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Inspection on 09/07/09 for Diamond House Care Home

Also see our care home review for Diamond House Care Home for more information

This inspection was carried out on 9th July 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

Prior to this inspection the home had been through a difficult period with limited management support and an inspection report that rated the home as a poor service. The home was having difficulty in offering the correct care support to the residents and if some of the long term staff had not been working in the home the service provided would not have been good. The majority of staff wanted the home to improve and have remained in their posts to support this.

What has improved since the last inspection?

The new manager with the support from the operations manager has started an improvement that can already be seen and measured. The environment is more suited to the needs of the residents living at Diamond House with much improved stimulation and tactile items throughout the home, especially upstairs. The home now has a designated activities staff member who has many ideas that have already started to improve the days for residents. Trips out, special day events and reminiscence are just some activities offered. Residents are now supported by a staff rota that is run at full capacity. If anyone is off sick or on annual leave the position is replaced by someone else. The manager herself will cover shifts if no other person is available. The staff now receive supervision and dates are planned to ensure they occur regularly. Training is improving and the aim for more NVQ qualified staff is now taking place.

What the care home could do better:

The home does need to improve the formats used for care planning to better the documentation on the resident to ensure person centred care is not only written but is easy to find in the folders. The staff available at weekends should not be reduced as the numbers of personnel who do not work weekends should be replaced to relieve the pressure on the care staff. The home does need to have a permanent manager who can be registered with the Commission to allow continuity and quality to continue through time as the home improves the service it offers.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Diamond House Care Home Bennett Street Downham Market Norfolk PE38 9EJ     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: Ruth Hannent     Date: 0 9 0 7 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 25 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 25 Information about the care home Name of care home: Address: Diamond House Care Home Bennett Street Downham Market Norfolk PE38 9EJ 01366385100 01366385600 diamondhouse@schealthcare.co.uk www.southerncrosshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Ashbourne Boss Limited care home 42 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Diamond House is a care home providing residential care for up to 42 older people including service users with dementia. It is situated on the edge of the town of Downham Market and is within easy reach of local facilities including shops, pubs and other community facilities. Diamond House is purpose built with accommodation provided on two floors. Stairs and passenger shaft lift service floors. There are 38 single rooms and 2 shared rooms. There are patio and garden areas that are visible from a number of service users bedrooms. Diamond House is one of several homes in Norfolk owned by the proprietors. The range of weekly fees at the home is £275 to £550. 1 9 0 1 2 0 0 9 0 0 Over 65 42 42 Care Homes for Older People Page 4 of 25 Brief description of the care home Care Homes for Older People Page 5 of 25 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: To complete this inspection report we spent 7 hours on a visit to the home. We received and Annual Quality Assurance Assessment (AQAA) prior to this visit and information written by the manager has been used to complete this report along with comments received from residents and relatives. The new manager had completed some regulation 37 report forms of incidents that had occurred in the home over the last 6 months and these were discussed in detail. During the visit we looked at reports such as care plans, medication records, servicing records, complaints and accidents records and staff files. Staff and residents were spoken to, observation of care practice took place and the information required of the day to day running of the home was offered by the manager and operations manager. Care Homes for Older People Page 6 of 25 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 7 of 25 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 8 of 25 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. Although the home has not admitted anyone since the last inspection the systems and procedures are in place to ensure the home is suitable for the individual before admission commences. Evidence: The person acting as the manager told us in the AQAA that all potential residents will be assessed prior to admission to ensure that the service is able to met that persons needs and is within the registration category as listed on the certificate. The AQAA also tells us that a service users guide and statement of purpose is available and an up to date service user guide was seen on the day of this inspection. The manager tell us that any interested persons is invited to visit the home and to see the facilities and rooms available. The family will be encouraged to contribute to any information that will help the assessment process and help the beginnings of the persons care plan. Since the last inspection the home has not admitted any new residents to the home Care Homes for Older People Page 9 of 25 Evidence: but the manager has assured us that the correct procedures for the admitting anyone in the future will be carried out as stated in the companys policies. The Operations Manager for the home was present during this inspection and assured us that contracts are issued to all residents on admission. Care Homes for Older People Page 10 of 25 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. The home has improved the information in the care plans but further improvement is still necessary to ensure all residents have a person centred care plan. Residents health care needs are met. The medication procedures are good but could be improved further for the applications of creams and lotions. Residents are treated with privacy and dignity. Evidence: The home has started to improve the information written on residents care plans. 