Inspection on 27/08/09 for The Rectory

This inspection was carried out on 27th August 2009.

CQC found this care home to be providing an Excellent service.

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

Other inspections for this house

The Rectory 07/09/07

The Rectory 14/11/06

The Rectory 09/03/06

The Rectory 07/10/05

The Rectory 21/02/05

The Rectory 26/04/04

Extracts from inspection reports are licensed from CQC, this page was updated on 28/03/2010.

Key inspection report Care homes for older people Name: Address: The Rectory 2 Trinity Road Taunton Somerset TA1 3JH     The quality rating for this care home is:   three star excellent 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: Alison Philpott     Date: 2 7 0 8 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 27 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 27 Information about the care home Name of care home: Address: The Rectory 2 Trinity Road Taunton Somerset TA1 3JH 01823324145 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: adam@manerscare.co.uk Maners Care Limited care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is 23 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Dementia (Code DE) Date of last inspection Brief description of the care home The Rectory is a two storey detached property on the outskirts of Taunton town centre. Accommodation is provided over two floors. All bedrooms are single occupancy. A passenger lift, assisted bathroom and call system are provided. There is an accessible garden at the rear of the property. The home is registered with the Care Quality Commission, to provide personal care for up to 23 people who have a dementia. The Registered Manager is Jill Camm and the Registered Provider is Maners Care Ltd. The Rectory has been approved by Somerset Social Services as a special rate care (specialist residential care) home providing enhanced care for people suffering from dementia. The current fee rate is £486.36 per week, this does not include hairdressing, chiropody and toiletries. Care Homes for Older People Page 4 of 27 23 Over 65 0 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was conducted over 7 1/2 hours by one inspector. On the day of the inspection, 23 people were living at the home. Jill Camm, Registered Manager was not on duty but came in for the inspection and was available throughout. We were given unrestricted access to all parts of the home and all records requested for this inspection, were made available to us. We were able to meet with people using the service, staff and a volunteer. The home completed its Annual Quality Assurance Assessment (AQAA) and this was received by the Commission within agreed timescales. The AQAA is a self assessment which focuses on how well outcomes are being met for people using the service. It also provides us with some numerical information. Care Homes for Older People Page 5 of 27 We received completed surveys as follows; two from people who live at the home; seven from relatives; five from staff who work at the home; and seven from social and health care professionals. Extracts have been included in this report where appropriate. The term we, used throughout this report, refers to we the Commission. We would like to thank all involved for their time and cooperation with the inspection process. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. Care Homes for Older People Page 6 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Prescribed creams should be dated on opening and discarded appropriately so that they are used when at their best. Care Homes for Older People Page 7 of 27 The home should seek to obtain a reference from the last employer of new staff. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 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. People receive sufficient information so that they can make an informed decision about the home. The home carries out detailed assessments to ensure that it can meet the individual needs of people before they move in to the home. Evidence: The home told us on the AQAA every resident has an individualised pre-admission assessment by a trained and competent person to ascertain whether the home can meet their individual needs and residents and their relatives are invited to visit the home prior to admission. A relative commented the user guide is good, has lots of information about the home, found it very helpful. People who live at the home and relatives who completed surveys all confirmed that they received enough information to help them decide if the Care Homes for Older People Page 10 of 27 Evidence: home was the right place for them. Placements to the home continue to be made by Somerset Social Services who block purchase all of the beds. The home is able to accommodate one person for short term respite. We looked at the information that the home had obtained about a new person living at the home. The home had carried out a pre admission assessment to identify the persons needs. Information had also been obtained from the placing authority. 