Inspection on 09/01/09 for Hillcrest

This inspection was carried out on 9th January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hillcrest 12/01/07

Hillcrest 23/01/06

Hillcrest 05/09/05

Hillcrest 04/11/04

Hillcrest 19/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hillcrest Elliott Street Tyldesley Wigan Greater Manchester M29 8JE     The quality rating for this care home is:   two star good 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: Jeanette Fielding     Date: 1 5 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Hillcrest Elliott Street Tyldesley Wigan Greater Manchester M29 8JE 01942891949 01942876393 ms.cal@hotmail.co.uk 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) : Caring Alternatives Limited care home 17 Number of places (if applicable): Under 65 Over 65 17 2 dementia mental disorder, excluding learning disability or dementia Additional conditions: 2 0 One named service user (WF) in the category of MD(E) (Mental Disorder over 65 years of age) may be accommodated within the overall number of registered places. The Registered Person must ensure that all staff working in the home have dementia and mental disorder awareness and training, which equips them to meet the assessed needs of the service users accommodated, as defined in the individual plan of care. The home is registered for a maximum of 17 service users to include:- up to 17 service users in the category of DE(E) Dementia over 65 years of age up to 2 service users in the category of DE Dementia aged between 55 and 65 years of age up to 2 service users in the category of MD(E) Mental Disorder over 65 years of age The service should at all times employ suitably qualified and experienced members of staff, in sufficient numbers, to meet the assessed needs of the service users with dementia and mental disorder. The service should employ a suitably qualified and experienced manager who is registered with the CSCI. Work on the external grounds of the home, to make the area safe, attractive and Care Homes for Older People Page 4 of 27 accessible to service users must be completed by 1.11.05. Date of last inspection Brief description of the care home Hillcrest is situated on the outskirts of Tyldesley town centre and is close to local amenities and is on a main bus route. St Georges church is adjacent to the home. Hillcrest is a converted vicarage and provides private accommodation on the ground and first floor. The home has had an extension to the property providing three additional bedrooms with en-suite facilities, an additional lounge and a lift has been installed. Three bedrooms are shared rooms, the rest are single bedrooms. All bedrooms have a hand washbasin and five rooms in total have en-suite facilities. Toilets are close to residents bedrooms and the lounge and dining areas. The home has extensive grounds, which the manager is in the process of arranging to have landscaped and made private and secure. The home offers accommodation and care for up to seventeen residents over the age of sixty-five years, who have dementia, including up to two residents under sixty-five but over the age of fifty-five, who have dementia and two designated residents who are over sixty five years of age who have a mental disorder. Fees are 415 pounds per week. Additional charges are made for hairdressing, outings and entertainers. 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: two star good 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 unannounced inspection commenced on 9th January 2009. The manager of the home was on annual leave and the team leader in charge did not have all access to all the necessary information. A second visit was made on 15th January 2009, following the managers return to the home to complete the inspection. A total of six hours were spent in the home. Records relating to the care of the service users were viewed to evaluate the level of care required by, and afforded to them. Staff files were viewed to ensure that all safety checks had been made on them prior to them commencing work at the home and to evaluate the training that they had undertaken. Safety certificates were viewed to ensure that all equipment and facilities within the home assured the health, safety and Care Homes for Older People Page 6 of 27 welfare of the staff and service users. A full tour of the building was undertaken, including most bedrooms to assess the environment in which service users live. Discussions were held with five members of staff to obtain their views of the home and to evaluate their knowledge and understanding of service users needs, the policies and procedures and their individual role and responsibilities. Discussions were held with the manager on the second day of the inspection. Five service users were spoken with during the inspection although it was not possible to evaluate their views due to their cognitive impairment. 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. Care Homes for Older People Page 8 of 27 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 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. A detailed and informative service user guide provides prospective service users and their relatives with full information regarding the facilities and services offered by the home to enable them to make an informed decision regarding their care provider. Evidence: The home has a detailed and comprehensive Service User Guide. Copies of this are placed in each service users bedroom to provide them, and their visitors, with full information regarding the services and facilities provided by the home. Prospective service users, and their relatives, are invited to visit the home prior to making a decision about their care provider to ensure that they have all the information they need. Pre admission assessments are carried out to identify the individual needs of the service user to ensure that the home can meet those needs. The