Care Home: Poppy Lodge Care Home

What the care home does well The new management have been in charge since 26th of August 2009. Poppy Lodge Care Home provides a safe homely environment and there is a strong management structure in place. Since August 2009, they have managed to improve the overall quality of the care people receive, they have nutritional and daily freshly cooked meals, fresh fruit, drinks anytime of the day, a number of different activities inside and outside of the home and generally the environment has been improved upon. The manager/providers has employed a full time activity organiser who focuses on group activities, 1-1 activities and outings within the local community. There is a musician and an entertainer who visit the residents regularly. A minister visits residents often and they have access to their local church. Some residents take part in the daily routines, such as, laundry, daily cooking, gardening etc. The medication system has been updated and improved upon. Risk assessments and care planning have been reviewed, re-written and includes people`s wishes, feeling and choices. Furthermore, the concerns, complaints and safeguarding issues which have been inherited from the previous management have been immediately dealt with and the necessary authorities, CQC, have been informed of every step taken and of the outcomes and actions taken. What has improved since the last inspection? This is their first Inspection since being registered in August 2009. What the care home could do better: For the Managers/providers to continue to develop the staff team so that people are supported better than they may of have experienced in the past. To further develop more person centred approaches to continue to improve the quality of life for residents. To fully implement the Annual Quality Assurance in August 2010 (when the service is a year old) so that feedback is given from professionals, residents and relatives. To continue to improve the environment so that it continue to improve the comfort, safety and suitability for all residents at Poppy Lodge. Key inspection report Care homes for older people Name: Address: Poppy Lodge Care Home 4 Drake Road Westcliff-On-Sea Essex SS0 8LP     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: Sarah Axam     Date: 1 8 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for 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) 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 26 Information about the care home Name of care home: Address: Poppy Lodge Care Home 4 Drake Road Westcliff-On-Sea Essex SS0 8LP 01702342793 01702342793 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Erbil Gulhan, Fatih Tekin t/a Poppy Lodge Care Home Name of registered manager (if applicable) Type of registration: Number of places registered: care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service: Care Home only - Code PC 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 Dementia - Code DE The maximum number of service users who can be accommodated is: 14 Date of last inspection Brief description of the care home Poppy Lodge cares for 14 older people, who may also have been diagnosed with dementia, in a residential area close to local amenities and the sea front. The home is on two floors and there is a passenger lift to enable access to both floors. There are 8 single bedrooms and 3 double bedrooms. The home has a large front car parking area Care Homes for Older People Page 4 of 26 Over 65 0 14 14 0 Brief description of the care home for staff and visitors. Inside there is a large lounge/dining area, conservatory and a large garden with an attractive patio area. 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: The unannounced site visit took four hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance of the registered managers/ providers and deputy manager. As part of the process a number of records relating to residents, care staff and the general running of the service were examined. We spoke with four residents, two relatives and three staff. We looked at all the information that we had received, or asked for, or what the service has told us about things that had happened in the service since the last inspection. Prior to this site visit, CQC (Care Quality Commission) sent out surveys to all interested parties and 8 were returned to us. Additionally the manager was sent an (AQAA) Annual Quality Assurance Assessment form by us (CQC). This is a self assessment required by law in which the provider can tell us how well they think the service is meeting the needs of the residents of Poppy Lodge. Care Homes for Older People Page 6 of 26 All information obtained was triangulated and reviewed against the commissions key lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. 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: 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 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 9 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. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. Evidence: The statement of purpose and service users guide was up-to-date and we found that it gave good information about the staff structure, their qualifications, the complaint process, support offered by staff, and any additional health services that maybe needed.(These have all recently been re-issued to the existing residents at Poppy Lodge) We were told by the manager/providers that this information can be provided in a number of different formats if need be, depending on their cultural and diverse needs of people. The managers/providers since taking over the service in 2009 have completed all new care plans for residents. We saw that the care plans are based on the Alzheimer society care planning structure/systems for care homes. We saw that this system is Care Homes for Older People Page 10 of 26 Evidence: based more on a person centred care approach and that all residents and families have been encouraged to be part of the reviews, care plans, needs assessment, risk assessments. Looking through care plans and pre -assessments, we saw that this system allows people a choice to say how they want their care to be carried out, what support they need and to know what has been written about them. Four residents and two relatives spoken with said that they felt better informed around care issues and felt included within this process. Again four of the residents we spoke with said that they felt they had plenty of information regarding the home, staff and support offered since the new managers/providers have been in place. Care Homes for Older People Page 11 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. Residents assessed needs are followed through in good care plans that give staff the necessary information to provide good care outcomes. Evidence: The Provider/managers told us that each person has a full assessment undertaken of their health and personal care needs and a care plan which describes how staff were to support the person. They also told us that staff received training people specific to the needs of residents including training in supporting people who have specific (dementia, diabetes etc) issues. All 8 surveys returned confirmed to us that they felt they were included in this process and that their views were taken on board and carried out by the staff. We looked at 10 resident care files and saw that each person had a health action plan, which described their needs and how staff were to assist and support them. Looking through daily notes showed us that staff knew individuals well and had the ability to record information. (The manager/provider has identified in their AQAA this area as one they wish to improve among the