Inspection on 25/03/09 for Thistlegate House

This inspection was carried out on 25th March 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 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thistlegate House 13/02/08

Thistlegate House 20/08/07

Thistlegate House 13/02/07

Thistlegate House 01/06/06

Thistlegate House 30/01/06

Thistlegate House 29/06/05

Thistlegate House 01/10/04

Thistlegate House 16/06/04

Thistlegate House 05/03/04

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Queensmount

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Didsbury Court Rest Home

Belma

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Thistlegate House Axminster Road Charmouth Dorset DT6 6BY     The quality rating for this care home is:   one star adequate 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: Sally Murphy     Date: 2 5 0 3 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 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) 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 30 Information about the care home Name of care home: Address: Thistlegate House Axminster Road Charmouth Dorset DT6 6BY 01297560569 01297560569 thistlegatehouse@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr John A Corney,Mrs June P Webb care home 18 Number of places (if applicable): Under 65 Over 65 18 old age, not falling within any other category Additional conditions: 0 One named person (as known to CSCI) in the category DE(E) may be accommodated to receive care. One of the following rooms may be used as a double at any one time: 4, 15, 17, 27, 28, or 31 Date of last inspection Brief description of the care home Mr J Corney and Mrs J Webb have owned and managed Thistlegate House, a Grade II listed building since 1994. The home has an elevated south facing position with views across the countryside and Lyme Regis bay and stands in four acres of grounds, consisting of a sunken garden, landscaped garden, kitchen garden as well as an area of natural woodland. Thistlegate House is located on the outskirts of the village of Charmouth, which is approximately 2 miles from the coastal resort of Lyme Regis. The home is registered to accommodate and provide personal care for up to 18 older people. Accommodation comprises 17 bedrooms, mainly for single occupancy on both the ground and first floor. The home has a large lounge, dining room and five Care Homes for Older People Page 4 of 30 Brief description of the care home bathrooms with additional WCs. One single bedroom and one double bedroom have ensuite WC facilities. There is no passenger lift in the home, however residents who have difficulty with the stairs are assisted by the staff using a Stairmatic chair, (this is a portable chair that can move up and down stairs and can also be used to assist residents with poor mobility around the home and out into the garden). At the time of the inspection the fees for the home range from 475 to 525 pounds per week. Current Inspection reports are available and the home has a colour brochure, Statement of Purpose and Service User Guide providing information on the services and facilities available. 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: This inspection was unannounced and was completed by two Inspectors over one day. Prior to the inspection the registered providers returned the Annual Quality Assurance Assessments (AQAA). Comment cards (surveys) were also sent to people living at the home, and visiting health and social care professionals. Information contained within these have been included within the report. During the inspection we talked with people living at the home, staff members, and the registered persons. Records relating to care, medication, staff training and recruitment and health and safety were examined. We also conducted a tour of the premises. The term we is used throughout this report to show that this is the view of the Care Homes for Older People Page 6 of 30 Commission for Social Care Inspection. What the care home does well: What has improved since the last inspection? Since the last inspection communal areas have been refurbished. The registered persons advised that they plan to update bathrooms and establish additional car parking. Care records had been reviewed and a moving and handling assessment had been completed for each person. All hand written entries on medication records and been checked and signed by a second person to confirm that the entry was correct. The Registered Managers have attended training on Adult Protection, Adult Protection Guidance for Managers, Dementia care, the Mental Capacity Act, and the Deprivation of Liberties. Guards have been fitted to all radiators to address the risk of scalding. The registered persons have both completed the Registered Manager Award since the last inspection. Care Homes for Older People Page 8 of 30 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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. People are provided with appropriate information to make and informed decision regarding admission to the home. Assessments are undertaken prior to admission to ensure that the home will be able to meet peoples needs. Evidence: The home has a Statement of Purpose and Service User Guide that provide information on the services and facilities available at the home. Care records were examined for two people who were recently admitted to the home. These included evidence of assessments being completed prior to people moving in, to ensure that the home would be able to meet their need. The registered persons advised that they had received a number of inquiries from people requiring care for Care Homes for Older People Page 11 of 30 Evidence: relatives who have dementia care needs, and had to decline these as the home is not able to cater for this type of need. Within the surveys received from people living at the home, four people stated that they had received a contract and two that they had not. Written contracts were seen for two people. These included appropriate information on fees, any notice periods required, and outlined the terms and conditions of residency at the home. These had been signed by both the resident and the registered providers. 