Inspection on 21/04/09 for Darley Hall

This inspection was carried out on 21st April 2009.

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

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

Other inspections for this house

Darley Hall 23/04/08

Darley Hall 06/06/07

Darley Hall 07/06/06

Darley Hall 23/11/05

Darley Hall 23/06/05

Darley Hall 22/12/04

Darley Hall 01/06/04

Darley Hall 19/12/03

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Darley Hall Park Lane Two Dales Matlock Derbyshire DE4 2SD     The quality rating for this care home is:   one star adequate 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: Rose Moffatt     Date: 2 1 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Darley Hall Park Lane Two Dales Matlock Derbyshire DE4 2SD (01629)735770 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Alison Treasure,Ms Glenis Pamela Wright,Mr A Wright,Mr David John Treasure care home 22 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 22 old age, not falling within any other category Additional conditions: 0 One DE(E) place for the service user named in the notice of proposal letter dated 28 October 2005. The home accommodates one named individual named in the notice of proposal for the duration of their stay. Date of last inspection Brief description of the care home Darley Hall is a converted Georgian building, built around 1796 and set in extensive grounds. This established care home provides accommodation and personal care for up to 22 older people. The accommodation is on three floors, with a passenger lift to the first and second floors. There are 17 single bedrooms and 3 shared. 10 bedrooms have en-suite facilities. There are two main lounge areas and a dining room on the ground floor. The fees are £360 - £390 per week, according to the needs and care required following Care Homes for Older People Page 4 of 27 Brief description of the care home individual assessment. This information was provided by the acting manager on 21st April 2009. Information about the home, including CSCI inspection reports, is available in the main entrance area of the home, or from the acting manager. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use the service experience adequate quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. The last key inspection of this home was on 23rd April 2008. We looked at all the information we have received, or asked for, since the last key Care Homes for Older People Page 6 of 27 inspection or annual service review. This included: the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also has some numerical information about the service; surveys returned to us by people using the service and from other people with an interest in the service; information we have about how the service has managed any complaints; what the service has told us about things that have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. We carried out an unannounced inspection visit that took place over 7 hours on 21st April 2008. The inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. We sent out 10 surveys to people living in the home and received 7 completed responses. We sent out 10 surveys to staff employed at the home and received 7 completed responses. There were 12 people accommodated in the home on the day of the inspection visit. People who live in the home, visitors and staff were spoken with during the visit. The acting manager was available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. 3 people were selected and the quality of the care they received was assessed by speaking to them and / or their relatives, observation, reading their records, and talking to staff. What the care home does well: 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 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. There was accurate assessment of individual needs and good staff training and awareness so that people were confident their needs could be met at the home. Evidence: People we spoke with and those who returned our surveys said they always received the care and support they needed. They told us, They look after us very well, and that they had care that was over and above what was needed. A relative said the person is receiving excellent care. We looked at the care records for 3 people and found that each had appropriate assessment information about their needs. From discussion with staff, looking at records, and from observation, we found that staff were knowledgeable about the individual needs of people in the home. Also, that Care Homes for Older People Page 10 of 27 Evidence: the home was suitably equipped to meet individual needs and that staff had appropriate training. The AQAA said they had improved in the last 12 months by introducing a keyworker system to ensure people were happy and well looked after. They planned to improve by involving keyworkers more in reviewing and updating care. Standard 6 did not apply as there were no people receiving intermediate care in the home. 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. Improvements in care records and good staff awareness ensured that the individual needs of people in the home were known and met. Evidence: All the people we spoke with and those who returned our surveys said they always had the care and support they needed, including medical support. They all said that staff listened to them and acted on what they said. We looked at the records of 3 people in the home and each had an individual care plan. The care plans had been improved since the last inspection to include all the assessed needs of each person and to have more detail of the action required by staff to meet those needs. There were some gaps in the information in one care plan, and a lack of detail in all the plans of how to ensure privacy and dignity were maintained. The care plans were signed by the person, or their representative, to indicate their involvement and agreement. The care plans had all been reviewed monthly and Care Homes for Older People Page 12 of 27 Evidence: updated as required. Each of the care records seen had appropriate healthcare assessments and risk assessments that had been regularly reviewed and updated. There were records of the input of GPs and District Nurses. People told us they saw their GP as needed. Medication was securely stored and there were good records of all medicines received, administered and disposed of. All staff had received appropriate training. Since the last inspection, 2 new reference books had been provided to ensure staff had correct and current information about medication. We observed that staff had a respectful approach to people in the home. People told us nothing is too much trouble for the staff, and that staff were very professional and caring - lots of empathy. Staff we spoke with and those who returned our surveys all said they had relevant training to help them to meet the needs of people in the home. Staff showed a good knowledge of peoples individual needs. The AQAA said the home had improved by putting a particular emphasis on personal care, including oral hygiene, and also by providing relevant training to staff. The AQAA identified that further improvement was needed in the care plans. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a suitable range of activities offered, flexible routines, and wholesome meals provided so that the lifestyle in the home met the needs and expectations of people living there. Evidence: 3 people who returned our surveys said there were always activities arranged by the home that they could take part in, 3 people said there usually were, (1 person said they were not interested). People we spoke with said there were usually activities offered that they could take part in. People told us they enjoyed the regular sessions of live music and gentle exercise. There were trips out each month to local places of interest. In the home, care staff organised games of dominoes, bingo, and arts and crafts. There were regular visits from local clergy. People told us they could follow their preferred routines - They let me do my own thing - and details of daily routines were included in the care records. Visitors told us they could visit at any reasonable time and were always made welcome. Care Homes for Older People Page 14 of 27 Evidence: People who returned our surveys, and those we spoke with, said they always or usually liked the meals at the home. People said they could have a choice, but they usually liked what was offered on the main menu. People could eat in the dining room, the lounges, or in their own rooms. The dining room was clean and pleasant, though a little gloomy. There were no menus displayed. The AQAA said that improvements had been made to activities as a result of listening to people in the home and their relatives. The AQAA said that further improvement was needed to ensure there were activities suitable for all of the people in the home. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were satisfactory systems in place and good staff awareness so that people were protected and their complaints were effectively dealt with. Evidence: People who returned our surveys and those we spoke with all said they knew how to make a complaint. The complaints procedure was included in the Service User Guide and was displayed in the main entrance area of the home. There were records of complaints with the action taken and the outcome, though none had been recorded since February 2008. The acting manager said this was because she believed in an open door policy for people in the home and their representatives to ensure any concerns were quickly and effectively dealt with. People told us they were happy to take any problems to the acting manager and were confident she would take appropriate action. No complaints about the home had been received directly by CSCI/CQC. Staff had received training about safeguarding vulnerable adults, but they had not had any recent updates. The acting manager said this training was planned soon. Staff spoken with were aware of different types of abuse and the correct procedures to follow if abuse was suspected. Information about the Mental Capacity Act 2005 was available for people in the home, Care Homes for Older People Page 16 of 27 Evidence: their representatives, and staff. There was also information about a local advocacy service. The acting manager said that she and the deputy manager would be attending training about the Mental Capacity Act 2005 in June 2009. The AQAA showed that relevant policies and procedures were in place and had been reviewed in 2008. The AQAA said the home could be improved by more in-depth training for staff about safeguarding vulnerable 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was homely and suitably equipped so that people had a comfortable environment that met their needs. However, the home was not clean in all areas, not well maintained and did not have safe access to the gardens, affecting the quality of life for people in the home. Evidence: There were comments on the surveys returned to us, and also during the inspection visit, that the home was in need of refurbishment, inside and out. We were told it needs renovating, bringing up to date, and, it is in need of redecorating everywhere from top to bottom. Staff commented that the home was let down by the state of the exterior grounds and interior decor. As observed at the last inspection, the decor in most areas of the home was tired and dated. We found that little work had been carried out since the last inspection to improve the grounds and the interior of the home. An external security light had been repaired as required at the last inspection. The staff had raised funds to plant flowers in pots at the entrance to the home to make it look more bright and welcoming. There were steps to the main entrance and no permanent ramp for people in Care Homes for Older People Page 18 of 27 Evidence: wheelchairs or with mobility problems. There was a temporary wheelchair ramp for use on the steps, however, this was not suitable for people to walk on. The area outside the front entrance had tables and chairs for people to use in good weather. However, this area was also used to park cars and so was not always pleasant and safe for people to use. There were extensive grounds to the home, but the paths were uneven and unsuitable for use by people with limited mobility. People told us they liked their bedrooms and we observed that bedrooms were personalised with their own belongings. One person was pleased with the views from their room. We saw that where bedrooms were shared, there was a screen to ensure privacy. We observed that 2 fire doors to bedrooms were wedged open. Suitable equipment was provided to meet peoples needs, such as profiling beds, special baths, lifting hoists, and handrails. The lounges were comfortably furnished. Most people who returned our surveys and who we spoke with said the home was always fresh and clean. We found that the lounges, toilets and bathrooms seen appeared clean and there were no offensive odours. However, there were many areas where we saw dust and cobwebs, mainly high up on bedroom and corridor walls and ceilings. The windows appeared dirty and we were told that they were never cleaned. Most staff had received training about the control of infection. Staff we spoke with were aware of good practice in infection control. The AQAA identified how the home could be improved by provision of safe and pleasant outdoor space for people to use, and by internal redecoration. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were satisfactory recruitment procedures and staff training so that people were protected and staff were competent to meet their needs. Ancillary support was not sufficient to ensure that care staff were always available to meet peoples needs. Evidence: 5 of the people who returned our surveys said staff were always available when needed. 