Inspection on 07/12/09 for Victoria Lodge Care Home

This inspection was carried out on 7th December 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Victoria Lodge Care Home 10/02/10

Victoria Lodge Care Home 18/11/09

Victoria Lodge Care Home 04/08/09

Victoria Lodge Care Home 25/06/08

Victoria Lodge Care Home 03/12/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 15/03/2010.

Random inspection report Care homes for older people Name: Address: Victoria Lodge Care Home Bent Street Brierley Hill West Midlands DY5 1RB zero star poor service 05/08/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jean Edwards Date: 2 9 1 2 2 0 0 9 Information about the care home Name of care home: Address: Victoria Lodge Care Home Bent Street Brierley Hill West Midlands DY5 1RB 01384572567 0138479658 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) : Select Health Care Limited care home 61 Number of places (if applicable): Under 65 Over 65 0 61 dementia old age, not falling within any other category Conditions of registration: 61 0 The maximum number of service users to be accommodated is 61. The registered person may provide personal care (with nursing - Code N) and accommodation for service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: - Old age, not falling within any other category (OP 61); Dementia (DE 61) Date of last inspection Brief description of the care home Victoria Lodge, a purpose built home was opened in the summer of 2007. It is registered to provide personal and nursing care to people who have dementia and people who have other care needs associated with old age. It can accommodate a maximum of 61 people at any one time. The home is located near to Brierley Hill High Street with easy access to main bus routes and a range of shops and other amenities. Care Homes for Older People Page 2 of 18 0 5 0 8 2 0 0 9 Brief description of the care home The premises consist of three separate floors, with dementia care provided on the first floor and nursing care provided on the second floor. Each floor has communal areas, a dining room and lounge, bathrooms and toilets. All bedrooms are single occupancy with en-suite facilities. There are hoists and pressure relieving equipment available. A passenger lift provides assisted access to all floors. There is a main kitchen and small kitchenettes on each floor. There are also laundry facilities. The small garden areas are accessible to people using wheelchairs. Care Homes for Older People Page 3 of 18 What we found: We, the Care quality Commission (CQC) undertook three random inspection visits during December 2009 to monitor requirements issued at the key unannounced inspection in August 2009 relating to the safety and well being of people living at the home. The service received a poor, zero star quality rating as a result of our key inspection and had failed to demonstrate the required improvements at a random inspection in November 2009. The home had Statutory Regulation Notices served in 2008 for breaches of the Care Homes Regulations 2001 and although some improvements were made in 2008, these have not been consistently maintained. The home has a history of considerable management instability; six managers in the short time the home has been operating. The acting manager, who commenced employment in January 2009, left her post without notice following our second inspection visit in December 2009. The series of random inspections were unannounced, which meant the home was not given notice of our visits. A pharmacist inspector spent nine hours at the first inspection, a team of three inspectors and a local area manager spent eleven hours at the second inspection and an inspector and area manager spent ten hours at the home at the third inspection. We looked at aspects of the medication systems, care records, the systems for dealing with complaints and safeguarding people, staffing arrangements, staff recruitment, management arrangements and the homes quality audits and improvement plan. We also looked at how people were supported and given assistance to meet their daily needs. We talked with people living at the home, staff and visitors. At the key inspection on 5 August 2009 we issued a requirement that each person must have appropriate and accurate care plans, risk assessments and health care screening assessments to maintain their health and well being. The organisation provided us with an improvement plan, which told us compliance would be in place, within the timescale identified. At the random inspection on 18 November 2009 the acting manager told us that the organisation had employed a consultant on a part time basis to re-write all of the care plans, with the involvement of each person, their relatives or representatives and staff. She explained that this was a slow and time consuming process, which also included mentoring the staff, so that they had a good understanding and could continue to develop care plans when the consultant had completed the work. At the random inspection on 18 November 2009 we looked at some newly completed records, which were comprehensive and person centered. From our observations of people in the home, they generally looked well presented and dressed appropriately for the weather and to maintain their dignity. At that time we received varied views from relatives. Some were positive, for example they told us that people living in the home were kept clean and dressed appropriately. Others made reference to changes in staffing arrangements and staff shortages. This meant staff did not know peoples needs and often staff had to think on their feet to respond to challenging situations. They also commented on the mix of acutely frail people and very mobile people with dementia on the nursing unit, all with diverse needs, making it difficult for staff to provide care and supervision. Care Homes for Older People Page 4 of 18 At the random inspection on 18 November 2009 the management had failed to put care plans in place for the use of as and when needed (PRN) medication for everyone prescribed this type of medicine. At the follow up random inspection visits on 7 and 9 December 2009 we saw examples where this failure had not been rectified. We also saw that some people with infections, such as urinary