Care Home: Four Seasons

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What the care home does well Four Seasons presents as a very warm, caring and friendly care home and residents appeared relaxed and comfortable with the staff. It was evident through interviews, general observations and discussions that staff had a good knowledge of the residents` individual care needs and the level of support required. During our visit staff were observed spending a great deal of time with residents, either on an individual basis or within a group. Care was seen to be given in a discrete, sensitive manner and staff were patient and gentle in their approach. Feedback from residents was very good; comments regarding the service included:"Staff are excellent" and "The carers are very efficient and kind to me - they show such patience". Prior to admission the manager assesses residents` health and social needs. Information collected is then used to form the basis for the plan of care. Assessment documentation seen had been completed to a very good standard and included key areas regarding the residents` health and general well being. Lots of different types of activities were arranged, both in the home and out in the community. The physical accommodation is of an excellent standard, with appropriate aids and adaptations available for the residents. There is an experienced and enthusiastic team of staff who work well together and enjoy taking part in training and development sessions. The staff are motivated and keen to ensure that residents receive high standards of care. The manager was experienced and ran the home well. She made sure she checked out staff before they started working at the home and gave them training and support to make sure they did the job to the best of their ability. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of `good practice`, particularly in relation to continuous improvement, staff training, resident satisfaction and quality assurance. There were no requirements made at the last inspection but the manager and staff have paid particular attention to improving the decoration, furnishings and improvements to the personal living accommodation for the people who live in the home. The staff development programme introduced by the manager has been greeted with enthusiasm by the staff and will further help to increase the knowledge and skills of the home`s workers. What has improved since the last inspection? There were no requirements made at the last inspection but the manager and staff have paid particular attention to improving the decoration, furnishings and improvements to the personal living accommodation for the people who live in the home.The staff development programme introduced by the manager has been greeted with enthusiasm by the staff and will further help to increase the knowledge and skills of the home`s workers. What the care home could do better: The storage of certain drugs requires a fixed metal cabinet and the manager has been asked to purchase this and have the cabinet installed in the medicine room, so that drugs stored in the home are safe. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Four Seasons 81 Halifax Road Littleborough Lancashire OL15 0HL     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: Bernard Tracey     Date: 2 3 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Four Seasons 81 Halifax Road Littleborough Lancashire OL15 0HL 01706376809 F/P01706376809 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Wendy Collinson care home 16 Number of places (if applicable): Under 65 Over 65 16 old age, not falling within any other category Additional conditions: 0 The registered person may provide the following category/ies 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 The maximum number of service users who can be accomodated is:16 Date of last inspection Brief description of the care home Four Seasons is a large detached house which, over the years, has been extended to offer personal care and accommodation to 16 service users over the age of 65 years. Nursing care is not provided. Accommodation is in 16 single rooms, with 12 rooms having en-suite toilet facilities. The home is located on the main A58 Halifax - Rochdale Road, approximately half a mile from Littleborough centre where a variety of shops and other facilities are located. Transport links are good, with a main bus route passing close to the home. A train station is located in Littleborough. The front door is accessed down three steps, ramped access is provided to the rear of the building. Parking is available on the main road across from the home and a small Care Homes for Older People Page 4 of 27 Brief description of the care home area is also located to the rear of the property. There are garden areas to the front and rear of the home. The home is owned and managed by Mrs Wendy Collinson. At the time of this inspection weekly fees were 396.56 There are no additional charges 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: The last key Inspection was undertaken on the 26th July 2007. In July 2008 we undertook an Annual Service Review. This is a report that we write for good or excellent services that have not had a key inspection in the last year. It does not routinely include a visit to the service. The review is an analysis of all the information that we have gathered about the service since the last main inspection. We (the Care Quality Commission) undertook a key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. The manager was asked to fill in a questionnaire, called an Annual Quality Assurance Care Homes for Older People Page 6 of 27 Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, these comments have been included in the report. We spent four and a half hours at the home over one day.During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. We spent time speaking to five residents, as well as speaking to four staff, two visitors and the Owner. We have received one complaints about the service since our last Inspection. This complaint was not substantiated What the care home does well: What has improved since the last inspection? There were no requirements made at the last inspection but the manager and staff have paid particular attention to improving the decoration, furnishings and improvements to the personal living accommodation for the people who live in the home. Care Homes for Older People Page 8 of 27 The staff development programme introduced by the manager has been greeted with enthusiasm by the staff and will further help to increase the knowledge and skills of the homes workers. