Inspection on 24/08/09 for Northgate House

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

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Northgate House 01/05/07

Northgate House 25/05/06

Northgate House 22/02/06

Northgate House 27/09/05

Northgate House 13/05/05

Northgate House 02/11/04

Northgate House 20/05/04

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Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Northgate House 2 Links Avenue Hellesdon Norwich Norfolk NR6 5PE     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: Ruth Hannent     Date: 2 4 0 8 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 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 25 Information about the care home Name of care home: Address: Northgate House 2 Links Avenue Hellesdon Norwich Norfolk NR6 5PE 01603424900 F/P01603424900 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Aisoobee Ruhomutally,Mr Faizal Ruhomutally care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Northgate House is a care home providing residential care for up to 22 older people. It is situated in a residential area of Hellesdon, which is approximately three miles from the city of Norwich. There are local shops, pubs and other amenities within the immediate vicinity of the home. Northgate House is an adapted and extended family house. The home accommodates twenty-two older people in single and shared bedrooms. Accommodation is located on the ground and first floor. Eight of the single bedrooms have en-suite facilities. There are bathing facilities, including assisted bath, on both floors and communal toilets are located throughout the building. Communal areas are located on the ground floor. There is a paved garden to the front of the home and limited off road parking is available. Weekly fees are from £360 to £450. 0 Over 65 22 Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced key inspection that took place on the 24th August. It was carried out over 51/2 hours and was assisted by the Registered Manager and Deputy Manager who are the husband and wife owners of this home. Prior to the visit we had received an Annual Quality Assurance Assessment (AQAA) that had been completed by the managers giving us a picture of the service throughout. Surveys had also been received from residents, relatives and professionals and some notifications have been sent from the home since the last key inspection. All the information received as well as the visit to the home is used to complete the report. Care Homes for Older People Page 5 of 25 What the care home does well: What has improved since the last inspection? What they could do better: The home does need to improve the style of care plans and the way recordings are written. The home are aware of these improvement needs and have already started to bring formats and ideas together. The home does need to have a regulatory metal medicine storage cabinet for the safe storing of all medications to replace the wooden cupboard in use at present. Many comments received talk about the lack of stimulation for the residents and although the home does have planned events and outside entertainment the day to day occupation for the residents could be provided and recorded as part of their day to day care needs. Lots of good practice is taking place but evidence of the practice is not so easy to find such as meetings of minutes or recordings of how the social care needs of each person is assessed, recorded, delivered and reviewed. The environment around the building could be more personalised by paintwork other than magnolia that is in residents own rooms and evidence should be available to show Care Homes for Older People Page 6 of 25 how the person helped in choosing their own colours, fabrics etc. Some furniture is looking scratched and worn and new furniture would improve the appearance and make it even more homely. 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 7 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential residents to this home will have the information and will be assessed to enable them to make a decision about the suitability of the home to meet their needs. Evidence: To help people make a choice about the suitability and service offered in this home we noted that in the residents bedroom there was a folder containing a service users guide and statement of purpose for the resident to read at any time. This document is available for any potential resident to read when making a decision about the home and if it is where they would like to live. The AQAA tells us that all potential residents are encouraged to visit and that a trial period for 4 weeks is encouraged. The home does offer respite care and many of the people who have started with respite have become permanent residents through their own choice. On the day of this inspection the care manager was about to visit a potential resident Care Homes for Older People Page 9 of 25 Evidence: in their own home. On looking through care plans a detailed pre-assessment form had been completed on a resident prior to admission. The details gave a good picture of the needs of this person and would have been a good guide to staff on the support this person would require on being admitted while awaiting the completion of the full care plan. It was also noted that information to assist in the initial admission had been received from a Social Worker giving a good picture of the needs of this person. On talking to this resident it was clear that this person was happy and contented with the care support offered and had no concerns. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do have a care plan that shows all the care needs required to meet their health and personal care is met in an appropriate, dignified and safe manner. Evidence: The AQAA tells us that all residents are treated with respect and their dignity is upheld. This is reflected in the information found in the care plans seen on the day of this inspection and on talking to the residents throughout the day. Each person has a care plan and although some of the detail is on old and mixed up formats that make the information difficult to find, the information is there. The home does have plans to develop and improve the way information of care is written and this was discussed in detail with staff. The aim is to transpose the information onto better forms for easier reading without losing the content and information that is relevant. Risk assessments were seen and details of how to manage the risk were in place. For example the moving and handling of residents risk assessment was inside the care plan documentation and dated. Care plan reviews with Social Workers were noted but it was not clear how and when Care Homes for Older People Page 11 of 25 Evidence: the home had carried out monthly checks of care plans to ensure all sections were up to date. This has been recognised by the management and ways of improving this was discussed. The home is supported by a number of GPs and District Nurses who names are written in the care notes when a visit or phone contact has been made. Clear instructions are written and staff are directed to read the notes via communication written in a staff handover book. The medication administration offered at lunchtime and observed was issued from a wooden cupboard that is locked in the dining room. Only two people needed medication at this time and it was noted that the chart was signed by the Manager at the tablets issued and that one person was asked if they would like pain relief. A concern of the drugs not being stored in a metal cabinet was shared with the Manager and will be a requirement for this inspection. It was also noted that some creams and lotions were in residents bedrooms ready for application when personal care was taking place. The recording of the application should be on a chart in the persons bedroom and signed for by the person who has applied the cream and not written later by the senior responsible as they have not administered the medication. The creams should also be in a locked cabinet within the persons bedroom. Relatives spoken to on the day and residents who were able to express their views all stated that the care they are offered is good and they are looked after well. Surveys received said I am well cared for, I am supported well with all my personal care needs, the care is so good I have improved in health and am able to get about more, personal care is excellent, courtesy is exeptional and the care staff are patient and considerate. One relative spoken to on the day gave us a very good picture of the way the home had taken their family member in to the home, built up his strength and ability to enable him to move on and live nearer to them. This family style run home has a lot of good care practices taking place and there is no doubt that all staff are very involved and know the residents well, but to improve further, they do need to ensure that recording of relevant information to evidence the well being of residents is in place. Throughout the visit is was noted that the whole home was calm and peaceful. No alarm bells were heard throughout the day and all care needs appeared to be met in a pleasant and dignified manner. Staff knocked on bedroom doors before entering and conversations were pleasant and respectful. Care Homes for Older People Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does meet the diverse needs of some of the residents but to ensure all social support is met more details need to be recorded in this area of care needs. The families and friends are able to visit as and when the resident wishes. The meals provided are enjoyed, nutritious and take into consideration the food required by people following their religious beliefs. Evidence: It is not clear how the residents social life is met. The home does provide outside entertainment and on walking the building residents were reading or outside enjoying the sun. One person was doing the garden which was giving him so much pleasure but comments received prior to the inspection state, there could be more stimulation, I am bored and depressed, activities and more stimulation could be improved were just some of the comments around activities received. This was not evident on the day and most people seemed to be occupied with something. Good practice was noted with one particular resident who practices a religion different to the rest of the residents and is assisted to continue to practice the belief. It was witnessed that this person is taken to her room to pray, the food was prepared separately with all cooking Care Homes for Older People Page 13 of 25 Evidence: equipment purchased for this person and that meals were planned to ensure that the menu was suitable. This person was dressed as wished and is in the process of writing a book which the home is encouraging. Relatives were seen coming and going. The comments from families were all very positive with them stating they were always made welcome. The home has a feeling of a good community and we always enjoy our visits. Residents also spend the better weather in the front courtyard watching and acknowledging the people who pass by. The residents are full of praise for the meals provided. All comments were positive. The menu for the week is on a wipe board