Inspection on 19/11/09 for Dr Anderson Lodge

This inspection was carried out on 19th November 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dr Anderson Lodge 08/11/07

Dr Anderson Lodge 23/11/06

Dr Anderson Lodge 08/05/06

Dr Anderson Lodge 19/01/06

Dr Anderson Lodge 29/06/05

Dr Anderson Lodge 04/11/04

Dr Anderson Lodge 05/05/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Dr Anderson Lodge East Lane Stainforth Doncaster South Yorkshire DN7 5DY     The quality rating for this care home is:   one star adequate 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: Sarah Powell     Date: 1 9 1 1 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: Dr Anderson Lodge East Lane Stainforth Doncaster South Yorkshire DN7 5DY 01302350003 01302351985 platinumcarehome@nascr.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Platinum Care Homes Limited t/a Dr. Anderson Lodge care home 61 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 61 The registered person may provide the following category of service only: Care home with nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP and Dementia - Code DE Date of last inspection Brief description of the care home Dr Anderson Lodge comprises of three units in two separate buildings. One building known as the Lodge can accommodate 40 people. 11 people are on one unit, which is for people within the catagory of old age with dementia and the other 29 bedrooms are for people within the category of old age with general Nursing needs. The other unit known as the Annex can accommodate people within the category of old age with dementia that require nursing care. This unit can accomodate up to 21 people. Both Care Homes for Older People Page 4 of 27 Over 65 0 61 61 0 Brief description of the care home units have safe accessible outdoor space. The home is situated in Stainforth close to local amenities. The fees at Dr Anderson Lodge at the time of the inspection ranged from £398.72 - £600.17. For further clarification please contact the home. 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: We went to the home without telling them that we were going to visit. This report follows the visit that took place on Thursday 19th November 2009. The visit lasted from 10:00 until 16:00. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The purpose of the visit was to make sure that the home was operating and being managed in the best interests of people living there. Information has been used from different sources for this report. These sources include; Care Homes for Older People Page 6 of 27 Reviewing information that has been received about the home since the last inspection. The annual quality assurance assessment. The manager had completed an annual quality assurance assessment (AQAA), which was completed with detailed comprehensive information. The AQAA focuses on how well outcomes are being met for the people using the service. It also gives us some numerical information about the service. Notifications (Regulation 37) relating to incidents in the home affecting people using the service. Details of complaints and allegations raised by people connected to the service. 9 surveys returned to us completed by the people who live at Dr Anderson Lodge. At the site visit one inspector spent 6.0 hours at the home. This inspection visit included talking with people living at the home, their relatives, the manager, Unit manager, Cook, Activities coordinator, and five care staff. During the visit we also walked round the building to gain an overview of the facilities. We also checked a number of records. Feedback was given to the manager at the end of the inspection. Care Homes for Older People Page 7 of 27 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 Care Homes for Older People Page 8 of 27 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 9 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 10 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. People had their needs assessed prior to moving into the home. Evidence: We looked at three peoples assessments of need, suitably qualified staff carried out the pre admission assessments on people who wanted to move into the home. The assessments we looked at were very detailed with all peoples needs identified, ensuring that the home could meet their needs before a place was offered to them. In the plans we looked at copies of assessments and reviewing information from placing authorities was also seen, this enables staff to ensure peoples needs were met. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs and risks were identified but not always followed through so needs were not always met. Medication procedures did not always protect people. Evidence: We looked at three peoples plans of care in detail to determine that all their needs had been identified and that measures had been put in place to meet those needs. Most peoples needs had been identified, the plans were regularly reviewed; people and their relatives were involved in this process. This ensured their views were listened to and their needs met. People and their relatives we spoke to told us they were aware of the plans, knew about the records staff kept and could look at them if they wanted. This ensured peoples needs were being met. However we saw that one person had lost weight, the weight was recorded in July and then in October and had lost considerable weight, however no follow up was seen in the care plan. The care plans and risk assessment had not been reviewed in light of the decrease in weight, and no additional measures had been put in place to address Care Homes for Older People Page 12 of 27 Evidence: the weight loss. No referral had been requested to a dietician to ensure the persons needs were addressed and met. The manager told us the person had been referred to the Care Home Liaison team to review her mental health needs and she would instigate a referral to the dietician through the GP. Another persons care plan we looked at did not clearly identify the persons changing mental health needs. The person was found in their bedroom shouting out and in a state of undress. Staff told us that the person had to be kept in the bedroom due to this, as it was not appropriate to let her undress in the lounge. This maintained their dignity but did not meet their needs as they appeared very distressed being left on their own in their bedroom. This was a possible restriction of their liberty and required reviewing and possible involvement from health/social care professionals, to ensure the persons needs were met. We spoke to some Health Care Professionals who visit the home they told us the care provided in the home by the staff is mostly good, and the manager communicates any problems and asks for advice, to ensure peoples needs are met. People were treated with respect and privacy and dignity upheld. During the visit we observed staff