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Inspection on 23/04/09 for The Old Rectory

Also see our care home review for The Old Rectory for more information

This is the latest available inspection report for this service, carried out on 23rd April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

All people that wish to use service benefit from a pre-admission assessment and the care plans are then generated from this initial assessment. The pre-admission assessment is kept in the persons individual care plan folder. We were told by the matron that all people who wish to use the service are admitted for two weeks which allows time for the staff to complete thorough assessments and for the individual to settle in and make a final decision about staying. Care plans and risk assessments contained enough information about the people using the service that allowed staff to care for them appropriately. The staff spoken to on the day were knowledgeable about the care needs of the people using the service. They were observed to be interacting and speaking appropriately to the people in a calm manner. The standard of catering is high and on the day of the inspection people using the service were enjoying a St Georges day celebration meal. Visitors can stay for meals and this was seen on the day. People using the service, who we spoke to, were complimentary about the quality of the food. The home is situated in well maintained grounds. People using the service are able to make use of the gardens with plenty of seating available and have access to shaded areas. The home is decorated to a high standard and maintenance and refurbishment takes place regularly. There are plenty of communal areas and in the conservatory newspapers and magazines are available. The home employs a team of physiotherapists who ensure that people who use the service are able to maximise the independence. A hydrotherapy pool is also available and the physiotherapists are responsible for assessing the people who use the service for their suitability to use this facility. A member of staff accompanies people who use the service to all healthcare professional appointments if the would like this facility. The staff member then reports in detail the outcome of the appointments and ensures that care plans are also adjusted if necessary. Regular training takes place and this includes the NVQ (National Vocational Qualification) which all staff have access to.

What has improved since the last inspection?

Four requirements were made following the last key inspection in April 2007 and these have now been met. The home still has no registered manager but is managed on a daily basis by a nominated manager who is supported by a matron who is a nurse.Recruitment procedures have been strengthened so that all new members of staff have the required paperwork before commencing work. Quality assurance checks are now in place and the views of the people who the service are sought. Supervision for staff members now takes place regularly.

What the care home could do better:

