Care Home: Hazel Court Nursing Home

What the care home does well Findings from this inspection indicate that there is a committed management team at the service who want to develop the service further. The atmosphere is relaxed, calm, and we observed positive interactions between the staff and people who live at the home. What has improved since the last inspection? At the previous inspection there had been thirteen areas where the service had to improve. The team at the home has taken action on all of these areas, which represents a positive response to the findings of the inspection and good developments to the service. This has also resulted in them receiving a higher star rating than at the last inspection. In particular, good improvements had been made to the care planning and training of staff. What the care home could do better: Areas where the home could be doing better are highlighted in the report and were discussed with the manager during the inspection. This includes some improvements to the environment that we saw needing to be addressed. Key inspection report Care homes for older people Name: Address: Hazel Court Nursing Home Haydon Way Wandsworth Off St Johns Hill London SW11 1YF     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: Louise Phillips     Date: 0 4 0 5 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 28 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 28 Information about the care home Name of care home: Address: Hazel Court Nursing Home Haydon Way Wandsworth Off St Johns Hill London SW11 1YF 02088706933 02088710824 gaynor.hewitt@shaw.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Shaw healthcare (Homes) Limited Name of registered manager (if applicable) Mohamed Haroon Dusmohamed Type of registration: Number of places registered: care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The maximum number of service users who can be accommodated is: 24 The registered person may provide the following category of service only: Care home with nursing (CRH - N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Dementia Code DE Date of last inspection Brief description of the care home Hazel Court is a purpose built single storey care home for older people with dementia. The service provides respite accommodation for up to two people at one time. It is situated off St John s Hill in Battersea, approximately twenty minutes walk from Clapham Junction Station, and is also accessible by bus. The service is managed by Shaw Healthcare Limited. Care Homes for Older People Page 4 of 28 Over 65 0 24 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 inspection took place over one day and included a visit to the service by a Regulation Inspector. During the inspection we looked specifically at areas from the last key inspection of the service (in June 2009) that we wanted to see improved, and had made requirements about. This involved us looking at records and relevant documentation held at the service and speaking to the manager and deputy manager. We also looked at the AQAA for the service, which is the Annual Quality Assurance Assessment that we asked the manager to complete about the service, since the last time we visited. The AQAA tells us about developments to the service, and areas of improvement that have been identified and planned for. Because we did not look at all areas in this inspection we have referred to the findings of the previous inspection and put these into this report, and we have made it clear in the report where we have done this. This is so that this report is a full document for the reader. Care Homes for Older People Page 5 of 28 Care Homes for Older People Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 28 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 8 of 28 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. The assessment process is thorough to ensure that the service is the right place for new people to move to. Evidence: Prior to people moving to Hazel Court they are appropriately assessed by the manager or deputy manager to ensure that the service is able to meet their needs. At the start of the assessment the service receives needs assessments and care plans from the local authority and from this the home carries out its own pre-admission assessment. This information is then used to form the basis of the care plan for the person. The assessment covers all activities of daily living of that the person is involved, including personal cleansing and dressing, their sleep pattern and their independence in mobilising. Care Homes for Older People Page 9 of 28 Evidence: The home does not provide intermediate care. Care Homes for Older People Page 10 of 28 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. Good improvements have been made to the care planning, risk assessment, and information about the needs of the people who live at the home. People who use the service are treated with respect and dignity by the staff team. Evidence: At the last inspection of Hazel Court we made a number of requirements around the care planning, risk assessment and risk management processes and recording, as we did not feel that those in use sufficiently ensured that the needs of people were being met, or risks being managed properly. During this inspection we looked at the care files of a three people who use the service, and we were pleased to see that a lot of positive work has taken place in the information about peoples needs in their care files. We saw that information no longer relevant had been removed and archived, and a new format introduced to enable easier access to information about peoples needs, and how they are supported with these. This involves using an index system for each care file, and also having clear Care Homes for Older People Page 11 of 28 Evidence: and detailed care plans that are individualised to each persons needs. We saw that care plans specific to areas such as diabetes and catheter care were now much improved, with clear information about how to monitor and manage these