2 of the people who returned surveys and all of the people we spoke with during the inspection said that staff were usually available when needed. During the inspection visit we observed that that were staff available when needed. However, the inspection visit took place on a day when there were 2 care assistants plus the manager and the domestic assistant on duty (see below). Staff who returned our surveys and who we spoke with said there were not always enough staff to meet the individual needs of people in the home. Staff told us it was particularly busy in the mornings - you can be run off your feet, its ok if there are no problems or emergencies. Staff said the situation would be improved by having 1 additional care staff, particularly for the morning shifts, and more domestic help. Care Homes for Older People Page 20 of 27 Evidence: The staff rotas showed that there were usually 2 care staff on duty for each shift, (morning, afternoon and night shifts). Usually on one day each week there were 3 care staff on duty for the morning shift to allow the manager some supernumerary time. There were people in the home who needed 2 care staff to assist with their care. This meant that there were times when both care staff were occupied in giving assistance, leaving other people unsupervised. There was no permanent cook at the home and so the manager and deputy manager shared the cooking duties between them. The manager said they were actively trying to recruit a cook. There was a domestic assistant for one day each week. The care staff carried out cleaning duties on six days per week with no extra hours allowed for this. This had an effect on the cleanliness of the home, (see Environment section of this report), as the priority for staff was the care of people in the home rather than domestic tasks. Care staff also did all the laundry. We looked at the records for 3 members of staff. All had the required documents and information, although 1 did not have a full employment history. Staff who returned our surveys and who we spoke with confirmed that relevant checks had been made - such as a Criminal Records Bureau (CRB) disclosure. There was an induction programme that met Skills For Care standards, although this had not been used as no new staff had been recruited since the last inspection. Staff training records showed that all staff had received required training. Of 12 care staff, 7 had already achieved a relevant National Vocational Qualification (NVQ) at level 2 or above. 4 staff were working towards an NVQ in care at level 3. People told us the staff were always helpful, and, very professional and caring. The AQAA showed there was no turnover of staff in the last 12 months and said that retaining staff had benefited people in the home as they were familiar with the staff. The AQAA said the home could improve by recruiting a cook and by having extra domestic help. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was generally well organised and effectively managed and there had been improvements in some areas since the previous inspection. However, there were ongoing issues that had not been addressed that had an impact on the health, safety and quality of life of people in the home. Evidence: People who returned our surveys and who we spoke with were positive about the home. They said It is outstanding in every way!, Its more like a big family, The matron and staff always do their best. The acting manager had been in post for about 3 years and was suitably qualified and experienced to run the home. The acting manager said she had recently started the application process to register with CQC. As at the previous inspection, we found the acting manager was allowed very little supernumerary time to carry out managerial Care Homes for Older People Page 22 of 27 Evidence: responsibilities. People told us they had confidence in the acting manager to sort out any problems. The acting manager had completed the AQAA and returned it to us by the due date. The AQAA had clear, relevant information supported by a range of evidence. The data section was fully completed. The acting manager said she had sent notifications to CSCI / CQC as required. We had not received the notifications and unfortunately the acting manager had not kept copies. The quality assurance system included questionnaires given out to people in the home and visitors. The acting manager said that staff had also been given questionnaires in the last survey in 2008. The acting manager said that action was taken as a result of information in the returned questionnaires, such as changes to the menu and increased social activities. There was no report produced to show the findings of the survey and the action taken. Where people wanted their personal money looked after by the home, this was kept securely with records of each transaction. We checked the money of 2 people and found the amount held did not match the balance recorded. Information from the AQAA showed that systems and equipment were maintained as required up to date. We looked at fire safety records and accident records and these were satisfactory. There was no audit carried out to look at patterns or trends of accidents. We found that staff had received training in most areas relating to health and safety such as manual handling, fire safety, infection control - but had not received training in first aid. There was no risk assessment to find out the need for first aid in the home. As noted in the Environment and Staffing sections of this report, we found issues that had an impact on the health and safety of people in the home, and on their quality of life. 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 1 19 23 There must be proper arrangements in place to ensure all parts of the home are kept clean. This will help to ensure a safe and pleasant environment for people in the home. 31/05/2009 2 19 23 Fire resisting doors must not 31/05/2009 be held or wedged open, unless fitted with a device to close them automatically when the fire alarm sounds. This will help to ensure the safety of people in the home. 3 38 13 There must be suitable arrangements in place for the training of staff in first aid. This will help to reduce risks to the health and safety of people in the home. 31/07/2009 Care Homes for Older People Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The care plans should have more detail of how staff are to ensure the privacy and dignity of people in the home is promoted. The daily menu should be displayed where it is easily accessible to people in the home. This will help to ensure that people know the choices available to them. There should be a permanent ramp to the front door to allow easy and safe access for people who use wheelchairs or who have limited mobility. There should be an external area that is private and well maintained so that people in the home can safely enjoy sitting outside. The acting manager should have sufficient supernumerary time to ensure she can carry out the necessary administrative and managerial tasks for the smooth running of the home. There should be enough staff available to ensure that peoples needs can always be met, and to ensure proper ancillary support for care staff. There should be a report produced to show the findings of the quality assurance survey and the action taken to address any issues raised. The report should be made available to people in the home and their representatives. This will help to ensure a robust system that takes seriously the views of people using the service. There should be a regular audit of accident reports to find any trends or patterns in the type and frequency of accidents. This would highlight issues and show where action was needed to reduce the risks to people in the home. 2 15 3 19 4 19 5 31 6 32 7 33 8 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 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!