Inspection on 08/12/08 for Eastbrook House

This inspection was carried out on 8th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Eastbrook House 17/11/09

Eastbrook House 02/08/06

Eastbrook House 18/10/05

Eastbrook House 16/05/05

Eastbrook House 15/02/05

Eastbrook House 04/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Eastbrook House 16 Eastbrook Avenue London N9 8DA     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: Margaret Flaws     Date: 0 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Eastbrook House 16 Eastbrook Avenue London N9 8DA 02088056632 02088056637 Eastbrookhouse@UK2.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Roland Jenkins Beacham,Mrs Janet Beacham care home 6 Number of places (if applicable): Under 65 Over 65 6 43 dementia old age, not falling within any other category Additional conditions: 0 0 The registered person may provide the following categories of service only: Care Home only-- Code PC To service users of the following gender--Both 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 The home is owned by Mr & Mrs Roland Beacham and managed by their sons Jonathan and Richard, the former being the registered manager. The Beacham family has run Eastbrook House for over twenty years. The home is registered to provide care for forty three older people. The number of double rooms had been decreased so that there is now only one room used as a double room. The communal space includes three lounges and a dining room. There is a passenger lift and the garden is to the rear of the property. The registered manager stated that the current cost of the service is Care Homes for Older People Page 4 of 28 Brief description of the care home #400 per week. The home displays the latest CSCI inspection report in the entrance hall of the home for the information of all. The registered manager stated that relevant information is shared with all concerned. Eastbrook House is situated in a quiet part of Edmonton at the end of a short residential road. The home is accessible by public transport and within ten minutes walking distance of the local amenities. The home aims to provide a safe and caring environment for service users. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: This unnannounced inspection took place over one day and the Registered Manager was present throughout. The inspection consisted of brief discussions with over half of the residents; interviews with most staff on duty, including the two heads of care and with the homes cook. We also spoke to one visiting relative. We did a tour of the premises, observed interactions and routines and inspected care, staff and general records in the home. We received two surveys from the residents and eight surveys from the staff. The Registered Manager provided CSCI with a basic Annual Quality Assurance Assessment (AQAA),which contributed information to this inspection. Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: All new staff must have full Criminal Records Bureau checks completed by the home before coming to work there. All new staff must have all pre-employment checks, including reference checks, photographic evidence of identity and right to work in the UK completed satisfactorily before coming to work in the home. The staff rota and compiled information about staff training completed must contain the full names of the staff, not just first names. The home must review its staffing levels to ensure that there are sufficent care and domestic staff working at all times to meet the needs of people living in the home. The home must review the dependency levels of residents on a regular basis to ensure that there are sufficient staff on duty to meet the needs of the residents.CSCI must be kept informed of the results of these reviews. The home must recruit a kitchen assistant to ensure that care staff do not work in the kitchen. Care Homes for Older People Page 7 of 28 All staff must have refresher training in safeguarding adults. The home must produce a training plan covering all areas of mandatory training and other training to meet to the needs of people living in the home. All areas for action identified in the homes environmental risk assessment must be completed. 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 –03000 616161. Care Homes for Older People Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents can be confident that their needs will be assessed before they come into the home and to ensure that these needs can be met. Evidence: The home voluntarily limits the number of people living in the home to forty and there were thirty eight people living there at the time of this inspection. Most people came from North London boroughs. The Registered Manager said that most referrals are from hospitals. We saw the files of five people who had been admitted to the home since the last inspection. According to the Annual Quality Assurance Assessment provided to CSCI, the home has had twelve new admissions in the past twelve months. These residents needs had been assessed before they came into the home. There were also regular annual reviews completed by the placing authorities. The information from these Care Homes for Older People Page 10 of 28 Evidence: reviews formed part of care plans updates. The home does not provide intermediate care. