Care Home: Moreland House

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What the care home does well The provision of health and personal care is good and is based upon privacy, dignity and respect. On admission to the home all residents have a nutritional assessment based on MUST, and weights are monitored on an ongoing basis with referrals being made to specialists if necessary. Residents told us that the food is very nice and that they are given a choice at mealtimes. Fresh fruit is available on a daily basis and drinks and snacks are also available throughout the day and night. People living at the home are encouraged to be as independent as is possible, with assistance being given by the care staff where necessary and appropriate. The premises are well maintained, clean and free from offensive odours. What has improved since the last inspection? Care plans are more person centred and those looked at gave a clear picture of the individual person and his/her needs. Social activities have improved and these include gentle chair exercises in the morning after breakfast, board games, quizzes and some external entertainers. Festivals and birthdays are celebrated by the residents and the home holds an annual summer barbecue which is always enjoyed by residents and their relatives and friends. What the care home could do better: There is still room for improvement around activities, especially those which encompass the wider community. Care plans need to include information on end of life wishes and also on where a person does not have capacity to make informed decisions especially on health and social care, medication, and financial management. Where a person is deemed not to have capacity it is necessary for a capacity test to be undertaken under the Mental Capacity Act 2005 with the outcomes and actions being clearly recorded. The administration of PRN (as required) medication must have the necessary protocols in place, and the controlled drugs cupboard must be in accordance with the new legislative requirements which can be obtained from the Commission`s website. Also a resident`s MAR (medication administration record) must include a photograph of the resident, and these were missing for many of the residents. It is also important that the registered manager receives regular supervision as required under the Care Homes Regulations 2001. Key inspection report br Care homes for older people br Name: Address: Moreland House 5 Manor Avenue Hornchurch Essex RM11 2EB br br     br br The quality rating for this care home is: br   br br two star good service br br 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: Sandra Parnell-Hopkinson br     br br Date: 1 2 1 0 2 0 0 9 br br 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. br br 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 br br 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. br 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 br br 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. br This is what people staying in this care home experience: br br 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 br Page 2 of 28 br br 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. br br Reader Information br 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 br br Internet address br br Care Homes for Older People br br Page 3 of 28 br br Information about the care home br Name of care home: Address: Moreland House 5 Manor Avenue Hornchurch Essex RM11 2EB 01708442654 01708443526 morelandhouse@btconnect.com br br Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: br br Moreland House Care Home Limited care home 16 br br Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Summary br 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 br br Choice of home br br Health and personal care br br Daily life and social activities br br Complaints and protection br br Environment br br Staffing br br Management and administration br br peterchart br br Poor br br Adequate br br Good br br Excellent br br How we did our inspection: This was an unannounced key inspection undertaken on the 12th October 2009. We arrived at the home at 08:00 hours. Evidence for this inspection has been taken from talking to staff and residents, the local authority, a tour of the premises, notifications required under regulations, viewing records and other documentation and from the AQAA (annual quality assurance assessment) which the home is required to complete and return to the Commission. The manager was available for most of the inspection. br br Care Homes for Older People br br Page 6 of 28 br br 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. Care Homes for Older People br Page 7 of 28 br br You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. br br Care Homes for Older People br br Page 8 of 28 br br Details of our findings br Contents br br 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 br br Care Homes for Older People br br Page 9 of 28 br br Choice of home br 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. br br 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 who use the service and their representatives are given the information needed to help them choose a home that will meet their needs. br br Evidence: The service has a statement of purpose that is available in the reception area of the home, together with a copy of the service user guide, complaints procedure and the last inspection report. All residents have a copy of the service user guide in their bedrooms. The statement of purpose is comprehensive and clearly sets out the objectives and philosophy of the service, and this document is regularly reviewed and updated. All prospective residents and their families are invited to visit the service and spend time with current residents. This is part of the process of giving them sufficient information to help them make an informed decision as to whether this home is the br Care Homes for Older People Page 10 of 28 br br Evidence: right one for them. A full assessment of need is undertaken prior to admission to ensure that the service can meet the identified needs of the individual. The assessment is conducted professionally and sensitively and involves the individual and his/her family representative, where appropriate. Wherever possible a life history