needs. We were informed that none of the people who live at the home have pressure sores. The service has reduced the amount of information held about risk assessments by incorporating these into the care plans, which avoids repetition. This also ensures that risks are not just assessed, but managed through appropriate planning. We saw that risk assessments are still place for areas such as falls, assisting the person with moving and handling and their mobility, and we felt that this is appropriate, as these are regarding specific needs and the support to be provided. The care plans and risk assessments are reviewed monthly, to reflect the changing needs of the people who live at the home, and an evaluation of these reviews recorded, with amendments made as necessary. We also saw that the named nurse carries out a weekly audit of the care files for the people they oversee, to ensure that all information corresponds, such as food and fluid charts being recorded properly, and that these correspond with the care planned for the person. During the inspection the staff were observed being polite and courteous to the people who use the service. We observed genuinely caring and positive interactions between the staff and people who use the service. Recently, there has been an issue at the service regarding the dignity needs of a person not being met. The deputy manager and manager acted promptly to ensure that this was addressed, and appropriately reported to the local authority. At the last inspection of the service we found that the blood glucose machine, for people with diabetes, was not being calibrated to ensure that it was safe to use and providing accurate measurements, and we asked that the service address this immediately, which they did. On looking at this we found that the two new machines bought are being calibrated approximately three times a week. We did not look at the medication system on this occasion, as this was found to be managed appropriately at the last inspection. However, we did check a sample of Care Homes for Older People Page 12 of 28 Evidence: medicine administration charts, and found that any medicine allergies of the person had been recorded, or none known written, as appropriate. Our findings from the last inspection, regarding the medication system is given in the two paragraphs directly below. The deputy manager explained that the medication system is audited by two team leaders at the service who monitor the recording of the medicine charts and check the stock weekly. When we looked at the medication for five people we found that these were in good order, with no omissions or errors identified. The medication is appropriately stored, with daily temperatures maintained for the medicine fridge that stores some medication that needs to be kept cool. Of the medicine charts that we looked at, three did not have any record of any allergies of the person, whereas some said nil known. It is required that this section of the medicine administration record is completed to detail any allergies, of if none are known. The care files hold records of all health care appointments that people attend, and the care plans detail the level of support that people need from community nurses, where necessary. Annual reviews of peoples care takes place with the involvement of the relevant health and social care professionals and the person who uses the service. The home has also recently introduced three monthly internal reviews with the person using the service, their next of kin and social worker, and records of this are maintained. Care Homes for Older People Page 13 of 28 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. People who use the service have the opportunity to be involved in activities. There is a relaxed, warm atmosphere at the home which is enhanced by the positive relationships between the staff and people who use the service. Evidence: We were informed that the activity coordinator left the service on the Friday prior to our visit, and the home is recruiting for another person to take on this role. We did not look at the activities during this inspection of the service, as these areas were met at the last inspection. We did follow up a recommendation we made about the ensuring the activity programmes in the care files are updated monthly, and saw that this is happening. The findings from the previous inspection are given in the paragraphs below. There is a schedule of activities on display at the service to reflect what people get involved in. These include outings, going into the garden, puzzles, playing dominoes and using the sensory room. Care Homes for Older People Page 14 of 28 Evidence: During the inspection we observed different music playing to reflect the different cultures of the people who use the service, as well as staff accompanying some people into the garden area. The care files for each person contain a document titled called outline of activity programme, which includes information about the persons orientation to reality, day, year, etc, reminiscence triggers, sensory stimulation, personal interests, hobbies and social activities that they like to do. These are a positive tool to use, though for a number of people they had not been reviewed for approximately eighteen months to two years. It is recommended that these are carried out monthly in light of the nature of the needs of people with dementia. This is because of the often dramatic changes they experience in their personality, interests, and physical needs. The feedback from these should then be used to inform the activity programme to ensure that it is based on the current needs of people who use the service. We met with the second chef during the inspection, who showed us the kitchen at the home. He explained that the menus for the home are on a four weekly rolling rota, and are provided by the organisation, however he did say that there is some flexibility within this to accommodate different cultural food preferences, and where people do not like what is offered at mealtimes. He