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care and support needs are assessed and care plans developed to meet these needs. Residents have access to appropriate professionals as needed. They are protected by the homes medication policies and procedures. People are also treated with respect in the home. Evidence: The residents in the home were quite mobile, with the exception of one person whom staff said preferred to remain in her room and several others who needed assistance in moving about. We saw eight care files. These had a clear and easy to understand structure, which covered specific areas of identified need, health and social needs, mental capacity assessments (only a few of these had so far been completed) and goals. There was good summary information in the front of each file with emergency contact details, information on peoples needs and preferences and important medical information. Peoples cultural and religious needs had been assessed and there was information about how these would be met. Care Homes for Older People Page 12 of 28 Evidence: Residents had indicated their preferences in their care plans and signed them off. The care plans had been regularly reviewed by each persons keyworker, with updated monthly summaries in place. The heads of care said that they take responsibility for ensuring that the keyworkers reviews are done and they discuss these reviews with the staff in their supervision sessions. For one person who spends a lot of time in their room and in bed, there were documented discussions about options for improving mobility and outlines of involvement from other health professionals such as district nurses. Healthcare needs were assessed and routine appointments planned for and recorded, for example, with dentists, doctors, chiropodists, district nurses and appointments at hospital. A range of risks were assessed, including the risk of pressure sores and risks of falling. These risk assessments were regularly reviewed. Residents we spoke told us that the staff treated them respectfully and that their privacy was protected. This was also confirmed in the surveys that the residents sent back to us. We saw the good sized and well laid out medication room and spoke to staff about how medication is handled in the home. There is a good quality audit system in place for checking when medication is received into the home or disposed of. Sample signatures are kept to identify who has given the medication. Good medication policies and procedures were in place and staff who give medication have been trained to do so. There was appropriate storage and recording for controlled drugs. The medication room and medication fridge temperatures are taken regularly and recorded to ensure that they were within a safe range. The Registered Manager and head of care said that the home is currently in a changeover mode using two pharmacies, a local pharmacy and Boots. This means that there are two seperate nomad dispensing systems in place, including one for seven people having their medication supplied by Boots at present. They explained that because the quality of the local pharmacy had been variable, the home had been using Boots on a trial basis. However, there had been some improvements with the local pharmacy and the home is still reviewing its options. Training is provided by Boots, Enfield Council and by the local pharmacy. The heads of care take lead responsibility for medication rounds but there are a number of staff trained to administer the medication. A requirement made at the last inspection, for staff who give medication to be trained, has been met. Medication reviews had been done by each persons doctor on some of the care files Care Homes for Older People Page 13 of 28 Evidence: we saw. We observed the residents in the lounge areas at different times during the day; watched interactions between the staff and the residents and noted that staff were respectful and careful in the way they worked with the residents. Residents we spoke to were also positive about the way staff supported them. They said that their privacy was respected and staff were observed knocking on residents doors before entering. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from activities offered by the home and they are supported to take up activities that they enjoy. Family involvement is encouraged. Residents are encouraged to make choices for themselves. Food in the home is good and the residents said they enjoy it. Evidence: A small range of activities are offered in the home. We discussed these with the residents and the part-time activities organiser (who also works as a care staff member). She said that there is a gap in actvities offered after the departure of the music and movement activities person. But on the day of the inspection, afternoon bingo took place in one lounge and people we saw appeared to be actively participating and enjoying the game. Many people participate in arts and crafts sessions and said they enjoyed them. Other activities include pub lunches, visits to central London and to the coast. Family involvement was recorded in peoples care plans and notes. Residents we spoke to told us about how the home supports their families to be involved and to visit regularly. One relative said she visits often and finds the home welcoming and Care Homes for Older People Page 15 of 28 Evidence: supportive. We spoke to the cook and inspected the kitchen. The menu for the day had offered two reasonable choices. We saw the four week menu cycle which offered good choices to people. The cook described peoples special diets, for example, for one person who was Hindu and vegetarian and for people who were diabetic. She had worked in the home a long time and demonstrated a good understanding of peoples needs. Fridge and freezer temperatures recorded daily and were within a safe range. The cook is assisted by a care staff member in the mornings and during lunchtime. This takes care staff away from providing direct care to the residents. The home needs to recruit a permanent kitchen assistant to work these kitchen shifts and a requirement is given. We observed the residents at lunchtime. People told us that they enjoyed the meals provided and these appeared healthy and nutritious. Minor kitchen repairs had been completed since the last inspection, meeting a requirement and a new fridge and freezer had been purchased and new kitchen units have been put in. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives can be confident that any concerns they raise will be taken seriously and addressed. Residents are also safeguarded by the clear policies and procedures on adult protection but would benefit from staff being trained more regularly in this area. Evidence: We saw the homes complaints records. One complaint had been received since the last inspection and this was being addressed at the time of the inspection. Residents we spoke to said that they would be happy to raise concerns if they had them. There have not been any safeguarding concerns raised since the last inspection. The home has a copy of the local authoritys safeguarding adults strategy. Staff we spoke to were aware of the issues involved and actions to be taken if there was a disclosure or allegation of abuse. However, we identified some gaps in staff training in safeguarding and a requirement is made under the section in Staffing section of this report. Care Homes for Older People Page 17 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents benefit from living in a comfortable and well maintained home. They would further benefit from improvements in domestic and kitchen staffing. Evidence: The home is spread over three floors with the top floor having been added to the building after it was built.We toured the home and found it to be in a reasonable state of repair. We visited several residents in their rooms. These were pleasantly decorated and personalised. The Registered Manager showed us a recently modernised bathroom and a pergola in the garden. He showed us the upstairs lounge which was not being used at the time. He said that most people preferred to come to the larger lounges on the ground floor. The home has several bathrooms and toilets on each floor. These were well decorated and maintained. Mobile heater guards are now available in some residents rooms, as required. There are hoists and bath chairs to support people with mobility difficulties and these had been serviced recently. There is a good nurse call system and a clinical waste disposal. Care Homes for Older People Page 18 of 28 Evidence: There was no laundry person on duty and staff said they were all chipping in to do the laundry while the designated person was on duty. We discussed this with the Registered Manager, who assured us that sufficient bank and permanent laundry staff were being recruited to cover laundry tasks in the home at all times. Staff have been trained in infection control procedures. Care Homes for Older People Page 19 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes recruitment procedure does not protect the people living in the home. Staff are generally well trained but residents would be benefit from improvements in mandatory staff training, including training in safeguarding adults. Staffing levels must be kept under review to ensure that they are matched to the residents changing needs. Evidence: In the AQAA supplied to CSCI, the Registered Manager stated that (out of thirty eight residents, one resident is bedfast, twenty five need help with washing and dressing, thirty seven need help with washing/bathing, twenty one need help going to the toilet, eight are singly incontinent and twelve are doubly incontinent, ten have dementia, nine need the help of two staff day and night, and six need help with their meals. Staff surveyed and spoken to said that the dependency level of people living in the home was increasing. Since the last key inspection, there have been changes in the way the home is staffed and how the work is organised. There have also been some gaps in the laundry and domestic staffing recently and care staff currently work in the kitchen. We discussed Care Homes for Older People Page 20 of 28 Evidence: staffing in the home with the Registered Manager and with the staff on duty. We also looked at staff meeting minutes where these changes were discussed and considered comments from the five staff who returned surveys. Some staff expressed concern that their ability that the changes had impacted on their ability to meet the residents needs. A requirement is given that the dependency level of residents and staffing levels needed are reviewed every three months and CSCI informed of the results. The home has had a relatively low turnover of staff and many staff have worked in the home for a long time. We checked several staff files, including the files of new staff and identified several gaps. Two staff had not had a Criminal Records Bureau check or POVA first check before they started work. Some staff did not have two written references nor checks for the right to work in Britain. We spoke at length to the Registered Manager about this and he acknowledged tThis is unacceptable practice. The homes recruitment procedures and the homes recruitment procedures had not been followed in these cases. The Registered Manager immediately took steps to address these serious gaps. Staff were stood down from work and necessary checks applied for immediately. The Registered Manager acted to provide immediate