tract infections, did not have short term care plans to give staff guidance for additional care and medication to be provided. At the inspection visit on 9 December 2009 we saw that a person recently admitted to the ground floor unit, following surgery for a fractured femur, did not have care plans and monitoring arrangements in place to assure their recovery. This person was not able to sleep comfortably in bed and was spending the majority of time in an armchair, resulting in a swollen, painful leg. The staff we spoke to had not monitored this persons condition or referred the symptoms to healthcare professionals for advice or treatment. Staff told us that the person would not be provided with a footstool to elevate their leg because of their funding arrangements. This persons condition had deteriorated since admission to the home and medical advice had not been sought, putting their health at risk. At the inspection visit on 9 December 2009 we saw that a person on the first floor dementia unit had undergone total knee replacement surgery. There was no reassessment of the risks or changes to their needs on readmission to the home. There were no care plans relating to the aftercare required, or for pain relief or exercise treatment regime, as prescribed by the physiotherapist. We saw daily information records dated 27 October 2009 X came out of hospital 2 pm, Physio came and showed us what exercises to do and recommended we did them hourly. The staff spoken to were unable to tell us how often the exercises should have been carried out. We spoke to a relative who told us that it was the family who made sure the exercises were done regularly, when they visited. They told us that they did not believe staff assisted with the exercise programme, with the exception of one member of staff on occasions. The person should have used a footstool to elevate the affected leg and the daily progress recorded stated that the persons son would provide the footstool. A relative disputed this information and told us that they were unaware of this and the footstool had not been provided by them. They told us that there was only one footstool on the unit and it was rarely available. Therefore the leg was not generally elevated. At the random inspection on 18 November 2009 we saw that no action was taken when a person had episodes of severe diarrhoea and poor appetite. At the inspection visit on 9 December 2009 we saw similar information in another persons daily records stating severe diarrhoea and poor appetite, again with no follow up actions taken. At previous inspections the management could not show us monitoring and management strategies for people described as having agitated, aggressive or other challenging behaviours. At the inspection on 9 December 2009, though there were some challenging behaviour charts, some records of incidents were incomplete. The charts did not record the use of risk management strategies or administration medication and there was no evaluation. We saw a care plan, for someone with dementia, described as being physically resistant to intervention when being assisted with personal care. The care plan stated, There will be times when 2 care staff will be required to assist X. At all times X will be encouraged to assist with the procedure. However X can be physically aggressive then 2nd care staff member will gently hold her hands to prevent any injury Care Homes for Older People Page 5 of 18 occurring to the staff. The care plan dealing with problems stated, If all fails then give Lorazepam. These instructions to use physical restraint had not been discussed with professionals to be in the persons best interests and were not adequate as a plan to administer as and when needed antipsychotic PRN medication. We saw daily records and challenging behaviour charts, with daily entries describing the person biting, scratching, hitting staff but there was no evidence of referral for advice from health and social care professionals to make decisions in this persons best interests. We had received information from a family that their relative at the home was unwell. They were concerned about the care and lack of medication and had taken the person to hospital, where he was admitted and treated for serious conditions. We referred this matter to the Local Authority as a safeguarding alert. At the inspection on 7 December 2009 a CQC pharmacist inspector checked compliance with the requirements relating to medication. We looked at medication storage, some care records and medication administration records. We spoke to staff and the acting manager. Due to concerns found in medicine and healthcare management we undertook a second unannounced inspection on 9 December 2009 when we saw further evidence that the health and well being of people living in the home were at serious risk of harm. Medicines were not always given to people safely and securely. For example, on 7 December 2009 we saw that medicines were being given unsafely. On arrival on the second floor, the nursing unit, we saw a nurse placing medicines for various people into medicine tots and placing them all into a basket. We saw five medicine tots in the basket. Each medicine tot had a piece of paper inside with the name of a person written on it. This practice was called secondary dispensing. This was unsafe practice that could potentially cause drug errors placing people using the service at risk of harm. At previous inspection were found that medicines were not stored at temperatures in accordance with manufacturers instructions. At the inspection visit on 7 December 2009 this had improved and we saw that the storage temperatures of medicines were being monitored each day and it was possible to ensure that medicines were being stored at the correct temperature. We saw that the service had installed new air conditioning units for the first and second floors. We saw records for the room temperature on the second floor, which was between 21 to 25 degrees C. This is within the safe storage temperature for medicines. We looked at the temperature records available for the refrigerator. Medication requiring refrigeration should be stored between two to eight degrees centigrade. We saw that the records documented temperatures between three