Care Home: Hill Top Care Home

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What the care home does well Staff enjoyed working in the service; one staff survey received commented that `it is a very friendly home. Everyone gets on well. All staff are comfortable with the work that we do` and another said `staff work well as a team`. Another staff survey said `this is a home from home and is family orientated`. One staff member told us `I have been made to feel really welcome here`. The service won praise from people using it for the standard of the care, which was described as `very good`, `excellent` and `can`t fault it`. Staff were described as `kind`. `friendly` and `caring`. People also praised the food as there was always a choice, individual preferences were accommodated and it was plentiful and nutritious. The complaints procedures were clear and people told us they were confident that any concerns raised would be properly addressed. The building was well maintained, clean, tidy and odour free. What has improved since the last inspection? Specialist care plans for people with dementia had been developed. Medication procedures were better and regular audits were undertaken to ensure that records and stocks were accurate. Recruitment checks on staff from the Independent Safeguarding Authority were in place prior to people commencing work in the service. A manager had been recruited for the service. What the care home could do better: The service must ensure that it provides relevant activities and stimulation for people with dementia and that it improves the environment to help orientate them. The service should be more pro-active in ensuring that everyone understands how to make a formal complaint. All staff should receive specialist training in dementia to ensure they are knowledgeable in how to support people. Key inspection report Care homes for older people Name: Address: Hill Top Care Home Colliery Road Church Gresley Swadlincote Derbyshire DE11 9LU     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: Janet Morrow     Date: 1 3 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 27 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 27 Information about the care home Name of care home: Address: Hill Top Care Home Colliery Road Church Gresley Swadlincote Derbyshire DE11 9LU 01283550354 P/F01283550354 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Judith Dena Griffin,Stewart Westley Barker Name of registered manager (if applicable) Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 23 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 23), Dementia - Code DE (Maximum number of places - 23), Physical Disability - Code PD (Maximum number of places 3) Date of last inspection 2 7 0 5 2 0 0 9 23 0 3 Over 65 0 23 0 Care Homes for Older People Page 4 of 27 Brief description of the care home Hill Top Care Home Limited is a 23 bedded service, providing nursing and personal care to persons aged 65 years and over, and to people with dementia, including 2 places for people aged 50 years and over with physical disabilities. The premises are a purpose built, single storey building, located in Church Gresley, and close to local shops and a bus route. The home has 21 single rooms and 1 shared room. Service users have access to two lounge areas and a dining room which can be partitioned from the lounge. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 is an overview of what the inspector found during the inspection. This key inspection took place over five hours; it was unannounced and was carried out by one inspector. Progress against requirements and recommendations made at the previous key inspection undertaken in May 2009 was assessed. A tour of the premises was conducted, service users care records and staff records were inspected along with administrative systems. Case tracking methodology was used, which means that the records of two people were looked at in detail and the relevant people, staff and visitors were spoken with to find out what impact the service had for their well being and quality of life. Care Homes for Older People Page 6 of 27 We spoke to seven people using the service, four sets of relatives, the manager and deputy manager and two staff members during the inspection visit. Feedback was also received prior to the visit from seventeen satisfaction surveys completed by people using the service, relatives, staff and visiting professionals. Internal satisfaction surveys were also viewed as part of the site visit. We spoke to one relative by telephone following the inspection visit. We received written information in the form of an annual quality assurance assessment (AQAA) from the service prior to the visit and this informed the inspection process. This is referred to as the AQAA throughout the report. Care Homes for Older People Page 7 of 27 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 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was sufficient admission information available to establish that the service could meet peoples needs. Evidence: The AQAA stated that Prior to admitting a resident to the home, we carry out a thorough pre-nursing assessment with the person in either the hospital or their home and that the service ensured we are able to meet the needs of the person prior to admittance. Four of the five service users surveys received responded that they received enough information prior to using the service. All the people we spoke with during the inspection visit told us that their needs were met and praised the care and the staff. Two peoples care records were examined. There were assessments available in the files examined. These covered all the essential areas regarding care and support as Care Homes for Older People Page 10 of 27 Evidence: well as risk assessments for nutrition, falls and pressure sores. Peoples needs were generally met and two of the three visiting professionals responded on surveys that the services assessment arrangements always ensured accurate information was gathered and one responded that they sometimes did. Discussions held with service users confirmed that they were satisfied with the services admission arrangements. Comments included: its very welcoming. one relative told us their relative was reasonably happy and another told us they couldnt believe how much their relative had improved since using the service. Two of the five surveys received from people using the service responded that they always received the care and support needed and three responded that they usually did. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were clear care plans and systems in place to ensure that medical attention was sought when required, which ensured health and personal care needs were met. Evidence: The AQAA stated that Residents have an individual Care Plan to meet all of their needs, evaluation and reassessment of the Care Plan is carried out Monthly, or as needed to reflect the changing care needs and A Nursing Assessment is carried out on the resident when admitted to the home. We examined two peoples care files and both had a care plan in place. These contained the essential information for care to be provided and covered areas such as mobility, personal hygiene and eating and drinking. it also had details of individual needs such as how to deal with a pressure sore. There were clear details in one plan regarding dementia that gave instructions on how to speak to the person concerned to ensure their experience was validated. Access to health professionals was clearly recorded and visits from Occupational Care Homes for Older People Page 12 of 27 Evidence: therapists, mental health practitioners, chiropodists, General Practitioners (GP) and opticians were documented. A visiting professionals survey commented that something the service did well was keeping us informed of changes. We spoke with staff and they told us that they knew what to do and were confident in their work. One staff survey received said that the service cares for each person individually, with respect and dignity and another said it gives the service users 100 on their care needs and requirements. Two of the five surveys received from people using the service responded that staff always listened and acted on what was said and three responded that they usually did. Four people responded that they always received the medical attention required and one responded that they usually did. We saw during the inspection visit that staff and people using the service enjoyed warm relationships and privacy and dignity was upheld. A relatives survey commented the care my mother has is very good. She seems contented and the care assistants are always caring and very friendly. People rated the care highly in discussion and told us you cant fault the care, they have tried every way to keep him comfortable, its spot on, the care is brilliant and there is a real love for people here. A general check on six medication administration record (MAR) charts showed that charts were completed properly with handwritten charts being signed by two people and the amount of medication received was recorded. However, codes were not being used consistently to show why someone had received an as required medication. Two peoples MAR charts were then examined in more detail. These were completed accurately and corresponded with the dispensing blister pack. The controlled drugs record was examined and showed that the stocks held corresponded correctly with the record. Refrigerator temperatures were recorded daily and showed that these were within safe limits. A random sample of medicines showed that they were stored safely within expiry dates. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a lack of appropriate activity for people with dementia, which did not ensure their social care needs were met. Evidence: A short period of observation in the lounges indicated that the television was on constantly and no activity was observed during the day. Peoples preferences were recorded in their care plans and the manager stated there were some age appropriate activities for people with dementia, although these were not on display in the lounges. There were no specialized activities for people with dementia, despite the service having recently been registered to cater for their needs. The services policy on supporting people with dementia was clear and gave examples of specific activities to maintain skills and well being, but this was not being implemented at the time of the inspection visit. A relative told us that they were unsure what activities took place, particularly for people who were in their rooms for long periods of time. However, an activities co-ordinator had been recently appointed and was still in the process of developing the role. She told us that she was keen to start trying new activities and was also doing some individual tasks with people, such as nail care and playing dominoes and cards. The manager stated that she was keen for the activities Care Homes for Older People Page 14 of 27 Evidence: co-ordinator to undertake specialist training in providing activities that met the needs of people with dementia. People told us that there were activities sometimes and that they enjoyed any musical entertainment that was arranged. Two of the five surveys responded that they were usually activities arranged and two responded that there sometimes were. One survey did not give a response. Relatives spoken with confirmed that they were able to visit at any time and stated that they were always made to feel welcome. One relative