Care Home: Derwent House

What the care home does well People told us they were satisfied with the care they received at the home. They said "I`m well looked after here", "I`ve lived here for 3 years so it`s good!", and, "good care". They told us the staff were "very helpful" and "tremendously kind". Visitors told us they were always made welcome at the home. They said there was "a good atmosphere" in the home, and that staff "always had time to talk" to them. There was a good programme of staff training provided and most of the care staff had achieved a relevant National Vocational Qualification (NVQ) at level 2 or above. What has improved since the last inspection? The Statement of Purpose and Service User Guide had been updated to include correct contact details for CQC. Improvements had been made in care records so that each person had a care plan in place and the care plans were more detailed. Staff had received training in the administration of topical medicines, as required at the last inspection. The floor covering in the passenger lift had been replaced to eliminate the odour noted in there at the last inspection. Improvements had been made to staff records so that people were better protected by a more robust recruitment process. What the care home could do better: Ensure a consistent approach to the review of care plans and ensure they are updated with any changes to the person`s needs. This will help to ensure that people`s changing needs are known and met by staff. Operate an effective system to ensure that there are always sufficient staff available to meet the assessed needs and dependencies of people in the home. This will ensure that staffing levels are determined by, and are sufficient to meet, the assessed needs of people in the home. Ensure a full employment history is provided by anyone applying to work in the home. This will ensure a more robust recruitment system that protects people living in the home. Key inspection report Care homes for older people Name: Address: Derwent House Ulverston Road Newbold Chesterfield Derbyshire S41 8EW     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: Rose Moffatt     Date: 2 6 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Derwent House Ulverston Road Newbold Chesterfield Derbyshire S41 8EW 01629537515 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.derbyshire.gov.uk Derbyshire County Council care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 40 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home Derwent House is located on the north-west outskirts of Chesterfield in a busy residential area, close to local shops and amenities and on a direct bus route to Chesterfield town centre. The home provides personal care and support for up to forty older people, having all single room accommodation, provided over three floors. Wheelchair access is provided throughout the building, which is suitably adapted to assist those people who may have mobility problems, including a passenger lift and emergency call system throughout. There is a range of communal lounge and dining rooms, including quiet areas and a smoking area. Assisted bathroom and toilet Care Homes for Older People Page 4 of 26 Over 65 40 0 0 5 1 0 2 0 0 9 Brief description of the care home facilities are located on each floor. Grounds and gardens are well maintained and include an internal courtyard/garden area with seating for people. People are provided with care and support from a team of care and hotel services staff led by a registered manager, who also has deputy and external management support via Derbyshire County Council. The home provides both short-term respite and long term care provision. The fees for a permanent placement in the home are currently £404.06 per week. This information was provided by the manager on 06/10/2009. Information about the home, including CSCI/CQC inspection reports, is available at 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 the service experience adequate quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information we have received, or asked for, since the last key inspection or annual service review. This included: surveys returned to us by people using the service and from other people with an interest in the service; information we have about how the service has managed any complaints; what the service has told us about things that have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have Care Homes for Older People Page 6 of 26 made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. We carried out an unannounced inspection visit that took place over 7 hours on 26/01/2010. The inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. We sent out 10 surveys to people living in the home and received 10 responses, all completed with help from staff at the home. There were 36 people accommodated in the home on the day of the inspection visit. People who live in the home, visitors and staff were spoken with during the visit. The acting manager was available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. 4 people were selected and the quality of the care they received was assessed by speaking to them and / or their relatives, observation, reading their records, and talking to staff. At the last key inspection in October 2009 the overall rating for the home was poor and so the home was included in the CQC improvement strategy. A management review was held with the inspector and regulation manager, and then a meeting with the providers of the service. The providers were required to produce an improvement plan detailing how they were going to make the necessary changes to comply with the regulations and improve outcomes for people living in the home. The improvement plan was produced in the required timescale and all the requirements made were addressed. 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: 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 Care Homes for Older People Page 8 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had sufficient information to be able to make a decision about living in the home. There was a comprehensive assessment process so that people were confident their needs could be met at the home. Evidence: The Statement of Purpose and Service User Guide had been updated since the last inspection to include correct contact details for CQC. People spoken with confirmed that they had seen the Service User Guide and that they had enough information about the home to decide if they wanted to live there. People who returned surveys said they hadnt received written information about the homes terms and conditions, or didnt know if they had received this information. People spoken with during the visit said they had received a contract with this information. We found that there were contracts in place that had been signed by the person of their representative. Care Homes for Older People Page 11 of 26 Evidence: People told us they usually received the care and support they needed at the home. They said Im well looked after here, Ive lived here for 3 years so its good!, and, good care. We looked at the care records of 4 people in the home. All had assessments in place of their individual needs. People came to the home for a day prior to admission, and often for a period of short term care before deciding to live there permanently. As noted at the last inspection, the admission procedures did not include asking if the person had made an advance decision on receiving medical treatment, and recording if the person had a Lasting Power of Attorney, Independent Mental Capacity Advocate, or Relevant Persons Representative. However, the providers told us they were working on how this could be achieved by the assessment team who were responsible for collecting initial information about people wanting to move into the home. Standard 6 did not apply as there were no people in the home receiving intermediate care. 