Care Home: Montague Road Nursing Home

What the care home does well The home continues to provide good quality personal care and health care for its residents who all told the inspector that they were happy living in the home. Relatives tell us `my relative has been at Montague Road for 5 years. They could not have received better care anywhere else`. Several surveys from residents said `It provides me with all the care I need`. There was seen to be an easy rapport between the residents and the staff who encourage them to make as many appropriate choices and decisions about their own lives as it is safely possible for them to so do and who give the residents good support to live in the home as independently as possible. The home provides a high standard of accommodation which is maintained to a good standard of decorative order and repair. Accommodation is very spacious and unrestrictive and provides residents with a very homely and relaxed environment in which to live. We visited most areas of the home and found everywhere to be very clean and fresh. The home provides a wide range of activities outings and social events, which are planned to meet individual residents needs and to accommodate their interests and requests. What has improved since the last inspection? Following the requirements we made at the previous inspection of this home we received a detailed improvement plan. At this inspection we were able to see progress on all areas with those developments in matters such as information about the home, care planning and staff supervision. These improvements are reflected within the detail of this report. What the care home could do better: Detailed feedback was given at the end of the inspection and the manager was able to action matters immediately. We received information promptly that evidenced good staff recruitment and protection of residents through improvements immediately made with regard medication. This report contains one recommendation around the need for management checks to ensure the accuracy of the Medication Administration Record charts. Key inspection report Care homes for older people Name: Address: Montague Road Nursing Home 14 Montague Road Felixstowe Suffolk IP11 7HF     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: Claire Hutton     Date: 0 7 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Montague Road Nursing Home 14 Montague Road Felixstowe Suffolk IP11 7HF 01394670111 01394276021 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Orbit Housing Association care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Montague Road is a 24-bedded residential home with nursing, providing care and accommodation to older people who suffer from either organic or functional mental health problems. The home was initially registered in April 1993 and is purpose built, sited in a residential area of Felixstowe, close to both the town centre and sea front. All admissions to the home are via the Social Care Services Department due to the joint funding arrangements with Orbit Housing Association who staff and administer the premises. Living accommodation is sited on two floors and is divided into three main living areas. Each of these consists of eight bedrooms with ensuite facilities, a communal bathroom, toilets and a lounge and kitchen dining room. A secure garden surrounds the building and there is limited car parking to the front. Care Homes for Older People Page 4 of 27 Over 65 24 24 24 24 Brief description of the care home A Statement of Purpose Service User Guide provides detailed information about the home, the services provided and access to local services. This is available at the home. The Statement of Purpose Service User Guide showed current fees, which the manager advises us are £803.95 per week. These charges cover all care, accommodation, heat, lighting, meals, and laundry and continence products. They do not cover additional services such as the dentist, optician, hairdresser, personal items such as toiletries, clothing, or daily newspapers. 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 inspection took place over 8 hours during a weekday. This inspection focused on the core standards relating to older people. During this inspection the inspector made a tour of the building, had in depth discussions with the homes manager, met all the residents and spoke individually with many of them, spoke also with the staff on duty and carried out spot checks on a number of the homes records. The comments in this report reflect the findings made by the inspector during that visit and also take account of information gathered over the past months from the homes manager and by way of pre-inspection questionnaires completed by the majority of the residents, their relatives and other professional stake holders in the home. The Annual Quality Assurance Assessment (AQAA), issued by the Care Quality Commission (CQC) was returned completed by the manager. This self-assessment gives providers the opportunity to inform the CQC about their service and how well they are performing. Care Homes for Older People Page 6 of 27 We (CQC) also assessed the outcomes for the people living at the home against the Key Lines of Regulatory Assessment (KLORA). This was a positive inspection. The home had a well-ordered and homely atmosphere where staff and residents were seen to be interacting positively together. The residents looked happy and without exception all said that they were well cared for. Comments such as I am very happy and pleased with this home were made by the residents to the inspector. The requirements and recommendations made at the last inspection have all been met; one good practice recommendation was made following this inspection. 