Care Home: New Victoria Nursing Home

What the care home does well The manager tells us in the AQAA and we confirmed after speaking to the nurse in charge, the New Victoria has achieved the `Investors in People` award for setting high standards of staff training and development including the recruitment of staff and systems they have in place to ensure people are protected and provided with care and support they need. One staff member said, "Its an achievement". Training opportunities and development of staff skills continue to be a priority, so that staff have the confidence and competencies to provide the care and support people who live at the home need. Comments from staff confirm the manager is supportive for staff to gain qualifications and attend courses to ensure they develop skills and competencies. Some members of staff have obtained qualifications additional to the minimum standard. One staff member said in a survey, "The manager encourages us to attend training and develop ourselves". A person who lives at the home wrote in a survey "The people who care for us know what they are doing". Comments from people who live at the home spoken to and surveys returned recommended the quality of food provided. Varied meals and choices are available if people don`t like the main meal on offer. People are allowed meals in their own room if they choose to. The cooks are well trained to provide a variety of foods to suit people who are diabetic or require liquidized meals. The cook spoken to said, "We make home made meals when we can and provide a nutritious diet". What has improved since the last inspection? The requirements from the last inspection have been addressed to ensure people live in a safer place and receive the care and attention required to improve their quality of life. Care records we looked at were accurate and reflected the needs of the individual, there was now evidence of involvement of the resident in the care they receive where possible. One staff member spoken to said, "We have improved the way we monitor and record the care needs of residents". Fire records were now up to date and checks carried out on a regular basis to ensure people are kept safe. We looked at records of safeguarding adults training, spoke to staff and confirmed what the manager informed us in the AQAA. We found training is now provided for all staff and updated when necessary. One staff member said, "I have recently updated my safeguarding training". What the care home could do better: We walked around the building and found some repainting of doors in hallways should be completed to improve the look of the building and keep it well maintained. One staff member spoken to said, "We know it needs doing". Some bedrooms we looked in had worn carpets with tape to keep them together. These should be replaced to ensure residents live in pleasant, safe surroundings. The manager should look at the dependency of people who live at the home to ensure their needs can be met by the number of staff on duty at all times of the day, so that they are not at risk. One survey returned from a person who lives at the home ,when asked `what they could do better` said, "More staff". Key inspection report Care homes for older people Name: Address: New Victoria Nursing Home 137 / 139 Hornby Road Blackpool Lancashire FY1 4JG     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: Kevan Royston     Date: 0 5 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: New Victoria Nursing Home 137 / 139 Hornby Road Blackpool Lancashire FY1 4JG 01253621043 01253292342 newvictoria@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Regency Healthcare Ltd Name of registered manager (if applicable) Marion Gourlay Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is: 30 Date of last inspection Brief description of the care home The New Victoria Care Home is situated in a residential area of Blackpool, with good access to shops and amenities including a regular bus service. The home is purpose built and provides care and accommodation for up to thirty people. Residents are cared for with a wide range of needs, from residential care to nursing. The home is set on three levels. There are lounges, dining areas and bedrooms on all three floors. All bedrooms are single rooms. Care Homes for Older People Page 4 of 26 Over 65 30 0 1 2 0 5 2 0 0 9 Brief description of the care home There is a Statement of Purpose/Service User Guide, which is given to all prospective residents. This written information explains the care service that is offered, who the owners and staff are, and what the resident can expect if he or she decides to live at the home. Information received on 05/05/10 showed that the fees for care at the home range from £303.52 to £575.00 per week, with added expenses for hairdressing, chiropody and newspapers. Care Homes for Older People Page 5 of 26 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 visit was part of the key inspection process and took place on the 05/05/10. We spoke to people living at the home, staff, the manager in charge and to a group of residents in the lounge. Care, maintenance, previous inspection reports and other records were looked at, as well as a walk around the building. As part of the inspection process we talked to people using the service and asked staff about those people needs. We also looked at their rooms, care plans and daily notes, this is called case tracking. Other people who are living at the home were invited to pass their opinions to us if they wish. We received responses from surveys/ questionnaires sent to people living at the home and staff for their views on how the home is run. Comments we did receive were positive and some are included in this report. Care Homes for Older People Page 6 of 26 