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. Care plans look at all areas of the individuals life. People receive personal and healthcare support using a person centred approach. Medication and records relating to medicines are well managed and protect people who live at the home. Staff treat people who live at the home with respect. Evidence: We looked at three care plans. The home has been developing care plans to make them more person centred. These contained a good level of detail about what the person could do independently and support needed, and included peoples preferences. One care plan told us that a person needs support with bathing. The care plan stated level of assistance increasing. Carer to assist. This care plan did not contain the same level of detail for staff to follow as the other care plans viewed. We discussed this with Care Homes for Older People Page 12 of 27 Evidence: the manager who told us that some care plans are still being reviewed and developed. Relatives of people who live at the home told us my relative is well looked after,when my relative was taken ill they could not have been better cared for. When we asked people who completed surveys do you receive the care and support you need?; six people said always and three people said usually. Staff confirmed that they are always given up to date information about the people they support. One person said residents care plans adopt a person centred approach and are evaluated monthly and updated. I find this really good.. We looked at detailed risk assessments relating to behaviour and falls. People have access to a wide range of health care professionals including GP, dentist, chiropodist, optician, occupational therapist, clinical psychologist, and district nurse. Social and health care professionals who completed surveys comments included caters well for individual needs, good communication between the home and health/social care professionals, person centred care is being provided on the whole and the home has in the past worked hard to rehabilitate residents working towards people moving back into independent or sheltered living. When asked what could the service do better, one person commented ensure that action points raised at reviews - such as the need for the dentist - is followed up. We looked at medicines and records. Medicines are stored securely. The home records daily temperatures of the medicine fridge to ensure medicines are stored at a safe temperature. The home uses a monitored dosage system. We looked at Medication Administration Record (MAR) Sheets. These were generally well organised. One MAR Sheet had been written by hand and signed by one person. It is recommended that two signatures are obtained to ensure that the entry is checked to be correct. Some people who live at the home are prescribed creams. We looked at the creams and found a number of creams were not dated on opening. We checked a stock of controlled drugs, these were found to be correct. Where medicines are taken as required, the home has introduced guidance for administration. Some of the protocols viewed were generic. The manager told us the home has started to write individualised protocols and there are plans for everyone receiving as required medicine to have one. The home carries out medication audits to ensure standards are being maintained. Senior staff are commencing a distance learning certificate in managing and safe handling of medicines. Staff will obtain witness statements and be assessed as Care Homes for Older People Page 13 of 27 Evidence: competent to administer medication. We observed good interactions between staff and people who live at the home. It was evident that staff were listening to people and treating people with respect whilst creating a calm, happy atmosphere. Staff were observed knocking on bedroom doors before entering to respect peoples privacy. People looked well and appeared to be relaxed and content. A noticeboard contained information about what does dignity mean to you. 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. The home offers a range of activities for people who live at the home. The meals at the home are balanced and nutritious. Evidence: On the day of the inspection, people were observed reading, having a hand massage, using the laptop computer with staff support, and listening to music. Relatives of people who live at the home told us my relative takes part in some activities of which there are many to interest the residents, there is a lot of activities for the residents and I think over the last couple years there has been more effort on introducing a lot more activities and visits from outside organisations eg donkey visits, musicians and dancing dogs. The day after the inspection, there was to be a singalong with a visiting entertainer. The pat dog now comes to the home once a month. Hand massages and hairdressing are available on a regular basis. The local vicar visits once a month for those who wish to take part in the service. Care Homes for Older People Page 15 of 27 Evidence: Health professionals commented the development of an activities programme has been very successful and involves all residents taking into consideration their needs and abilities. When asked what could the home do better comments included continue to expand the activities.. and would like residents to access local groups or go out of the home more... When staff were asked what could the home do better one person commented arrange more day trips with the service users based on their interests so that they can socialise and participate in community activities. Staff at the home told us there are plans to bring more activities into the home. The local fire service visited the home with crew and engines recently and we looked at photographs of people enjoying this. One person at the home told us how they like to go shopping. People have recently been to the Taunton flower show. The home does not have a minibus, transport is provided by car and taxi vouchers. This means that the home can not always arrange as many outings as they would like to. We looked at a wall of photographs in the dining room called a year in the life of... This was made up of lots of photographs of