Inspection on 18/11/08 for Glebe Court Nursing Home

This inspection was carried out on 18th November 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Glebe Court Nursing Home 03/12/07

Glebe Court Nursing Home 23/10/06

Glebe Court Nursing Home 17/02/06

Glebe Court Nursing Home 16/08/05

Glebe Court Nursing Home 11/01/05

Glebe Court Nursing Home 09/08/04

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: Glebe Court Nursing Home Glebe Way West Wickham Kent BR4 0RZ     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: Rosemary Blenkinsopp     Date: 1 8 1 1 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 29 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Glebe Court Nursing Home Glebe Way West Wickham Kent BR4 0RZ 02084626609 02084629971 glebecourt@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Glebe Housing Association Name of registered manager (if applicable) Ms Gillian Payne Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 51 The registered person may provide the following category of service only: Care home with nursing (CRH - 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 Date of last inspection Brief description of the care home Glebe Court is part of the Glebe Housing Association, which provides housing and support through sheltered housing as well as warden assisted bungalows to elderly persons. The Association has one nursing home, which is Glebe Court. This is a purpose built care home for the nursing care of older people. The home is set in its own grounds on Bencurtis Park. There is car parking to the front of the home and a sheltered garden to the rear. The fees in this home are between £ 581 and £791 for single bedrooms, with extra fees payable for hairdressing, chiropody, newspapers and Care Homes for Older People Page 4 of 29 care home 51 Over 65 51 0 Brief description of the care home toiletries. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was conducted over a one day period. An expert by experience Mr Melvyn Seqeira accompanied us to the site visit. He spent time talking to residents and relatives whilst observing routines and practises. The manager facilitated the site visit. Periods of observation were undertaken by Mr Seqeira who also spent time chatting to staff residents and visitors. Prior to the inspection the manager had completed the AQAA and forwarded this to the CSCI. Comment cards were sent to the service and provided during the site visit. During the visit the inspector met with several residents. Staff were interviewed as part of the site visit. Care Homes for Older People Page 6 of 29 All of the information obtained from the sources identified above has been incorporated into this report. A selection of documents were inspected including care plans, complaints information as well as health and safety records. Feedback was provided to the manager at the end of the inspection. Other information which has been considered when producing this report and rating, is the information supplied and obtained throughout the year including Regulation 37 reports and complaints. Ten surveys were completed and returned seven from staff and three from residents. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 29 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 29 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. Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Residents are subject to assessments conducted by the manager of the home,supporting information is obtained through members of the multidisciplinary team which gives a comprehensive picture of needs. Assessment information helps to determine the homes ability to meet the residents needs. The home must not seek to admit outside of their registration category. Evidence: Care plans evidenced that an assessment was undertaken by the homes manager prior to placement. The admission assessment is a standard format and those seen contained relevant information in some sections particularly physical needs. Information on other aspects of care was less well documented including social care. Other information in those files inspected included hospital discharge letters GP summaries and Continuing Care Assessments. Care Homes for Older People Page 10 of 29 Evidence: One file had a residents diagnosis as Dementia, a category for which the home is not registered. The home must only seek to admit residents for whom they are registered. The manager explained that Dementia was part of this residents diagnosis, however, her physical health needs out weighed her Dementia needs. This is still not acceptable as staff will not have the skills to deal with the Dementia element of the condition so that all of the residents needs can not be met. Information provided to residents included the Statement of Purpose and Service User Guide. On admission the home provides a welcome pack in the allocated bedroom which provides a lot of information including local facilities as well as that relating to living in the home. Flowers are given as part of a welcome in to the home. The manager stated that pre admission visits were encouraged and these could take place at any time within reason. Relatives spoken to confirmed that pre admission information and visits had been undertaken prior to placement. One comment received by the expert by experience, Mr Melvyn Sequeira, was the following : we had visited many care homes, but a visit to this place made him feel that we had found a good home for his mother. Care Homes for Older People Page 11 of 29 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are in place for each resident. These provide staff with good information on the