pre admission Care Homes for Older People Page 11 of 27 Evidence: assessments of the two most recently admitted service users were seen and were found to contain full information regarding the service users medical, care and social needs. Information is recorded about the need for any specific equipment required to assist the service users and to identify any individual preferences. The manager has gathered information from a range of agencies, relevant to dementia care, with a view to improving the forms used for the pre admission assessment. Discussion took place regarding the proposed change and the information that would give the staff greater understanding of the service users needs and abilities. The home does not offer intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans are prepared for each service user to provide the staff with full information regarding each service users care needs, social needs and individual preferences to promote a good quality of life. Evidence: Individual care plans are prepared for each service user to provide staff with information regarding the service users needs and preferences to ensure that these needs and preferences can be met. The care files of three service users were viewed and two showed that the care needs had been identified and action plans put in place to address those needs. Plans are in place with regard to personal care, moving and handling, nutrition and all other care needs. Risk assessments had been undertaken and risk management plans put in place to reduce or remove any potential risk. Evidence of visits to and by GPs, optician, district nurses and other health care professionals was seen together with information or instructions made by these professionals. Care Homes for Older People Page 13 of 27 Evidence: The care file for one service user did not contain full information. The service user had recently been admitted to the home and a short term care plan was in place. New service users are assessed over the first few weeks at the home to enable a comprehensive plan of care to be put in place. The short term plan identified personal care needs and preferences but some information was lacking in respect of issues relating to diabetes. The chef had been informed of the specific dietary needs and information regarding diabetic diets is held in the home. Information regarding blood sugar tests and chiropody had not been adequately recorded, although the manager was able to confirm that chiropody had been arranged. Some of the care files contain information that is no longer relevant to the needs of the service users and some outdated information is held. Consideration should be given to placing outdated information in a separate file to enable current information to be more easily accessed. Daily reports are completed by the team leader or senior care assistants. These were found to be extremely well written and informative. Details are recorded of all the care given to service users on a daily basis and include information in relation to the time of rising or going to bed, and the name of the care assistant who assisted them. Copies of the basic plan of care are laminated and placed in the daily record folder to ensure that the staff have full information at all times without having to refer to the full care file. This was effective in ensuring that all care needs were available for the staff. Medications are dealt with in accordance with the homes policy and procedure. Records were well maintained and up to date. The medications storage area was clean and organised and no unwanted medications are stored in the home. Information regarding medications is readily available for staff and the pharmacist is available to offer information or advice whenever necessary. The home has polices and procedures to ensure that privacy and dignity are respected and observation of the interaction between staff and service users provided evidence that these are respected at all times. Screens are provided in shared rooms to protect privacy and plans are in place to improve this in one of the bedrooms. Discussion took place with many of the service users but few were able to give their views about the home. Those that were able to express their views spoke positively about the staff and the care that they gave. Service users may meet with their visitors in the privacy of their own bedroom or in one of the communal areas as they wish. The home provides two lounges and a separate dining room which may be used for this purpose. Visitors are welcome at any Care Homes for Older People Page 14 of 27 Evidence: time and the visitors book shows that friends and relatives visit at various times during the day. No visitors were present in the home at the time of the inspection and so it was not possible to obtain their views or opinions. Care Homes for Older People Page 15 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. A good number and range of social opportunities and activities are available to promote social interaction and stimulation. Evidence: The care files provide information regarding service users social needs and preferences to enable appropriate social activities to be provided. A range of activities is provided and records of these are held in the files. Photographs are displayed of a recent cake making session and it was evident that this was enjoyed by all who participated. A good selection of board games, puzzles, jigsaws and DVDs are held. Staff confirmed that service users also enjoyed skittles, music and singing. Song sheets are also provided to enable service users to participate fully. One service user was being taken by a member of staff to the local shops on the day of the visit and the records held in the home provide evidence of visits to local cafes, pubs and garden centres. Regular trips out are arranged and entertainers visit the home on a regular basis to provide further stimulation. Staff