people who live at the home taking part in activities and events. The home is developing life books for each person who lives at the home to learn more about the person and their interests. We looked at one book which contained photographs and correspondence. The home produces a monthly newsletter that is sent out to relatives. One relative said the newsletters are fantastic, very bright and cheerful and informative. We looked at the August edition which included photographs of activities undertaken such as car washing, forthcoming events, information about staff and the home. The home told us on the AQAA socialising is greatly encouraged within the home, all families and friends are welcome to visit at times to suit their own needs. We offer full use of any of the activities in the activities cupboard to all visitors. Relatives commented on the warm friendly atmosphere. The home holds regular meetings for people who live at the home. This is a social event where people can enjoy a glass of punch. We looked at the minutes of the recent meeting. People discussed planned activities including baking a plum crumble with plums from the garden, new staff, and were asked what do you like about the Care Homes for Older People Page 16 of 27 Evidence: Rectory and what would you change. A health professional commented involving residents and relatives through regular meetings and the development of a newsletter ensures communication is good. The home has a four week menu. We observed lunch being served in the dining room. One person was helping staff to lay the tables and was enjoying this. A choice of beef lasagne or chicken and broccoli bake was available. Staff showed people both dishes so they could pick their preferred dish. The food looked and smelt appetising. One lady had chosen to eat in her bedroom. The homes main meals are frozen foods supplied by Apetito which are heated on site. We asked people if they like the meals at the home; three said always, five said usually and one said sometimes. The home has introduced a seating plan in the dining room to try and match peoples interests and abilities. Further to a request from people who live at the home, the last Friday of every month is fish and chip day. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an open culture that allows people to express their views and concerns. The homes policies relating to abuse and whistleblowing protect people from the risk of harm. Evidence: The home has a complaints procedure in place. People who live at the home knew what to do if they had any concerns. The home has not received any complaints in the past 12 months. The home has a whistleblowing policy which is displayed at the entrance of the home. Staff spoken with knew what to do if they suspected or witnessed abuse. We found that staff recruitment files contained all of the required checks to protect people from risk of abuse. Staff confirmed that checks had been carried out before they started work. The home has had one safeguarding incident. Appropriate action was taken. A health professional said any cause for concern around practice of members of staff is always acted on in a professional manner. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience 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 clean, well maintained, and provides a comfortable environment for the people who live there. Peoples bedrooms are personalised to reflect their individual tastes and interests. Evidence: The Rectory is a large, older building with many charming features including an attractive tiled hall, fireplaces and stained window. The home has 23 bedrooms, most rooms have en suite basins. The home has good communal space with two lounges, and a large dining room. The accommodation is provided over two floors. There is a passenger lift available for access to both floors. Access is mostly level, there are two steps down to some of the bedrooms and people who occupy these rooms would need to be able to manage these. The environment is homely and welcoming. The home provides comfortable furnishings and all areas are well maintained. Relatives of people who live at the home commented clean and pleasant surroundings, and the new decoration of the front room is lovely. The rooms are always clean. A health professional told us the home have worked very hard over the last year or two to provide a homely, stimulating and Care Homes for Older People Page 19 of 27 Evidence: interactive environment. Signs and symbols are used to help orientate people. Bedroom doors have pictures that reflect the persons interests so that they can identify their bedroom more easily. Items from the past such as a typewriter and sewing machine have been placed in the home to prompt memories. We looked at most of the bedrooms. These were nicely personalised to reflect peoples individual interests and tastes. Five of the bedrooms have been redecorated and refurbished. The home has plans for further redecoration. Specialist equipment such as pressure relieving mattresses, call bells, grab rails and mobility aids were available to meet peoples needs. The gardens are well maintained, pleasant, well stocked with shrubs and provide seating areas so that people can enjoy spending time there. We observed that all areas of the home are cleaned to a good standard. The laundry contains a range of commercial washing machines. We observed that liquid soap and paper towels were available in all bathrooms and toilets. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are normally sufficient staff on duty to meet the needs of people who live at the home. People who live at the home benefit from having caring, skilled and trained staff. The homes recruitment procedures protect people from risk of harm. Evidence: We looked at rotas. Four staff are on duty in the morning; three staff are on duty in the afternoon and two staff are on duty overnight. On the day of the inspection, the deputy manager was working with three care staff and the homes volunteer. We asked people who live at the home are staff available when you need them; six said always and three said usually. One person who lives at the home told us could do with extra staff at times when busy. We asked staff are there enough staff to meet the individual needs of all the people who use the service; three said always and two said usually. One member of staff commented employ more staff to perform other tasks such as laundry and in the kitchen (for longer periods) so that care staff have adequate time to care and support service users in daily activities. The home told us that they have applied for funding for additional staff in these areas. Care Homes for Older People Page 21 of 27 Evidence: The home also employs housekeeping staff, a handyman who works three days a week, and catering staff. People told us the staff are most friendly and helpful, and staff are always kind and happy. One person who volunteers at the home is taking on the role of care ambassador with Care Focus. In this role, they will raise awareness of the care industry. The home is also joining a local network of homes to enable them to share good practice and provide support to each other. We looked at four staff recruitment files. These contained all of the required information and checks. One applicant had provided two personal references despite having a recent employer. The home should seek to obtain a reference from the last employer of new staff. We spoke with a new member of staff who confirmed that they had undertaken an induction when starting work at the home. Staff who completed surveys told us that their induction covered everything they needed to know. Comments from staff included staff work together as a team to meet individual care needs. Staff are provided with constant training and access to NVQs and distance learning. The home has a staff training matrix. Training is provided in fire; manual handling; abuse awareness; infection control; food hygiene; medicines; life stories; mental capacity and deprivation of liberty safeguards. The home told us on the AQAA established greater links with outside agencies to access further training eg NHS partnership, social services, Care Focus, Train to Gain, Strode College. Seven staff have recently completed an appointed persons first aid course. The manager is booked to attend care planning for managers with Somerset County Council in October 2009. Eight staff have recently completed a qualification in dementia care awareness. All of the staff have completed NVQs at level 2 or above. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at this home benefit from an open and transparent management ethos that takes their views and opinions into account regarding the day-to-day running of the service. Effective quality assurance systems are in place. The homes health & safety policies and procedures protect peoples health, safety and welfare. Evidence: Jill Camm is the registered manager. She is a registered nurse and has many years experience of working in the care industry. Jill has completed a certificate in management studies, mental health certificate and the A1 assessors award. She has a good knowledge of the people who live at the home and has made improvements and identified areas for further improvement to benefit people. Care Homes for Older People Page 23 of 27 Evidence: The home has recently appointed a deputy manager to provide support to the manager. The deputy manager has worked at the home previously and was enthusiastic about returning to the home. People told us that the management at the home is open and approachable. A relative commented commend the manager for her knowledge and care. Staff commented the management are all very supportive and approachable. Health professionals told us the management strives to be a good role model. The manager empowers her staff and leads by example and the care home manager is always approachable and if there are any problems identified, communication is always effective between the home and the care manager and residents family. The home sends out questionnaires annually to monitor quality. A relative said the home seems to be working very hard to improve things all the time. They often ask if there is anything more they can do. We looked at health & safety records and checks for fire systems; electrical installation; gas safety, portable appliance testing and lifting equipment. These were all up-to-date. The home checks water temperatures on a regular basis. Chemicals were stored securely. The home has a fire risk assessment and emergency evacuation plan in place. Arrangements have been made for emergency shelter and food. The home has achieved a four star quality rating for the kitchen. We looked at accident records. The home carries out a monthly accident analysis to help them to identify trends and look for ways to minimise occurrences. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Prescribed creams should be dated on opening and discarded appropriately so that they are used when at their best. The home should seek to obtain a reference from the last employer of new staff. 2 29 Care Homes for Older People Page 26 of 27 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 27 of 27 - 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!