Care Home: Burford House

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What the care home does well Generally the residents appeared content and well cared for. They live in a homely and clean environment. Mobility is encouraged and the majority of the residents were in the communal areas on the day of the site visit. Many participated in the group therapeutic activity of catching and throwing balloons and reminiscence. The group activities provide social, physical and mental stimulation. Members of staff respect the residents and interacted well with them. It was noted that the care staff assist the co-ordinator during activity time and readily assisted those residents who needed help during lunchtime. Mealtime was unhurried and the majority of the residents seemed satisfied with the meals provided. The residents spoken to gave positive feedback about the care and service provided. Similar complimentary remarks were received from residents, relatives and other respondents in a recent survey carried out by us. Comments received included: "The staff are wonderful." "I am more than happy here. The staff are very caring." "The food is quite good. There is a choice of hot meals." "I don`t like curry. I prefer traditional food so I have an alternative dish on the day. But the staff are wonderful and caring." "Excellent food. No complaints." "I am happy with my bedroom. The cleaner cleans it everyday." "There is kindness, care and attention." "The activity staff are enthusiastic and imaginative." "The activities have improved. There are activities most weekdays. My (relative) doesn`t always want to partake but it is nice to have the option." "Most of the staff are always cheerful." "Burford House has a welcoming and caring atmosphere and everyone is always made very welcome." "I notice that they have regular training and keep up to date with their paper work." "The chef serves well cooked food with lots of green vegetables, salads and fruits." "Extremely warm atmosphere at Burford. Staff are friendly and willing. Management are always available if needed to discuss any problems.""They are caring to the needs of the clients as their first priority as well as the needs and support of the client`s families." "Burford House has a wonderful, happy and relaxed atmosphere ensuring that it is a `home` to everyone who visits. We have received numerous compliments from friends who visited my (relative) saying how homely and comfortable Burford House is to visit." "The new manager is very good. Everything seems to run smoothly since she took up the post." What has improved since the last inspection? Under the new home manager, the service has improved to a good standard. Positive changes in the service and care practice have been made since her appointment. The home has also appointed a deputy manager to assist in the administration and management of the service. The service has improved its menu having listened to the residents and relatives and has recently changed its supplier for fresh meat and vegetables. What the care home could do better: Following a recent safeguarding investigation under the joint safeguarding procedure, the management has taken remedial steps to ensure that there is proper documentation for daily oral hygiene care for those residents who are unwell and who may have issues with fluid intake. All the nurses have had a refresher course on the safe administration of medication following a medication error in November 2008. The resident was not unduly affected by the error. Appropriate measures have since been put in place to ensure that such an error is avoided in the future. It would be good if the management took note of the following comments from some relatives: "My (relative) loves classical music. Most of the entertainment consists of old time and popular music." "The evening meal should be more varied. The sandwiches are rather boring. However, my (relative) asks for something else and is given an alternative dish. Weekend cooking is a bit disappointing for (my relative)." Inspecting for better lives Key inspection report Care homes for older people Name: Address: Burford House Rickmansworth Road Chorleywood Hertfordshire WD3 5SQ     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: Yoke-Lan Jackson     Date: 1 5 0 6 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: Burford House Rickmansworth Road Chorleywood Hertfordshire WD3 5SQ 01923282818 01923282951 burford@westgatehc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Westgate Healthcare Limited Name of registered manager (if applicable) Mrs Debra Read Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: This home may accommodate 30 older people who require nursing care This home may accommodate 30 older people who require nursing care Date of last inspection Brief description of the care home Burford House is a residential care home, provided by Westgate Healthcare Ltd. The home is registered for 30 people in the Old Age category and who may need nursing care. The home is situated in Chorleywood, close to the M25 motorway. Both Rickmansworth and Chorleywood railway stations are nearby. There is parking in front of the building. The building is a large period house with modern additions. The administrative office, kitchen and communal rooms, comprising a lounge/diner and a second lounge (with library and television) are all on the ground floor. Accommodation is on two floors served by a lift. There are 24 single bedrooms and three double bedrooms. The double Care Homes for Older People Page 4 of 27 care home 30 Over 65 30 0 Brief description of the care home bedrooms are used as single bedrooms or for couples who wish to share a room. To the rear of the building is a large and attractive landscaped garden with a fish pond stocked with koi fish. The patio has garden furniture and seating for residents. The garden is accessible to wheelchairs. The home charges £547 to £781 per week. Information about the home and the service it offers is contained in the Statement of Purpose and the Service Users Guide. A copy of these and the most recent CQC inspection report are available in the home. 