Care Home: Lisburne Court

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What the care home does well People living at the home said they liked the manager and staff and thought they were generally well looked after. All the people that returned surveys thought they received the care and medical support they needed. Comments from people included, "I think the home gives good quality care and (staff) are very pleasant. They make you feel at home", "It is very caring and the staff are always pleasant and helpful" and " I have been happy living here, having lived alone; they made me fit in and I have settled down without much trouble". One visitor said staff kept her up to date with any changes in in the condition of her relative and she was made welcome when she came to the home. Medicines were managed well and the systems in place ensured the safety of people living there. Most people liked the food provided at the home. People said they were offered a choice and we saw staff discussing the menu with them on the morning of our inspection. We chose one of the options, an omelette, for lunch and it was very tasty. People living at the home said they felt comfortable to raise concerns or complaints if they needed to and said staff listened to them. Borough Care do take complaints seriously and we were satisfied that where any complaints highlighted shortfalls action was taken to address the issues. The home was clean and well maintained and people said it was usually fresh and clean. In the AQAA the manager reported that 68% of the staff had successfully completed National Vocational Qualifications (NVQ). This qualification is obtained following training in providing personal care. This meant that staff had a good basic knowledge of the care they needed to provide and the reasons such care was needed. Staff also benefited from a programme of mandatory training and it was reported that other specific training had taken place to ensure staff had skills in dementia care. Regular health and safety checks were made of the building and equipment to ensure the safety of staff and people living at the home. What has improved since the last inspection? At the last inspection we made 3 recommendations and two of these had been acted on whilst the third had been looked at but still needs some development. A system of co-workers has been implemented to try to improve the opportunities for people to engage in social activities. However this does still need more work. People living at the home had been asked for their ideas about social events and meals etc. This is an area that can now be further developed and expanded. What the care home could do better: Although care plans were in place for each person they do need to be more detailed and staff need to make sure that when they are reviewed action is taken to follow up any issues that are highlighted. Because more people with dementia are now living at the home care plans need to be improved especially for peoples` mental health care so staff have the information to manage challenging behaviour and monitor people effectively. Although staff do recognise the need to provide opportunities for social interaction and stimulation, activities tend to be group focused and do not necessarily meet everyone`s interests. Better person centred planning would help staff meet peoples` social care needs in more diverse ways that suit their abilities and expectations. Meetings are held for people living at the home but it was not always evident that suggestions from them were used to develop social care in the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lisburne Court Lisburne Lane Offerton Stockport Cheshire SK2 5LU     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: Fiona Bryan     Date: 1 7 0 6 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: Lisburne Court Lisburne Lane Offerton Stockport Cheshire SK2 5LU 01614830671 01614840248 lisburnecourt@boroughcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Borough Care Limited care home 42 Number of places (if applicable): Under 65 Over 65 4 42 1 dementia old age, not falling within any other category physical disability Additional conditions: 0 0 0 The registered person may provide the following category of service only: Care home only: Code PC, to service users of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP (maximum number of places: 42). Dementia over 65 years of age: Code DE(E) (maximum number of places: 4). Physical disability over 65 years of age: Code PD(E) (maximum number of places: 1). The maximum number of service users who can be accommodated is: 42. Date of last inspection Brief description of the care home Lisburne Court is situated in the Offerton area of Stockport. Shops, public houses and other local amenities are close by. Stockport town centre and the motorway network are easily accessible by car. The home is registered to accommodate up to 42 service users, four of whom may have dementia. One place is offered for a service user with a physical disability. Lisburne Court also provides a day care service. Care Homes for Older People Page 4 of 28 Brief description of the care home The large building accommodates service users on two floors. There are 40 single rooms and one double room. A passenger lift and three stairways enable access to both floors. There are several lounges and dining areas for sharing during the day and evening. A separate lounge and kitchen are available for visitors, enabling privacy when visiting their respective relative or friend. Fees for accommodation and care at the home are £428 per week. A service user guide is available on request. 