Care Home: Maplewood House

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What the care home does well Maplewood House provides a comfortable,clean and homely environment for service users. The service user group is now well established and staff are familiar with their needs. Care plans are completed to a good standard and person centred planning is progressing. Medication procedures are robust and measures have been taken to strengthen them. Health needs are well met and the home is addressing the fact that service users needs change as they grow older. There is a low level of complaint and the one received since the last inspection was dealt with thoroughly. Service user`s rooms are well decorated and furnished,service users said they liked their rooms,rooms are all personalised. Staff are well trained and receive supervision,they are competent and those spoken with were genuinely interested in the lives of the people they support. Documents and records are completed to a good standard and there are robust quality assurance processes in place. What has improved since the last inspection? Medication procedures and storage are better and the key to the medication cabinets is stored more safely. Guidelines for staff are in place for the management of behaviour. More activities have been provided for service users. Fire safety is being improved with the fitting of new door guards and intumescant strips. The cleanliness of the fridge and freezer are now good ,all food is covered and bottles and jars labelled with the date of opening. Some staff have attended equality and diversity training. What the care home could do better: Improvements need to be made to the environment in some areas. The front garden needs to be tidied up and the front door painted. The stated aim of fitting hand towel dispensers in toilets and bathrooms must be carried through. The damaged bath panel must be replaced and the woodwork surround in one bathroom repainted. The damage to the smoking room ceiling must be repaired and the room redecorated. Measures need to be taken to control the temperature in the building better. Staff are doing their best to enable service users to enjoy a varied and active lifestyle and staffing levels must not impact on this.The organisation must review the arrangement that the registered manager works on the rota for over half of the week. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Maplewood House Off Chatfield Court Caterham Surrey CR3 5YA     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: Jo Griffiths     Date: 0 2 0 4 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 27 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 27 Information about the care home Name of care home: Address: Maplewood House Off Chatfield Court Caterham Surrey CR3 5YA 01883383807 01883383812 Krisha.Govinden@sabp.nhs.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) : Surrey and Borders Partnership NHS Trust care home 14 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 14 The maximum numbr of service users to be accommodated is 14. 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: Learning disability (LD). Date of last inspection Brief description of the care home Maplewood House is a detached property providing accomodation for fourteen service users who have mild to moderate learning disabilities,the majority of the service users are over sixty five.The home is in Caterham with easy access to local shops,public transport and other services.The accomodation for service users is on the ground and first floors,all bedrooms are singles. The home has dedicated transport and parking at the front of the building.There is a large garden that is mainly lawn. At the time of the inspection weekly fees ranged from one thousand and twenty eight pounds forty pence a week. Care Homes for Older People Page 4 of 27 Care Homes for Older People Page 5 of 27 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 unannounced key inspection of Maplewood House took place over six hours,during the visit time was spent with the registered manager,deputy manager,service users and care staff. The home was toured in the company of a member of staff,a range of records and documents were examined including care plans,staff files and records,medication records and health and safety and home maintenance documents. Observation of working practices took place and lunch was partially observed. Throughout the visit service users and staff were helpful in providing information. Information from the AQAA (Annual Quality Assurance Assessment) document was also used as evidence for this inspection. Care Homes for Older People Page 6 of 27 Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Improvements need to be made to the environment in some areas. The front garden needs to be tidied up and the front door painted. The stated aim of fitting hand towel dispensers in toilets and bathrooms must be carried through. The damaged bath panel must be replaced and the woodwork surround in one bathroom repainted. The damage to the smoking room ceiling must be repaired and the room redecorated. Measures need to be taken to control the temperature in the building better. Staff are doing their best to enable service users to enjoy a varied and active lifestyle and staffing levels must not impact on this. Care Homes for Older People Page 8 of 27 The organisation must review the arrangement that the registered manager works on the rota for over half of the week. 