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed before they are admitted to the home and this gives an assurance to everybody, that a person is only admitted if the home can meet their needs. Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. Care files contain relevant paperwork, including social work assessments and reports from health care professionals prior to a person choosing to stay at the home. The manager also carries out an assessment, which includes a visit to see the person in his or her own home or while in hospital. These measures ensure that admissions to the home only take place if the service is confident staff have the skills and ability and qualifications to meet the assessed needs of the prospective resident. This results in successful placements. One resident told us it is a very friendly home and the staff are very kind and caring. Care Homes for Older People Page 11 of 27 Evidence: Standard 6 does not apply. The home does not provide Intermediate Care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal care needs are being met and are addressed in detailed care plans. Evidence: Care plans were examined, two of which related to residents who had lived at the home for a relatively short time. Each resident in the home had a detailed, up to date and individual plan of care, covering all personal, health and social care needs. Any areas of risk for the resident were highlighted, along with the planned action to reduce that risk. Care plans demonstrated that residents personal choices and preferences had been taken into account by staff. We spent time talking with care staff who were working in the home, they were able to demonstrate knowledge, skill and a caring manner in carrying out their specific tasks. They were also supported by the District Nurses from the local surgery who support Care Homes for Older People Page 13 of 27 Evidence: and advice for the residents living in the home. All care plans had been regularly reviewed by staff on a monthly basis. Evidence of resident or relative involvement was seen on two of the care plans, one of which had recently been reviewed with relatives. The care plans of the two residents who had moved in recently had been signed or agreed with them or their representative. Care plans clearly recorded GP, District Nurse,and care management involvement. Residents spoken with said these health professionals were contacted when necessary. One resident described the care as extremely goodand other residents spoken with were satisfied with the overall care provided at the home. . Healthcare arrangements were also good. Residents had good access to their local doctors, dentist and optician and some were also under the care of a district nurse. A visiting district nurse told us, I have nothing but praise. Very good. Quick to alert us if a resident needs care and they always follow directions. The Manager is very skilled and pro active in contacting us. Other colleague doctors and nurses feel the same A resident told us that the The carers and especially Wendy (manager) really look after us There is an efficient Medication Policy supported by practice guidelines. Staff follow robust systems to make sure that medication records are fully completed, contain required entries and are signed by appropriate staff. The home is required to provide a fixed metal cupboard for the safe storage of Controlled medicines. Personal care was provided privately in bedrooms or bathrooms, and door locks or engaged signs were used. Residents wore their own clothes and were dressed appropriately for the weather and their activity. A relative spoken with during our visit stated The residents are very well cared for. The staff are very approachable if I need to ask them for anything. My mum is quite content here and all the residents seem to be well cared for personally and individually. It is an excellent 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily routines of the home were flexible and people were encouraged to maintain their leisure interests and activities whilst living there. The management of meals was good and visitors were made welcome to the home. Evidence: The social care needs of people moving in to the home had been assessed very well by the use of a social history and life preference document which described any significant events in peoples lives and told us about the people important to them. The information gathered so told us about individual leisure interests and hobbies as well as their life history. Collectively this information provided a clear pen picture about peoples lives throughout the ages. There was a lot of evidence available to show that a wide range of activities were available for people wishing to join in. The activities were well organised and planned in advance. We were told about how the home celebrated special events and about the themed activity days during the year. Trips out were arranged at intervals when transport was hired to take people to local places of interest. Care Homes for