Inspection on 18/02/09 for Rose Cottage

This inspection was carried out on 18th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rose Cottage 10/07/06

Rose Cottage 02/02/06

Rose Cottage 09/02/05

Rose Cottage 04/08/04

Rose Cottage 03/02/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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: Rose Cottage 99a High Street Woodford Kettering Northants NN14 4HE     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: Kathy Jones     Date: 1 8 0 2 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Rose Cottage 99a High Street Woodford Kettering Northants NN14 4HE 01832735417 Telephone number: Fax number: Email address: Provider web address: info@rosecottagewoodford.co.uk Name of registered provider(s): Type of registration: Number of places registered: Mr Richard John McLoughlin care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The Home will limit its services to the following service user categories: No person falling within the category Older Persons (OP) can be admitted where there are already 8 persons of category OP already in the Home. The total number of service users in the Home must not exceed 8. Date of last inspection Brief description of the care home Rose Cottage is registered to provide personal care and support to up to 8 older people over the age of 65 who require such personal care and support due to their old age. Community health care professionals provide all health care needs. The home is located in a quiet residential area in the village of Woodford. It is an extended detached property offering ground floor accommodation in single bedrooms all with ensuite facilities. Care Homes for Older People Page 4 of 27 Over 65 8 0 Brief description of the care home The home has two lounges and a dining area adjacent to the kitchen, and there is a well-maintained and attractive garden with pleasant patio area that is fully accessible to Service Users. The registered owner and manager live on site, on the first floor of the registered home, and the adjoining adjacent property. The weekly fee is £430.00 with chiropody, hairdressing and daily newspapers are at an additional cost. 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: The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. Key standards under the National Minimum Standards (NMS) were inspected during the course of the inspection. The Commission for Social Care Inspection (CSCI) focus on these standards as they are considered to be the standards, which have a particular impact on the health and welfare and outcomes for people who use the service. This inspection was unannounced and carried out by one regulation inspector over the period of a day. On this occasion the inspection took place on a weekday. Judgments reached within each outcome area in the report were reached as a result of drawing together information from a range of sources such as, the reviewing of care Care Homes for Older People Page 6 of 27 plans and other care records including medication records, complaints records and written and verbal communications with the registered provider and registered manager. We found that people were able to communicate their views about their experiences and the care and support provided. During the inspection all of the eight people who are currently using the service were offered the opportunity to speak with the inspector. We spoke with one person individually and five as a group. This information formed the basis of our judgments. To support the information we received, we case tracked one person who uses the service which involved sample checking care records (care plans) held at the service in relation to their health, safety and welfare. In addition general observations of care practices were made and discussions took place with visitors and staff to help us gain an insight into peoples experiences. During this inspection four visitors were asked if they wished to speak with the inspector, all said they didnt feel it was necessary as they had no concerns. We did speak briefly with two visitors who confirmed they were very happy with the care. Staff files were sample checked to evaluate how the service ensures people are protected through their staff recruitment, training and support and development programmes. Feedback on the inspection findings was discussed with the person in charge throughout the inspection. 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.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 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 9 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. The admission process helps to ensure that peoples needs and expectations can be met once they have moved in. Evidence: An important part of choosing a home is having access to information. We found that information about the home and the services provided is available in a statement of purpose and service user guide. The documents had just been reviewed in December 2008 so were kept up to date. We did advise that the name and address of the regulatory authority requires alteration as a result of changes. Further changes will occur in April 2009 when regulatory responsibilities transfer to the Care Quality Commission requiring further revision. Details of the current fees were included within the service user guide and we were informed that everyone is charged the same rate. This helps people to arrange and plan their finances. A copy of the most recent inspection report was also available in Care Homes for Older People Page 10 of 27 Evidence: the foyer which helps people to see what we have found through our inspections. We spoke with people during the inspection about choosing the home, people couldnt recall exactly how the decisions had been made but said that they were happy with the choice. We looked at the records for someone who uses the service and found that an assessment of their needs had been carried out before they moved to Rose Cottage. The assessment clearly identified daily living activities that the person could manage independently and those where help may be required. Information was also gathered about the persons medical history. There was sufficient information within the assessment to enable the manager to make a decision as to whether the persons care needs could be met, helping to avoid any unecessary moves for the person. Intermediate care is not provided at Rose Cottage, therefore this standard was not assessed. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive a good standard of care which meets their needs and helps them maintain some independence. Evidence: People spoken with were happy with the care and support that they received with most saying they very pleased with it. People told us that most of them are fairly independent and just need a little help. Peoples desire to maintain as much independence as possible is respected and this is reflected in their plans of care. The care plans are clear about tasks that people require some help with and are sufficiently detailed to be a working tool for a new member of staff, though most people currently living at Rose Cottage are also quite able to ask for help if needed. The care plans are based on peoples individual needs and preferences and include information about any health and care needs, preferences in relation to routines and diet and any religious and cultural needs. Information is requested about peoples personal and life history to help staff to understand people as individuals, however peoples right not to give this information is respected. There was evidence that staff Care Homes for Older People Page 12 of 27 Evidence: take note of the information people have given them. For example someone had said they find a particular drink helps if they feel unwell. Daily information records show that this was provided at such a time. Everyone living at Rose Cottage at the time of the inspection was able to mobilise independently with the aid in some cases of a walking frame. We looked at the care records for someone who had a falls risk assessment on file and noted that they had the occasional fall. Although the risk assessment was in place there was no care plan to guide staff in how to move the person should they fall. Discussion with staff identified that currently there are two people who are at risk of falls. There is no movement and handling equipment provided in the home to assist staff with safely moving the person from the floor which potentially puts them and staff at risk of injury. Staff advised that in the event of someone falling another member of staff is called in and people are helped to help themselves up. Staff advised that movement and handling training was scheduled to take place in the home shortly after the inspection. Advice has been given to contact the trainer to ensure that the training is going to be around the specific needs of the people who live at Rose Cottage now and may in the future and also to seek advice regarding movement and handling plans and necessary equipment. Records show that people have access to health care services such as the General Practitioner, District Nurse, Optician and dentist. We noted that staff had taken someone to the doctor on the morning of the inspection as they had noted a change in condition and later made arrangements for a check at the hospital on the General Practitioners advice. Staff were reassuring and people spoken with confirmed they make arrangements for people to receive medical treatment promptly if someone is unwell. Good systems are in place for recording medication received, administered and disposed off. We checked a sample of the medication against the records and found that the correct number of tablets were in stock indicating that the medication was being given as prescribed. Medication is kept in a locked cabinet with controlled drugs kept in a locked safe. Since the last inspection legislation has changed increasing the requirements for the storage of controlled drugs. Advice needs to be sought and storage which complies with the current legislation needs to be provided. We noted that people are given the option of administering some or all of their own medication. It is important that people have this option to help them maintain their independence as long as possible. We did advise that a more detailed risk assessment Care Homes for Older People Page 13 of 27 Evidence: is put in place which identifies what each medication is prescribed for and symptoms that may be displayed if people are taking too little or too much. This will help staff to be aware of any difficulties people are having in the event of changes in their physical or mental health and enable them to provide appropriate support. People spoken with during the inspection confirmed that staff treat them with dignity and respect. We observed staff to knock on peoples doors before entering their rooms and most people were able to recall that staff do this all the time. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are happy with their daily lives and are able to have some choice and control in respect of how they spend their time. Evidence: Peoples preferences in relation to daily routines such as the time they like to get up and go to bed, where and how they like their meals is detailed in their care plans and their choices are respected. At the time of the inspection three people preferred to stay in their rooms. The other five spend most of their time together and valued the friendship and companionship that had developed between them, though said if they wanted some peace and quiet or to watch a different channel on television they would go to their rooms for a while. We spoke with one person who stays in their room and is happy with their own company. They told us that someone who is linked with the local library brings a selection of books on a regular basis which is appreciated. We spoke with five people about the activities provided and asked specifically about