Care Home: Cambrian Lodge

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What the care home does well Cambrian Lodge continues to provide a homely, caring and supportive environment for people living there. Staff are dedicated to meeting the needs of people living in the home in a personal, "person centred" way. This was evident in the way the care needs of people living in the home were recorded, and also how staff could identify the individual needs of the person when asked. Staff had a clear understanding of the importance of individuality and allowing people to maintain control over their everyday lives. People we spoke to told us they felt well cared for by staff who understand their needs. One person told us "they are so kind and always helpful". We spoke to a group of people sat in the dining room after lunch and they praised staff highly and said they were very happy with the care and support they received. People felt that they could comment on how the home was run and that their opinions really mattered. We observed staff to have a friendly cheerful rapport with people in the home, and assistance was given in a caring enabling manner. We saw that people living in the home could take part in a small and meaningful programme of activities which included exercise to increase and maintain ability, games, jigsaws, walks in the park, and trips out enabling people to maintain contact with the local community and their place of worship. We noted the manager and staff have reviewed policies and procedures to include current guidelines regarding equality and diversity, this was also evident in the way the manager was reviewing the quality assurance processes followed by the home. What has improved since the last inspection? The requirements and recommendations from the last inspection had been fully met. The home has continued to provide a good service and sought to increase the standard of the environment, and the skills and knowledge of the staff team for the benefit of people living in the home. What the care home could do better: Residents would benefit from increased facilities to bath or shower that are more accessible and would enable them to have more baths or showers per week. Residents would be better protected if all staff consistently followed medication guidelines for safe administration of medication. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cambrian Lodge 4 Battery Road Portishead North Somerset BS20 7HP     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Patricia Hellier     Date: 2 0 0 8 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: Cambrian Lodge 4 Battery Road Portishead North Somerset BS20 7HP 01275848844 01275849649 Karen.cambian@southwestcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: South West Care Homes Limited care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: May accommodate up to 28 persons aged 65 years and over requiring personal care. Date of last inspection Brief description of the care home Cambrian Lodge provides personal care for up to 28 people over 65 years of age. Cambrian Lodge is a pleasant period property situated in a residential area close to the lake grounds in Portishead, with gardens that are well kept. The property is owned by South West Care Homes and Mr Beale is the managing director. Cambrian Lodge has a purpose built extension and two passenger lifts offer easy access to all areas of the home. Car parking is provided at the front of the building, and there is a pleasant garden and patio to the rear. Accommodation is offered in 22 single and 3 double rooms. At present no rooms are shared and en-suite facilities are provided in 11 of these. The provider makes information available through a brochure and information pack. The information pack contains the Statement of Purpose and Service User guide Care Homes for Older People Page 4 of 27 Over 65 28 0 Brief description of the care home and all relevant information about the home. CSCI/ CQC reports are displayed in the entrance to the home and available for all to read. The fees range between 394.68 pounds and 408.49pounds a week with additional charges being made for hairdressing, chiropody, newspapers, and toiletries. This information was provided in August 2007. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over one day and a total of seven hours were spent in the home. To gather enough evidence to support our judgements for this inspection, we (The Commission) asked the service provider to complete an Annual Quality Assurance Assessment (AQAA) form. The Aqua is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gives us the numerical information about the service, and how they intend to maintain or improve outcomes for people using their service. Once we have received this information we carried out a visit to the home and spoke to 10 people living there, six staff and three relatives. Whilst in the home we also looked at documents maintained for the day-to-day running of the service. These included Care Homes for Older People Page 6 of 27 care plans, staff recruitment, training and supervision. We also reviewed records relevant to the administration of medication, the service records and health and safety issues. What the care home does well: 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 7535. Care Homes for Older People Page 8 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 9 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 excellent 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 is comprehensive and provides prospective residents with information to make an informed choice. Prospective residents benefit from a thorough assessment process thus ensuring the home is able to meet their needs. Evidence: Residents are provided with a comprehensive Residents booklet containing the Statement of Purpose, Service User Guide and all the information required to ensure they, or their relatives, have access to the relevant information at all times. The Statement of Purpose includes