4 were looked at in total. (2 from upstairs and 2 from downstairs). The Senior Carer on duty gave details on how she had recorded and reviewed the care plans she was responsible for. One was looked at in detail and showed records that is person centred and information had been gathered to support this person with outside agencies on concerns such as the loss of sight. Items to support this person had been provided but Care Homes for Older People Page 11 of 25 Evidence: there is still room for further development. The formats used for the care plans are not user friendly and some details are repeated. The paper used is found to be pulled out of the file and liable to be lost. The care plans are not easy to understand for any new staff member and the home would benefit from a more streamlined format to care plans that are easier to understand and more robust so as not to fall out of folders. The health care needs of the home is met by the local GP practices. The community nurses do support the home with nursing needs and noted in one care plan was the support offered by the Community Psychiatric Nurse. The AQAA tells us that the home has a good rapport with all health professionals to ensure the residents receive a high quality of care. Records of any transaction by a health professional is recorded and was seen in the individual care plan. Day to day interaction with residents is now carried out and recorded within the persons own bedroom to enable staff to record at the time they do the task. The home has just received an audit on medication from the Primary Care Trust. Although the outcome of this audit is not yet available the feedback to the home is that the results are good and no concerns were found. The medication cupboard was found to be tidy and the trolleys in order. Medication administration records (MAR) were completed correctly and the senior staff member responsible for medication told us the pharmacist supplier was supportive and that no problems have occurred. The Commission had received 2 notifications in the last 3 months of errors made on medication. The manager informed us that the staff member responsible no longer has medication responsibilities and the home has acted appropriately on finding these errors. The home does have creams stored in residents own rooms for application during personal care. The recording of the application of this cream would be better done in the persons room as the staff member carries out the task. A separate form in the bathroom cabinet would be more appropriate and the senior who has NOT applied the creams does not have to complete the MAR chart. (Only the person actually administering should be the person signing the chart). Throughout the day staff were observed interacting with the residents in a professional manner. Tasks were carried out in a dignified manner and all personal care was carried out in the persons own room. Care Homes for Older People Page 12 of 25 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. The social activities and stimulation has greatly improved with a wide choice of occupation to suit all needs. Contact with friends and relatives is encouraged and information of the home activities is communicated to interested parties. The meals are offered with choice and are well balanced and appealing. Evidence: The last inspection showed a poor outcome for residents with little or no activity to stimulate or occupy people and a requirement was made. On this visit it was much more evident that a lot more was happening to try and meet the social needs of residents. The corridors upstairs are full of stimulating and colourful items for residents to stop and look at, touch and take with them if they so wish. Imitation flowers are in trellis work for picking and replacing. Mirrors at different heights let people look at themselves. Shells and sea scenes create a tactile area. The manager informed us that a small lounge is about to be turned into a 50s style room and appropriate furniture of that era has already started to be gathered. The sensory equipment is to be removed from a lounge and offered to people who are now Care Homes for Older People Page 13 of 25 Evidence: spending their days in bed. The home has now employed an activities organiser who has lots of ideas and plans displayed on the notice boards. On our arrival many pictures of old adverts had been collected and a quiz was taking place to guess the product. Later in the day the manager had arranged for her own musical instruments to come to the home and an hour of singing and music took place and was enjoyed by a large number of the residents. In the garden there is new furniture and the home had created a beach scene. Photographs were seen of residents with their feet in the paddling pool, smiling with sun hats on. One resident has taken on a task of creating a nice flower bed which is beginning to look colourful. He told us his next project is a rockery garden and he was being taken out to buy more items required. The home has access to a mini-bus and 2 trips have already taken place with another planned for next week. The activities staff member was noted to have just the right manner and enthusiasm to encourage residents to be involved and once those individuals were involved it was noted how much the activity was enjoyed. The new manager has held a relatives meeting with the minutes seen showing that the families have already noticed a difference within the home. Comments such as welcoming and open door were just some of the positive comments mentioned. 