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: 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 8 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 9 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. Residents can be assured that admissions to the home are not agreed until a full needs assessment has been carried out and the home is satisfied that it can meet these needs. Sufficient information is provided for prospective residents and their families to enable them to make an informed choice about using the service. Evidence: There is information about 14 Montague Road in the form of a Service Users Guide and a Statement of Purpose. This document is very informative and contains information on how to access the service, fees charged and what is included and information on contracts. This document was last revised in August 2009. Assessment of health, social and care needs are completed by the manager. If it is thought that these could be met in 14 Montague Road then the prospective resident, Care Homes for Older People Page 10 of 27 Evidence: and if they wish it, friends or family members also, are invited to visit the home. The Service Users Guide states. A short visit and overnight stay will be offered for two nights to enable you to familiarise yourself with the home and team. We were able to examine assessments completed by the manager and see additional information that had been obtained from other professionals. This information enabled the manager to determine that they could meet residents needs before they were placed at the home. Care Homes for Older People Page 11 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. Good, up to date care plans are used on a daily basis. Residents are given every opportunity and encouragement to make as many decisions about their own lives, as is safely possible for them to do. The homes medication storage and administration system is generally robust and gives good protection to the residents. However, some improvements could be made. Evidence: The health and personal care needs of the residents are met following an assessment of their individual needs and with due reference to them retaining their dignity and respect. A number of care plans were inspected to track how the care was determined and delivered and to see how the level of support required was ascertained. Each plan was well maintained with all files kept in a uniform manner, with information filed within clearly defined sections. The recording was seen to be up to date and regular care need reviews and reviews of risk assessments could also be evidenced, these accommodating changing care needs. Care Homes for Older People Page 12 of 27 Evidence: The pattern of care for specific health needs such as pressure area care and continence care and nutritional care could be evidenced via the various recording charts including a waterlow score, manual handling, wound care and nutritional and weight recording charts which included the management of diabetes. The care records reviewed showed that residents have regular access to a variety of medical professionals. The self-assessment completed by the home told us We offer individual care packages that are agreed with the service user and their appropriate others, we involve staff in the plan of care and other professionals to ensure the best package of care is provided to each individual. We would agree with this statement as we found evidence to support this way of working. Social care professionals have been in touch with us and agree their is collaborative working. Relatives tell us my relative has been at Montague road for 5 years. They could not have received better care anywhere else. Several surveys from residents said It provides me with all the care I need. All the residents were observed to be wearing smartly laundered clothing. Overall the personal hygiene of the residents was very good and supported their dignity. Personal care was seen during this inspection to be being delivered to the residents in a kind and understanding manner by staff who clearly understood their care needs both physical and emotional. Staff were seen to reassuringly intervene when a resident became somewhat anxious, this being done in a manner which promoted their independence and feeling of well-being. The home continues to use the Monitored Dosage System (MDS) and a nurse was observed administering medication during this inspection. It was seen that each blister pack had a photograph of the resident for identification purposes. Administration around the home is carried out using a locked medication trolley, which is otherwise stored in the clinical room. This room is kept secure. The Medication Administration Records (MAR) charts were reasonably well maintained, but better use could be made of the reverse of these to give explanation of changes. We found that one persons medication had altered and this had been hand written as well as printed on the medication administration sheet. Therefore it was not possible to audit the medication for this one person. However after the inspection the manager confirmed with the surgery and that a mistake on the prescription had been made. The manager confirmed They have accepted the mistake was made on the prescription and have assured me a new prescription will be issued today. This error highlights the need for Care Homes for Older People Page 13 of 27 Evidence: a system to evidence the regular Management checks of the accuracy of the medication administration records. We also fed back to the management team the need for clear guidance on the use of PRN (as and when required) medication. Clear instruction of how much medication in what circumstances must be provided for staff to follow. 