Care Home: Croft (The)

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What the care home does well The home is a large purpose built property and it is situated in its own grounds. There are (number) lounge areas, plus other quiet areas for people to use if they wish. Staff members are polite and generally talk to and about people with respect. We talked to people during this inspection and they said the staff are nice, respect their privacy and one person said, "The staff take good care" and "The staff care about my needs". Care plans and risk assessments are completed so that staff members have enough guidance about how to safely meet people`s needs. There are areas where there should be more information and guidance for staff, but the care records generally tell staff what they need to do to meet people`s needs. Medication is given and stored safely. Records are kept to show when people are given medication and why it is not given. People can have visitors when they want and there are places where they can meet in private. They are usually able to choose when to get up and go to bed and what they do during the day. There is a choice of main meals each day and staff members stay with people who need help to eat. Everyone we spoke to said they like the meals and the food is good. There have been no complaints made to the home in the last year. People said they know who to talk to and how to make complaints. Staff members know how to keep people safe and what to do if they think abuse has happened. There has been one safeguarding referral in the last year. Staff have induction training before they start working with people and other training to help them care for people properly. Care staff also complete National Vocational Qualifications and at the time of this inspection almost 75% of staff have completed the training. Staffing levels are usually high enough so that staff can care for people properly, but sometimes people do have to wait. Recruitment checks are completed properly before people start working at the home, so that new staff members are safe to work there. A quality assurance survey is carried out every year at the home, where people are asked what they think of the care and the environment in which they live. Money that is kept and transactions that are made on behalf of people at the home is recorded. Records are also kept of the health and safety checks that are carried out, which means the home can show if things are in good working order and what they have done to repair problems. What has improved since the last inspection? Staff members have enough training to be able to meet the needs of people at the home. This includes training for specialist needs, such as dementia. What the care home could do better: Information about why people are going to live at the home is not available and assessments are not always obtained before they go to live there. This is especially important for people who go to the home in an emergency situation, as it means staff members have no information about meeting their current needs. It can mean that people are not given the correct care. All staff members must have training in fire safety. Most staff have this, but it is important that all staff know what to do in a fire situation. Fire drills must also be practiced by all staff, including night staff. Issues that are identified in the annual quality assurance survey should be followed up to make sure the home is providing as good a service as it can. Key inspection report Care homes for older people Name: Address: Croft (The) Walsingham Way Eye, Peterborough PE6 7XB     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lesley Richardson     Date: 0 9 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Croft (The) Walsingham Way Eye, Peterborough PE6 7XB 01733222448 01733223895 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Peterborough Primary Care Trust care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home Purpose-built in the 1960s, The Croft is in a residential area in the village of Eye and offers a home to 39 older people. The home is on two floors and all areas are accessible to people who use wheelchairs. On the ground floor there are three lounges with dining areas, toilets, bathrooms and some single bedrooms, as well as a main kitchen, laundry, smoking lounge and office. Upstairs there are single bedrooms, a quiet lounge, toilets, bathrooms and the managers office. All bedrooms have a washbasin and are comfortably furnished. The home is set in pleasant gardens, and is within walking distance of local shops, pubs and churches. The city of Peterborough, with its wide range of leisure facilities including a large shopping centre, restaurants, cinemas and a theatre, is within a few minutes drive or bus ride. Good road and rail services link Peterborough to London and other major cities. Care Homes for Older People Page 4 of 26 1 0 1 0 2 0 0 8 3 0 3 Over 65 6 39 0 Brief description of the care home Residents financial status is assessed so that they pay what they are deemed to be able to afford, up to a maximum of the local authority benchmark rate. Additional charges include hairdressing, chiropody, newspapers and any personal items such as toiletries, alcohol, tobacco and clothing, as well as some outings. Copies of the CSCI inspection reports are available in the foyer of the home. