Care Home: Garden Lodge

What the care home does well The home is well managed and run in the best interests of residents. Checks are in place including the use of questionnaires to monitor the standards of care provided. There is a stable staff team of experienced mature carers that provide a good standard of care for residents. There is a thorough assessment of residents needs to ensure that appropriate care is provided. Residents are treated with great warmth and respect. Positive comments from questionnaires are; I like being here. The home is clean and friendly and they care about us. There are nice hard working staff. Friendly and helpful staff. In recent weeks my mother has been very ill and has received the best treatment she could have. Professional visitors commented; You get a warm welcome, the staff are very helpful and the home is very clean and tidy. This is the only home in the area I recommend. The staff are committed to providing the best quality service possible. They support people to live an independent life. What has improved since the last inspection? This home was assessed as good at the last inspection and many of the systems in place ensure this continues. Maintenance and renewal works are ongoing. Training of staff to ensure that care practices are good continues and the manager and her deputy constantly look at how care can be improved. The requirements made at the last inspection have been addressed. What the care home could do better: Activities provided in the home should be improved with the introduction of an activities coordinator. Four residents commented in a questionnaire that more activities outside of the home could be arranged. A resident commented they spend alot of time in their room now but they used to like playing bingo. Professional visitors stated there could be more done with the garden. And more staff would make this good home excellent. The recently introduced meetings between key worker and resident should continue with improved information relating to general wellbeing and social stimulation. Provide a shower room to provide choice for people in bathing. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Garden Lodge Philipson Street Walker Newcastle Upon Tyne Tyne & Wear NE6 4EN     The quality rating for this care home is:   two star good 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: Allan Helmrich     Date: 1 1 0 8 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 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 26 Information about the care home Name of care home: Address: Garden Lodge Philipson Street Walker Newcastle Upon Tyne Tyne & Wear NE6 4EN 01912636398 01912636946 noemail 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) : Robert Pattinson t/a Manor Care Home Group care home 41 Number of places (if applicable): Under 65 Over 65 0 41 dementia old age, not falling within any other category Additional conditions: Age on admission 55 years and over 41 0 The maximum number of service users who can be accommodated is: 41 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 - maximum number of places 41 Dementia Code DE, maximum number of places 41 Date of last inspection Brief description of the care home Garden Lodge is a modern purpose built care home providing accommodation with personal care for up to 41 residents. The accommodation consists of 2 units, both on the ground floor with the upper floor used for storage and staff facilities. One unit consists of 20 bedrooms with ensuite toilet facilities for frail older people; the other is of 20 bedrooms with ensuite toilet facilities for older people with a dementia. The home Care Homes for Older People Page 4 of 26 Brief description of the care home does not provide nursing care. Garden Lodge is situated in a residential area of Walker, a suburb to the east of Newcastle upon Tyne. The home is close to local shops and public transport links. Information about the home and current inspection reports are available in the home. The homes fees range from £363 to £373. 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: 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Before the visit we looked at: Care Homes for Older People Page 6 of 26 Information we have received since the last visit on 25th July 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of residents, their relatives and other professionals who visit the service. The inspection was unannounced and was undertaken by the link inspector for the service. Information was collected over two days. During the visit we: Talked with people who use the service and their visitors. Talked with the registered manager and staff on duty. Looked at information about the people who use the service and how well their needs are met. Looked at case records for four people and other records which must be kept, including medication. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to assess if it was clean, safe and comfortable. Checked what improvements had been made since the last visit. Questionnaires were provided to the home to distribute to residents, staff and professional people who come into the home. Returns were received from fourteen residents, four staff and three professional visitors. Information from these sources is used in the production of this report. What the care home does well: What has improved since the last inspection? What they could do better: Activities provided in the home should be improved with the introduction of an activities coordinator. Four residents commented in a questionnaire that more activities outside of the home could be arranged. A resident commented they spend alot of time in their room now but they used to like playing bingo. Professional visitors stated there could be more done with the garden. And more staff would make this good home excellent. The recently introduced meetings between key worker and resident should continue