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 27 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 27 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. Service users are only admitted to the home following a needs assessment. Information about the home is up to date and reflects the service available, it is accessible for service users Evidence: The service users living at the home are well established and there were no current plans for any new admissions at the time of the inspection, the majority of service users are now aged over sixty five.Care plans contained pre admission assessment information and individual contracts. The statement of purpose and service users guide are up to date and give clear information about the home,each service user is given a pictorial copy to keep in their room which is replaced if they loose it. As most service users are now ageing the home is catering for a wide range of needs and abilities and is reviewing needs regularly to make sure they can continue to be met. Care Homes for Older People Page 11 of 27 Evidence: Care Homes for Older People Page 12 of 27 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. Care plans reflect the current needs of service users and service users are becoming more involved in the developmemt of the plans. The information in care plans needs to be made more accessible for service users and staff. Medication procedures are thorough and staff follow the policies and procedures in place. Staff treat service users respectfully and are aware of individual needs and preferences. Evidence: Service users have individual care plans that incorporate health action plans and person centred planning documentation.The home is continuing to develop person centred planning and the three care plans read contained varying amounts of information that service users had been involved in compiling.The plans were being regularly reviewed and there was evidence of reviews taking place with social services Care Homes for Older People Page 13 of 27 Evidence: representatives and dates for the next meeting. Likes,dislikes and personal preferences were being recorded clearly and there was information about activities service users like or would like to participate in as well as about their other aspirations.One service user had identified they would like to live in a smaller home.It is important that the process of developing PCPs fully for each service user is completed and information needs to made more accessible for them, for example by the use of photographs or pictures.Whilst their involvement is in evidence most service users would not find the plans easy to understand. It is recommended that the amount of information in care plan folders be reduced by archiving some very old information to make current documents easier to find. Health needs are well recorded and service users have regular health checks,one service user had been for a check during the morning and said their blood pressure and other checks had taken place. Any health concerns are referred to health colleagues promptly, a service user whose behaviour had changed recently had been seen by their consultant and medication reviewed. Risk assessments are in place,if needs changed or a new risk was identified they were prepared or reviewed. Medication procedures are improved and now all medication,creams and ointments are more securely stored.All staff who administer medication are trained to do so and staff administering rectal PRN medication attended this training.Medication administration records were completed properly.One person self medicates and explained how staff support them by checking their dossett box daily. During the visit staff were observed to treat service users with dignity and respect and had good relationships with them,they knocked on doors and were aware of individual routines and preferences. Care Homes for Older People Page 14 of 27 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. Service users have opportunities to participate in a range of activities at home and in the community. The organisation must make sure that there are always sufficient staff available to facilitate planned community activities. Contact with friends and relatives is supported. Meals are healthy and nutritious and choice of meal is available. Evidence: Service users are supported by the home to attend a range of activities that are appropriate for their ages and abilities.Each person has a pictorial personal planner in their room and information about activities is on care plans. During the inspection several service users attended a day centre for part of the day,other activities include going to the gym,hydrotherapy,line dancing,shopping and art.The staff provide some activities at home and service users who wish to help with shopping at a nearby supermarket. Outings and social events are arranged,one service user said they liked going to the seaside and having fish and chips.Aromatherapy sessions have recently been started at the home and the manager is arranging for a specialist mobile activity Care Homes for Older People Page 15 of 27 Evidence: provider to visit the home regularly and hopes to arrange sessions at a dance night.Theatre and concert trips are organised,one was to see an Elvis show the following week.A small number of service users are able to go out independently.One spoke of going shopping and out for walks. Service users are offered holidays and take part in choosing them,those who do not like to stay away or travel far can have days out,holidays in this country and abroad have been arranged. Staff try as far as possible to make sure that service users attend all booked activities,although there is a shortage of staff who drive and recent sickness had curtailed staff availability for some activities,where possible if there is no driver a taxi or public transport are used.It is hoped that more drivers can be recruited. Contact with relatives is supported,one service user said they like the location of the home as they can visit their mother each week,another said they stay with a relative for holidays, telephone contact is supported if relatives are unable to visit. The menu is healthy and varied,a summer menu to be started in a few weeks has been prepared and agreed with the homes dietitian.Two service users require a soft diet and this is catered for.The main meal is taken in the evening.Service users contribute to meal planning this was evidenced in the service user meeting minutes.Choice of meal is always available and service users who commented on the food confirmed there was choice and said they liked the meals.Those who are able and