Random inspection report
Care homes for older people
Name: Address: The Squirrels 7 Oaks Crescent Chapel Ash Wolverhampton West Midlands WV3 9SA zero star poor service 03/03/2010 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Tina Smith Date: 2 2 0 6 2 0 1 0 Information about the care home
Name of care home: Address: The Squirrels 7 Oaks Crescent Chapel Ash Wolverhampton West Midlands WV3 9SA 01902423855 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Merron Care Ltd Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 11 Number of places (if applicable): Under 65 Over 65 0 0 11 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 1 1 0 The maximum number of service users to be accommodated is 11 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP, Dementia - Code DE, Mental Disorder, excluding learning disability or dementia - Code MD Date of last inspection
Care Homes for Older People 0 3 0 3 2 0 1 0 Page 2 of 18 Brief description of the care home The Squirrels is a detached house near the city centre, with ramped access and car parking. Personal care is provided for up to 11 older people. Merron Care Limited have run the home since January 2009. Single and double bedrooms are on two floors accessed by a lift, with assisted bathing and toilet facilities nearby. Some rooms are ensuite, including one with a wet room. Communal areas include the lounge, dining room and garden. The fee range was in the statement of purpose on our visit, £364£424 per week. Please contact management for up to date fee information. Care Homes for Older People Page 3 of 18 What we found:
On 22/06/10 compliance and pharmacist inspectors visited the home in order to check on peoples safety in light of deterioration noted on our visit in May 2010, and a new incident of unexplained bruising the home notified us about. We followed up the incident with the manager by phone and found that the homes policies and procedures had not been followed to ensure the person was safe. We asked the manager to report this immediately to the council under the safeguarding protocol. We wanted to check that an improvement plan was accurate, and gather further evidence of action taken to comply, or of further non-compliance with immediate requirements, expired requirements and statutory notices. In-between visits CQC made decisions about enforcement action in accordance with our policies. We met with a multi-agency safeguarding strategy group chaired by the council following CQCs second report about institutional abuse and neglect at the home within the past six months. Two councils had reviewed most of the people living in the home with their relatives, and told us about concerns following several visits they made to the home and about another injury which staff had not noticed. The police were planning involvement. The home did not know we were coming on 22/06/10. The Primary Care Trust arrived during our visit. They had arranged with the area manager to review peoples health needs and conditions. We found that the homes manager was off sick following an accident at the home two days earlier and was not expected back, as they had resigned. We were made aware on the visit that other staff had resigned and others were expected to leave. Some relatives were aware of this, and Merron Care were also aware, but CQC had not been notified. The Director informed us at the start of our visit that a decision was made to close the home. A date was to be negotiated with the councils who fund peoples care so that the provider could inform people, families and staff. We requested this was negotiated urgently in light of their staffing and oversight situation, which posed immediate risks. We were directed to the area manager to provide a realistic plan for oversight of the home and medication administration until closure to ensure service continuity and safety for seven people living there. We were not presented with a concrete or feasible plan or rotas beyond 26/06/10 throughout the rest of the day, although we asked several times. MEDICATION There were only two seniors authorised to administer medication four times a day, soon to be one senior, and we found that these seniors were not managing medicines competently for four people, and placed two peoples health at serious risk. An immediate requirement was left by the pharmacist inspector to consult a doctor after out of date blood pressure medication had been administered for ten days, so it would have been less effective e.g. to prevent a stroke. Since our last visit another person had a stroke and was experiencing swallowing difficulty. Their medication had been changed to a liquid form. Thickening powder had been prescribed for drinks and a health specialist was due to visit. Care records showed that the prescription was still waiting collection from the pharmacy for over a week and
Care Homes for Older People Page 4 of 18 there was no evidence of its use in the homes records. The person had told the compliance inspector that the doctor wanted them to drink, and they had recurrent infections so needed fluids. The pharmacist inspector asked for the powder. The senior in charge knew nothing about this powder or the need for its use. This was queried again by both inspectors with the area manager, who went into the kitchen and eventually found the container with instructions to use when required, and said staff were not communicating with each other. The pharmacist inspector asked what was meant by the term when required and the area manager said that it was to be used when she started coughing. In our opinion this would be too late. No written guidance was prepared for staff, no advice was sought from health specialists and no instructions were given to staff on our visit for the persons safety. This was a recurrent concern about medication practice at the home. The pharmacist inspector also found, as on previous visits, that medication could not be accounted for and that medication records were not accurate. This meant that we could not confirm that people were given medication