Key inspection report
Care homes for older people
Name: Address: Kirkdale Nursing Home Radcliffe Crescent Teesdale Estate Thornaby Stockton-on-Tees TS17 6BS The quality rating for this care home is:
one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Bassett
Date: 0 6 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People
Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home
Name of care home: Address: Kirkdale Nursing Home Radcliffe Crescent Teesdale Estate Thornaby Stockton-on-Tees TS17 6BS 01642611199 01642618899 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cleveland Alzheimers Residential Centre care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: A maximum of 8 places can be used for people with dementia aged 50 . Date of last inspection Brief description of the care home Kirkdale is a modern, purpose built facility that is registered to provide personal and nursing care to thirty-eight older people with dementia. The home is single storey. The home is divided into two units, Lavender and Rosemary. Each unit has three lounge areas and a link lounge in addition to a dining room. Bathing and toilets are available on each unit. Bedrooms in the home environment are single in nature and meet the required amount of space. Bedrooms do not have en-suite facilities. Externally there are surrounding grounds and a pleasant enclosed garden/seating area for people that use the service. Car parking is available at the home. The home is on a bus route and close to Stockton town centre 1 1 0 5 2 0 0 9 0 Over 65 38 Care Homes for Older People Page 4 of 26 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 quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was a key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Care Quality Commission say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 5 of 26 The inspection was carried out by two inspectors and a pharmacy inspector. An unannounced visit to the home was carried out, the visit lasted a total of seven hours. During this time the inspectors looked at a range of documentation including, service user and staff files. The inspectors spoke to families of people who live at the home, the deputy manager and the manager. The manager of the home completed an Annual Quality Assurance Assessment (AQAA). At the time of the inspection the home was providing services to 38 people. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? Work has been carried out since the last inspection to develop and improve the information contained within plans of care giving greater detail of the care task and how this is to be met. Plans of care were seen to be reviewed and evaluated on a monthly basis as recommended at the previous inspection. Work has been carried out to improve the way staff at the home deal with and record medication. The manager has developed and carries out monthly audits of fire tests, maintenance checks, care plans and medications. Action has been taken since the last inspection to improve the experience for the people living at the home during meal times. The manager told the inspector staff rotas have been altered and hours increased to allow additional staff to be on duty over the lunch time period. One person told the inspector that she is present at most meal times and how things have improved, she said meal times are much better, they really have upped it, staff are coming on duty at 1pm and going straight into the dining room to feed people. Environmental improvements made since the previous inspection include new signage Care Homes for Older People
Page 7 of 26 for toilet doors and the provision of red toilet seats, to aid recognition for people who suffer from dementia promoting increased independence. The lounge in Rosemary unit has been painted and there are ongoing improvements to decor in the bedrooms. A number of memory boxes have been placed on walls outside of bedrooms and themed corridor areas are being developed. A large aquarium has been sited in a lounge area that is accessible to all who live at the home. The home has also been recently awarded a silver medal by Northumbria in bloom for the best kept grounds in a care home. Information on the staff rota indicated the usage of agency staffing has generally decreased, and where agency staff are used it is usually the same staff, promoting consistency of care. Family members who spoke to the inspectors commented there are now more regular staff or if agency regular staff are sent. The inspector saw evidence that fire alarms are tested weekly and hot water temperatures are checked and recorded weekly as required at previous inspections. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 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 26 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. The home has procedures that should ensure that prospective service users have their needs assessed and those needs can be met . Evidence: Information contained in the AQAA indicated before going into Kirkdale people who are to use the service have a care management assessment from Social Services and/or Health. This assessment is forwarded to the home for the Manager to look at to determine if the needs of the person can be met. Staff from the home would then carry out their own assessment. During the visit the inspectors examined the files of four people who live at the home. Two of these people had been recently admitted. Each file contained evidence that a pre admission assessment had been carried out by staff from the home. People who are to use the service and their relatives are welcome to visit the home, have a look round and meet the staff. The home does not provide intermediate care.