information regarding equality and diversity issues and the homes philosophy of care that includes meeting cultural and diversity needs. Two recently admitted residents told us they had received good information and were able to show us the information folder in their room, to which they could refer if needed. Care needs are well met through a full assessment process as evidenced in the three Care Homes for Older People Page 10 of 27 Evidence: care plans inspected. The registered manager carries out a needs-based preadmission assessment for all prospective residents, and admissions to the home take place once the registered manager is confident the residents care needs can be met. The registered manager writes to new residents, or their relatives, to confirm the home can meet their individual needs. Three residents assessment documentation were read to find out how well the needs are assessed. The assessments were informative and clearly documented all aspects of physical, mental, social and emotional needs providing staff with a good knowledge base from which to provide person centred care. The assessments were informative and demonstrated residents had been consulted about the care needs. Two recently admitted residents when spoken with told us they are very kind; know what I need and look after me well. Care practices observed showed that staff were fully aware of the residents needs as stated in the assessments. Prospective residents are encouraged to visit the home and assess the quality of facilities at the home for themselves thus providing them with the opportunity to see the home, meet the staff, and discuss any queries with the staff and management. The home does not provide intermediate care. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Cambrian Lodge benefit from personal and specialist healthcare support that is provided in a person centred way, respecting their privacy and dignity. They benefit from the homes policies and procedures for the administration of medicines,however the manager needs to ensure staff follow the guidance provided. People are supported to continue to manage their own medication if they wish. Evidence: We looked at the care plans for three people living in Cambrian Lodge. The care plans were recorded in the Person centred way. They were easy to read and gave a clear view of how the person wished to be cared for without becoming impersonal. They showed us that staff have understood the way to record the personal likes and dislikes of the residents in their care. Other care plans we saw reflected this approach with clear guidelines for staff about peoples personal likes and dislikes and the way in which they prefer to receive their care. One newly admitted resident did not have a full care plan in place despite having been at the home for a week. We mentioned this to the Team Leader in charge as this Care Homes for Older People Page 12 of 27 Evidence: did not support the information supplied in the AQAA. She told us this had been overlooked due to staff sickness, and commenced work to rectify it immediately. The daily record maintained by staff was seen to be very detailed and gave a clear account of how the individual had spent their day. All the care plans we looked at included regular reviews which reflected the changes in peoples lives showing a continuity of care. We commented on how inclusive the care plans are, enabling a new member staff to have a clear understanding of the individuals needs. Staff spoken with told us they were involved in the way care plans are developed and written, enabling them to clearly understand all the changing needs of people at home. We observed staff talking and laughing with residents in a friendly and relaxed way. People we spoke to told us they were happy with the way in which they are cared for. One person said they are so kind and always have a smile. We spoke to a group of people sat in the dining room after lunch who told us that the care and support was very good and they could not fault any of the staff. One person told us they had regular meetings when they could say how they would prefer to be looked after. Another person told us the staff are always understanding. Residents felt they are kept well informed of any significant issues, and that their involvement is welcomed. One relative told us that assistance with personal care is sensitively and discreetly given for the comfort and well-being of the individual. People living at Cambrian Lodge have access to healthcare specialists and care plans showed the District Nurse could be consulted when the home felt they needed some expert advice. On the day of the inspection the GP was seen visiting at lunchtime. We observed the staff handled this in a sensitive and discreet manner. This good practice is to be commended. People are also helped to attend outpatient appointments, the dentist, optician and chiropodist. Cambrian Lodge has clear policies and procedures for the receipt and administration of medication. Staff receive training before they can give medication to people. We looked at the records kept by the home for medication and the way that medication is stored. We thought all procedures were being carried out correctly. However we noticed one instance of poor practice at lunchtime where a residents medication was not given in line with the policy. This potentially put the resident at risk through misadministration of medication. We discussed this with the Team Leader who agreed to raise our concerns with the individual member of staff. If a person is assessed as able to manage their own medication and have expressed the wish to do so they are supported by staff to maintain their independence. Care Homes for Older People Page 13 of 27 Evidence: Although we have made a recommendation regarding the administration of medication the overall outcomes for people in this area are excellent, this is reflected in the level of care and support provided for people in the home. 