demonstrated an awareness of the specific dietary needs of some of the people who use the service, and spoke about how these are accommodated, such as puddings made without sugar for people who are diabetic. We saw a variety of fresh, frozen, dried and tinned foods and vegetables available for the preparation of meals at the service. Care Homes for Older People Page 15 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to reduce risks to people who use the service. Evidence: The service has a complaints procedure that is displayed at the home. There is a file held in the managers office specifically for the logging of complaints, along with records of actions taken and any correspondence relating to these. Over the past year there have been some safeguarding issues at the service, and these have all been managed and reported appropriately by the management at the home. The home has also used the findings of these to implement better processes and training at the service to minimise risks to people who live there. The training records indicate that staff receive training in safeguarding vulnerable adults, and that this is ongoing. Staff have also had training in the Mental Capacity Act, and Deprivation of Liberties Safeguards to ensure the service works in the best interests of the people who live there. Care Homes for Older People Page 16 of 28 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 environment is welcoming, homely and relaxed for the people who live there. The staff help create a calm atmosphere throughout the home. The standard of decoration is fine in most areas, though some improvements are needed to make the home more comfortable for the people who live there. Evidence: Hazel Court is situated a short walk from Clapham Junction station and is close to local shops and services. The home is purpose built to accommodate people with dementia care needs as it is single storey and circular shaped, with a sensory room for use. People have their own bedrooms and there is a communal lounge and dining area. There is also a secure garden in the centre of the home that people can are able to access. There are a number of toilet and bathroom facilities situated around the service. These were seen to be in need of looking more homely, and some of the toilet rooms are in need of redecorating as the paint was seen to be peeling off the walls. We also noticed that some toilet seats are stained and in need of replacing. Care Homes for Older People Page 17 of 28 Evidence: The home was observed to be clean and fresh smelling at the time of inspection. Care Homes for Older People Page 18 of 28 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 service carries out appropriate recruitment procedures to minimise risks to residents. Staff receive training to enhance their skills and knowledge for working with people who live at the home. Evidence: The manager informed us that the service is currently fully staffed, apart from the activity co-ordinator vacancy, due to the person recently leaving their employment. At the last inspection of the service we were informed that staff have to carry out the handover of information between shifts in their own time, by arriving early or staying late, as the shifts start and end at 8:00am or 8:00pm. We did recommend that the shift times are altered to give a minimum of a thirty minute period between shifts to allow for a structured, thorough handover to take place, to ensure that all relevant information regarding the needs of people who use the service is communicated to the oncoming staff team. However, this has not taken place, and the recommendation has been restated. The care staff team at Hazel Court consists of trained mental health and general nurses, and care workers. The training records for staff demonstrates that a number Care Homes for Older People Page 19 of 28 Evidence: of the care workers have obtained at least the National Vocational Qualification level 2 in care. The manager explained that where staff have not undertaken this, they are due to in the near future. We did not look at the recruitment files on this occasion, as this area was met at the last inspection of the home. Our findings from the last inspection are given in the paragraph directly below. The service holds recruitment information on all staff employed at the service. These were seen to contain relevant information such as proof of identification, Criminal Records Bureau check, two references and a record of the interview of staff, to demonstrate that appropriate checks are carried out prior to their starting work at the service. We saw evidence to confirm that new staff receive an induction to working at the home which covers areas such as the service policies, health and safety, moving and handling, safeguarding adults and food hygiene. At the last inspection of the home were we concerned that staff were not receiving enough training to meet the needs of the people who use the service. The training records we looked at indicate that positive improvements have been made in this area, with staff receiving training in a number of areas, to enable them to carry out their role. We also saw that training is being provided not just internally by the organisation, but through other providers, such as the Primary Care Trust and Wandsworth local authority. The manager also told us that Shaw Healthcare Limited have also recently enlisted the use of an external training provider to deliver training to staff across the company. The training records for staff show that they are receiving ongoing training in areas such as catheter care, pressure area care, dementia care, diabetes, fire safety, infection control and health and safety, as well as training in safeguarding adults and moving and handling. The deputy manager said that training has not yet been undertaken in administering suppositories and enemas, as no people who live at the home currently have these needs. However, she said that they are looking into having training in these areas, should a persons needs