interacting very well with people and their relatives. One relative told us, The staff are lovely they look after people very well, I am very happy with the care my relative receives. Nine of the ten surveys sent out were returned from people living at the home the comments received were very positive. One person said, I am looked after very well. Other comments included, The staff are very good and it is safe and comfortable. A very caring home. I am very happy here, nothing is too much trouble for the staff. Risk assessment were in place and risks had been identified and measures in place to meet those needs however not all measures were followed through. For example one person was at a high risk of poor nutritional intake and required a fortified diet, the risk assessment stated a food and fluid chart was to be completed. The chart did not detail the diet given and did not show any supplements, this person had also lost weigh, therefore their needs were not being met. Care Homes for Older People Page 13 of 27 Evidence: The care plan looked at in detail for a person on the residential unit was very good all needs were identified and met, all risk assessments in place and being followed. This ensured the persons needs were met. We looked at medication, good records were seen for receipt of medication and disposal. We identified some errors with administration of medication. One person had for a period of at least two weeks been refusing most medication, it was not clear why. Staff were not sure if it was the persons mental state or the fact that they could not swallow the medication. This had not been reviewed or the persons GP contacted to determine if the medication is required or if it could be dispensed as a liquid. To ensure the persons needs were met. Another person had pain relief patches prescribed to be applied every 72 hours, we found it had been out of stock from 27 September to 6 October a period of 9 days. There was no record it had been given on 10 or 16 November. This was a controlled drug that needed recording separately in a controlled drug book, records in the book and the medication administration record (MAR) did not tally. Some were recorded on the MAR sheet and not in the controlled book. One member of staff had documented in the book that one patch was missing yet no further action had taken place to locate the patch or alert the manager. The manager was very surprised to find these discrepancies as she had not been informed. Since our visit the manager has carried out a full audit and the missing patch has been accounted for. The manger has also implemented the homes disciplinary procedure for the staff involved and has acknowledged errors occurred, which clearly had outcomes for the person and did not meet their needs. The daily records in the persons care plan who was prescribed the patches, stated they had been shouting out and very loud on a number of occasions. The patches were prescribed for pain relief. 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. People exercised choice and control over their daily lives and activities ensuring their needs were met. Evidence: The people and their relatives we spoke to all said that contact with family, friends and the local community were encouraged by the staff. All said relatives were always made welcome. One comment in the returned surveys said, I enjoy the time with the activity lady, she is very good. A new activities coordinator had been employed and worked 32.5 hours a week, group activities and 1 to 1 sessions were organised depending on the peoples needs and choices. We spoke to the coordinator who was enthusiastic, understood peoples needs and adapted activities to suit individuals. Ensuring peoples needs were met. The coordinator told us she was getting to know what people liked doing and participating in and was adapting the activities to peoples abilities and choices. Care Homes for Older People Page 15 of 27 Evidence: Activities were varied and changed depending on the choices of the people, records were kept of activities delivered and the records showed varied and appropriate activities to meet peoples needs. A varied, balanced and wholesome diet was provided for the people with good choices available. We observed a meal, which was well presented, there was good communication to the people from staff when it was served. Seconds were offered, people were asked if they were finished before plates were taken and a choice of drinks were also offered. This ensured peoples needs and choices were met. People who required assistance were given it discretely and sensitively to ensure there needs were met. There were plentiful supplies of food available in the store rooms, food was provided that was suitable for the client group, The cook was knowledgeable on the needs of people who lived at Dr Anderson lodge, she was aware of how to provide an enriched diet for people who were at risk of a poor nutritional intake, ensuring peoples need were met. A recent survey undertaken in the home had highlighted that people preferred a lighter pudding at lunchtime and a cooked pudding at tea time, this had been changed by the cook as a result of the survey. This showed peoples views were listened to. An Environmental Health inspection had been undertaken in August 2009 and the certificate they provided showed they had achieved a five star excellent rating. 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. People who lived in the home were listened to and protected. Evidence: There was a comprehensive complaints procedure, which was clearly displayed, in the entrance hall. All people we spoke to were aware of the procedure and told us they would either speak directly with the manager or staff. The manager had received one complaint in the last year, which had been fully investigated and resolved, we saw evidence of this in the complaints log. This ensured people were listened to and taken seriously. Relatives told us, the manager is always approachable. However most had not needed to raise any concerns and told us their relatives were looked after very well. All staff had received training in adult safeguarding, all staff we spoke to had a good knowledge of the procedures and what to do should an incident occur. Staff we spoke to were also aware of the whistle blowing policy, which safeguards people in the home. 