with improved information relating to general wellbeing and social stimulation. Provide a shower room to provide choice for people in bathing. Care Homes for Older People Page 8 of 26 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 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. A range of useful information about the home is available to prospective service users and before being accepted into the home each persons needs are assessed by a senior member of the care team to ensure they can be met. Evidence: Available in the home are copies of the homes brochure and service user guides. These contained location plans and details to enable prospective residents to make an informed choice about the home. A file of other information and photographs is available to show visitors past events and activities that residents have been involved in. Since the last inspection each new arrival is greeted with a welcome card and letter containing information useful to people in the early days of settlement. The records of a recent admission were reviewed. There was a full assessment of the persons needs obtained prior to offering a place in the home. The file contained care managers assessments and details obtained to limit the possibility of the home offering a place to Care Homes for Older People Page 11 of 26 Evidence: someone whose needs they could not meet. The file detailed the residents daily living and health care needs to ensure staff provide appropriate care. Although this person was admitted several weeks earlier there was no photograph in the file that could be used for identity. The manager did state that a digital camera and printer was recently obtained for this purpose. All other files reviewed contained a recent photograph. Several residents spoken to all said that they enjoy living in the home and during the inspection a prospective resident and family were greeted by senior staff and given a tour of the home. At the second visit the home was preparing to accept this person. A respite bed is available in the home but the home does not offer a specialist rehabilitation service to enable residents to return to independent living. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs are well supported by good care planning, regular involvement from other professionals and clear recording. Evidence: Four care plans were reviewed each contained a social assessment and a plan for daily living. As stated before, the plan for a recently admitted person did not contain a photograph to identify them to staff reading the files. Care plans contained information to describe to staff how care is to be provided. Each persons health is assessed and support is obtained when necessary from relevant professionals. There was detail in one file showing how staff were working with a professional person. Staff had received training and were attempting various strategies introduced to address some challenging behaviours. Several plans seen had been rewritten following changes in assessed need. This shows people needs are constantly being re-assessed. Care Homes for Older People Page 13 of 26 Evidence: People are weighed regularly and the home has sit-on scales to aid this process. Care plans are generally reviewed monthly to ensure the care provided meets the individuals needs. Since the last inspection key staff have been instructed to review the care provided with the individual and by looking back at the previous recordings made. The records of these meetings tended to concentrate on health care and missed looking at the person and how their lifestyle had been since the last meeting. A development of this should provide a good basis of person centred planning. Systems are in place to meet the needs of any resident with a pressure sore and residents at risk are provided with the equipment to support them. All of the care plans have been regularly assessed. The homes system for administering and dispensing medicines was checked and found to be in good order. An air conditioning unit was fitted in the medication storage room following a requirement at the last inspection. Temperature monitoring shows medicines are now stored at appropriate temperatures. MAR (medical administration record) checks showed there were no gaps in recording, two signatures evidence hand written information and a photograph of each person who receives medication is in place. Controlled drugs are appropriately stored and recordings were correct. All staff who dispense medicines have been trained and assessed as competent. Residents seen were dressed appropriately in their own clothes. Staff were seen to treat residents respectfully and deal with any personal issues with dignity. Locks on bathroom and toilet doors checked during a tour of the building worked smoothly to enable people with less mobility to use them. Residents spoken to during the inspection all said that staff provided good care and were respectful. Three surveys returned by visiting professional people were all positive about the care and support provided. None of the fourteen surveys returned by people in the home criticised the health care provided by staff. 