Older People Page 15 of 27 Evidence: The activities programme was displayed in the home so that people could decide what events they would like to join in and so that they could plan their days ahead. Those living at the home told us that they were able to decide their own daily routines and they were happy with the range of activities provided. Discussions with staff showed that they welcomed the opportunity to be involved in the planning and implementation of social and therapeutic activities. However, one person living at the home said, there is not much to do, but I dont get bored as I spend a lot of time reading my books. The information pack provided to people contained details about visiting arrangements, showing that relatives and friends were able to visit at any time and that contact with the local community was regularly encouraged, such as visits from religious ministers and local school children. Information about local advocacy services was easily accessible within the home, so that people were aware of how to access someone to act on their behalf, should they wish to do so. One visitor spoken to said that he was always made to feel welcome by staff. The food provided at the home was appetising and nutritious and there was plenty of choice. The dining room was light and nicely furnished, with pleasant table settings. Those we talked to told us that the food was good and that they were happy with the choices that were on offer. Lunchtime was a very relaxed, enjoyable experience for those living at the home and people were offered the daily choice of food. Staff were very aware of the likes and dislikes of those who were unable to make their own choices. The management of meals was good. We observed lunch being served. Staff were very sensitive to the needs of people living in the home, especially a new admission. Quiet encouragement was given, which people responded to positively. One person living at the home said, the meals are very good and I always enjoy them. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints were managed well and people living at the home were adequately safeguarded by the robust policies and procedures adopted by the home. Evidence: There was a clearly displayed and easily accessible written complaints procedure for the people living at the home and their relatives and this was included in the homes information pack. All six people who we spoke to told us that, in general, the staff listened to them and acted up on what they said. All six said that they would know who to speak to if they were unhappy and they would know how to make a complaint if they needed to do so. People who we spoke to said that they had no complaints at all about the service provided and that they were quite happy with the care and support received. However, they said that they would know what they needed to do should they wish to make a complaint. There was information readily available about the use of advocacy services and where people could get advice if they needed it. The advocacy service is used for anyone who would like an independent person to act on their behalf so that they are given the same opportunities as others and so that their affairs are protected. The home had Care Homes for Older People Page 17 of 27 Evidence: started working towards implementing strategies around the Mental Capacity Act so that everyone living at the home were given the same opportunities. When we visited we were informed that no person lacked capacity to consent to the arrangements made for their care or treatment and is being deprived of their liberty without the authorisation of the appropriate supervisory body. There were policies and procedures in place for the Protection Of Vulnerable Adults and the training matrix showed that most of the people working at the home had been given training on abuse awareness. All staff members who sent us comment cards and those we spoke to on the day of our visit told us that they would know what to do should a person living at the home their relative, advocate or friend be concerned about the welfare of someone living at the home. Evidence was available to show that where complaints or safeguarding adult issues had been raised, the manager at the home dealt with them in accordance with agreed polices and procedures and in an effective and efficient manner. Systems for recording any such issues were satisfactory. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, safe and well maintained, and provides a high quality living environment for the residents. Evidence: Four Seasons is a very well maintained, attractive home and has very good access to community facilities and services. It has a wide range of up to date specialist equipment and adaptations to meet the individual needs of people who use the service. The home is purpose built and accommodation is provided on two levels. It is fully accessible to people who are physically disabled and is fitted with aids and adaptations to promote independence. The main entrance hall is spacious and there is ample information available regarding the home and the service it provides. The home is well maintained, decorated to a high standard and was clean and tidy during the site visit. A partial tour of the building was undertaken, one bathroom, a shower room and six bedrooms were viewed. The bathroom and shower room were clean and tidy and hot water temperatures are recorded each month to ensure the hot water is delivered to a safe temperature. Bedrooms viewed had individual items and Care Homes for Older People Page 19 of 27 Evidence: were homely. A resident said, I have everything I need, including some of my own furniture. The manager also arranged for my telephone to be installed. Bedrooms have door locks and storage space for valuable items. Bedrooms have a call system with a