to five degrees C. This meant that it was possible to ensure that peoples medication was being stored within the recommended temperature ranges. At the inspection visit on 7 December 2009 prescribed medication was not available to administer according to the directions of a doctor. We saw that four people had not been given their prescribed medication as prescribed. For example, we saw a MAR chart for an identified person for a liquid medicine to be given twice a day for emphysema, a chronic breathing condition resulting in severe shortness of breath. On 7 December 2009 we found that the medicine was about to run out and there was enough available for two more doses. There was no more medicine available in the home. When we returned on 9 December 2009 we found that the medicine was not available to give to the person. The Care Homes for Older People Page 6 of 18 medicine had not been given for two doses. We were informed by a senior member of staff that nobody had informed a doctor that the person was without their prescribed medication for emphysema. This meant that the person was at risk of increased shortness of breath and therefore was at risk of harm. Information relating to medication to be given when required was not always available. For example, we looked at two care plans for people who were prescribed medication used to treat anxiety and agitation when required that can cause sedation and drowsiness. The first care plan we looked at did not include a protocol for the administration of the when required tablets. The tablet was prescribed as one to be taken when required up to twice a day. We looked at the MAR chart for the person and saw that the tablet had been given at 2200 hours on 11 November 2009. The second care plan we looked at did not include a protocol for the administration of two prescribed medicines, which caused drowsiness. One medicine was an antipsychotic and the second medicine was a sedative. We were concerned that two medicines were prescribed with no agreed protocols available to inform staff when the medicines should be given. We spoke to the senior carer who told us that the medicines would be given when the person became mithered but could not distinguish between the two different medicines. We looked at the MAR chart and saw that both medicines were signed as being given on various dates and on one occasion that both medicines had been given on the same day. This means that due to a lack of protocols with regard to when required medication people were at increased risk of harm. At the inspection visits in December 2009 we discussed our serious concerns about the continued failures to plan, monitor and make appropriate provision for each persons health and personal care with the management of the service. We had previously highlighted that the improved care plans would not be effective unless there were actions taken as peoples needs changed. We were seriously concerned that staff on each unit were failing to recognise when peoples needs changed or when they showed signs of deterioration. This meant that assessments, advice and treatment were not sought in a timely way, posing risks to peoples health and well being. We copied documentary evidence, which may be used in enforcement action. We served two Statutory Requirement Notices on the organisation in relation to the health and welfare of people living at the home, which included the administration of each persons medication. These were used as part of enforcement action to secure improvements and keep people safe. The organisations improvement plan submitted to us in October 2009 had given assurances of compliance with the requirement to ensure staff were appropriately trained, competent and would diligently follow safeguarding procedures. In November 2009 we saw evidence of an incident of abusive behaviour between two people living at the home. At that time the acting manager told us that the unit manager on the nursing unit had not reported the incident to her. She acknowledged that no Regulation 37 notification had been submitted to us and no referral had been made to the Local Authority to be considered under the safeguarding remit. At the inspection on 9 December 2009 we saw daily progress records and challenging behaviour charts with two recorded incidents of physically abusive behaviour between people living at the home; and one complaint from a son, which read, X complained about Y hitting his mom and pestering her. The record also indicated another relative Care Homes for Older People Page 7 of 18 had made sure her bedroom door was locked. There was no risk assessment relating to the locked door. The staff on duty and the management claimed to be unaware of these incidents. There were no records of Regulation 37 notifications or safeguarding referrals and the complaint had not been logged. At the inspection visits on 7 and 9 December 2009 we saw during discussions and observations that staff did not know about each persons assessed or changing needs. Staff on the dementia unit on the first floor were not supervised or directed to meet peoples needs. There was little interaction between staff and people living at the home apart from essential tasks, such as personal care and meals. Staff on duty on the dementia unit told us they had not received dementia or safeguarding training. At one point during the afternoon of this visit the dementia unit was left with one care assistant, who had no formal training. The senior in charge and two other care assistants had gone to the ground floor for various reasons. During this time a person, who was wandering in the corridors was saved from falling by the intervention of the homes administration assistant. The care assistant, who was attending to another person elsewhere on the unit, told us that X was unsteady because he had been given his afternoon medication. At the inspection on 9 December 2009 we informed the acting manager that the evidence we found demonstrated a lack of compliance with the previous requirement: that the number of care staff on duty are skilled and trained and in sufficient numbers to meet the needs of people living at the home. At the inspection on 9 December we were told that the unit manager on the nursing unit had been demoted