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. Residents are supported to access community facilities and make choices. But activities provided could be improved. Meals are well presented and a healthy diet is offered. Evidence: Each of the care plans reviewed contained good detail of peoples preferred social activities and interests. A life history is obtained together with details of family and friends. This is particularly useful for staff when assisting residents with a dementia. People said they choose what to do and where to go but some people criticised the activities available and four people said they would like to go out more. One person spoken to was enjoying sitting near the front door watching people come and go. Some women were sitting in a group in a lounge reading glossy magazines. They all said they like living in the home and talking to each other. Seating areas are located throughout the home to enable residents to form small social groups. The book that records activities showed that several regular activities have been cancelled. The records generally showed that people have family visits and watch television. Staff Care Homes for Older People Page 15 of 26 Evidence: stated they do take residents to local shops and parks. Several residents attend a day centre nearby and community church groups visit the home. Some photographs of social occasions and activities residents are involved in are in an album to show to visitors and to remind residents of past times. The manager stated an activities person is being employed soon. Risks in daily living are assessed and mitigated. However one very able persons assessment appeared to question their ability. The manager stated the risk should have identified the risk was from other people in the home. Although no visitors were spoken to during the inspection residents confirmed they have regular visitors and a welcome note to visitors is posted at the entrance. Menus reviewed demonstrated that a range of healthy foods is provided. A choice is offered at each mealtime and details of the meal are written on a board each day. A lunchtime meal was observed. The meal was well presented and unhurried with adequate staff numbers supporting residents in a quiet dignified way. Residents confirmed they enjoy the meals provided. The cook is doing a nutrition and health course to improve her awareness. She understands the needs of people with a dementia and provides meals that include finger foods to promote independence. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured their complaints are taken seriously and that they are protected by a well-trained staff team. Evidence: A complaints procedure is provided in the homes Service User Guide given to each resident on admission. The manager takes complaints seriously and records all issues of dissatisfaction with the service provided. Each issue brought to the attention of the manager was recorded in a log with how they were resolved. All staff have received training related to abuse awareness and the manager and some senior care staff have attended an advanced course. Appropriate procedures and Department of Health guidance are available in the home for staff and the manager has undertaken an assessment of staff awareness in relation to protecting residents. However some staff spoken to were unsure about their responsibilities in this area and this could leave people vulnerable in the home. Staff training records seen during the inspection clearly showed these staff had received recent training in this respect. 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 is safe, clean and well maintained. Evidence: The home is purpose built. It has two separate units providing care for older people and older people with a dementia. Some people with a mild dementia are admitted onto the wing for older people in the knowledge they can be transferred should their needs change. All living space is on the ground floor with level access to the outside. In addition to lounge and dining areas, seating is provided in corridors and at the entrance to encourage residents to collect in small groups. Recently a Gazebo and seating has been made available in the garden and plans to redevelop this area to involve the community are planned. This new idea will involve the participation of those residents who choose. The temperature in the home on both days of the inspection was high and staff felt oppressed although no people living in the home had any complaints. Peoples bedrooms are individually styled and contain many personal possessions. Each persons door now has a picture they can identify to better be able to locate their room. Care Homes for Older People Page 18 of 26 Evidence: Residents spoken to during the inspection are happy with the standard of appointment. A programme of cleaning is in place, the home is clean and no odours were detected. Maintenance of the building is ongoing. New carpets have been laid in corridors and handrail have been painted a vivid blue to help people with a dementia. There are four lounges in the home and each has a new large screen television with free view channels. The family of a past resident donated a Wii player for use in the home. One of the homes bathrooms is not used but was not locked for safety. The home can not offer shower facilities at the moment. This restricts people choice in bathing. Also the water temperature in one bathroom exceeded the safe comfortable temperature of 43 degrees centigrade and another was only 33 degrees. The laundry contains appropriate equipment to meet disinfection standards and laundry staff are provided with information and instruction regarding laundry. A member of senior staff attends meetings with the infection control nurse in the NHS to obtain best practice information. The kitchen was well equioed and there was a good standard of hygiene. Doors and windows had fly screens and there was good food storage. The home received an excellent 5 star rating for hygiene at the last Environmental Health inspection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home operates a thorough recruitment process and trained staff employed in appropriate numbers support people and ensure they are safe and their needs are addressed. Evidence: Staff levels were reviewed as these have been reduced since the last inspection. Previously seven care staff were on duty each day and this is now reduced to five. Night time staffing levels remain the same at four care staff. The manager is supernumerary and is available on weekdays. Currently the home is operating at under occupancy with 34 residents but should this change or the needs of people