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. There were some inconsistencies in the review and updating of care plans, and the individual dependency levels of people in the home had not been assessed, so that peoples changing needs may not always be met. Evidence: Since the last inspection, care records had been reorganised, reviewed and updated. We looked at the care of 4 people and each had a care plan in place. The care plans had better details of individual needs and preferences, and of the action required by staff to meet those needs. People in the home, or their representatives, had signed care plans and other documents to indicate their agreement and involvement. We found that 3 of the care plans seen had been reviewed monthly up to date. For one person there were no recorded reviews since September 2009. For 3 of the records seen, the information in care plans had been updated as necessary when there were changes in the persons needs. For one person, the information in the manual handling assessment and plan conflicted with the most recent review as their needs had changed. Care Homes for Older People Page 13 of 26 Evidence: We found assessments in place of the persons risk of falls, nutritional needs, personal handling needs, and oral health. These assessments were mostly signed and dated, though none of the oral health assessments were signed. One person had an assessment of their risk of developing pressure sores. This had last been reviewed in November 2009 although there was an instruction to review monthly due to the high level of risk. People told us they always had the medical support they needed and saw their GP when necessary. The records of visits of GPs, District Nurses and other healthcare professionals had not yet been completed in the new care records, though had been in the old records. Of the 10 people who returned surveys, 3 said staff were always available when needed, 2 said staff usually were, and 5 said staff sometimes were. People spoken with during the inspection visit said staff were usually available when needed. We observed that there appeared to be sufficient staff available at busy times, such as lunchtime and to assist the hairdresser. Staff told us that although no changes had been made to staffing levels since the last inspection, there were less people in the home and individual dependency levels were not as high. We found that although there was a system for assessing individual dependency, assessments had not been carried out. We found that one person regularly needed 3 staff to assist with manual handling, but there were only 2 staff on duty at night. The acting manager told us that a third care assistant could be used at night if necessary. People told us the staff were very helpful and tremendously kind. People said staff usually listened to them and acted on what they said. We observed a friendly and respectful approach by staff to people in the home. Soon after the inspection visit, staff received training in the administration of topical preparations, as required at the last inspection. We found that the procedures for safe-handling and administration of medication were generally satisfactory. On one administration record the member of staff had not signed handwritten instructions. 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. There were flexible routines, a range of suitable activities and nutritious meals provided so that the lifestyle in the home met the expectations of people living there. Evidence: Most people told us there were activities offered in the home that they could join in with. There were 3 staff employed at the home to coordinate and help with activities. As noted at the previous inspection, the activities staff were also expected to provide some assistance with personal care of people in the home, taking people to appointments, serving teas and coffees, and helping at mealtimes. We were told that the activities staff had not all had relevant training and so the quality and range of the activity programme was variable. The acting manager was aware of these issues and had already organised for activities staff from another home to share ideas and support. People told us they could get up and go to bed when they wanted to, and could follow their preferred routines during the day. We observed people moving freely around the home and using different areas. There were regular meetings for people in the home where they could give their views on the service provided and make suggestions for improvement. Care Homes for Older People Page 15 of 26 Evidence: Visitors told us they were always made welcome at the home. They said there was a good atmosphere in the home, and that staff always had time to talk to them. We did not fully assess standard 15, (meals and mealtimes), as it was met at the previous inspection in October 2009 and people who returned surveys and those we spoke with all said they enjoyed the meals at the home. 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. There were satisfactory systems in place to ensure that people were protected and appropriate action was taken to address their concerns. Evidence: People told us they knew who to speak to informally if they were not happy about anything. Most people told us they knew how to make a formal complaint. People said they were confident that appropriate action would be taken to address any concerns raised. There were appropriate policies and procedures in place regarding complaints and safeguarding vulnerable adults. Staff training records showed that all staff had received training about safeguarding vulnerable adults. Staff were aware of the correct procedures to follow if abuse was alleged or suspected. We had not received any complaints about the home and there had been no safeguarding vulnerable adults referrals since the last inspection. A requirement made at the last inspection, to ensure all events as specified in the regulations must be notified to us, had been met. Care Homes for Older People Page 17 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 was clean, well maintained and suitably equipped to meet the needs and preferences of people living there. Evidence: The home was large and spacious with a choice of lounge areas for people to use, including a room for people who wanted to smoke. The bedrooms seen were bright and clean and were personalised with peoples possessions. The home was suitably equipped with manual handling equipment, specialist baths and beds, ramps and handrails. There was an enclosed courtyard garden with seating for people to use. Since the last inspection the floor covering in the passenger lift had been replaced to eliminate the odour noted in there. The home appeared clean in all the areas seen and