and the deputy manager was managing the nursing unit until a replacement could be recruited. We were told that the services of an external consultant were being used to re-write care plans and mentor staff in relation to a more person centred approach. In addition a manager recently recruited for a new home within the organisation had been relocated to provide additional managerial support and monitoring. There was also administration support was in place. At the inspection visit on 9 December the management audits had not identified areas of concern as highlighted in this report such as failures to implement important aspects of care planning and medication improvements. Prior to our visit on 29 December 2009, We informed Select Healthcare that we considered the risks posed to people living at the home were very serious. We required a number of assurances from them, including their full co-operation with other agencies such as the Local Authority and Dudley Primary Care Trust. We required the organisation to attend a meeting with us as a matter of urgency where we informed them that we had considered what further enforcement action we needed to take to secure improvements for the health, well being and safety of people at the home. The organisation told us that the acting manager and Responsible Individual had left their employment without notice on 11 December 2009. Select Healthcare told us that an area manager who was registered as a Responsible Individual for other homes in the organisation would be taking responsibility for this home and that an another area manager, would be acting as manager for Victoria Lodge and would submit an application to be the registered manager. At the inspection visit on 29 December 2009 we looked at the homes records such as Care Homes for Older People Page 8 of 18 staff training, accident records and Regulation 37 notifications in relation to safeguarding people at the home. The information told us that the management of this service had failed to effectively report issues relating to safeguard vulnerable persons. This meant that they were unable to assure us that they had taken action and made improvements to safeguard people living at the home. We took copies of documents, which may be used in future enforcement action. At the inspection visit on 29 December 2009 we saw that the new management arrangements were in place. The new Responsible Individual and acting manager acknowledged our findings and assured us that they were willing to work in cooperation with all agencies to make the necessary improvements. We saw that there were small improvements, particularly in notifying agencies when there were concerns about peoples health. At the unannounced inspection on 29 December 2009 staff reported positive steps had been taken to improve the care and welfare of the people living in the home. Most were able to describe the difference the new management team have made and reported that the new team were approachable and responsive. Training and updating of staff had begun and was being planned to ensure staff were skilled to undertake their roles. We reviewed staffing records which were, in general, well kept. However there were some concerns, for example, the high number of vacant posts which needed to be recruited to and a need to assess the competency and skills of existing staff through performance appraisal and development. We have informed the organisation that we will continue to undertake inspections to monitor the service to safeguard people living at the home. What the care home does well: What they could do better: Peoples needs must be thoroughly assessed prior to admission and be kept under Care Homes for Older People Page 9 of 18 review. Reassessments and appropriate referrals must be made to health and social care professionals without delay, so that peoples heath is not put at risk. Care plans must be accurate, up to date and give clear guidance about how to meet the needs of each person in the home. Medication practices were potentially unsafe. Storage, administration practices and records must be improved. The organisation must take action to demonstrate compliance with Statutory Regulations Notices served to secure improvements to safeguard the health and welfare of people at the home. Improvements must be made to the policies to safeguard people. All staff must be provided with suitable training so that they understand how to protect vulnerable people and diligently report concerns to appropriate agencies without delay. The management must be able to demonstrate that there are skilled staff in suitable numbers to meet all the needs of the people living at the home. Thorough employment checks and supervision arrangements must be put in place to make sure the people are suitable to work with vulnerable people living at the home. Action must be taken to demonstrate that all staff are competent in their work practice. Communication systems must be improved so that all staff are fully aware of their role and responsibilities. The quality assurance audits must be more robust so that failings are recognised with appropriate actions taken to improve the service. Any adverse event affecting people living at the home must be notified to us without delay to show that people are safeguarded. Records must be more rigorously monitored and improved so that risks are recognised and controlled. Fire training must be provided to all staff, especially night staff to make sure people can be kept safe from the risks of fire. 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 2. Care Homes for Older People Page 10 of 18 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 7 12 Care plans, monitoring and 31/12/2009 management strategies must be put in place for people described as having agitated, aggressive or other challenging behaviours with ways to evaluate the effectiveness of strategies and use of PRN medication. This will ensure that staff take required actions to promote peoples health and well being. 2 7 15 To ensure that there are 01/10/2009 health care assessments, risk assessments and care plans, which include all of each persons assessed needs, and are updated to accurately reflect all changes to health and care needs. This is to ensure care for each persons health and well being is properly provided at all times. 