Inspection on 24/06/09 for Harbledown Lodge Nursing Home

This is the latest available inspection report for this service, carried out on 24th June 2009.

CQC found this care home to be providing an Excellent 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.

Other inspections for this house

Harbledown Lodge Nursing Home 16/05/07

Harbledown Lodge Nursing Home 31/08/06

Harbledown Lodge Nursing Home 13/12/05

Harbledown Lodge Nursing Home 22/06/05

Harbledown Lodge Nursing Home 14/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Harbledown Lodge Nursing Home Harbledown Lodge Nursing Home Upper Harbledown Canterbury Kent CT2 9AP     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: Sarah Montgomery     Date: 2 4 0 6 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: Harbledown Lodge Nursing Home Harbledown Lodge Nursing Home Upper Harbledown Canterbury Kent CT2 9AP 01227458116 01227784816 manager.harbledown@njch.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Unique Help Group Name of registered manager (if applicable) Mrs Pauline Matthews Type of registration: Number of places registered: care home 56 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 56 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 Dementia - DE Date of last inspection Brief description of the care home Harbledown Lodge is an elegant Georgian country house, which is set within 50 acres of grounds and is accessed via a private drive. There is a separate Day Centre within the grounds, which is not included in this inspection report. There are adequate parking facilities at the front of the house. Care Homes for Older People Page 4 of 27 Over 65 0 56 56 0 Brief description of the care home Harbledown Lodge is part of a group of care homes called the Nicholas James Care Homes Ltd. There are four other nursing homes owned by this company within the vicinity, and some activities for residents include more than one home at a time. The home can be easily accessed via the M2 motorway, and is close to the historic city of Canterbury, with all its accompanying facilities. Most bedrooms are for single use, and most have their own en-suite toilet facilities. Each room is fitted with a call bell, telephone point, and TV. The home is a registered nursing home for older people, and older people with dementia (and nursing needs). There is no segregation between these categories, but the Provider has stipulated that service users who may be disruptive to others will not be considered suitable for admission. There is an enclosed garden area for the safety of residents with dementia, and outside doors are fitted with keypad locks for security. The fees are approximately £650 per week, depending on the type of room, and the care needs required. 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: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. The site visit to Harbledown Lodge Nursing Home formed part of the inspection process and was conducted over one day in June 2009. It was unannounced, which means that the managers, staff and people living at the home did not know it was going to take place. During the course of the site visit, discussions took place with those living at the home, as well as relatives and staff. Relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas were seen. Every year the provider completes a self-assessment (AQAA), which gives information Care Homes for Older People Page 6 of 27 to the Commission about how the home is meeting outcomes for the people using the service and how the quality of service provided is monitored. We also ask for some numerical information to be given to us on this form. Information from the AQAA was used to inform the inspection report. We observed the activity within the home and tracked the care of four people during the site visit. The total key inspection process focused on the outcomes for people living at the home and involved gathering information about the service from a variety of different sources over a period of time. Care Homes for Older People Page 7 of 27 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. Care Homes for Older People Page 8 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents benefit from having the information they need to make an informed choice about where to live. Evidence: Standards 1, 3, and 4 were assessed. To assess these standards we looked at the service user guide and statement of purpose, we assessed four pre admission assessments, and looked at information supplied by the home in its annual quality assurance assessment (AQAA). We also spoke with the home manager, and spoke with residents about their experiences of moving into the home. Standard 6 does not apply as the home does not offer intermediate care. Information about the home was readily available for people considering living at Harbledown and their relatives. Care Homes for Older People Page 11 of 27 Evidence: The service user guide and statement of purpose were inspected. These documents contained comprehensive information for prospective residents and their representatives. We spoke with several residents and one visitor, all of whom said that they had been given enough information about the home before they moved in so that they could decide if it was the right place for them to live. We case tracked the care of four people living at the home during the course of our inspection. We found that detailed information had been gathered from a variety of sources for all of these people before they were admitted to Harbledown. The home had also conducted thorough assessments to ensure that the staff team were certain that they could meet the needs of each individual. In addition to assessment of support needs, the home also ensures they gather information about the individuals life history, hobbies, wishes and aspirations. This demonstrated the homes commitment to ensuring the social needs, as well as the health needs of residents are known, planned for, and met. When asked what the service does well, the registered manager wrote on the homes self assessment: We have a detailed Statement of Purpose which provides lots of information for the prospective service user. The document has recently been reviewed. This informs them of what they can expect from our home, and the services we provide. We remain confident all is achieved that is stated. A pictorial version is being revised at present. We have recently compiled a new welcome information pack for service users and their families to have on admission. We continue to have an extensive pre-admission assessment form that is completed before any new admission to the home. This gives us a great deal of information to base our care plans on to ensure we can meet their needs wholly. We have a good link with social services and they can provide us with additional information on the service user and advice should we require it. We have comprehensive care plans in place for all of our service users and we encourage family involvement in the planning process. These care plans are in the process of being reviewed specifically for dementia diagnosed service users. Before admission to the home, all staff are briefed about the arrival of the new service user and their needs explained to them. The rooms are prepared in advance to ensure their transition into the home goes smoothly. Dietary needs are informed to the kitchen in advance for new service users. A four week trial period remains in place before permanent residency. 