Care Home: Bryony House

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What the care home does well The pre-admission assessment process ensured the staff knew the needs of the people being admitted. People are able to visit the home before admission to assess the facilities available. There are good systems for recording the needs and preferences of each person, including their health needs, so that staff know how to provide care in the most appropriate way. There are various activities and entertainments available in the home, but people`s right not to participate is respected. People are provided with a variety of meals which are well presented and meet their needs and preferences. Relationships between the people living in the home and the staff are good. The rotas showed that there are adequate numbers of staff on duty throughout the day and night to meet the needs of the people living in the home. Staff have access to training which ensures that they have the required skills and knowledge to meet people`s needs. Recruitment procedures at the home are robust. There are also good arrangements for handling complaints. Staff are trained in adult protection. This means that people in the home are kept safe. The home provides people with a very comfortable, clean, well maintained and safe environment in which to live. The manager ensures the smooth running of the home in a competent manner. The health and safety of the people living in the home and the staff are well managed. What has improved since the last inspection? The care plans are now recorded in an improved way so that they are now more specific to each person. They include more detailed risk assessments and more information about how each person prefers to be supported. These help staff to meet each person`s needs. Improvements in the systems for checking and auditing the care plans mean that these are now up to date and changes are made when necessary, so that people continue to have their needs met when their circumstances change. There are better arrangements for the administration and recording of the medication which people need to take. These include improvements in the checks which are made to make sure that all medication is provided in the right way. The home now has better checks in the area of Health and Safety so that people are kept safe.There are more activities for people to join in with if they wish to do so. There is also more entertainment. What the care home could do better: The manager told us that she plans to increase the frequency of staff meetings in order to further improve the quality of communication within the staff team. The manager plans to provide staff with more training in auditing so that they are more involved in the quality assurance process. The manager is trying to form a resident committee to provide people with more opportunities to be involved in day to day decisions about all aspects of their home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Bryony House 30 Bryony Road Selly Oak Birmingham West Midlands B29 4BX     The quality rating for this care home is:   two star good 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: Christine Lancashire     Date: 2 2 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: Bryony House 30 Bryony Road Selly Oak Birmingham West Midlands B29 4BX 01214752965 01216801300 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) : Bryony House Committee care home 35 Number of places (if applicable): Under 65 Over 65 35 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 35 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) 35 Date of last inspection Brief description of the care home Bryony House is a purpose built residential home situated in a residential area within the Bournville Village Trust, providing care for up to 35 older people. There are shops and a church in the locality and easy access to the public bus service. Community facilities are within walking distance. The home is a large three-storey building with a lower ground floor. Accommodation is situated on all floors of the home. There are toilets and assisted bathrooms on all floors and all the bedrooms have en-suite facilities. One shaft lift connects the ground floor with the lower ground floor and the another connects the ground floor to the first Care Homes for Older People Page 4 of 27 Brief description of the care home and second floors. There are also six flights of stairs throughout the home. On the ground floor are the main kitchen, laundry, office space, a dining room, two lounges and a large conservatory that leads out to the large and well maintained rear garden. A further lounge has been established on the first floor of the home and there is a hairdressing facility on the second floor. At the front of the home there are parking spaces for several vehicles. The fees for this home are available on application to the home. The fees cover a single room, personal care, laundry, all meals and beverages and the activities programme. There is an extra charge for hairdressing, chiropody, newspapers, purchases from the shop and telephone. 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: 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: We visited this home on a weekday without telling anyone that we would be arriving. The purpose of the visit was to see how the home is meeting key National Minimum Standards and to make sure that the requirements made in previous reports have been addressed. Before the visit we had received information from the manager in an Annual Quality Assurance Assessment (AQAA). This provided us with information about the running of the home and the plans for development. This information arrived when we asked for it and it contained good detail. we also sent surveys to a sample of staff, people who live in the home, their relatives and professional visitors. We received several completed forms. At the inspection we spoke to the manager, several members of the staff team Care Homes for Older People Page 6 of 27 and several people who live at the home. We looked round the building and