Care Homes for Older People Page 10 of 26 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. Care plans used within the home have been improved and contain more detail of the persons health and personal care and how the care is to be met, promoting peoples health and wellbeing. Medication records are generally up to date for each person and medicines received, administered and disposed of are recorded. Evidence: During the visit the inspectors examined the files of four people who live at the home. Each was seen to contain a range of assessment documentation that included a holistic assessment of need, nutritional assessment, moving and handling, falls risk, deprivation of liberties and risk of pressure damage. One file examined by the inspector included information that indicated bed rails were used for this person. The inspector noted a regular audit and examination of bed rails takes place however was not able to evidence a risk assessment that reflected Department of Health Guidance. Work has been carried out since the last inspection to develop and improve the information contained within plans of care. The detail of information varied throughout
Care Homes for Older People Page 11 of 26 Evidence: the care plans. The majority of plans seen contained very detailed information including the persons preferences, the others contained information on the need and basic details of how this was to be met. For example in two files seen by the inspectors there were brief details of dealing with the persons continence needs contained within other care plans. Care plans were seen to be reviewed and evaluated on a monthly basis as required at the previous inspection. A number of files were seen to contain short term care plans in relation to acute health problems, these were seen to be reviewed and evaluated. All files contained daily statements with regard to the persons health and care given. Two of the files seen contained detailed social and family information, one of which was written by a family member. The manager told inspectors this was an area that was being developed and it is hoped to have the information in all files in the near future. Family members who spent time with the inspectors confirmed plans of care had been discussed with them and they had been asked about their relatives likes and dislikes as well as the persons social history. The manager carries out regular audits of care planning and assessment documentation. Families of people who live at Kirkdale told the inspectors they were satisfied with the care their relative receives. Comments included The staff look after xxx very well The staff are very nice, they listen to us Staff acted quickly when xxx was poorly, they looked after her well Does not matter what happens care staff take it on as a matter of course they are very thorough There was clear evidence of the involvement of GPs, District Nurses and other health care professionals such as speech therapy, dentist and chiropodists. Relatives of people living at the home confirmed that if their relative was feeling unwell, the GP would be called. The home employs a physiotherapist who visits fortnightly. There were few administration gaps on the MAR (Medication Administration Record) charts meaning that people living in the home can expect to receive their prescribed medication correctly. Medication for two people were out of stock at the time of the visit. Action was taken by the home to obtain supplies of these medicines and documentation was available to show the actions taken. Controlled drug records were neat and balanced with the stock available. There were people living in the home who were prescribed medication when required or as directed. Guidance about giving this medication was insufficiently clear to ensure such medicines would be given as Care Homes for Older People Page 12 of 26 Evidence: intended. The MAR chart records for prescribed creams were incomplete. Medicines are now stored securely either in locked trolleys or cupboards. The temperature of the medicine storage room and fridges are regularly monitored however recorded fridge temperatures were lower than those recommended by the manufacturer. The medication room now has an air conditioning unit and meets manufacturers guidance. The date of opening is now added to liquid medication and medication with a limited use once open. Care Homes for Older People Page 13 of 26 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. Social and recreational activities take place within the home, however these can be restricted by the availability of care staff. The food at the home is of good quality. Staff are aware of people dietary needs and assist people who require help in such a way as to make them feel comfortable and unhurried. Evidence: Information in the AQAA returned to CQC indicated there is a monthly activities programme which is carried out by the care staff. One relative said they wished there could be more going on for people but understood that some people were to frail to join in and care staff could be busy with other things. The inspectors were told about fortnightly visits by a company called Movement and Motivation. Families spoke of events such as the summer fete, trips out, sing a longs, BBQs and entertainment within the home. All said families are encouraged to visit and get a warm welcome. People spoke of being involved in their relatives daily lives and care given. The inspector observed the lunch time meal in both Lavender and Rosemary units. The lunchtime menu on the day of inspection was pizza, chips, beans or salad, with cheese potato and liquidized vegetables as the pureed diet. Dessert was fruit whip. Action has been taken since the last inspection to improve the experience for the people living at