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. Residents benefit from having their health and personal care support needs recorded in an individual plan of care. Evidence: Standards 7, 8, 9 and 10 were assessed. To assess these standards we looked at care plans, risk assessments, and at health care records. We inspected policies and procedures for medication, and looked at how the home ensures safe practice. We spoke with residents and staff about how healthcare needs are met, and looked at information supplied in the homes annual quality assurance assessment. The care records examined were person centred and contained a lot of detailed information, providing staff with clear guidance about the assessed needs of people living at the home and how these needs were to be met. Information contained in care records told us that the individual resident or their relative had been involved in the care planning process. Care plans seen had been reviewed regularly and any changes in need were reflected Care Homes for Older People Page 13 of 27 Evidence: well so that staff were kept up to date about the changing needs of people in their care. The plans of care showed that where possible people were supported to be independent and that their privacy and dignity was respected. Staff were seen treating people with respect and talking to them in a nice manner by discussing things that the people living at the home were interested in. The service usersguide showed that privacy, dignity, diversity and equality was respected and practiced at the home. Records showed that a wide range of external professionals were involved in the care of people living at the home to ensure that all their health care needs were being appropriately met. The assessed needs of people were recorded well within the plans of care, which we found were being followed in day-to-day practice. A wide range of risk assessments had been conducted for each person to ensure that any potential hazards were identified and strategies had been implemented to eliminate or minimise the element of risk so that the safety of those living at the home was protected. The management of medications was assessed. The home has a dedicated treatment room. This is kept locked. Storage facilities for all drugs are good. This includes prescribed drugs, controlled drugs, drugs kept in the fridge, and first aid supplies. Staff spoken with demonstrated competence in medication protocols. Medication administration records (including the controlled drugs register) seen were appropriately kept. Information contained in the homes annual quality assurance assessment told us that recent multidisciplinary surveys from GPs, Continuing Care Lead Coordinator, Care Manager etc score care and all aspects of the home as excellent. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users can be confident they will be supported and encouraged to enjoy a lifestyle of their choosing, and will be offered a range of activities to participate in. Evidence: Standards 12, 13, and 15 were assessed. To assess these standards we looked at records which told us about the daily routines in the home, and about how service users are supported to make decisions regarding their daily lives. These included planned activity records, daily individual notes, and care plans. We also looked at how the home meets service users nutritional needs by looking at menus and speaking to service users. In addition, we looked at the homes annual quality assurance assessment. Detailed social care assessments were in place for those whose care was tracked, showing that peoples leisure interests were considered whilst living at Harbledown and demonstrating how people were supported to maintain their hobbies and interests whilst living at the home. The type of lifestyle people preferred was recorded well and their likes and dislikes were clear within the plans of care. One activity co-ordinator was responsible for planning and implementing the Care Homes for Older People Page 15 of 27 Evidence: programme of activities for those living at the home. The activity programme currently in use was displayed in the reception area of the home, which included the celebration of any special events and activities suitable for the people living at Harbledown. The routine of the home was seen to be flexible so that people living there were able to spend their day how they wished to do so and staff were observed offering people a variety of choices during the course of the day. We spoke to the activities co-ordinator who explained what people in the home enjoyed doing and she showed us records of participation which were retained so that activities were offered fairly and so that any isolation could be identified. When asked if there were suitable activities arranged by the home, residents spoken with told us there always were, both in the house, and outings off site in the minibus to the beach and to places of interest. Arrangements for visiting were well published and organised. Those spoken to said that they were made to feel very welcome at the home and were able to visit people in private if they wished to do so. The menu which offered people a wide range of choices and people were encouraged to be independent, where possible, whilst others were being supported with their meals in an appropriate way. Residents told us they enjoyed the food, telling us its always good, and there is always plenty to eat. The dining tables were pleasantly arranged and condiments were available for people to help themselves. People were able to eat at their own pace so that meal times were an enjoyable experience for people living at the home. Many residents choose to eat in their rooms. The home has purchased heated meal trolleys to ensure all residents receive their meals at the appropriate temperature. 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. Residents can be confident their complaints will be listened to, taken seriously and acted upon. Evidence: Standards 16 and 18 were assessed. To assess these standards we looked at the homes complaints policy and adult protection protocols. We spoke with residents about how they make a complaint, and spoke with staff about their understanding of their responsibilities regarding protecting residents from harm and abuse. We also looked at information the home had sent us in their annual quality assurance assessment. The complaints procedure was clearly displayed within the home and it was included in the service users guide. This enabled people living at the home and their relatives to access relevant information about making a complaint if they wished to do so. Any complaints received had been recorded and addressed in accordance with the policies and procedures of the home to ensure that complaints were dealt with appropriately. We spoke with several service users. They all said that they would know who to speak to if they were not happy at the home and that they would know how to make a complaint if they needed to do so. Staff spoken with said that they would know what to do if a person using the service, Care Homes for Older People Page 17 of 27 Evidence: their relative or advocate had concerns about the home. The registered manager told us how the service had improved in the last twelve months and she wrote on the homes self-assessment, It would appear there has been a decline in the number of concerns raised in the home. There are more staff in management positions within the company now, to cover the group, district and area therefore affording increased channels of access for service users and relatives. People living at Harbledown were protected from harm by the robust policies and procedures adopted by the home and staff spoken to told us that they had received relevant training in relation to the Protection Of Vulnerable Adults and that they would know what to do should they have concerns about someone in their care. 