Inspection on 19/10/09 for Dalby Court Care Home

This inspection was carried out on 19th October 2009.

CQC found this care home to be providing an Good 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.

Other inspections for this house

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for older people Name: Address: Dalby Court Care Home 1 Dalby Court Coulby Newham Middlesbrough Cleveland TS8 0XE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jean Pegg     Date: 1 9 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Dalby Court Care Home 1 Dalby Court Coulby Newham Middlesbrough Cleveland TS8 0XE 01642578000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: European Care (GB) Ltd care home 68 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Maximum number of places 68 The registered person may provide the follow category of care service only : Care home - Code PC. To service users of the following gender : Either whose primary care needs on admission are within the following categories : Old age not falling within any other category : Code OP Date of last inspection Brief description of the care home Dalby Court is a large residential care home that can provide accommodation for up to 68 older people. Accommodation is provided over two floors and includes a range of different communal lounge and dining areas. All bedrooms have en-suite toilet and wash hand basin facilities and built in wardrobes. There are garden areas around the building and an enclosed garden area that provides a safe environment for people to enjoy. Car parking is available directly in front of the building. Local transport and shops are nearby. As of 19 October 2009, the fees for this home are £458 - £488 per week. The fees Care Homes for Older People Page 4 of 27 Over 65 0 68 Brief description of the care home include 24 hour care, food and laundry services. Please contact the manager for more details on fees and what they include. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection visit was completed on 19 October 2009. The report is based on our findings from the visit, results of surveys that we sent to people who live and work at the home and other professionals who visit the home. When we visited the home we walked around the building talking to people and watching what was going on. We also looked at records and documents held in the home. Before our visit we asked the manager to complete a self assessment document called an Annual Quality Assurance Assessment (AQAA). This document helped us to understand what progress the manager thought that the home was making against the achievement of the national minimum standards for care. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: The statement of purpose and service users guide should be updated as soon as possible to reflect details of the new ownership of the home and to ensure that people are provided with accurate written information about the home. Staff should have regular reminders about following good practice when administering medication. Consideration should be given as to how the speed of service at meal times can be improved to ensure that people receive hot meals and are not left waiting for long Care Homes for Older People Page 7 of 27 periods of time. We were told I have noticed that the standard of food is not as good since it was taken over by a new company. As I eat in my room, the food is not always as hot as I would like it. The renewal of linen and redecoration programme should continue to make sure that people live in a well cared for home. Communal bathing areas could be improved to make them more pleasant environments for people to use. The manager should apply to register with the Care Quality Commission as soon as possible. When cash held on behalf of people living at the home is given out, then the record should state exactly who the money has been given to and if possible they should sign to confirm receipt of that money. And where significant amounts of cash are accrued, then people living at the home should be encouraged to open savings accounts so that they can earn interest on their money. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information about the home is available for people to use in deciding if the home is right for them. Contracts are provided that state the terms and conditions of residency. People have their needs assessed and met by staff within the home. Evidence: Information about the home is available for people to read, however, it does need to be updated to reflect the change in ownership of the home. Of the eight people who returned surveys to us, five confirmed they had been provided with enough information about the home to help them decide if the home was right for them. One lady we spoke to also confirmed that she had been given information about the home and how to complain. Six of the eight people who returned surveys to us confirmed that they had been given a contract outlining the terms and conditions of their care. We looked at five care plans and saw copies of signed contracts in all of them. Care Homes for Older People Page 10 of 27 Evidence: The annual quality assurance document completed by the manager before the inspection took place said that we involve the family and the service user in a complex and comprehensive pre admission assessment and ask them to come and have a look around the home... In all of the care plans we looked at, we saw evidence of completed pre admission assessment forms. Both of the health care professional surveys returned to us confirmed that assessment arrangements usually ensured that accurate information was gathered and the right service planned for people. Seven of the eight people who returned surveys to us said they either always or usually received the care and support they needed. All eight of the staff who returned surveys to us felt that they always or usually had enough support, experience and knowledge to meet the different needs of the people who live at the home. Both of the health care professional surveys said that peoples social and health needs were usually properly monitored, reviewed and met by the care service. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have their health and personal care needs met. Evidence: We looked at a sample of five care plans that included people with high and low dependency needs. Each care plan followed the same structure and clearly described the level of care needed for each person. There was also additional assessments and risk assessments in place to support the care plans. There was evidence of monthly evaluations and six monthly reviews being completed by staff at the home. The six monthly reviews also involved the service user and their representatives. We were told that no one living in the care home was subject to any Deprivation of Liberty. The manager told us that they would be changing the structure of the care plans plans in line with the new owners, European Care, policy and guidance. In the staff survey we asked are you given up to date information about the needs of the people you support or care for? six said always and two said usually. The care plans we looked at included records of other visiting health care professionals for example the G.P., district nurse, occupational therapist and dietitian. There were Care Homes for Older People Page 12 of 27 Evidence: also records of food preferences, weight charts and a pressure sore risk calculator to help with the management of pressure sore areas. The manager told us that they were also introducing a new nutritional assessment tool. We discussed the use of terminology used when recording care of pressure sores and the manager said that she would talk to staff to ensure a consistent approach when recording. We also suggested that a decision making tool should be used to show that the use of cot sides is the only option available to staff. The manager confirmed that the cot sides in use were monitored by the occupational therapist. In our survey we asked service users does the home make sure that you get the medical care you need? seven said always and one said usually. One lady told us that she had been seen by the doctor that day. In the staff survey one comment made suggested that carers were often without access to (incontinence) pads. When this concern was raised with the manager she suggested that there were insufficient pads due to them being used for people who had not been assessed for them. This is an issue that the manager should follow up to ensure that people who need incontinence pads can and do have access to them. We observed the lunch time medication round both upstairs and down. We also checked the records held for medicines in the home. During our observations we did notice some bad practices being used, for example tablets taken from the blister pack without checking to see if the person was ready to take them and leaving the medicine trolley unattended. The staff we spoke to admitted that they had not administered the medication properly and the manager also identified the poor practice following our observations. When we checked the medicines held we found that some eye drops were being stored in the wrong conditions and that instructions on the label had not been followed. This was corrected immediately. We also noticed that the recording of fortified drinks was not good for one person. This was also corrected immediately. We were shown evidence of how staff competence was monitored. Only senior staff and team leaders administer medication. They are tested twice a year using both a written test and direct observation and feedback. The manager told us that the pharmacy providing the medication was also providing staff with an open learning pack that covers drugs and their side effects. Of the eight staff that completed survey forms for us, all said that they were given training that gave them enough knowledge about health care and medication. We did not observe any practices that suggested that peoples privacy and dignity was not respected. The home has a phone available for people to use and have recently installed a post box. One lady told us Its a good idea, you used to have to wait for someone to come round, now you can just post them The same lady said that she thought the home would benefit from heated towel rails in the main bathrooms as it Care Homes for Older People Page 13 of 27 Evidence: was sometimes cold when they got out of the bath. In our survey we asked Do the staff listen to you and act on what you say? Four said always and four said Usually. One person told us The staff are always courteous and generally friendly and Excellent night service. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A variety of activities are provided in the home. People are encouraged to maintain their individual lifestyles. Meals and meal times could be improved to meet the needs and desires of the people who live at the home. Evidence: As we walked around the building we could see evidence of a variety of board games, DVDs and books. A lot of people were in their own rooms with either music playing or watching day time television. One lady we spoke to showed us examples of textile work that she and some friends had completed. This work was on display in the conservatory area in the home. We also noticed some people going out for walks independently. There was an activities sheet on display that listed what activities were available. The manager told us that one to one activities were available for those who did not like taking part in group activities. In our survey we asked Does the home arrange activities that you can take part in if you want? three said always three said Usually and two said Sometimes One person