Care Home: Kimberley Residential Home

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What the care home does well The management and staff encourage residents to see the home as their own home. Staff demonstrate their commitment to achieving best outcomes for residents. Staff stated they expressed job satisfaction and liked working in the home. Residents who spoke to us confirmed in their own words that they receive a good quality of care from staff that are courteous, respectful, communicate well, and deliver care in the way they prefer. A resident spoke highly of their regular care staff and felt that their privacy was respected. Any problems or issues identified have been dealt with appropriately by the agency. What has improved since the last inspection? It was evident through the inspection process that the home is taking steps to improve the standards of care. Improvements were noted in respect of all of the identified areas from the last inspection. Social care planning has been improved. The report confirmed compliance with the statutory notice made at the last Key Unannounced inspection. However further improvements were recommended within this report. What the care home could do better: The inspection identified several areas that were in need of being addressed. The management of the home has recognised the shortfalls and has indicated a willingness to work with the Commission to ensure that any shortfalls are addressed. The main areas that were identified were :It was recommended that further improvements could be made with regard to social care planning and fully exploring the resident`s needs and wishes where possible and opportunities for social development and enrichment. On going need for improvement in the state of decoration within the home. It was evidenced that a few staff had not received all the training to enable them to perform their role. Training has improved and the home has evidenced that a lot of effort has been put in by the management to improve training since the last inspection and that it is an improving situation. However as aforementioned gaps in training need to be addressed. No requirement has been made at this time. Key inspection report Care homes for older people Name: Address: Kimberley Residential Home 40 Miskin Road Dartford Kent DA1 2LS     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: Robert Pettiford     Date: 1 8 1 1 2 0 0 9 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 26 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) 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 Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Kimberley Residential Home 40 Miskin Road Dartford Kent DA1 2LS 01322291885 01322275410 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Kimberley Residential Home Ltd care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 22 The registered person may provide the following category/ies of service only: Care home only ? (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 (OP) Date of last inspection Brief description of the care home Kimberley residential home is registered for the accommodation of up to 22 older people. The premises have 8 single and 7 shared bedrooms situated on ground, first and second floors. Stair-lifts assist access to the first and second floors. Residents have the benefit of a number of communal areas, including a separate building in the rear garden. Weekly fees are available from the home. Additional charges are made for hairdressing, chiropody and private medical prescriptions. 2 6 0 1 2 0 0 9 0 Over 65 22 Care Homes for Older People Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place at 9:00AM on 18th November 2009 We agreed and explained the inspection process with the registered manager. The focus of the inspection was to assess the home in accordance with the Care Home Regulations 2001 and the National Minimum Standards for Older Persons. In some instances the judgement of compliance was based solely on verbal responses given by those spoken with. We used a varied method of gathering evidence to complete this inspection, pre inspection information such as discussion and correspondence with the registered provider/manager was used in the planning process. This was to support us to explore any issues of concern and verify practise and service provision. The home had completed an annual quality assurance assessment questionnaire (AQAA). This Care Homes for Older People Page 5 of 26 provided us with information relating to What the agency considers it does well, What we could do better, What has improved within the last 12 months and plans for improvement. The judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable the Commission to be able to make an informed decision about outcome areas. Further information can be found on the Commissions website with regards to information on KLORAs and AQAAs. Documentation and records were read. Time was spent reading a sample of written policies and procedures, reviewing care plans and records kept within the home. Other areas viewed included risk assessments, pre-admission assessments, rotas, and training records. In addition an environmental tour took place. We identified several residents for case tracking (a review of the level of care and support needed, and if it is being provided in a way that treats them with respect and dignity). Care Homes for Older People Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents know that their needs will be assessed prior to moving to the home and they receive comprehensive information about the home and services provided. Intermediate care is not provided. Evidence: Three assessments were reviewed. Records showed that residents have an assessment, which identifies their individual needs prior to or on admission to the home. However they were limited in detail and in the view of the Commission need to be much more comprehensive. This the manager agreed with and confirmed that this would be addressed. The AQAA and other evidence shows that prospective residents can be referred through Social Services or through private arrangement. From an initial enquiry, the home arrange to visit the prospective resident at his/her home or at another location Care Homes for Older People Page 9 of 26 Evidence: at the request of a care manager or member of the family. enquirer. The AQAA and discussions with the manager confirmed that if procedure is successful for both parties the prospective resident is invited to take up a trial period before a long-term arrangement is discussed. This is of a two way benefit, as it allows the resident to settle into the new environment and to assess whether the changes they are experiencing are beneficial to their quality of life. On admission care needs are discussed with the new resident and or their relative or advocate in attendance and a Care Plan established and agreed. Each resident is encouraged to bring personal items and to make their room as personal and homely as they wish. There is developing awareness of equality and diversity issues and some evidence of positive practice to address these areas. The provider has an understanding of the importance of these issues and staff have attended equality and diversity training. However the assessments need to detail more information in this regard. The home does not provide intermediate care. Care Homes for Older People Page 10 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having individual plans that identify there physical and medical needs and provide the support they need. Residents can