physical health needs of the resident on how to address the individual’s care. Supporting risk assessments are in place and kept under review. Some of the verbal information received about health care indicated care needs were not always fully addressed. The medications are safely stored, administered correctly and have supporting records in place. Evidence: Observations were made on care practices and supporting records. We found care plans to reflect the physical health needs of residents and have Care Homes for Older People Page 12 of 29 Evidence: supporting risk assessments in place. Other psychological, spiritual and social needs were less well addressed although some improvement in the documentation was evident. Whilst the record keeping around these areas was limited there were a number of inputs, activities religious services and the use of volunteers ,which were in place in the home to meet residents needs. There was a record of visiting health professionals retained in the care notes which reflected regular input from these services. Some of the daily events were limited in so much as they did not detail the specific care given to residents. Melvyn Sequira made the following observations : The residents appeared to be neatly dressed. The carers I spoke to told me that they did help the residents with dressing and bathing. A GP visits the premises every fortnight. Visits to the dentist are arranged. A hygienist visits regularly. Hairdressing and nail cutting services are also made available. Two concerns were made in relation to health care: one about delays in recognising and calling assistance in a timely manner to a residents who sustained a fracture. This was referred to Mr Lillee the Responsible Individual for investigation. A copy of the letter was handed in during the inspection to us. The second outlined overall standards of poor heath care including lack of attention to personal hygiene and attention to detail in personal care. These concerns have been referred to Social Services. We observed the medication systems in operation as satisfactory. The home uses the Boots dosette system. The medication charts contained clear photographs of the individual resident, allergies are recorded. Records are maintained of medications received into the home as well as those for medications disposed of. The home maintains records of all prescribed medication. Any changes to the prescribed dose are recorded. We found examples of recent changes to insulin dosage in place for one resident, included within the MAR sheet with supporting risk assessments and care plans. Those medications with a short shelf life, once opened, had the dates of opening recorded. Staff confirmed training in medication and regular updates and auditing conducted. Reference manuals to check medication issues were available to staff. Care Homes for Older People Page 13 of 29 Care Homes for Older People Page 14 of 29 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. Activities are provided to residents that are both varied and age appropriate. Contact with friends and family is promoted with open visiting and events which families are invited to. Residents have choice in their day and are encouraged to retain interests and activities. Evidence: The expert by experience spent the majority of his time with residents and relatives hence the information in this section relates to his findings : Activities are organised daily. The residents are brought into the activity room which also doubles as a quiet room with books and games. Residents who want to participate are encouraged to do so. List of activities is up on the notice board in the dining room. It was encouraging to see that residents were helped in their activity in a sensitive manner, to do something which they enjoyed and at the end they looked quite pleased they had achieved something. In addition the activities co-ordinator organised a hymn service every six weeks which I was told was very popular with the residents. The residents told me that there was no pressure on them to go to their bedrooms. Care Homes for Older People Page 15 of 29 Evidence: They could and did so when they wanted to retire ( at a reasonable time of course). I was told that the kitchen had been modernised. A visit to the kitchen showed it to be spotless with everything in its place. The food smelt appetising and looked appetising Newspapers and magazines are made available to those who want them. Some of the residents preferred to have their meals in their rooms. I saw the carers making sure that these residents received their meals on time. There was a choice of two meals. Drinks were also available during lunch. I saw carers taking a great deal of trouble to ensure that those who needed help to eat were given this help. The wife of one of the residents who suffered from Parkinsons told me that the kitchen was quite prepared to produce a different meal from that on the menu, if this choice was unsuitable for her husband. She had high praise for the cooks and the kitchen staff. There was little wastage of food. The carers told me that when they served the residents, they knew how much the resident would eat and so the quantity for food provided was adequate. After lunch, some of the residents went to the conservatory , other were taken to the lounge. Those residents in wheelchairs had to be lifted by hoist to put them in the seats. I watched (covertly) the way in which this was done and found it was done with great care and respect for the dignity of the person. The carers are also aware of the procedures to be followed in case of falls. I talked to a few residents about their