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: This service was last inspected in June 2008. As it was an adequate service, an unannounced inspection was carried out on 15/06/2009. The home has been under new management since 01/04/2008. The newly registered Home Manager and the Operations Manager were both present. The home has 26 people in residence. The inspection included a tour of the premises. Time was spent observing how the staff interacted with the residents during lunchtime and group activity. Staff and residents were interviewed and documents were examined. Survey questionnaires were sent to the residents and the relatives and their responses and other information received by us were reviewed. This included the Annual Quality Care Homes for Older People Page 6 of 27 Assurance Assessment (AQAA) form which providers of registered services are required to complete. The AQAA focuses on how the outcomes are being met for the people using the service. What the care home does well: Generally the residents appeared content and well cared for. They live in a homely and clean environment. Mobility is encouraged and the majority of the residents were in the communal areas on the day of the site visit. Many participated in the group therapeutic activity of catching and throwing balloons and reminiscence. The group activities provide social, physical and mental stimulation. Members of staff respect the residents and interacted well with them. It was noted that the care staff assist the co-ordinator during activity time and readily assisted those residents who needed help during lunchtime. Mealtime was unhurried and the majority of the residents seemed satisfied with the meals provided. The residents spoken to gave positive feedback about the care and service provided. Similar complimentary remarks were received from residents, relatives and other respondents in a recent survey carried out by us. Comments received included: The staff are wonderful. I am more than happy here. The staff are very caring. The food is quite good. There is a choice of hot meals. I dont like curry. I prefer traditional food so I have an alternative dish on the day. But the staff are wonderful and caring. Excellent food. No complaints. I am happy with my bedroom. The cleaner cleans it everyday. There is kindness, care and attention. The activity staff are enthusiastic and imaginative. The activities have improved. There are activities most weekdays. My (relative) doesnt always want to partake but it is nice to have the option. Most of the staff are always cheerful. Burford House has a welcoming and caring atmosphere and everyone is always made very welcome. I notice that they have regular training and keep up to date with their paper work. The chef serves well cooked food with lots of green vegetables, salads and fruits. Extremely warm atmosphere at Burford. Staff are friendly and willing. Management are always available if needed to discuss any problems. Care Homes for Older People Page 8 of 27 They are caring to the needs of the clients as their first priority as well as the needs and support of the clients families. Burford House has a wonderful, happy and relaxed atmosphere ensuring that it is a home to everyone who visits. We have received numerous compliments from friends who visited my (relative) saying how homely and comfortable Burford House is to visit. The new manager is very good. Everything seems to run smoothly since she took up the post. What has improved since the last inspection? 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 Care Homes for Older People Page 9 of 27 7535. Care Homes for Older People Page 10 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 11 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 use this service can be confident that they will be supported for the home will only admit a prospective client whose care needs can be met. They can be assured that a thorough pre-admission assessment will be carried out to ensure that the home can meet all their care needs and there is a trial period before a permanent contract is agreed. Evidence: The pre-admission documents for two new admissions were examined and they were found to be detailed and informative. The manager had carried out a thorough assessment of each prospective clients personal, healthcare and social care needs. The manager said that the home will only admit prospective clients whose care needs can be met appropriately. The two new admissions seemed settled in their new home. There is a trial period of stay of six weeks before the contract is finalised. Care Homes for Older People Page 12 of 27 Evidence: Recently the home has admitted a client whose nursing needs outweigh their dementia condition. The home manager assured us that the home is able to meet their care needs and that all the staff have had dementia awareness training. The resident seemed settled and the spouse spoken to said that they are very pleased with the progress the resident has made since they were transferred from another care home. Care Homes for Older People Page 13 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. People who use the service can expect to be treated with respect and they will receive personal and healthcare support in the way they prefer and require and they will be protected by the homes medication policy and procedures. Evidence: Each resident has a written care plan which is person-centred. The home manager said that work is in progress to improve all written care plans to reflect the person-centred care provided. This ensures that those who are looking after the residents have the required information to deliver the personal, social and healthcare needs