Care Home: Homemead

What the care home does well People appear happy at the home and there is a relaxed and welcoming atmosphere. The staff are kind and attentive and people who live at the home are able to make choices about what they do and where they go. The staff appear happy and well supported. There are good systems for them to communicate with each other to make sure peoples needs are met. What has improved since the last inspection? The manager has acted on the things that we asked her to do at the last inspection. There have been improvements to care planning, record keeping, monitoring people`s health and wellbeing, staff training and the environment. What the care home could do better: The manager should continue to monitor the service and make improvements which benefit the people who live there. These include improvements to the environment and activities. In particular we identified: People need to have their individual social needs met. People need to have information presented in a way which they can understand and which helps them make choices. The manager needs to make sure all staff have regular formal supervision. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Homemead 28 Park Road Teddington Middlesex TW11 0AQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sandy Patrick     Date: 0 2 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Homemead 28 Park Road Teddington Middlesex TW11 0AQ 02089775002 02089778888 carmel.regan@ccht.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Central & Cecil Housing Trust care home 30 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: 30 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: Dementia - Code DE Date of last inspection Brief description of the care home The service is operated by the Central and Cecil Housing Trust, a not-for-profit provider. The home provides accommodation for a maximum of twenty-nine older people who may have dementia. Staff support is available to residents twenty-four hours a day. The home is situated in a residential area of Teddington. The nearby high street provides a range of community facilities, such as shops, banks, pubs and restaurants. Care Homes for Older People Page 4 of 28 Over 65 0 30 Brief description of the care home Bushy Park is a short walk away and the River Thames is close by. The Central and Cecil Housing Trusts mission statement reads as follows: We aim to maintain and improve the quality of life, independence and dignity of all within our care by providing comfortable, secure homes in an environment of support. Fees are between £600 - £680 per week. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. As part of the inspection we made an unannounced visit to the home on 2nd July 2009. We met people who live there, visitors, staff on duty and the manager. We looked at the environment, records and how people were being cared for and supported. We wrote to the manager and asked her to complete a quality self assessment. We wrote to people who live at the home, their representatives and staff and asked them to complete surveys about their experiences. We looked at all the information we had received since the last inspection of the Care Homes for Older People Page 6 of 28 service. Some of the things people told us were: They take care of us. What more can we want when everything is done for us. The home provides a very friendly caring service. I have noticed an improvement to the quality of care at Homemead towards residents, furniture and fittings. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 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 9 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. People have enough infromation to help them when they are deciding whether to move to the home. They have their needs assessed to make sure the home is the right place for them. Evidence: People told us that they had enough information to help them make a decision about moving to the home. The manager visits people who are interested in moving to the home. The person is also invited to visit Homemead and spent time there joining people for a meal and activities. The manager uses these visits to compile an assessment of their needs. She talks to the person and other important people in their lives. The assessment is recorded and the organisation makes a decision about whether they can meet the persons needs. Care Homes for Older People Page 10 of 28 Evidence: People moving to the home have a trial stay and at the end of this time they can decide whether the home is the right place for them. If peoples needs changed while they live at Homemead they have these reassessed to make sure they are still getting the care and support they need. The manager told us that there had been improvements to the assessment process making it more thorough so that a place would only be offered to people if the organisation felt their needs could be met at the home. Care Homes for Older People Page 11 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. People are given the support they need to stay health and they are well cared for. Information for staff is up to date and accurate and reflects individual wishes and needs. People are given the support they need with their medication. Evidence: People told us that they were well cared for and able to make choices. One person said, the staff give calm reassuring help to residents and their families. Another person said, they give attentive care for residents and make sure they are well dressed, clean and they keep me (a relative) well informed of how they are. One person we spoke to felt that there could be improvements in the way their relative was cared for. Everyone has their personal and health care needs recorded in a plan which shows the staff how to support each individual. The staff have started to create summaries of these plans which will be kept in each persons room. These will be available for the person, their relatives and staff to see what has been recorded as their main care needs. The manager