Inspection on 26/01/09 for St Cecilia

This inspection was carried out on 26th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Cecilia 17/01/08

St Cecilia 19/05/06

St Cecilia 13/03/06

St Cecilia 04/08/05

St Cecilia 31/01/05

St Cecilia 15/07/04

St Cecilia 23/02/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: St Cecilia 29 Nelson Road Branksome Poole Dorset BH12 1ES     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: John Hurley     Date: 2 6 0 1 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 30 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 30 Information about the care home Name of care home: Address: St Cecilia 29 Nelson Road Branksome Poole Dorset BH12 1ES 01202767383 01202767383 st.cecilia29@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Robert John Eshelby care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: One named person (as known by the CSCI) under the age of 65 may be accommodated to receive care. Only independently mobile residents may be accommodated in the second floor rooms. Date of last inspection Brief description of the care home St Cecilia is registered to provide care for up to fifteen older people over 65 years of age with mental health needs. The home is detached and situated in a quiet tree lined residential street. There is easy access to the shops and amenities of Westbourne. Accommodation comprises of six single rooms on the ground floor four of which have en-suite facilities and a further six rooms on the first floor, one of which is a double room and one of which has an ensuite facility. There is a bathroom and WC on both the ground floor and the first floor. The second floor has recently been refurbished and now provides two single bedrooms and a bathroom. There are secluded gardens to the Care Homes for Older People Page 4 of 30 Over 65 15 15 0 0 Brief description of the care home rear of the property and a tarmac drive at the front of the home with trees, shrubs and a seating area. The current level of fees for personal care and accommodation at St Cecilia is 494 pounds based on the local authority rate of payment for care services. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection was undertaken over the course of one day in January 2009 by one inspector. The focus of the inspection was to look at relevant key standards under the Commission for Social Care Inspection ( now the Care Quality Commission) Inspecting for Better Lives 2 Framework.This focuses on outcomes for residents and measures the quality of the service under four headings; these are excellent, good adequate and poor. The judgment descriptors for the seven sections are given in the individual outcome groups and these are collated to give an overall rating for the quality of the service provided. Surveys were sent out to medical and health care professionals, staff and residents. The responses have been collated and are Incorporated into this report. The home completed an Annual Quality Assurance Assessment( AQAA) and information provided in that is also referred to in this report. Care Homes for Older People Page 6 of 30 We looked at three selected care files in detail, the staff files , undertook a tour of the building and looked at all the documentation relevant to the running of a care home. Care Homes for Older People Page 7 of 30 What the care home does well: What has improved since the last inspection? What they could do better: The management need to improve the care plans to ensure they provide sufficient detail of all individual health and social needs to ensure that clear guidance is given to staff. Care plans must be kept under review and updated as necessary to make sure that they reflect peoples current needs and circumstances. Risk assessments to the environment and where appropriate people who live at the home should be undertaken to ensure people are not put at undue risk of harm. Improvements must be made in relation to the administration of medication so as not to put people at risk of harm. The management must ensure that all bedding, linen and towels provided by the home are maintained in good condition. The management must re-establish good infection Care Homes for Older People Page 8 of 30 control practices to ensure the safety of all who live and work at the home. 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 9 of 30 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 30 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 thorough pre-admission procedures that provide information and opportunities to assist the prospective resident when making a decision about moving in. Initial care assessments have enough detail recorded in order to ensure that the home can evidence that they can meet peoples assessed needs. Evidence: We sampled the statement of purpose and service user guide and found these documents to be in good order and generally reflected the services and procedures at the home. The management of the home ensures that arrangements are made to carry out an assessment of need, which in the main is completed prior to any person moving into the home. We looked at a sample of the initial assessment documentation and found Care Homes for Older People Page 11 of 30 Evidence: that key issues had been identified with sufficient detail to enable their individual needs to be met. Care Homes for Older People Page 12 of 30 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. The care planning and review of existing plans needs to continue to improve in order to demonstrate how needs are being met. Medication administration must be improved upon in order to ensure the safe administration