some things mentioned in the annual quality assurance self assessment. It was identified through discussion that although the internet is available, this particular group of people arent interested in accessing it. However this may be useful and welcomed by people in the future and it Care Homes for Older People Page 15 of 27 Evidence: is positive that different things are tried. We were told that people enjoy the organist who visits regularly and also the church services. There was generally a fairly vibrant atmosphere in the home with lots of conversation and some laughter. During the day visitors arrived which people seemed to appreciate and because the home is small they tended to talk with everyone rather than just their relative. This benefits those without regular visitors. People do have the option to have a visit in private if they wish. Relatives spoken with were very positive about the home and care provided, arrangements for visiting were relatively flexible and visitors were made welcome. There is a small dining area, next to the kitchen which allows conversation with staff as they dish up the meals. Tables were attractively laid with flowers on the table and the weeks menu was available. We noted that there was no choice of main meal on the menu. When we discussed this with people who use the service, they all said that this is never a problem as they like all the meals and felt sure that they could have something different if they didnt for any reason. A staff member advised that people who use the service are involved in choosing the menu. Someone told us that they have a vegetarian menu and that given there are several foods that vegetarians would rely on that they dont eat, staff manage to provide a reasonable variety. We noted that care plans identified what people liked for breakfast and how they liked it served. For example someone liked a tray with tea, a glass of water, toast with the crusts cut off and a port of marmalade and butter. This attention to detail is important in peoples daily lives. Staff advised that people all have a choice of tea and often up to five different things are prepared. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Concerns and complaints are listened to and taken seriously which helps to safeguard people who use the service. Evidence: The Commission for Social Care Inspection have received no complaints about Rose Cottage. People spoken with during the inspection said that they felt able to raise any concerns they might have with staff, though most couldnt recall having the need to, and were keen to point out that they had no concerns and were very happy in the home. A book is kept where issues raised by people who use the service are recorded. Review of a sample of the entries identifies that most of these are minor grumbles and that they had been dealt with appropriately. Details of the complaint procedure are available in the statement of purpose and there is also a copy on the wall in the entrance hall. A poster produced by Northamptonshire County Council about how to report abuse of vulnerable adults was prominently displayed on a notice board in the dining room. Discussion with staff and a samplecheck of records confirmed that staff have received training in safeguarding vulnerable people from abuse. This helps to safeguard people who use the service. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained home which provides a cosy and comfortable environment. Evidence: Rose Cottage is a small care home catering for up to eight people who are all independently mobile. All rooms are single and have en-suite toilets with wash basins. There is a shared lounge, dining room and bathroom. The entrance hall provides some additional seating with access to a computer if this is required. We spent time with people who use the service in the lounge and dining room and visited someone in their room. All areas were warm, pleasantly decorated and comfortably furnished. People told us that they are able to spend time with each other if they wish but also to have some privacy in their rooms. There is a patio area at the front of the house and staff advised that the owner had just purchased new outdoor furniture ready for use when the better weather arrives. People who use the service told us that they enjoy being outside in the warmer weather. There is a small shared bathroom which contains showering facilities. These facilities consist of a shower chair which swivels over a half sized bath where people are Care Homes for Older People Page 18 of 27 Evidence: showered. Staff confirmed that these arrangements meet the current needs of people. We noticed a lock on the door of the room of someone who uses the service which is of a type that can be locked from either side of the door and requires the use of a key to unlock it. In discussion with the occupier of the room they confirmed that when the lock had been fitted it was to ensure their privacy and they had been provided with a key to the room, however as time has gone by it is no longer used. It is important that peoples privacy is respected and that they are able to lock their rooms if they wish. Advice has been given to consider the suitability of the locks used, to help ensure that people can lock and release the lock easily from the inside and also that staff can access the room in an emergency. We noted that the lighting was poor in one small area where the corridor from the dining area to the bedroom area meets. Additional lighting in this area would reduce the risk to people whose sight may be deteriorating. All areas of the home seen during the inspection were very clean and tidy and people who use the service confirmed that this is always the case. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a small stable staff team who receive training and work flexibly to meet peoples needs. Evidence: There is quite a small staff team who appear to work flexibly to support people who use the service. There is normally only one member of staff on duty who is responsible for the provision of care and also cooks the meals. People who use the service advised that they are mostly relatively independent and need minimal assistance from staff, which was confirmed through discussion with staff. We discussed arrangements for situations where people were poorly and needed more help, fell or needed to be escorted to hospital. Staff advised that the manager and owner live on the premises and are available most of the time and if not two members of staff live in the village and provide back up support to each other in an emergency. At the time of the inspection the manager was away for a few days. Additional staff cover was arranged to take someone to the General Practitioner due to a health concern and then later for a hospital appointment with no adverse effects on people who use the service. These arrangements seem to work well at present as there is a stable staff team who live locally and are willing and able to be flexible. Certificates were available to confirm staff training. A sample check of certificates for Care Homes for Older People Page 20 of 27 Evidence: one member of staff confirmed that they had achieved a National Vocational Qualification at level 3 which help to provide an understanding of the needs of older people and care practices. Other training undertaken within the last year included management of medication, food safety, fire safety, movement and handling, safeguarding of vulnerable adults, falls and fractures and first aid. This helps to ensure that staff have the knowledge and skills to meet the needs of the people in their care. We discussed the need for staff to keep up to date with new guidance and legislation such as the Mental Capacity Act 2005 and Deprivation of Liberty safeguards. Following the inspection we have been informed that the manager and a member of staff are due to attend this training. No new staff have been employed since 2006. We looked at the recruitment process on two staff files and found that criminal record bureau checks had been undertaken and references obtained which helps to safeguard people who use the service. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Rose Cottage is well managed and the views of people who use the service are taken into account. Evidence: There is an experienced registered manager in post who holds the National Vocational Qualification level 4 (NVQ 4) in management and also the Registered Managers Award. People who use the service are happy with the way Rose Cottage is managed and when five people were asked during the inspection what could be done to improve the service, they said there was nothing and that they were happy with how things are. Questionnaires about the quality of care and services provided are sent out annually to people who use the service and their families. Information was collated and suggestions listened to and taken into account. Advice was given to consider obtaining feedback from other people involved in the service Care Homes for Older People Page 22 of 27 Evidence: such as General Practitioners and District Nurses. There was also evidence that people have opportunities to express their views on the service provided and the care they receive more frequently. This is through involvement with their individual care plans, helping to devise menus and meetings. People spoken with felt they wouldnt need to wait to be asked for their views if there was anything concerning them. Small amounts of money are held for people who request this, to assist with payment of services such as chiropody and hairdressing. Signed records are kept to support the transactions made, helping to provide some safeguards. Staff receive training in safe working practices such as fire safety, food safety and movement and handling and have also received first aid training. There was evidence that they receive regular updated training in these areas. At the time of the inspection there was no movement and handling equipment. As identified in the health and personal care section of the report, everyone at that time was independently mobile, however as some are at risk of falls and records show that there have been falls, we advised that the need for equipment is reviewed to ensure that people are assisted safely and in accordance with movement and handling regulations. This is to reduce the risk of injury to people who use the service and staff. We were told that movement and handling training was due to take place shortly after the inspection and advised that this would be a good opportunity to look at equipment to meet the specific needs of people currently living at Rose Cottage, bearing in mind that peoples needs may change. Care Homes for Older People Page 23 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 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 13 Safe systems for movement and handling must be implemented for people following a fall, which include provision of movement and handling plans and equipment To reduce the risk of injury to people who use the service and staff. 15/04/2009 2 9 13 Storage arrangements for controlled drugs must comply with current legislation. To meet legislative requirements and keep medication safe. 01/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 A more detailed risk assessment should be implemented for Page 25 of 27 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 people who self administer medication. This should identify the reason for the medication and alert staff to any symptoms which may indicate too much or too little has been taken. 2 24 Doors to peoples private accommodation should be fitted with locks that suit their capabilities and are accessible to staff in an emergency. Additional lighting should be provided in the area where the corridor from the dining room and that to the bedroom meet to reduce the risk of injury. 3 25 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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