said that this will help new and temporary staff as the Care Homes for Older People Page 12 of 28 Evidence: information will be clear and situated where they need it. We saw an example of these mini care plans. They are a good idea and incorporate key information the staff would need to know to help them to get up and go to bed and the things that are important to them. Computerised care plans give the staff more detail about individual needs. We saw that these care plans were regularly reviewed and updated. We saw that individual needs were discussed in team meetings and handovers so that the staff were up to date about specific changes in need. Some care plans focused on supporting people to be as independent as they could. Care plans emphasised the importance of staff giving people choices and respecting their privacy and dignity. Where people make choices that may put them at risk the staff had assessed these risks. The records of these assessments were detailed. Some risk assessments needed to be reviewed to make sure they are still accurate. There is a system to make sure the staff check on everyone at least every half an hour. People are free to spend time in their rooms or communal areas and the recorded checks are a way to make sure everyone is safe. Everyone is registered with local GPs and other health care professionals as needed. We saw records of health consultations. We saw evidence that action had been taken to follow advice from health professionals. People told us that they had the support they needed to stay healthy. One person said, they act when a resident is unwell and keep families informed. There is an appropriate medication procedure and staff who are responsible for administering medication are trained. Medication is stored securely and we saw that accurate records are kept. We saw that the manager makes regular checks on medication records and storage and writes a report of recommendations for staff if things need to be improved. 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. There are planned activities which people can participate in but more support needs to be given to people to meet their individual social needs. People are able to entertain visitors and relatives can continue to be involved in caring for their loved ones if they wish. Evidence: People told us that they liked some of the planned activities and special events. Some relatives felt that the staff should do more to get people involved in activities and to be more mobile and active. On the day of our visit there was a pleasant atmosphere at the home. Some people were in the main lounge and conservatory. Some were joining in group activities whilst others were watching the TV or knitting. Some people were using the garden. The home employs 2 activities officers who coordinate and organise activities for everyone. We met these staff and found them enthusiastic. Unfortunately both activities officers were due to leave employment shortly after the inspection. The posts had not been recruited to and there were no definite plans for the organisation of activities whilst these posts were vacant. The manager must make sure activities Care Homes for Older People Page 14 of 28 Evidence: continue and are well planned and that specific staff are assigned to run these. Regular activities at the home include games, craft activities, baking, film club, nail care and discussions. On the day of our visit people were reading vintage newspapers and discussing things from their past with an activities officer. Some one had a birthday and this was celebrated with a cake. One person told us that the staff always celebrated peoples birthdays. There have been some special events organised and some people were taking a boat trip along the Thames shortly after our inspection. One person told us, the staff decorate the home for special events and add a different subject and theme for everyone to talk about. The staff told us about a recent picnic in the gardens where a local school and sheltered housing residents joined people who live at Homemead and their families in the garden. This event was enjoyed and seen as a success. One of the people has owned a pet tortoise for many years. This pet has now moved to Homemead and is a popular addition to the home. Although group activities take place, these are not well advertised and people who live at the home cannot see what is planned and make a choice about whether they want to participate. The activities coordinators told us that these planned activities were flexible and open to change, and this is important considering the needs of people who live at Homemead, however the planned activities should be displayed to give people an informed choice. Information on notice boards in the main hallway was a mix of information for staff, people who live at the home and visitors. This may be confusing for people who live at the home and it would be a good idea to have a dedicated notice board for them which is attractively decorated and clear for them to understand and see. There is a board in the dining room which gives some information about lunch and staff on duty, but further information about activities, hairdressing and other events would be useful. In addition some people do not use the dining room so may not see information there. The manager should consider using photographs and pictures to help give people clearer information about the menu and and other activities There is limited information on each persons personal social needs and hobbies. Only 10 of the 27 people living at the home at the time of our inspection had a care plan relating to their social needs. For many people there was no record of their lives before they moved to Homemead, their interest and people, dates or places that are important to them. This information is important to help the staff plan the care of each Care Homes for Older People Page 15 of 28 Evidence: individual and make sure their social needs are met. There are regular catholic and church of england services. We found