were observed to spend time sitting with service users, chatting and providing one to one activities. One service user confirmed that activities were always available Care Homes for Older People Page 16 of 27 Evidence: and that everyone was encouraged to join in, but they were free to choose not to participate if they wished. Meals are served in the dining room, the lounge or the service users own bedroom as they wish. The menus provide evidence that a varied and balanced diet is offered. Special diets can be provided on the advice of the GP or dietitian, or at the request of the service users. A choice of meals is available and information is held of individual likes and dislikes. This is particularly useful and some of the service users are unable to express their preferences due to their dementia. Much of this information is gathered from relatives. The menu shows that hot meals are provided at all mealtimes, with the main meal of the day being served at lunchtime. The provision of a hot evening meal ensures that service users who do not wish a hot lunch are provided with a nutritional diet. Every effort is made to use only fresh foods for the meals, with some frozen foods to offer greater choice for vegetable which are not in season. Local suppliers provide most of the fresh foods for the home and this ensures quality. Staff confirmed that service users preferred meals which contained meat, vegetables and potatoes rather than pasta or rice and this was reflected in the menus. The meals served during the inspection smelled appetising and were attractively served. Dining tables are laid in an attractive manner and a selection of condiments are available. The dining room is bright and decorated to a high standard and provides a pleasant environment. Staff were observed to assist service users discreetly during mealtimes and it was evident that meals were not rushed. One service user did not wish to take her meal at lunchtime and so the meal was served a little later. It was evident that the staff respected service users choices and preferences. The kitchen was clean and organised and all foods were observed to be stored appropriately. Two service users spoke highly of the meals and said that they enjoyed everything that was served. Care Homes for Older People Page 17 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. Staff have been given training on the Protection of Vulnerable Adults and of how to identify abusive practices to ensure that service users are protected at all times. Evidence: The home has a robust complaints policy and procedure. Information on how to make a complaint is displayed in the foyer and is also detailed in the Service User Guide which is in each bedroom. No complaints have been received by the home or by CSCI since the last inspection. Staff spoken to were aware of the procedure to follow in the event of a complaint being made. Staff are given training on the Protection Of Vulnerable Adults (POVA) during their induction and NVQ training. Records are held on the staff files to provide evidence of this. Further POVA has been given to staff and one member of staff spoken to was aware of the action to be taken in the event of abuse being suspected. The home provides comment cards for service users and visitors to the home to complete as they wish. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Hillcrest is clean and fresh and the ongoing programme of redecoration and refurbishment ensures that service users have a pleasant and safe environment in which to live. Evidence: Hillcrest is located on the outskirts of Tyldesley town centre an is close to shops and local amenities and public transport. The home is a converted vicarage and is set in its own grounds. Car parking is available at the front of the home. Two lounges are provided and are decorated and furnished to a high standard and provide a homely environment for the service users. The separate dining room is attractively decorated and furnished and provides a pleasant area where service users can take their meals or spend time if they wish. Service users are accommodated in single or double bedrooms. Privacy screens are provided in shared rooms to protect service users privacy and dignity. Bedrooms are decorated to a good standard and service users are encouraged to personalise their rooms by the provision of pictures, photographs and items of memorabilia. Bedrooms are bright and homely. Care Homes for Older People Page 19 of 27 Evidence: Picture signs have been placed around the home to identify toilets and bathrooms to assist service users with orientation. Some of the bed bases were noted to be in need of replacement and the manager was able to provide evidence that six new beds had been ordered. One specialist bed has been ordered for a service user following a full assessment of that service users needs. Additional bed bases will need to be purchased to replace those that have become stained. Two bedroom carpets were noted to be stained, despite regular cleaning, and the manager explained that the replacement of these had been identified and put on the list of work to be undertaken. Priority should now be given to the replacement of these carpets. A high number of toiletries were observed, both in bedrooms and in communal areas. Toiletries should not be stored in communal areas and each service user should be provided with a receptacle to store these. Some toiletries may present as a risk as some service users are not able to identify what can be ingested. Risk assessments should be undertaken in relation to toiletries and appropriate risk management plans put in place where necessary. Some hairbrushes were seen in communal areas and should be returned to their owners. Hairbrushes were noted to require cleaning or replacing. Service users clothing and linens is carefully laundered on the premises and it was evident that care is taken to ensure that laundered