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. Residents benefit from flexible routines and menus. A variety of activities is offered, and residents rights, choice and control over their lives is well respected, and encouraged. Friendly staff always welcome relatives and visitors. Evidence: Many residents commented on the atmosphere of the home. One person described it as nicely informal, and residents felt that their visitors are also helped to feel relaxed and at home. When asked about activities and their daily routine residents said, we have them sometimes while another said we go out to lunch sometimes. On the day of inspection residents were seen enjoying conversations together in the lounge, reading their papers, enjoying the garden or relaxing in their own rooms. In the afternoon some residents were taken for a walk in the local park. A range of activities is provided with a diary of events displayed on the noticeboard near the dining room. This includes hair and nails, arts and crafts, music and movement sessions. Three residents told us there are things to do if you want. Two residents told us they like to just sit and read the paper. There is a quiet lounge and a lounge with a television, which we were told, is well used in the late afternoons and evenings. Care Homes for Older People Page 15 of 27 Evidence: During the inspection some people who use the service were seen exercising choice of activity, and being encouraged to undertake the activity they chose. People who use the service told us they can see their visitors at any time, helping them to feel this is their home. Relatives spoken with told us they feel welcomed when they come, and that there is a warm, caring feel to the place. The dining room is homely and tables were well presented providing an atmosphere that is conducive to an enjoyable meal. All residents said they liked the meals and felt good and balanced diet is provided. On the day of the inspection lunch was seen to be an enjoyable social activity. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected from abuse, and they can be confident that complaints are taken very seriously. Evidence: The home has a comprehensive complaints procedure and all residents receive a copy on admission. There have been three complaints since the last inspection. Records inspected show that all had been resolved within the stated timescales. We saw the home has a system for keeping clear records of complaints received, with actions taken however, outcomes of the complaint are not always recorded to demonstrate if complaints have been met to the satisfaction of the complainant. This practice is recommended. Residents stated that if they were not happy about anything they would speak to the manager. Residents told us the manager and staff are very approachable and they would always raise any concerns with them. Staff and residents spoken to, say the manager is very approachable and understanding. One resident said I have nothing to complain about, its just like home-we are one family. The registered manager permits the residents individual rights in the home. Information leaflets were available on the notice board as to how to contact advocacy agencies, and residents can vote at political elections if they choose, with staff enabling them to go to the polling station or obtaining a postal vote Care Homes for Older People Page 17 of 27 Evidence: for them. The home has a copy of the No Secrets in North Somerset guide and a comprehensive local policy and procedure for responding to allegations of abuse, for the protection of residents. Staff spoken with confirmed that they had attended training in safeguarding adults, they were aware of the organisations whistleblowing policy and who to contact if they felt that a resident was at risk of abuse. Training records also showed that staff had received training in the correct procedures to follow if they suspected a resident was at risk. All residents said the staff are very kind and take time. I cant fault them. 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. Residents are provided with homely, safe and comfortable surroundings. Outdoor space is attractive and accessible for residents to enjoy. The home has suitable equipment to maximise resident independence. Satisfactory infection control practices are followed. Evidence: The home is nicely decorated and well maintained with a welcoming atmosphere, and made comfortable with homely communal spaces. Accommodation is provided over three floors with a shaft lift to access these. The decor, fixtures and fittings are in good order. The lounges are furnished with a variety of suitable comfortable chairs to fit residents needs. The home has a well maintained garden for residents to enjoy. Since the last inspection some areas of the home have been redecorated for the benefit of residents, and ongoing maintenance and refurbishment was well described in the AQAA form submitted by the provider. During our tour of the home we were made aware that there are not enough usable bathrooms for the number of residents, as outlined in the standard. In discussion with the Team Leader we ascertained that a number of residents have to go some distance in the home to access the bathroom, which can be undignified and does not provide appropriate facilities for people living in the home. In discussion with the Team Leader Care Homes for Older People Page 19 of 27 Evidence: we were told that plans to refurbish one of the bathrooms have been identified. To ensure adequate provision of usable bathing facilities we have required this be completed within a six-month period. Residents rooms are personalised and comfortable to suit their needs. All rooms have ensuite facilities for residents comfort. There are plenty of toilets within easy access of all communal rooms. People we spoke to told us they liked their rooms and commented on the cleanliness of the home in general. The home showed a good standard of housekeeping and no offensive odours were apparent. The staff spoken with showed a clear awareness of infection control policy and procedures and the Team Leader confirmed that she can obtain guidance from outside agencies if required. 