spoken with described the service as friendly The service had received information on the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards. The manager had attended training on this. She stated that no one using the service had an advocate at the present time. She was able to demonstrate in discussion that she was familiar with the principles of the Act and had arranged an assessment to determine capacity for one person. The service also had its own documentation to establish levels of capacity. We observed the serving of the lunchtime meal and those people spoken with enjoyed the food. The meals served were well presented and nutritious. The dining area was pleasant and bright and tables were laid with cloths and condiments. People requiring assistance with eating and drinking were helped in a sensitive manner and encouraged to eat. One person spoken with said the food is lovely and a relative told us meals were like a banquet. Two of the five surveys received from people using the service responded that they always liked the meals and three responded that they usually did. One survey described the food as excellent. Care Homes for Older People Page 15 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The systems and procedures in place for safeguarding people were clear and ensured that people concerns were listened to objectively and their safety maintained. Evidence: The service had a clear complaints procedure that was on display in the premises, which stated complaints would be investigated within twenty-eight days. The AQAA stated that two complaints had been received in the last twelve months, neither of which were upheld. A more recent complaint received in the service was still being investigated. This was discussed with the manager. She was clear about what had been done to address the issue raised but had not fully recorded progress in the complaints system. She stated that this would be done when the investigation was completed. Three of the five surveys received from people using the service said they knew how to make a formal complaint but two said they did not know. A safeguarding adults policy and procedure was in place and the service also had an up to date copy of the Derbyshire Local Authority procedures. The written information supplied by the service stated that there had been no allegations of abuse received internally in the last twelve months. However, one external referral had been made to the Local Authority under safeguarding procedures and the service had taken Care Homes for Older People Page 16 of 27 Evidence: appropriate action to deal with the allegation. All six staff surveys received responded that they knew what to do if anyone raised concerns about the service. Staff interviewed confirmed that they were aware of their responsibilities in reporting any potential abuse and knew the correct action to take if any allegations were made. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although the premises were well maintained, they were not adapted to meet the needs of people with dementia, which did not fully ensure their comfort and safety. Evidence: The AQAA stated that monthly checks enable us to identify areas of the home which are in need of redecoration and Outdoor space is provided in the form of a small garden area. Although the premises were generally well maintained, no adjustments or adaptations had taken place to address the needs of people with dementia, with the exception of signs on bathrooms and toilets, since the service had been registered for dementia in August 2009. There had been no changes to communal spaces or corridors and few bedrooms had any identifying features on the doors. We also saw that people were sitting for periods of up to half an hour at the dining room table prior to the meal being served. One person told us that an improvement would be having less time sitting waiting for things to happen. Several people sat in wheelchairs at the dining table for meals and it was identified that the dining chairs were not suitable for everyone. Three of the five surveys received from people using the service responded that the Care Homes for Older People Page 18 of 27 Evidence: premises were always fresh and clean and two responded that they usually were. One survey commented that the premises could do with brightening up and a relatives survey also commented that the decor was something the service could improve. A staff survey said updating the rooms was something the service could do better. Staff spoken with were knowledgeable on how to control infections and confirmed that there was a plentiful supply of gloves and aprons. They also said that their communication systems at hand overs worked well and ensured that all staff knew promptly of any infections in the service. The kitchen had recently received a four star rating from the Local Authority Environmental Health Department for food hygiene standards. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sufficient, well trained staff to ensure peoples needs were met. Evidence: The AQAA stated that the service wanted to Continue staff training and development to retain qualified staff and ensure all staff are trained to more then just adequate levels. It also stated that nine of sixteen care staff had achieved a National Vocational Qualification (NVQ) at level 2 or above and a further five were undertaking the training. This means the service is meeting the target of having 50 of staff with an NVQ2. All six staff surveys received confirmed that relevant training took place and one commented that training was kept up to date and another said staff get regular training. The training records supplied by the service showed that mandatory health and safety training took place and courses related to care had occurred in the last twelve months; for example, in dealing with challenging behaviour, dementia and medication. The manager also confirmed that courses were planned in 2010 on dementia and tissue viability. Staff told us that they were keen to do more training in dementia and managing difficult behaviours and the records showed that not all care staff had undertaken these courses. Care Homes for Older People Page 20 of 27 Evidence: The staff rota for the week ending 17th April 2010 showed that there were three staff on duty in the morning and three staff in the afternoon, with an additional member at specified periods. There was one qualified nurse on duty throughout the day. During the night there was one care worker and one qualified nurse. Four of the six surveys received from staff responded that there were usually enough staff to meet individual needs and two responded that there always were. Two surveys from people using the service responded that there were always enough staff when needed and four responded that there usually were. Two staff files were examined for recruitment information. This showed that a proper recruitment process was in place and that all the information required by the Care Homes Regulations 2001 was in place, including Criminal Record Bureau (CRB) checks, identity information, two written references and Independent Safeguarding Authority (ISA) checks. However, there was insufficient detail on the employment history part of the application forms as one application did not refer to a previous role and another gave employment history in years rather than months. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service was well managed in peoples best interests. Evidence: A new manager had been appointed and was in the process of undertaking relevant managerial qualifications. She had not yet applied to become registered with the Care Quality Commission. She was experienced in caring for older people but was not a qualified nurse. Therefore, a nurse had been appointed as the clinical lead for the service. The AQAA stated that a Quality assurance system is in place - resident survey and there was an updated Health & Safety Policy. It also stated that maintenance checks were up to date. The responsible individual did not have an annual development plan for quality assurance purposes but the manager told us that she was developing a system of audits to assure the quality of the service. For example, regular audits of medication Care Homes for Older People Page 22 of 27 Evidence: practice were taking place. There were also periodic surveys for people using the service and their relatives. The last surveys undertaken by the service in September and October 2009 showed high levels of satisfaction with the service and made comments such as staff are great with my mother. Meetings had also been established for people using the service and their relatives and the most recent had taken place in January 2010. There was a system in place for dealing with peoples personal finances. Two peoples financial records were examined and were accurate. Receipts for individual purchases were available and two people were signing the record. Health and safety issues were generally addressed. The AQAA stated that maintenance checks were up to date; for example, it said emergency lighting and fire detection equipment had been checked in March 2010. This was confirmed during the inspection visit. However, it also stated that the emergency call system was not routinely maintained; this was discussed with the manager who confirmed that an external company were called out for repairs as well as the handy person being available but there was no regular verified maintenance check made. Staff training in mandatory health and safety areas occurred; for example, the training records stated that fire prevention training had occurred in July 2009, moving and handling in December 2009 and food hygiene in January 2010. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 The service must ensure that it provides specialist activities to meet the needs of people with dementia. This is to ensure the service is compliant with its registration and to ensure peoples needs are met. 14/07/2010 2 19 23 The service must ensure that the environment is suitable for the needs of people with dementia. This is to ensure that the service is compliant with its registration and that the needs of people with dementia can be met. 14/07/2010 3 31 9 The manager must make an application to be registered with the Care Quality Commission. This is to ensure a suitable person is running the service. 14/07/2010 Care Homes for Older People Page 25 of 27 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 2 3 9 12 16 Codes should always be used for denoting whether or not person has received an as required medicine. Activities that are arranged should be based on individual needs and preferences and be inclusive. The service should be pro-active in ensuring that all people using it and their relatives know how to make a formal complaint. The service should consider re-decoration of key areas such as corridors and bedrooms. The service should consider providing dining furniture that is suitable for peoples needs. The service should ensure that there is always a full employment history that shows employment dates in months and gives a complete picture of previous employment. The service should ensure that all care staff undertake specialist training in dementia. The service provider should develop an annual plan to assure the quality of the service. The service should ensure that a regular maintenance check is undertaken on its emergency call system. 4 5 6 19 19 29 7 8 9 30 33 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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