3 8 12 To ensure that people with 31/12/2009 changes to their condition such as poor nutritional intake, weight fluctuations are monitored using recognised screening tools as frequently as required by Page 11 of 18 Care Homes for Older People 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action their risk assessments and care plans. This will ensure that staff take required actions to promote peoples health and well being. 4 8 12 To ensure that staff make timely referrals to health care professionals for specialist assessment, support and advice, with action taken to diligently follow instructions for each persons care needs. This will ensure that staff take required actions to promote peoples health and well being. 5 8 13 To devise and implement 01/09/2009 written protocols agreed with health professionals and obtain appropriate training for staff who undertake blood glucose monitoring, which is an invasive body procedure. This is to safeguard peoples health and well being from risks of harm. 6 9 13 The records of the receipt, 01/10/2009 administration and disposal of all medicines for the people who use the service must be robust and accurate to demonstrate that all medication is administered as prescribed. This is to maintain the health Care Homes for Older People Page 12 of 18 31/12/2009 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action and well being of people living at the home. 7 9 13 To ensure prescribed 01/09/2009 Allendronic Acid 70mgs weekly is administered in accordance with special instructions, to be taken at least half an hour before first food or drink and the person advised to sit or stand for half an hour following administration. This is to safeguard people from avoidable side effects which may harm their health and wellbeing. 8 9 13 Medication must be stored 01/10/2009 within the temperature range recommended by the manufacturer to ensure that medication does not lose potency or become contaminated. This is to safeguard peoples health and well being. 9 9 13 To ensure that variable 01/09/2009 dosages, such as 1 or 2 tablets, 5mls or 10mls are recorded as administered on MAR sheets. This is to ensure that peoples health and well being is safeguarded. 10 9 13 Staff who administer 01/09/2009 medication must be competent and their practice must ensure that people Page 13 of 18 Care Homes for Older People 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action receive their medication safely and correctly. This is to safeguard the health and wellbeing of people living at the home. 11 9 13 To ensure that all persons 01/09/2009 living at the home receive their medication as prescribed by their doctor and the Medication Administration Records must be accurately completed to demonstrate either medication has administered or an appropriate code entered to record the reason for non administration. This is to maintain the health and well being of people living at the home. 12 9 13 To ensure there are care plans in place for the administration of when and as needed medication and staff act appropriately to monitor and inform the relevant healthcare professionals as needed. This is to safeguard the health and well being of people living at the home. 13 9 13 Risk assessments must be 01/09/2009 put in place for any medication which is self administered, including creams, sprays and inhalers. This is to safeguard the Care Homes for Older People Page 14 of 18 01/09/2009 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action health and well being of people living at the home. 14 18 13 To provide appropriate, up to 01/11/2009 date policies and procedures, and safeguarding training for all staff, with monitoring arrangements to ensure the homes and Safeguard and Protect procedures to protect vulnerable people are implemented and followed diligently at all times. This is to safeguard all persons living at the home from risks of harm. 15 27 12 To demonstrate that the number of staff on duty are skilled and trained and in sufficient numbers to meet all of the needs of each person using the service. This is to ensure that the health, well being and safety of people living at the home can be assured at all times. 16 29 19 To ensure that all staff 01/09/2009 employed at the home are recruited following robust recruitment procedures, with documentary evidence to demonstrate diligent compliance with The Care Homes Regs 2001, Reg 19(1). This is to safeguard people living at the home from risks of harm. 01/10/2009 Care Homes for Older People Page 15 of 18 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 17 31 9 To ensure that an application 01/11/2009 is submitted to register the manager. This is to ensure that the home is managed to safeguard everyone at the home. 18 33 24 To implement effective 01/10/2009 quality monitoring systems, which demonstrate that positive quality outcomes are consistently achieved for all persons living at the home. This is to safeguard the health, well being and safety of people living at the home. 19 37 37 To ensure notifications are submitted to the Care Quality Commission and Inspection of any incident that has affected the health, safety or wellbeing of the people at the care home, without delay. This includes medication errors. This is to safeguard the health, well being and safety of people living at the home. 01/09/2009 Care Homes for Older People Page 16 of 18 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, 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 4 14 Each persons needs must be 01/02/2010 assessed by a competent person, be kept under review and be revised at any time as necessary in relation to any changes. This is to safeguard the health and well being of people living at the home. 2 38 23 All staff, and especially night 01/02/2010 staff must receive fire training and attend fire drills at frequencies approved by the West Midland Fire Service. This is to safeguard people at the home from risks of harm from fire. 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 17 of 18 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 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). 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