of the individual is also obtained as this helps in meeting the future health and social care needs of the person. The assessment focuses on achieving positive outcomes for people, and this includes identifying and meeting the ethnic and diversity needs of the individual. New residents are provided with a contract which sets out in detail what is included in the fee, the role and responsibility of the provider and the rights and obligations of the individual. br br Care Homes for Older People br br Page 11 of 28 br br Health and personal care br 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. br br 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 health and personal care that people receive is based on their individual needs and the principles of respect, dignity and privacy are put into practice. br br Evidence: People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness and respect. The personal healthcare needs of people, including specialist health and dietary requirements are recorded in each persons care plan. The assessment, care plans and life history recorded in the files give a clear picture of the individual and his/her needs. During the inspection we observed that personal support is responsive to the varied and individual needs and preferences of the individual, and staff interaction was friendly and positive. This was confirmed to us when talking to many of the residents who told us that all of the staff are always kind and caring, and nothing seems to be too much trouble for them. Residents are encouraged and supported to be as independent as possible and to continue to take responsibility for their personal care needs, with assistance from staff where needed. br Care Homes for Older People Page 12 of 28 br br Evidence: Where necessary residents have access to healthcare services and this includes GP, dentist, optician and chiropodist. However, with cut backs within the local Primary Care Trust some residents are buying chiropody and dentist care privately. District nurses visit the home to attend to the nursing needs of some of the residents such as dressing wounds, taking blood and other health related needs. Risk assessments, where appropriate, are in place and these include residents who are at risk of falling. Currently the service does not use telecare equipment such as pressure mats and cushion alarms. Such equipment can be useful in alerting staff when a person at risk of falling gets out of bed or rises from a chair. This may not always prevent a fall, but it will alert staff of the possible risk so that preventative action can be taken sooner. Other aids and equipment such as hoists and zimmer frames are available. Currently many of the residents have varying degrees of memory loss, or a diagnosis of dementia. This may result in a person lacking capacity to make an informed decision in certain aspects of their lives. The recently introduced Mental Capacity Act 2005 starts from the assumption that, unless proven otherwise, every adult has the capacity to make a decision about their lives. It is therefore necessary to ensure that where a person indicates that he/she may not have capacity to make an informed decision about such things as health or finances, a capacity test must be undertaken with the decisions and outcomes clearly recorded on the persons file. This was discussed at length with the manager during the inspection, especially with regard to one particular resident. The manager has assured us that the necessary steps will be taken to ensure that the aforementioned processes are followed and recorded. The home has a good record of compliance with the administration of medication, and the local pharmacy undertakes regular audits and training of the care staff involved in the administration of medication. We looked at the administration of medication processes and generally these were in good order. However, it is necessary to have in place protocols for the administration of PRN (as required) medications and, again, this was discussed with the manager and the senior carer during the inspection process. Due to a recent change in the legislation around the storage of controlled drugs, it is necessary for the manager to ensure compliance with this new legislation and, again, this was discussed during the inspection. Information about this can be obtained from the Commissions website. The service continues to work on end of life care plans, and it is important that this work continues at a pace. However, from looking at correspondence and talking to the br br Care Homes for Older People br br Page 13 of 28 br br Evidence: manager and staff we are satisfied that care staff work to clear and robust practices when caring for individuals who have a degenerative condition or terminal illness. Care staff, together with the resident, family, GP and district nursing service would constantly monitor pain, distress and other symptoms to ensure that individuals receive the care they need. One relative wrote I know mum appreciated all the help and kindness you all gave her over the years. I would like to say a big thank you to you all. br br Care Homes for Older People br br Page 14 of 28 br br Daily life and social activities br 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. br br 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 who use this service are able to make choices about their life style, and are supported to develop and maintain their life skills. Social, cultural and recreational activities generally meet the expectations of the individual residents. br br Evidence: Residents are involved in daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. Where possible they have been involved in the planning of their lifestyle and quality of life. We spoke to one resident who told us that she really enjoyed reading and that the home had supplied her with a variety of books. Several other residents were involved in doing a jigsaw puzzle with some assistance from a member of staff. All residents are encouraged to participate in gentle chair exercises after breakfast to aid flexibility and mobility of arms and legs. The service is aware of the need to encourage and motivate residents in activities of daily and social life and continues to look at ways to involve residents in community and other social activities. The