into three bedrooms. We chose three people who live in the home and we looked at the records which the home is required to keep about them and the way in which their needs are met. These include records about their needs and preferences, safety, menus, staff rotas, medication, staff recruitment and training, complaints and minutes of meetings. We looked at the systems which the home has for monitoring its performance and at the results of questionnaires completed by people who live there. We used this information to write this report. What the care home does well: What has improved since the last inspection? The care plans are now recorded in an improved way so that they are now more specific to each person. They include more detailed risk assessments and more information about how each person prefers to be supported. These help staff to meet each persons needs. Improvements in the systems for checking and auditing the care plans mean that these are now up to date and changes are made when necessary, so that people continue to have their needs met when their circumstances change. There are better arrangements for the administration and recording of the medication which people need to take. These include improvements in the checks which are made to make sure that all medication is provided in the right way. The home now has better checks in the area of Health and Safety so that people are kept safe. Care Homes for Older People Page 8 of 27 There are more activities for people to join in with if they wish to do so. There is also more entertainment. 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. People who are considering moving into this home are provided with the necessary information to make an informed choice. Assessments and visits to the home ensure that people know, before they move in, that their needs can be met by the home. Evidence: The home has a Statement of Purpose and service user guide which provide people with information about the home and the services provided. The manager told us that peoples needs are assessed prior to being admitted, so that she can be sure that the home can meet their needs. She went out to assess someone who was in hospital on the day of the inspection to see if they would be fit to return and to see how the care plan may need to be altered to accommodate their changed needs. We looked at the records for three people living in the home, including two who had recently been admitted. The notes showed that the manager had carried out an Care Homes for Older People Page 11 of 27 Evidence: assessment of their needs and the date and location of this was clearly recorded. The assessments contained details of peoples needs and the potential risks in various areas, including general health, mobility, communication, religion, language and interests. Each person had been to the home for a visit prior to being offered a place. One had participated in an activity during their visit. The reaction of the person to the visit was recorded and there was a record of the decision about when they could move in on a months trial. This shows that peoples needs are assessed before they are admitted so that the home can be sure that staff can meet their needs. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social needs are set out in a care plan so that they can be met by staff. People are treated with respect and their privacy and dignity are maintained. They are protected by the homes practices in relation to the storage and administration of medication. Evidence: We looked at the records for three people who live in the home. we saw that the information gathered at the time of assessment had been transferred into a care plan, to inform staff about how to care for each person, in a way that meets their needs and preferences. The care plans are divided into sections such as mobility, bathing, dressing and interests and each section contains details of the persons needs in that area. In addition to the needs in each area, there are details of the objectives, the possible risks and the means of minimising these and the assistance required, including the number of staff. We saw good examples of instructions for staff such as in one Care Homes for Older People Page 13 of 27 Evidence: persons record, it says, I sometimes require assistance when dressing or undressing so I change in the correct order. Another said, I have limited mobility...and sometimes can appear rigid...I do not have any discomfort when dressing and undressing . Staff showed at the handover time, that they were aware of the needs of various people in the home. Any changes were discussed at this time, so that all staff are made aware of the current needs of each person in the home prior to starting each shift. This means that they are well prepared to provide appropriate support to people. There is a section in each care plan which provides details of each persons health needs. These contain the relevant diagnosis and any specific instructions for staff about how they need to be supported.The initial assessment includes a dietary assessment and an assessment of tissue viability. We saw that there are notes about peoples ongoing medical conditions such as diabetes, and the ways in which they need to be supported. There are also notes which tell staff about the possible symptoms to look for. For example, I am not known to have any form of diabetes. Should I develop any symptoms of diabetes, such as increased thirst, passing water frequently, fatigue or weight loss, these matters should be discussed with my GP. The care plans show how each person needs to be supported to maintain good nutrition and to avoid pressure sores. We saw that people are weighed on a regular basis. There are graphs showing their weight and body mass index and staff can see easily if someone is losing or gaining weight so that they are heading for one which may be unhealthy. We saw the records for several people who had been admitted from hospital under their desired weight, but had put on weight since being at the home. We saw a clear list in each persons file of the medication which they need to take. This has details of what each medication is used for and the dose and frequency. We saw assessments about whether or not people are able to manage their own medication and when they do so, this is clearly marked on the plan. Staff give people their medication at the right times and this means that sometimes people need to be given their tablets at a different time from others. For example, we saw staff give one person antibiotics at the lunch table, because these tablets needed to be taken with food. 