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: This key unannounced inspection, which included a visit to the home, took place on Wednesday 17th June 2009. The staff at the home did not know that this visit was going to take place. All the key standards were assessed at the site visit and information was taken from various sources, which included observing care practices and talking with people that live at the home, visitors, the deputy manager and other members of the staff team. Key standards refers to those standards we feel are particularly important in ensuring the health, safety, welfare and quality of life of people living at the home. The care and services provided to three people were looked at in detail, looking at their Care Homes for Older People Page 6 of 28 experience of the home from their admission to the present day. A selection of staff and care records was examined, including medication records, training records and staff duty rotas. Before the inspection, we asked for surveys to be sent out to people living at the home and staff asking what they thought about care at the home. 5 people and 3 staff returned their surveys. Comments from these questionnaires are included in the report. We also asked the manager of the home 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 see the service they provide the same way that we see the service. The manager completed the form well and showed that she was able to identify most of the areas where the service could be developed. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 28 Although care plans were in place for each person they do need to be more detailed and staff need to make sure that when they are reviewed action is taken to follow up any issues that are highlighted. Because more people with dementia are now living at the home care plans need to be improved especially for peoples mental health care so staff have the information to manage challenging behaviour and monitor people effectively. Although staff do recognise the need to provide opportunities for social interaction and stimulation, activities tend to be group focused and do not necessarily meet everyones interests. Better person centred planning would help staff meet peoples social care needs in more diverse ways that suit their abilities and expectations. Meetings are held for people living at the home but it was not always evident that suggestions from them were used to develop social care in the home. 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 9 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 10 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 their needs assessed before they move into Lisburne Court so they know their needs can be met. Evidence: A statement of purpose and service user guide were available, which gave good information about the services provided at the home. Borough Care also has a website that gives information about all the homes within the group. Five people living at the home returned surveys and said they had received all the information they needed to make a decision to move into the home. The care provided to three people was looked at in detail. Records for each of them showed that full assessments had been carried out before they came to live at the home, although the information gathered could still be used better to create more Care Homes for Older People Page 11 of 28 Evidence: detailed care plans. This would give staff more specific information about the care they needed to provide. Care Homes for Older People Page 12 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. Peoples care needs are not always documented well enough although staff do provide support to make sure that generally individual personal and health care needs are met. Evidence: The care for three people was looked at in detail. Care plans were in place, which provided basic information but they did not always specify what the aims of the care being provided were or what the abilities of the person were. There were also some gaps in information, for example what type of pressure mattress someone was using, how often they needed help to change position and what someones food allergies were. Over the last few months Lisburne Court has started to accept more people with dementia to live at the home and some of them have challenging behaviour. Care plans need to be more detailed in describing peoples mental health needs and how Care Homes for Older People Page 13 of 28 Evidence: staff should manage challenging behaviours. Some of the actions stated as being needed in care plans was not always carried out in practice. For example one person had challenging behaviour and staff were supposed to complete a monitoring chart to try to identify possible causes of aggression and the best ways to deal with it but the charts were not completed although it was recorded elsewhere that this person had been aggressive on a number of occasions towards staff. Risk assessments had been undertaken to assess the risk to people of falls and moving and handling. Staff use a trigger system to identify people that may be at risk of poor nutrition or skin damage and determine when they need to be referred to the district nurses. However, it was not always clear when staff would refer people; two people lost weight but there was no evidence that this had prompted staff to ask the district nurses to carry out a nutritional assessment and they were not weighed any more frequently than usual. The district nurses had recently started to undertake nutritional assessments for all people living at the home so each person will be assessed in due course but assessments that had already taken place did not appear to have been as a result of the trigger system. Of the 5 people that returned surveys, 4 said they always or usually received the care and support they needed and that staff listened and acted on what they said. All of them said they always or usually got the medical attention they needed. Comments included, I think the home gives good quality care and are very pleasant. They make you feel at home and It is very caring and the staff are always pleasant and helpful. People we spoke to on the day we visited said that in general staff were very good, although one person commented that some staff were sometimes rough. Another person said, Anything you want you only have to look at them and a visitor said she was happy with the care provided to her relative. This person said her relative always looked clean and well cared for and staff had been prompt in getting medical attention when needed and had kept her up to date with any changes in