Care Home: Ashington Grange

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What the care home does well Good systems are in place to make sure that people have enough information about the service before they come to live in the home. Peoples` care and health needs are well met by the service in a way that suits their individual needs. Individual records are very well maintained to show how staff meet peoples` needs. The good systems that are in place for dealing with medicines protect people living in the home. Peoples` individuality and diversity is respected and met by the good service offered at Ashington Grange. Social activities and outings are well organised and planned to suit the needs of the people using the service. The people using the service enjoy the varied programme of events. The food is well cooked and presented with good options available at each mealtime. People feel able to make their views about the service known and have plenty of opportunities to raise issues with the manager and staff. People are protected by the home`s systems for dealing with complaints and safeguarding matters. Staffing levels are sufficient to meet the individual needs of the people living in the home. Good recruitment practices and procedures are in place to protect people using the service. Staff training is well organised and delivered to staff to ensure that they have the skills to meet peoples` individual needs. Good management systems are in place to make sure that the quality of the service is regularly reviewed and changes are made to improve the service. Good health and safety systems protect people living and working in the home. What has improved since the last inspection? Specific care plans are now in place to describe how staff support people who have dementia with daily living. Medication records are fully completed so that there is an accurate records of the medicines give to people living in the home. Hand rails are available in toilets for the safety of the people in the home.Water temperatures in hand washing sinks is regulated so that staff are able to wash their hands safely and effectively. Threadbare towels have been replaced. The laundry and treatment rooms were clean, tidy and free from clutter. Bins are foot operated to reduce the spread of infection. The stair wells are not being used for storage. There is a five year electrical safety certificate in place. A monitored dosage system is in use for administration of medicines and this makes stock control much easier to monitor. Staff are aware of controlling background noise. There is a choice of food at each meal time. What the care home could do better: There needs to be a refurbishment plan identifying timescales that takes account of the need to replace stained and worn carpets, chairs and furniture. It must also identify dates for work on redecoration of corridors, paintwork and rooms. This will make the environment more attractive and comfortable for the people living in the home. Some laminate flooring needs replaced where the surface has worn away and become sticky to walk on. Bathrooms and toilets should have good quality sanitary ware fitted that is not rusty or damaged. Any plugs for baths and sinks should be properly attached. Taps should clearly identify whether they are hot or cold. Boxing around pipework should be checked to ensure that it is properly painted and not damaged in any way so that it can be easily cleaned. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashington Grange Ashington Grange Moorhouse Lane Ashington Northumberland NE63 9LJ     The quality rating for this care home is:   three star excellent 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: Anne UrwinBrown     Date: 0 1 0 7 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Ashington Grange Ashington Grange Moorhouse Lane Ashington Northumberland NE63 9LJ 01670857070 01670854144 ashingtongrange@schealthcare.co.uk 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) : Southern Cross Home Properties Limited care home 59 Number of places (if applicable): Under 65 Over 65 0 25 dementia old age, not falling within any other category Additional conditions: 34 0 Of the following age range: Aged 55 and above The maximum number of service users who can be accommodated is: 59 The registered person may provide the following category of service only: Care Home with Nursing - Code N 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, Code OP - maximum number of places 25 Dementia Code DE, maximum number of places 34 Date of last inspection Brief description of the care home Ashington Grange is a two storey purpose built care home which is situated in a residential area and is approximately one and a half miles from the centre of Ashington. The home provides care for residents who have dementia and general nursing care for up to 59 older persons. The home also offers social and personal care for older people. Care Homes for Older People Page 4 of 27 Brief description of the care home The home is divided into two units called the Charlton Wing and the Milburn Wing. Each unit has its own facilities including single bedrooms, 10 of which are en-suite. Each unit has two lounges and dining rooms and there is safe access to the garden areas. Car parking areas are provided at the front and sides of the building giving level access to the home. The home shares the site with another home, which is owned by the same company. Fees range from £436.00 and £456.00 per week. Information about the care provided and facilities in the home are available in the service user guide and statement of purpose in the home. A copy of the most recent inspection report is also available. Care Homes for Older People Page 5 of 27 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: The quality rating for this service is 3 stars. This means that the people who use the service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Care Homes for Older People Page 6 of 27 Before the visit we looked at: Information we have received since the last visit. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The Visit: An unannounced visit was made on 1 July, 2009. The visit lasted a total of six hours. During the visit we: Talked with people who use the service, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? Specific care plans are now in place to describe how staff support people who have dementia with daily living. Medication records are fully completed so that there is an accurate records of the medicines give to people living in the home. Hand rails are available in toilets for the safety of the people in the home. Care Homes for Older People Page 8 of 27 Water temperatures in hand washing sinks is regulated so that staff are able to wash their hands safely and effectively. Threadbare towels have been replaced. The laundry and treatment rooms were clean, tidy and free from clutter. Bins are foot operated to reduce the spread of infection. The stair wells are not being used for storage. There is a five year electrical safety certificate in place. A monitored dosage system is in use for administration of medicines and this makes stock control much easier to monitor. Staff are aware of controlling background noise. There is a choice of food at each meal time. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good assessments are carried out before people are admitted to Ashington Grange to ensure that their needs can be effectively met. People have plenty of information about the service to help them make an informed choice about living at the home. Evidence: People have sufficient information about the service provided at Ashington Grange before they come to live there. Two people living in the home said that they had enough information about the service before they came to live in the home. The Statement of Purpose has been reviewed in the past year and the service user guide gives clear information about what it is like to live at Ashington Grange. Before each person moves into the home a pre-admission assessment is completed by senior staff to ensure that his or her needs can be met at the home. Information from the assessment and from relatives and or from the care manager is also used to Care Homes for Older People Page 11 of 27 Evidence: prepare an individual plan outlining each persons care needs. The home understands the importance of having good information about peoples needs before agreeing a placement. Two people said that staff knew what they needed help with when they first came to live at the home and they were very supportive. Intermediate care is not provided at Ashington Grange. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place for ensuring that each person has an individual plan that provides clear information about their needs and how these are met. Evidence: Each person has a personal plan in place that clearly outlines their care needs and how these are met to suit their individual needs. These plans are well recorded and provide excellent information. Personal support is in a way that responds to peoples individual needs and preferences. There was clear information in plans and in daily records about how peoples personal care, physical and social and emotional needs are met by staff. Assessment tools are well used to identify changes in peoples needs and care plans are updated to reflect changing needs. Other healthcare information is well recorded and evidence was available that good systems are in place to ensure that individual needs are well met. Evidence was available that privacy and dignity is respected and that staff are sensitive to personal preferences. Equality and diversity training has been addressed Care Homes for Older People Page 13 of 27 Evidence: by the manager in individual sessions for all staff and more formal training is planned. During the inspection three people said how good the care and support is that they receive. They said that staff were kind and always available when they needed them. One person said I like living here and the staff are always kind and nice. There was a good atmosphere and staff responded well to individual requests during the inspection. There is in place an effective medicines policy that supports good procedures and practice. Staff training has been provided for all staff responsible for administering medicines. Medicines records are well completed and contain required entries. There are regular checks of medicine practice by the manager and records were available to show this. A monitored dosage system is in use and stocks of medicines are well monitored. Arrangements for the storage of medicines are satisfactory. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to make choices about their routine and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits individuals. Evidence: Peoples routines are organised to suit their individual needs and two people said that staff are supportive of their choices and preferences. Good information about social care needs are recorded in care plans to show interests and preferences about activities and routines. Recently a new full time activity organiser has been appointed and she has started to getting to know the people living in the home so that she can plan a new timetable taking account of peoples interests and views. There is evidence that good opportunities are provided for people to take part in planned activities that meet their social needs. There were some excellent examples of artwork on display and hanging baskets outside the home were made up by people living in the home. It was evident that there are plenty of opportunities to join in arranged activities and outings or to spend time quietly if preferred. People said that they were satisfied that there were Care Homes for Older People Page 15 of 27 Evidence: plenty of interesting things to do. The residents said the food was very good and alternatives were available at each meal time. They said that they thought that they could get something else to eat if they did not like what was on the menu, but had never had to ask for that. The menus provide a good variety of food using the Nutmeg system that takes account of healthy eating principles, while still offering a choice. The kitchen is well organised and stocks of food and storage arrangements are satisfactory. Kitchen staff have undertaken appropriate Food Handling training. Drinks are provided regularly through the day and there is a varied selection offered. There was tea, coffee, or cold drinks of either juice or milk. There were biscuits provided. Fruit was also available. Individual bedrooms are personalised according to the taste of the resident. People said they were happy with their rooms and that they had a lot their own personal items around them. People have visitors at any time and are able to use their own rooms, or the lounges to see them. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the good systems in place at Ashington Grange for dealing with complaints and safeguarding. Evidence: The complaints procedure is clear and provides good information about how to make a complaint and the action that is taken to deal with complaints. Good systems are in place to record complaints, their investigation and outcome. There is also a system for monitoring the type and frequency of complaints. People living in the home said that they felt able to raise any concerns or complaints with the manager or her staff and they were satisfied that these would be taken seriously. One person said she was aware of that she could complain and thought that her family would help her with that. Three complaints have been made since the last inspection. There are written procedures for dealing with safeguarding matters. Four safeguarding referrals have been made since the last inspection and these have all been satisfactorily dealt with by the manager. The manager was commended by the local authority for her handling of the last referral. Staff training is ongoing to ensure that all staff members have a good understanding of safeguarding procedures and new staff are given information when they first start work. Records show that staff have completed training. There is a policy in place for whistle blowing so that staff can feel confident that if they had any concerns they would be listened to and the information Care Homes for Older People Page 17 of 27 Evidence: would be treated in confidence. Good systems are in place for dealing with money held on behalf of people living in the home. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Ashington Grange provides a comfortable, well maintained and decorated accommodation that suits the needs of the people living there. Evidence: The home is generally clean, with no odours. Bedrooms are generally well personalised with pictures and personal belongings to suit the needs of the people using the rooms. Maintenance issues are dealt with promptly by the handyman employed at the home and he works hard to keep up with the work needed. Some areas of the home are well decorated, however there are other areas where improvements are necessary to provide a comfortable and attractive environment. Areas requiring attention include damaged paintwork in corridors and some bedrooms, laminate flooring that has damaged surfaces making it sticky to walk on, marked and stained carpets in halls and corridors, chairs that are stained and worn or are unsuitable for elderly people. The manager has identified these issues in the redecoration programme, but no timescales have been set for the completion of work, which means that people are living in a poor environment despite the best efforts of the manager and staff to make improvements. In most toilets and bathrooms the tops have come off the taps so it is not easy to determine which is hot and which is cold. Some sinks had plugs that are not attached to chains and these are difficult for people to manage. In one bath the plug was Care Homes for Older People Page 19 of 27 Evidence: attached to some twine (although this was removed during the inspection). The enamel on most baths was damaged and in some cases the metal bath was rusty, which could present risks of cross infection or skin damage to people using the baths. These baths are still in everyday use. In one toilet there was an unpleasant drain smell. Most toilets had damaged boxing around pipes, some from water damage. All bathrooms and toilets would benefit from refurbishment to improve the environment and to prevent risks to infection control. There are enough sitting and dining areas to meet the needs of the people living in the home. There are attractive pictures and memorabilia that people can relate to and staff have worked hard to find items that connect to the local area. The first floor has two units for people with dementia and staff have taken account of this in the choice of decor. The manager has ordered ten new chairs for the upstairs lounge where new flooring was laid on the day of this inspection, however in other areas there are chairs that are marked and stained. There