that care plans did not give details about peoples religious and cultural needs. For example one care plan of someone with a specific religion referred only briefly to an aspect of their dietary need. The care plan did not make reference to other areas of their culture and religion which may be important and which the staff should be aware of. Visitors are welcome at any time and we saw people entertaining visitors throughout the day of our inspection. Some visitors said that they would like facilities to make themselves and their relatives hot drinks. The manager told us that she was considering the best way of enabling this. There are quarterly meetings for people who live at the home and their relatives. These are minuted and used to keep people informed and ask for their views and opinions. The manager told us that meetings specifically for the people who live at the home has recently started. These are designed for people to discuss the things that they chose and that are important to them. At a recent meeting for people who live at the home they suggested that activities included sweet tasting, and trying different snacks. We saw that this had been introduced and that people had been given the snacks they requested. On the day of the visit people were offered sweets and tangerines. Throughout the day we saw that staff showed respect to people and treated them with kindness. We overheard the staff chatting to people and asking them about their wellbeing and enjoyment of meals. People are able to eat in the dining room or lounge, and we saw that people chose to eat their lunch time meal in different places. We saw that people were offered drinks and snacks throughout the day and that jugs of cold drink were available in communal areas. There is a varied menu of freshly prepared food. People told us that they liked the food at the home. Care Homes for Older People Page 16 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. People are protected by procedures designed to keep them safe and to enable them to make complaints. Evidence: There is a complaints procedure and this is displayed around the home. Copies of the procedure are given to people when they move to the home. People told us that they knew what to do if they were unhappy about anything or wanted to make a complaint. The organisation have procedures on abuse and whistle blowing. The home also has a copy of the local authority procedure on safeguarding. The staff have all had training in this area. The staff we spoke to had a good understanding of how to keep people safe. Care Homes for Older People Page 17 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. People live in a clean, homely and well maintained environment. Evidence: The environment is generally well maintained and decorated. There is an attractive sensory garden. There are three bedrooms which can be shared. The manager told us that only one of these was shared at the time of the inspection and that these rooms would be offered to couples or people who specifically wanted to share with each other. We saw that people had personalised their rooms with their own ornaments and furniture if they wished. We saw that the manager had made risk assessments of all equipment and furniture in bedrooms and taken steps to make sure the risks of accidents in bedrooms is mimimised. All bedrooms have en suite WC and hand wash basin. Some bedrooms have their own bathrooms. The manager said that people did not use these and they were most unsuitable for the people living at the home. She said that if these baths were replaced by shower rooms they would be more useful and appropriate for peoples needs and wishes. The organisation should consider this. Since the last inspection there has been some improvements to the building including Care Homes for Older People Page 18 of 28 Evidence: decorating some rooms and replacing flooring and furniture in some rooms. The manager told us that the organisation was due to supply locked cabinets in each bedroom where people could store their valuables as they do not all currently have this facility. People are being offered blinds to replace curtains in their rooms if this is what they want. Some areas of the building would benefit from attention, for example stained carpets should be replaced. All bedrooms are equipped with thermometers so that the temperature can be monitored. People have their names on bedroom doors. The manager told us that photographs would also be put on all doors in the near future. The staff should offer people the opportunity to label their doors with other familiar things that may help orientate them if they wish. We found that the home was clean and fresh throughout on the day of the inspection. Care Homes for Older People Page 19 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. People are cared for by well supported, trained and appropriately recruited staff. Evidence: People told us that they liked the staff and that they were kind and helpful. One person said, they are always available when we need them. Another person said, the staff are always very happy to discuss any problems and offer advice to residents and their families, they also share a joke and are friendly. There are appropriate procedures for recruiting staff. These include formal interviews and a written test at the home. We looked at a sample of files for newly recruited staff. We saw evidence of recruitment checks, including criminal record checks and references. The organisation has a planned programme of staff training. The manager keeps up to date records of staff training and monitors when refresher training is due. Since the last inspection the staff have had their manual handling training updated. They have also attended specialist dementia training and had updated fire safety and first aid training. All staff, including domestics have had the specialist dementia training so that they are aware of how best to support people. There are appropriate procedures for inducting new staff, including specialist training and completion of a work book about their role and care practices. We saw evidence of comprehensive inductions for Care Homes for Older People Page 20 of 28 Evidence: new staff. The manager told us that Homemead worked with a local staff agency providing training and an induction into care work for agency staff. There are regular meetings for staff and a handover of information at the beginning of each shift. We saw records of these and saw that staff were well informed and able to contribute their ideas and opinions. The staff use communication books with each other and visiting professionals to make sure information is recorded. 