Care Home: Lyndhurst Lodge

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What the care home does well The accommodation is homely and comfortable. Bedrooms are individually decorated and personalised. One resident said, `My room suits me and I have it how I want it.` All areas inspected were clean and tidy. Residents told us they were pleased with the care they received at Lyndhurst Lodge. One resident said, `I have my own routine. When I want to get up or go to bed I call the staff and they help me.` Other comments included, `The general day to day care is good` and `The staff keep us clean and tidy.` The staff on duty were friendly and helpful. One resident told us, `The staff are all lovely and they have lots of time for us.` Another said, `I get on well with all the staff. We have many a laugh together.` Residents told us they were happy at Lyndhurst Lodge. Comments included, `I wouldn`t live anywhere else`, and `I never want to leave here.` What has improved since the last inspection? A cook has been employed which means that care staff can focus on the residents while food is being prepared. More activities have been provided. These include bingo, arts and crafts, trips out, and visiting entertainers. Quality assurance questionnaires have been distributed to residents and relatives. As a result a programme of redecoration has been planned, and changes made to the home`s menu. The Acting Manager has achieved her NVQ Level 4 and the Leadership and Management Award (recognised qualifications for people who run care homes). A radiator in one of the shower rooms has been covered to minimise the risk of scalding. The home`s Environmental Health Officer has inspected the home and given the kitchen a three star `good` rating. What the care home could do better: Care plans are in need of improvement. Clearer, more person-centred care plans would be better for both residents and staff. Only three members of staff are trained in medication administration. A further member of staff should also be trained, so there is always someone on duty to give our medication when needed. Some of the home`s medication is kept in the same safe as residents` monies. This is not acceptable and alternative storage facilities must be provided. At present only group activities are provided. There should also be one-to-one activities, where possible, for residents who do not want to be in a group. There is no clear procedure for staff to follow if a safeguarding issue arises. Some areas of the home are in need of refurbishment. Some staff have not had recent training in dementia care so this should be provided. The Acting Manager told us she is applying to become the Registered Manager. Her application must be submitted promptly, as the home has been without a Registered Manager for a year. Key inspection report Care homes for older people Name: Address: Lyndhurst Lodge 87 Burton Road Ashby De La Zouch Leicestershire LE65 2LG     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: Kim Cowley     Date: 1 1 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 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 28 Information about the care home Name of care home: Address: Lyndhurst Lodge 87 Burton Road Ashby De La Zouch Leicestershire LE65 2LG 01530563007 01530831779 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Keith Halliwell care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Service user numbers. No person falling within category MD(E) or DE(E) may be admitted to the home when 6 persons in total of these categories/combined categories are already accommodated within the home. Date of last inspection Brief description of the care home Lyndhurst Lodge is a 19-bedded residential home for older people, some of whom have a mental disorder or dementia. It is situated close to the centre of Ashby de la Zouch. The home has bedrooms on the ground and first floors. Access to the first floor is via the stairs or a passenger lift. The home has two large lounges, one of which is also used as a dining area. Outside there is an enclosed garden, which provides a safe place for residents to sit and walk in. The home is on a main bus route and has car parking Care Homes for Older People Page 4 of 28 Over 65 6 0 6 19 0 1 0 0 Brief description of the care home available at the back of the building, off Churchill Street. Further information, including the fees, is available on request from the home. 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. This was a key inspection that included a visit to the home and inspection planning. Prior to the visit, we (throughout the report the use of we indicates the Care Quality Commission) spent half a day reviewing information relating to the home. During the course of the inspection, which lasted five and a half hours, we checked the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means we looked at the care provided to three residents living at the home by meeting them; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Care Homes for Older People Page 6 of 28 Other issues relating to the running of the home, including health and safety and management issues, were examined. We also talked to two other residents, the Owner, Acting Manager, and two care assistants. Eight surveys from the people who live in the home were returned to CQC prior to the inspection. All respondents made many positive comments about the home. Some of these are quoted in this report. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Care plans are in need of improvement. Clearer, more person-centred care plans would be better for both residents and staff. Only three members of staff are trained in medication administration. A further member of staff should also be trained, so there is always someone on duty to give our medication when needed. Some of the homes medication is kept in the same safe as residents monies. This is not acceptable and alternative storage facilities must be provided. At present only group activities are provided. There should also be one-to-one Care Homes for Older People Page 8 of 28 activities, where possible, for residents who do not want to be in a group. There is no clear procedure for staff to follow if a safeguarding issue arises. Some areas of the home are in need of refurbishment. Some staff have not had recent training in dementia care so this should be provided. The Acting Manager told us she is applying to become the Registered Manager. Her application must be submitted promptly, as the home has been without a Registered Manager for a year. 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 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. Residents needs are assessed prior to admission to ensure the home is suitable for them. Evidence: People who are interested in coming to Lyndhurst Lodge are invited to visit prior to making a decision. If they are unable to their representatives sometimes come instead. One resident told us, My family looked at the home and thought it would be fine for me. They made a good choice. All prospective residents have an assessment to determine what their needs are. The Acting Manager carries these out, visiting people in their own homes, in hospital, or during a visit to Lyndhurst Lodge. The assessment process helps to ensure the home is suitable for those who are considering living there. The home has a Statement of Purpose provides comprehensive information about the Care Homes for Older People Page 11 of 28 Evidence: Lyndhurst Lodge and the services if offers. It is made available to potential residents and their representatives. There was one factual error in the Statement of Purpose which we asked to be corrected. The Acting Manager contacted CQC on the day following the inspection to say this had been done. Standard 6 was not inspected, as this home does not provide intermediate care. 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. Staff in the home, and in the wider community, meet residents health and personal care needs. Medication storage facilities are in need of improvement. Evidence: All the residents we spoke to said they were pleased with the care they received at Lyndhurst Lodge. One resident told us, I have my own routine. When I want to get up or go to bed I call the staff and they help me. Other comments from CQC residents surveys included, The general day to day care is good and The staff keep us clean and tidy. Care plans were in need of improvement. Although they met basic standards, those we looked at were not user-friendly. All the residents had the same set of care plans, regardless of their needs, squeezed onto two pages. This meant they were not particularly person centred. In addition, the review system was inflexible and timeconsuming for staff to complete. We discussed this with the Acting Manager who agreed that clearer, more personCare Homes for Older People Page 13 of 28 Evidence: centred care plans would be better for both residents and staff. She agreed to contact the local authority with a view to attending one of their courses on person-centred care planning. This will help her to ensure that future care plans focus on residents individual needs, taking into account their views on how these should be met. Records showed that that residents health care needs are monitored, and GPs and other health care professionals contacted when necessary. Since the last inspection hand cleaning sprays have been provided inside the front and rear entrances to the home and outside the lounge to help reduce the spread of infection Only senior staff give out medication, following approved training. However senior members of staff are not always on duty, so if medication need administering during this time the Acting Manager comes in especially to give it out. This situation is not ideal and problems could arise, for example during leave periods or if staff were sick. It is recommended that at least one further member of staff is trained in medication administration. This will help to ensure that there are always trained members of staff on duty to give our medication when needed. Medication storage facilities were inspected. Although secure, we found that some residents monies were being kept with the controlled drugs. This is not acceptable as it means that the number of people having access to the CDs is increased. We explained this to the Acting Manager who agreed to take action to resolve the problem. On the day after the inspection she contacted CQC to say that, on the advice of the homes contract pharmacist, she has ordered another secure cabinet so residents monies could be kept separate from medication supplies. During their induction staff are trained to treat residents with respect and maintain their privacy. They also sign the home s policy on this. All the residents we spoke to said they were pleased with staff attitudes. One resident told us, All the staff treat us with respect. I wouldnt stay here if they didnt. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents social and cultural needs are identified and met. Evidence: Since the last inspection, and at the request of residents and relatives, the amount of group activities has increased. Once a week local teenagers come to the home with their teacher and provide a two hour activity session. Residents play bingo and do arts and crafts. The Acting Manager told us that both the teenagers and the residents have benefited from these sessions and good relationships have formed between all those taking part. Other activities provided include visiting entertainers, trips out (two residents recently went to a local school to see a play), board games, and church services. The home has a small library area and books (including some in large print) are changed regularly by a visiting librarian. One resident told us they did not want to join in group activities, but enjoyed it when staff visited them in their room for a chat. We discussed this with the Acting Manager and it was agreed that this arrangement should be formalised and a set time put aside for a member of staff to socialise with the resident in question. This will mean that Care Homes for Older People Page 15 of 28 Evidence: activities are not limited to groups, but also provided for those who prefer one-to-one sessions. Visitors are welcome at Lyndhurst Lodge and encouraged to make themselves at home. They can see residents in their bedrooms or in the lounge or dining room. Since the last inspection a cook has been employed which means that care staff can focus on the residents while food is being prepared. Lunch was served during the inspection and appeared appetising and well presented. 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. Residents and their representatives are encouraged to talk to staff about any concerns they might have. The safeguarding procedure should be improved. Evidence: All the residents we spoke to said they would speak out if there were anything they were unhappy about in the home. One said, If I wasnt happy I would tell the Manager. The Acting Manager told us she wanted all residents and relatives to tell someone straight away if they had a complaint so it could be put right as soon as possible. There is also a formal complaints procedure that residents and their representatives can use. This is displayed on the homes notice board. However it is difficult to follow, and does not make it clear who to go to with a concern. We discussed this with the Acting Manager and she agreed to improve it. On the day after the inspection she contacted CQC to say she had re-written the complaints procedure to make it simpler and more straightforward. This will help to ensure that anyone with concerns about the home knows how to raise them. Records showed there have been no complaints since the last inspection. Since the last inspection the Acting Manager has been on a safeguarding trainers course. She has also facilitated in-house safeguarding training course for care staff. All Care Homes for Older People Page 17 of 28 Evidence: staff have completed this and been assessed as competent by the Acting Manager. We looked at the homes safeguarding policies and procedures. There is a copy of No Secrets (local guidance on safeguarding) and other information in the home, but no clear procedure for staff to follow if a safeguarding issue arises. It is recommended that one is put in place emphasising the role of social services as lead agency in any safeguarding investigation. This will help to ensure that staff know what to do and who to contact should they become concerned about the welfare of any of the residents. A specific issue (identified at the inspection) concerning safeguarding was discussed, and the Acting Manager advised to carry out a written risk assessment, and contact social services should the need arise. 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. Residents live in an environment that is safe, comfortable, and mostly well maintained. Suitable improvements should be made in consultation with residents . Evidence: The accommodation is homely and comfortable. Bedrooms are individually decorated and personalised. One resident told us, This room suits me and I have it how I want it. All areas inspected were clean and tidy. One respondent to the CQC survey told us, Some of the decor could be freshened up. We looked round the home and saw that some areas were in need of redecoration and improvement. For example, the Acting Managers office and the area outside it were shabby and institutional. And some carpets, although clean, were stained and in need of replacing. We discussed this with the Owner and Acting Manager. They told us that a refurbishment programme was planned for 2010. This would include redecorating some areas and laying new carpets where necessary. Consideration should be given to the needs of residents with dementia when planning changes to the interior of the home. This is because certain colour schemes are believed to be beneficial to their well-being. Dementia specialists may be able to Care Homes for Older People Page 19 of 28 Evidence: advise staff at Lyndhurst Lodge on this. Residents should also be involved to help choose how they would like the home to look. 