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. Care plans generally provide staff with appropriate guidance to enable them to meet peoples needs. Risk assessments should be completed in relation to nutritional, pressure sore and self medication so that possible areas of risk are identified and measures put in place to address these. People confirmed that staff treat them with dignity and respect. Evidence: Care plans are maintained for each person. Three care plans were examined in detail during this inspection. Those records seen provided information on peoples needs and preferences. Care plans included information on personal care, health and sensory needs. A moving and handling assessment had been completed for each person. Within the surveys sent by CSCI people were asked Do you receive the care and support you need? to which four people responded always, one usually and one sometimes. One person wrote that the home provides a very personal and attentive Care Homes for Older People Page 13 of 30 Evidence: level of care. The home does not complete nutritional or pressure risk assessments for each person. Due to the increased dependency needs of people entering care homes, these should now be completed on admission, then at regular intervals monitor any changes that may warrant referral to health care professionals. One person living at the home has pressure relieving equipment provided. The home maintains a record of meals taken for all people, however the use of nutritional assessments would better inform the plans of care for people identified as being at high risk of poor nutrition. People living at the home are weighed on a monthly basis. It was found that the weights for all people living at the home had been recorded together on the same document. This practice does not comply with data protection legislation and does not easily allow staff to track any gains or losses in weight. Care plans included records of professionals visits. There was clear guidance regarding one person who has their blood sugar levels tested by staff at the home, including the procedure they are to follow and the normal limits for that person. During the inspection we were able to speak with one visiting health care professional. They provided positive feedback regarding the care provided at the home. Medication records were examined. It was found that these had been appropriately maintained. There were no gaps in recording and handwritten entries had been witnessed and signed by a second staff member as correct. Medication records included a photograph of the person. On the day of inspectin all medication had been stored securely. We were advised that a Controlled Drugs cabinet had been ordered. This will be re-assessed at the next inspection. Controlled Drugs records had generally been maintained in the CD registered and signed by two people, however there were two instances where liquid Temazepam and tablet Temazepam had not been stored in line with Controlled medication or signed by two staff members. The home has a medication policy. This includes guidance on use of the monitored dose system self medication and refused medications. The policy must be updated to include information on the administration of eye drops, ear drops and external creams. The home has a policy on the administration of homely medicines. An appropriate risk assessments had not been completed for the one person living at the home who self administers their medication. The person receiving the medication Care Homes for Older People Page 14 of 30 Evidence: had signed the medication record, but there was no record of the procedures in place to monitor and review their self medication. Medication is transported around the home in a large bag. The home should review this practice to give consideration to how medication may be stored securely should staff have to respond quickly in the event of an emergency, such as someone suffering a fall or becoming unwell within the home. Within the AQAA it states that our clients are treated with the utmost respect and courtesy with their dignity being protected at all times. During the inspection staff were observed knocking on doors before entering and interaction between staff and people living at the home was respectful. Those people spoken with during the inspection confirmed that people treat them with dignity and respect. 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. People are provided with assistance to meet their social needs. Meals are nutritious and provide a well balanced diet. Evidence: Within the surveys sent to people living at the home we asked Are there activities to take part in? to which five people responded sometimes and one person usually. During the two weeks prior to the inspection there had been visits from the Hairdresser, a joint birthday party, exercise session and a service held by local clergy. The registered providers advised that the library visits the home and that people are able to access the gardens. Within 3 of the 4 surveys received from staff members, there were comments stating that activity provision is an area that they felt could be improved. Within the Statement of Purpose information is provided on the Dorset Advocacy Service. All of the people who returned surveys to CSCI confirmed that staff do listen and act on what they say. Care Homes for Older People Page 16 of 30 Evidence: We spoke with people living at the home about the meals provided. They told us that there is always a choice and that they enjoy the food. However two people told us they would like to have more fresh fruit, and this was discussed with the registered providers at the time of our visit. On the day we visited the meal was well presented and people living at the home confirmed that that it was very enjoyable. One person had chosen an alternative and this had been provided. The Cook demonstrated a good knowledge of individuals dietary needs and preferences. They advised that all meals and cakes are home made and that vegetables are provided from the homes kitchen garden. 