home is situated near to several local shops, and some residents like to visit the shops with assistance from the care staff. Family members and friends are encouraged to visit the home and also to participate in the celebration of festivals and birthdays. The home always holds a summer br Care Homes for Older People Page 15 of 28 br br Evidence: barbecue where residents, family, friends and staff can relax and enjoy each others company. One relative wrote We very much enjoyed the garden party this year, and so did mum. Shes the oldest resident but like many of the others still enjoys good music and this was a hit with everyone. Residents can continue to practice religious observance and this is supported by the service. During a tour of the home we were invited by several residents to view their bedrooms, and these were seen to have been personalised by the individual with items such as family photographs, some pieces of furniture and ornaments. Meals are well balanced and nutritional and cater for varying cultural and dietary needs of residents. We observed breakfast being served and staff were seen to be giving assistance in a discrete and sensitive manner. Mealtimes can be flexible and one resident, who likes to get up later in the mornings, was having breakfast at a time of her choosing. She told us I like to get up later and the staff dont mind even though it may be causing extra work for them. They are all so lovely and assure me that it is no problem to them. Residents told us that they enjoyed the meals and if there is anything that they do not like there is always something else to choose from. People are encouraged to retain control over their daily routines and this includes choosing when to get up and when to go to bed. Some residents like to have a rest during the afternoon and are enabled to do this. br br Care Homes for Older People br br Page 16 of 28 br br Complaints and protection br 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. br br 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 who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. People are protected from abuse and have their rights protected. br br Evidence: The home has a complaints procedure that is readily available to residents and visitors, and a comments book is also available in the reception area of the home where visitors and residents can write down their views on areas of concern or compliment. We spoke to several residents who told us that If I wasnt happy over anything I could always talk to Jane who always listens. The home has an open culture that allows people to express their views and concerns in a safe and understanding environment. People told us that they were very happy with the care at Moreland House, and that the staff are always kind, considerate and caring. The service maintains a comprehensive record of complaints and this includes details of the investigation and any actions taken. We looked at the current complaints log and found that the service does respond within the agreed timescale. The service learns from complaints and uses the outcomes to improve services. Policies and procedures are in place around safeguarding matters, and staff spoken to br Care Homes for Older People Page 17 of 28 br br Evidence: were aware of these and also of the whistleblowing procedures. Training records show that staff have undertaken training in safeguarding vulnerable adults. The manager demonstrated a good understanding of the procedures for safeguarding adults and would always work co-operatively with external agencies as required. There are no safeguarding issues at the time of this inspection. Staff were aware of what restraint is and that alternatives to its use in any form would always be looked for. Equipment that may be used to restrain individuals such as bed rails, keypads, recliner chairs and wheelchair belts would only be used when necessary, and following a risk assessment and multi-disciplinary meeting involving the individual where possible, and his/her representative. Another area of restraint could be prescribing and administration of medication and this has been referred to elsewhere in this report. br br Care Homes for Older People br br Page 18 of 28 br br Environment br 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. br br 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 physical design and layout of the home enables residents to live in a safe, wellmaintained and comfortable environment. br br Evidence: We undertook a tour of the home, and found it to be clean and free from any offensive odours. The home provides a physical environment that is appropriate to the specific needs of the people who live there. Specialist aids and equipment are available to meet the needs of residents. There is a lift to the first floor. The communal areas are well decorated and furnished and the bedrooms are single with en suite toilet and handbasin. The front garden is well maintained and provides some car parking facilities, and the rear garden is also well maintained with appropriate seating areas for residents. One resident told us that I really enjoy walking in the garden and also sitting and reading, especially on a lovely warm summers day. The service operates a good infection control policy and will seek advice from external specialists where necessary. br br Care Homes for Older People br br Page 19 of 28 br br Staffing br 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. br br This is what people staying in this care home experience : Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained and skilled to support the residents and the smooth running of the home. br br Evidence: The service has a well developed recruitment procedure that has the needs of people who use the service at its core. The recruitment of good quality care workers is seen as integral to the delivery of a good service. Residents told us that they have confidence in the staff who care for them, and that they are kind and caring. Staff told us that they work as a team and support each other for the benefit of the residents and themselves. Staff training is given a priority within the service, and approximately 75 of staff have achieved a qualification to NVQ level 2. Recent training has included dementia awareness, infection control, basic principles