Inspection on 10/03/10 for The Manor House Lynmouth

This is the latest available inspection report for this service, carried out on 10th March 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Manor House Lynmouth 28/10/08

The Manor House Lynmouth 24/04/08

The Manor House Lynmouth 19/11/07

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for older people Name: Address: The Manor House Lynmouth The Manor House Lynmouth Devon EX35 6EN     The quality rating for this care home is:   one star adequate 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 Walsh     Date: 1 0 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: The Manor House Lynmouth The Manor House Lynmouth Devon EX35 6EN 01598752269 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Waltraut Charlotte Watson,Mr Gordon Wilfred Watson Name of registered manager (if applicable) John James Smith Type of registration: Number of places registered: care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 17. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category (Code OP) Date of last inspection Brief description of the care home The Manor is a detached Georgian property situated in a secluded position, in its own grounds, overlooking the sea at Lynmouth. It is within easy access of the facilities of Lynmouth. It is registered to accommodate up to 17 elderly people. Accommodation is provided in 13 single occupancy and two double occupancy rooms. The fees for accommodation at this home range from GBP288.00 to GBP460.00 per week. Care Homes for Older People Page 4 of 27 Over 65 17 0 Brief description of the care home Additional fees are levied for items such as chiropody, newspapers, hair dressing and toiletries. Copies of previous inspection reports are available at the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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 inspection took place during a week day in March and lasted approximately 5.5 hours. The focus of the inspection was to gain the views of the people who live at the home and all individuals were spoken to during the inspection. We observed care practices throughout different times of the day, but particularly around the lunchtime period. We also spent time talking to staff including the new manager, 2 care staff, one cook and the domestic staff member. Both registered providers were available for the feedback. We spent time looking at some of the key documents including plans of care, assessments, staff recruitment files, records relating to medications. This helps us to understand how well the home is run. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us Care Homes for Older People Page 6 of 27 how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. During the inspection 2 people were case tracked. This involves looking at peoples individual plans of care, and speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process we try ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to people living at the home; representatives, health and social care professionals (including GPs and care managers) and staff. At the time of writing the report, responses had been received from 7 people living at the home, and from 3 staff. We had two surveys from health or social care professionals. Their comments and views have been included in this report and helped us to make a judgment about the service provided. The home have been subject to a safeguarding process over the last 6 months. They have worked with CQC and the commissioning teams to ensure that they are meeting individuals needs. The key issues had been around the registered providers lack of understanding and experience to follow up on individuals changing and complex health care needs. This has highlighted the need for them to get a new manager in post so that they have someone who has this experience and knowledge. Their new manager started in early January, and she has to date made good progress. The registered providers are aware that without a registered manager in place they are unlikely to be able to demonstrate fitness to re register under the Health and Social Care Act 2008. 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: Plans of care should include an assessment of the individuals mental capacity, so that staff are aware of what support and assistance individuals may require in making decisions in their everyday lives. Although medication procedures are now more robust, staff should ensure that any hand written entries are double signed to help prevent any potential errors occurring. Training in key areas of health and safety needed to be updated for all staff on a Care Homes for Older People Page 8 of 27 regular basis. The manager has a programme of training in place to ensure that this will now happen. The registered providers must ensure that all parts of the home are safe and well maintained. This refers to ensuring that the stair lift is serviced at least annually, that all portable electrical equipment is tested for its safety and that equipment such as hoists are serviced at least 6 monthly. Failure to comply with this could place individuals and staff at risk. Requirements have been made with short time frames to ensure that this work is completed. The new manager has made a good start on meeting requirements and has developed links with other local homes and with the community nurse team. She now needs to register with CQC. Two surveys we have had returned form health or social care professionals have highlighted that they believe without a registered manager in place then individuals changing and/or complex needs may not be well met. 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. Individuals can be assured that their needs will be fully assessed before they are offered a placement at The Manor House. Evidence: During this inspection we looked at the pre admission assessments for two individuals who have recently used the home for a short break and who were privately funded. We saw that the new manager had been able to complete all sections of the pre admission information form, which includes details about the individuals personal and health care needs and a little on their social or diverse needs. The manager was in contact with CQC about one individual who did not fall within the homes registered category. She was able to demonstrate that she understood the persons needs and who she should go to if their needs changed or increased. This shows a willingness to work with the Commission in a flexible way. It also demonstrates that the manager understands the limitations of the registration categories. Care Homes for Older People Page 11 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. Individuals needs are being planned for and this could be further improved to ensure care and support is person centered. Evidence: During this inspection we were able to speak to everyone who currently lives at the home and to one individual who comes in once a week for day care. Everyone says they enjoy living at the Manor House. Several people have lived at the home for many years and regard it as their home. One person told us that they have been asked by their family and by social services if they would like to move and they have said I cant imaging