Care Homes for Older People Page 14 of 26 Evidence: the home. The manager told the inspector staff rotas have been altered and hours increased to allow 2 additional staff to be on duty over the lunch time period. On the day of inspection it was seen there were sufficient staff to meet peoples needs. Staff were seen to sit and feed a maximum of two people at the same table. Staff were seen to give others help and support as required. People can eat in their own rooms if that is preferred. Staff were observed to communicate with people and involve them in the process. Where possible people were asked what choice they wished to have. One relative told the inspector the food was generally of a good standard another person said the food is good quality, if there is something you dont like there are alternatives. Relatives confirmed they had been asked about peoples preferences with diet and these were catered for. For example one relative said staff are very accommodating with food, staff try all sorts to get her to eat. One person told the inspector that she is present at most meal times and how things have improved, she said meal times are much better, they really have upped it, staff are coming on duty at 1pm and going straight into the dining room to feed people. Care Homes for Older People Page 15 of 26 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service and / or their representatives are enabled to express their concerns and have access to a complaints procedure. Adult protection procedures are in place which helps to protect people from abuse. Evidence: Information contained in the AQAA returned to CQC indicated the home has policies and procedures in relation to handling complaints and safeguarding vulnerable adults. Further information indicated there have been no complaints since the previous inspection. Family members who spoke to the inspectors confirmed they were aware of how to raise any concerns. One person said I can go to manager with a concern another person said if something is not quite right we change it. A third person told the inspector I have no complaints, the manager listens and acts on things. Information received by CQC indicates the management of the home has acted appropriately with regard to safeguarding referrals made since the last inspection. Care Homes for Older People Page 16 of 26 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 standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. Evidence: The home is a modern, purpose built facility that is registered to provide personal and nursing care to thirty eight older people with dementia. The home is single storey. The home is divided into two units, Lavender and Rosemary. Each unit has three lounge areas and a link lounge in addition to a dining room. Bathing and toilets are available on each unit. Bedrooms in the home environment are single in nature and meet the required amount of space. Bedrooms do not have en-suite facilities but they do contain a sink. Externally there is a pleasant enclosed garden/seating area for people that use the service. On the day of the inspection the home was found to be clean and odour free. Improvements made since the previous inspection include new signage for toilet doors and the provision of red toilet seats, to aid recognition for people who suffer from dementia promoting increased independence. The lounge in Rosemary unit has been painted and there are ongoing improvements to decor in the bedrooms. A number of memory boxes have been placed on walls outside of bedrooms and themed corridor areas are being developed. A large aquarium has been sited in a lounge area that is accessible to all who live at
Care Homes for Older People Page 17 of 26 Evidence: the home. The home has also been recently awarded a silver medal by Northumbria in bloom for the best kept grounds in a care home. A bathroom in Lavender unit was seen to contain a cracked tile that requires repair. Care Homes for Older People Page 18 of 26 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 homes recruitment procedure is good, which helps to ensure that people are protected. Mandatory training and other training relevant to the job staff do is provided ensuring that staff are knowledgeable and experienced to meet the needs of people using the service. Evidence: During the visit the inspectors examined a total of 10 staff files. Two of these were for people who had recently been recruited. Both contained the required information and documentation including application form, written references, and CRB (Criminal Record Bureau) check. It was noted by the inspector the reference request forms sent out by the home asked people how long they had known that person, but did not ask for specific dates of employment. Training at the home is organized and completed by a training coordinator. The inspectors saw evidence of induction training and further training in relation to food safety, health and safety, fire safety, COSHH (control of substances hazardous to health), moving and handling, and first aid. A number of staff files contained evidence of dementia awareness and prevention of abuse training. The inspectors saw evidence that indicated qualified members of staff have recently completed further training, provided by the dispensing pharmacist in relation to administration of medications. Information in the AQAA returned to CQC indicated 30 staff have completed infection control training and 59 of care staff have achieved NVQ at level 2 or above. The manager told the inspectors a number of staff are