was free from any offensive odours on the day of this inspection visit. The laundry was suitably equipped and there were systems in place to ensure dirty and clean laundry were kept separately. The laundry floor covering was splitting in places and lifting at the edges. If this became worse, it could be difficult to ensure effective cleaning of the floor. Care Homes for Older People Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lack of assessment of individual dependency of people in the home did not ensure that people always had appropriate staff support to meet their needs. Evidence: Of the 10 people who returned surveys, 3 said staff were always available when needed, 2 said they usually were, and 5 said they sometimes were. People we spoke with during the inspection visit told us staff were usually available when needed. As noted in the Health and Personal Care section of this report, we observed that there appeared to be sufficient staff available at busy times. Staff told us that although no changes had been made to staffing levels since the last inspection, there were less people in the home and individual dependency levels were not as high. We found that although there was a system for assessing individual dependency, these assessments had not been carried out. The provider continued to base staffing levels on the number of people in the home, rather than taking their needs and dependency fully into account. At the time of this inspection visit there were 34 people living in the home, (although 1 person was in hospital), and 2 people staying for short-term care. The staff rotas showed there were 4 care assistants for the morning shift - although at weekends 1 of these worked a shorter shift until 11am. There were 4 care assistants working the afternoon shift, 1 of these working a shorter shift from 5pm - 9pm every day. In Care Homes for Older People Page 19 of 26 Evidence: addition, there was a deputy manager working each shift and the manager or acting manager working 5 days per week. The care staff were supported by an administrative assistant, domestic and laundry assistants, kitchen staff, and activities staff. Staff told us that staffing levels were usually sufficient to meet peoples needs during the day. However, they were concerned that the situation could deteriorate if people were admitted to the home who had more complex needs and were more dependent. Staff wanted staffing levels to be increased in line with the assessed needs of people admitted to the home. As found at the previous inspection, there were 2 care assistants on duty for the night shifts. Staff told us at the last inspection and at this inspection that they were concerned for the safety and welfare of people in the home during the night as they felt that peoples needs could not be safely and properly met with only 2 staff on duty. The home is on 3 floors with bedrooms on each floor. We found there were several people who were wakeful and walking around during the night, several people who required 2 staff to provide care, and 1 person who regularly needed 3 staff to assist with personal care. The acting manager told us that a third member of staff could be used at night if needed, but had not been used yet. We looked at the records for 3 members of staff. We found that nearly all the required documents and information were in place, although 2 did not have a full employment history. There was an induction programme in place for new staff that met the Skills For Care standards. Training records showed that staff were up to date with all the required training. Most of the care staff had achieved a relevant national Vocational Qualification (NVQ) at level 2 or above. Care Homes for Older People Page 20 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was effective management of the home with satisfactory systems in place to ensure that the health, safety and welfare of people was promoted and protected. Evidence: Since the last inspection, the registered manager had been provided with additional support from a manager and deputy manager of another home owned by the same provider (Derbyshire County Council). As noted previously in this report, improvements had been made to care plans, other care documents, and staff records. Some issues remained with inconsistencies in the reviewing and updating of care plans, and with the lack of assessment of indivdual dependency to determine staffing levels. Staff told us that staff morale had improved as they felt their concerns were being taken seriously by management, and also because the workload was less demanding. Staff were pleased that the provider was recruiting relief staff as this would increase the number of staff available to cover for sickness and holidays. However, staff told us Care Homes for Older People Page 21 of 26 Evidence: they were concerned that the current improvements would not be maintained if people with a high level of needs were admitted to the home and the staffing levels were not increased accordingly. The quality assurance system included surveys of people in the home, and/or their representatives. An annual report was produced with the analysis of quality assurance measures and details of action taken. The report was available to people in the home and their representatives. There were regular meetings for people in the home to express their views and ideas for improvements. The service manager carried out monthly visits and produced detailed reports that included comments from people in the home. We looked at the records of the personal money of people in the home. We found that all transactions were now signed by staff, as recommended at the last inspection. Since the last inspection, we had received notifications of events under regulation 37 as required. We looked at accident records and found these were satisfactory. At the last inspection in October 2009 we found that other health and safety records were satisfactory and up to date. Care Homes for Older People Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be kept under review and updated with any changes to the persons needs. This will ensure that peoples changing needs are known and met by staff. 31/03/2010 2 27 18 There must be an effective system operating to ensure that there are always sufficient staff available to meet the assessed needs and dependencies of people in the home. This will ensure that staffing levels are determined by, and are sufficient to meet, the assessed needs of people in the home. 31/03/2010 Care Homes for Older People Page 24 of 26 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Handwritten instructions on medication administration records should be signed by the person who has written them and countersigned by another member of staff who has checked they are correct. This will ensure people are protected and medication is given as prescribed. The floor covering in the laundry should be repaired or replaced to ensure an impermeable surface that can be effectively cleaned. People applying for employment in the home should provide a full employment history. This will ensure a more robust recruitment system that protects people living in the home. 2 26 3 29 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). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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