Every year the person in charge or manager is asked to provide us with written information about the quality of their service they provide and to make an assessment of the quality of their service. This document is called an Annual Quality Assurance Assessment (AQAA). We use this information, in part, to focus our inspection activity. Care Homes for Older People Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: We walked around the building and found some repainting of doors in hallways should be completed to improve the look of the building and keep it well maintained. One staff member spoken to said, We know it needs doing. Some bedrooms we looked in had worn carpets with tape to keep them together. These should be replaced to ensure residents live in pleasant, safe surroundings. Care Homes for Older People Page 8 of 26 The manager should look at the dependency of people who live at the home to ensure their needs can be met by the number of staff on duty at all times of the day, so that they are not at risk. One survey returned from a person who lives at the home ,when asked what they could do better said, More staff. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 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. The admission and assessment procedures were clear and precise, to ensure care needs of people who come to live at the home can be met and people can make an informed choice before moving in. Evidence: We looked at assessment information for two people living at the New Victoria, both had comprehensive information obtained by the manager who is a registered nurse and from social services funded residents, to develop a care plan and ensure their needs can be met. One person who lives at the home required nursing care, a full nursing assessment had been carried out by the home and social services to ensure all needs had been identified and a plan of care in place. We spoke to a person who lives at the home about the time she moved in and she said,It felt like home when I first came. A staff member said about the admission procedure, We Like people to visit a few times before moving in if possible to get to know us. Care Homes for Older People Page 11 of 26 Evidence: A care plan had been developed from the assessment information to ensure health, mental health, nursing, social and welfare needs are identified and care and support required can be met. Information looked at showed evidence of family involvement to gather information so that all needs of people who come to live at the home are looked at, this was confirmed from speaking people. Information in the AQAA confirms the assessment process continues to develop to ensure all details are provided to the home so that a detailed plan of care is developed and staff can meet the needs of residents Families and potential residents are given a Service User Guide (brochure) which details all the services and care on offer at the home to ensure people are given enough information to make an informed choice. One staff member wrote in survey All information about the home is given to families and potential residents. Standard 6 was not assessed as the home does not provide intermediate care. Care Homes for Older People Page 12 of 26 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. People who live at the home have their health, nursing and personal care needs met by staff who are caring and well trained to give respect, dignity,and privacy. Evidence: Care records looked at for people living in the home are comprehensive and set out a plan of care monitoring all nursing care, health and social interests. People have a say in the care they receive and in the way they are supported. This was evidenced by staff and residents spoken to, also people who live at the home and families signing they agreed with the care provided. Comments from staff and people who live at the New Victoria about the standard of care included, No problems with the care and support given to me from the staff. Also, The staff are willing to spend time with us. One person who lives at the home wrote in a survey,The staff are always happy to care for me. We discussed with staff the needs of people we case tracked they had a very good awareness of peoples needs and were able to discuss all aspects of the persons support and what care was required. One member of staff spoken to said, The care records have been improved to make them easier to follow and provide good support. Care Homes for Older People Page 13 of 26 Evidence: Each person has risk assessments in place to ensure their safety. Looking at records of care we confirmed these are updated monthly, or when necessary to reflect any changes that may have occurred in the building or individually ensuring people are protected and safe. We looked at the medication procedures with the nurse in charge, medication of people we case tracked had safe practices in place to ensure people receive the right medicine at the right time and they are protected by the procedures in place. One member of staff spoken to said, Nursing staff give out medicines. The manager in charge explained to us they have a good relationship with the pharmacist who visits the home to instruct staff on medication issues when required. One staff member said, We have a very good relationship with the pharmacist. We looked around the storage area where medication is kept and found everything in order and clean and tidy. We looked at records and confirmed nutritional screening of people who live at the home is monitored so that any health issues are noticed and acted upon. This was confirmed by information contained in the AQAA. Records of people who live at the home show they have access to health professionals and where possible a doctor (GP) of their