Two requirements were made following this key inspection. The home`s statement of purpose and service user guide to be reviewed and updated to ensure it contains all the information required. The home`s safeguarding adults procedures to be reviewed to ensure that they match the local authority`s procedures. This ensures that people who use the service are protected from abuse.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Old Rectory The Old Rectory (Ewhurst) Co Ltd The Old Rectory,The Street Ewhurst Cranleigh Surrey GU6 7PX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lesley Garrett     Date: 2 3 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 29 Information about the care home Name of care home: Address: The Old Rectory The Old Rectory,The Street The Old Rectory (Ewhurst) Co Ltd Ewhurst Cranleigh Surrey GU6 7PX 01483267195 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Old Rectory (Ewhurst) Co Limited care home 35 Number of places (if applicable): Under 65 Over 65 35 0 old age, not falling within any other category physical disability Additional conditions: 0 35 The maximum number of service users to be accommodated is 35 The registered person may provide the following category of service: 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 category: Physical disability (PD) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home The Old Rectory is a large detached property that has been converted and extended into a comfortable, well equipped care home. The home is set within its own large well maintained gardens and is situated close to the village of Ewhurst within walking distance of local shops and amenities. The home provides accommodation and nursing care for up to 33 older people. The home also has a hydrotherapy pool and fully equipped physiotherapy centre and provides a varied programme of therapeutic care Care Homes for Older People Page 4 of 29 Brief description of the care home and treatment for service users living in the home and to outpatients. Bedrooms are arranged over two floors, accessible by passenger lift or staircase. Most rooms are single, with a few double rooms, and all have en-suite facilities. Communal facilities in the home consist of a large, comfortably furnished lounge leading on to a sunny garden room, a large dining room, an activities area and a further, recently added lounge. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the care home was an unannounced Key Inspection. Mrs Lesley Garrett, Regulation Inspector, and Mrs Rosemarie James, Local Area Manager, carried out the inspection. The manager represented the service and we were also assisted by the matron who is a nurse and responsible for the daily care and assessments for all people using, or wishing to use, the service. The provider was also in attendance for the feed back session at the end of the inspection. We arrived at the service at 10:00 and were in the home for five hours. It was a thorough look at how well the home is doing. It took into account information provided by the home and any information that CQC has received about the service. The manager for the service supplied CQC with an AQAA (Annual Quality Assurance Care Homes for Older People Page 6 of 29 Assessment) and this document was used to assist with the inspection. The AQAA was submitted to us late and we spoke to the manager and provider about the importance of getting the documents to us in good time. The inspector also spent time talking with some of the people using the service, staff members and a healthcare professional. We looked at how well the service was meeting the key national minimum standards and complying with the regulations and have in this report made judgements about the standard of the service. Documents sampled during the inspection included the homes care plans, daily records and risk assessments, staff files, training records and the homes safeguarding and complaints policies and procedures. From the evidence seen by us, and the comments received, we consider that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. What the care home does well: What has improved since the last inspection? Four requirements were made following the last key inspection in April 2007 and these have now been met. The home still has no registered manager but is managed on a daily basis by a nominated manager who is supported by a matron who is a nurse. Care Homes for Older People Page 8 of 29 Recruitment procedures have been strengthened so that all new members of staff have the required paperwork before commencing work. Quality assurance checks are now in place and the views of the people who the service are sought. Supervision for staff members now takes place regularly. 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 set out 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 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service benefit from a pre-admission assessment from a suitably trained person from the home to ensure that the home can meet their needs. Evidence: We looked at the service user guide and statement of purpose. They did not contain all the information required. These documents need to be updated to ensure that they contain all of the information as specified in the regulations. A requirement will be made at the end of the report. The matron explained to us that all people that are admitted to the home usually come for a two week assessment period. Information is gathered prior to their admission to ensure that as far as possible they can meet their needs. During the two week stay detailed assessments take place so that the home can be sure it can meet the needs of the person wishing to use the service. The matron explained this also gives the Care Homes for Older People Page 11 of 29 Evidence: perspective person the opportunity to see if they like the home. Documentation sampled during the inspection showed us that these assessments take place. One person spoken to on the day had been a new admission. They told us how easily they had settled into the home and that so far it had provided them with the care and treatment that had been expected. They also told us that since the admision their condition and level of mobility had improved. The home does not offer intermediate care. Care Homes for Older People Page 12 of 29 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. The health and personal care of people using the service is a good quality with staff knowledgeable about their needs. Care plans were well written with sufficient information available to allow staff to care appropriately for the people using the service. Evidence: Three care plans were sampled and all contained detailed information about each person using the service and they had been written in a person centred way. The way personal care was to be delivered was described and it was apparent that consultation had taken place with each person using the service. Risk assessments were detailed with clear instructions for