feel confident that they are fully supported with their healthcare needs. Residents are treated with respect and dignity and their rights to make decisions about their lives and they have the opportunity to be consulted on, participate in, all aspects of life within the home as they wish or their capacity allows. Residents can feel confident that the homes policy and procedures with regard to the administration and dispensing of medication is sound. Evidence: We viewed and discussed with the manager the care records relating to several residents at the home. In the care plans viewed there were guidelines in respect to support needed. The home undertakes regular reviews. Formal reviews involving significant professionals and relatives where possible are also undertaken. Care Homes for Older People Page 11 of 26 Evidence: The care planning system overall was of a good standard. Significant improvements have been noted since the previous inspection. We made recommendations for improvements by having a more person centred planning approach to care plans. It was recommended that further improvements could be made with regard to social care planning and fully exploring the residents needs and wishes where possible and opportunities for social development and enrichment.The care plan is used as a working tool and is understood by all staff. We viewed a sample of care records and specific health care records relating to several residents. Records viewed confirmed residents had access to a range of health care inputs as and when required and as part of regular health checks for some of the residents. The documentation seen confirmed that all residents have a Doctor and visits from other health professionals are arranged and enabled.Risk assessments are in place with regard to identifying the risk and the control measures needed to minimise risks. During the inspection we saw that that residents were seen making choices about their lives and were seen to be part of the decision process. A relaxed atmosphere was noted with the residents interacting with staff. We had the opportunity to speak with several residents who expressed a great deal of satisfaction with the care offered and given. They felt that the home offered an inclusive family atmosphere and that the manager was receptive to their comments and suggestions. There was clear evidence available to demonstrate that the health care needs of residents are met. Records are maintained of all health care professional input including district nurses, GPs. The records include outcomes of any consultations, which are then included within plans of care and appropriately communicated to staff as part of regular health checks. The home ensures that residents have access to their chosen Doctor where possible for medication reviews. Residents have regular access to health check ups, Dentist, Optician and so on. Detailed policies on medicines management were available so that members of staff have clear guidance and could follow a common approach when managing medicines. A pharmacist has visited the home since the last inspection to improve on the issued identified within the last report.Medicines in use were stored safely.The home does have clear and detailed records around medicines use. Staff training is provided. Systems are in place with regard to medication coming into and out of the home. A sample number of Care plans were checked. These had records of doctors visit and district nurse input. Care Homes for Older People Page 12 of 26 Evidence: Service users privacy and dignity are respected. Staff knock on doors before entering and call service users by their preferred name. Interactions between staff and residents were observed as friendly and relaxed but respectful. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents engage in a good level of activities, which are appropriate to their needs and capabilities. Residents are supported to maintain contact with family and friends, which ensures they continue to receive stimulation and emotional support. Residents can be confident that they are offered a range of opportunities for personal development. The residents benefit from the appetising meals and balanced diet offered at the home. Evidence: Residents were observed participating and interacting with staff. Residents have been enabled to and encouraged to participate in activities, which they had an interest in. Discussion with residents confirmed that the level of activities were of a good level and that they enjoyed a level of stimulation through leisure and recreational activities suitable for their needs. We joined residents at 9:00am. We had the opportunity to speak to several of the residents who expressed their opinion of the home and the activities they participated Care Homes for Older People Page 14 of 26 Evidence: in and enjoyed. Other residents were observed participating and interacting with staff. Residents have been enabled to and encouraged to participate in hobbies and activities which they had an interest in, and specific recreational activities. It was confirmed that residents are enabled to maintain contact with relatives and friends where they wished to do so. From observation, records viewed it was evident that residents were offered a choice of menus that meet their dietary needs and individual preferences. Meal times are flexible to suit the residents activities and schedules. The meal being served at lunchtime at the time of inspection was a home made sheppards pie with a good range of vegatables. A pudding was also offered. Residents are able to choose where to eat, and also and have drinks and snacks. Residents on evidence seen have had been involved in planning and choosing what to eat. This was additionally confirmed following discussion with one resident. However another resident wished to have more choices at mealtimes. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can feel confident that their concerns and complaints are taken seriously. Residents are protected from the risks of abuse. Evidence: A copy the complaints procedures was reviewed. The procedure included details of how to complain, timescales for response and information for referring a complaint to the service provider. Residents within the service have an understanding of how to make a complaint as their capacity and understanding allows. Any complaints that have been received from information contained within the AQAA on evidence seen were dealt with appropriately to achieve the best outcome for the complainant. The homes Policy for the Protection of Residents and staff Whistle blowing procedure was discussed. These include procedures for the reporting of suspicion or evidence of abuse with a format for the recording of any allegations and action to be taken. Full training has been provided for staff, evidence of this was seen within the staff files and training record. Staff trained in NVQ 2 (National Vocational Qualifications) have covered a module of adult abuse and also have attended a study day on abuse. The Commission identified a very small number of staff that had not received such abuse training. The manager is aware of this shortfall and confirmed that it would be addressed as a priority. The Care Homes for Older People Page 16 of 26 Evidence: Commission is confident that this will be the case and has not made a requirement at this time. The manager stated robust policies and procedures are in place as well as having good practice documentation in place such as the Kent and Medway Adult Protection procedures. The manager speaks to the residents daily when working as this gives the residents an opportunity to express any concerns or anxieties. Communication is effective and residents and families feel comfortable to raise concerns or worries. The manager stated that Criminal Record Bureau Checks (CRB) had been obtained for all staff. The Commission saw evidence of this. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a generally well maintained environment, which provides a homely warm atmosphere. However some areas are in need of refurbishment. Residents are protected by the homes infection control procedures and policies Evidence: It was apparent that the individual and collective needs are being met in a generally comfortable environment. The standard of internal decoration and fixtures and fittings are maintained and of a generally good quality. Some areas, furniture and furnishings however would benefit from a degree of refurbishing. The manager is aware of this and confirmed that it forms part of the homes action plan. An environmental risk assessment has been carried out to maximise the safety of residents. The management and staff encourage residents to see the home as their own home. It provides a safe comfortable, home which has all the specialist equipment and adaptations needed to meet individual residents needs. The home is planning shortly to have a new stair lift installed to further improve the environment for the residents and decorate the upstairs landings and hallways. This was seen a major investment for the home and a mark of the providers commitment to improve the experience of residents living within the home. Care Homes for Older People Page 18 of 26 Evidence: Evidence seen and the AQAA showed that the layout of the home is suitable, accessible and well maintained for the residents to meet their needs. It is kept hygienically clean to a good standard. Bedrooms have been personalised to suit individual tastes. They are encouraged to bring personal belongings and furnishing to aid transition and ensure that they will be comfortable in the care home with their own personal belongings. The home is very well lit, tidy and smells fresh. The premises are kept clean, hygienic throughout and the manager stated systems are in place to control the spread of infection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents care, social and emotional needs are promoted by the employment of caring staff in such numbers to support their needs that put the interests of the residents first. Residents can feel confident that they are supported by staff that have been employed by the home using sound recruitment procedures and that they are trained to a good standard overall. Evidence: From discussions with the manager, observations and reviewing the staff rotas sufficient staff were on duty at the time of inspection to meet the residents needs. Staff are receptive to residents needs and work together as a team. Risk assessments have been prepared both for the residents as individuals and the environment. It was reported at the previous inspection that the number of staff at weekends were less that during the week. Upon discussions with the residents they commented that their needs continued to be met and that they did not see it as a problem. Therefore the Commission wishes to be proportionate in this matter and intends not to make any requirements at this time as outcomes are good. The manager stated staffing levels are always under review to ensure the needs of the residents are met. The staff training records indicated planned and undertaken training in all the key Care Homes for Older People Page 20 of 26 Evidence: areas. Core training in Infection control, moving and Handling, Basic Life support, fire training, food hygiene, and Adult protection has been provided. The manager evidenced that individual and group staff training needs had been identified. Core courses are undertaken by staff to maintain current qualifications and for protection of residents. It was evidenced that a few staff had not received all the training to enable them to perform their role. Training has improved and the home has evidenced that a lot of effort has been put in by the management to improve training since the last inspection and that it is an improving situation. However as aforementioned gaps in training need to be addressed. No requirement has been made at this time. The manager confirmed that the home has a development programme for all new staff, which meets Sector Skills Councils workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users, and that all members of staff receive induction training to specification. The inspection of the recruitment files at the previous inspection evidenced that the required checks had been carried out and that the standard was met. Upon reviewing a sample of recruitment file the standard continues to be met. All required information was contained within the files and all checks of identity have been carried out. All staff have a CRB (Criminal Record bureau Checks). Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are currently being met and can be confidant that the home is managed appropriately by a competent experienced manager and that the quality assurance of the service is monitored. However the quality assurance visits of the provider could be improved. Residents can feel confident that their health and safety is protected. Evidence: The manager is actively involved in the day-to-day management of the home and works with staff and residents. She has many years of experience caring for others. Outcomes for the quality of care are good. Residents expressed a great deal of satisfaction of the care provided and the staff are very supported of the manager and have a positive ethos. There is strong evidence that the ethos of the Home is open and transparent. The views of both residents and staff are listened to, and valued. Care Homes for Older People Page 22 of 26 Evidence: Quality assurance was discussed and the views and opinions of many of the residents and stakeholders sought. The residents and visitors spoken with confirmed a great deal of satisfaction of the quality of care offered within the home and residents felt confident that their views and opinions were valued by both staff and management. The registered provider of the home does regularly visit the home. Completion of what is known as a Regulation 26 visit takes place. This requires the provider to assess the quality of care within the home and ensure that it is meeting with the required National Minimum Standards. We recommended to the manager that the visits additionally need to focus more on outcomes for residents with regard to quality of care, staffing, adult protection, recruitment, audits of policies and procedures, staff training, activities in addition to health and safety. The home has a full range of policies and procedures to promote and protect residents health and safety. There is full and clearly written recording of all safety checks and there is no evidence of a failure to comply with other legislation. There is a good understanding of risk assessment and this is taken into account in all aspects of the running of the home. The quality assurance system confirms that the findings from risk assessments have been actioned. The manager however needs to ensure all staff are trained in health and safety matters and have regular planned updates at the required frequency. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 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. 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