of medication to those who use the service. Evidence: We sampled a number of the care plans that had been generated from the original assessments. They contained lots of detail with regards to the individuals who lived at the home but did not illustrate how or what interventions were taking place in order to meet peoples health care needs for example, one persons plan state that they need encouragement to eat and drink but there was no recording in relation to monitoring either fluid or food intake, there was no recording of weight monitoring since admission or no explanation on why this was important. On first entering the home we spoke with a Senior member of staff about care plans and risk assessments relating to a recent admission, they did not know if here were any. Care Homes for Older People Page 13 of 30 Evidence: As the home is registered to care for people with dementia a persons history prior to coming into the home is one of the keys to establishing a successful transition to the home, at least one of the three peoples files did not contain any social history. This person was noticed when looking around the home because their hair was unkempt and would have benefited from a wash. Staff spoken to were clear that the person did not like this to be done. On looking at the persons file it was hard to establish when the last time the person had been offered to be assisted in washing their hair or any mention of the issue. The files contain evidence of regular routine doctors and district nurse visits to the people who live at the home. The people we spoke with confirmed that they considered their health care needs to be met and gave examples of how when feeling unwell they had been supported to get the necessary help. It was noted that all of those files sampled had been regularly reviewed. The reviews did not always illustrate the changing needs of the individuals in areas such as risk assessments following periods of agitation and conflict with others for example, It was noted in one persons documentation that between the 18/11 and 28/ 11 there were three recorded incidents were a person was verbally and physically aggressive. The care plan and associated risk assessments had not been updated to explore these issues. There was no recorded triggers to the behavior and no statements made informing staff how they should work with this person. We looked at the initial assessment were it was briefly noted that the person was aggressive but the associated risk assessment had not been made. At least one other persons file described similar situations to that previously described. Whilst the registered manger was aware of the Mental Capacity Act full assessments had yet to be included in the care planning documentation. It was however reassuring that plans to carry this out had been made. Whilst there are areas where care planning could be improved there are more strengths than weakness in the processs used and so it is considered that the approach to care planning is adequate. We viewed the medication administration recording sheets and noted in there are improvements that can be made. To further improve the management need to ensure that people who use the service have a recorded rationale for the administration of medication via the Per Required Needs (PRN) route. This will ensure that medication is only given under a controlled set of circumstances with boundaries recorded for usage; for example if a person has been prescribed pain relief on a PRN basis for a Care Homes for Older People Page 14 of 30 Evidence: painful back and are now complaining of a painful leg the medication is not administered until such time as a medical practitioner has been consulted. This should ensure that changes to an individuals needs are monitored and addressed in a timely fashion. It was positively noted that some people take control for some of their own medication. Whilst this practice has been risk assessed this needs to be reviewed on a regular basis to ensure the individuals continued safety. We noted that some of the records kept did not accurately reflect the amounts of medication held on the premises. We discussed our observations with the registered manager at the time who agreed to review the medication procedures without delay. Relatives who we spoke with expressed how much they appreciated that the care staff respected peoples privacy and dignity. Our observations at the time found that staff interact positively with those who live at the home. Care Homes for Older People Page 15 of 30 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. The home is flexible in its approach to the provision of activities and meals, enabling people to retain control over their lives wherever possible. The pace of life at the home appears to meet the expectations of the resident group allowing a relaxed way of living. Evidence: People who live at the home and friends are encouraged to visit as often as possible and no restrictions are placed upon them. This was confirmed in discussion with those who use the service, staff and by viewing the Visitors Book. People are encouraged to choose their own lifestyle within the home and make choices wherever possible. These include choosing when to get up or go to bed, what to wear, what to eat or drink. They are able to bring their own possessions into the home to personalize their bedrooms. Individuals confirm that their individual preferences and routines are respected. Care Homes for Older People Page 16 of 30 Evidence: As reported in the personal care section of this report there is some recognition that the home needs to do more to identify