Inspection on 19/05/09 for Swan House

This inspection was carried out on 19th May 2009.

CQC 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

Swan House 20/05/08

Swan House 06/11/07

Swan House 03/04/07

Swan House 24/04/06

Swan House 12/08/05

Swan House 12/04/05

Swan House 25/10/04

Swan House 01/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Swan House 47 - 49 New Road Chatteris Cambridgeshire PE16 6EX     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: Elaine Boismier     Date: 1 9 0 5 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 28 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 28 Information about the care home Name of care home: Address: Swan House 47 - 49 New Road Chatteris Cambridgeshire PE16 6EX 01354696644 01354696645 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons Homes (No 4) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) care home 40 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 40 40 25 old age, not falling within any other category physical disability terminally ill Additional conditions: No more than 25 nursing places only 0 0 0 No more than 25 places for terminally ill residents over 65 years of age (TI(E)) only Date of last inspection Brief description of the care home Our last key uannounced inspection took place on the 20th May 2008.Swan House, close to the centre of the town of Chatteris, is a care home registered to provide care, including nursing care, for people over 65 years of age. There are 40 single bedrooms and 39 of these have ensuite facilities. Six bathrooms are also available in the home. The home is arranged on two floors that offer bedroom accommodation, dining room areas and a choice of sitting rooms. The upper floor can be reached via stairs or a lift. There is a small garden at the back of the home. Current fees range from £347 to Care Homes for Older People Page 4 of 28 Brief description of the care home £589 and additional costs include hairdressing, chiropody, newspapers and toiletries. Further information about fees should be available from the home. A copy of the inspection report is available at the home or, alternatively from our CQC website at www.cqc.org.uk. Please note that although this inspection report is that of the former regulation and inspection authority, the Commission for Social Care Inspection (CSCI), the CSCI transferred its powers over to the Care Quality Commission (CQC) on the 1st April 2009. Care Homes for Older People Page 5 of 28 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: On the 14th April 2009 we carried out an Annual Service Review (ASR) of the home. We looked at the Annual Quality Assurance Assessment (AQAA) and results of the surveys from staff (5), residents (4) and a relative. We concluded, from our ASR, that we would bring the next key unannounced inspection forward from 2010 to the 19th May 2009. We, The Care Quality Commission (CQC) carried out this key unannounced inspection, by two Inspectors, between 9:55 and 16:25 taking 6 hours to complete. We looked around the premises, watched what was happening in the home,spoke with some of the residents and some of the staff and examined some of the records. We case tracked two of the residents which means we spoke with them and compared their records with what we saw and heard. Care Homes for Older People Page 6 of 28 For the purpose of this report the people who live at Swan House are referred to as people, person, resident or residents. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 8 of 28 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 28 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 28 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. People have a good standard of information to help them in their decision where to live. Evidence: All of the residents surveys said that the person had received enough information about the home before they moved in. As part of our case tracking we asked the two people to tell us how they first learned about the home before they moved in. Both of them said that their relatives visited the home, on their behalf, and following these visits the person moved in. Their care records contained their pre-admission assessments and these had been completed by care managers from local authorities and hospitals. The Manager told us that although the home offers rehabilitation and hospital avoidance admission services it is unclear whether the home provides intermediate Care Homes for Older People Page 11 of 28 Evidence: care, as defined by the Department of Health. Due to this lack of clarity we have taken a view, on this occasion, that Standard 6 is not applicable although we suggest that the registered provider reviews this part of the care and the service provided. Care Homes for Older People Page 12 of 28 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. There are some risks to the heath and welfare of some of the residents. Evidence: As part of our case tracking we spoke with two of the people, in their rooms, and compared what we saw and heard with their care plans. The care plans that we saw provided guidance for the staff that was none-person centred, sometimes inaccurate and sometimes there was no guidance. The care plans indicated that there was a lack of the peoples social histories. For example one of the people told us about their family, their work history and their friends although none of this was recorded in the persons care plan and for the staff to build on this information as part of forming a relationship with the person and recognising their individuality. We noted that the person had some difficulties in remembering and became agitated with this difficulty. The Manager agreed that the person had such difficulties although there was no care plan for the staff in how to help the person with this area of care. For the care plan for the management of the persons diabetes there was detailed information for the staff in how to