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Inspection on 03/02/09 for Abbeyfield Residential Care Home

Also see our care home review for Abbeyfield Residential Care Home for more information

This inspection was carried out on 3rd February 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Abbeyfield Residential Care Home Castle Farm Road Newcastle Upon Tyne Tyne & Wear NE3 1RF     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: Janine Smith     Date: 0 3 0 2 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 28 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 28 Information about the care home Name of care home: Address: Abbeyfield Residential Care Home Castle Farm Road Newcastle Upon Tyne Tyne & Wear NE3 1RF 01912841344 01912841331 chris@abbeyfieldcastle.demon.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Abbeyfield Newcastle upon Tyne Society Limited (The) Name of registered manager (if applicable) Mrs Christine Major Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Abbeyfield Castle Farm provides a home for twenty-four older people who require residential care. Nursing care cannot be provided. The weekly fees are £456 per week. The building is single storey providing ground floor accommodation throughout and is set in a residential area close to Jesmond Dene and the Freeman Hospital. There are public transport links close by. There are a variety of aids and adaptations around the building to allow residents to move about more independently. All of the bedrooms are single and have an en-suite toilet. All have low level windows, which means their occupants all have a view of the garden from a sitting position. There are three communal bathrooms, which also have toilet facilities and a shower. The home is set within very attractive large grounds filled with mature plants, which are well maintained. The home is run by the Abbeyfield Society, which is a voluntary organisation. Information about the service, including inspection reports, is readily Care Homes for Older People Page 4 of 28 0 Over 65 24 care home 24 Brief description of the care home available. Care Homes for Older People Page 5 of 28 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: Before the visit we looked at the following. Information we have received since the last visit on 6th February 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. An unannounced visit was made by Mrs Janine Smith, regulatory inspector, and Mrs Betty Fellows, expert-by-experience. An expert-by-experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in Care Homes for Older People Page 6 of 28 or use the service. During the visit we talked with people who use the service, relatives, staff, the manager and visitors. We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept. We checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around parts of the building to make sure it was clean, safe and comfortable. We checked what improvements had been made since the last visit. We told the manager what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: The home carry out detailed assessments before offering a place in the home. This means they can make sure they will be able to meet the needs of anyone coming to stay. They carefully consider each persons individual needs to make sure that the admission process is carried out smoothly and the new person feels comfortable and welcomed. The staff work hard to meet each service users health and social care needs. Service users made comments such as, I couldnt wish for better care and staff are wonderful and always ready to help. A general practitioner and community nurse, who regularly visit the service, made the following comments in a survey. The service provides high quality care in a friendly environment for residents and family. (They) support the District Nursing Team. They have well trained staff. Continuity of staff. (There is) good communication and (it is) well managed. (They) always have clients needs uppermost in mind. There are plenty of social activities from discussion groups to chair aerobics. Service users decide what type of activities they want and are supported by the staff with the arrangements. There are opportunities for service users to get out and about in the community. The home has also built up links with a local school, so that service users and pupils are working together to produce a mural in the school. Service users visitors are welcomed. Service users enjoy the food, which is of very good quality and very well presented. Staff provide sensitive support to service users at mealtimes when needed. There is an culture of openness and respect in the home, which means service users are encouraged to discuss any concerns or worries. This means that any complaints are properly dealt with. There is a quiet and calm atmosphere in the home. The building is purpose built and provides qood quality, well maintained accommodation. The home was clean and smelled nice throughout. There is very little staff turnover. Many of the staff have worked here for many years, which means that there is good consistency, which helps provide better care for service users. The staff receive good training. A community nurse who visits the home, said in a survey, carers are very experienced, use correct skills at all times, delivering high quality care. The home is very well managed and there are effective quality assurance systems in place. Service users and their relatives are encouraged to give their views about the services provided, through surveys and regular meetings. Their views are taken account of when planning and delivering the services provided. The management of the home take steps to ensure that