as prescribed by doctors for their health and wellbeing. The quantity of medication received into the home was not always recorded, and disposal records had quantities which differed from medication administration records. A medication review had taken place by a doctor but care records did not explain the outcome. We established that a persons anti-depressant was changed. One tablet was noted as not administered because the medication arrived too late that day, six days after the medication review. We expected to find the tablet in the monitored dose system packed by the chemist, but the tablet was missing and there was no record of it having been returned to the chemist. Missing medication can pose risk to public health. Another person did not have analgesia twice, which was queried. We were told that the tablets arrived with the wrong directions on the label and as a consequence staff had returned the tablets to the chemist and asked for a new prescription with the correct instructions. The new set of tablets were not ready in time for the start of the new monthly cycle so the person did not have any pain relief until these tablets arrived. It should have been possible to query and note directions from the doctor so that the person was not left in pain. Instructions for another persons analgesic were unclear again and we were not able to establish whether a doctor was involved in changing the dose. We checked the temperature of the drugs fridge and found that the maximum temperature was 21 degrees Celsius and the minimum temperature was 5 degrees Celsius. At the last inspection we were unable to find the temperature record book. During this visit we found the book and saw that the staff were measuring the temperature of the fridge on a daily basis but were not measuring and recording the maximum and minimum temperatures. The home were therefore unable demonstrate that medicines being stored in this fridge were being stored within the correct temperature range so that they remain effective. This was a recurrent problem at the home. Between inspections the area manager notified us that a form had been devised so that medication competence of staff could be assessed in all of the providers care homes. We found that The Squirrels had introduced this assessment but it did not direct the assessor
Care Homes for Older People Page 5 of 18 to observe and assess the competency of the staff to administer medicines safely and correctly to people. The assessment of the administration process is fundamental in ensuring the health and welfare of the people who live in the home. The form also does not include staff knowledge, recording and actions to maintain safe medication storage. We were therefore unable to determine what criteria the home used to determine whether the seniors authorised by management were competent to administer medicines safely and correctly. The area manager said that a second form was being devised. The staff file of two seniors had an assessment by the manager using this form which was determined to be satisfactory, casting doubt as on our previous visits that management know how to protect people with regards to medication. During the day the compliance inspector observed a senior handle medication which had spilled, and did not wash their hands in-between people, which posed infection control risk. HEIGHTENED RISKS TO PEOPLE People continued to have unexplained injuries some of which were caused by unsafe moving and handling practice when staff lift them, rather than use the hoist as directed by care plans. A person already at high risk of falls had a stroke since our last visit, so were at even greater risk of falls. They had a fresh unexplained bruise which staff had not noticed or reported. There was no evidence that staff had sought health advice to prevent falls out of the wheelchair and armchair, and no evidence that staff had written or were following guidance to prevent falls out of bed. There was no bedrail risk assessment, in accordance with the homes policy for someone immobile. Two people were underweight and malnourished; another dropped a dress size. Staff did not feed one of these people, and they did not eat anything at dinner time. We had seen the person fed a soft and well cut up diet by staff on our visits since December and knew their dentures didnt fit. They were served food that they could have choked on. We asked why they were not fed and were told by the senior that they could feed themselves. Food records did not give us confidence, nor did the care plan. The senior in charge of the home was clearly not familiar with it. The care plan stated the person needed to be fed if she did not feed herself, and that she ate better when staff who spoke her language assisted. Records showed that food was often refused and there was no check on whether the person was eating a balanced diet. There was insufficient monitoring of food and fluid intake, and no record of a prescribed nutritional supplement being discontinued. These were not produced when we asked to see them. The GP had not been consulted when they did not like them. There were no foods or menus seen for religious and cultural needs, low fat or high fibre diets and the cook confirmed that no provisions were delivered by the Director as we had been told or as appeared on care plans. The PCT Commissioner overheard and informed the senior that there were other types of nutritional supplements available through the GP, and pre-packaged cultural meals are readily available in Wolverhampton, so there was no excuse for neglecting the persons nutritional needs. We found people to be at risk of losing further weight until closure due to dietary provision. For example, the cook had prepared food with artificial sweetener for everyone on our visit, although only two people had diabetes. A relative told us that food provided