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. Peoples lifestyles in the home match their preferences and suitable activities are arranged. They are encouraged to maintain significant relationships with people in the community and they receive a choice of nutritious meals which meet their needs and take account of their preferences. Evidence: We saw that peoples care plans contain details of their preferences in terms of activities. The home has a varied programme of activities available and we saw these displayed in the entrance area, with the relevant dates clearly noted. Each person has a diary. We saw that staff had recorded the events in each persons days, including visitors and outings where relevant. People have recently participated in keep fit, arts and crafts, dog patting, a strawberry tea and flower arranging. The records show that some people prefer to read in their rooms or to watch television, such as the tennis. Where people do not wish to participate in organised activities, this is recorded in their notes. For example, one persons notes said that they disliked taking part in keep fit and craft activities. Care Homes for Older People Page 15 of 27 Evidence: We saw many examples of people being provided with choice. We heard staff asking people what they wanted to drink and enabling people to help themselves to milk and sugar where possible. We heard one member of staff providing a person with a choice of several different choices of biscuits and making sure that they really wanted what they had chosen. The care plans contain a section on choice and the ones which we looked at contained notes about peoples likes and dislikes and their preferred routines. Several people told us that staff listen to what they say and respect the choices which they have made. The manager told us that she is trying to form a residents committee so that people can be more involved in all aspects of running their home. There is a newsletter which provides people with details of what is going on in the home and we saw this on a noticeboard. We saw that there are nutritional assessments for each person in the home and their likes and dislikes in terms of food are recorded. When people have specific needs for medical or other reasons, these are recorded. The menus show a choice at each meal time. People told us that they like the food. One person said, it is always lovely here. We ate a meal in the home and it was well presented and appeared to be well balanced in terms of nutrition. The meat was tender and the vegetables were easy to cut, without being overcooked. People sitting at the table with us had a range of plates. One was large, another was small and another had a rim. This means that staff are aware of peoples different needs. All the people at our table had chosen the same main course, but they had different puddings. As well as serving the meals, staff stayed in the room during the meal to provide people with assistance and conversation. 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. There are good arrangements to ensure that people are protected, including the arrangements for handling complaints. Evidence: The home has a procedure for dealing with complaints and the manager told us that people are issued with a service user guide which includes the details for how to make a complaint. People living in the home told us in conversation and in their responses to questionnaires that they know how to complain. One person told us that they would go to a member of staff. We saw that there is a record of complaints received by the manager and this contains details of how each situation was sorted out. These records show that the staff are good at responding to peoples comments. We saw policies and procedures in relation to safeguarding and whistle blowing. The home has a copy of the multi-agency guidelines for adult protection and this details all the necessary contact numbers if there is a suspicion or allegation of abuse. Staff demonstrated at the handover time that they had an understanding of the issues involved. The training records show that they have received training in this area. The care plans contain a section on abuse and this has details of the assessment of the persons vulnerability, together with any measures taken to make them more safe. Care Homes for Older People Page 17 of 27 Evidence: People who live in the home told us that they feel safe. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, clean and safe environment which meets their needs. Evidence: We looked round the building and saw the communal areas as well as three bedrooms. The home has ample communal space with two large lounges and a conservatory on the ground floor and a smaller lounge on the first floor. There is a separate dining room with tables for four people. All the communal areas are well furnished. There are extensive grounds to the rear of the home that are very well maintained and accessible to the people living in the home. The manager told us that people make use of the garden when the weather is warm and dry. There are numerous toilets, bathing and showering facilities throughout the home. All bathrooms and toilets provide the people living in the home with a variety of facilities which allow for full staff assistance. There are two toilets on the ground floor of the home directly opposite to the lounge. These allowed good access for people with walking aids. All bedrooms have en-suite facilities of toilet and wash hand basin and some have floor level showers fitted. The bedrooms seen during the course of the inspection contained personal items and looked comfortable. Several people told us that they like their rooms. The home is able to accommodate some couples allowing for them to share a bedroom and have some Care Homes for Older People Page 19 of 27 Evidence: lounge space. All bedrooms are lockable and the occupants may have keys if they wish to do so. All areas seen on the day were clean and free from unpleasant odours. The home has policies and procedures for preventing the spread of infection and staff receive training in this area. Staff have access to gloves, aprons and antibacterial handwash. We saw staff in the kitchen wearing suitable protective clothing. This shows that the home has good arrangements for preventing the spread of infection. 