change where they need this kind of treatment. This was a requirement at the last inspection. However, as there are not currently any people who live at the service with these needs, this has now become a recommendation. It is also recommended that the service have a regular subscription to a nursing journal, to ensure that up to date information is regularly coming to the home. Care Homes for Older People Page 20 of 28 Evidence: The service should also be proactive and install computer equipment so that staff can access professional on-line information to enable them to have the most up to date information to meet the needs of the people in their care. Care Homes for Older People Page 21 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good management team that are committed to developing the service to ensure it is run in the best interests of the people who live there. Good improvements have been made to the supervision of staff and quality assurance processes. Evidence: The management team at Hazel Court consists of the manager and deputy manager. Our observations are that they work well together and have a positive professional relationship. The manager is well supported by the deputy manager, who is very competent and demonstrates a good knowledge of what is required for ensuring the service runs well, and this compliments the managers leadership style. The manager of the service has a number of years experience in nursing, and has relevant qualifications for his role. Care Homes for Older People Page 22 of 28 Evidence: Findings from the last inspection of the service was for a quality assurance system to be in use and maintained to monitor all aspects of the service. We saw that improvements have been made in this area, with monthly visits being carried out by the area manager and quarterly internal monitoring taking place by the manager. This is a summary of various checks carried out on such areas as maintenance and care planning audits, which is then fed back to the organisation. This is positive, though more clearer records of action planning would be beneficial to see how the service plans to address issues and develop the service further. We saw that regular staff meetings take place and meetings with people who use the service occur with their relatives approximately twice a year. We did not look at the monies held by the service on behalf of the people who live there, as this was met at the last inspection. Our findings from the last inspection are given in the paragraph directly below. The service holds a personal allowance for each person who uses the service that is funded by themselves, their family or through social services. The money held is to purchase any toiletries, clothes or to pay for hairdressing carried out at the service. Records and receipts are maintained of all transactions. We checked the monies held for five people who use the service, and these were seen to correspond with the amount recorded. The administrator directly oversees the management of the money, which is overseen by the registered manager of the service. The administrator confirmed that the arrangements for holding money were the same as at the last inspection, whereby no one within the organisation is an appointee for any person who lives at the home, and that all the peoples monies held are paid into the same bank account. At the last inspection the Financial Accountant for the organisation confirmed that the account is non interest bearing, and during this inspection the administrator confirmed that this was still the same situation. Following our last inspection, where we made a requirement around the supervision of staff, we found that good improvements have been made in this area, to ensure that staff are receiving regular, planned supervision, a minimum of six times a year. We did not look at health and safety checks carried out by the service, as these were found to be met at the last inspection of the service. Our findings from the last inspection are given in the paragraph directly below. The service maintains records to demonstrate that appropriate health and safety checks are carried out. There is routine testing of fire equipment, along with hazard risk assessments for environmental issues in the home. Appropriate food safety Care Homes for Older People Page 23 of 28 Evidence: checks are carried out on the temperature of the food being served, and of food storage temperatures. Our findings from this inspection indicate that record keeping at the service has improved, so they are comprehensive, relevant and up to date. Care Homes for Older People Page 24 of 28 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 28 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 19 23 The service must ensure that the toilet rooms are well maintained. So that the premises is safe and homely for the people who live there. 31/08/2010 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 19 The bathrooms and toilet rooms should be made to more look more homely for the comfort of the people who live there. It is recommended that the shift times are altered to give a minimum of a thirty minute period between shifts to allow for a structured, thorough handover to take place. This is to ensure that all relevant information regarding the needs of people who use the service is communicated to the oncoming staff team. The service should have a regular subscription to a nursing journal, to ensure that relevant guidance and up to date information is regularly coming to the home. Training should be provided to staff in administering suppositories and enemas. Page 26 of 28 2 27 3 30 4 30 Care Homes for Older People 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 5 30 The service should install computer equipment so that staff can access professional on-line information to enable them to have the most up to date clinical information to meet the needs of the people in their care. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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