of food hygiene, Mental Capacity Act, drug safety and administration, safeguarding of vulnerable adults, basic fire awareness, basic health & safety, manual handling, slips, trips and falls and first aid. The service is aware of the need to improve on the documentation around end of life, and this will also include specific training for the care staff. Staff meetings take place on a regular basis and also all staff have regular supervision which includes 1:1 and observations of care practices. There is little use of any agency br Care Homes for Older People Page 20 of 28 br br Evidence: or temporary staff. br br Care Homes for Older People br br Page 21 of 28 br br Management and administration br 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. br br 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 management and administration of the home is based on openness and respect. The service has effective quality assurance systems. br br Evidence: The manager has the required qualifications and experience and is competent to run the home. Supported by the systems of the organisation, the manager is competent in delivering effective budgetary control. During the inspection the manager was able to demonstrate a clear understanding of the key principles and focus of the service, based on organisational values and priorities. The manager has a clear understanding of equality and diversity issues and of promoting human rights, especially in the areas of dignity, respect and fairness. The service has become more person centred, and there is a strong ethos of being open and transparent in the running of the home. Staff told us that the manager is very supportive, as is the wider organisation. br br Care Homes for Older People br br Page 22 of 28 br br Evidence: The service has sound policies and procedures which are regularly reviewed and updated, and the manager ensures that staff follow these. The home works to a clear health and safety policy and the manager ensures that staff put theory into practice. Observation of practices by the manager ensures that staff are working to the policies and procedures. Safeguarding of vulnerable adults is given a high priority and the homes policies and procedures underpin good practice. Where appropriate risk assessments are in place and are regularly reviewed. Where possible people are supported to manage their own money, but where this is not possible the homes arrangements are robust with receipts being provided against expenditure. Record keeping is generally of a good standard and the maintenance records were up to date as was the insurance cover to enable the service to fulfil any loss or legal liabilities. The service has quality assurance procedures in place and these include surveys to residents and relatives, together with feed back from health and social care professionals. The AQAA (annual quality assurance assessment) which is a document required by the Commission was generally comprehensive. Due to the resignation of the group manager, the registered manager is not currently receiving regular supervision. It is necessary for the organisation to address this issue to ensure that the managers practice, skills and knowledge is based on continuous development. At the time of this inspection there are no safeguarding issues nor any referrals under the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DOLS) br br Care Homes for Older People br br Page 23 of 28 br br Are there any outstanding requirements from the last inspection? Yes £ No R br br Outstanding statutory requirements br 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. br No. Standard Regulation Requirement Timescale for action br br Care Homes for Older People br br Page 24 of 28 br br Requirements and recommendations from this inspection: br 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. br No. Standard Regulation Requirement Timescale for action br br 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. br No. Standard Regulation Requirement Timescale for action br br 1 br br 7 br br 12 br br The registered persons shall 21/11/2009 so far as practicable enable service users to make decisions with respect to the care they are to receive and their health and welfare. Where people are not able to make informed decisions the registered persons must ensure that a capacity assessment is undertaken as required in the Mental Capacity Act 2005, and that the outcomes of this assessment are properly recorded within the care plan. Also that end of life aspect of the plan are included. br br 2 br br 9 br br 13 br br The registered persons shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. br br 30/10/2009 br br Care Homes for Older People br br Page 25 of 28 br br 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. br No. Standard Regulation Requirement Timescale for action br br The registered persons must ensure that the controlled drugs cupboard meets the requirements of new legislation with regards to drugs, and also that protocols are drawn up for the administration of PRN (as required) medication and that the photograph of each resident is at the forefront of his/her MAR sheets. This is to ensure the safety of the residents during the administration of medication. 3 36 18 The registered persons shall 30/10/2009 ensure that persons working at the care home are appropriately supervised. It is essential that the registered manager receives regular supervision to ensure that her practice, skills and knowledge, is based on continuous development for the benefit of the residents. 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. br No Refer to Standard Good Practice Recommendations br br 1 br br 12 br br The registered persons should continue to pursue br br Care Homes for Older People br br Page 26 of 28 br br 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. br No Refer to Standard Good Practice Recommendations br br community activities which would be of interest and beneficial to residents to enable them to continue to lead a fulfilled life. br br Care Homes for Older People br br Page 27 of 28 br br 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. br br Care Homes for Older People br br Page 28 of 28 br br - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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