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. Residents benefit from, and are protected by, the staffing levels and skill mix of staff in the home. They are further protected by robust recruitment procedures and adequate staff training to ensure a competent and confident staff team. Evidence: The staffing rotas for the two weeks prior to the inspection were reviewed. Staffing levels appear to provide sufficient care staff to meet residents needs. A good team of ancillary staff supports them. The rotas also showed that staffing is flexible so that extra staff can be brought in to cover busy times such as activities or trips out. In discussion with residents we were told the staff are very good and always there when you need them. Other comments received were staff know their job and do it well. Relatives feedback about staffing was the staff are sensitive, compassionate and understanding. Staff interviewed, and survey responses from staff, told us we provide fantastic care to residents. I am proud to work here. Another commented staff feel valued and are happy and this has a knock-on effect to residents. A further comment was we make new residents feel welcome, meet individual needs appropriately and are supported by a helpful manager. Care Homes for Older People Page 21 of 27 Evidence: The Team Leader confirmed that staff are encouraged to obtain a National Vocational Qualification (NVQ) in Health and Social Care. 75 of their staff have obtained a level II or above qualification whilst the others are attending training and seeking to develop their skills and knowledge. The home has also encouraged non-care staff to obtain NVQ qualifications so kitchen staff have catering qualifications, and domestic staff also follow an NVQ course. Staff spoken with told us they felt well supported in attending training relevant to the needs of the people in their care. Records showed that staff have all attended mandatory training as well as training that is necessary to provide a good level of care to the people living in the home. Cambrian Lodge has strict policies and procedures for the recruitment of new staff. The personnel files for people who had recently been employed showed the manager follows these guidelines as all the relevant checks such as references and Criminal Records Bureau (CRB) checks had been completed before the person started work. All new staff follow a concise induction programme which follows the skills for care guidelines, to ensure staff have the relevant training and understanding to meet residents needs. 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. Residents benefit from living in a well-run home with an appropriately qualified manager and supervised staff. Residents monies in the home are well managed for their safety and protection. People working and living in the home are protected by robust health and safety procedures. Evidence: The manager is qualified and has a number of years experience in this area she is supported by team leaders. We observed and were told of a very open and approachable management style which people living in the home said they appreciated. The manager seeks to give leadership, guidance and direction to staff to ensure they are knowledgeable and competent to meet the needs of people who use the service. People who use the service and relatives feel she is approachable, available and seeks to ensure all their needs are met. One resident told us she cant do enough, another told us she was always helping. Staff interviewed stated they felt supported by an Care Homes for Older People Page 23 of 27 Evidence: approachable manager. A formal quality assurance tool was available for inspection in order to demonstrate that the home consults with residents and relatives. A summary report of the most recent survey was not available at present as it is currently being prepared. We were told that the results are fed back at a residents meeting and the outcome issues discussed. Minutes of residents meetings held since the last inspection show how residents can have their say, and the suggestions are incorporated into the running of the home. Pocket monies, for the people who use the service, held by the home were inspected and found to be accurate and to have clear records for the protection of residents. Staff personnel files show that regular supervision is planned and carried out to ensure staff have the knowledge and skills to care for residents in the home. Any training and development needs are identified and followed up where possible. Staff spoken with told us of the helpfulness of supervision in identifying areas of training they would like, and being encouraged to access it for the benefit of residents. Records were available to show regular safety and fire checks were carried out, to maintain safe systems for the protection of residents. Staff spoken to said they had received fire instruction regularly and records supported this, demonstrating staff would have the expertise to safeguard residents in the event of fire. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 21 23 The registered person shall 21/03/2010 ensure that suitable and sufficient baths and showers are provided in appropriate places to meet the needs of residents. To provide residents with sufficient bath or shower facilities within an acceptable distance of their room to maintain privacy and dignity. 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 9 The registered person ensures that all staff fully adhere to the homes medication administration policy, for the protection and safety of all residents. The registered person should ensure that a record of the outcome for the complainant is recorded to demonstrate a satisfactory investigation of the complaint has been undertaken. 2 16 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. 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