the health and safety of all those who live, work or visit the home is not compromised in any way. Care Homes for Older People Page 8 of 28 What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 28 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 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have the information they need to help them decide if this is the right home for them. Evidence: There is a notice board in the reception area, which is kept up to date, and contains a lot of relevant information. This is displayed well, using large coloured paper, using printing fonts which are easier for people to read. Potential service users or their representatives are offered opportunities to visit the home, to help them decide if it is the right place for them. A local authority social care assessment officer, who completed a survey, said that the home always ensure that accurate information was gathered and the right service planned and given to service users. Care Homes for Older People Page 11 of 28 Evidence: Four residents who completed a survey said they had received good information before they moved in and had received a contract. Three people spoken to during the inspection said they had received plenty of information about the home before they moved in. One had been on the waiting list for a while and took the opportunity to move in when a place was offered. All three said their health and care needs were being met very well. Bedrooms were adapted to meet the needs of the people who were to use them. The care records for one person recently admitted, showed that the manager had obtained an assessment from the local authority care manager, which provided information about the persons needs. The home had also carried out its own assessment, which included contacting the persons doctor for informaton. This is routinely done with the permission of the person concerned. Any cultural or spiritual needs are also identified at this time. An appropriate care plan had been put in place. This included details of how care staff would help this person to settle in by gradually introducing her to other service users who would be supportive to her. Care Homes for Older People Page 12 of 28 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 that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Two care care plans were looked at. These include a variety of physical and mental health assessments, which are designed to help highlight the help people need with their day-to-day care. These were regularly updated. Relevant and appropriate care plans were in place, which contained useful information so that staff know how to care for the person concerned. These also contained details of the service users spiritual or cultural wishes. Four staff who completed a survey, said that they were always or usually given up to date information about the needs of people living in the home. One said, Before each shift, we are given a staff handover so as to be kept up to date a residents needs. Care plans are readily available for staff to review. Care Homes for Older People Page 13 of 28 Evidence: The records showed that service users were receiving routine and necessary healthcare when needed and their weight was being monitored regularly. A service user who was not eating very well due to frailty, was supported by staff to take nutritious foodstuffs, which appealed to him. Doctors and community nurses had been contacted when staff had concerns about service users, for instance, if they had had falls, not eating well, or at risk of developing pressure sores. Preventative equipment was being used to help care for frail service users, vulnerable to pressure sores. A staff record showed that a carer had been given relevant training, including prevention of falls, management of diabetes, depression and the elderly. Four staff who completed a survey, said that they felt they were well trained to meet the needs of the people they cared for. A general practitioner and a community nurse who visit the home, stated in a survey that the home always sought advice and always or usually were able to meet the needs of service users. One commented, that the staff are well trained, (there is) good continuity of staff, good communication and well managed. (The staff) always have clients needs uppermost in mind. Both also said the home always respect peoples privacy and dignity. Service users spoken to during the inspection, said they were looked after very well by the staff team. Four service users said in a survey that they always received the personal and medical care they needed. Two visitors said that their relatives were being very well cared for. Both health professionals who completed a survey, said that service users privacy and dignity was always respected. Service users were observed to be well dressed in their individual styles. Staff were observed to respect peoples privacy, by ensuring they knocked bedroom doors and waited to be invited in. Previously, the manager notified the Commission of a medication error, which occurred mid 2007. Following this event, steps were taken to ensure that the carer involved was re-trained and supervised. The manager had also taken steps to address statutory requirements made at the last inspection about medication and to this end, had sought advice from a pharmacist employed by the health trust. The arrangements for medication was discussed with a senior carer and a sample of records were looked at. The carer could clearly describe the system used and what safeguards are in place to ensure that medication is handled safely. The medication records seen were up to date and clearly recorded. She confirmed she had received Care