Care Homes for Older People Page 6 of 18 was not liked. Two people were having medical investigation of pain and discomfort as a result of their poor nutritional intake. Care plans lacked accuracy and cannot be followed for personal care. When we asked if people are being bathed, the area manager said yes and the senior said no because it is not safe. At our request, both demonstrated facilities and equipment for bathing, and all confirmed this was unsafe. We made an immediate requirement to protect people in light of the lack of transparency in how the service was run. We came across incidents of people being extensively bruised which had not been reported in accordance with the homes policies and procedures or local safeguarding protocols. Relatives and statutory agencies including CQC, nurses and doctors were not made aware of all the bruises, skin tears and grazes occurring to people, most of whom lacked mental capacity to make their own decisions or to communicate and seek help without the involvement of staff. From various records used in the home we identified over 26 injuries for three people since February 2010, in addition to others we noted in May 2010. The manager collated and investigated some injuries, but not all of them, so a pattern was not established, nor was multi-agency expertise sought to prevent recurrence and to keep people safe. Incident records were not checked on the providers unannounced visits to the home. Relationships between management and staff had broken down, and attempts to change ways of working were ineffective and too slow to meet peoples needs. The senior in charge was not familiar enough with care plans to ensure this, and records showed that staff would not follow instructions of seniors or the manager. By the homes own definitions, institutional abuse and neglect was taking place unchecked. The area manager was intending to meet with staff individually. Four peoples care plans and risks assessments were inadequate to address interlinked risks for their health, wellbeing and safety. Care plans were more personalised but they were not accurate. The scoring of a variety of risk assessments lacked consistency, so risk was underestimated. People had become frail, with tissue paper skin. Four people had become immobile; three were having recurrent infections and were at high risk of developing pressure sores. There was insufficient monitoring of nutritional and fluid intake, insufficient pressure relieving aids, lack of exercise and mobilising causing muscle weakness. Five people needed wheelchairs to get to the dining room. On this visit people ate in wheelchairs. We noted that two injuries occurred at the dining table, and one person told us the wheelchair was not wide enough. People, their representatives and interested parties such as council funders were not consulted in accordance with the mental capacity act at the time decisions about restraint and controls on freedom of movement were needed. These decisions were not reviewed regularly and Deprivation of Liberty authorisations were not considered. This means that peoples rights were not protected. Staff and managers were making decisions that were not in peoples best interests, such as to lift them, use lap belts, bedrails and sedation whether they were incapacitated or able to make their own decisions. No one had keys or door locks to their bedroom. Only one person had a consent form about this, and it was signed only by the area manager. A number of people slept most of the day and night. Sedation was considered a less
Care Homes for Older People Page 7 of 18 restrictive option to bedrails on the homes risk assessment form. Three people were being treated for depression linked in records to lack of stimulation, which in turn reduced their appetite. One persons behaviour showed that they were trying to call attention to pain and emotional distress as they could not communicate with managers and were no longer happy in the home. Two relatives were seeking to move people. The manager had arranged a one-off trial visit by a music and movement instructor, which took place during our visit and two people in particular clearly benefited. However a senior administered medication during this session, which was distracting for people, and the session did not take place at their best time of the day. We received an improvement plan on time following the key inspection in March 2010, but it lacked accuracy in light of our findings. We found little or insufficient action taken or planned to comply with requirements within timescales or to address deficits we fed back about at the last inspection regarding statutory requirement notices. Call bells were still not working or not installed. Instead, peoples assessments now said that they were unable to use them or to raise help. A system of night checks was written into care plans, but there was no evidence that these were taking place. A maintenance plan dated May 2010 said call bells would be addressed within three to six months, and a bath panel preventing use of an assisted bath was not planned for repair before the end of the year. Rotas and the staff signing in book showed gaps in staffing, and on the night a person fell out of bed there was only one night care assistant in the home. Peoples dependency assessments showed rising needs, and care plans showed that more people needed two staff for mobilising. Four people needed assistance with feeding. No changes were made to staffing levels or organisation of meals, so some people had to wait and were fed cold food. Staff were given roles they were not trained for. For example, although the area manager told us that all staff who prepare food all had food hygiene training, audits and training plans showed that this was not accurate. The provider had a poor track record of overseeing the home and an inexperienced acting manager. Supernumerary hours were being eroded. Tasks such as risk assessments, recruitment and compliance with the law had been delegated without sufficient systems for accountability. What the care home does well:
A positive decision was made by Merron Care Ltd. to close the home. There have been no new admissions since registration due to a voluntary decision until management arrangements were resolved. Some action had been taken on the day of our visit to improve stimulation, with a trial session by an external music and movement instructor. People took part for as long as their concentration allowed and there was a noticeable difference in two people. The home was cleaner than on our last visit. A second sling had been purchased so that slings which are shared could be regularly washed to limit cross-infection. This met a recommendation made in March 2010. Care Homes for Older People Page 8 of 18 One persons bed was changed so that the hoist could be used for transfers, which met an immediate requirement made in May 2010. This meant that staff did not have to lift the person several times a day and risk causing them injury, however the foam mattress to prevent pressure sores did not fit the bed and overhung posing a slip risk which not assessed. Some action had been taken to assess fitness of new staff, and measures were put in place for staff who were pregnant or recovering from illness to do their jobs without risking their own health. The manager had also booked training, and we were told that dates were awaited from training consultants. We received an improvement plan and a response about action taken to immediate requirements on time, and information agreed at the May 2010 inspection. What they could do better:
Immediate requirements have increasingly been necessary. Two immediate requirements were made on this visit to protect health and safety. Out of date medicine had been administered for 10 days. Due to lack of transparency in running the home, we needed to prevent use of unsafe bathing facilities. Care plans did not accurately reflect how care could be provided safely, and the maintenance plan did not intend to address this before the end of the year. By the end of a long visit, 12:40 pm to 23:45 pm we found peoples health, emotional wellbeing and safety had deteriorated and they were placed at heightened risk of further deterioration before closure. Staff in charge of the home lacked knowledge of peoples care plans and did not meet their needs on our visit. A person was not fed, another was not having thickened fluids for swallowing difficulty. Dietary provision and food prepared placed people already malnourished and underweight at risk of further weight loss. The medication system did not protect people. Staff were not managing medication competently and there were insufficient staff to administer medication and oversee the home by the weekend. There were no feasible or concrete plans by Merron Care Ltd. to address this. Staff and management relationships and accountability had broken down. A proposed introduction of temporary staff and management could have made matters worse in light of inaccurate care plans. There was risk to life, health and the wellbeing of people living in the home and insufficient haste by Merron Care to meet their legal obligations and duty of care to people. Risks were underestimated and interlinked key risks not recognised. Three people had significant weight loss, four were at high risk of developing pressure sores, six were at risk of falls and two were at risk of choking. There was insufficient monitoring of food and fluid intake. Action had not been taken to obtain aids and specialist advice to prevent falls, for pressure relief and nutritional supplements. People were being treated for impaction, as well as depression, linked to lack of stimulation and periods of not eating. People were being sedated, and some were sleeping most of the day. One person was increasingly distressed and their behaviour became self harming. Sedation was considered as a less restrictive option to bedrails in the homes policy, procedure and forms. Restraint and restrictions did not always have timely or appropriate consent in accordance with law and peoples rights were unprotected. A new concern
Care Homes for Older People Page 9 of 18 arose about lap belts, although this is not in care records, nor is lifting people. Staff were not following care plans and had a less caring approach. The senior in charge was not clear enough about the care plans to direct staff to meet needs appropriately. When we pointed out our concerns no action was taken by the senior or area manager. A wide range of unexplained bruises and injuries had not been reported to relatives, health professionals, or statutory agencies including CQC. During the day and after our visit CQC managers discussed serious concerns we found with the council. Four out of seven people could not make their own care, medication and handling decisions, and could not communicate their needs, and one person needed an independent interpretor or advocate. The provider was not acting in their best interests or seeking multi-agency assistance to safeguard people. By the homes own definition, institutional abuse and neglect was taking place unchecked. Attempts to change working practices of staff were ineffective and too slow for peoples physical and mental frailty. Over the past eight months Merron Care have not provided appropriate oversight at The Squirrels, have not recruited staff safely or provided staffing arrangements to meet peoples changed needs. Peoples conditions exceeded the homes registration categories as well as the skills and abilities of the staff. Little action was taken to comply with the law and statutory notices, and efforts to improve were not sustained. Proper provision was not made for people. Financial constraints we were aware of since December 2009 may have had some bearing on the ability of staff and management to improve the service. However peoples health, wellbeing and safety should have been foremost. The provider should have worked with CQC, statutory agencies, people and relatives transparently. Although a decision was made to close, we sent a warning letter after our visit about the need for haste to avoid emergency closure in light of impending and heightened risks posed to people. During our visit the Director informed us that The Squirrels will not be used for care services in the future. We will not oppose a voluntary cancellation of registration. A recent application to re-register the service under new care law will not be applicable in light of their decision to close. We understand that by 24/06/10 there was no clear plan and the council removed everyone from the home to safeguard them. 