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. The home is well-staffed and residents are happy with the staff team. Not all staff have been trained in dementia care. Evidence: The staff on duty during the inspection were friendly and helpful. They got on well with the residents they cared for. One residents told us, The staff are all lovely and they have lots of time for us. Another said, I get on well with all the staff. We have many a laugh together. The results of the CQC survey also showed that the staff at Lyndhurst Lodge are well regarded. Many positive comments were made about them including, The staff are always around when we need them, The staff make Lyndhurst Lodge a home from home, The staff are very friendly and caring, and I cannot fault the attention of the staff. We looked at the rota and saw that staffing levels were comparatively good, and the Acting Manager was usually supernumerary. She said this allowed her the time to talk to residents individually, and listen to their views on the home. Recruitment procedures were discussed with the Acting Manager. She confirmed that all staff are subject to CRB and POVA checks, and references are obtained. No Care Homes for Older People Page 21 of 28 Evidence: member of staff works unsupervised until they have had satisfactory clearance from the relevant agencies. This helps to ensure residents are safeguarded. Staff receive good training opportunities. The majority are either studying for, or have obtained, NVQ Level 2 in Care or its equivalent, and have taken a variety of relevant courses. However, not all staff have been on a recent dementia care course. This was discussed with the Acting Manager and she agreed to arrange for them to have this training. This will help to ensure staff have the knowledge and and skills they need to carry out their work. 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. Residents live in a home that is safe and well managed. A Registered Manager must be put in place. Evidence: An Acting Manager is presently in charge of the home. She has worked there for 12 years and has NVQ Level 4 and the Leadership and Management Award (recognised qualifications for people who run care homes). She told us she is applying to become the Registered Manager. Her application must be submitted promptly as the home has been without a Registered Manager for a year. Quality assurance questionnaires are distributed to residents and relatives annually. Feedback is analysed and staff act on information received. As a result of the last questionnaire a programme of redecoration has been planned, and changes have been made to the homes menu. If residents wish the Acting Manager will look after small amounts of money for them. This is kept securely with appropriate records maintained. Care Homes for Older People Page 23 of 28 Evidence: At the last inspection there was concern that a second floor flat within the premises might be let to a member of the public not employed by the home. This was discussed with the Acting Manager. She said that a decision has been made not to let the flat as it is being kept by the Owner for his own possible future use. Since the last inspection a radiator in one of the shower rooms has been covered to minimise the risk of scalding. A fire risk assessment has been completed, and the homes Environmental Health Officer has inspected the home and given the kitchen a three star good rating. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 22 13 The radiator in the toilet & 28/04/2009 shower room with the hand towel rail needs a further risk assessment. In this way the risk of people burning themselves on it will be reduced. Regular checks must be made around the area of heating. 28/04/08 The registered person must 28/05/2009 appoint a member of staff who will be willing to undertake the registered manager responsibility at the care home and register with the Commission for Social Care Inspection. 2 31 9 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 9 13 Appropriate storage facilities 11/03/2010 must be provided for all the homes medication. To ensure medication is kept securely in the home. 2 31 8 A Registered Manager must be appointed. To meet requirements and help ensure that a suitable person, approved by CQC, is in charge of the home. 11/04/2010 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 7 Care plans should be re-written to make them clearer and more user-friendly, and a simpler review system put in place. This will help to ensure that staff have the information they need to meet residents needs. Staff should be trained in person-centred planning. This will help to ensure that care plans focus on residents individual needs, taking into account their views on how these should be met. Page 26 of 28 2 7 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 12 One-to-one activities should be provided, where possible, for residents who do not want to join in group activities. A record should be kept of these. A clear safeguarding procedure should be put in place emphasising the role of social services as the lead authority in any safeguarding investigation. This will help to ensure that staff know what to do and who to contact should a safeguarding issue arise. Consideration should be given to the needs of residents with dementia when planning changes to the interior of the home. This is because certain colour schemes are believed to be beneficial to their well-being. All staff should have training in dementia care. This will help to ensure they have the knowledge and and skills they need to carry out their work. 4 18 5 19 6 30 Care Homes for Older People Page 27 of 28 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). 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