Care Home: Ganarew House

What the care home does well People have access to written information so that they can make an informed choice about whether they wish to move into Ganarew House. People can be confident that their needs will be fully assessed before they move in, so that staff know how to support them. People can be confident that staff will provide a high standard of care. Medication is generally managed safely. The home provides a range of activities so that people have access to a variety of social and leisure opportunities. Meals provide a nutritious and balanced diet. People can be confident that the manager will listen to any concerns and do her best to resolve them. Staff understand their responsibility in protecting people from the risk of neglect or abuse. The home is a safe and comfortable place for people to live. It is generally kept clean and fresh. There are enough staff on duty to meet people`s individual needs. Staff receive training which gives them the skills and knowledge they need to support people with a dementia illness. The manager makes sure that the needs and wishes of the people who live there are given a high priority. The home is managed well and the policies and procedures help to promote people`s independence and right to make choices. What has improved since the last inspection? Care plans give staff clear guidance on how to support people whose behaviour poses a risk to themselves or others. Care plans are reviewed on a regular basis, and are updated to reflect people`s changing needs. The home has employed a full time activities co-ordinator to ensure that there is access to a wide range of social and leisure opportunities. What the care home could do better: Some improvements should be made to the way in which medication is recorded. Infection control is not always well managed, which means that people could be put at risk. Key inspection report Care homes for older people Name: Address: Ganarew House Ganarew House Ganarew Near Monmouth Monmouthshire NP25 3SS     The quality rating for this care home is:   two star good 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: Sarah Blake     Date: 0 7 0 4 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 29 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 29 Information about the care home Name of care home: Address: Ganarew House Ganarew House Ganarew Near Monmouth Monmouthshire NP25 3SS 01600890273 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Milkwood Care Limited Name of registered manager (if applicable) Ms Sylvia Williams Type of registration: Number of places registered: care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 37. 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 Dementia - Code DE Date of last inspection Brief description of the care home Ganarew House is a converted country house in a rural hamlet between the towns of Ross on Wye and Monmouth. The setting is very attractive with views over open countryside and gardens to the front. There is a small-enclosed courtyard to the rear. Care Homes for Older People Page 4 of 29 Over 65 0 37 37 0 1 8 1 2 2 0 0 8 Brief description of the care home The Provider is registered in respect of the Home to provide care for up to 37 people with care needs relating to the ageing process or the effects of having a dementia illness. An extension to the premises was opened in 2007 and the old rooms have been upgraded. There are bedrooms on both the ground and first floors, four of which are available for shared occupancy. There are a range of communal rooms on the ground floor. The ground floor has space for people who like to walk around during the day. The Provider is Milkwood Care Ltd who took over the Home on 4th October 2005. Information about fees is available on request from the home. A copy of this report can be viewed at the home. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection. One inspector spent a day at the home, talking to the people who use the service and the staff, and looking at the records, which must be kept by the home to show that it is being run properly. These include records relating to the care of people who use the service. We looked in detail at the records for three people living at the home. The service had previously completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Some of the comments from the AQAA have been included within this inspection report. We also received completed survey forms from people who use the service, their relatives and health professionals who work with the home. The information from these Care Homes for Older People Page 6 of 29 sources helps us understand how well the home is meeting the needs of the people using the service. Care Homes for Older People Page 7 of 29 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. Care Homes for Older People Page 8 of 29 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 29 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 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to written information so that they can make an informed choice about whether they wish to move into Ganarew House. People can be confident that their needs will be fully assessed before they move in, so that staff know how to support them. Evidence: The home provides people with written information, in the form of a Service User Guide, to help them decide if they wish to move into Ganarew House. The parent company, Milkwood Care, also has a website with information about the services it provides. We saw that the Service User Guide contained useful information about life at the home. We looked at records for one person who had recently moved