told us that they liked the day trips. We noticed people visiting the home. The manager told us that they were planning to provide restaurant evenings. These evenings would be open to the people who live at Care Homes for Older People Page 15 of 27 Evidence: the home and their relatives as another opportunity to socialise. We were shown the minutes of resident meetings held January , April and July 2009. The manager also holds a weekly out of hours surgery for relatives and staff if they have any concerns that they wish to discuss. The standard of cleanliness in the upstairs dining room was not very good when we visited just before lunch. The cook and the manager showed disappointment with what we found and instructed staff to put it right. We observed the serving of lunch both upstairs and down. Up stairs we commented that we thought the service was slow with people sitting at the table quite some time before being presented with a meal. The presentation of the food was nice. We observed trays being prepared for people who like to eat in their rooms. The cook followed a list that indicated what food each person had ordered. In the kitchen we saw that special diets were listed along with some specialist advice for people with swallowing problems. The manager told us that the meal orders were taken each morning for the day and that they planned to have daily menus placed on each table for people to see. We received mixed comments about the food in the home. For example we asked Do you like the meals at the home? three said always four said Usually and one said Sometimes . When we asked for examples of what the home did well, we were told provides excellent care, good food and staff who care. When we asked for examples of what could the home do better, we were told I have noticed that the standard of food is not as good since it was taken over by a new company. As I eat in my room, the food is not always as hot as I would like it, but, that may be difficult to resolve. The home also asks for comments about the food it serves and again these varied. We noticed that people were able to personalize their own bedrooms and many of them had private telephones installed. Routines in the home appeared relaxed and we were told Staff give me the care and support that I require to meet my needs. The health care professionals told us that the service respects the needs and individuality of all the residents. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are responded to and people are protected. Evidence: We asked people in our survey, if there was someone they could speak to informally if they were not happy, all eight said yes. We also asked Do you know how to make a formal complaint? Seven said Yes and one said No. One lady we spoke to confirmed that she had been given a copy of the complaints procedure. Another person said All complaints dealt with. We asked staff do you know what to do if someone has concerns about the home? All eight said Yes. The health care professionals were asked Does the care service respond appropriately if you or a person using the service have raised concerns? Both respondents said always. We looked at the record of complaints made to the home and saw that they had been recorded appropriately. There have been no adult protection referrals made since the home was registered. Staff are provided with training in the protection of adults. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained but in need of some redecoration to reduce the clinical look and to make it more homely. Evidence: We walked around the building and visited some people in their private bedrooms. The building was clean but a lot of the communal areas were cold and clinical in appearance. The manager explained that they were trying to improve this by introducing pictures and ornaments and by redecorating with better colour schemes. We also suggested that improvements could be made to the communal bathrooms to make them a more pleasing environment to be in and as stated earlier, one person who lives at the home has suggested that heated towel rails could be installed as it was cold when they got out of the bath. This suggestion was passed on to the manager. The home received a satisfactory Fire Safety report in May 2009 and was awarded four stars in the Tees Valley Hygiene awards in 2008. We noticed that the linen in use was looking old and worn. The manager confirmed that they were gradually replacing the linen. The home has an internal safe garden area that can only be accessed from inside the building as well as grounds that surround the building. The home has a number of different lounge and dining areas and communal bathing areas. Each bedroom room is spacious and has built in wardrobes and en suite toilet and wash hand basin. There are some double rooms available for couples if needed. There is a passenger lift that was in good working order when we visited. There was Care Homes for Older People Page 18 of 27 Evidence: also a variety of different mechanical hoisting equipment that was also in working order. We tested the temperature of the water and found it to be within acceptable limits. The home was clean and generally odour free. Staff have been provided with training in hand hygiene from the Health Protection Agency and personal protective equipment was used during our visit. We were told that there had been shortages of personal protective equipment, the manager acknowledged that this was true when the home was first purchased but that it was no longer a problem. The cleaning trolleys that we saw all had labeled containers in place clearly identifying the products that were being used. Six people living at the home said that they thought the home was always fresh and clean and two said usually. They also told us The home has a pleasant atmosphere and attractive environment. and Provides a safe, clean and welcoming environment. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment and training practices are good. There are generally sufficient staff on duty to meet the needs of the people who live at the home. Evidence: The staff rotas showed that for fifty six people there were ten staff on duty during waking hours, five staff on each floor. Staff are allocated to each floor each day and responsibilities for tasks are allocated on a daily basis. The home has a management structure in place that includes team leaders and senior care staff. In addition to care staff there are kitchen staff, admin staff and maintenance staff. We asked people living at the home Are the staff available when you need them two said Always one said sometimes and five said Usually. When we asked what could the home do better? we were told sometimes the staff are so busy they forget to carry out a task which they were doing for me. Of the fifty seven care staff employed at the home, thirty two have a National Vocational Qualification in Care at level two or above. Several other staff are also working towards a National Vocational Qualification awards. The percentage of qualified care staff is 56 . We looked at three staff files to make sure that all recruitment checks had been carried out properly. All had evidence of application forms, references and criminal Care Homes for Older People Page 20 of 27 Evidence: record bureau checks. We were told that it was company policy to renew the criminal record bureau checks for staff every three years. We asked staff Did your employer carry out checks, such as your Criminal record bureau check and references, before you started? All eight said yes The manager provided a matrix of staff training. This showed that a wide range of topics was available to staff. It also showed a clear record of who needs to do what training and when refresher courses are due. The vast majority of mandatory training has been completed by staff and is in date. The records showed that staff need to do more training on nutrition and equality and diversity. The manager confirmed that nutrition is new topic that is to be made available to staff. Staff told us Training is always ongoing. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed well and in the interests of the people who live and work there. Evidence: The manager has an National Vocational Qualification in care at level four and is currently working towards the Registered Managers Award. The manager has experience in senior roles within the care sector, but this is her first managers appointment. She has yet to register with the Care Quality Commission. Staff told us that the manager is very approachable. We were given a copy of the service user questionnaire completed by the home in June 2009. Some very positive results were shown with 70 of respondents saying the overall service they received was very good and 30 saying it was good. The manager showed us a range of different audits that she completed and told us about the quality assurance system that was to be put into place in accordance with European Care policy and procedures. Notifications or Regulation 37 reports are completed and sent to the Care Quality Commission and, copies of these are kept on Care Homes for Older People Page 22 of 27 Evidence: file in the home. Regulation 26 reports that are also required by regulation are completed by the area manager. Monies held on behalf of people living in the home are kept in a secure place. We checked three accounts and found that the amounts of cash held were correct. The record keeping was good but could be improved upon by being more specific about who money was being given to for example family member, staff member or service user. We also advised that some cash held on behalf of the people living at the home would be better placed in individual savings accounts so that they can earn interest. The home received a satisfactory fire safety report in May 2009. We noticed that equipment around the home had been serviced recently and that records were kept of fire drills, training etc. Since our visit we have been informed that a new clinical waste contract has been agreed and that regular collections would be made. Care Homes for Older People Page 23 of 27 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 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 1 The statement of purpose and service users guide should be updated as soon as possible to reflect details of the new ownership of the home and to ensure that people are provided with accurate written information about the home. Staff should have regular reminders about following good practice when administering medication. Consideration should be given as to how the speed of service at meal times can be improved to ensure that people receive hot meals and are not left waiting for long periods of time. The renewal of linen and redecoration programme should continue to make sure that people live in a well cared for home. Consideration should be given to the provision of a heated towel rail to improve the bathing experience for people who live at the home. Communal bathing areas could be improved to make them more pleasant environments for people to bathe in. The manager should apply to register with the Care Quality Page 25 of 27 2 3 9 15 4 19 5 21 6 7 21 31 Care Homes for Older People Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Commission as soon as possible. 8 35 When cash held on behalf of people living at the home is given out, then the record should state exactly who the money has been given to and if possible they should sign to confirm receipt of that money. Where significant amounts of cash are accrued, then people living at the home should be encouraged to open savings accounts so that they can earn interest on their money. 9 35 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!