5 relatives comments had been received prior to this inspection visit and all but 1 were happy with the service offered. Newsletters are to be circulated quarterly and events and special days will be advertised. The home has now placed menus on the tables for residents to be able to read the meal of the day. The manager explained that choice of meals are now carried out at the table at the time of the meal enabling the resident to decide at the time of eating what they would prefer. The Nutmeg meals have been introduced to encourage a suitable well balanced diet. The comments received from residents show the meals are enjoyed and two people spoken to on the day both praised the meals and said they had plenty to eat. Care Homes for Older People Page 14 of 25 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. The home will listen and act on any concern/complaint that is verbally of written. The residents are protected from abuse. Evidence: At the previous inspection no records of complaints could be found. At this inspection all incidents of concerns and complaints had been recorded. One relative asked to see the inspector and is unhappy with the outcome of some of the complaints made. We looked at this and found the home has tried to meet some of the concerns and will work with this person to try and achieve the most suitable outcome for this persons relative. None of the complaints written placed anyone at risk and on discussion with the manager and operations manager the home will follow procedures and treat all concerns/complaints seriously. The complaints procedure is in the front entrance and in literature offered to all residents. The home did have a poor record of staff who had trained in protection of vulnerable adults. The manager has given us a training matrix that shows 100 of staff are now trained. The staff spoken to said they had all completed the training and understood the whistle blowing procedure. The records held at the home show that all staff who have commenced employment have all had a CRB check. Care Homes for Older People Page 15 of 25 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. Residents do live in a well maintained, suitable home that is clean and tidy but needs to improve the bathing facilities. Evidence: The home environment has improved with some corridors and bedrooms have been freshly painted. The fire records were looked at and were completed and up to date. On walking around the home and looking into some bedrooms it was noted they were clean and fairly tidy. Residents own personal belongings make the rooms homely and personalised with pictures and ornaments on display. The gardens are being developed and residents are taking an active part in the development of these areas to make them more attractive and inviting. It was noted that some outside areas have some slabs and paths that need levelling to prevent any trips. On discussing this with the manager and operations manager this has been noted and is programmed for improvement. The home needs to improve the bathing facilities to ensure that both staff and residents can use the facilities in comfort. At present the baths are too low to the floor Care Homes for Older People Page 16 of 25 Evidence: and assistance is difficult with bending. The general areas of the home were clean and tidy. One complaint received had been around areas of cleanliness and the manager is working with the domestic team to resolve concerns. No unpleasant odours were detected and all bathrooms and toilets looked in were clean and fairly tidy. Care Homes for Older People Page 17 of 25 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. The home has improved the staffing in the home by being consistent with the number of staff on duty. These numbers need to be retained at weekends as well as in the week. The home is increasing the numbers of staff who are NVQ qualified and the training in suitable courses is improving. Staff are recruited safely by policies and procedures being followed correctly. Evidence: On the day of this visit the home had three care staff downstairs and four care staff upstairs. The needs of residents upstairs is high and the staff are caring for 25 residents on this floor. At a previous inspection we were informed that the staff team often ran short through annual leave and sickness. The new manager informed us that this no longer happens and the shifts are all covered. The manager herself will stand in and cover a shift if no one else is available. The staff spoken to (5 in total) all gave a much better picture of the home and said at long last we are being listened to and things are slowly improving. The one concern was the lateness of the rotas being available with often only two or three days notice given. This was discussed with the manager and operations manager who stated they are aware of this and are planning to make the rotas available earlier. Care Homes for Older People Page 18 of 25 Evidence: At the weekends the home does not have as many staff in the building to cover administration, activities and maintenance. This means less staff around to answer the door, manage a fault or occupy the residents. Due to the high level of need required 7 days a week the home should consider increasing the care staffing levels at weekends to cover the shortfall of other staff who do not work weekends for continuity of the service provided. The NVQ qualification of staff is at 41 to date but the manager informed us that the numbers are to increase as more staff are to be registered to take the award or are in the process of completing the award. Two personnel files of staff who have been recruited since the inspection 6 months ago were looked at. The information within the