experience. All of them were quite happy in the way they were looked after in the home. Watching the interaction between carer and resident, it appeared to me that the carers were sensitive to the physical disabilities of the residents. I also met and talked with a few of the relatives who came visiting. All of them were pleased with the quality of care being provided. As one said I like the way in which my mother is looked after by the carers Another said that he had visited many care homes, but a visit to this place made him feel that he had found the right home. Of particular interest was the presence of volunteers, one, whose relative had been a resident in the home. It seemed to me that the presence of such volunteers helped to ensure that the home was well run. It turned out that some of them had access to members of the Management Committee to whom they could convey their concerns if there were any. I am sure that this knowledge kept the carers on their toes. Hairdressing and nail cutting services are also made available. Outings are arranged at Care Homes for Older People Page 16 of 29 Evidence: times. Care Homes for Older People Page 17 of 29 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information on how to make a complaint is provided and available to residents, relatives and staff. The system of recording complaints ensures clarity and transparency to protect residents. Staff were knowledgeable about what constitutes abuse and residents can feel safe that such allegations will be actioned. In respect of whistle blowing staff were less confident in this area. Evidence: The home retains a record of complaints, and the records seen included a number of issues ranging from missing laundry to staff attitudes. There was details retained of what investigation had taken place, a summary of the outcome and whether the complainant was satisfied. The records of complaint had improved since the last inspection site visit. Staff confirmed that they had received training on POVA and abuse and that this was updated. The staff interviewed demonstrated a reasonably good knowledge in dealing with abuse although external avenues for reporting such were less well known. During staff interviews reporting issues externally needed a lot of prompting by the inspector to get staff to state that this is the action they would take. Care Homes for Older People Page 18 of 29 Evidence: In respect of whistle blowing staff were aware of what constitutes whistle blowing and confirmed training on the topic. The action to take in such cases was either less well known or understood, as staff seemed hesitant in this area of reporting and taking action on it. There were four individual concerns raised regarding whistle blowing and specifically the management response and action resulting from such reports. There are procedures in place relating to abuse and whistle blowing. However concerns over how such information was received and dealt with by the management of the home, was cited as a problem. In addition the lack of confidentiality was also an issue . Care Homes for Older People Page 19 of 29 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with clean, comfortable and well maintained accommodation. A selection of sitting areas enables residents to choose how and where they spend their day. Evidence: This was the summary of the environment made by Melvin Sequeira: Sometimes first appearances do matter. The home looked welcoming with a pleasant aspect on the outside and well designed and well lit on the inside. There was plenty of space on the ground floor in the dining room and the lounge. It did not feel cluttered. There were no unpleasant smells as one walked into the building. It looked clean and inviting. Walking round the premises, I found the rooms of adequate size. Many of the residents had personalised their rooms with prized photographs of their family. The rooms were not stuffy or draughty. I could see no sign of dust on the furniture which is always a good sign. The home had many items of equipment in use including pressure relieving equipment mobility aids specialised baths and showers foot rests etc. All bedrooms have a toilet and wash hand basin. Care Homes for Older People Page 20 of 29 Evidence: The home has two lifts. Parking is provided to the front of the building for staff and visitors. The communal areas were homely with a television,newspapers and magazines. There have been improvement made to bathrooms and showers and a new hairdressing room has been developed. The reception and office areas have been improved by way of an extension giving better accessibility. On going redecoration of communal areas has also benefited the home. There was evidence of clocks and calendars in many bedrooms. Call bells and fluids were at hand in those bedrooms inspected. Safes, for storage of valuables, were in each wardrobe. COSHH and other substances, which may be hazardous, were safely stored. Care Homes for Older People Page 21 of 29 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are provided in sufficient numbers to meet the resident’s needs. Additional time is allowed for the completion and upkeep of records. Supervision is conducted. Staff are trained to undertake the work they do. Recruitment procedures are in place, and robust enough to afford safety to residents. Evidence: On the day of the site visit the home was staffed with a full staff team including qualified nurses, care staff, ancillary and administration staff. Three registered nurses were on duty one on each floor and another supernumerary. The manager was also on duty. Staff were interviewed as part of the site visit. Discussion