Homes for Older People Page 14 of 28 Evidence: training and evidence of this was seen on the staff record. Senior carers were observed ensuring that service users had taken the medication given to them. Service users are supported, if they wish to look after their own medication. To ensure they can do this safely, a thorough risk assessment is carried out and their GP is also consulted for advice. Care Homes for Older People Page 15 of 28 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. Service users live their lives as they wish and can choose from a good range of food and activities. Evidence: A monthly activities programme is drawn up, which included visits from a pat dog, a coffee morning, church services, reminiscence and arts and craft activities. Service users also devised their own entertainments. These included a discussion group and regular poetry readings. Some of the service users have been assisting a local school with ideas for a new mural. One service user said the activities could be improved but it was difficult to please everyone. She also added that there was a regular exercise activity for hands and feet, which she enjoyed. She also enjoyed the garden, which is large and well maintained with plenty of interest. Some service users said they loved the movement to music activity. Four service users who completed a survey said there were always or usually activities that they could take part in, although one said but I often choose not to join in. One said, I enjoy going out on a regular basis and I am supported with this. Care Homes for Older People Page 16 of 28 Evidence: A service user said she enjoyed visits from friends and that there were no restrictions on when they could visit. Two visitors also said they were always welcomed. Daily menus were clearly displayed on the noticeboard and showed choices were available for each meal. The menu offered well balanced and nutritious meals. The chef is kept informed of peoples individual preferences and can provide ethnic or cultural requirements, when needed. Lunch was a choice between barbecued grilled chicked thighs or breaded white fish, both with vegetables. This was followed by poached apple and plums with custard or cream. The meal was sampled and found to be well-prepared and served. There were two choices of everything and the care staff were available when needed to assist service users. They were also clearly aware of service users individual preferences. All four service users who completed a survey, said they always liked the meals provided. A member of staff said in a survey, the quality of meals is excellent and the chef does consider any dietary needs and will always try to accommodate particular likes and dislikes. Service users who were spoken to said they were happy and contented. They confirmed they could live their lives as they chose, for example, they could stay in bed late if they wanted and could have breakfast in bed. One survey was received from a GP and one from a district nurse and one from a care manager. All three said the home always supported service users to live the life they choose. The GP added that the service users are given choices whenever possible. Care Homes for Older People Page 17 of 28 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 live here are able to express their concerns and have access to a robust, effective complaints procedure and are protected from abuse. Evidence: No complaints have been received by the Commission about the home. Four service users, who made comments through surveys, said they knew how to make a complaint if they were not happy about anything. Two health professionals, who completed surveys, said that any concerns were always dealt with appropriately. Three members of staff, who completed a survey, were clear about what to do if a service user had concerns or complaints. A service user spoken to during the inspection, said they would always talk to the manager if they had any concerns, as she manages the home well and sorts out any issues. A member of staff confirmed that they had received training about protecting vulnerable adults from abuse and could describe what the homes whistle blowing policy was about. Since the last inspection, this policy has been reviewed by the manager to ensure it complies with advice issued by the Department of Health. Training has also been provided to staff about how to respond to challenging Care Homes for Older People Page 18 of 28 Evidence: behaviour. Evidence of the training provided was seen on a sample of staff records looked at. Care Homes for Older People Page 19 of 28 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. Service users live in a well-maintained home, which is kept clean and safe. Evidence: Each service user has a single bedroom with an en-suite toilet, except where two people choose to share a room. Where two people share, an additional bedroom has been set aside to provide a comfortable lounge. Bedrooms seen were clean, comfortable and individualised. A service user said they liked their bedroom, which they had been able to bring items from home to. They particularly enjoyed the view of the garden. All the windows are low level, so people can see the garden from a sitting position in their rooms. The garden is landscaped, with good paths and seating areas. The home has three large bathrooms, which are equipped with mobility aids. There has been an outbreak of sickness and diarrhoea due to a virus in March last year. The home appropriately sought advice from the local Infection Control Team. A domestic explained the cleaning routines in the home and said she had a good range of equipment, as well as protective clothing, to help keep the