Care Home: Benoni Nursing Home Ltd

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What the care home does well There is a small committed staff team that work hard to meet the needs of the residents. Comments received from residents confirm their confidence in the staff. Many of the people who live at Benoni feel that they are offered a good standard of care. Staff undertake a pre-admission assessment plus gain the views and opinions of any specialist workers involved with prospective admissions. Care plans are detailed and informative, and supported by similarly detailed daily notes from the care staff and nurses. Observation of the interaction between the residents and the staff was very positive and contributes to the pleasant environment at the home. Residents were seen to have personal possessions, and are free to determine their own lifestyle within the parameters of their care needs. The residents have confidence in the staff. The visitors` book, daily records, and comments from residents confirm that contact with loved ones and friends are encouraged. All encounters seen and heard between staff and residents were appropriate with staff addressing people by their preferred name. Staff were heard to be respectful when talking with service users and seen to be gentle when directing and assisting them. The manager (elect) is a registered nurse with a nurse education background. What has improved since the last inspection? Requirements and recommendations identified at the previous inspection have been met or partly met. There has been a marked improvement in the social/recreational experience of the people that live at Benoni. There has been a marked improvement in staff training provision. People are now protected by the home`s recruitment procedure. What the care home could do better: Information could be provided in alternative formats (e.g. audio/video) for people with sensory deficits. More could be done to ensure the involvement of the resident or their representative in regular review of care plans. Choice at meals could be actively offered to residents, and a record kept of the choices made. Common care standards induction training (www.skillsforcare.org) for all new staff should be implemented.There is no formal quality assurance system in place to ascertain the views of those that use the service, though it is accepted that this is in hand and will be introduced in the new year. The home protects residents by ensuring adherence to a robust employment procedure, but records could be improved, especially where there is a potentially contentious matter. Key inspection report Care homes for older people Name: Address: Benoni Nursing Home Ltd Benoni 12 Carrallack Terrace St Just Cornwall TR19 7LW     The quality rating for this care home is:   two star good 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: Alan Pitts     Date: 0 8 1 2 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 26 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 26 Information about the care home Name of care home: Address: Benoni Nursing Home Ltd Benoni 12 Carrallack Terrace St Just Cornwall TR19 7LW 01736788433 01736788433 kernowcare@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Benoni Nursing Home Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia dementia old age, not falling within any other category old age, not falling within any other category physical disability physical disability terminally ill Additional conditions: Four service users may be accommodated who are aged between 55 to 64 years. The maximum number of service users who may be accommodated is 25. The registered person may provide the following category of service only: Care Home with nursing - Code N to service users of either gender whose primary care needs on Care Homes for Older People Page 4 of 26 Over 65 2 2 25 21 2 2 2 0 0 0 0 0 0 0 admission to the home are within the following categories: Old age, not falling within any other category (Code OP) - maximum of 25 places Dementia aged 65 years or over on admission (Code DE[E]) - maximum of 2 places Physical disability aged 65 years or over on admission (Code PD[E]) - maximum of 2 places Date of last inspection Brief description of the care home Benoni is a detached building situated in a residential area of St Just. The home is registered to provide accommodation and care, with nursing, for a maximum of 25 service users. This can include two service users with a dementia and 2 service users with a physical disability on admission. The home is also registered to accommodate four service users from age 55 years of age to 64 years of age. Bedrooms are situated on the ground floor, first floor, and there are also three bedrooms for service users receiving residential care on the second floor. There are three double rooms. The first and second floors are accessed by a shaft lift. The grounds are modest in size though there are areas for sitting outside. The slope from the road and car parking area to the main door is ramped and quite steep, but is negotiable by a person in a wheelchair with assistance. There is a small step and a threshold at the main entrance; these are accessible with a wheelchair with assistance. The home has a strong link with the community and town of St Just. The registered provider is Benoni Nursing Home Ltd. The responsible individual is Mrs Helen Hutson. The registered manager position is vacant, though the Commission anticipate a registered manager application in respect of Mrs Wendy Murray who is currently taking on the role. Fees ranged from 550 to 750 pounds per week at the last inspection, but these should be confirmed with the home. 2 4 0 3 2 0 0 9 Care Homes for Older People Page 5 of 26 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: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection took place over approximately 7 hours. We looked at documentation, toured the premises, met with residents and staff, and discussed our findings with the financial director and the manager (elect) of the home. Overall, the home meets the care needs of the people that live there, and this is confirmed by the positive comments made. Improvements could be made in respect of management systems, but the outcome for the people living at Benoni is good. There have been significant improvements in areas identified at the last inspection where improvement was needed. The registered providers, manager (elect) and staff are to be commended on these improvements. Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Information could be provided in alternative formats (e.g. audio/video) for people with sensory deficits. More could be done to ensure the involvement of the resident or their representative in regular review of care plans. Choice at meals could be actively offered to residents, and a record kept of the choices made. Common care standards induction training (www.skillsforcare.org) for all new staff should be implemented. Care Homes for Older People Page 7 of 26 There is no formal quality assurance system in place to ascertain the views of those that use the service, though it is accepted that this is in hand and will be introduced in the new year. The home protects residents by ensuring adherence to a robust employment procedure, but records could be improved, especially where there is a potentially contentious matter. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 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. The Statement of Purpose and Service User Guide have been reviewed and revised to provide prospective residents and/or their representatives with comprehensive information to enable them to make an informed choice of home. Residents have their needs assessed prior to moving into the home. This is so that the home can assure them the prospective resident that they are able to meet their individual care needs. Evidence: Copies of the Statement of Purpose and Service User Guide (documents that tell a person about the home) are given to relatives, and this includes the homes Complaints Procedure. An alternative format is not available for people with sensory deficits, and this was discussed with the manager (elect). We were advised that the home plan to introduce a quarterly newsletter as an aid to ensuring people have the information they need. Each resident is provided with a Statement of Terms and Conditions. This sets out in Care Homes for Older People Page 10 of 26 Evidence: detail what is included in the fee, the role and responsibility of the provider, and the rights and obligations of the resident. Prospective residents are given the opportunity to spend time in the home. People are given information to help them to feel comfortable in their surroundings, and enable them to ask any questions about life in the home. Admissions are not made to the home until a full needs assessment has been undertaken. The home are then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the Statement of Purpose. For people whom are self funding and without a care management assessment the assessment is always undertaken by a skilled and experienced member of staff. Documentation and training records show that specialist areas of work, such as dementia awareness, have been explored and that staff have access to detailed guidance and training materials. The home does not provide intermediate care, though respite care is offered. Care Homes for Older People Page 11 of 26 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. Many of the people who live at Benoni feel that they are offered a good standard of care. Each resident has a care plan. This is written in plain language, and is easy to understand. Care plans are informative and detailed. The care records also include relevant risk assessments. Evidence: Comments received from the people who live at Benoni were very positive. Many of the people at Benoni have dementia or mental health needs and are not able to always explain their needs or difficulties. It is therefore important that there are written care plans that detail how needs are to be met to ensure that staff know the nature of the care they are to provide. The care plan forms the basis of the care and support provided. The care plans identify the health care needs of the residents with evidence of health care professional involvement for example chiropody and optician visits. The residents are regularly weighed. Care documentation is written in clear language. Each care plan includes a risk assessment. Care plans are detailed and informative about physical care, and now include social/recreational details and Care Homes for Older People Page 12 of 26 Evidence: preferences. Care should be taken to ensure the involvement of the resident or their representative in regular review of care plans. The daily entries were good, detailed and informative. Social and lifestyle statements were included and there is good evidence of the efforts made by the home to provide social and recreational activities. Supporting documentation showed that clients have access to relevant professional health care agencies as needed. All the people that live at Benoni are registered with a local GP surgery. Residents personal aids are well maintained and the home provides the necessary aids and equipment to support both staff and residents in daily living. Clients preferred names are recorded and used. Clients have access to a telephone for private use. Staff were observed to knock before entering residents rooms. The home adheres to a comprehensive medicines policy and procedure. Medicine Administration Records were seen to be in order, with hand transcribed records show two initials, indicating the entry has been checked as correct. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The records reflect the social/recreational activities available and an activities coordinator has been appointed. Visitors are welcomed to the home at anytime. Choice is not always shown to be available to residents. Evidence: Sufficient staff resources are provided to allow time for activities and stimulation. The daily entries in the care documentation could be improved with more information. Daily entries are informative when people have visitors, but there is still a tendency for entries such as happy in the lounge as opposed to entries that inform how the person actually spent their day. Social and recreational activity records demonstrate that stimulation is provided frequently and regularly for the people that live at Benoni. There has been a marked improvement in the provision of social/recreational stimulation since the last inspection and the registered providers, manager (elect) and staff are to be commended. Some people are fit and active and able to walk to local facilities. There is now an appointed Activities Organiser. Observation of the interaction between the residents and the staff was very positive and contributes to the pleasant environment at the home. Residents were seen to have personal possessions, and are free to determine their own lifestyle within the Care Homes for Older People Page 14 of 26 Evidence: parameters of their care needs. The residents have confidence in the staff. Contact with loved ones and friends is encouraged. The design of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. Residents are encouraged to take responsibility for their own financial affairs, or to have a representative take care of this for them, and to use their money as they wish. Staff will support those people who need help in financial matters (e.g. storage of small amounts of money). Choice at meals was discussed with the manager (elect) as many residents have some degree of confusion. The benefit of people being actively offered a choice of meal was discussed, and the manager (elect) said that it was planned to improve this aspect of the service. Choice is available at breakfast and tea, but improvements could be made at lunch. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people at Benoni are confident that their concerns will be listened to and acted upon. The people that live at Benoni are fully protected from abuse by appropriate procedures and ongoing staff training. Evidence: The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. There is a complaints procedure displayed near the entrance to the home. A copy of the complaints procedure is available in the Statement of Purpose and Service User Guide. Comments from the people that live at Benoni confirmed that they had confidence in the staff. The manager (elect) said that the home had received two complaints since the last inspection, both of which had been resolved to the satisfaction of both parties. The home keeps a record of complaints received. The policies and procedures regarding protection of residents are of a good quality and are regularly reviewed and updated. The service is clear when incidents need external input and who to refer the incident to. There is a safeguarding policy, and ongoing safeguarding training taking place to ensure staff awareness and understanding of this issue. People are protected by the homes employment procedure. Care Homes for Older People Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at Benoni benefit from accommodation that is comfortable and pleasant. The accommodation is clean and odour free. Evidence: An extension to the property was completed towards the end of 2008. This increased the homes operating capacity from 21 beds to 25 beds (4 new en-suite single rooms). There are 3 double rooms, 5 single en-suite rooms, and 14 single rooms. There are 2 communal bathrooms, and 5 communal lavatories. The shared areas provide a choice of communal space with opportunities to meet relatives and friends in privacy or in their own rooms. We looked around the home and the rooms seen were all clean and in good order, there were no unpleasant odours. Some of the people had brought items of their own in to decorate their rooms. All of the rooms are of sufficient size, though room 6 does have limited floor space as a double room. Room 4 has an area to the rear of the room, which is used by staff to store a variety of equipment including a mattress and cushions. This area is adjacent to a wash hand basin and partly separated from the residents room by a curtain. Privacy and dignity of the people in rooms 7 and 8 would be improved with the provision of suitable screening as room 8 is accessed via room 7. New carpets have been ordered for some bedrooms and are planned to be fitted later this week. Care Homes for Older People Page 17 of 26 Evidence: The home has a sluice facility, which was seen to be in use. Staff were observed to be using protective clothing and protective equipment is provided in the relevant areas. There is plenty of hot water and the temperature in the home can be changed. The home is well lit, clean and tidy and smells fresh. There is a good infection control policy. The home seeks advice from external specialists, e.g. infection control, and encourage their own staff to work to the homes policy to reduce the risk of infection. Care Homes for Older People Page 18 of 26 