hand held buzzer to call for assistance. The home has a well equipped laundry and there was evidence of gloves and aprons for staff use. Infection control training is given to staff and infection control policies are available. Residents commented on the good laundry service they experienced saying that care was taken with their clothes and they were returned to their room in good time. Residents say that there is always plenty of hot water and the temperature in the home can be changed to meet their personal choice, especially in their own rooms. The home is always very well lit, clean and tidy and smells fresh. Residents individual rooms are light and spacious and those seen showed a good level of personalisation with furniture and memorabilia. The home provides a well maintained, clean, comfortable and attractive place in which to live and which meets all the assessed needs of the residents. 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. At the time of our visit to this service the number and skill mix of staff on duty met peoples assessed needs and those working at the home had received training so that they could do their jobs properly. Evidence: The owner/manager had provided details of the staffing arrangements in the home prior to the inspection, the details of which were checked during the visit. Staffing levels within the home were seen to meet the needs of residents. Care staff that undertook their duties in a friendly and caring manner, promptly supported residents needs. Residents confirmed that staff were always respectful and met their needs competently. In the main, residents were satisfied with the support they were given and described staff as find time to listen and very caring and good with me when I need extra help. Sufficient ancillary staff were employed, e.g., domestics, laundry and kitchen assistants, cook and handyman. Staff were, in the main, knowledgeable about the needs of residents and demonstrated Care Homes for Older People Page 21 of 27 Evidence: that they understood their own role. Staff files demonstrated that a robust recruitment process is in place, with all appropriate checks being undertaken. These include references, Criminal Record Bureau disclosures, application forms and references with one from the previous employer always obtained. New staff undertake a full induction programme that is followed by further in-house training. Several staff are presently undertaking National Vocational Qualifications in care at Level 2. The home has an ongoing training programme that staff can apply for. Since the last inspection several staff have received training in abuse awareness and more are booked to attend in the future. Staff spoken with showed that their knowledge had increased since the training and that they were more aware and confident in reporting concerns. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was managed well so that the health, welfare and safety of the people living and working there was protected Evidence: The home was being well managed and staff spoken to told us that they were well supported by the manager of the home and that there was a good rapport between the staff and the people living there, which was quite evident from the very happy and friendly environment, which was full of fun and laughter whilst we were there. Four Seasons was clearly being run in the best interests of those living there and people using the service and visitors to the home all spoke very highly of the staff and the manager of the service. When asked if the management of the home supported staff and discussed with them how they were working, one member of staff wrote on the comment card, we have a very supportive manager. She continues to give us support in our work areas as she Care Homes for Older People Page 23 of 27 Evidence: works with us, another commented, my manager does supervisory meetings. Also I can approach her whenever I need to as she is very supportive and a third stated, all the time my manager is very good. She tells me all about good care and how to work. There was an excellent system in place for monitoring the quality of service provided, which included a wide range of risk assessments and audit trails so that any potential risks, strengths or areas for improvement could be identified and addressed as was necessary. A variety of meetings were held at regular intervals, with minutes retained, so that people concerned could pass on any relevant information and discuss any topics of interest. Some surveys had been conducted for people using the service and their relatives so that those living at the home could say what it was like living at the home. The results of surveys conducted were correlated and presented in an easy format so that any interested parties could see what the outcomes for people living at the home were like. A random selection of service certificates were examined, which showed that systems and equipment within the home had been appropriately checked by external contractors to ensure that they were safe for use so that those using them were protected from harm. An extensive range of internal checks had also been conducted so that people living at the home and those working there were kept safe. A clear record of accidents and injuries was maintained with statistics being collated quarterly so that any emerging trends or patterns could be easily identified and addressed as was necessary. 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 9 13 The manager must ensure that an appropriate metal cupboard fixed to the wall is available in the medicine room. This will ensure that controlled drugs are safely stored. 30/10/2009 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 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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