are some metal dining chairs still in use that are not really suitable for the people living at Ashington Grange and the manager has identified these for replacement. Bedrooms are personalised to suit the needs of the individuals occupying the rooms. Some rooms have marked and worn chairs and carpets. One or two carpets have an odour and the manager is aware of this and has requested these be replaced. The decor in some bedrooms is poor as walls and paintwork is shabby or damaged and this has already been noted on the redecoration programme. Some rooms have en-suite accommodation, however some of these are carpeted. This is not easy to keep clean and the manager has identified these as needing replaced with impermeable flooring. Health and safety records were checked and internal checks are up to date. The laundry was inspected and it was clean, tidy and well organised. There are two industrial dryers and washers. A laundry assistant is employed 8am-4pm. The treatment room is spacious and was clean and tidy. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient appropriately skilled and trained staff to meet the needs of the people living in the home. Evidence: Staffing levels are adequate to meet the needs, activities and wishes of individuals living in the home. During the visit to the home there were enough staff nurses, carers, domestic and catering staff. Two people living in the home said that there were always enough staff and they were very kind and supportive. The manager said that existing staff members work additional hours to cover sickness and annual leave. Staff said that they feel well supported by the manager and that there is good communication within the staff team. They also said that there are enough staff working in the home to cover the rota. Good staff recruitment procedures are followed for appointing new staff that take account of equality and diversity principles. Records showed that the manager recognises the importance of effective recruitment in protecting people living in the home. Appropriate checks including reference, Criminal Records Bureau and POVA checks are carried out and records confirmed this. Staff receive appropriate training to equip them to meet the needs of the residents. Care Homes for Older People Page 21 of 27 Evidence: Training is focused on achieving better outcomes for people living in the home. Internal and external providers are used to deliver training for staff. Staff said that they get enough training opportunities and are well supported by the senior staff. Individual training records are in place and are kept up to date. Eighty-seven per cent of staff have completed national qualifications in care. More than half the staff have completed specialist Alzheimers training. Staff meetings are held regularly and a staff supervision programme is in place. Staff said that they are able to raise issues and concerns and their views are taken seriously. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a well managed home and are encouraged to put forward their views. Evidence: The manager is well qualified and experienced to run the home and meet its stated aims and objectives. She has a good understanding of the organisations strategic and financial planning systems and how the business plan for the home is developed and implemented. She has a clear vision of the homes priorities and communicates a clear sense of direction. Equality and diversity, human rights and person centred service delivery are all given priority by the manager. She is well supported by an experienced senior staff team. The manager undertakes regular training that has included equality and diversity. The home has in place good systems for assessing and reviewing the quality of the service that provide excellent information about the performance of the home in Care Homes for Older People Page 23 of 27 Evidence: meeting its aims and objectives. There is evidence that the manager and the senior staff team are involved in improving and developing systems that monitor practice and compliance with the plans, policies and procedures of the home. Good systems are in place to ensure that the quality of the service is regularly reviewed taking account of the views of people living in the home and other stakeholders, such as relatives, care managers and health care professionals. People are encouraged and supported to retain control of their own money. If people are unable to manage their money clear information is kept in their individual records about the reasons for this. All transactions relating to money held are clearly recorded and appropriate procedures for managing residents money are in place so that staff are clear about their responsibilities. Lockable storage is provided in each persons room so that they can keep money or valuables safely. Health and safety policies and risk assessments are in place and staff receive appropriate mandatory training at regular intervals. Good records of training are kept. Regular checks and servicing of fire equipment are carried out and records show staff have received appropriate fire training. Good records are kept of all accidents and there was evidence that these are monitored by senior staff. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 There needs to be a clear refurbishment plan in place identifying timescales for addressing the issues identified in this inspection. This will ensure that the home provides a pleasant and comfortable environment that suits the needs of the people living in it. 30/09/2009 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 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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