choice. During our visit we talked to residents in their own room, the lounge area, individually and watched staff caring for people and helping them in a sensitive, dignified way. One person who lives at the home wrote to us and said, The staff are always respectful. The manager tells us in the AQAA how it is important for staff to care for people who live at the home with respect, dignity and equality. They are given instruction so they are aware of how to treat people to ensure respect is shown at all times, this was confirmed by talking to staff. One member of staff wrote in a survey, We encourage people to make choices about the way they spend time. Care Homes for Older People Page 14 of 26 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. Social activities and meals are well managed, creative and provide daily variation and interest for people living at the home. Evidence: Routines watched during the day looked relaxed, some people were sat in the lounge area and staff were carrying on with their daily routines. We noticed staff chatting to residents when they had time and nursing people who required attention in a dignified way. The home now have a member of staff spending time organising activities for residents to join in with which has helped provide entertainment and stimulation for people living at the home. Comments from people living at the home about activities and social events included, One staff member plans social events and bingo sessions. And, They try and please every one with putting bingo and other games on. The manager informs us in the AQAA of planned social activities, entertainment and trips out. One resident wrote in a survey, They try and put more things on now. The manager tells us in an effort not to isolate people who are bedfast more effort is made by staff to ensure their social needs are being met as much as possible. One staff member said, We try and get everyone to join with activities. Records show hobbies and interests of people who live at the home are written down so that staff are aware of what individuals prefer. Care Homes for Older People Page 15 of 26 Evidence: We had a talk to the cook and a look around the kitchen area which we found clean and tidy. We asked about training and one staff member said, Both of us have completed Food and Hygiene courses. Comments from people who live at the home about the standard of meals provided included, The food is very good. Also,Plenty of choice and enough of it. One of the cooks spoken to said, I always use fresh food and enjoy baking. Surveys returned from people who live at the home said about the meals provided, Good food. Records looked at show staff monitor the intake of food and liquid of people living at the home to ensure any concerns are identified and appropriate action taken. We spoke to the cook about liquidized meals which are prepared for some people who live at the home and the cook was well aware how to present meals so they look appetizing and are presented well. The cook said, Food is presented separately when we have to liquidize it. A visitors policy is available in the Service user Guide (brochure) which says visiting times have no restrictions. All people who live and work at the home spoken to confirmed friends and relatives are welcome any time. People we spoke to who live here confirmed they were able to bring some personal items into the home which was agreed during the admission. Rooms we were invited into had personal possessions around so that people who live here felt it was home. One person who lives at the home wrote in a survey, I brought my own items in . One staff member wrote in a survey, We encourage residents to bring their own furniture in. Care Homes for Older People Page 16 of 26 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. Arrangements for complaints are handled well and taken seriously ensuring people feel listened to. Evidence: Policies and procedures are in place for dealing with any complaints, concerns and issues people may have to ensure they are dealt with correctly and fully investigated with outcomes recorded. One person who lives at the home spoken to about complaints said, Yes I know how to make a complaint. A member of staff spoken to about complaints said, We do have a system for complaints. More information and details about the complaints policy is given to potential residents and their families in the brochure of the home. A survey from a person who lives at the home wrote, I have no complaints about the home or staff if I did I would say so. Information the manager gave us in the AQAA tells us of how they have provided safeguarding adults training for almost all staff to ensure they are aware of any signs of abuse taking place and are able to take the appropriate action. Staff spoken to confirm they have attended training both at the home and through the National Vocational Qualification (NVQ). One member of staff spoken to said, I have completed a course put on by the manager in safeguarding adults. Care Homes for Older People Page 17 of 26 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 building is kept clean, tidy and is maintained well. Evidence: We had a walk around the home and found it to be clean, tidy and maintained. The building is a large home, the furnishings and decoration are homely and ensure people live in pleasant surroundings. Comments from people who live at the home all commented on how clean it is kept. One said, The home is always clean. The manager tells us in the AQAA how they have improved the surroundings by putting new furniture in some rooms and continuing a programme of decoration. However doors to bedrooms and communal doors were marked and paint chipped off, these should be repainted to ensure the building continues to