assess a change in the persons blood sugars although this was of a general Care Homes for Older People Page 13 of 28 Evidence: nature, rather than specific to what physical and behavioral signs the person presented with during such episodes. The care plan also told us that the person was on a diabetic diet and that the kitchen staff were to be informed about such a diet. The persons nutrition assessment stated the person was to be on a normal diet. We saw the person when eating their meal and their food was the same as other residents. We spoke with the kitchen staff and looked at the record of the meal that the person had been offered. Evidence from this indicated that the person was on a normal diet. The care plan for the management of diabetes also said that the person was to have their blood sugars tested each day although the blood sugar records indicated that the blood sugars might not have been taken on the 1st ,3rd,7th,9th,13th,15th and 16th May 2009 as there were no recorded entries for these days. There was no change in the care plan to tell the staff there had been a change of how often the persons blood sugar should be tested. There was no detail about how the person was to have their insulin injection (the staff and the Manager explained how the person was supported in giving their own insulin injection); there was no risk assessment for such activity and there was no care plan guidance to inform the staff in how and where the person was to have their insulin injections in different sites of their body.The staff acknowledged that they would not know what part of their body the person was to give their injection of insulin, if the staff had not been on duty on the previous occasion. We saw that the person had been referred, and seen, by a community psychiatric nurse. The Manager told us that this was due to a change in the persons behaviour: there was no care plan for such a change and how the staff were to manage and support the person with such a change. For the second person, who had been admitted following a fall, there was no risk assessment for falls. Their admission assessment contained the persons personal details such as their name and address but there was no other information recorded within this document. The person explained to us that they had pain in their groin as a result of the fall and this was recorded on a body map. There was monitoring of the persons pain and how and what affected the level of their pain. The care plan indicated, however that the person had pain, not in their groin area but in their right hip. Their care plan was suggestive for a person with long term care needs, rather than rehabilitation needs. For example we read that they were to be encouraged wherever possible with their care. We found no evidence of targets for the person to rehabilitate to; we found no information about the persons home environment, where they were intending to move back to (to ensure that the home was suitable and the person was safe to move back there). We found that the person received domiciliary care and support from their family although there were no details as to what this care and support contained. The person said that they did not know when they were to go home as no target dates were set. We found no evidence that the people were actively consulted about their care plans. We have made no requirement on this occasion, as Care Homes for Older People Page 14 of 28 Evidence: we have found no direct ill-effect experienced by the people, although we expect the home to ensure that the people are protected by accurate and complete care records. All of the four residents surveys and the relatives survey said that the person always or usually received the care and support, including medical support, that they needed. One of these surveys said I am happy with the care I am receiving. The two people we spoke with, as part of our case tracking, said that they were happy being at Swan House and they told us that they had been seen by general practitioners, a physiotherapist and a chiropodist. The peoples care records also told us that the people had access to hearing aid and hospital services and diabetes specialist nurses. According to the Manager no current resident had a pressure sore. Although a member of staff and a staff survey said that sometimes they had to cut corners when giving residents their personal care, we noted that those people we spoke with and saw had clean hair and finger nails and were wearing clean clothes. We looked at the practices and procedures for the safe use, handling and recording of medicines. Medicines are stored securely for the protection of residents in controlledtemperature conditions which maintains the quality of medicines in use. We looked at the medication records for several residents and in general these were of a good standard. Records are made when medicines are received into the home but it was sometimes difficult to clearly account for all medicines in use in the home as the stock balance of medication left over from the previous month is not always recorded and when people refuse to take their medicines once the medication has been removed from its container there are not always records made that it is disposed of. One persons medication record had not been filled in correctly to show that they had been given their medicines as prescribed and for another person who injects his insulin himself, the record did not clearly show the actions of the care staff. So these records do not always fully account for medication in the home and do not always demonstrate that people receive their medication as prescribed. We have made requirement about this. We watched medicines being given to some residents at lunchtime and this was done with regard to their dignity and personal choice. Although we saw one of the staff going into a persons room before knocking (the person was in their room) we saw no other infringements of privacy and