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was a key inspection of this service and it took place over 7 hours and 35 minutes as an unannounced visit to the premises. It was spent talking to the manager and staff working in the home, talking to people who live there and observing the interaction between them and the staff, and examining records and documents. The requirement from the last inspection has been met. There have been one further requirement and no recommendations made as a result of this inspection. The last key inspection was carried out on 10 October 2008. Information obtained from the Annual Quality Assurance Assessment (AQAA) and from returned surveys was used in this report. The AQAA is a self assessment that focusses Care Homes for Older People Page 6 of 26 on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. We received seven surveys from people living at the home, three surveys from visitors and five surveys from staff members. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 26 Information about why people are going to live at the home is not available and assessments are not always obtained before they go to live there. This is especially important for people who go to the home in an emergency situation, as it means staff members have no information about meeting their current needs. It can mean that people are not given the correct care. All staff members must have training in fire safety. Most staff have this, but it is important that all staff know what to do in a fire situation. Fire drills must also be practiced by all staff, including night staff. Issues that are identified in the annual quality assurance survey should be followed up to make sure the home is providing as good a service as it can. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are not assessed properly before care starts, which means the home does not know whether the persons needs can be properly met. Evidence: Only two (out of 7) of the people who we received surveys from said they had received a contract, one person said they did not have a contract with the home and four people said they didnt know if they had or not. Four people (over half) of those who returned surveys said that they had enough information before moving to the home. Although, again one person said they did not have enough information. The manager said there have been very few people move permanently to the home since the last inspection as most people use the respite service. Assessments are obtained before people move into the home and these are obtained from the local social care team. We looked at the care records of 3 people who have moved into the home since the last inspection and were there when we carried out this inspection. A Care Homes for Older People Page 11 of 26 Evidence: written assessment completed by Peterborough Social Care Teams was available in 2 peoples care records. However, one of these people had come to live at the home as an emergency and the assessment was dated over 4 1/2 months before they came into the home. It didnt contain any information about the persons current problems or why they needed to live at the home. One person didnt have an assessment on their care records at all and this person also started living at the home due to emergency need. There was no information in the persons care records to tell staff why the person had been admitted. There are no records in any of these peoples care records to show staff from the home have visited them to carry out an assessment. We spoke to staff at the home who said they didnt know why either of the people mentioned above had started living at the home on respite. Although they were able to tell us about peoples needs now, there is information in one persons assessment that they have a history of mental health problems, but the staff member did not know about this. The home does not provide accommodation specifically for intermediate care or for rehabilitation purposes. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care records are not always completed in enough detail although staff care for people in a positive way, which usually ensures the health and welfare of people living at the home. Evidence: People who commented in surveys said they get the care and support they need from staff members and during the inspection people told us care staff are nice, are polite and treat them with dignity and respect. We saw this during the inspection and that staff knock on doors before entering rooms. People we spoke to said staff are nice and comments we received were, The staff take good care and The staff care about my needs. A comment from one of the visitors who returned a survey was, When ever I visit my aunt the staff always seem to be attending to needs. At the last inspection we commented about the way staff members talked about people. We found during this inspection that there has been a big improvement in this area and we only heard one staff member refer to people in a way that is not appropriate. We spoke to the manager about this after the inspection. Care Homes for Older People Page 13 of 26 Evidence: Care plans for three people were looked at as part of this inspection. They show that each person has a plan that gives staff members information about what they need to do to meet most of the identified needs. Risk assessments, for things like falls and moving and handling, are completed and reviewed regularly. We found the care plans do not always give staff members enough advice about how to meet peoples needs, but that the level of detail varied between different people. For example, one person can become aggressive and become arguementative and threatening. The care plan does not tell staff how to manage this, although we talked to staff members who were able to tell us exactly what they do to make sure the behaviour does not become worse. Another persons plan gives staff clear instructions about how they should manage a medical situation, what they should be looking for and who they should contact. One visitor who returned a survey said, Not the fault of The Croft but when agency staff are used old people do not like change and they do not know