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. The people who live in this home are cared for by sufficient numbers of staff who are well trained and competent to do their jobs. They are protected by the homes recruitment practices. Evidence: We looked at the rotas and they showed that there are adequate numbers of staff on each shift. The manager told us that there were two members of staff on long term sick and two on maternity leave at the time of the inspection and her priority was to make sure that all shifts were covered. We sampled three staff files and found that they had been recruited by means of a standard procedure which includes taking up references and obtaining a check through the Criminal Records Bureau. The manager has recently changed the format of the reference requests so that these include an overview of previous training undertaken. Staff complete a skills audit when they are interviewed and when they start working at the home, all staff are provided with induction training, followed by more specific training to meet the needs of the people in the home. The manager is in the process of updating the training records so that they will be easier to read and up to date. The records which we examined showed that over 90 per cent of staff have NVQ level 2 or above and over 50 per cent have level 3. In Care Homes for Older People Page 21 of 27 Evidence: addition, staff have been provided with training in a range of relevant areas, including infection control and adult protection. There is a planned update in manual handling in the near future. The manager has undertaken training in the Deprivation of Liberty Safeguards and is looking for suitable courses for staff. On the office wall, we saw written advice for staff in areas relevant to their job. The manager also shared information at the handover period, which makes sure that staff coming onto the shift are aware of the issues affecting each person in the home that day. These arrangements mean that staff are provided with good information and training so that they are able to meet the needs of the people in the home. In addition to handover periods, the staff attend staff meetings to share information. The manager told us that she plans to increase the frequency of staff meetings in order to further improve the quality of communication within the staff team. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well managed home which is run in their best interests and where there are good systems for maintaining the quality of care. Their financial interests are safeguarded and their health, safety and welfare is promoted and protected. Evidence: The manager has many years of relevant experience, is a registered nurse and also has the Registered Managers Award. Throughout the inspection she demonstrated a good knowledge of the needs of the people living in the home. She showed in her AQAA that she is committed to maintaining the standards at the home and to making improvements where possible. The main issues raised at the previous inspection were the need for more robust risk assessments and for care plans to be updated as the needs of the people living in the home changed. There is good evidence to show that these improvements have been made. We saw that the home has a quality assurance system which includes auditing the Care Homes for Older People Page 23 of 27 Evidence: service against the National Minimum Standards. Surveys are sent out to the people living in the home and their relatives covering topics such as food and activities. People are also asked about the quality of the meals on a daily basis. The audit system includes daily checks on various aspects of safety in the home. There are also regular visits by members of the committee. These arrangements help to make sure that the standards are maintained so that people continue to have their needs met. The manager told us that she is planning to provide staff with more training in auditing so that they are able to contribute more to this process. The home continued to manage some money on behalf of some of the people living in the home. We watched staff recording money taken out and checking the amount. We sampled the records and found them to be appropriate. Money was kept in the safe in the main office and was not accessible when the administrative staff had gone home. The manager told us that there is a system to ensure people have access to money out of office hours. The manager told us that she audits the system with the administrator on a regular basis. We saw risk assessments on peoples files. Records show that staff receive training in safe working practices and the home is well maintained. The kitchen has received four stars from the Environmental Services. The manager provided date for the servicing of equipment in the home. We saw that the records for the in house checks on the fire system are up to date and fire drills are carried out as required. The home continues to notify the Commission of accidents and incidents in the home. This shows that there are good arrangements for making sure that people who use the building are kept safe. 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 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). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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