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 2. Care Homes for Older People Page 10 of 18 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 1 7 12 12(1), 13(4)(c): The 27/05/2010 registered person is required by the end of the day, 26/05/10 to make appropriate arrangements to minimise risks to the health and safety of a named person and staff involved in their care. This is so that the person can be assisted to have their continence and hygiene needs met safely. (Met on 27/05/10) 2 8 12 12(1), 13(5): The registered 28/05/2010 person is required to ensure there is an appropriate hoist and system of manual handling in place within 48 hours so that people can be safely bathed and their health and hygiene needs met. This is to protect health and to prevent pressure sores developing and deteriorating. 3 9 13 13(2): Medication records must be completed at the time medication is administered by the care worker involved. 14/04/2010 Care Homes for Older People Page 11 of 18 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Medication records must be accurate to ensure people have medication as prescribed. (Not met on 27/05/10 and 22/06/10) 4 9 13 13(2): The dose of when 14/04/2010 required medication must be recorded when administered. Medication records need to confirm that the homes protocols are followed for peoples health. (Not met on 27/05/10 and 22/06/10) 5 9 13 13(2): Records of the 22/06/2010 receipt, administration and disposal of all medicines must be robust and accurate to demonstrate that all medication is administered as prescribed. Peoples health must be protected. 6 9 13 13(2): Medication must be stored at the correct temperature, in accordance with their product licence. This is to ensure medication is safe and effective for peoples health. 7 9 18(1)(a) Staff knowledge and competence in the safe 03/01/2010 22/06/2010 Care Homes for Older People Page 12 of 18 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action handling, recording and administration of medication must be established and regularly confirmed. Peoples health must be protected. (Not met on 21/01/10 and 03/03/10. Statutory Notice issued on 20/04/10 with compliance due by 30/04/10. Not met on 27/05/10 and 22/06/10.) 8 12 12 12(1)(a)(b), (3): Sufficient and appropriate stimulation must be provided matching individual needs, as agreed with people. 03/06/2010 Mental and physical agility and independence needs promotion and protection. (Not assessed on 27/05/10. Not met on 22/06/10) 9 15 16 16(2)(i): A varied and nutritionally balanced diet must be provided that matches individual health, religious and cultural needs. 14/04/2010 People need to eat well and have their customs respected to retain their health, wellbeing and dignity. Care Homes for Older People Page 13 of 18 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action (Not met on 27/05/10 and 22/06/10) 10 18 17 17, Schedule 3: A timely 14/04/2010 record of incidents, accidents and the homes actions must be made in accordance with the homes policy and procedures, and notifications made to statutory agencies as appropriate. People must be safe after events such as falls, medication errors and unexplained bruising. (Not met on 27/05/10 and 22/06/10) 11 22 13 13(4)(c): Call systems must be accessible to people to reach staff day and night. 14/04/2010 People must be able to call for assistance and in an emergency. (Not met on 27/05/10 and 22/06/10) 12 27 12 12(1): Staffing levels and roles need to reflect that they match peoples needs day and night. Help should be available when needed and without people left unattended for long periods. (Not met on 27/05/10 and
Care Homes for Older People Page 14 of 18 03/05/2010 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 22/06/10) 13 29 19(1) To ensure that all staff 03/12/2009 employed at the home are recruited following robust recruitment procedures, with documentary evidence to demonstrate diligent compliance with The Care Homes Regs 2001, Reg 19(1). This is to safeguard people living at the home from risks of harm. (Timescale of 01/08/09 not met on 03/12/09 and 03/03/10. Statutory Notice issued 20/04/10 with compliance due by 30/04/10. Not met on 27/05/10 and 22/06/10) 14 38 26 26: Unannounced monthly 14/04/2010 visits must take place by a suitable person on behalf of the registered provider, in accordance with the CQC guidance. Accurate and timely reports of visits which account for follow up actions must be retained at The Squirrels and must be sent to CQC monthly. Management must ensure ongoing health, safety and welfare of people and the service. (Not met on 27/05/10 and 22/06/10)
Care Homes for Older People Page 15 of 18 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, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action 15 38 24(a) Merron Care Limited must supply accurate improvement and action plans to the Commission on request, within the timescales set. 03/01/2010 This is to ensure peoples health, safety and welfare. (Not assessed on 03/03/10 and 27/05/10. Not met on 22/06/10) Care Homes for Older People Page 16 of 18 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 1 38 13 13(4)(c): Use of the hoist 12/07/2010 and transfer to the assisted bath seat in bathroom 17 must cease until such time as repairs are undertaken to make the equipment safe for use. Action must be taken to instruct staff within 24 hours. This is to protect people from unnecessary risk of injury. (Not fully met on 23/06/10) Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 17 of 18 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. Care Homes for Older People Page 18 of 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