home clean and free from infection. The home was clean and smelled nice. Care Homes for Older People Page 20 of 28 Evidence: Four service users, who completed surveys, said that the home was always fresh and clean. One added, it is excellent. Rooms thoroughly cleaned and clothes washed and ironed beautifully. Care Homes for Older People Page 21 of 28 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. Evidence: Examination of the rota and discussion with staff showed that the numbers of care staff are as follows:8 am to 2.30 pm - 1 senior carer and 3 carers 2.30 pm to 9 pm - 1 senior carer and 2 carers 9 pm to 8 am - 2 carers The managers hours are not included in the above, nor staff employed for other tasks such as food preparation, cleaning or laundry. Of the four staff who completed a survey, three said there were always enough staff to meet the individual needs of people living in the home and one said there usually were. A carer spoken to during the inspection said the staffing levels were ok but it would be useful to have more staff in the event someone has a fall and needed to go to hospital. She said staff were able to spend time with service users on social activities, including going out of the home. All the service users spoken to during the inspection and those who completed surveys said that they were looked after well and staff were always available when they Care Homes for Older People Page 22 of 28 Evidence: needed them. The following comments were received. The staff are always happy to help, Extremely helpful and kind staff. There has been no staff turnover amongst the care staff team since the last key inspection. One carer spoken to said she had worked there for many years and enjoyed her job. She said the staff worked well as a team. The record of one person employed since the last inspection was looked at and showed that full vetting checks had been carried out before they were were employed. A fairly new member of staff confirmed she had received induction training and was enjoying her job. Her record showed that induction training had been provided. Four staff confirmed in the survey that they had received induction training and further ongoing training, which helped them understand and meet the needs of service users and kept them up to date. The manager has confirmed that 75 of the care staff team have achieved a National Vocational Qualification at Level 2 or above. Evidence of this training was seen on one of the two staff files looked at. This person had also received training in falls prevention, diabetes and its management, depression in the elderly, report writing and understanding people with dementia in addition to essential basic health and safety training. The other carer had completed essential basic health and safety training. A carer spoken to confirmed they had received relevant training and that the manager always encouraged staff to get training. Two health professionals who completed a survey said the staff always have the right skills and experience to support the people staying in the home. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed very well and there is a culture of openness and respect, which means that service users can express their views and contribute to the running of the home. Evidence: Mrs Christine Major has managed the home very well for a few years and is registered with the Commission. She keeps up to date with any changes, such as recent new legislation, by undertaking training. A member of staff who completed a survey said, Mrs Major always goes as far as possible within her area to do the best for every one concerned. Members of the staff team confirmed they received support from the manager and had regular one-to-one discussions with the manager or a senior member of staff to discuss their work and training needs. Staff also confirmed that regular appraisals are also carried out. Care Homes for Older People Page 24 of 28 Evidence: A quality assurance system is in place, which includes audits, visits from the committee which oversees the running of the home, surveys of residents, relatives, and also meetings with them. A meeting for residents was planned. A service user confirmed that these meetings took place regularly and that there was also one for relatives. These meetings give service users opportunities to give their opinions to the Abbeyfield Committee, who are responsible for running the home. There is a system in place to look after any monies belonging to service users, who wish the home to store this for them. Appropriate records and receipts were held. There is a training programme in place to ensure that the staff team are given training in moving and handling skills, fire safety, first aid, food hygiene and infection control. Evidence of training was seen on the staff records looked at and confirmed by staff spoken to. A sample of servicing/maintenance documentation was seen for some of the hoisting equipment, gas appliances and electrical wiring, which showed that these were checked regularly by an appropriately skilled person. Care Homes for Older People Page 25 of 28 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 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 29 Change the layout of the application form so that applicants for posts are asked to provide the dates and reasons for leaving previous employments. This helps to ensure that this information is provided at an early stage and helps identify whether applicants have gaps in their employment history which need to be explored further. Care Homes for Older People Page 27 of 28 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. 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