in the dining area and residents stated they can have a choice if they do not like what is on the menu. On the day of this visit the meal was steak and mushrooms with fresh vegetable and potatoes. On asking, everyone said what a good meal it was. One person whos care plan had been seen had a very poor weight record on admission, but as the monthly weight was taken it showed a gradual increase as the dietary needs were improved. Care Homes for Older People Page 14 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that their concerns and complaints will be listened to, dealt with correctly and within the timescale stated in the policy. Procedures are in place to ensure residents are protected from abuse. Evidence: From all the surveys received (20) none of them talk of complaints or concerns other than residents requiring more stimulation. One complaint was received earlier in the year and was dealt with promptly and thoroughly with letters received by the Commission of the full investigation that took place. The needs of this person could not be met at Northgate House and was moved to another home that the person preferred. The management has stated in the AQAA that all complaints will be followed within the timescales written in the homes policy. The complaints procedure was noted in the information in the residents room and in the entrance to the home. The AQAA tells us that all staff are trained in the Protection of Vulnerable Adults and understand the no secrets. The manager told us that this is one of the first training events in the new staff members induction on recruitment. The home has a whistle blowing policy that is given to all new staff members to read and one staff member said the staff team are all supportive and if any poor practice was seen or heard it would be reported on and dealt with correctly. Care Homes for Older People Page 15 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe for residents by being regularly maintained. It is comfortable and decorated to an adequate standard but furnishings and fittings could be improved upon. The home is clean and tidy and has no unpleasant odours. Evidence: The home has been added on to at various stages to extend and accept more residents. At present the home has 19 people living there. The Manager was able to show the safety certificates for the gas (20/07/09), the fire protection (24/04/09) and the servicing of the lift (Feb 2009). The fire drills were recorded and the latest one showed all staff had attended (04/08/09). The home could improve the environment by replacing some furniture that is looking tatty and with redecoration of some rooms. Everywhere was magnolia that looked chipped and marked in a number of rooms. Although the Manager said the person has a choice of how they would like their room decorated this was not evident and on talking to one resident they do not remember ever being asked. It was noted that not all rooms had a lockable cupboard in them for people to be able to safely store money and valuables and many seats throughout the building were worn and did not match except for the small lounge. The laundry area has been temporarily extended and is in the process of being made a Care Homes for Older People Page 16 of 25 Evidence: proper extension to improve the size of what was a cramped room. There is one commercial sized washing machine and dryer with a washing line in the recently purchased garden and semi next door. This house is being used as and office/training facility for staff to have an opportunity to learn away from the areas the residents use. There is a newly refurbished main kitchen that is kitted out well to cater for the residents. There is stainless steel work areas and wall panels for easy clean and suitable floor covering. The Environmental Health Officer has seen and approved the new kitchen with no requirements made on his report seen, from his visit in February 2009. Throughout the tour of the home it was noted everywhere was very clean and tidy. Comments received from families and residents all mention the cleanliness of the home and that there is never any odours. It is home from home and always clean and tidy, the building is kept nice and clean, rooms are kept very clean, were just three comments of a number received. Care Homes for Older People Page 17 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are cared for by staff who are competent, trained and recruited following procedures to ensure they are in safe hands at all times. Evidence: On the day of this visit 2 care staff and the deputy manager/owner were assisting residents with personal care. The registered manager was dealing with tasks that included meal preparation, due to the cook being sick and administration. The daughter who is now involved with the business was working on the development of care plans and social stimulation for residents and a housekeeper was working on cleaning the rooms and assisting at meal times with washing up. No one appeared hurried, residents were content and occupied and everyones appearance was smart, clean and tidy. The manager informed us that there is always two care staff on through the night and this appears suitable for the number of residents and care needs presently required. The staff are encouraged to complete their NVQ 2 qualification with the AQAA telling us that at least 50 of staff are qualified. The deputy manager showed us the various training agencies that are being applied to to find the most suitable company to offer NVQ training. (Funding for this can vary greatly). Discussions around the gaining of the qualification has caused some staff to leave as they did not wish to complete the course. Care Homes for Older People Page 18 of 25 Evidence: Discussions around recruitment with the manager told us that difficulty due to the long delay in the return of the CRB has caused some problems in staffing numbers. Staff are called in to carry out there induction once the POVA and references have been received but are not left alone, carrying out care tasks, until the CRB is returned. The AQAA tells us that the home follows stringent recruitment procedures before recruitment commences. 