staff. The documents were user friendly and allowed staff to identify easily the care needs of a particular person using the service. It was clearly documented, by the carers and nurses, that reviews had taken place and that the care plans had been agreed by the people using the service following a consultation. Staff spoken to on the day were knowledgeable about the care needs of Care Homes for Older People Page 13 of 29 Evidence: the people using the service. Aids and equipment are provided to encourage maximum independence for people using the service and these are reviewed and replaced to accommodate peoples changing needs.The home employs three physiotherapists who are involved with the assessment of people using the service with regard to their manual handling. There is also a hydrotherapy pool for use by people needing this facility. A full assessment by the physiotherapist takes place prior to them using the pool. On the day of the inspection the GP was visiting the home. He told us that without doubt, by some margin, this is the best nursing home that he has worked in. The matron told us that he visits every weak to see those people using the service who are unwell. The GP told us that he also ensures that everyone is seen four times a year and a medication review takes place also.The matron told us that he was a good support to the home and that he took into account the wishes of the people who use the service. On the day of the visit one particular person had requested that although they were unwell they did not wish to be admitted to hospital. The GP was ensuring that the home had all it needed to ensure this person could be supported in the home. The matron told us that the chiropodist visits every six weeks and this is included in the fees. The people who use the service also access to the dentist and optician. The manager told us that the home employs a carer who will escort the people using the service to all hospital or other healthcare appointments. This ensures that the home has the information should any treatments change. There are medication policies and procedures in place. The matron told us that they had recently changed pharmacies and were now receiving a good service. All medications are delivered every month and are in blister packs. The AQAA told us that the home has a comprehensive policy relating to the receipt, storage, handling, administration and disposal of medication and has a sustained record of full compliance in this area. During a tour of the building it was observed that staff were speaking appropriately to the people using the service by their preferred name which had been documented in their care plan. All people were dressed in clothes appropriate for the weather with hair well groomed and nails clean. Staff were knocking on peoples bedroom doors prior to entering and responding to the call bells within a reasonable time. The matron told us that to ensure the privacy and dignity of people using the service the domestic staff are not allowed to collect the laundry or empty the waste bins in each bedroom until after 11:00. The matron said that by this time most people are up, washed and dressed. Care Homes for Older People Page 14 of 29 Evidence: Care Homes for Older People Page 15 of 29 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. People who use the service are able to take part in social, religious and recreational activities and are able to exercise choice in their daily lives. The standard and quality of the meals are high resulting in nutritional needs being met. Evidence: The matron told us that the home employs two activity organisers who ensures there is a programme of events for the year. The activity programme is available for a month at a time. On the day of inspection the home was celebrating St Georges day and the communal areas were decorated with flags and a special menu was available for that day. The activity programme is agreed following consultation with the people using the service. The AQAA told us that the home owns a number of vehicles which are used to take the people using the service to activities outside of the home. The home also has access to a wheelchair friendly vehicle which ensures that all people using the service has access to outside visits. The matron told us that visitors are welcome in the home at any time and the home Care Homes for Older People Page 16 of 29 Evidence: promotes open visiting. On the day of inspection it was observed that people using the service had guests to lunch with them and visitors were also seen during the day in individual bedrooms. One visitor told us that they are always made welcome and tea or coffee is offered to them. There is a church close to the home and the matron told us that people using the service can attend the church services on Sunday and a member of staff will escort them. The vicar visits the home regularly and communion is available every month. It was observed that in the care plans it was clearly documented the preferences of the people using the service. It stated preferences for getting up in the morning and going to bed. It is also documented those people who prefer an early morning cup of tea.The AQAA told us that the home also offers a shopping service together with postal and e-mail services. People using the service can also choose daily newspapers and magazines that are delivered to their bedroom. All people using the service have access to telephones in their bedrooms. The AQAA told us that the home serves high quality home cooked food. On the day of inspection the menu was planned around St Georges day. One person told us that they were excited to see what dragons feet would be. People using the service that we spoke to on the day were complimentary about the quality of food served. Pre lunch drinks are served in the drawing room and people who use the service and their relatives and friends are encouraged to socialise before a three course lunch is served. The matron told us that the chef has recently held individual meetings with the people using the service to discuss their individual tastes and preferences. The matron also told us that special diets can be catered for and that consultation takes place with the dietitian or speech and language therapist should pureed or liquidised diets be required. Care Homes for Older People Page 17 of 29 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. People who use the service can be confident that their complaints are listened to and that they are protected from abuse from a staff team that have received training in safeguarding adults. Evidence: The manager said that during the last year they had received no complaints but lots of compliments. The complaints policy is available in the service user guide. The address for CQC contained within the complaints policy needs to be updated. The provider was advised that the address for contacting us will change again very soon and the policy will need to updated again. The home has not had