into the home. These showed that a senior member of staff from the home had visited the person before they moved in, so that a full assessment of their needs can be carried out. We saw Care Homes for Older People Page 11 of 29 Evidence: that the assessment was brief, but informative, and took into account the persons individual needs and wishes. A family member told us that they had been involved in this assessment, particularly in assisting the home to find out about the persons likes and dislikes and their family history. This information helps the home to ensure that it can meet peoples individual needs, and gives staff the information they need to provide care for people. We spoke to relatives of two people who had recently moved into the home, and they told us that they had visited the home before making a decision. They also said that their relatives had settled in well. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that staff will provide a high standard of care. Medication is generally managed safely, although some improvements should be made to the way in which medication is recorded. Evidence: We looked in detail at the care provided for three people who live at the home. This included checking their care plans and medication records, and talking to staff about how their care is provided. We also spoke to relatives of two people to find out their views on how care is provided. We saw that care plans are reviewed every month and amended as peoples needs change. Records showed that families are encouraged to be involved in care planning if they wish. The care plans were detailed and addressed peoples individual needs by giving staff clear information about their needs and how to meet them. For example, one person had been assessed as being at risk of falls. The risk assessment and care plan had been updated following a recent fall, so that staff would know what steps to take to prevent further falls. Care Homes for Older People Page 13 of 29 Evidence: Another person has mobility needs, and staff use specialist equipment to assist them. The use of this equipment was clearly explained to staff in the care plan. Staff were able to explain clearly how they would use this specialist equipment safely. We saw that peoples preferences, such as preferred time of going to bed, were noted in the care plans, and that the care plans were written in a person-centred way. The Alzheimers Society explains how person-centred care works: Instead of treating the person as a collection of symptoms and behaviours to be controlled, person-centred care considers the whole person, taking into account each individuals unique qualities, abilities, interests, preferences and needs. During the day of the inspection, we saw staff encouraging people to make choices about the day to day aspects of their lives, such as what they would like to do after lunch. Records showed that the home accesses medical support as necessary. We spoke to a District Nurse, who told us that the home always carries out any instructions from her or her colleagues. She praised staff at the home for the way in which they always inform her of any concerns about peoples health or welfare. The home ensures that everyone who moves into the home has their nutritional needs assessed, and that they are weighed regularly to ensure that they are not at risk of malnutrition. We saw that two people had not been weighed for several months. The deputy manager explained that they were not able to stand on the scales. It is important that people who are at risk of losing weight are monitored regularly. We saw that one person sometimes behaves in a way which could put them or others at risk. The care plan contained detailed information about the persons behaviour and what staff should do to calm the person down. One person had bed rails on their bed, and we saw that there was no risk assessment to show why the bed rails were necessary and how they should be used safely. The bed rails were not protected by padded covers. We made an immediate requirement that the home must carry out a full risk assessment for the use of bed rails. The deputy manager made sure that this was done, and was able to show us the completed forms. We found that medication was stored safely and in accordance with legal requirements. A check of some medications showed that the home has good procedures in place for recording the receipt and stock control of medication. Care Homes for Older People Page 14 of 29 Evidence: We saw a senior carer signing Medication Administration Record (MAR) charts after the medication round had finished. She explained that a tick box is filled in after each person has taken their medication, and then she signs all the MAR sheets at the end of the medication round. This is not good practice, as it is important that there is an accurate record of exactly what medication each person has been given. This practice is also not in line with the homes own procedures, which clearly state that staff should sign the MAR chart immediately after giving the medication. During the inspection, we saw that staff treated people with respect and took care to make sure that their privacy and dignity was promoted. Care Homes for Older People Page 15 of 29 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. The home provides a range of activities so that people have access to a variety of social and leisure opportunities. Meals provide a nutritious and balanced diet. Evidence: People who live at the home told us in our surveys that there are usually enough social activities for them to take part in, although some people commented that this could be improved. The home has