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. In general the home was well maintained, clean, pleasant and comfortable ensuring people lived in a safe environment. Evidence: The location and layout of the home was suitable for its stated purpose mostly the environment was maintained to a good standard. It was homely and well decorated. The standard of cleanliness observed during the visit was good. However the decor on the Annex was not maintained to a similar standard, wallpaper was peeling from the walls and the carpets were marked and stained in some areas. It required redecoration and new carpets to ensure people lived in a well maintained environment. it was also very dark on the downstairs corridor on this unit and required more lighting to ensure people could see. An odour was also present on this unit, on investigation it was most probably the carpets although regularly cleaned still had an odour. The manager told us she was hoping to replace the carpets. The outside gardens were well maintained kept tidy and attractive providing a safe, accessible environment for people. Care Homes for Older People Page 18 of 27 Evidence: There was a maintenance and renewal programme, many rooms had been redecorated since the last visit and some new furniture purchased. The upstairs corridors on the Lodge were being repainted during our visit, which was a great improvement and ensured it was well maintained for people. 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. Most staff were appropriately trained, the recruitment procedures were robust ensuring people were in safe hands at all times, had their needs met and were protected. Evidence: There was a good staff structure and staff told us they supported each other to meet the needs of the people. There was always a nurse in charge of each shift. The care staff numbers were determined by the number and needs of the people on each unit and appropriate levels were maintained on the day we visited ensuring peoples needs were met. However the manager had identified a need for additional staff from 7.30pm until 9.30pm. The day staff finish at 7.30pm and the number of night staff did not meet peoples needs during these hours. At the time of the visit the manager was implementing this to ensure peoples needs were met. There were 29 care staff employed at Dr Anderson Lodge 23 had achieved NVQ level 2 and others were registered and working through the qualification. The manager wanted to achieve 100 of care staff with NVQ level 2. This showed commitment in the workforce by the manager and providers and ensured people are in safe hands at all times. Care Homes for Older People Page 20 of 27 Evidence: The manager told us all staff went through an induction on commencement of employment, however at Doncaster Councils Contract visit, it was identified in six files they looked at that no record of formal induction was available, completed induction should be kept in staff files to determine people have received the appropriate information to be able to do their jobs and meet peoples needs. Most mandatory training was up to date for the two members of staff we looked at and there was evidence that this was maintained and refresher courses completed within timescales. This ensured staff were appropriately trained to meet peoples needs. The staff files we looked at also had records of attendance at specific training on conditions associated with old age and other medical conditions that affected residents to ensure staff understood all peoples needs. Some staff training required updating this included first aid, medication training, food hygiene and health and safety, staff must receive training to ensure they are competent to do their jobs. A thorough recruitment procedure was in place, two staff files were seen on the day of the visit and contained all the required information. Protecting people who lived there. 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. Management and administration safeguards people, good health and safety policies and procedures were in place ensuring the safety of people in the home. Evidence: The manager was qualified and experienced to run the home. She had achieved the registered managers award and continually kept herself updated to ensure the homes stated purpose, aims and objectives were met. Quality monitoring was carried out, the manager did regular audits and the provider carried out regulation 26 visits, these are visits to gain feedback from staff, people living at the home and relatives. The provider would also look at the environment and care plans and other documentation, which may be relevant. The manager had regularly sent quality monitoring questionnaires to people in the home and their relatives. This ensured the home was run in the best interests of the people who lived there. Care Homes for Older People Page 22 of 27 Evidence: The home managed some peoples finances and personal money, this had been recently audited by Doncaster Council and no concerns had been raised. This ensured peoples financial interests were safeguarded. The home had a comprehensive health and safety policy. We were able to evidence that regular maintenance of equipment and systems was carried out. Risk assessments were carried out on all safe working practises, regular audits were carried out on the building and all accidents were properly recorded and reported ensuring people in the home were safeguarded. When we looked around the building we found tea and coffee making facilities in an upstairs lounge for visitors, although this is a good idea it may pose a risk to some people living at Dr Anderson Lodge. There is a risk of burning themselves from the boiling water. The manager had not completed a risk assessment to determine risk. The manager decided to place the facilities in a more prominent position where staff were always working. To reduce the risk but still providing the facility. this will ensure peoples safety. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 9 13 All medication must be administered as prescribed and recorded and signed for on the medication administration charts. This will make sure that people receive their medications as prescribed. 10/12/2008 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 7 12 Peoples changing needs 28/02/2010 must be reviewed and action taken. This will ensure peoples needs are met. 2 8 12 Maintain peoples health needs and ensure access to health care services in particular dieticians. This will ensure peoples needs are met 28/02/2010 3 9 12 Arrangements must be in 28/02/2010 place to ensure effective systems to request, obtain and retain adequate supplies of prescribed medication in the home. This will ensure medication can be given as prescribed. 4 30 18 Staff must be appropriately trained and receive regular updates. 28/02/2010 Care Homes for Older People Page 25 of 27 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 This will ensure that staff have the knowledge and skills to do their job. 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 2 19 38 Continue the redecoration programme in the Annex unit to ensure people live in a well maintained home. It is recommended a written risk assessment is put in pace for the tea and coffee making facilities. Act on any identified risks to reduce the risk to people. 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). 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