of the people living in the home. The key worker carries out a six weeks review of each residents care needs and there is a yearly review of care needs that involves the resident, their next of kin and the relevant healthcare professionals. Appropriate records are kept. Residents have access to their own doctor and to specialist medical, nursing and other Care Homes for Older People Page 14 of 27 Evidence: therapeutic services when required. Following a referral, one of the residents now has the use of an electric wheelchair which enables them to move about easily with the push of a button. There are other residents with mobility issues but they are all up and about in the communal areas. Members of staff continue to encourage them to move about every day. Currently there is a resident with chronic leg ulcers which have since improved. There is a wound progress chart in place. The resident continues to attend the dermatology clinic in the local hospital. On the day of the inspection, it was noted that two members of staff were assisting a resident who needed hoisting in one of the lounges. The curtain was drawn and the members of staff ensured that there were no other persons in the room before the hoist was being used, An appreciation of respect and dignity were clearly demonstrated. A trained nurse administers medication. All controlled drugs are stored in a controlled drug cupboard which is firmly fixed to the wall in the medication storage room. Proper records are kept. All other medicines that are in use are stored in a drug trolley, which is attached to the wall in the medication storage room when not in use. The Medication Administration Record (MAR) charts examined were correctly signed following administration of medicines. There were some medicines that had been carried forward from the previous month. The management said that all stock medicines are returned every two months when not in use. The manager ensures that appropriate support is given to a resident who is required to take at least 20 tablets three times a day so that the resident does not feel hurried while ensuring that medication is administered in accordance with legislation. All the nurses have had a refresher course on the safe administration of medication following a medication error in November 2008. The training was provided by the supplying pharmacist. Since the incident appropriate measures are in place to ensure that such an error is avoided in the future. Care Homes for Older People Page 15 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 who use the service can be assured that they will be given the opportunity to make everyday choices and their wishes and preferences will be respected. They will be encouraged to maintain links with their friends and families and they will be encouraged to have a healthy diet. Evidence: Residents interviewed during the site visit were complimentary about the service and care given. During lunchtime, members of staff were readily present to assist individuals to the dining room for lunch. It was noted that lunchtime was unhurried. A number of residents needed assistance and members of staff were readily available to help them. There has been a change of supplier for fresh meat and vegetables. The menu is reviewed weekly and the daily menu is displayed on the dining table for the individual to select their daily choice of dishes. The chef discusses the menu with the residents and takes into account those residents with dietary needs. A member of the kitchen staff had further training recently to enable them to assist the main chef. The home has two activity co-ordinators who work opposite shifts to ensure that Care Homes for Older People Page 16 of 27 Evidence: residents have the maximum benefit in enjoying themselves with planned group activities, entertainment and one-to-one attention. The care staff assist with activities. Residents are given opportunities to plan their daily social routine. The activity coordinator showed us a tray with different objects and scented materials that are being use during a therapeutic sensory session to encourage each individual to develop their senses of touch and smell. There is a reminiscence session as well. On the day of the site visit, there were a dozen residents in the activity lounge involved in the balloon throwing and catching therapeutic exercise. There were two care staff assisting the co-ordinator. Other activities include cake decorating, daily walks in the garden or to the local shops. The manager said that at least 8 residents attend the local church on a Thursday and get involved in the Young at Heart Club. The activity programme and photos of group activities were on display on the noticeboard. Care Homes for Older People Page 17 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 who use the service can be assured that the service has a robust Complaints Policy and Procedure and can be assured that they will be listened to and any concerns raised will be investigated and appropriate action taken. Evidence: The home manager investigates complaints or concerns that are raised by residents, relatives and others. There are regular Residents and Relatives Meetings and minutes are taken. Immediate action is taken to resolve any issues, which are documented. All members of staff have received training on the Protection of Vulnerable Adults and the Hertfordshire Joint Safeguarding Procedure. They are aware of the Whistle-Blowing Policy. Since the last inspection, there has been a safeguarding referral that was investigated and the management has implemented a more robust system of personal care and documentation for residents who have problems with fluid intake. 