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. Residents benefit from living in a safe, well maintained and homely environment. Evidence: Standards 19 and 26 were inspected. To assess these standards we looked at communal areas of the home and some bedrooms. We looked at protocols and systems the home adopts to ensure the home is kept clean and hygenic. We also looked at information contained in the homes annual quality assurance assessment. We toured the premises during the course of our inspection, when we viewed a randomly selected number of bedrooms and all communal areas. We found that the environment was fit for its purpose, providing lovely surroundings for people to live in. The quality of furnishings and decoration was of a high standard and the home was well maintained so that people were provided with a comfortable and safe place in which to live. The bedrooms seen were adorned with peoples personal belongings, which made the private accommodation individualised and homely. The home was warm, clean and pleasant smelling. The communal areas were well furnished and tastefully decorated so that those choosing to spend their day in these areas could do in comfort. One person living at the home told us that they were very happy with their bedroom and that it was very comfortable. During our visit to the service we observed some good hygiene practices so that the Care Homes for Older People Page 19 of 27 Evidence: risk of cross infection was minimised. Clinical waste was being disposed of appropriately and robust policies and procedures were in place in relation to infection control and disposal of clinical waste so that staff were aware of necessary precautions. Records showed that staff had received training about infection control measures and those spoken to confirmed this information. 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. Residents benefit from being supported by a staff team who are appropriately recruited and have received the necessary training. Evidence: Standards 27, 28, 29 and 30 were assessed. To assess these standards we looked at records which told us about staff skills and staff numbers. This included information about training and staff rotas. We also looked at staff recruitment records. This told us whether staff were being recruited appropriately, and whether information regarding the staff members suitability for the post was obtained. This information included references and police checks (criminal records bureau). A clear duty rota was in place at the home and staffing levels were calculated in accordance with the assessed needs of those living at Harbledown. When asked if staff were available when they were needed, people living at the home said that they were. It was pleasing to note that there was a very low turn over of staff, which promoted continuity of care. People working at the home told us that a lot of training was provided for them so that they were kept up to date with current ways of working and the changing needs of people in their care. Care Homes for Older People Page 21 of 27 Evidence: Recruitment procedures adopted by the home are robust. The staff files of two people employed were examined, and we found that all relevant checks had been conducted, to ensure that people living at the home were consistently protected. All staff spoken with said that their employer carried out relevant checks before they started work and that their induction covered everything they needed to know to allow them to do the job properly when they started. A detailed induction programme was in place for all new staff and a training matrix had been developed, which showed that an extensive range of training was provided, including mandatory courses and training relevant to the specific needs of people living at Harbledown. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a well run home. Evidence: Standards 31, 32, 33, 36, 37 and 38 were assessed. To assess these standards we looked at information which tells us how the home is run. This includes the qualifications and experience of the registered manager, the ethos and management approach of the home, records which demonstrate the home monitors how it is run, and documents which evidence the health, safety and welfare of service users are promoted and protected. In addition, we spoke with the registered manager, and with residents and staff, and looked at information the home gave us in their annual quality assurance assessment. Harbledown was being well managed and the health and safety of those living at the home was evidently of great importance. The manager of the home was appropriately qualified and was registered with the Care Quality Commission. She had a lot of experience in the management of care services and was knowledgeable about current Care Homes for Older People Page 23 of 27 Evidence: guidelines and legislation. Staff told us that their manager meets with them regularly to give support and to discuss how they are working. One staff member said, the manager liaises with us daily and meets with us almost every week and another commented, we get excellent support and regular progress discussions with our manager. A wide range of risk assessments and internal audits had been completed by the home to ensure that the standard of service provided was monitored and that the safety of those living at Harbledown was promoted. A variety of meetings were held regularly and minutes were retained so that those concerned were provided with relevant information. There was a robust health and safety policy in place and we could see from the homes annual quality assurance assessment that there are service certificates to ensure that systems and equipment within the home had been appropriately checked and deemed as safe to use, so that the people living at and those working at Harbledown were protected. Accident records had been completed appropriately so that any incidents could be monitored and to ensure that people living at the home were as far as possible protected. The quality of service provided was monitored well, with a variety of surveys being conducted for people living at the home, their relatives and stakeholders in the community. Monthly inspections were carried out by someone from the company, following which a report was written showing any strengths or weaknesses so that the manager could see where improvements were needed. Comments from those living at the home included, I think the home is very good and lovely and I am really happy here. 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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