Care Home: Holt House - The Salvation Army

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What the care home does well Residents at the home were being cared for and supported well by the registered manager and her staff. Residents spoken to said the quality of care provided was very good. Residents said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included: `The staff are very kind and treat me with respect`, `I feel that I am being well looked after by caring staff who are very nice`, `they make sure the doctor comes to see me if I am not well`, `I would say the care here is very good, they speak to you properly and always knock on the door before coming in my room`, `they always let me know if [my relative] is not well`, `I feel that my privacy is respected and that they make sure I am not embarrassed when they are helping me`. The home was being managed effectively. What has improved since the last inspection? All the things we asked the home to do (following the last inspection in July 2008) to improve the quality of care and support provided to residents have been done. Improvements have been made to the way staff are trained and Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 how recruitment records are kept. There have also been improvements to the environment of the home which has increased residents comfort generally. What the care home could do better: There are no requirements as a result of this inspection. However it is recommended that to comply with good practice skin integrity assessments should be formally evaluated at least monthly. Also to maximise safety, when staff are making handwritten transcriptions to resident`s medicine records these should be signed by two staff. Discussion with the registered manager, responses in the AQAA document referred to above, and the outcomes of checks (audits) conducted at the home by the representative of the home`s owners indicate that areas where improvement can be made are regularly identified and acted upon appropriately. Key inspection report CARE HOMES FOR OLDER PEOPLE Holt House - The Salvation Army Holt House Headlands Drive Prestwich Manchester M25 9YF Lead Inspector Mike Murphy Key Unannounced Inspection 16th July 2009 09:00 DS0000008477.V376397.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Holt House - The Salvation Army Address Holt House Headlands Drive Prestwich Manchester M25 9YF 0161 773 0220 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Salvation Army Mrs Theresa Blackburn Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 32 service users, to include: up to 32 service users in the category of OP (Older People). The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 30th July 2008 Date of last inspection Brief Description of the Service: Holt House is a spacious, well-maintained property situated in a residential area of Prestwich. It provides personal care and support for up to 32 people over 65 years of age. The home is divided into three units, each with its own lounge and kitchen area. There is also a large communal lounge, dining room and conservatory. All but one room are single occupancy. Ramped access is provided to the front door of the home and ramps and a passenger lift are provided internally. There is a large garden area to the rear of the home, which is well maintained. Level access is provided to a patio area where service users can sit and enjoy their surroundings. A conservatory, overlooking the garden is also provided. Parking for approximately 10 cars is provided within the grounds. The Salvation Army owns Holt House. The fees at the time of inspection were £375.89 to £499.00per week. (Information supplied by the provider). Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This inspection included an unannounced visit to the home on the 16th of July 2009 between 9am and 5pm. During the visit we talked to residents, relatives, staff and the registered home manager. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. Before the inspection, we also asked the registered home manager to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. What the service does well: Residents at the home were being cared for and supported well by the registered manager and her staff. Residents spoken to said the quality of care provided was very good. Residents said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included: ‘The staff are very kind and treat me with respect’, ‘I feel that I am being well looked after by caring staff who are very nice’, ‘they make sure the doctor comes to see me if I am not well’, ‘I would say the care here is very good, they speak to you properly and always knock on the door before coming in my room’, ‘they always let me know if [my relative] is not well’, ‘I feel that my privacy is respected and that they make sure I am not embarrassed when they are helping me’. The home was being managed effectively. What has improved since the last inspection? All the things we asked the home to do (following the last inspection in July 2008) to improve the quality of care and support provided to residents have been done. Improvements have been made to the way staff are trained and Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 6 how recruitment records are kept. There have also been improvements to the environment of the home which has increased residents comfort generally. 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. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents were being assessed prior to admission to the home to ensure their care and support needs could be properly met. EVIDENCE: Prior to admission residents are assessed by a senior member of the care staff who is suitably qualified and experienced in conducting such assessments. A written assessment is made of the prospective resident’s care and support needs. The three assessments seen included consultation with the resident, their relatives and health and social care professionals (such as doctors, nurses and social workers). The reason for the assessment is to help the prospective resident (and their relatives) in deciding how suitable living at the home would be and enable the person doing the assessment to judge if the home will be able to properly meet the resident’s care and support needs. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 9 Discussion with residents and relatives indicated that they were fully included in the assessment process before and after admission to the home. Prospective residents and their relatives are actively encouraged to visit the home prior to admission. A formal review of all admissions is conducted around six weeks after admission. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10. People using the 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 were satisfied they were being properly supported to ensure their health and personal care needs were being met appropriately. EVIDENCE: Resident’s health, personal and social care needs were being set out in an individual plan of care. We looked at the care records of three residents on this occasion. These were organised and regularly maintained. Care plans described what action needed to be taken by the care staff to ensure that residents care and support needs were being properly met. The care records also contained risk assessments that identified possible threats to a residents health and safety and described things that needed to be done to keep them safe at the same time as maintaining their freedom and independence. For example risk assessments had been done with regard to resident’s mobility, nutrition and Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 11 moving and handling needs. Care records had been in the main kept up to date. Whilst it is noted risk assessments are conducted, in respect of the condition of resident’s skin these had not been evaluated regularly. It is recommended that, in line with good practice, that risk assessments should be reviewed at least once per month. Arrangements had been made to register all residents with a local GP. Information in the care records and discussion with residents, their relatives and staff indicated residents were able to access health care services appropriately. A record of all such access was kept. Resident’s medicines were being looked after safely and securely. Appropriately trained senior care staff managed resident’s medicines. A medicine record was kept in respect of each resident. These had been, in the main, completed properly. However, to maximise safety, when staff are making handwritten transcriptions to resident’s medicine records these should be signed by two staff. Residents spoken to said that the manager, care and other staff treated them respectfully and maintained their privacy and dignity, especially when they were being provided with personal care. They said that staff knocked on bedroom doors before entering and spoke to them in a proper manner. Comments made included: ‘The staff are very kind and treat me with respect’, ‘I feel that I am being well looked after by caring staff who are very nice’, ‘they make sure the doctor comes to see me if I am not well’, ‘I would say the care here is very good, they speak to you properly and always knock on the door before coming in my room’, ‘they always let me know if [my relative] is not well’, ‘I feel that my privacy is respected and that they make sure I am not embarrassed when they are helping me’. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People using the 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 were supported to enjoy a stimulating lifestyle and access a wide range of social and leisure activities. Residents were encouraged to make as many personal choices in their daily lives as possible, and the general view of food provision was positive. EVIDENCE: The routines of daily living and the social activities available were flexible and varied and met resident’s expectations, preferences and capacities. Residents were supported to access a wide range of social and leisure activities and entertainments. Information about forthcoming events, activities and entertainments is prominently displayed. Residents said they enjoyed the programme of activities available. Relatives and friends of residents are actively encouraged to participate in all the social and leisure activities available. Residents were able to follow their own religious practices and as in Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 13 other areas of life in the home were able to exercise their own personal choices in respect of this. Residents and relatives said there were no unreasonable restrictions on visiting at the home. Residents may receive their visitors in the privacy of their own room or quieter lounge areas of the home if preferred. Residents also said they were able to exercise choice and independence in their daily lives. Comments made included: I am able to decide if I stay in my room for some privacy or use the lounge rooms’, ‘I like to get up early and go to bed on the late side and there is no problem with this here’, ‘it is up to you if you want to join in activities or go out on the trips’, ‘I choose each day which clothes I want to wear’, ‘the staff do listen to me and help me do what I want to do’. Menus were displayed throughout the home and were varied, balanced and provided choice. Residents said they can always request an alternative from the menu if they wish and are comfortable to do so. Comments regarding the food included: the food is excellent’, the food is plentiful and tasty, quite good and they will always give you something else if you want something different, the food is quite good and there is always enough to eat. Lunch was observed on the day of inspection. This was a hot and substantial meal. Staff served and assisted residents appropriately and sensitively. The dining areas were comfortable, suitably furnished and appropriate for residents to take their meals in. Some residents chose to take their meals in their own room. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the 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 an accessible and clear procedure in place to deal with complaints. Staff had been provided with recent safeguarding training and there are procedures in place that describe how to protect residents and keep them safe. EVIDENCE: Information on how to make a complaint was prominently displayed in the home. This information detailed who to contact and how the complaint would be dealt with. A complaints record is kept by the home. Complaints appeared to have been dealt with properly. Discussion with residents and relatives indicated that the registered manager or senior staff are always available and that any issues raised are dealt with promptly and rarely need to become formal complaints. The home operates safeguarding and whistle-blowing policies, including those developed locally and operated by Bury social services, which seek to keep residents safe. Staff were aware of the importance of keeping residents safe and described their role in doing so. They confirmed they have been provided with recent safeguarding training. Inspection of training records revealed that safeguarding training has been provided to all staff at the home. At the time of Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 15 this inspection the manager was making arrangements for staff to be provided with training related to the Mental Capacity Act and protecting residents liberties. In relation to the Mental Capacity Act the registered manager informed us that no people living at the home were subject to a deprivation of liberty authorisation and that no one living at the home was having their liberty deprived without authorisation. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24 and 26. People using the 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 provided a suitable, comfortable safe and well-maintained environment for residents. EVIDENCE: On the day we visited the home was clean and free from offensive smells. There was an ongoing programme of maintenance and two lounge areas had been very recently re-decorated and refurbished. Lounge and dining areas were comfortably and appropriately furnished and accessible to all residents. Bathroom, shower and WC areas were suitably equipped and adapted to ensure residents could be cared for and supported Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 17 appropriately and safely. We were informed that plans have been made to refurbish some of the bathrooms in the home. Twelve resident’s bedrooms were looked at during this inspection. These were clean and appropriately furnished and equipped. Many were highly personalised. Residents spoken to said they were happy with the accommodation provided. Comments made included: ‘my room is lovely and is kept very clean’, ‘my room is warm, clean and I have been able to bring in quite a few of my own things so it feels like my home’, ‘my relatives room is always clean, the bed linen is regularly changed and there are never any offensive smells’, ‘the lounges, conservatory and dining rooms are very comfortable and the garden is beautiful’. Suitable arrangements were in place to manage residents laundry needs. And appropriate measures were being taken to minimize the potential spread of infection within the home such as adequate hand washing facilities and the provision of protective clothing for staff as well as appropriate cleaning practices within the home. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People using the 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 staffing provision, staff recruitment procedure and the staff training provided at the home seek to ensure residents are cared for and supported safely and appropriately. EVIDENCE: The registered manager and staff on duty were of the view current staffing levels were able to meet the care and support needs of residents at the home. However as at the last key inspection concern expressed (by staff and a relative of a resident) that if numbers and care needs of residents increase night staffing levels should be increased. This was discussed with the registered manager who informed us that she has the authority to do this should those circumstances arise. The registered manager stated she will continue to carefully monitor staffing provision (particularly night provision). Residents spoken to were of the view that they are cared for properly by staff in a timely way and did not express any concerns regarding staffing – either about the number or quality of staff. The home had a proper procedure in place for recruiting new staff. This is vital to ensure, as far as possible, that Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 19 residents are being cared for and supported by suitable people. The recruitment procedure included criminal records checks and another special check regarding the suitability of the applicant to work with vulnerable people. Over 75 of the care staff have obtained a national vocational qualification in care (NVQ). The remaining care staff were undergoing this training or were expected to do so in the near future. The arrangements for staff training have improved since the last key inspection. we were informed the induction training process is currently being reviewed. The manager has registered the home with Bury local authority training partnership and has started to access the training available from them. Also staff have been provided with a wide range of recent training in safeguarding, fire safety, moving and handling, health and safety, medication awareness, first aid and infection control. Plans were also being made to enable staff to access dementia awareness training, and training in respect of the Mental Capacity Act protecting resident’s liberties. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. People using the 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 was being managed effectively. Residents, their relatives and staff are confident the home is run in the best interests of residents. EVIDENCE: As required the home manager has become registered with the Care Quality Commission since the last key inspection in July 2008. Discussion with residents, their relatives and staff revealed that the manager creates an open, positive and inclusive atmosphere at the home and provides leadership. The views of residents, relatives and staff are actively sought. Discussion with them Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 21 revealed that the manager listens to any issues/suggestions raised and responds appropriately. The representative of the home’s owners visits the home monthly and conducts checks (audits) on how effective different aspects of the way the home is run. For example regular checks are made in respect of how care records are maintained and the state of the environment. The arrangements to support residents with their money (personal allowances only) were secure and appropriately documented. The arrangements for the health and safety of residents (and others) in the home were adequate and appropriate. Staff are provided with regular training in respect of moving and handling, fire safety, food hygiene and the prevention of infection. Hazardous substances were being securely stored and gas and electrical systems had been checked/certificated regularly. We were informed hot water temperatures are controlled by special valves. Procedures were in place for the appropriate reporting of accidents, illnesses and injuries. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP8 OP9 Good Practice Recommendations That skin integrity assessments be formally evaluated at least monthly. To maximise safety, when staff are making handwritten transcriptions to resident’s medicine records these should be signed by two staff. Holt House - The Salvation Army DS0000008477.V376397.R01.S.doc Version 5.2 Page 24 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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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