Care Home: Abbeygate Care Centre

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What the care home does well Each person has a clear and comprehensive care profile, these have care plans that tell staff what care is needed and how this should be given. The person or their representative sign these to show they agree with the care. Before admission each person has an assessment and are told in writing if the home can meet their needs, this means that each person can be sure on admission that the home can care for them. One relative told us ` The admission was an emergency, but they asked for the information and decided before my relative came in that they could met her needs` The medication management and administration is safe and this means that each person gets their medicines as prescribed by their doctor. There are good risk assessments in place and where risks are noted, staff take action to reduce these. There are suitable activities and people are encouraged to maintain their Independence where possible. The complaints process is good and information is available in large print. Staff have received training in safeguarding and there is good information to assist staff if a referral had to be made. There are good employment processes in place which minimise the risk to others and there is a very low turn over of staff, this means that the people using the service and the staff know one another well. The management is open and consistent, this means that improvements can be made and all those living in and using the service can view their opinions. What has improved since the last inspection? Care planning has improved and contains more information. Parts of the home have been decorated and there is an ongoing program for this to continue A robust quality assurance system has been put into place. The management are committed to make continuous changes so that the home runs to the best interest for those who use it. What the care home could do better: Short term plans of care should be available when someone develops a short term condition or illness.Concerns should be recorded centrally so that these can be analysed and information used as part of the quality assurance systems. Key inspection report Care homes for older people Name: Address: Abbeygate Care Centre 2 Leys Road Brockmoor West Midlands DY5 3UR     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: Suzette Farrelly     Date: 3 0 0 7 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 28 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 28 Information about the care home Name of care home: Address: Abbeygate Care Centre 2 Leys Road Brockmoor West Midlands DY5 3UR 01384571295 01384571295 abbeygate@abbeycare.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Hilary May Sahadew,Mr Dasrath Sahadew care home 17 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 17 The registered person may provide the following category of service only: Care Home Only (Code PC) To 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) 17 Date of last inspection Brief description of the care home Abbeygate Care Centre is a detached building, with original parts of the house dating from 1845. It is situated in Brockmoor, which is to the west of Brierley Hill and close to the Merry Hill Shopping Centre. It has mature gardens and car parking available, it has been adapted and extended for use as a Care Home for older people. Seventeen people can live here and the home is designed to meet their needs. Up to date costs of living at this home should be requested from the provider. Items Care Homes for Older People Page 4 of 28 Over 65 17 0 Brief description of the care home that are not covered by the fee include hairdressing, chiropody, toiletries and newspapers. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection was unannounced which means that the management did not know we were coming. At the last inspection this home was given a quality rating of adequate, since then the manager has worked hard to improve many areas. The home is safe for those who live there and the staff are committed to the care of those who live there. To establish that this home meets the needs of the people who live there and that the processes in place protect them from harm, the following was undertaken. We ask the manager to send us a completed Annual Quality Assurance Assessment form, this is the managers self assessment of their service and tells us if they have assessed the facilities and the outcomes for those living at the service. This was returned to use when we asked and told us what they do well and what improvements Care Homes for Older People Page 6 of 28 are needed. At the visit three people were case tracked, this involves reading their records, discussing their care with staff and each of them if possible. Medication management and administration is also assessed to establish that this is safe, records concerning staff, employment, support and training are examined to ensure that this is appropriate and staff are supported to learn. The maintenance of the home is also looked at to ensure that the environment is safe and suitable to live in. The opinions of those using the service and their families are sought. Where possible the opinion of others such as the doctor are also asked for. This inspection took five hours and all areas were looked at. We found that the management ensure the environment is safe and that the people living at the home are protected by good quality assessment and robust processes. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Short term plans of care should be available when someone develops a short term condition or illness. Care Homes for Older People Page 8 of 28 Concerns should be recorded centrally so that these can be analysed and information used as part of the quality assurance systems. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person can be assured that they will have a full assessment before admission to ensure that the home can meet thier needs. Evidence: There is an up to date Statement of Purpose and Service User Guide available in the reception area of the home, which means that people using the service and their relatives can read these at any time. The provider told us that this is given to anyone enquiring about the home. A relative told us that they have this information and can refer to it if they need to. A copy of the most recent inspection report was not readily available, this means that people using the service and their relatives may not be aware of the areas for improvement and the stregths of this service. Three peoples records were seen and this told us that each person has a full Care Homes for Older People Page 11 of 28 Evidence: assessment before admission which ensures that the management have enough information to decide if all the needs and assistance required can be met. After the assessment a letter is sent to the person or their relatives stating that if the home can meet their needs, the room they will occupy and the cost of care on a weekly basis. This ensure that the person is aware of these aspects before admission. In the case of an emergency admission, a full pre-admission assessment is not carried out. The assessment is then conducted after admission and a final decision is made if admission to this home is suitable. One persons relative told us that they had been admitted as an emergency and they were happy with the way this was conducted and that they had sufficient information about the home. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person can be assured that their needs with be met by trained and competent staff. Each person can be confident that the management of medication is good and protects them from harm. Evidence: Three people were case tracked, this involves looking at the information available in their care profiles and other written information. Meeting the person, talking to staff and observing practices. The care profiles are organised and information was easily found. Each person had clearly written care plans, which tell staff what is needed to assist or care for the individual. There was a lack of depth of information in some areas which means that the way care is given may not be consistent. This does not happen as there is a stable staff group and during discussion it was confirmed that the staff are fully aware of all the needs of each person and how these should be met. There are clear records of visits made by other professionals such as the district nurse Care Homes for Older People Page 13 of 28 Evidence: and the doctor. These notes state what action has been taken and what the staff in the home need to do. Daily records and other written information told us that the staff follow this. The doctor, who visits the home told us that he was satisfied with the service, the care was good and the staff informed him in a timely manner of changes to the health of those people he cares for. There was written information that told us that each person is assessed by the doctor regularly to ensure that their medication and treatment is appropriate. There are no short term care plans to tell staff what actions should be taken when there are changes in health that last for only short periods. There was information in the daily records and other records that told us that care for short term issues were dealt with consistently by the staff. Risk assessments that determine the level of risk for each person in relation to Moving and Handling, Nutrition, Falls and pressure to the skin are completed monthly. If the risk assessment shows that there is a risk, actions are put into place to minimise this. All care plans are signed by the person receiving the care or their relative. This shows that they are consulted and involved in deciding the care and assistance needed. A relative told us that the staff tell them what is going on and that they are also told about the care and asked their opinion. The surveys completed by the home show a high level of satisfaction with the way care is delivered. There is a robust system for the management and administration of medication. All medication is stored in accordance with legislation and the temperature of the room is checked daily to ensure that this is within an acceptable range. A small number of medications were checked and it was found that these were correct. The Medication Administration Records are completed properly and there were not gaps showing that each person receives their medication as prescribed. There was clear information to show if there were any medical allergies, which means that each person is protected from the prescription of drugs that may cause them harm or discomfort. The local pharmacist assesses the management of medication in the home and these reports told us that there are no concerns. Care Homes for Older People Page 14 of 28 Evidence: All staff who administer the medication have received training. There is a list of names with initials and signatures to aid with identification. During discussion and observation we saw that each person is treat with dignity and respect. One relative told us that the staff were polite and considered the needs of each person. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person can be confident that there social and interest needs will be met and that they will receive varied and satiable meals to their liking. Evidence: There is a person employed at the home who organises activities. Each person has a Life History that also tells the staff their likes and dislikes and helps them to develop activities that will suit them. There is a folder containing photographs and examples of work completed during activities, this told us that the people at the home are engaged in daily life and enjoy the activities. The homes survey told us that the people who use the service are mostly satisfied with the activities available. During the visit some of the people at the home were playing board games and interacting with the staff and others around them. This told us that there was a relaxed atmosphere and people feel comfortable and at ease. There is monthly outside entertainment and someone comes into the home each month to conduct music and exercise. Care Homes for Older People Page 16 of 28 Evidence: Each person is supported to maintain their relationships with family and friends and are encouraged to go out with them where this is possible. This was witnessed during the visit to this home. The staff also encourage the people using the service to go out to the shops, local pubs for lunch and general outings when the weather is good. Birthdays are celebrated, the home buys each person a card a flowers and arranges for a buffet tea. The family are invited to buy the cake, if this is not possible then the home will supply this. Preparation for a forthcoming birthday was seen. There is a religious service run by the Church of England each month for anyone who wishes to attend. We were told that it has been difficult to get a Catholic Priest to visit regularly, but this can be arranged if required. Discussion took place about other groups of people, we were told that the service would be able to make changes to meet the needs of other ethnic and religious groups. The kitchen has recently been inspected by Environmental Health and been awarded a 4 Star rating, this tells us that the management of the kitchen is safe and protects each person from harm. There is a menu available that offers choices to the main meal. The chef spends time each day with people living at home to ensure that they like what is on the menu, fancy a change and to chat with them. It was noted that all the people at the home looked well and written information told us that records are kept of food made available and how well people are eating. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person can be assured that their concerns and complaints will be listened to and acted upon. They can also be assured that they will be protect from harm through good training and employment practices. Evidence: There are good policies and procedures available in relation to Safeguarding, this ensures that the staff have the information to guide them in what to do if there is an incident or suspicion of abuse. The policies contain information form the local social service department and also developed by the management of the home. All staff have received a full days training with Dudley Social Services and a further half day update to ensure that they are fully aware of their role in preventing and reporting any abuse. The last training was competed in December 2008. Staff spoken to were aware of adult abuse and what they should do. Information about abuse and how to contact social services was available on the community notice board. There are policies that state how to make a complaint and how this will be dealt with. Copies of this are available to staff in the office, on the Community Notice Board and in the Service User Guide. The policy is also available in large print and can be translated into other languages if needed. One relative told us that they had been Care Homes for Older People Page 18 of 28 Evidence: given this information, but had never needed to complain. The management are proactive and transparent in their management which enables the people using the service and their families to discuss concerns and therefore deal with these quickly and promptly. These are recorded in the persons daily records, it is recommended that there is a separate record kept to aid with quality assurance and improvements in the home. Personal monies of the each person are managed by the home, the process of storage and recording is good and protects each person from financial abuse. Employment processes are robust and this ensures that anyone employed is suitable to work with vulnerable people. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person can be assured that they live in a clean, safe and homely place that is managed to minimise infection. Evidence: The environment is clean, fresh and homely. There is sufficient communal space to allow each person to spend time where they like. The back garden is secure and people can go into the garden from the patio doors in the lounge and from most of the downstairs bedrooms. These doors require attention to ensure they are secure. In the past year the lobby has been re-plastered and decorated and some bedrooms have also been decorated. There is a program of maintenance and up dating of the home, when the job is completed this is signed and dated. This shows that the management are pro-active in ensuring that the building is maintained to a suitable and safe standard. There is a lift so that every one can easily use the upper floor. There is one assisted bathroom and it is planned that the other bathroom will converted into a walk-in shower. Checks to fire, water and equipment used is carried out which ensure that the home is safe to live in. Care Homes for Older People Page 20 of 28 Evidence: The laundry is organised and there is a washing machine with a sluice facility. Staff follow good infection control measure to minimise the risk of spreading infection and the deputy manager is an Infection Control Champion and has received training in the prevention and management of infection. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person can be assured that they are cared fro by staff who are trained and suitable employed, therefore minimising the risk of harm and increasing the level of good care. Evidence: There are 17 people living at this home, the majority are of low or medium dependency and need assistance from one staff member for some daily living tasks. There are three staff on duty during the busy times of the day and two staff in the mid afternoon and at night. People using the service and two relatives told us that when assistance is needed staff give this quickly and professionally. During the visit we saw staff spending time with people in the lounge areas and addressing needs and giving assistance when needed. There is a cook who works 4 hours for 6 days a week to cook the main meal of the day. The care staff prepare and organise breakfast and the evening meal. As there are three care staff and the manager usually present this does not detract from the care given to each person. Laundry is also done by the staff, this is minimal as continence management is good and there is very little incontinence laundry. Care Homes for Older People Page 22 of 28 Evidence: Only one member of staff has been employed in the last 12 months, their records were looked at and this told us that the management ensure that all checks are carried out to ensure that the person is suitable to work with vulnerable people. The staff record was organised and all information required was present. Training is supported by the management and 69 of the staff have achieved an National Vocational Qualification in Care at Level 2 and 19 have achieved this qualification to Level 3. This means that the staff have sufficient knowledge to give good and consistent care. There is an induction programme for all new staff. This gives them information about the running of the home and also about how care is to given. Other training is given to ensure that staff have an understanding of the various conditions that people present with. Training in Lewy Body Dementia is planned for September. There is a very low turn over of staff and many of the staff have worked at this home for many years. This creates stability and ensures that the care given is consistent. It was evident that the staff knew the people they care for well and also their friends and family. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person can be assured that the home is run to their best interest by a trained and committed management team. Evidence: The owner of this service is also the manager, he is a qualified nurse. He is an executive member of the Dudley care Homes Association and through this there are joint meetings with Dudley Council, this assists him to up date his information, know what is new in care and how legislation is changing. He is also the Dignity Champion and has completed a 2 day course on Equality and Dignity. This information is shared with the staff during discussions but also in supervision and as part of the care planning to ensure that each persons dignity is maintained. There are three monthly meetings with the people who use the service and their families to up date them with any changes and to give them an opportunity to say Care Homes for Older People Page 24 of 28 Evidence: what they feel is working and where improvements can be made. Each person and their family are given a survey every year, this is analysed and the results are available in the Service User Guide and on the Community Notice Board. Last years showed that all those who answered were mostly satisfied with the services supplied. Other people are also surveyed such as the doctors, district nurses and other professionals that enter the home on a regular basis. There is a new quality assurance system in place that reflects the Annual Quality Assurance Assessment that is required by us. The manager is checking a different outcome group each month and there was written action plans to show areas that needed improvement. This shows that the management are pro-active and make changes to improve the lives of those using the home. All staff receive supervision six times a year, there is a format for this and the manager discusses areas such as safeguarding, deprivation of liberty safeguards, changes in legislation, working practices and other areas where there are changes or new methods. The manager is support by the deputy manager, she has worked at the home for nine years and has been the deputy manager for three years. She is responsible for the medication and takes on the management responsibility when the manager is not available There is a maintenance person who is available to carryout repair jobs when required. The manager ensures that other checks that are required to maintain the safety of the home are carried out when required, and there are contracts in place to ensure that equipment is checked to ensure it is in good working condition. Each person can leave small sums of money with the manager, so that they are able to pay for hairdressing and other personal items. The money is safely stored and records are kept of all money received and spent with corresponding receipts. This ensures that each person is protect from financial abuse. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 7 15 Short term care plans must be developed for changes in health that are not permanent. This will ensure that there is consistent care and that this can be evaluated for effectiveness. 30/09/2009 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 1 A copy of the most recent inspection report should be available with the Service user Guide so that people using the service and their relatives know what the outcomes were. Re- assessment of anyone whose health care needs have changed or have been in hospital should be undertaken to ensure that their needs can still be met. It is recommended that any concerns are recorded in a central file to assist with quality assurance and to show how these are dealt with. Assessment of all the patio doors should take place and action put into place to secure these. 2 3 3 16 4 19 Care Homes for Older People Page 27 of 28 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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