be maintained. We looked in some bedrooms and found carpets worn these should be replaced to ensure residents live in pleasant surroundings. The manager wrote in the AQAA when asked what they could improve, upgrade carpets in bedrooms. One member of staff spoken to said, The carpets in some rooms need replacing. A maintenance person is employed and a record of repairs is kept to ensure any problems are attended to quickly and people are kept safe. One member of staff spoken to said, Maintenance records are kept and repairs attended to. There is a laundry facility which is situated away from the kitchen and food Care Homes for Older People Page 18 of 26 Evidence: preparation area. Policies and procedures are in place for the control of infection to protect and safeguard people. Specific staff are employed to attend to laundry duties to ensure clothing and bedding is attended to on a regular basis. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The availability of training and good access to courses means the staff are well trained and have the skills to support people who live at the home. Thorough recruitment procedures are in place to make sure suitable staff are employed. Evidence: We looked at staffing rotas, spoke to staff and watched people being helped in a sensitive way. We found sufficient numbers of staff on duty at the time of the visit and a good mix of nurses, domestic and care staff to ensure needs of residents were being met. However the manager should look at the dependency of people who live at the home to ensure their needs can be met by the number of staff on duty between 7 & 9 pm. One staff member spoken to said, At times we are a bit short in the evening. Thorough recruitment procedures are in place to ensure suitable people are employed. We looked at staff records for recruitment and found all the checks required were in place and each staff member had been checked properly and received induction training. One staff member spoken to about the selection process said, The recruitment and induction process was informative. Speaking to staff and information in the AQAA confirm there has been little change in personnel for a long time which helps staff understand each other better and provide quality support for people living at the home. One staff member spoken to said,Most Care Homes for Older People Page 20 of 26 Evidence: of us have been here a number of years that tells you something how well we get on. A person living at the home spoken to said about the staff, The staff are very good at what they do. Training opportunities are good for staff to develop their skills and ensure people living at the home receive the right care and support from a competent staff team. One staff member said, Very good access to training courses. The manager tells us in the AQAA over 50 of care staff have completed the National Vocational Qualification (NVQ) to level 2 which is a recognised qualification in care. One staff member spoken to said, Staff now are completing level 3 and 4 NVQ. Staff spoken to said they are clear about their role and work well as a staff team to ensure the individual and collective needs of people who require a lot of nursing care receive it. One person who lives at the home wrote in a survey about the attitude of staff, I am always asked if I need anything or if I am alright. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run well with good systems in place for the protection of people who work and live at the home. Evidence: The manager is a qualified nurse and has the necessary skills and is qualified to support staff and people who come and live at the New Victoria nursing home, and ensure the home meets it aims and objectives. Comments from staff and surveys returned praised the manager on how the home is run,they included,The home is run well. Also, I feel we are supported by the management. There are good systems in place to get together staff, relatives and residents views on how the home is developing and how they feel the home is run. There are regular staff, resident meetings and questionnaires given out to people who live at the home and families periodically to get opinions on how the home operates. Records looked at for people living at the home we case tracked were found to be Care Homes for Older People Page 22 of 26 Evidence: comprehensive,well written, easy to follow and up to date, ensuring the information contained was correct and health and social care needs are continuously monitored. We looked at health and safety records and found a procedure in place for recording any accidents, regular checks on fire safety procedures and all equipment checked, ensuring the people who live and work at the home are kept safe. The home has achieved the Investors in People award for setting high standards of how the home operates, staff training and development including the recruitment of staff and systems they have in place to ensure people are protected and provided with care and support they need. One staff member spoken to said, We all worked hard to achieve this award. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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 19 Redecoration of doorways in some areas of the home should be completed to ensure the building continues to be maintained well. Some bedrooms for residents had worn carpets and repaired with tape, these should be replaced to ensure residents live in pleasant, safe surroundings. The manager should look at the dependency of people who live at the home to ensure their needs can be met by the number of staff on duty which decrease between 7 & 9 pm to ensure they are not at risk. 2 19 3 27 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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