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. People confirmed that they are able to raise any concerns and feel that these would be acted upon. The home has appropriate procedures in place with regard to the protection of vulnerable adults. Evidence: The home has a complaints procedure. There have been no complaints received by the home or CSCI since the last inspection. Within the surveys returned by people living at the home, all respondents confirmed that they would know who to speak to if they were not happy and were aware of how to make a complaint. People spoken with during the inspection advised that they would speak with the manager or that staff would see to it. All of the people who returned surveys stated that staff do listen and act on what they say. The registered managers have attended training on Adult Protection, Adult Protection guidance for Managers, Dementia care, the Mental Capacity Act and the Deprivation of Liberties. They advised that the home has a policy regarding the protection of vulnerable adults, however this could not be located during the inspection. This has been forwarded to the Commission following the inspection. The home must ensure that people working at the home have access to appropriate procedures on the Care Homes for Older People Page 18 of 30 Evidence: protection of vulnerable people. The home has a whistle blowing policy, that includes details of external agencies such as CSCI which staff may contact. 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. Communal areas and bedrooms have been decorated and furnished to a high standard. The kitchen and laundry areas require attention to ensure that they meet current standards and promote the health and safety of people living and working at the home. Evidence: The home is set within large landscaped gardens. Communal areas comprise of a lounge which has sea views and a dining room. The home is decorated and furnished to a high standard in the arts and crafts style. There is a call system available at the home. Bedrooms are arranged on the ground and first floors. There is a mechanical aid to assist people to transfer between floors and to manage further steps within the property. Those bedrooms seen had been personalized to reflect individual tastes and preferences. Two bedrooms have en suite toilet facilities and the remainder have toilets located nearby. Whilst talking with one person it was noted that they did not have access to a call bell Care Homes for Older People Page 20 of 30 Evidence: as the lead didnt reach to their chair. Therefore they would not have any means of summoning assistance. Staff told us that they regularly check on this person, however they should be provided with a call bell to promote their Independence and well being. One bathroom on the ground floor had been used as a storage area to keep walking frames and other aids. There were some cleaning chemicals within this bathroom. All baths had green marks close to the taps. The registered persons advised that these are deposits from the homes private water supply. Within the AQAA the providers advised that they plan to update the bathroom facilities and add some further en suite bathrooms. Hand washing facilities consisting of liquid soap and paper towels had been fitted in bathrooms and toilets. Tablets of soap and toiletries were found in some bathrooms, these may pose a risk of cross infection and should be removed from communal areas. Waste bins should also be foot operated. Hot water temperatures were tested and found to be within appropriate limits. Risk assessments have been completed in relation to window openings not being restricted. Since the last inspection radiator covers have been fitted throughout the home. The home had recently had an inspection by an Environmental Health Officer. This had resulted in a number of legal requirements relating to food storage, cleanliness and the decorative state of the kitchen. It was found that some of the requirements relating to cleanliness had not been addressed. This was discussed with the providers at the time of our visit, who advised that they had advised staff of the tasks to be undertaken and that they planned to replace kitchen unit doors and worktops and undertake general decoration of the walls and ceiling to address the requirements made by as a result of the environmental health inspection. The laundry is situated in an outbuilding. This requires some attention to ensure that hygiene standards can be maintained. This includes the provision of a waterproof floor that can be thoroughly cleaned. The homes infection control advises that soiled items should be soaked. This practice poses a risk of cross infection and must be ceased. The provision of alginate bags was discussed with the manager. Care Homes for Older People Page 21 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. People living at the home are supported by a well motivated and stable staff team. The registered persons must ensure that staff receive regular updates in mandatory training so that they may safely meet peoples needs. Evidence: Duty rotas are maintained. There are generally three staff on duty throughout the day, in addition to the registered persons and a Cook. There is one waking member of staff at night and the registered persons provide on call support. Within the surveys sent to people living