dignity of the people. We saw other staff knock on the peoples doors and we saw that the staff interacted with the people in an appropriate manner. The people we spoke with said that the staff were OK. One of the residents surveys said The staff have a pleasing mix of professionalism, politeness and open-hearted warmth. All very genuine too. A residents survey said that The staff are excellent as is the Manager. Care Homes for Older People Page 15 of 28 Care Homes for Older People Page 16 of 28 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 have opportunities to live a good quality of life. Evidence: Two of the four residents surveys said the home always provided suitable activities that the person could take part in whereas the remaining two residents surveys said that the home sometimes provided such activities. One of these last two surveys went on to say ...I would love to see more exercise classes (1 per week?) and more craft activities. I was expecting a daily activity, I must admit. The activities are of a good standard... In the morning we saw some of the residents playing cards within a group and the Manager and staff told us that in the afternoon the activities co-ordinator was providing hand and nail care to some of the people who were unable to leave their rooms. The people we spoke with, as part of our case tracking, said that they preferred to be alone, rather than join in any of the activities. Reports of monthly visits, made by a representative of the registered owner, were seen for visits carried out during March and April 2009 and these said that the home provided excellent activities and supported this view to say that the home had activities and celebrations for Easter, St Georges Day and raising money for Red Nose Day. The home continues to provide information about forthcoming events, with the newsletter The Trumpet Care Homes for Older People Page 17 of 28 Evidence: and copies of this were seen around the home. The Manager stated that a member of the staff has taken the responsibility to provide activities during the weekends and we saw a notice, for visitors, about this. We found no record of what activities were provided and what the people chose or otherwise, to take part in and the Manager was aware of this lack of recording. We expect the home to improve such recording. The bedrooms that we visited and looked in had personal items such as photographs and ornaments. We saw some of the people receiving their guests and the people we spoke with said that they had visits from their families. All of the four residents surveys said the person always or usually liked their meals.One of these surveys said The variety is good, there is plenty to eat. Those people we spoke with gave a range of views about the food from It is very good; there is always plenty to eat to Its alright to facial expressions of dislike. One of the people said that they had enjoyed egg and bacon for their breakfast. We saw the staff offering people choices of what they would like to eat and drink, including a glass of wine. We saw also that where people needed help with their food the staff were sitting down to help. We saw, during this time, that opportunities for the staff to engage with the person in a 1:1 activity were missed, such as talking to them. We saw some of the people who were able to feed themselves had some difficulty with getting their food onto their cutlery as there were no plate guards provided. One of these people, who had the use of one hand only, said that they found it difficult sometimes to eat their food and we saw that their food was falling off the side of their plate. We expect the home to improve this area in order to promote the dignity of the residents when eating their food.We saw that the menus offered two choices at lunch and tea time although there was no record of what vegetables were to be offered. We expect the home to improve the menus. Care Homes for Older People Page 18 of 28 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 are listened to and are safe from the risk of abuse. Evidence: We have received no complaints about the home and the record of complaints and the AQAA confirmed that the home has received no formal complaints. All of the four residents surveys said that the staff listened and acted on what the person said to them and that they would know who to speak to if they were unhappy about something. All of the four residents surveys and those surveys from the staff and a relative said that the person knew what to do if someone wanted to make a complaint against the home. We have received no allegations of abuse against any of the residents and this was confirmed by the AQAA. The staff training records indicated that the staff have attended training in safeguarding vulnerable people and the staff that we spoke with told us what they would do if they witnessed or suspected abuse against any of the residents had taken place. Currently there were no contact numbers for the safeguarding agencies, such as the police and social services: the Manager said that she would provide such information for any person working at and visiting the home. Care Homes for Older People Page 19 of 28 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 clean and safe place that could be homelier. Evidence: We looked around the premises, including the outside and garden areas. We found the home to have a relaxed atmosphere and this was also noted in both of the monthly reports, for March and April 2009, written by a visiting representative of the registered owner. The home has been provided with a new assisted bath and there have been some replacement of carpets. The records indicated that there is an ongoing redecorating programme and according to the Manager there has been a review of the bathing facilities within the home, as currently there are no shower facilities. We found that there were some areas that could be made more homely and tidier: some of the