more details on care plans such as personal interests. This will allow the home to be able to plan activities based on individuals aspirations and interests. Having said that all of the people observed and spoken to at the home appeared to be happy and well cared for. They themselves told us that they liked the staff and there was enough to do. It was positively noted that people are encouraged to help with the running of the home by way of laying the tables and collecting the dishs following meals. People said that the meals provided were fine or very good and if they did not want what was on the menu for the day they could have an alternative meal. Staff said that special diets such as low sugar or low fat foods were available. Fresh fruit, drinks and snacks were available and people said that some snacks were provided on request . We noted that whilst the staff wore cloth aprons, including the cook, these were either ill fitting and in poor condition with holes in them, this undermines the purpose for wearing them. Care Homes for Older People Page 17 of 30 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. The people who use the service and people important to them consider that their views are listened too and comments made are acted upon. Incidents at the home must be robustly recorded and plans made to address behavior problems in order to ensure that people who live at the home are not at an undue risk. Evidence: St Cecilia has a satisfactory complaints procedure that is displayed in the home as well as included in the Welcome Pack. Those spoken to confirmed that they knew how to make complaints and would feel able to do so should the need arise. No complaints have been made either to the home or to CSCI since the before that last inspection. St Cecilia has a copy of the local authority guidelines on managing and reporting any allegations of abuse or poor practice. Additionally the home has its own policy which informs staff of the appropriate procedures and to refers them to the local authority guidelines. Staff informed us of what needs to be done if there are suspicions of abuse and impressed ass people who would report concerns. As noted in care planning some people at the home have enduring mental health problems that mean in their own individual circumstances they may hit out at staff and others. It is therefore imperative that care plans fully document these actions and Care Homes for Older People Page 18 of 30 Evidence: behaviors along with any triggers to these behaviors to ensure that all of the home are protected. Care Homes for Older People Page 19 of 30 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. The management must ensure that the home is furnished and decorated to a good standard. All towels and bedding must be kept in good condition in order to promote peoples dignity and self respect. Infection control policies and procedures must be adhered to to ensure the safety of all who live and work at the home. Evidence: We toured the premises when we first entered the home inspecting a number of communal areas. It was found that a number of issues noted at the last inspection had been addressed but not all for example; Many of the bedrooms did not have extending cables from the call system box in the room. In many cases people would not be able to summon help from the bed or chair, this was still the case. The lock on the door of the second floor bathroom which was missing had been replaced. Many of the vanity units in the bedroom that were old and damaged had been replaced. Some pieces of bedroom furniture were old and in need of attention to ensure doors/drawers etc closed properly was again still the case. The managers office is outside of the main building. This means that the manager is Care Homes for Older People Page 20 of 30 Evidence: distanced from the day-to-day running of the home and opportunities to observe staff and people who live there are limited. Laundry facilities consist of a domestic washing machine and a domestic tumble drier in an out building. Care staff are responsible for laundry. Clean laundry is sorted on the dining table and ironing is also undertaken by staff in the dining room area of the home. When touring the building we found that the home was generally clean in most areas observed. It was noted that all toilet and bathrooms were found to be clean but contained a number of items that would undermine the infection control policies such as hand and bath towels and creams that were not labeled to identify who they belonged too. One toilet did not have a call bell to summon help if required. The toilet designated for the staff to use had a rubbish bin that was overflowing at 9.30 when we first toured the building, this still being the case at 2.30 in the afternoon. The home provides hotel type services in relation to bedding and towels. It was noted that an unacceptable number of these items were in poor condition and required replacing. The registered manager acknowledged these observations. The chairs in the main dinning room / lounge were showing signs of wear and need to be replaced. Above the sideboard in the dinning area of the lounge it was noted there was a box of latex gloves attained to the wall in a dispenser. This undermines the dignity of those who use the service. We noted that one of the carpets in the communal area was heavily stained and required attention. It was further noted that a number of radiator covers had been removed or were in a dangerous condition for example with screws being to long leaving a sharp point exposed. Not all of those who live at the home had easy access to call bells