is an on going programme of renewal and refurbishment and regular audits of cleaning and infection control procedures. Care Homes for Older People Page 8 of 27 Copies of maintenance records are kept within 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. People who are considering moving into or staying at the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: Three peoples care files were seen. All contained evidence of pre admission assessments and were comprehensive, providing sufficient details of all care needs. The home continue to admit people for short term care within 24 hours of assessment and have improved their assessment process in this area, meeting a recommendation made in the last report. 9 residents returned Commission surveys prior to the inspection, some of which had been completed by relatives on their behalf. All stated that enough information had been received by themselves or their family, prior to moving in, so they could decide if Alexandra House was the right place for them. 8 people also confirmed that they had received a contract upon moving into the home, 1 person was unsure. Care Homes for Older People Page 11 of 27 Evidence: The two social and health care professionals surveys told us that usually the care services assessments arrangements make sure that accurate information is gathered and the right service is planned for people. 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Three peoples care records were looked at. A new standard assessment, care planning, risk assessment and daily record system has been implemented since the last inspection. The plans are clearly based upon the initial information gained during the pre admission process, are person centred and give clear instructions to staff as to how to meet these needs. Two requirements made at the last inspection regarding care plans and accident recording, were found to be met at this visit. 8 out of the 9 surveys returned by people living at the home, stated that they always received the care and support they needed, whilst 1 person said usually. A daily record is kept for each person and it was possible to see that individuals care needs were being met each day as identified in their care plans. A comprehensive record is kept of when healthcare professionals visit a person or are involved in their Care Homes for Older People Page 13 of 27 Evidence: ongoing care. These included GPs, chiropodists and specialist nurses. The weighing scales used for people in the home were also appropriately calibrated, ensuring they gave accurate readings and meeting a good practice recommendation made in the last report. When asked if they received the medical care they needed, 7 out of 9 survey respondents said always and 2 said usually. The 2 healthcare professionals who responded to the surveys, felt that peoples social and healthcare needs were properly monitored, reviewed and met by the home and commented that they would be happy for their own parents to be residents in the home. Since the last inspection, the home have changed their medication supplier which has been an improvement in how medication is handled, stored and administered. Three good practice recommendations made in the last report were all found to be met at this visit. People wishing to self-administer their medicines can do so following a risk assessment process and one person was self medicating at the time. It was recommended that residents also sign the assessment sheet to evidence that they have read and agreed it. Where medications are prescribed as required or PRN, there are instructions for staff to follow regarding how often they can be administered and for what reason. No gaps were seen in the MAR charts, fridge temperatures were well recorded and all hand written entries seen were double signed. Staff were observed to be compassionate and caring in their interactions with people living at the home and clearly well aware of individuals needs. There was a calm atmosphere in the main lounge with staff coming in and out providing drinks and generally chatting with people. Peoples privacy and dignity was also seen to be respected, by staff knocking on their doors and offering personal care discretely and in private. 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. People who live at the home are able to participate in social activities and are given choices to maintain their quality of life. Evidence: There is a full time activities co-ordinator who provides a programme of activities and a weekly schedule was on display on the notice board in the corridor. Personal profiles have been established for all people living at Alexandra House and the activites organiser writes to families of those people who are unable to provide any information themselves. Daily activity records were seen for everyone, including short stay admissions. Several photoboards displayed pictures of events held at the home and also on display was artwork by people living there and the raffle prizes for the up coming fete. The dementia unit lounge was busy with people , some reading, listening to music, cuddling soft toys or talking. There was a very calm, peaceful atmosphere and staff were seen coming and going, chatting with people. When asked if there were activities that they could take part in, 8 out of 9 people responded always, 1 said usually. Healthcare professionals also felt that the home Care Homes for Older People Page 15 of 27 Evidence: supported people to live the life they chose. Since the last inspection it has been agreed that during any absence of the activities organiser, additional care hours will be provided and care staff can choose to work these extra hours to provide activity cover. This is in response to a good practice recommendation made in the last report. Menus showed that the people who live there have a choice of meals throughout the day. The menu was varied and meals appeared nutritious. Lunch on the day of the visit was roast pork with stuffing, spring greens, broccoli and a choice of mashed or roast potatoes. The alternative was a jacket potato with cheese and salad. People appeared to be enjoying their lunch and several staff assisted those who needed help, chatting about what they were doing and asking people what they would like. 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. Complaints procedures make sure that peoples, relatives and representatives concerns and complaints are listened to and acted upon. A staff team who have a good knowledge of how to respond to any suspicion of abuse and to keep people safe from harm, support the people living at the home. Evidence: 11 complaints have been received by the home since the last inspection and clear documentation was kept of the outcomes and any actions taken. There is an appropriate complaints policy and procedure in place which is prominently displayed in the home and also included in the statement of purpose (residents handbook). 8 out of 9 surveys returned indicated that people felt there was always someone to speak to informally if they were unhappy, whilst 1 did not reply and 7 people knew how to make a complaint. There have been 11 safeguarding referrals made to and coordinated by the local authority since January 2009. The home has raised all of them and co-operated fully with the investigations and taken action where necessary. Staff have attended training in the Protection of Vulnerable Adults (POVA) so that they are aware of the different ways vulnerable people are at risk of abuse, and would Care Homes for Older People Page 17 of 27 Evidence: know how to respond. Staff spoken with and surveys returned, showed that they were confident on how to whistle blow and how to report any allegations of abuse. Discussion took place with the registered manager over a good practice recommendation that was made in the last report, regarding the safeguarding policy and procedure in place. It was agreed that Alexandra House have reviewed their policy since and have acted appropriately in reporting any incidents that they feel should be considered as possible safeguarding issues. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is maintained and furnished so that people live in a relaxed, homely and comfortable environment. Evidence: A tour of the premises found the home clean, tidy and well maintained, with a warm and relaxed atmosphere. Despite the home being an older building without ensuite toilets and bathrooms, the AQAA (annual quality assurance assessment) received showed that there was an on going programme of refurbishment in place. Some bedrooms seen had just recently been redecorated and other areas had been recarpeted. During the tour of the home, we saw curtains in bathrooms and toilet areas that were hanging off the rail and discussed the infection control risks that could arise from having soft furnishings in such areas. It was recommended that either a regular, documented laundry system for them was implemented or they were removed. The manager took immediate action and the curtains had been removed by the second day of the inspection. 6 of the survey respondents felt that the home was always fresh and clean, whilst 3 thought usually. Care Homes for Older People Page 19 of 27 Evidence: The laundry room was clean and tidy however due to the restricted size of the room and limited positioning of equipment, it was not felt to be a comfortable working space. Also handwashing facilities were not used in there due to restrictions in reaching them and staff used the toilet handwash facilities across the corridor. A good practice recommendation has been made regarding this. Otherwise good systems were seen in place to reduce the risk of infection, with ample supplies of disposable gloves, aprons and hand gel available around the home. Staff had recently received an update in infection control training in May 2009. 3 good practice recommendations made in the last report were found to be met at this visit. 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 people living in the home are protected by robust recruitment practices and supported by a competent and managed staff team. Evidence: On both days there were sufficient staff to meet the needs of people living at the home and there is an established tier structure in place. Each day shift benefits from having a care team manager, as well as a senior carer and 5 healthcare assistants. In addition to this there are 2 domestics, a laundry assistant, a chef and kitchen assistant, an activities organiser and the home manager or deputy on duty. It was recommended that the duty rota be amended to accurately show the full names and positions of all staff. There are currently 2 waking staff and 1 sleeping staff member working at night, however the manager told us that will soon be changing to 3 waking staff, 1 of whom will be a senior carer. When asked if staff were available when they needed them, 5 out of 9 people said always, whilst 4 said usually. The recruitment files of three staff were looked at and found to contain all the required Care Homes for Older People Page 21 of 27 Evidence: documentation, including 2 references and evidence of identity. Comprehensive interview notes were kept and any issues arising from this or references, were thoroughly discussed and appropriate actions taken if needed. All staff had received POVA (Protection of vulnerable adults) checks and CRB (Criminal record bureau) checks, prior to starting work and the organisation keeps copies of these at their head office. The AQAA, discussion with staff and the staff training records demonstrated that staff complete an induction programme. The training matrix showed that staff attend a range of training programs to be able to meet the needs of the people living at the home. Staff responding to surveys, generally indicated that they felt happy with the level of induction, support and training they received to help them care for people properly. One healthcare professional commented that the home had happy cheerful staff who were very caring. 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 benefit from living in an improving and well managed home. People and others are able to express their views and these are listened to and acted upon. Evidence: A new manager has come into post since the last inspection and following this visit, has since been registered with the Commission. During the visit staff appeared confident in their roles, the home was relaxed and people appeared at ease and comfortable. Staff spoken with commented positively about the style of management and leadership from the manager, their job role and the people living at the home. The manager and organisation have taken action to ensure that the outcomes for people living at the home have improved since the last key inspection. The manager produced an improvement plan on how the shortfalls were to be met. All of the requirements and recommendations issued at the last key inspection have now been met. Care Homes for Older People Page 23 of 27 Evidence: The home provided a completed AQAA (annual quality assurance assessment) prior to the inspection as required. The organisation employ an external audit company, Stratus Consultancy Ltd, to conduct their annual quality assurance work and they review all key national minimum standards set out by the Commission. Regular audits are carried out within the home for such things as medication, resident care files, accidents, infection control and cleaning. Regular resident meetings take place, with the minutes seen for the last two held. Annual staff surveys undertaken by the Social Care Association were seen from last year. It was recommended that these were dated accordingly as staff were left to date them individually and many had not done so, therefore not evidencing when they had been completed. The finances of people were well managed and all paper receipts and statements seen to be kept. Health and safety records were sampled, including the fire safety log and these showed that health and safety matters were well managed. There were organisational systems in place for the routine servicing of equipment and fire, heating and electrical systems and equipment seen during the inspection was in good order. Staff training in mandatory areas, including fire safety, health and safety, moving and handling, emergency aid, and basic food hygiene, was ongoing. 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 9 All risk assessments provided for people who choose to self medicate, should be agreed and signed by both the home and the individual. It is recommended that consideration should be given to the layout of the laundry room, to ensure that it provides a comfortable and accessible space for staff to work in and meet necessary infection control procedures. The duty rota should accurately reflect the full names and positions of all people working at the home. It is recommended that annual staff surveys are clearly dated to evidence when they are completed. 2 26 3 4 27 33 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. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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