took place on topics such as training, supervision and key working systems. Staff demonstrated a good knowledge of their resident group and confirmed that training was provided in house and through external providers. Information regarding induction, and thereafter ongoing training, was evidenced through records retained in personnel files and the training matrix kept by the manager. Training records are retained on site. Training provided in house included moving and Care Homes for Older People Page 22 of 29 Evidence: handling; fire, food hygiene and COSHH. Some of this is in the form of videos with question and answer format. Food hygiene training is one of those using this method for the care staff, although kitchen staff undertake the food hygiene certificate. Supervision was taking place regularly although a copy of the supervision notes was said not to be provided although it was shown to the employee. Supervision can be a valuable forum for staff to relate issues and concerns to the management and two way discussion should be encouraged. Employee files were inspected and they evidenced that recruitment procedures were undertaken prior to employment. The personnel files contained standard documentation including application forms, reference request forms, offer letters, terms and conditions,two references and confirmation of NMC registration status. CRB checks are made prior to employment and the original forms retained separately. The home is undertaking the recommendation of repeating CRB checks every three years. Vacancies are minimal with one full time RGN position and a care post vacant. Care Homes for Older People Page 23 of 29 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is managed by a trained and experienced nurse. Health and safety issues ensure the home is safely maintained. Quality assurance measures include Regulation 26 visits, which are conducted monthly, unannounced. The annual quality assurance tool which incorporates the views of residents relatives staff and all stakeholders needs to be further developed. Evidence: The manager has been in post for five years and has a lot of experience in the care home field. In previous sections of this report there have been concerns raised about the management style and approach. This was raised both through staff and visitors. It is essential when managing such a service that the management is strong enough to manage the service whilst demonstrating sympathy and empathy. Staff need to feel supported and that concerns will be appropriately actioned. This needs to be addressed. Care Homes for Older People Page 24 of 29 Evidence: The home has in place policies and supporting risk assessments relating to health and safety. A selection of health and safety certificates were inspected including those for gas, electrical and lifting equipment. The PAT testing for portable electrical appliances, was last undertaken February 2008 the maintenance staff member addressed this. The fire risk assessment was conducted January 08. Weekly fire alarm testing was recorded. Fire training was conducted regularly and at different times including one on night duty. This is good practice as all staff need to be familiar with fire procedures including night staff when there are far fewer staff working. An audit of the personal finances of the residents case tracked was undertaken. There were records in place although the records did not show signatures either of staff or resident, for monies paid out. The only details recorded were the date and amount. Receipts for monies spent are retained where possible. All monies were cross-checked with the amounts recorded, those seen were accurate. Signatures for all transactions need to be recorded. Regulation 26 visits are undertaken by Mr Lilly. Reports were available and the content of these was to a good standard. Other audits undertaken by the manager include those on care plans, accidents, infection rates and medications. Mr Lillee had conducted a survey with families early 2008 the results were made available September 08. Approximately half of the surveys 24, out of 48 were returned. In general favourable responses were received. To supplement quality assurance measures the home needs to undertake a review of the quality of care provided by the home that includes consultation with residents and other stakeholders and encompasses aspects of living in the home. Care Homes for Older People Page 25 of 29 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 26 of 29 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 3 14 The home must only admit residents for whom it is registered namely older people. Staff need to have the skills to be able to meet residents needs. 31/12/2008 2 8 12 Residents health and personal care must be addressed by staff in the home. To ensure that residents health is maintained. 31/12/2008 3 18 22 Whisltleblowing and 31/12/2008 concerns must be met by a receptive management team where staff and relatives feel confident that appropriate action will be taken. relatives nd staff These procedures must be in place to ensure residents safety and staff well being. Care Homes for Older People Page 27 of 29 4 31 9 Management of the home 31/12/2008 must promote an open and transparent culture where staff, relatives and residents feel safe to raise issues. Residents to feel secure that issues will be raised and actioned accordingly by a competent management team. 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 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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. 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