recognised that it needs to do more to enable people to enjoy social and leisure activities, and has recently appointed a full-time activities co-ordinator, who has plans for a more varied range of activities. Records showed that recent activities had included an Easter cream tea including the local community, and hand massages. Some people living at the home enjoy carrying out general household tasks such as dusting and sorting laundry. This helps to give people a sense of purpose in their lives. On the day of the inspection, some people were going out in the homes minibus for an outing to a local farm to see the new born lambs, and we saw staff asking people is they would like to join the trip. In the AQAA, the home told us family relationships are encouraged and supported. Care Homes for Older People Page 16 of 29 Evidence: We spoke to relatives of three people who live at the home, and they told us that they are always made very welcome. Staff try to make sure that there is plenty of stimulation in the environment. This is especially important for people with dementia. For example, there is a large colourful calendar on the main corridor wall, and we saw staff updating it with the days weather. There is also a sensory board with fabrics of different textures and colours, and we saw people touching them as they went past. Staff told us that they had noticed that some people were trying to open the front door of the home, so the handyman made a locks and latches board for them. The home provides a menu of food which provides a varied and nutritious diet. The menu is rotated on a six-weekly basis, so that people have variety in their diets. Lunch on a typical day might be roast chicken with roast potatoes and fresh vegetables, followed by fresh fruit salad. There was no choice of main meal shown on the menu, but staff told us that people are told that the cook will make alternatives if requested. Lunch was a sociable occasion, and staff generally supported people in a sensitive and respectful manner, although we saw one member of staff helping two people to eat at the same time, rather than sitting beside one person and taking time to make the occasion enjoyable for the person. Care Homes for Older People Page 17 of 29 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 can be confident that the manager will listen to any concerns and do her best to resolve them. Staff understand their responsibility in protecting people from the risk of neglect or abuse. Evidence: In our surveys, people told us that they knew how to raise any concerns or complaints with the home. We spoke to three relatives of people living at the home, and they told us that they would feel comfortable raising any issues and felt confident that they would be listened to, and the situation resolved. All three told us that they had never had any reason to complain. Records showed that the home had received no complaints in the past year. We, the Commission, have not received any complaints about the home since the last inspection. One of the ways in which homes can ensure the safety of the people who live there is by ensuring that they carry out staff recruitment in such a way that only suitable staff are employed. We looked at records for two members of staff. We saw that the required checks, such as Criminal Records Bureau (CRB) checks, had been carried out. We spoke to staff, who showed a good understanding of how to protect vulnerable people from abuse or neglect. Records showed that staff at the home have attended Care Homes for Older People Page 18 of 29 Evidence: training in the protection of vulnerable adults. Care Homes for Older People Page 19 of 29 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 a safe and comfortable place for people to live. It is generally kept clean and fresh. Infection control is not always well managed, which means that people could be put at risk. Evidence: Ganarew House is a large converted country housesituated in a rural location, between Ross-on-Wye and Monmouth. It has been extended and adapted to meet the needs of older people. The home looks fresh and clean throughout and the paintwork and soft furnishings are in very good decorative order. There are two lounges with comfortable seating, one of which has been designated as a quiet lounge where there is no television. In addition, there is a comfortable seating area at one end of the dining room. All the communal rooms have large pictorial signs on the doors, to help people orientate themselves around the home. There are reminiscence boxes on the walls of some of the corridors, with memorabilia which might help people to reconnect with the past. We saw that people are encouraged to personalise their bedrooms with items of their own furniture and ornaments. The bedrooms all have an en suite toilet and washbasin. Care Homes for Older People Page 20 of 29 Evidence: The home has improved the way in which signs and pictures are used to help people orientate themselves around the home. This includes large print signs and pictures on bathroom and toilet doors. We spoke to relatives of people living at the home, and they told us that the home is kept clean and warm. We saw that staff were using gloves and aprons appropriately when providing personal care to people. There were plentiful supplies of hand wash and paper towels in the bathrooms, and hand sanitiser was available throughout the home. All these measures help to prevent the spread of infection. However the laundry room contained dirty laundry piled on the floor, and we saw a member of the care staff come into the laundry room with dirty laundry clutched to her chest; she was not wearing