living anywhere else, I am treated well here and want to stay. One person told us You ought to check other homes, there is nothing wrong here, we are very well treated. Another person said that they liked living at the home but that they wanted us to tell the registered providers that they wished to spend more time in their own room. We did pass this onto the providers who said that they were aware of this, but that they had been encouraging the individual to spend some time in communal areas as they did not want them to become socially isolated. Care Homes for Older People Page 12 of 27 Evidence: One individual spends most of their time in their room, but staff reported that they have been encouraged out to join in activities a few afternoons and that the person appeared to really enjoy the social contact. We looked at all the plans of care and in particular at two. We found that they are now being more regularly undated and reviewed so that any changes can be recorded and monitored. We saw for one person that their mobility appeared to have deteriorated. Staff said that this was variable depending on the time of day and form day to day. It was agreed that this individual should be assessed by a specialist in mobility such as a physiotherapist and/or occupational therapist. This will help to ensure that the home have and are using the right equipment and that support is being given in a way that maintains the individuals Independence as far as possible. We saw that plans contain risk assessments where bed rails are in use. We recommend that the home also record that the bed rails are being regularly checked to ensure that they are still fitted safe. Plans could be further enhanced by including more detail about the individuals preferred routines and ways they wish to be supported. This has been looked at and could be expanded further. Plans should also contain an assessment about the individuals mental capacity as this would assist staff to understand areas that people may need support in to help them make decisions in their everyday lives. We checked the medication records and system for safe storage. We saw that previous requirements have been complied with. The home now have a controlled drugs cabinet that is securely fastened to the wall. They also have a book that has numbered pages for the recording of controlled drugs being administered. The pharmacist also made a requirement that the home should properly record when any medicine is being taken out of the home. This referred to when an individual went out and took their medication with them. This is no longer happening but the manager assured us that they have a recording system in place for medications that leave the building including any returned medication to the pharmacist. Individuals who self medicate have a risk assessment in place. This is mainly only topical creams and inhalers. We saw that the record of administering medications was kept up to date and appeared to accurately reflect what had been administered. We recommend that any hand written entries should be double singed to help prevent against potential errors. Care Homes for Older People Page 13 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. Individuals social and diverse needs are being well met Evidence: Individuals we spoke to said that they enjoyed spending time with staff and that most afternoons they played bingo board games or watched a film together. Several people mentioned that they had enjoyed or were looking forward to a one to one outing to Barnstaple with the registered providers. This gave them an opportunity to look at the shops and to buy any items they wished as well as having lunch out. This activity appeared to be very popular and was being well received by people. One person told us It makes such a change to get out and about and means I dont have to always rely on my family to bring me in any items I need, although staff are very good they will get you anything you want from the village. Staff that we spoke to said that they were able to spend quality time with individuals during the afternoons, and this was observed during the inspection. Current low numbers of people living at the home does mean that staff have time to spend talking and doing activities with people. We asked the manager how this will be continued if more people live at the home. She has indicated that they would look to increase the staffing levels so that they can continue to offer quality social time for people. Care Homes for Older People Page 14 of 27 Evidence: The home continues to offer a good range and choice of meals for people. Everyone we spoke to was very complimentary about the food. Meals are served in a relaxed and unhurried manor and as there is only a small number of people at present they can cater for everyones individual needs. One person told us that tea time was a range of options and that Val will always try to make sure you get exactly what you like. Everyone is currently on a normal diet, although some on a reduced sugar intake due to diabetes. Care Homes for Older People Page 15 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. Systems are in place to ensure that individuals views are listened to and acted upon Evidence: We spoke to everyone currently living at the home and they all returned surveys. They said they could make their concerns known and that they would be listened to. One person said that following the last CQC inspection they were told to move out of their room, so they wanted to make a complaint about that. It was explained that we had not required them to move rooms but that the damp in their bedroom needed to be looked at. They have been reassured by the registered providers that once the external work is completed to stop damp coming in, the room can be redecorated and they can return to the room. The home have not listed this as a complaint as the individual is not actually complaining about them. The AQAA says they have had no other complaints. The registered providers said that as they are currently very hands on and see everyone almost every day, they sort out any issues before they become complaints. The home have been subject to a safeguarding process over the last 6 months. They have worked with CQC and the commissioning teams to ensure that they are meeting individuals needs. The key issues had been around the registered providers lack of understanding and experience to follow up on individuals changing and complex health care needs. This has highlighted the need for them to get a new manager in post so that they have someone who has this experience and knowledge. Their new manager Care Homes for Older People Page 16 of 27 Evidence: started in early January, and she has to date made good progress. The registered providers are aware that without a registered manager in place they are unlikely to be able to demonstrate fitness to re register under the Health and Social Care Act 2008. We spoke to one newer member of staff about their understanding and awareness of safeguarding processes and abuse. They said that they had covered this as part of their induction and knew the basic details of what and who they should report any suspicions to. The manager said that updated training had been arranged for