Care Home: Milldene Nursing Home

What the care home does well People using the service receive good care that is organised to suit their individual needs. Staff have appropriate training to meet the needs of the people at Milldene. Good information is kept about peoples` care and health needs that ensures that they get consistent care. Care plans are updated to reflect any changes to peoples` care and health needs. The systems in place for managing medicines protect people living at Milldene. Social activities are very well organised and planned to suit the needs of individuals using the service. The food is well cooked and presented taking account of individuals` taste and specific needs. Milldene provides comfortable accommodation that suits the needs of the people living there. Appropriate aids and equipment is available to ensure that each person is supported in their daily lives. Good levels of staff who are well trained are available to meet the needs of the people staying at the home. Recruitment practices and procedures are clear and protect people using the service. Good management systems are in place and these ensure that good quality care and support is provided. What has improved since the last inspection? The manager is now registered with the Care Quality Commission. Life histories are available in each person`s records and these provide good information for staff. Staff have received accredited medication training. Staff photographs are available in each staff member`s file. Fire tests are being carried out at appropriate intervals. A programme of redecoration of bedrooms is ongoing and this means peoples` rooms are comfortable and reflect their personal taste. The carpeting near the kitchen door has been replaced with easily cleanable flooring. What the care home could do better: Further staff training should be provided to ensure that they are clear about the need to protect peoples` privacy and dignity when the chiropodist visits. Systems should be in place to ensure that complaints records are completed to show how the complaint was investigated, the outcome of any investigation and whether or not the complainant is satisfied. Key inspection report Care homes for adults (18-65 years) Name: Address: Milldene Nursing Home 34 Field Street, Off Station Road South Gosforth Newcastle Upon Tyne Tyne & Wear NE3 1RY     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: Anne UrwinBrown     Date: 2 0 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 Adults (18-65 years) 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Milldene Nursing Home 34 Field Street, Off Station Road South Gosforth Newcastle Upon Tyne Tyne & Wear NE3 1RY 01912846999 01912131521 amanda.bain@anchor.org.uk www.anchor.org.uk Anchor Trust care home 13 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) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Milldene is a care home with nursing, providing care for 13 adults with enduring mental health problems. The home is owned and managed by Anchor Housing Trust, a large national provider of services to vulnerable client groups. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is situated in South Gosforth in the city of Newcastle upon Tyne close to local shops and good public transport links. The building has two floors with single bedrooms, all with en-suite facilities. The home has a suitable passenger lift facility. There is a large dining and sitting room on the ground floor and a small room designated for smoking. Residents have access to a communal bathroom and a shower facility. Fees range from £499.30 to £555.30 per week. A Statement of Purpose and Service User Guide are available at the home to help people when selecting a home. 13 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit: We looked at: Information we have received since the last visit. How the service dealt with any complaints & concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service & their relatives, staff & other professionals. Care Homes for Adults (18-65 years) Page 5 of 28 The Visit: An unannounced visit was made on 20 January, 2010 and a further visit was made on 2 January, 2010. The visits lasted a total of eight hours. During the visit we: Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe & comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. Care Homes for Adults (18-65 years) Page 6 of 28 What the care home does well: What has improved since the last inspection? What they could do better: Further staff training should be provided to ensure that they are clear about the need to protect peoples privacy and dignity when the chiropodist visits. Care Homes for Adults (18-65 years) Page 7 of 28 Systems should be in place to ensure that complaints records are completed to show how the complaint was investigated, the outcome of any investigation and whether or not the complainant is satisfied. 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 Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Good arrangements are in place to ensure that the home is able to meet the needs of the people using the service. Evidence: There are good systems in place for planning an admission that focuses on the personal needs of the individual. Prospective residents and their families are fully involved and are central in making decisions about how the process of admission is managed. There is emphasis placed on responding to individual needs for information, reassurance and support. The Statement of Purpose provides good information about the service provided and it is updated annually. It is also available in large print, other languages and there is a DVD available to tell people about the service offered by Anchor Homes. A comprehensive needs assessment is undertaken before admission by staff. The home also obtains a care management assessment and care plan before admission. Individuals are supported and encouraged to take part in the admission process. Information is collected from a range of sources including professionals working with Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: the person, relatives and from pre-visits to the service by the individual. One person said that she had been involved in the admission process and was satisfied that there was enough information for her to make the decision to come to live at Milldene. Before agreeing to an admission the service carefully considers the assessment information and the capacity of the home to provide a suitable service. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 in the home receive good quality care that is organised to suit their individual needs. Evidence: Each person has a care plan that is based on a central assessment. The plan is developed to suit the needs of the person concerned taking account of their views and preferences. Plans include reference to equality and diversity issues relevant to each person. There is clear information to show the development of plans and peoples changing needs. Information about peoples health care needs is clearly recorded. One person living in the home said in a questionnaire returned to Care Quality Commission that staff look after me very well. Care plans are up to date and there is evidence of good systems for reviewing plans. Any restrictions on freedom or choice are clearly identified and involves the person in the decision making process. Plans reflect peoples changing needs and are updated to take account of these. One person said that she was pleased with the quality of care Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: and felt satisfied that staff knew what she needed help with. She said that they were kind and always had time to talk to her. Each plan included comprehensive risk assessments that were up to date and clear. The service has a positive view towards risk assessments that focuses on supporting people to live the life they want to lead. Records show that assessments are regularly updated. Any limitations on freedom, choice or facilities are in peoples best interests and these are well documented and agreed with the person concerned and their representatives where necessary. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to make choices about their routine and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits individuals. Evidence: People are encouraged to live an ordinary, meaningful life that is suited to their individual needs. Staff recognise the importance of enabling people to take an active part in life in the local community. Policies and procedures for staff take account of the need to respect peoples rights and their equality and diversity. There was evidence that people are encouraged and supported to follow their interests and hobbies. Outcomes for people are positive and people said that they receive good support from the staff. People were relaxed and looked happy during the inspection. Staff were respectful towards people and there was evidence that individuals preferences were Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: well known to the staff. Staff said that service users are out regularly in the local community using local services and facilities. On the day of the inspection two people were out shopping locally and they said they enjoyed going out regularly. Visitors are always welcome at any time and links with family and friends are supported and encouraged. Daily routines are organised to suit individuals needs and preferences. Staff knocked on peoples doors and waited for permission to enter during the inspection. There was evidence of a relaxed atmosphere and a good rapport existed between staff and people living in the home. Menus show that meals are well balanced and nutritious and are based on healthy eating principles. Alternatives are available for people so that there is a choice, although individual likes and dislikes are well known to staff. Staff provide assistance to those who have difficulty with feeding and special diets are provided. Particular dietary needs are identified within individual care plans. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive appropriate personal and healthcare support to ensure that their needs are effectively met in the way that they prefer. Evidence: Individual plans provide good information about the personal and healthcare support provided to each person living at Milldene. Staff demonstrated a good knowledge of the care and support needed by each person. Individual choices about routines and lifestyle are respected by staff. People have the aids and equipment necessary to help them lead a normal life. Examples of specialist help from tissue viability nurse, psychiatrist, chiropodist and others were identified within individual records. There was evidence that good assessment tools are in use to ensure that peoples needs are reviewed regularly. One concern was identified when the chiropodist provided treatment on the ground floor corridor to a person living in the home with staff present. This was discussed with the nurse on duty who spoke to staff about this bad practice and lack of dignity for the person concerned. She said that this has not happened before. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Staff training has been provided to ensure that appropriate skills are available to support individuals. The home fully respects the rights of people living at Milldene in the area of healthcare and medication. Staff are alert to changes in mood, behaviour or general well-being and understand how they should respond and take action. There are good procedures and policies in place to protect service users receiving medication. Records of administration of medicines are well maintained and ordering and disposal records were available for inspection. Arrangements for the storage of medicines are satisfactory. Staff training in administration of medicines has been provided. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the good systems in place at Milldene for dealing with complaints and safeguarding. Evidence: A good complaints procedure is in place that is clearly written and easy to understand. There has been one complaint made in the past year and information about how this was dealt with was available, although not fully recorded in the complaint record. The record was completed for this during the inspection. Systems are in place for recording any complaints, the investigation and outcome, but had not been followed for the complaint received. One resident said that she would speak to the staff if she had any concerns and was satisfied that they would take her concerns seriously. Questionnaires returned by people using the service showed that they were satisfied that the staff listen to them and act on what they say. There have been two safeguarding referrals made since the last inspection. These matters have been acted upon appropriately. Clear policies and procedures are in place for safeguarding adults. Staff at the home demonstrated that they are aware of what the procedure is and how to respond. They receive updating training in safeguarding and a session was planned for shortly after this inspection. Individual risk assessments protect residents from potential self-harm. People are also protected by good staff recruitment procedures and practice. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Any money held on behalf of people living in the home is recorded. Good recording systems are in place to show any transactions and to keep a running total of money held. Care Homes for Adults (18-65 years) Page 19 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. Milldene provides a comfortable, well maintained and decorated accommodation that suits the needs of the people living there. Evidence: This purpose built home provides comfortable accommodation on two floors and has a shaft lift fitted to provide access to the first floor. The home is situated in a pleasant residential area near to the centre of Gosforth with bus links nearby to Newcastle city centre. It has a secure garden to the rear of the building, which can be accessed from the sitting/dining area. The home was clean, tidy and homely and is easily accessible with flat access at the front and rear doors. There is a good sized sitting/dining area, which is well used by the people living in the home. The furniture and fittings are of a good standard and are organised to suit clear access for people in wheelchairs and those with mobility problems. Good arrangements are in place to ensure that repairs and maintenance is carried out as necessary. Redecoration is carried out at regular intervals and the decor throughout the building is good. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Bedrooms are personalised and very attractive. People have music systems and televisions in their rooms as well as ornaments and pictures to suit their taste. Equipment including air mattresses and hoists are available in bedrooms to suit the identified needs of residents. Records show that equipment is regularly checked and serviced. Two people said that they were very happy with their rooms and that they had been given opportunities to make choices about furnishings and the decor. The bathrooms and shower rooms are well fitted with aids to suit peoples needs. In one shower room the fan needed cleaning and in the bathroom the heater needed cleaning. Both these jobs were completed before the inspection ended. No odours were evident during the inspection. Cleaning materials and other potentially hazardous substances were safely stored. Policies and procedures were in place relating to the Control of Hazardous Substances and Infection Control and other Health and Safety matters. Training is provided in Health and Safety and Food Hygiene. The laundry is well organised and equipped and people can assist with their laundry if they are able. There is a washer with sluice facility and a dryer provided. Care Homes for Adults (18-65 years) Page 21 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient appropriately skilled and trained staff to meet the needs of the people living in the home. Evidence: There is a nurse and two care staff on duty throughout the day at Milldene. At night there is one nurse and one care staff on waking duty. The staff rota shows that staffing levels are maintained at this level and that this is adequate to meet the needs of the people living at Milldene at present. Records show that individual support is provided to ensure peoples needs, aspirations and activities are met. Staff demonstrate a good rapport with residents. The culture in the home is positive and staff said they enjoy working there. There is a good atmosphere in the home and residents appear well cared for with their individual needs met. Good recruitment procedures are in place and records show that these are followed. Staff records contained appropriate information. This included two references and criminal records checks. A comprehensive induction takes place for new staff that includes reference to equality and diversity issues. Staff said that new staff members are well supported and they given enough information about the service and the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: people living there to be able to help them understand their role and responsibilities. Records show that staff have appropriate training opportunities to help them with their work. Nurses are encouraged and supported to keep up with their training. All staff have received statutory training that relates to health and safety. Training has been provided in infection control, health and safety, first aid, moving and handling, protection of vulnerable adults, foot care, and medication administration. Staff said that they get plenty of training opportunities. Care staff have opportunities to access training leading to national qualifications. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 benefit from living in a well managed home and are encouraged to put forward their views. Evidence: The manager is now registered with the Care Quality Commission. She previously worked in the home and is experience in working with people with mental health problems. She has a good knowledge of the systems at Milldene and of the people living in the home. Records show that there are good systems in place to help her develop her knowledge of the organisations strategic and financial planning systems. She understands the importance of equality and diversity and person centred planning in planning the services development. She also is aware of the legislation relating to Deprivation of Liberty and of who to make a referral to if the need should arise. There is a good system of quality assurance in place that takes account of the views of people involved with those using the service. Monthly checks and audits provide good information that is used to assess the quality of the service. There was evidence that the manager is developing her knowledge of the value of these systems. Action plans Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: focus on areas of planned improvement and provide clear goals for future work. Staff said that the manager is open and they feel able to discuss any issues or proposals for changing the delivery of the service with her. All working practices are regularly reviewed. Good systems are in place for checking on health and safety in Milldene. Records are kept to show regular checks or tests of equipment. Appropriate training is provided for staff and regularly updated. Risk assessments for the premises and for fire are in place. Accident records are kept in an appropriate form. Care Homes for Adults (18-65 years) Page 25 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 Adults (18-65 years) Page 26 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 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 18 Further staff training should be provided to ensure that they are clear about the need to protect peoples privacy and dignity when the chiropodist visits. Systems should be in place to ensure that complaints records are completed to show how the complaint was investigated and the outcome of any investigation and whether or not the complainant is satisfied. 2 22 Care Homes for Adults (18-65 years) 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). 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. 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