information on all staff recruitment checks and the missing checks were completely within three days. We are satisfied that he has gained an understanding of the seriousness of these ommissions. We saw the training matrix which detailed all the staff training that have been completed. Staff had been trained in core areas of medication, moving and handling, first aid, fire safety, infection control, health and safety and food hygiene. A requirement to train the staff in some of these core areas from the last inspection is met. However the staff training information was not up to date on the matrix and some training certificates were missing. The home needs to ensure that all staff training in core areas is kept to date, with a formal training plan with identified training needs, planned training matched and evidence of training kept on file. Requirements are given. Not all staff had been trained in safeguarding adults and a further requirement is given. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents in the home are adequately protected by the homes management but significant improvements are needed in future staff recruitment procedures. Residents have an opportunity to contribute their views and their financial interests are protected. Health and safety in the home generally protects the residents. Evidence: The Registered Manager has worked at the home since 1995. Another family member works in the home as an Administrator. Concerns have been identified in the staffing section of this report about poor adherence to recruitment procedures and requirements for improvement have been made. The two heads of care both have NVQ Level Four qualifications. They demonstrated a very good understanding of the needs of the residents and they undertake staff supervisions, which were documented. Care Homes for Older People Page 22 of 28 Evidence: The home now provides Regulation Thirty Seven reports to the CSCI, informing us of any significant incidents and if a resident dies. This meets a previous requirement. Good systems are in place to protect peoples financial interests and we observed good practice in this area. The home has a regular survey and residents meetings to enable the residents to express their views. Another outstanding requirement from the last inspection was for the home to obtain a gas safety certificate, have electrical testing done and provide evidence that the water system has been checked for legionella. These steps were completed and the home now has all the required up to date health and safety certificates. Fire safety related requirements from the last inspection have been met. The stairwells were kept free of obstruction; fire doors have been checked by a fire officer, who has also been consulted on smoke seals. Fire equipment had been recently serviced. The home has a fire risk assessment and had been visited by a fire officer. However, there were some actions identified on the fire risk assessment which had not been completed and a requirement is given that these be addressed. Care Homes for Older People Page 23 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 27 18 The Registered Manager must recruit kitchen assistants to ensure that care staff do not work in the kitchen. Care staff should not be working daily staff in the kitchen. This is a domestic duty and should be done by domestic staff. 15/05/2009 2 27 18 The Registered Manager 15/05/2009 must review the dependancy level of residents on a regular basis to ensure that the staffing levels match their needs. staffing levels must be matched to the needs of the residents and the home needs to ongoingly review the residents changing needs responsively 3 27 18 The Registered Manager 15/05/2009 must keep the staffing levels under review to ensure that there are always sufffient Page 25 of 28 Care Homes for Older People staff on duty at all times to meet the needs of the residents. there should always be adequate staff on duty. 4 29 19 The Registered Manager must ensure that all new staff must have all preemployment checks, including reference checks, photographic evidence of identity and right to work in the UK completed satisfactorily before coming to work in the home. all staff must be properly vetted before commencing employment 5 29 19 The Registered Manager 15/05/2009 must ensure that all staff must have enhanced Criminal Records Bureau checks completed by the home before coming to work there. all staff must be properly vetted before commencing employment 6 30 19 The Registered Manager must ensure that home has a training plan in place that covers all areas of mandatory training and other training needed to meet the needs of the residents. 15/05/2009 15/05/2009 Care Homes for Older People Page 26 of 28 gaps in staff training must be addressed and the home should take a systematic approach to staff training 7 30 18 The Registered Manager must ensure that all staff have refresher training in safeguarding adults. all staff need to be trained in safeguarding to protect the SU. 8 30 18 The Registered Manager must ensure that staff rota and training records have the full names of staff recorded. staff identity must be establishable 9 38 12 The Registered Manager must ensure that all areas for action identified in the homes environmental risk assessment must be completed. outstanding actions identified must be addressed. 15/05/2009 15/05/2009 15/05/2009 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 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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 28 of 28 - 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!