admitted increase, the staffing should be reviewed to ensure everyone living in the home obtains the support they need. Domestic and catering staff are employed in sufficient numbers to maintain the home and meet peoples needs and an activities organiser is awaiting CRB clearance before starting work in the home. No care staff under 18 years old are employed and no-one under 21 years old is left in charge. Currently there are vacancies for two full time care staff and these duties are being covered temporarily by staff working additional shifts. Staff training needs are identified in supervision and appraisal sessions. Statutory training is reasonably up to date and video training sets have been provided for inCare Homes for Older People Page 20 of 26 Evidence: house refresher training. These are in addition to specific accredited training. Fifteen care staff have achieved a National Vocational Qualification (NVQ) in care. Trainees are provided with induction training that meets nationally recognised standards and a senior member of the staff team signs off this training. In addition competency assessments are recorded to demonstrate staff employed have appropriate skills. Since the last inspection four new staff have been employed. Each of their files was reviewed and found to contain appropriate references and Criminal Records Bureau information. Inductions conducted by the home were detailed together with all training undertaken. Staff sign to confirm they have read important policies. The manager uses an employment checklist to demonstrate the homes recruitment process is followed. All staff receive a company handbook with useful employment information. Many of the staff team have worked in the home for several years and throughout the inspection residents praised the quality of care provided. Staff spoken to stated that a good range of appropriate training is provided, that clear direction is provided by management and that good support is available from other staff. This helps them provide a good service to the residents. Surveys returned by for staff also confirmed that staff development takes place and their views are respected. Staff meetings are held and minutes are made available to the staff team. Minutes of meetings held on 21st May and 18th February attended by 11 and 13 staff respectively were seen. A good range of issues were discussed. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 run for the benefit of the people who live there by an experienced manager who understands the needs of vulnerable people. Systems for self-monitoring are in place and safe working practices are promoted. Evidence: The manager has been in charge of care homes for older people for several years. She has the Registered Managers Award which demonstrates her knowledge and experience in managing a care home for vulnerable people. Four staff who completed a survey all recorded they get good management support and one person commented the manager runs a very good home and is easy to talk to if I have any problems. People spoken to during the inspection stated that the manager is always available to discuss matters relating to the running of the home. Care Homes for Older People Page 22 of 26 Evidence: A quality monitoring system is in place that involves the use of questionnaires and regulatory visits are made by a Representative of the owner to monitor the home. There are regular meetings with people who live in the home and minutes were seen for the two latest meetings held on 10th March and 8th January. A range of issues were talked about including food preferences and activities. Monies held for residents are recorded in a log and all spending is recorded and signed by two staff members. A receipt is retained for all purchases made for residents by staff. These records were regularly audit by management. Systems are in place to ensure the home is safe for residents. Certificates were seen to demonstrate maintenance tasks carried out by external contractors were done. Current certificates were seen for; gas servicing, portable appliance testing, hoist maintenance and for the quality of the homes internal wiring. Water temperatures are checked and a risk assessment is in place to show the water system is free from Legionella. Accidents in the home are recorded and reviewed by management to keep residents safe. A fire risk assessment has been produced and regular fire checks are recorded and staff training provided to ensure residents are safe. Each member of staff has a handbook that includes details of health and safety in the home. Kitchen staff use an audit system to promote better food standards in the home. Infection control systems and systems to ensure a good standard of hygiene is maintained is in place and a member of senior staff meets periodically with the infection control nurse to obtain current best practice information. Since the last inspection easily cleanable light pulls have been introduced to improve hygiene standards. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 3 The manager should ensure that a recent photograph of new residents is obtained as this may be useful in the early days identifying the person to new staff on shift or in the event of the person go missing. Continue with the development of a more person centred involvement in care planning using regular meetings between key worker and resident. Ensure by competence testing that staff are aware of issues relating to the protection of vulnerable people. Consider the provision of a full assisted shower room to be able to provide choice to people who live in the home. Record then review the temperatures in the home to ensure they meet peoples needs. 2 7 3 4 5 18 21 25 Care Homes for Older People Page 25 of 26 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). 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. 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