choose to can help with some food and meal preparation, such as laying tables and preparing vegetables. Lunch was a relaxed and sociable time, the dining room could do with repainting and some refurbishment as it is a little gloomy looking. If service users wish to they are supported to attend church regularly. Care Homes for Older People Page 16 of 27 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. Service users and thier representatives can feel confident that any concerns will be taken seriously and addressed. The policies and procedures in place at the home protect service users from harm. Evidence: The home has a complaints procedure that is available to service users in a pictorial format and included in the service users guide.One formal complaint had been made since the last key inspection,the registered manager had addressed it in accordance with procedures and written to the complainant regarding the actions the home had taken as a result of the concern.Some service users would need the support of a staff member or representative to raise a concern due to limited communication. There had been one safeguarding vulnerable adults alert since the last visit,the home was not implicated in the alert and it was closed.Staff have safeguarding training that is regularly updated. Advocacy can be made available for service users and one currently has an advocate who they see on a regular basis. Care Homes for Older People Page 17 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and provides a comfortable environment to live in. Service users bedrooms are decorated and maintained to a high standard. The living and dining room need some refurbishment to keep them pleasant to use. Improvements and maintenance requested to bathrooms and toilets must be carried through in the interests of health,safety and hygiene. Evidence: The home was clean and tidy throughout and service users bedrooms were very well presented,they are nicely decorated and personalised,personal items include photos,posters,TVs and radios,ornaments and cuddly toys,each bedroom has a wash hand basin.Most of the bedrooms are upstairs, there is no lift.One bedroom is equipped with a hoist and commode for the personal use of the occupant. Shared areas are the through lounge/dining room,smoking room and kitchen. The lounge and dining room were clean but need some refurbishment as some furniture is damaged by general wear and tear.The smoking room was identified at the last inspection as needing work done as the carpet is stained and the ceiling has water damage from an upstairs water leak,the registered manager provided e mail evidence that the organisation was taking action on the smoking room.There are grab and handrails thoughout the home. The kitchen was clean and hygienic,all opened food jars or Care Homes for Older People Page 18 of 27 Evidence: bottles in the fridge are labelled with the date of opening and staff said they are very aware of the need to meet high food hygiene standards. There is a shower room and two bathrooms upstairs,one bath had a damaged panel that was rusty and broken,again the manager evidenced that this was reported to the organisation for action,this must be acted upon as soon as possible .There were no hand towel dispensers in any toilets or bathrooms,an order for them was seen,it was hoped they would shortly arrive.There is a Parker bathroom downstairs, the woodwork panel needed repainting,again this had been reported by the manager to the organisation for action recently. The home is not equipped with a thermostat to control the heating so heating is on even when the weather is hot which can be uncomfortable for service users and staff, the home has to arrange for it to be turned on and off daily under these circumstances which is impractical. The back garden is well kept and accessible with a patio area,the small front garden area was unkempt looking with litter and the front door needs repainting.It is recognised that the home is near a public area where litter is dropped and blows about but the first impression of the home is marred by this. The laundry was clean and hygienic and red bags are used for any soiled items. Care Homes for Older People Page 19 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisational recruitment processes protect service users. Staff are well trained and supported and have good relationships with service users. The registered manager is working as a member of the care staff for three days per week and this does not allow for sufficient time to meet management responsibilities in full. Evidence: The home is staffed by care staff and a deputy manager supports the registered manager.Four staff are on duty during daytime shifts with two waking staff on at night.Due to staff sickness over recent months some bank and agency staff have been used,they are people who are familiar with the home and they receive supervision from the service.Where agency staff are used the manager gains information from their agency that they have been successfully vetted. During the visit two care staff,a shift leader and the registered manager were on duty in the morning,there was changeover in the afternoon.There was a good mix of male and female staff of different ages.The registered manager is on the rota for three days per week and has Care Homes for Older People Page 20 of 27 Evidence: two days to devote to management activities.This does not allow for adequate time to be given purely to management and organisational tasks and duties. Despite limited time the manager is to be commended on the standard of staffing,training,supervision and other documentation he is responsible for that was read during the visit. As referred to in the lifestyle outcome area there are not always enough drivers on duty to take service users to activities planned,partly due to limited numbers of staff who drive. Staff spoken with all said they liked working at the home,they were keen to give information for the inspection and had a good rapport with the service users.Service users were treated respectfully.One member