2 personnel files were looked at and both had the relevant paperwork to ensure residents were cared for by safe hands. The training starts with the Skills For Care common induction standards. The deputy manager ensures that one of the first training offered is the protection of vulnerable adults and then all the statutory training is carried out by either an in-house trainer, outside trainer or via distance learning. The home also has video training with questionnaires to ensure competency that was seen during this inspection. Staff spoken to talked of the training completed and also of the full encouragement they receive from management to complete the training. It was evident that the care manager tries all avenues to find the correct training to support the staff in suitable courses, through discussion during this visit, notes and training information shared and practical evidence observed throughout the day. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed well with a joint effort made to ensure that the home is safe for all who are involved. However evidence of good record keeping of both meetings held and money management could be improved. Evidence: The home is run by the husband and wife who own the home and are now working with their daughter to develop and improve the home. Mr Ruhomutally is the registered manager and deals mainly with the building and administration of the home with Mrs Ruhomutally managing the care and staff of the home. Both are management qualified with RMA and have many years of experience having run this home for 22 years. Mrs Ruhomutally shared with us her recent training and development using the courses and workshops provided by the local council as well as her recently completed RMA and NVQ 4. Throughout the day relatives visited the home and displayed there obvious involvment with the management team. The interactions were open and friendly and without any Care Homes for Older People Page 20 of 25 Evidence: prompting gave a clear picture of the quality and care offered at the home. Two different families reported on the improvement of their loved one since being admitted to the home and how the management had put their minds at ease. They also talked of being involved in meetings and annual reviews of the service offered. The evidence of meetings was not available as minutes are not taken and is an improvement mentioned in the AQAA as a development for the future. Family members comment on the approach of the management and feel they are listened to. The management and staff always find time to talk to me was just one comment noted. The home does need to improve the methods used to record and ask for money for the hairdresser, chiropody etc. The record at present is noted adhoc in a small red book. The details are then written after a couple of months onto an invoice that is sent to the family. The manager told us the families do not always want a receipt but the Commission has been informed, prior to this visit, of mistakes in what is charged for. This poor record keeping does need to be improved to ensure that both parties are safeguarded by clear record keeping. The home is managed safely and all people who use the premises are protected. The staff are trained and kept up to date with all aspects of health and safety which was clarified by staff spoken to. The housekeeper talked of safety in the cleaning methods and that up to date safety data sheets are in the locked cleaning chemical cupboard. Two taps were hand tested during the day of the visit and both felt to be at a suitable, safe temperature. Risk assessments were noted in the residents documentation and records of accidents were seen and the recorded information was clear. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 The home must store medication in the recommended metal cabinet. A recognised metal cabinet used for the storage of medication should ensure the home has complied with safe storage of medicines. 01/10/2009 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 Creams and lotions applied during personal care should be signed for by the person assisting that residents at that time. Charts need to be placed in the rooms for cream/lotion applications only. Lockable cabinets should be in all rooms for the safe storage of creams and lotions. The home should consider the way it gathers and records the information regarding social care needs. The home does need to look at the quality of the furniture and plan a refurbishment programme for the areas that are Page 23 of 25 2 3 4 9 12 24 Care Homes for Older People 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 beginning to look shabby. 5 24 The decorating of various rooms of both bedrooms and communal areas needs to be considered to show that choice by the individual has been made. It is recommended that minutes of meetings are written for relatives and staff as part of the quality assurance process. The home should have clear and accountable records for any money transactions that occur on behalf of the residents. 6 7 33 35 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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