an apron, so the dirty laundry was in direct contact with her uniform. The care worker then put the dirty laundry in a basket which contained clean laundry. We saw that the laundry baskets were not labelled, to say whether they contained clean or dirty laundry, so it was easy to see why the mistake had occurred. It is very important that clean and dirty laundry are stored separately, and it is not good practice to have dirty laundry on the floor as this increases the risk of cross-contamination. Care Homes for Older People Page 21 of 29 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 on duty to meet peoples individual needs. Staff receive training which gives them the skills and knowledge they need to support people with a dementia illness. Evidence: We spoke to people living at the home and their relatives, and everyone spoke very highly of the staff. Comments included absolutely fantastic, so caring, they understand that everyone is an individual, I cant sing their praises too much Ive yet to find anyone whos been anything other than hospitable, helpful and friendly. People told us that there are always plenty of staff on duty and that their needs are always met in a timely manner. We saw that staff were very busy but they did not give the impression of being rushed and in a hurry. Records showed that staff receive a range of training to give them the skills and knowledge they need to carry out their roles. We spoke to staff, who showed a good understanding of the needs of the people who live at the home. They told us that they feel well supported by the manager and deputy manager. During the inspection, we saw that staff were kind and caring in their approach to people, and we observed one staff member being very patient in explaining something Care Homes for Older People Page 22 of 29 Evidence: several times to one person, until she was sure that they had understood. Care Homes for Older People Page 23 of 29 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. The manager makes sure that the needs and wishes of the people who live there are given a high priority. The home is managed well and the policies and procedures help to promote peoples independence and right to make choices. Evidence: The registered manager, Sylvia Williams, has worked at the home for several years and continues to work hard to ensure that the home is run for the benefit of the people who live there. On the day of the inspection, the deputy manager was in charge, and was able to provide all the information we needed to carry out the inspection. This shows that there is an effective management structure which does not depend solely on the manager. The AQAA was returned when we asked for it, and it contained detailed information about the home, and showed that the manager recognises where improvements need to be made. Care Homes for Older People Page 24 of 29 Evidence: Because most of the people living at Ganarew House have a dementia illness, we looked to see if the home had carried out assessments under the Mental Capacity Act (MCA). This would ensure that peoples interests are protected if decisions need to be taken by the home on their behalf. There were statements about the Mental Capacity Act in each persons care plan, and the deputy manager showed that she understood how the Act should be used in practice. The parent company, Milkwood Care, carries out its own internal quality assurance, and we saw that questionnaire forms were displayed in the reception area for people to complete if they wished to. The home has policies and procedures which help to ensure that the service is provided to a high standard, and which promote independence and choice. We saw that the home has a Physical Intervention policy, which allows staff to use physical intervention under exceptional circumstances. However, there was no evidence that staff have received training in how to use physical intervention or restraint safely. Any physical intervention puts people at risk of injury unless staff have been trained in safe ways to carry it out. The home keeps records of maintenance and any health and safety issues. Staff are trained in health and safety, and know the fire safety arrangements for the home. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 8 13 (4)(c) You must ensure that the use of bed rails is governed by a written risk assessment, and that consent is gained for their use. This is so that people are not at risk of injury. 09/04/2010 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 8 12 (1) You must ensure that people who are at risk of malnutrition are accurately monitored. This is so that people are not at risk of harm. 24/07/2010 2 9 13 (2) You must ensure that 24/07/2010 records of the administration of medication are accurate. This is so that people can be confident that they will receive their medication as prescribed. 3 26 13 (3) You must put an effective system in place to ensure that laundry is managed in a hygienic manner. 24/07/2010 Care Homes for Older People Page 27 of 29 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 This is so that people are not at risk of harm from cross-contamination. 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 15 You should review your procedures for supporting people to eat, so that people are supported in a way which promotes their dignity. You should review the homes policy on physical intervention, to ensure that people are not at risk of harm. 2 38 Care Homes for Older People Page 28 of 29 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. © 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. 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