of staff said service users were like family and they enjoyed taking them out and on holidays.There is a key worker system,staff were aware of individual service users needs and were well established at the home. Staff files were sampled,all were maintained to a good standard,all necessary documentation was in place and where documents such as CRBs are received by the head office they supply evidence of this.Staff are required to fill in an internal form annually stating if they have any recent cautions or convictions. The manager keeps the training schedule up to date,core training is regularly updated,safeguarding training is updated annually and specialist training is provided.The manager and two staff members have so far attended equality and diversity training.Fifty per cent of the permanent staff have gained an NVQ in care,a new staff member had started NVQ 3. Staff receive regular recorded supervision and annual appraisals and staff meetings are held. Whilst the provision of staff training and supervision is good and staff are doing their best to meet all the service users needs, it is not satisfactory for the registered manager to need to devote over half their working week to working as a carer.The organisation must employ more staff so the home can be more suitably staffed at all times and there are more drivers available to take service users to activities. Care Homes for Older People Page 21 of 27 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. The home has a friendly atmosphere and is run in the best interests of service users and staff. The registered manager runs the service efficiently,they should be further supported in their role by being given more time to devote exclusively to the management of the service. Quality assurance systems are in place and the views of service users and others are acted upon. Evidence: The home has a friendly and welcoming atmosphere,staff were keen to help with the Care Homes for Older People Page 22 of 27 Evidence: inspection and give information on the service,service users and their roles. The registered manager is experienced and well qualified and makes sure that he keeps up to date with new legislation and related training such the Mental Capacity Act. Staff are well supervised and there is an open door policy. The home and organisation undertake quality assurance,Regulation 26 visits take place and are well recorded,the manager records actions taken as a result of the visits. This years survey results had started to come in from relatives,forms so far returned gave positive feedback.The views of service users are sought via service user meetings,individually and through surveys. All documentation that was the responsibility of the manager had been completed as required and in addition extra information such as a very useful folder of information containing documents and information needed for inspection purposes had been prepared in case the manager was not available when an inspection took place.The use of the managers time the majority of the week as a member of the care staff must be addressed by the organisation. Regular health and safety and maintenance checks take place,work needed is identified and reported.Improvements are being made to the home to improve safety measures during the visit magnetic door closures were being installed and shortly intumescant door strips were to be fitted.Regular fire drills take place and fire risk assessments are inplace. The employers liability insurance certificate had run put two days before in visit and the managed had not yet received the new certificate. Policies and procedures are in place for the management of service users finances. The AQAA (Annual Quality Assurance Assessment) that each registered service is required to complete was received within the timescale given and completed to a very good standard.The home informs the Commission of any matters that we need to know about and an improvement plan was developed after the last inspection in response to the recommendations then made. Care Homes for Older People Page 23 of 27 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 27 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 21 13 R13(4)(a)(b)(c) 06/06/2009 The registered person shall make suitable arrangements to prevent infection,toxic conditions and the spread of infection in the care home. All parts of the home to which service users have access are so far as is reasonably practicable free from hazards to their safety,avoidable risks and unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. In that the damaged and rusty bath panel in one of the upstairs bathrooms must be replaced 2 37 12 The registered person shall 30/06/2009 ensure that the care home is conducted so as to make proper provision for the care and where appropriate treatment,education ans supervision of service users. Care Homes for Older People Page 25 of 27 The registered provider must review the arrangement that the registered manager has limited time for dedicated management responsibilities and must provide sufficient staffing to make sure that service users can attend planned activities. 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 It is recommended that person centred planning include information that is accessible for each service user and care plan information be made easier for staff to access. It is recommended that the front garden be made more attractive and free from litter and the front door be repainted. The living and dining room furniture that is damaged be replaced and plans be made for the redecoration of both rooms. It is recommended that the organisation install a thermostat to the home for the comfort and well being of service users to keep the temperature at the home at a suitable level. It is recommended that the organisation always supply the home with a new insurance certificate to display before the last one runs out. 2 19 3 21 4 34 Care Homes for Older People Page 26 of 27 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. 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