bathrooms had boxes of disposable gloves in view and in one there were some unused incontinence pads. On top of a toilet cistern we saw a plastic jug with For urine only written on it. The inner courtyard area had flower and herb beds and garden furniture. We noted that within the herb bed a hosepipe and watering can had been left lying among the plants; weeds were also present. Care Homes for Older People Page 20 of 28 Evidence: In August 2008 we received a notification that told us a number of the residents had acquired a skin infection and that infection control measures were implemented to reduce the spread of this infection to other people. The home was clean and free of offensive smells. All of the four residents surveys said the home was always or usually clean and fresh. One of these surveys went on to say Some urine smells but inevitable we think. Care Homes for Older People Page 21 of 28 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. People are generally in safe hands. Evidence: According to the Manager there has been an increase in the number of care staff to meet the increased number and increased needs of the residents. Some of the staff said that there was always enough staff on duty although some of the staff felt that, due to the needs of the residents, sometimes they were unable to provide the care that they would like to give. We were told that sometimes people did not have a full wash each day and sometimes the staff do not have the time to sit and talk with the people. We timed the response to residents call bells and this was less than two minutes. According to the staff and the Manager there has been a reduction in the use of agency staff and that the team of staff has become more stable. The home has 20 care staff of which 9 have the National Vocational Qualification (NVQ) level 2 or equivalent in care i.e. 45 : this Standard has therefore not been met. We looked at three of the staffs recruitment files and we found that all the required information was available in the first two files. We found in the third file there was all the required information with the exception of an unexplained gap in the persons Care Homes for Older People Page 22 of 28 Evidence: employment history between March 2002 and April 2004. We have made no requirement on this occasion as we expect the home to manage this issue. We received five surveys from the staff and all of these said that the person was satisfied with their induction training and ongoing training. The staff told us that they have attended induction training and ongoing training and we found from the training records that staff have had opportunities to attend training in topics such as infection control, medication, care planning and record keeping and care of someone with continence difficulties. Care Homes for Older People Page 23 of 28 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. People benefit from a well-managed home Evidence: The Manager, a Registered General Nurse, who has the Registered Managers Award, has been managing Swan House since October 2007 when Swan House was assessed to be providing poor quality outcomes for the residents. Under her management the home has improved and those improvements have, on the whole, been sustained for the home to be assessed as having good quality outcomes for the residents. She is supported by a deputy manager who is also a Registered General Nurse. We saw copies of monthly reports made by a representative of the registered owner, for visits to the home during March and April 2009, and these contained views of residents and the staff and audits of areas such as the environment. Records of quality assurance audits, dated February 2009, were seen and these included reviews of care records, the environment and health and safety matters. The AQAA was completed in Care Homes for Older People Page 24 of 28 Evidence: an adequate manner and it identified areas that the home does well in, where it has improved in and areas that action is intended to be taken to improve other areas. The home does not keep any residents personal monies although there are records kept on file and on the data base of individual residents monies coming in and monies going out. We saw that these records were satisfactory. Although the AQAA was not completed when we first asked for it we received a completed part of the AQAA, in response to our draft ASR report. The information provided told us that service checks were in date for equipment such as fire detection and fire fighting and equipment for moving and handling the residents. On the day we were at the home portable electrical appliance equipment was being tested. The staff told us that they had attended fire safety training and training in safe moving and handling and first aid and the staff training records confirmed that this was the case. Fire alarms and emergency light tests were recorded as being carried out weekly and monthly respectively with the last tests being carried out on the 8th May 2009. A fire drill had been carried out in January 2009 with 16 members of staff attending. We saw individual records of temperatures of hot water for when people had had a bath and these records showed that the hot water was delivered at a safe level. In 2009 the Environmental Health Officer awarded the homes kitchen four stars for its food hygiene and cleanliness. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 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 9 13 Clear records must be kept 15/07/2009 to account for all medicines in use and records made when medicines are given to people must be accurate and complete. This will ensure medication fully accounted for and demonstrate people receive the medicines prescribed for them. 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 27 of 28 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. Care Homes for Older People Page 28 of 28 - 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!