at the home we asked Are staff available when you need them? to which five people answered always, and one person that this was usually the case. Staff confirmed that with the present number of people living at the home that they dont feel rushed, and that staff work together as a team. Care staff also undertake cleaning tasks as part of their role. Recruitment records were examined for three staff members. It was found that a POVA first check, CRB disclosure and two references had been obtained prior to each of them commencing work. However some employment history records were incomplete. For one person the reference stated that the person had previously worked within the care Care Homes for Older People Page 22 of 30 Evidence: industry but this was not evidenced within their application form. The registered persons must ensure that a full employment history is obtained and any gaps in employment investigated and recorded. Staff training records were examined. All staff had received training on moving and handling and fire safety. All staff had received training on the Protection of Vulnerable Adults and the Mental Capacity Act. Newly appointed staff are provided with Induction training and appropriate records are maintained. Of the eleven care staff employed, three already hold the NVQ level 2 qualification or above and a further five are studying toward NVQ level 3. Care Homes for Older People Page 23 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. People living at the home confirmed that they providers are approachable and that their views are listened to. The home has generally taken appropriate action to promote the health and safety of people living at the home. The registered providers have not notified CSCI of significant events affecting the home. Evidence: The registered persons have both completed the Registered Managers Award since the last inspection. They both live on the premises and are available within the home each day. Questionnaires have also been sent to people living at the home and relatives and their responses audited to provide feedback on the service provided. Care Homes for Older People Page 24 of 30 Evidence: The registration certificate had been displayed in the hallway. Both pages should be visible so that people may see both the number of places and types of need that the home is registered to provide care for. The employers liability insurance certificate displayed in the hallway expired on 13/11/08. The registered persons have subsequently forwarded a copy of the updated certificate to CSCI. The registered persons confirmed that they do not assist anyone at the home in managing their finances. Fire records were examined and it was found that equipment had been tested and serviced as required. Servicing records for electrical equipment, and lifting aids had been appropriately maintained. Only three staff members have current training in First Aid. The home must complete a risk assessment in relation to the level of first aid training required and take action as appropriate. As previously described within Environment, some cleaning fluids had not been stored securely. Since the last inspection two people had passed away, but these had not been notified to CSCI. The registered persons must ensure that CSCI is notified of any significant events affecting the home, in accordance with Regulation 37 of the Care Home Regulations 2001. Care Homes for Older People Page 25 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 26 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 8 17 The arrangements for recording peoples weights must be reviewed. This is to ensure that the records comply with data protection legislation and so that changes in weight may be easily identified. 15/05/2009 2 9 13 The medication policy must be updated to include information on the administration of eye drops, ear drops and external creams. Controlled Drugs must be stored in accordance with legislation and appropriate records maintained. For those people who self medication a risk assessment must be completed and procedures put in place to monitor and review this practice. 15/05/2009 Care Homes for Older People Page 27 of 30 This is required to ensure that medication is stored, administered and managed safely. 3 19 23 Work must be undertaken within kitchen. This is to meet the requirements from the inspection by the Environmental Health Officer. 4 22 23 People living at the home must have access to a call bell to summon assistance. This is to promote their independence and ensure that they are able to alert staff if needed. 5 26 13 Infection control practice and procedures within the home must be reviewed and any necessary action taken. This is required to reduce the risk of cross infection within the home. 6 37 37 CSCI must be notified of any 15/05/2009 significant events affecting people living at the home. . 7 38 13 Hazardous substaces must be stored securely. To ensure the safety of people at the home. 15/05/2009 30/06/2009 15/05/2009 30/10/2009 Care Homes for Older People Page 28 of 30 8 38 18 The registered persons must 26/06/2009 complete a risk assessment in relation to the need for first aid training and take action as necessary. This is required to ensure people receive appropriate support in the event of an accident. 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 The home should review the arrangements for transporting medication to give consideration to how this may be stored securely should staff have to respond quickly in the event of an emergency within the home. A full employment history should be obtained and any gaps in employment investigated and recorded. 2 29 Care Homes for Older People Page 29 of 30 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 © (2010) 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 30 of 30 - 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!