folders were correct. Although the home does not hold a record in each file of the CRB clearance, the computer system used by Southern Cross has a record, which was seen by us. All staff have been CRB checked and a number issued to follow through, if necessary, any concerns. The home has a training matrix for all information on the state of the staff training to date. A copy was given to us to show that the training is on the increase and more staff are being updated. It was noted that the POVA training has recently been done and that the home has 100 attendance. Although dementia training is not statutory, this home does need to train the staff in this subject as many residents are in the late stages of dementia. The senior carer has been made the trainer for the YTT training (Yesterday, Today and Tomorrow). This knowledge will be cascaded to staff shortly and the knowledge of staff should be improved. The staff spoken to all stated that the training was available and that they are now able to attend more courses. A list of training dates was also posted on the wall in the office and seen during this inspection. Care Homes for Older People Page 19 of 25 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 is managed by a suitably experienced temporary manager who will ensure residents benefit from her leadership approach. A registered manager does need to be in place. There has not been a full quality monitoring system carried out to date but one is planned. Residents money is safeguarded by clear procedures that are followed. The health and safety of residents and staff is promoted. Staff are now receiving supervision to ensure they are carrying out their duties correctly. Care Homes for Older People Page 20 of 25 Evidence: The home has a new temporary manager in post due to the registered manager being on long term sick. The company is working with this manager to help improve the home and raise the levels of the quality of the care provided. This person has a number of years of care home management experience and has already made a difference to the quality of the care provided that was found at the last inspection of 6 months ago. The staff spoken to all found the new manager approachable and were able to talk to her in confidence. One staff member said her problem had been listened to and resolved. Details written in the family meeting minutes also state that the home has improved and that the manager is available. The home has not carried out a full quality audit to date as the manager has only been in post a number of weeks. The operations manager explained to us that a full quality monitoring procedure will take place shortly and will include the views of residents and stakeholders. This does need to be in place for the home to plan and improve as the new manager develops and builds the quality of the service. The home has had monthly regulation 26 visits that is carried out by a senior manager within the company. The last three completed were seen by us during this inspection. We spent time with the new administrator going through the procedure of handling residents money. The information offered was clear and the procedures are followed as required by Southern Cross. Details of the transaction were discussed and receipts are all held within a locked cabinet. The administrator is about to create individual files for residents to improve the system even further. Staff spoken to all stated they have already, or have booked, a one to one session with their line manager. One person said they really benefited from this time and hoped they would continue on a regular basis. (This had not been happening under previous management). The health and safety in the home is monitored correctly. The service files for equipment were in the building and shown by the maintenance officer. Staff are nearly all up to date with statutory training and induction for new staff is in place although could be improved. This has already been mentioned as an action point by the new manager in the received AQAA and is planned for. Accident recordings were looked at by us and found to be in order. There was some concern over the safety of the water temperatures and was discussed. Due to the unusual water pipe system in Diamond House the maintenance officer gave a full explanation and demonstration of the system to ensure that the water temperature is safe and monitored correctly. Care Homes for Older People Page 21 of 25 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 22 of 25 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 9 13 The administration of creams and lotions should be recorded by the person applying them and not later by a senior. To ensure safe practice of administering medication is adhered to. 01/09/2009 2 21 23 The home must have 01/09/2009 suitable assisted bathrooms fitted with appropriate baths or showers. To ensure that residents have enough usable bathrooms that are suitable and staff can assist appropriately. 3 31 8 The home should register the temporary manager To ensure the home is compliant with regulations and has a registered manager in the home. 01/10/2009 Care Homes for Older People Page 23 of 25 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 4 33 24 The home does need to introduce a robust quality monitoring system and include all stakeholders. To ensure the monitoring, improving and development of the home is suitable for the residents of the home. 01/10/2009 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 home should continue to improve the care plans and consider using I rather than the persons name showing the care plan document belongs to the person. The home needs to continue the drive to have qualified staff in the home. Staff need to be up to date with dementia training. 2 3 28 30 Care Homes for Older People Page 24 of 25 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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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