their relatives care. We looked at how medicines were managed for a small number of people and found these to be generally satisfactory. We checked the records and stock of controlled medicines and these were accurate. Care Homes for Older People Page 14 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social care planning is not very person centred which means people do not always have opportunities to participate in stimulating and meaningful activities of their choice. Evidence: An activities organiser is not employed as it is part of the role of the carers to identify and meet peoples social care needs. Since the last inspection however, one of the supervisors has been given responsibility for overseeing and coordinating the arrangements for providing social events and activities. We looked at the care provided to three people in detail. Each person had a social care plan but in general these were quite limited, for example the plan for one person was that they liked watching TV and smoking! Another person had several interests that were not mentioned in her care plan and her key worker was not aware of them. This person told us she understood that staff cant see to individual things. Minutes of a residents meeting recorded that this person had mentioned types of music she would like to listen to in the afternoons and staff had agreed to arrange this but there was no evidence that anyone had. Care Homes for Older People Page 15 of 28 Evidence: Activities that did take place tended to be group activities such as quizzes, hot pot suppers, movement to music, reminiscence and singalongs. Staff recorded what activities had taken place each day and which people had joined in. There was little information in individual care files about what people had done and how they had spent their day. Recording social participation in each persons own care file would help staff review how well their social care needs were being met and identify peoples interests in a more person centred way. The manager did acknowledge in the AQAA that social care planning was an area that they wanted to develop. We noticed that the televisions were on in both main lounges throughout the whole day regardless of whether anyone was watching or not. One person who returned a survey responded to the question what could the home do better by writing They could do better with more activities and less TV. Another person said they thought more outings should be arranged. We were told by several people that routines within the home were flexible and that their visitors were made welcome. People were generally happy with the food provided at the home, saying it was usually god and that there was always a choice. We saw staff talking to people throughout the morning, telling them what was on the menu and asking what they wanted. Several people said they didnt want the main option and alternatives were suggested by staff. Lunch on the day of our inspection was broccoli and potato soup, assorted sandwiches or omelette and salad. Some people had a ham salad instead. People said they were enjoying their meals and we tried an omelette and it was very tasty. Menus were displayed on the dining tables and they showed that there was a choice of lasagne and salad or steak and kidney pudding and chips for tea. We noticed that staff did not know what type of soup was being served so they were unable to tell people when they asked. We also observed one person really struggling to cut up her food but the carer did not seem to notice and did not offer to help although it was recorded in the persons care plan that she did need some help with cutting food up. Staff do need to be observant and aware of who needs help so they can be proactive in providing the assistance they need. 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 living at the home and their relatives are able to complain and action is generally taken to respond to their concerns. Evidence: The home has a complaints procedure, which is displayed in the reception area of the home. Of the 5 people that returned surveys all said they were aware of the complaints procedure. Most people we spoke to on the day of our inspection said they would speak to Someone in the office if they had concerns and they felt confident they would be listened to. However, one person was not sure what she would do if she wanted to complain and a visitor said she had made a complaint in December 2008 but had never received a response. A record of complaints was kept. In most cases a record was kept of how the complaint was dealt with but there was not always any further information about whether the complainant was satisfied with the response. Since the last inspection we have received one complaint which we passed to Borough Care to investigate and respond to. We were satisfied with how the complaint was dealt with and the complainant told us that the issues she raised had been addressed. Care Homes for Older People Page 17 of 28 Evidence: In the AQAA the manager confirmed that all staff had received training in safeguarding adults. However one staff member we spoke to was very unsure about the procedures she should follow if she had concerns about abuse and was also not aware of where the homes policies and procedures were kept if she needed them for reference. The training matrix showed that safeguarding training had been undertaken by this member of staff in 2005 so refresher training would be beneficial. Records did show that there had been a significant number of incidents where staff had been assaulted by people living in the home. Although none of these incidents involved other people living at the home, staff need to be mindful that if people are displaying increasing levels of aggression action needs to be taken to review their management in order to minimise the risk to other people living there. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is appropriately maintained, decorated and cleaned to enable people to live in a pleasant, safe and hygienic environment. Evidence: A partial tour of the home was undertaken. The home was clean and tidy and smelled fresh. Of the 5 people that returned surveys 4 said the home was always or usually fresh and clean. In the AQAA the manager reported that since the last inspection a new carpet and curtains had been provided for the main lounge, and one of the bathrooms had been converted to a wet room. The dining room and the room for smokers had both been refurbished and a hot trolley had been bought so people could see what choices of meal were on offer more easily. Areas of the home were made secure with the use of key pads, due to the increasing numbers of people living there who have dementia. A number of peoples bedrooms were nicely personalised with their own belongings and some rooms had memory boxes outside them with photographs and personal possessions of the occupant to help them recognise their room and orientate Care Homes for Older People Page 19 of 28 Evidence: themselves. Further development of the communal areas to take into account best practice guidance for dementia care settings should be undertaken due to the increasing numbers of people living at the home with dementia. Colour coding, signage, providing more objects and artwork for visual and tactile stimulation and looking at the use of smaller lounges for quiet space when someone needs a calm environment for example should be considered. Care Homes for Older People Page 20 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. Staffing arrangements, recruitment and training ensure that people are cared for and supported safely. Evidence: Since the last inspection concerns have been raised with us by one relative who felt that staffing levels were no longer sufficient, since the decision had been made to accept more people with dementia to live at the home. Some of these people are more highly dependent and therefore needed more help from staff. These concerns were passed to Borough Care to investigate and staffing levels have subsequently been increased. Several people we spoke to said they felt staffing levels were generally acceptable and 4 of the 5 people that returned surveys said staff were always or usually available when needed. Two staff files were examined. Criminal record disclosures had been obtained for each person and the records contained confirmation that references had been received and were on file at Borough Cares head office. It was reported that 68 of staff at the home have a NVQ level 2 or above. Borough Care Limited provides a comprehensive training programme and an excellent Care Homes for Older People Page 21 of 28 Evidence: induction package for new staff. Staff receive annual mandatory health and safety training and it was reported that most staff had undertaken some training in dementia awareness. It is recommended that further training is considered for staff around person centred care, record keeping especially in relation to mental health needs and dealing with challenging behaviour. Care Homes for Older People Page 22 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. Lisburne Court is managed with systems, policies and procedures in place to ensure the health and safety of staff and people living there are promoted and protected. Evidence: The manager is registered with us and has completed the Registered Managers Award. Staff and people living at the home said that the senior management team in the home were all approachable and supportive. It was reported that a managers development programme had been developed by Borough Care and that senior staff had attended training about the Mental Capacity Act. Meetings had been held for people living at the home and minutes of the meetings showed that people had been able to make suggestions and give feedback about life at the home. However, there was not always evidence that peoples suggestions had been followed up. We were told that another meeting was due and it is recommended that it is recorded in the minutes what action was taken as a result of the suggestions Care Homes for Older People Page 23 of 28 Evidence: made at the previous meeting. This will provide an audit trail for quality assurance as to how the manager is using feedback to develop the service. Borough Care Limited distributes surveys to people living at all their homes each year and the results and feedback from these are published in an annual report. It was reported that surveys were about to be distributed for this year. There had been no change to the way in which the home dealt with peoples finances since the last inspection. Small amounts of money were held for people living at the home to purchase small items. Systems were in place to ensure the safe handling and storage of their money. It was reported that the companys finance manager undertakes an audit every six months. Regular checks were made on the building and equipment to ensure the health and safety of people living there and staff. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Care plans must be detailed 30/07/2009 and address all aspects of peoples care needs including mental health needs where appropriate. Staff must ensure that they follow the care plans and maintain associated records. This will ensure that staff know what care each person needs and how it is to be monitored. Accurate records will ensure that the care being delivered can be reviewed and changed effectively. 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 8 The trigger system should be robust enough to ensure that where reviews of risk assessments indicate the need for referral to other healthcare professionals this is recognised and carried out. Page 26 of 28 Care Homes for Older People 2 12 Staff should consult with people living at the home to expand and develop the range of activities and opportunities for social interaction with them in a way that meets their needs, expectations and abilities. The record of complaints should always show the outcome of any investigation and indicate whether the complainant was satisfied. Records should show how peoples suggestions and feedback about life at the home are used to develop the service. 3 16 4 33 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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