Care Homes for Older People Page 19 of 26 Evidence: undertaking training in relation to the Gold Standard Framework. Inspectors saw evidence that indicated care staff are receiving formal supervision. Clinical supervision and supervised medication rounds are taking place for qualified staff. A staffing rota was seen by the inspector. This showed there was 1 qualified nurse, 4 care assistants plus 1 care assistant giving 1:1 support on Lavender unit during the day. 1 qualified nurse, 4 care assistants plus 2 care assistants giving 1:1 support on Rosemary unit during the day. 1 qualified nurse, 3 care assistants, plus 1 care staff assistant giving 1:1 support overnight. Information on the staff rota also indicated the usage of agency staffing has generally decreased, and where agency staff are used it is usually the same staff, promoting consistency of care. Family members who spoke to the inspectors commented there are now more regular staff or if agency regular staff are sent. Other comments received from family members included Staff can be busy especially at meal times, they could always do with more staff. I think they work hard and are really cheerful people. Nice mixture of staff everyone works together. They do a pretty good job. Care Homes for Older People Page 20 of 26 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 home is generally well managed and run in the best interests of the people who use the service. The health, safety and welfare of people who live at the home and staff is promoted. Evidence: The Manager is a Registered Mental Nurse who has many years of experience working with dementia and people who have mental health problems. The Manager told the inspectors her application for registration was ongoing and is to be resubmitted to the Care Quality Commission. Information in the AQAA returned to CQC indicated both the manager and the deputy manager are working toward NVQ level 4 in management. Further information in the AQAA indicated the home has a range of policies and procedures that should promote the safety and wellbeing of the people who live there. Other information indicated the home and equipment are maintained and checked as required. The inspector saw evidence that fire alarms are tested weekly and hot water temperatures are checked and recorded weekly as required at previous inspections. The manager has developed and carries out monthly audits of fire tests, maintenance
Care Homes for Older People Page 21 of 26 Evidence: checks, care plans and medications. Accidents were seen to be recorded appropriately. The manager stated the home looks after small amounts of money for some people that use the service, appropriate systems are in place, and records are maintained as established at previous inspections. There have been a number of staff and relative meetings held in which the outcomes of the previous inspection and improvements have been discussed. Comments received from family members include, Since the last inspection they have been trying all sorts to improve. The manager is approachable, everything I ask or say will be looked into, she will do her best to help. The manager listens and makes you feel part of the family, the deputy manager is good also. Its team work they all work well. I have no complaints, the manager listens and acts on things. Care Homes for Older People Page 22 of 26 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 23 of 26 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 7 7 Work should continue to document peoples life histories to promote the wellbeing of people living at the home. Risk assessments in relation to the use of bed rails should be developed and reflect Department of Health guidance and information to promote the safety and wellbeing of people living at the home. Work should continue so all care plans contain details of how a need is to be met taking into consideration the persons abilities and preferences to promote the health and wellbeing of people living at the home. The prescriber should be asked to provide information when medication has a dose of as directed or when required. This makes sure that the medication is given correctly. Records of administration for creams should be made after medication is given. This makes sure that an accurate record exists Regular monthly prescriptions should be seen before sending to the pharmacy. This makes sure a check can be made to ensure all medicines required have been listed and
Page 24 of 26 3 7 4 9 5 9 6 9 Care Homes for Older People 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 prevents people being without. 7 12 Consideration should be given to the employment of an activities coordinator to promote both group and individual activities. The cracked bathroom tiling in one bathroom should be repaired or replaced to promote infection control. Consideration should be given to develop employment reference requests to include information to confirm specific dates of previous employment. The manager should continue with her application to be the registered manager of Kirkdale. This will enable the Care Quality Commission to determine fitness to register. 8 9 19 29 10 31 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!