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. The diverse social and activity needs of the residents are well supported and enjoyed by all. The residents receive a healthy diet of freshly prepared good quality food, which is provided with good variety according to individual needs and preferences. Evidence: The home provides a wide range of activities outings and social events, which are planned to meet individual residents needs and to accommodate their interests and requests. Information about these activity programmes is advertised in the homes entrance hallway and individual activity planning was recorded on the residents care plans. The home employs an activities organiser who works several afternoons each week and in addition a number of care staff lead other activities on a daily basis. The range of activities over the Christmas period included a well attended pantomime on the day we were visiting, carol concerts and visits to the pub for some Christmas cheer as one resident said. In the surveys we were told about many activities that included crafts, bingo, dominoes, card games, hair and manicure sessions and visits to Easton Farm Park. Care Homes for Older People Page 15 of 27 Evidence: One resident said I like to go to the cliff tops and see the sea. I like to go shopping and have a cup of tea. Many of the residents surveys also said they were satisfied with the catering. One person spoke of how the home carefully prepared the food for their relative/friend to eat as they had swallowing problems. However, 2 people thought that choice could be improved around the evening meal. On the day we were there choice was seen to be given. The planned meal of fish pie did not happen because no one chose this however 3 other choices were given. The self assessment said We offer a nutritious choice of meals, we have family meals where we invite relatives to join service users for a meal. 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. The home has an open culture that allows the residents to express their views and concerns in a safe and understanding environment. The homes complaints policy is clear and freely available. The home has a good understanding of the policies and procedures concerning Adult Protection and how these give protection to the residents. Evidence: Information concerning the homes complaints policy and procedures was seen to be freely available in the home. Information gathered from residents and relatives evidenced that most people had a good awareness of these. However 3 people told us they did not know how to make a formal complaint, but also said I am very happy and pleased with this home or something very similar. Therefore we believe if people were not satisfied then information is freely available for them to use processes open to them. We looked at the log of complaints held by the home and tracked some information in detail. The responses we saw showed that matters are taken seriously and dealt with openly and fairly. Where needed other professionals had been consulted and reference to the Mental Capacity Act was in place. In addition there are no repeat matters being expressed by people who use the service, therefore we believe the service learns from concerns raised. The self-assessment told us We have a clear and robust procedure Care Homes for Older People Page 17 of 27 Evidence: for recording complaints. We have a multi stage approach to reviewing complaints and feedback. We view complaints as an opportunity to improve our services. In the last 12 months there has been 1 complaint made about this service therefore there are not an undue number of concerns raised. There have been 2 incidents concerning Safeguarding Adults (Adult Protection) since the last inspection. These have been investigated and resolved. We found the home had the relevant up to date information on adult protection. Staff consulted had a good awareness of safeguarding and were clear that they would refer matters. Refresher training for all staff was planned on 4 different days in the month following our inspection, therefore staff are kept up to date with practice and developments. Care Homes for Older People Page 18 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 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 very well appointed and subject to regular maintenance and so offers a good environment, which meets the space standards and the residents needs. Evidence: The home is divided into three living units each accommodating eight residents. In addition to bedroom facilities which are all for single occupancy and have the benefit of an en suite (some with shower), each living unit has its own lounge, dining room, kitchen and communal bathroom, with assisted bathing. There are two living units on the ground floor and one on the upper floor which can be accessed via a stairway or passenger lift. To the front of the building there is a large reception area, with comfortable seating, where residents can sit and watch the comings and goings of the home. Leading off the reception area there is a spacious communal lounge where larger homes functions can be held and where residents can spend some quiet time if desired. All units have unrestricted access into the homes enclosed gardens which are very attractive and maintained to a high standard. The home was clean throughout on the day of the inspection. Bathrooms were inspected and found to be clean and uncluttered with appropriate paper towels and liquid soap. There were stocks of protective clothing and gloves. Hot water is regulated by thermostatic valves, it was found to be at an appropriate temperature on Care Homes for Older People Page 19 of 27 Evidence: the day of the inspection when it was tested at a number of outlets. This minimises the risk of people living in the home scalding themselves when taking a bath or shower. The home was nicely decorated, and furnished. It was warm and comfortable offering a good standard of accommodation. Evidence was seen that people are provided with aids and equipment for the prevention of pressure areas, where