their routines. As mentioned above permanent staff members have a good knowledge and understanding of peoples needs. However, the home uses agency staff who are not familiar with peoples routines and therefore clear guidance in care plans is important so that all staff are able to care for people appropriately. Plans are reviewed monthly and we saw that information and changes are recorded. All of the people who returned surveys said they receive medical attention when they need it. There is information in care records to show health care professionals, such as specialist nurses, opticians and chiropodists, are contacted for advice and treatment. Medication administration records (MAR) were looked at for all of the people who live in one unit at the home. The MAR sheets are completed and there are no records with entries missing. Entries for medications that have not been given show the reason for this. Amounts of medication remaining in blister packs of medication tally with the amount the MAR indicates are remaining. Cream medications are not recorded when they are applied, even though forms for this are kept in peoples room with the creams. We spoke to the manager about this and she said she is aware and is trying to find other ways of making sure staff sign when they apply the creams. Medications with a variable dose are recorded separately and this is also kept with the MAR sheets. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities are available and people can usually choose what they do, which means most people have control over their lives. Evidence: Staff at the home are responsible for arranging for entertainers to visit the home, activities and events in the home. Most of the people (six out of seven) who returned surveys to us said there are activities that they can always or usually take part in. We received no specific comments in the peoples surveys about activities. One person we spoke to during the inspection said, not much to do here, shame really, but there isnt much. There is a weekly activity programme available that provides something for people to do each afternoon. On the day of this inspection we watched staff play carpet bowls with people in one of the lounges. They were able to encourage people to play and made it easier or more difficult depending on the persons ability. This also give people a point of interest to talk about. Staff members who returned surveys were divided about whether there were enough activities. One staff member said there are not always enough staff at the home to be able to do this. Care Homes for Older People Page 15 of 26 Evidence: People are able to make everyday choices about when to get up and go to bed, how to spend their days, whether that is in their own room, or in the lounge areas. We saw and listened to how staff members interact with people and found they usually ask what people would like and how they would like it rather than telling people or giving limited options. Staff members we spoke to know the people they care for and were able to tell us their preferences and how they like to be cared for. The home has an open visiting policy and people can have visitors at any time of the day. Two visitors who returned surveys said the home helps their relative keep in touch and keeps them up to date with issues affecting their relative. The other visitor said they are only sometimes kept up to date with any issues. The main meal is served at lunchtime and there is a choice of two hot meals every day. We saw lunch being served in dining room. Food was served appropriately in a relaxed and unhurried way and drinks were offered throughout the meal. Everyone we spoke to said they like the meals and the food is good. Staff help people if they need this and we saw them most of them being attentive and concentrating on what they were doing without being distracted. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know how to make complaints and concerns known and most of the time these are dealt with properly. Evidence: All seven of the people returning surveys said they know who to speak to and almost all of the said they know how to make a complaint if they have to. Five people said that staff always or usually listen to what they say and act on it, although two people said this only happens sometimes. All of the visitors who returned surveys said they know how to make a complaint, one visitor said they are appropriately dealt with and one visitor said they are never appropriately dealt with. We spoke to one persons relative who told us they had raised concerns about their relatives care with the manager but had not had a lot of joy at present. The person said they would raise their concerns with more senior managers. The home has a complaints procedure and keeps a complaint log to show how they have looked at and the outcome of complaints that have been made. We were told before the inspection there have been no complaints made to the home in the last 12 months. The Care Quality Commission (CQC) has not received any complaints directly about the home. The staff training matrix shows that staff members, care staff and housekeeping staff, have received training in safeguarding (adult protection) people. We talked to care Care Homes for Older People Page 17 of 26 Evidence: staff who said they had received this training and were able to tell us what should be done if abuse was suspected. Information provided to CQC before the inspection shows there has been one safeguarding referral in the last 12 months. However, we have no record of this. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is generally clean and provides a safe environment, giving most people a pleasant place to live. Evidence: The home is a large purpose built property situated on the village of Eye, on the north east outskirts of Peterborough. People living at the home have access to a number of communal areas in each house, including three lounge areas and a small fenced patio area at the side of the property. The general decor in most parts of the home is satisfactory, and it was clean and tidy. Generally there were no offensive smells, except for a slight lingering smell of stale urine in one of the lounge dining areas that was still evident during lunch. Everyone returning surveys said the home is always or usually fresh and clean. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff members most of the time with the training and skills to be able to care for people properly. Evidence: The training matrix shows new staff members are given induction training, which includes mandatory health and safety training. Four of the five staff members who returned surveys said their induction covered everything they needed to know to care for people at the home. We spoke with one new staff member who told us they had completed an eight day induction that included mandatory training. Information provided in the Annual Quality Assurance Assessment (AQAA) shows that most staff members have completed an induction that meets the recommendations made by Skills for Care. We looked at the staff training matrix and saw that most staff members have received mandatory training and updates at the required intervals. However, there are some staff who have not received updated fire training. Additional training is given to staff so that they are able to properly meet peoples needs, such as care of people with dementia, and training on the Mental Capacity Act and deprivation of liberty. Information in the AQAA tells us that almost 75 (3/4) of care staff have a National Vocational Qualification (NVQ) in care at level 2 or above. The recommended number Care Homes for Older People Page 20 of 26 Evidence: of staff with a NVQ is 50 . Six people who returned surveys said staff members are available when they are needed and seven people said that they get the care and support they need. People we spoke to during the inspection said there is usually enough staff on duty during the day. Staff members we spoke to during the inspection said there are usually enough staff, although there are times when people have to wait. Although only two of the five staff who returned surveys felt the same way. We looked at recruitment records for three staff members employed since the last inspection and they all contained the appropriate recruitment documents including references, application forms, and PoVA/CRB checks. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is a safe place to live and people are asked their opinion, but there is little information to show that things they are not happy with are changed. Evidence: The manager has been managing the home for several years and in that time has gained a Registered Managers Award management qualification and a NVQ level 4 in care. She is supported by duty managers when she is away from the home. An annual quality assurance survey was carried out by the home at the end of last year, a report has been written but was not available for this inspection. We received a copy from the manager after the inspection that showed the results of the survey, although it doesnt show whether the home has looked at any issues or what has been done about these. Most responses were positive and in total over 80 of people were happy with things. But there is nothing about any of the sections where percentages have dropped. For example, 75 (three quarters) of people said staff are prompt when they need help and they feel staff are adequately trained, but this means that Care Homes for Older People Page 22 of 26 Evidence: 25 (one quarter, or one person in every four) doesnt think this. The service manager completes an unannounced visit every month and talks to people living at the home. We saw one of these reports during the inspection, which showed people are happy with staff but that they take a long time to answer calls. We asked the home to complete and return an Annual Quality Assurance Assessment (AQAA) before the inspection. They did this within the time we asked for it and they gave us most of the information we asked for but didnt give us much evidence to support it. For example, the sections on evidence is simply a list of where it can be found. The home keeps some money on behalf of people who live there. Accounts are kept of transactions of money put in and taken out. We looked at two of these records; all three are clearly written and show how money has been spent. Information provided in the AQAA shows equipment, like hoists, lifts and fire-fighting equipment has been serviced or tested as recommended by the manufacturer. Fire safety checks are completed at the required intervals and these are recorded. Records for fire drills are also kept and show staff members attend and practice these every three months. However, night staff dont practice fire drills and the manager said the procedure is discussed in supervision instead. An arrangement has been made with the fire safety officer to visit staff and update their knowledge in the near future. We discussed with the manager the need for night staff to be included and the importance for them to practice fire drills so they know what to do in the event of a fire. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 3 14 Assessments must be completed before people come to live at the home. So that the home is sure their needs can be met, that staff have the right skills, training and knowledge to care for the person and the person is not put at risk. 31/12/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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