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. The numbers of staff on duty are sufficient for all care needs and the efficient management of the service. The recruitment procedures are robust enough to safeguard residents. Training has progressed significantly since the last inspection. Evidence: The duty rota and discussion with staff confirms that at the time of the inspection there were 24 people living at Benoni. Two clients are funded for a number of 1:1 staffing hours. There is routinely 1 nurse and 5 care staff on duty during the period 8am to 2pm, and 1 nurse and 4 care staff during the period 2pm to 8pm. Management encourage staff members to undertake external qualifications beyond the basic requirements, and recognise the benefits of a skilled, trained workforce. The service clearly defines the roles and responsibilities of staff through accurate job descriptions and specifications. The training matrix displayed on a white board on the wall of the office is up to date and accurate. There are training certificates in individual personnel files. There is a system for monitoring staff training needs (e.g. 1st Aid). New staff receive in-house induction training, though the recording of this could be improved with the inclusion of staff initials and dates against the topics covered. The home must be able to demonstrate common care standards induction training (www.skillsforcare.org.uk). Approximately 48 of care staff are qualified to NVQ Level 2 or above, with a further two staff undertaking this training. Care staff are provided Care Homes for Older People Page 19 of 26 Evidence: with a copy of the General Social Care Council Handbook. Examination of personnel files showed that the home is adhering to a robust employment procedure. The staff personnel files inspected showed at least two references, and sometimes four references. An up to date photograph is held on file for all members of staff. The use of a checklist at the front of personnel files to readily access core information (such as start date, date crb sent, date crb received, crb reference) is used. Employment records would benefit from more detail, especially where there may be contentious issues discussed with the prospective employee (e.g. record of interview). All encounters seen and heard between staff and residents were appropriate with staff addressing people by their preferred name. Staff were heard to be respectful when talking with service users and seen to be gentle when directing and assisting them. Staff were seen and heard to knock on doors before entering bedrooms. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager (elect) has the required qualifications and experience to run the home. Feedback is not routinely sought from residents and/or their relatives regarding the way in which the home is run. Staff are supervised. Evidence: The registered manager position is vacant, though the Commission anticipate a registered manager application in respect of Mrs Wendy Murray who is currently taking on the role. Mrs Murray has a nurse education background and has previously managed her own care home. There is a strong ethos of being open and transparent in all areas of running of the home. The home has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. A formal quality assurance system is not in use to ascertain the views of those that use the service. Discussion took place with the manager (elect) about the best way to ascertain peoples views of the service, summarize, and publish the findings (including Care Homes for Older People Page 21 of 26 Evidence: any action taken as a result of these). Financial records are supported by receipts. The home has no involvement in the management of individuals finances, though will look after small amounts of money if requested to do so. Care staff are receiving formal supervision frequently and regularly. The premises and equipment within are regularly maintained and checked. There is appropriate insurance in place. Fire training is being provided at the frequency recommended. Care Homes for Older People Page 22 of 26 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 23 of 26 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 30 18 The registered provider 01/01/2010 must be able to demonstrate common care standards induction training (www.skillsforcare.org.uk) for all new staff. This is to improve outcomes for residents and assist with the provision of a consistent standard of care delivery. 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 The registered provider should consider providing information in alternative formats (e.g. audio/video) for people with sensory deficits. Care should be taken to ensure the involvement of the resident or their representative in regular review of care plans. The registered provider should make arrangements for choice at meals to be actively offered to residents, and a record kept of the choices made. 2 7 3 15 Care Homes for Older People Page 24 of 26 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 4 16 The registered provider should consider providing information in alternative formats (e.g. audio/video) for people with sensory deficits. The registered provider should make arrangements to ensure the privacy of people sharing rooms. Employment records would benefit from more detail, especially where there may be contentious issues discussed with the prospective employee. The registered provider should promote the use of quality assurance surveys to relatives and other stakeholders, and publish a summary of the findings. 5 6 24 29 7 33 Care Homes for Older People Page 25 of 26 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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