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. People live in a well managed service. They are able to contribute their ideas and opinions. Quality of the service and health and safety are monitored. Evidence: The registered manager is appropriately qualified and experienced. She has worked at the home for a number of years. She demonstrated a good knowledge of the individual people who live at the home. We saw that she had a good rapport with people and they appeared to like and respect her. The manager and senior staff have all had leadership training and a more comprehensive training in dementia care than the other staff. The staff told us that they felt there was good informal support from the team and managers. We saw that formal supervision and support meetings for each member of staff had not taken place as regularly as they should. The manager showed us new systems she had introduced to make sure senior staff were offering all staff regular planned supervision meetings. Care Homes for Older People Page 22 of 28 Evidence: Until recently the organisation employed a quality monitoring officer who visited the home each month to conduct themed quality checks. These checks focused on outcomes for people, staff views and records on a specific areas. Recommendations for change and improvement were recorded. Recent checks included staff supervision, food and health and safety. In the last few months the quality officers checks has been replaced by checks from the area manager and the organisation plans to invite registered managers to inspect each others services. The organisation should consider continuing with thematic visits as these are a very good way to give an in depth check on a specific area. People who live at the home are asked to give their views and opinions through regular meetings. Their individual care needs and plan are also reviewed each month. The organisational procedure is for staff to have their work appraised every year. Central and Cecil orgainised for an independent charity to carry out individual interviews with all the people who live at the home to gain their views on the service. They are compiling a report of their findings. This was not available at the time of the inspection but a copy of this and recommendations for change will be given to the manager. People make their own external arrangements for managing their finances. However, they are able to leave small amounts of cash with the manager for purchases such as toiletries, hairdressing or papers. The manager keeps this money in a safe place. We saw that accurate records of balances and expenditure are kept and that relatives can see how their money is being spent if they wish. There are receipts for all purchases. Records are up to date, accurate and neatly organised so that information is clear and accessible. We saw that regular checks on health and safety, including fire safety, electrical appliances and water temperatures are carried out. We saw that these and any action required were recorded. Care Homes for Older People Page 23 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 24 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 12 12 The registered person must make sure care plans about peoples religious and cultural needs include all their cultural needs. Because they may have specific needs which are not being met because they have not been recorded and the staff are not aware of them. 30/09/2009 2 12 12 The registered person must make sure peoples individual social needs are recorded and that a plan to meet these needs is developed. Because peoples social wellbeing is important and they may have specific needs, hobbies and interests which are not being met through the organised group activities. 30/09/2009 Care Homes for Older People Page 25 of 28 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 3 12 12 The registered person must make sure people are well informed about planned activities and that these are advertised. Because people need to be able to make an informed choice about whether they want to join in planned activities. 31/08/2009 4 12 16 The registered person must make sure a member of staff is allocated to organise and coordinate activities. Because people need to have the opportunity to participate in well organised and run group activities if they wish. 31/07/2009 5 36 19 The registered person must make sure all staff have regular, planned, formal supervision meetings with their line manager. 30/09/2009 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 13 14 The manager should consider creating facilities for visitors to make themselves drinks. The manager should consider using photoraphs to help give people more infromation. Page 26 of 28 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 3 14 The manager should make sure there is a dedicated notice board for people who live at the home, giving them clear information which is easy to access. The organisation should consider replacing en suite baths with showers which would be more suitable for the people living at the home. The organisation should replace worn and stained carpets. The manager should give people the opportunity to label their bedroom doors with additional photographs, pictures or symbols that will help them identify their own room. 4 19 5 6 19 19 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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