required. Care Homes for Older People Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Experienced and trained staff are employed in sufficient numbers to support the people who use the service and thereby ensure the smooth running of the service. Evidence: The staff were observed to be working very well together as a team in a proactive rather than a reactive manner. They were enthusiastic about their work and clearly had very good relationships with the residents several of whom had also been living in the home for many years. The staff demonstrated a through understanding of the particular needs of the residents and thereby could deliver effective person centred care. The comments made by the residents both written and verbal evidenced that they felt that there was always sufficient staff to meet their care needs although some times of the day were always busier than others. Staff spoken with were keen to undertake further training and personal development. The home has good training records. Recent training included first aid, food safety, working with behaviour that challenges and dementia training. Staff had also received training in The Mental Capacity Act and were fortunate to have a manual handling coordinator at the home to deliver training and updates when needed. The manager spoke of developing a training plan for the home, but had more training planned for staff in dementia and safeguarding from abuse. Whilst we were there an NVQ assessor was visiting a staff member and gathering evidence for their qualification. The self Care Homes for Older People Page 21 of 27 Evidence: assessment told us that the home employ 28 care staff and of these 19 are NVQ qualified. The self assessment also said improvements with staffing had included Providing staff uniforms, providing much more training than in previous years and considerably increased the number of staff at the home. The recruitment records of recently appointed members of staff evidenced that the correct procedures and checks had been carried out and that the new staff had not commenced duties until CRB checks had been made. Care Homes for Older People Page 22 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. Residents and their relatives can be assured a competent, experienced and qualified manager and management team leads the home. The management and administration of the home is based on openness and respect. An effective quality assurance system is in place to ensure peoples views are obtained and incorporated into the running of the home. Evidence: The manager has the required qualifications and experience and is competent to run the home. She has a clear understanding of the key principles and focus of the service and her aim is to continually improve an increased quality of life for the residents, with a good awareness of the need for equality and an understanding of the diversity needs of the residents. However, at the point of writing this report we have yet to formally process the managers application to become registered. Staff and residents spoken with confirmed that the manager is supportive and Care Homes for Older People Page 23 of 27 Evidence: approachable. Staff consulted said the manager was a good communicator, was involved with all staff and service users and was approachable and knowledgeable. Written comments from relatives also confirmed this and evidenced that the home is run in the best interests of its residents. The home has clear health and safety policies of which staff had a good awareness. Spot checks made of these records during this inspection including fire testing, water temperature logs and risk assessments evidenced that the records are well maintained and that routine checking is carried out. We did discuss with the manager the need to have consistent fire procedures throughout the home. We did find evidence of inconsistent information posted around the home, but when consulting staff they were all aware of the same procedure to follow in the event of a fire. The manager agreed to audit information posted around the home. Records are kept securely and staff are aware of the requirements of the data Protection Act. The good maintenance of these records promotes the safety for the residents. This included the development of a disaster plan and contingencies should they be needed. We did discuss with the manager the requirements around notifications required by the Commission. We believe that the home was sending us information that we did not require, but this was able to be clarified and have since found that the correct notifications in line with regulation have been made. Appropriate staff supervision was evidenced from consulting with staff and from surveys returned. Regular staff meetings are held at the home as are regular hand overs from each shift. Therefore communication within the home is good. The home has a current Liability Insurance Certificate and the Registration Certificate was on display. The quality monitoring system includes written questionnaires and the information gathered from these is collated into an annual report. This was displayed for everyone to see in the main main public area. The recently introduced of the Annual Quality Assurance (AQAA) form, a self assessment, issued to the home for this inspection, was returned in good time with clear and detailed information. Care Homes for Older People Page 24 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 25 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 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 9 Management checks made of the accuracy of the Medication Administration Record charts should be formally recorded to provide a robust audit tool. Care Homes for Older People Page 26 of 27 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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