in their rooms, their was no associated risk assessment in relation to this issue. We quickly toured the garden and found that the handrails that had been installed were not appropriate due to the materials used. These were made of unplanned wood and so poised a risk of splinters. Bedrooms are situated on the ground and first floors, there is a stair lift to the first floor. There is a dining / lounge and also a small conservatory. Aids and equipment are available for people who may have disabilities, to help promote independence. People informed the inspector that they are able to bring personal possessions with Care Homes for Older People Page 21 of 30 Evidence: them into the home. The inspector looked at a sample of the bedrooms used by people who use the service and found that they had been personalized with pictures, furniture and photographs to reflect the individuals taste. People said they enjoyed living at the home and found it to be warm and comfortable. Care Homes for Older People Page 22 of 30 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 staff team are knowledgeable with regards to the needs of the people who use the service. There are sufficient staff on the rota to meet the current needs of the people who live there. Evidence: Staff records were examined for two recently appointed members of staff. Records demonstrated suitable checks had been undertaken prior to staff commencing duties in the home. The staff files that were sampled contained sufficient detail with which to establish the prospective employees suitability for the job. Care staff are responsible for the homes laundry and cleaning as well as providing all the care for residents. Previous inspections have recommended that a cook should be employed to free up care staff time. At the time of the inspection there was a cook on duty to provide the midday meal. Care staff also provide the evening meal although this does not take so much preparation time as it consists of a lighter meal or sandwiches. The files sampled continue to indicate that staff have undertaken mandatory training in areas such as Moving and Handling, Food Hygiene, Infection Control and general vulnerable adults issues. Some staff have also attended various day courses and are undertaking the NVQ Award in Care at varying levels. Care Homes for Older People Page 23 of 30 Evidence: There is evidence that staff have a formal induction into the home and its care practices. Staff stated that they enjoyed working at the home, and received appropriate support. Through discussion with the staff group and by observing the people who use the service it is reasonably clear that the staff team have empathy for the people who live at the home. Induction in accordance with Skills for Care standards had been carried out. Care Homes for Older People Page 24 of 30 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 management team at the service provide good leadership. People live in an adequately managed home with the management and staff team working together to provide a stimulating environment that respects and protected peoples rights. More needs to be done to ensure the safety of those who live and work at the home Evidence: The manager has been in post for a number of years now and has kept their own training up to date. The home is ran with the best interests of those who live there in mind. We were informed that people are consulted about their views on the home on a regular basis. Records on health and safety and COSHH were available. A fire risk assessment for home had been completed and updated. There was records of equipment testing and Care Homes for Older People Page 25 of 30 Evidence: reports of repair where necessary. Accidents and incidents were recorded and the registered manager said that these records were regularly reviewed and audited. There was no written record of the audits carried out or how these accidents had influenced care plans or programmes of maintenance. Care Homes for Older People Page 26 of 30 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 27 of 30 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 7 15 The registered person must ensure that the care plans include sufficient detail to provide clear guidance to staff on the actions to be taken to meet all identified needs. To make sure that all needs are identified and clear guidance for staff is given on how to meet such needs 22/05/2009 2 9 13 The registered person shall make arrangements for the recording, handling, safekeeping,safe administration and disposal of medication. To ensure that people are safe through correct accounting and administration procedures 22/05/2009 Care Homes for Older People Page 28 of 30 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 3 19 23 The registered person shall 09/06/2009 regard to the size of the care home provide adequate furniture bedding and other furnishings To ensure the home remains fit for the purpose of providing care to its client group 4 26 13 The registered person shall 09/06/2009 make suitable arrangements to prevent infection This is to reduce the risk of cross infection in relation to those who live at the home. 5 38 13 The registered person shall that unnecessary risks to health and safety of those who use the service or work at the service are identified and so far as possible eliminated. To ensure the safety of those who live and work at the home 22/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 29 of 30 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 30 of 30 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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