clothes are returned to the correct service user. The home was found to be extremely clean and fresh throughout and there were no unpleasant odours. The gardens are large and the lawn is bordered by plants, trees and shrubs and a gardener is employed to maintain the grounds. The manager explained that consideration is being given to provide a secure area which service users can access without risk. At present, there is no means of ensuring that service users using the garden are prevented from leaving the grounds and getting out on to the road. Care Homes for Older People Page 20 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. The home employs a well trained staff team who are experienced and skilled to meet the individual needs of the service users. Evidence: On the first day of the inspection, the manager was on annual leave. Arrangements were made to visit the home when the manager returned. It was evident, following both visits, that the staff continued to provide the same level of care when the manager was not in the home. The home has a full compliment of staff and the turnover of staff is extremely low, with some of the staff having worked at the home for many years. This has assisted in ensuring that service users are provided with a consistent level of care which is provided by persons that they know. The staffing structure within the home provides a registered manager, care manager, team leader, senior care assistants and care assistants. In addition to this, there are domestic, catering and administration staff. The atmosphere within the home was warm and comfortable. The staff used body language and eye contact when communicating with service users and there were a lot Care Homes for Older People Page 21 of 27 Evidence: of smiles all round. Staff spoken to during the inspection said that they enjoyed working at the home. One member of staff said that she had worked somewhere else prior to working at Hillcrest but had not had the same satisfaction or enjoyment as she had now. The home has a robust recruitment procedure and inspection of the staff files showed that this had been adhered to. All prospective staff are required to complete an application form prior to being called for interview. A record of the interview is held on their files. Checks are made on Criminal Record Bureau and Protection of Vulnerable Adults registers to ensure that the service users are protected. Two references are required to be provided and these were seen on the staffs files. All new staff are required to complete an induction training programme and evidence of this is held. Ongoing training continues for all staff and evidence of training undertaken is held on the staffs files. At present, 76 of the care staff team hold NVQ qualifications. Arrangements are in place for additional staff to obtain NVQ qualifications. A training matrix is held to ensure that training needs and updates can be clearly identified. Staff supervision is given by the manager or the care manager and regular staff meetings are held to discuss care issues and to provide a forum for the dissemination of information. Staff spoken to during the inspection were extremely positive about the home. They were enthusiastic about training and were able to demonstrate that they were fully aware of each service users individual care needs. There were clear lines of communication between the staff with detailed hand-overs given at the beginning of each shift. Care Homes for Older People Page 22 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. The manager has a clear development plan and vision for the home which she has effectively communicated to service users, staff and relatives. Evidence: The registered manager of the home is extremely experienced in managing care homes for older people. She has continued to undertake training to further develop her knowledge and understanding. She holds an NVQ in management at level 4 and was able to demonstrate that further training has continued. The manager has undertaken audits on all aspects of the home and of the care of service users. This ensures that improvements continue to be made to enhance the lives of the service users. The views of service users are obtained on a one to one basis and relatives are spoken to individually as often as possible. Care Homes for Older People Page 23 of 27 Evidence: Small amounts of money are held for service users and comprehensive records are held including receipts for any purchases made on service users behalf. Safety certificates are in place and all were found to be well maintained and up to date. Evidence was seen to demonstrate that all equipment within the home had been checked and approved as safe to use to ensure the protection of service users and staff. Training is given to all staff in the use of equipment. Tests on fire detection equipment have been made and duly recorded as required. Fire drills are undertaken on a regular basis to ensure that staff are aware of the action to be taken. Policies and procedures are reviewed and updated on a regular basis to ensure that changes to legislation and good practice are clearly identified. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 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 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 24 24 The two stained bedroom carpets should be replaced to provide service users with a pleasant and clean bedroom. The programme of refurbishment should ensure that all stained bed bases are replaced to provided service users with a clean and comfortable bed. Dirty hairbrushes should be cleaned or replaced to promote a good standard of hygiene. Toiletries should not be held in communal areas to ensure that service users personal items are not used by others. 3 4 26 26 Care Homes for Older People Page 26 of 27 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). 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