staff in understanding the protection of vulnerable people. Care Homes for Older People Page 17 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 Manor House is homely and provides people with spacious and pleasant surroundings, but improvements are needed to ensure that all areas are safe and well maintained. Evidence: During this inspection we looked at all individual bedrooms, some bathrooms and all communal areas. The home is kept clean and free of any offensive odours. Some areas of the home are colder, but as they have only six people currently living at the home some areas have had the heating turned down or off. No one complained they were cold. Everyone said that they were kept warm and comfortable. One person said that they had asked for additional heating for their bedroom and this had been supplied. The registered providers have clearly worked hard to make the environment homely and comfortable. They have refurbished some of the bedrooms and have made two of their bathrooms into a walk in shower rooms so that they are more accessible to people. They have ensured that soap dispensers and paper towels are replenished to help with infection control. Care Homes for Older People Page 18 of 27 Evidence: One area that has been highlighted for improvement via their AQAA, is that they need to ensure that maintenances and servicing of equipment is done and kept up to date. The AQAA shows that their portable electrical equipment had not been tested and checked to ensure safety since 2008. The stair lift has not been serviced since 2008 and their portable hoist had no information about when that had been serviced. These need to be addressed and we have made requirements in respect of these. The registered providers need to ensure that they have a routine programme of maintenance and renewal with records kept. For example we asked the registered providers to ensure that they complete regular checks on any bed rails used. They say they they do this each evening, but this is not recorded. They also said that they been unaware that they needed to ensure that hoisting equipment needed to be serviced according to manufacturers recommendations. Care Homes for Older People Page 19 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 staff team have training and support from the new manager to ensure that they can do their jobs well. Evidence: The people who live at the Manor say that staff treat them well and that there is always two staff members on duty throughout the day. We checked the staff rota and saw that for the waking night cover each shift records G/V We asked the registered providers what this means and they said that Gordon Watson covers some of the night cover and then Val Watson covers the rest. We have said that this is not sufficiently detailed to tell people exactly who is working. We have left this requirement in, in order to ensure that the providers comply fully they need to state on the rota exactly who is covering each hour of the day and night. We checked the staff recruitment files for three staff members and found that they all had satisfactory references and checks to show that they are suitable to work with vulnerable people. We discussed the training with the manager and registered provider. The induction for new staff follows the national guidelines. The ongoing skills and health and safety training has been organized to ensure that all staff have updates in key areas. Care Homes for Older People Page 20 of 27 Evidence: Four staff surveys were returned. All said that they thought they provided very good care and support to people that live at the home. Three said that they had training and support to do their job, one said they needed more. With the programme of updated course now in place, this may well be addressed. The new manager has made a start at providing supervision and support to all staff and is planning to offer this at least 6 times per year with more if needed. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the home is currently running well under the new manager, health and safety improvements are needed to ensure that individuals and staff are safe. Evidence: The new manager has previously been registered with the Commission to run a service that was rated as good. She has made a good start on ensuring that the requirements made from the previous inspection have been followed up, actioned and complied with. She is now in the process of registering with CQC. The manager is beginning to look at quality assurance and reviewing the the support and care offered using the views of the people who live at the home and other stakeholders. She is aware of what is needed from her previous role and has already made links with other local providers and with the community nurse team. We checked with the registered providers and since the last inspection the one individual they did hold money for, they draw the money out and it is held in a secure Care Homes for Older People Page 22 of 27 Evidence: place. We have already highlighted that health and safety of individuals and staff may be compromised if equipment and facilities are not well maintained and serviced regularly. One area that has been highlighted for improvement via their AQAA, is that they need to ensure that maintenances and servicing of equipment is done and kept up to date. The AQAA shows that their portable electrical equipment had not been tested and checked to ensure safety since 2008. The stair lift has not been serviced since 2008 and their portable hoist had no information about when that had been serviced. These need to be addressed and we have made requirements in respect of these. Accidents and injuries are recorded appropriately and new staff are following a national programme of induction. We saw that risk assessments are in place for all safe working practices and we were told that the Environmental health officer had recently visited and awarded the home 4 out of five stars, making some minor recommendation in relation to the kitchen. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 31 17(2) The registered providers must ensure that there are clear lines of accountability within the home, including ensuring that people are aware of who is rostered for each shift within the home 30/11/2009 Care Homes for Older People Page 24 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 1 38 23 The registered provider must ensure that portable electrical equipment is checked and teated at least annually to ensure that the equipment is safe to use 30/04/2010 2 38 23 The registered provider must ensure that the stair lift and hoisting equipment is regularly serviced according to manufacturers recommendations to ensure that both individuals and staff are safe in the use of such equipment 21/05/2010 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Plans of care should include a mental capacity assessment Page 25 of 27 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 so that staff are aware of what areas people may need support in to make everyday decisions. 2 9 Any hand written entries to medication records should be double signed to help prevent against errors. 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). 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