a safeguarding referral during the last year. Training takes place regularly for all staff and they are knowledgeable about the procedure. The homes policy on safeguarding adults is not in line with the local authoritys policy and procedures. It will be a requirement at the end of the report for this document to be reviewed and updated. CQC have not been made aware of any complaints about the home or any referrals under the safeguarding procedures. Care Homes for Older People Page 18 of 29 Care Homes for Older People Page 19 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home enables people who use the service to live in a safe, well maintained and very comfortable environment. Standards of hygiene and cleanliness is high. Evidence: During the tour of the building it was observed that people using the service benefit from a well maintained and decorated environment. The interior and exterior of the home is excellent. All bedrooms are single and have en-suite facilities. It was observed that the bedrooms had been personalised and the AQAA states that the management of the home encourages people to bring in their personal belongings. There are plenty of communal facilities which include lounges, a dining room and a conservatory. One lounge benefits from a balcony with views across the gardens. People who use the service also have access to a heated hydro-therapy pool which is available to them following assessment by the physiotherapist. The bedrooms benefit from adjustable beds, bed-rails, (if required), and plenty of equipment to aid manual handling which includes hoists. The gardens are large and well maintained and some rooms on the ground floor have patio doors which open into the garden. The home has domestic staff who work every day to ensure the home is clean and free Care Homes for Older People Page 20 of 29 Evidence: from offensive odours. Standards of cleanliness within the home is high with evidence seen that the staff are working to COSHH (control of substances hazard to health) guidelines. Soap dispensers and paper towels were available in the communal areas which assist with infection control within the home. Records showed that staff have also received infection control training. Care Homes for Older People Page 21 of 29 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers at the home on the day of inspection were sufficient to meet the assessed needs of the people using the service. NVQ training for the care staff continues to ensure a good skill mix of staff on duty. Evidence: The home benefits from an experienced staff team and when sampling the staff rota it was observed that staffing levels are consistent. The AQAA told us that many of the staff live locally who have worked for the home many years. The matron told us that she does the rotas for the staff and that they always try to ensure that there is a high ratio of staff to people who use the service. We was also told that the home does not have to use agency staff as very often empty shifts are covered by the current staff team. The matron also told us that staff levels can be increased if the dependency levels of the people using the service increases. The manager said that well over 50 of the care staff have NVQ certificate and some at level three. The training at the home is on going and that they benefit from having assessors and verifiers on the staff team.Records confirmed that this training takes place. Four staff employment folders staff were sampled and were found to have all the Care Homes for Older People Page 22 of 29 Evidence: necessary paper work to enable the home to safely employ those people. This ensures that the people who use the service are protected by the homes recruitment procedures. The home benefits from a training manager who ensures that all training necessary for staff takes place. Records showed that mandatory training takes place which includes fire awareness, safeguarding adults, food hygiene and first aid. Staff spoken to on the day told us that they had received lots of training and that the owners of the home are very supportive with the training that is provided. The AQAA told us staff also receive a comprehensive induction programme which is in line with the national induction programme called Skills for Care. The training manager provides the classroom element of the course and the training assistant provides the practical element. Care Homes for Older People Page 23 of 29 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. Management arrangements at the home ensures the staff team is adequately supported and there are clear lines of managerial accountability. Quality assurance systems are in place which improve the quality of care offered to the people who use the service. Evidence: The registered manager of Boughton Hall is currently in charge at the home. Both homes are owned by the same company and is a family run business. The provider has regular contact with the home also. The manager is supported by the matron who is in day to day control of the nursing duties of the home. The matron told us that she is well supported by the current manger and provider, and that they are always available if she should need them.The manager and matron run an open door policy and encourage people who use the service and their relatives to talk to them if they are worried or have any concerns about the service provided. Care Homes for Older People Page 24 of 29 Evidence: The manager told us that questionnaires are sent to the people who use the service and their relatives/representatives to seek their views on the quality of the service and care provided. Regular meeting are also held for the people who use the service which enables them to pass comments to the home directly. No personal money is held by the home. All invoices are passed to the relatives, representatives or to the person using the service for them to settle the bill themselves. All necessary health and safety certificates are in place and we also observed a range of policies and procedures relating to health and safety. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 6 To review and update the statement of purpose and service user guide. To ensure that all people wishing to use the service has access to the current information about the home. 12/06/2009 2 1 6 To review and update the homes statement of purpose and service user guide. To ensure that people who use the service and their representatives have the information required to make an informed choice about living at the home 12/06/2009 3 18 13 To review and update the homes safeguarding adults policy and procedure to ensure that it follows the local authoritys procedures. 12/06/2009 Care Homes for Older People Page 27 of 29 To ensure that staff have the understanding of the agreed protocols for their area in which they work. 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 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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