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 who use the service can be assured that the environment they live in is well maintained, comfortable and safe and that they will have access to all communal facilities. Evidence: The premises are well maintained, clean and tidy. There is an ongoing maintenance programme. The premises and bedrooms are cleaned daily. There have been additional domestic staff recruited since the last inspection. The residents interviewed said that they are quite happy with their bedrooms, which have personal items and potted plants on display. The surrounding grounds and the back garden are neat and attractive with healthy-looking bushes and plants. The rear landscaped garden with a patio and garden furniture is accessible to all residents including wheelchair users. Part of the attraction is the fish pond with a number of healthy-looking koi fish. The home manager confirmed that all equipment such as hoists and wheelchairs has been regularly serviced and is maintained in good working order. The home has recently employed a maintenance man who is also the gardener. He has done a good job of maintaining the grounds and improving the environment as commented on by a visitor in a recent survey by us: The new maintenance person Care Homes for Older People Page 19 of 27 Evidence: has improved the garden and grounds. 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. People who use the service can be assured that the home has an effective staff team who will support them and can be confident that they are safeguarded by the homes robust recruitment policy and procedures and the improved training programme for staff. Evidence: The home has an effective team of nurses, care workers and domestic staff. On the day of the site visit, both the home manager and deputy manager were present. The home manager said that at the present time one nurse is allocated per shift but reassured us that additional nurses will be deployed if the need should arise. The home manager herself prefers to be hands-on to get to know her staff and residents well. Under the new home manager, the nurses have more roles and responsibilities and they are playing a key role in the admission process and person-centred care planning and documentation. This enhances their administrative skills and professional skills as trained nurses and maintains their nursing practice in line with the requirements of the registration body, the Nursing and Midwifery Council. The main chef is attending further training for a Level 2 Award in Healthier Food and Special Diets. All the staff records have been updated. New recruits have Criminal Record Bureau checks and Protection of Vulnerable adults (POVA) checks done. The home has Care Homes for Older People Page 21 of 27 Evidence: recently appointed a deputy manager following the retirement of the previous one. Staff supervision is carried out six times a year and proper records are kept. There is a rolling training programme for all staff. The home follows the Skills for Care common induction training programme for new recruits and the management is making arrangements for NVQ training for the care workers. One care worker is currently studying for NVQ3 and another has started NVQ2. All the staff have had dementia awareness training. Other topics included wound management, personcentred care planning, infection control and the Mental Capacity Act 2005. The nurses interviewed said that they all have had a refresher course on the administration of medication the day before the site visit. This was given by the supplying pharmacist. One of the activity co-ordinator has taken up a course on activities with a recognised training provider. A new administrator has been appointed while the current one is moving on to a newly registered sister home. 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 who use the service can be assured that the standards of administration and management of the service are well maintained and that their health and safety are promoted and protected. Evidence: The home manager, who was appointed on 01/04/2008 as acting manager, became the new registered home manager on 13/02/2009. She is an experienced and qualified nurse and has completed the Leadership and Management in Care Award. Under the new management there have been a number of positive changes in the care and service. The care plans have been reviewed, revised and improved. Residents care needs are reviewed regularly and documented. All members of staff have had regular supervision and there is an improved system of record keeping and updates. The servicing records have been well maintained. The management carry out a monthly audit of accidents, falls, wounds and pressure sores. The nurses are given Care Homes for Older People Page 23 of 27 Evidence: more roles and responsibilities and the quality of communication among staff and with the residents has improved as has the activity programme. The provider carries out an annual quality assurance and monitoring survey. This includes written questionnaire feedback from residents, relatives and others. In addition, the new Operations Manager conducts a monthly visit and produced a monthly report as required by legislation. The home is not involved in the residents finances or personal allowances. All records for the protection of the residents are kept secure and handled in accordance with the Data Protection Act 1998. In a recent written survey by us, the following comments were addressed to the manager and her team by a respondent: Continue the good work (manager) and your team ensuring that Burford house continues to be a home of choice. We are so glad you had a place for (relative) when we were looking for a house to address (relatives) needs and also ours. Your staff are attentive and positive to the needs of your clients. The Annual Quality Assurance and Assessment (AQAA) forms issued by the Commission were received on time for this inspection. The information provided was detailed and was included in this report. 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. 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