staff team, the quality of writing up/recording Care Homes for Older People Page 12 of 26 Evidence: notes/observations etc) We saw by records that staff supported service users to receive medicines and to monitor their general health and welfare. Looking through information it is apparent that the service has good relationships and support from other professionals and maintains good link with the local health authority and social services departments, we saw this by the letters and e mails received from those professionals and by what the people they support told us and our involvement with them. The manager/providers have recently changed the old medication system (that was inherited by the last owner) to the Boots monitored dosage system. We saw by documents looked through that boots provide audit checks and staff training. We saw that the booking in, disposing of and administration of medicines follow the expected Royal Pharmaceutical criteria and guidelines. Evidence of staff medication training and the fact that there have been no incidents reported around medication issues or practice would suggest that the administration of any type of medication is kept to a strict protocol and policy and procedures were good around these issues. Looking at the medication training, it showed us that they gave good guidance and knowledge to staff. Three staff spoken with confirmed this to us and said that they felt well supported by the management and knew the residents needs well. Care Homes for Older People Page 13 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. People using the service can be confident that their identified needs will be met appropriately and that they will be able to live the lifestyle they choose. Evidence: Previous to the current owners the residents informed me that very little activities were carried out with them. Four residents and two relatives spoken with felt that this had improved significantly. All 8 surveys returned confirmed to us that they felt they were kept occupied when they wanted with the activities or pursuits that they chose. Observation showed that staff although very busy at times, listen to and gave residents attention, respect and time. The manager/providers told us that they are encouraging residents to become more involved in activities and to maintain or even develop new social outlets and contacts. This is an aspect that we saw was included in every residents care plan and needs assessment. The home has a comprehensive activities programme for residents to engage in if they wish. During the inspection the activities coordinator carried out a session of light exercises with people. Speaking with 4 of the people about activities they told us that they felt happy that they were being provided with regular activities and that special occasions such as, birthdays, Christmas, Easter and other events were celebrated. Care Homes for Older People Page 14 of 26 Evidence: We saw that a four weekly menu is used that is of good nutritional value and speaking with people told us that it was of their choice. One resident had told us that they had requested fish on a Friday every week and this had been put into place without any hesitancy or question. We saw that the staff provide three meals each day with at least three choices for lunch, using only fresh produce. We saw and were told by the residents that snacks and drinks are available and we could see that fresh fruit was freely accessible. The manager/provider since buying Poppy Lodge, has sent round satisfaction surveys where they encouraged the residents to comment on the food and choice of meals being provided. Since August 09 the manager/provider has held 3 residents and relatives meetings to discuss all areas of the home, including, food and menus, activities, future refurbishment, etc. All comments and suggestions are considered, with many already put into practice. We saw this when looking through the minutes/notes of the residents and relatives meetings and by what people told us. Care Homes for Older People Page 15 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. There are systems in place to ensure that peoples views are listened to acted upon and support residents to be protected from abuse. Evidence: Previous to the current owners taking over the care of the residents living at Poppy Lodge Care Home, there were a number of concerns and safeguarding issues raised by various parties. Prior to exchanging contracts the manager/providers have shown a real dedication to deal with these issues. They have managed to raise the quality of care and have formed good partnerships with the Southend and Essex authority, CQC and the Safe guarding Vulnerable Adults department by following their gudance and resolving safe guarding issues that were raised. They have shown us that they are quick to respond to any suspicion of neglect or abuse of the residents and take advice given by other agencies quickly and work transparently with them. All of their staff are appropriately screened and trained in protection of vulnerable adults, we could see this by the 4 staff files looked through and other things such as, recruitment procedures, whistle blowing policy, induction and training records, incident records, the staff hand books issued, staff meeting minutes and 1-1 supervision support given to staff. Care Homes for Older People Page 16 of 26 Evidence: Again there were a number of concerns and complaints left without any action taken from the previous owner, which the current management followed up quickly and subsequently resolved. We saw that this had been carried out thoroughly and within expected timescales. (Looking through the complaint folder held with the premises and notifications sent to CQC and the safeguarding team). Four residents and two relatives spoken with said that they felt they could rely on the management team to resolve any concerns they may have to their satisfaction and that all staff were approachable. Three staff spoken with knew what to do if a complaint was received and about the safeguarding procedures. Additionally when entering the home, a complaint leaflet is freely available in the homes reception area. All 8 surveys returned confirmed to us that they felt they were able to make a complaint and knew who to go. 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. People live in a clean safe environment. Evidence: When we carried out a tour of the home we saw that it was fully accessible throughout for people who have physical disabilities. Throughout the home adaptations and specialist equipment were seen and fitted to blend within the homely environment. The management had a good infection control policy and all staff did have training to reduce the risk of infection, this was further backed up by the documentation we looked at (cleaning schedule, health and safety folders and training certificates) which protects the residents welfare. We saw that the management had a proactive infection control policy and they work closely with their own staff and all had training in universal infection control measures to ensure that infections are minimised. During the tour of the building there were no apparent odours and residents rooms were all clean and well maintained. All bathrooms, showers and toilet are in good working order, clean and provide plenty of facilities for all residents to use. Four residents and two relatives stated to us that their rooms were kept clean and that if there was any kind of a problem it was quickly rectified. We saw that there was a lockable storage room which holds all of the chemicals or substance hazardous to health, (COSHH) date and safety sheets were acquired and updated to ensure that Care Homes for Older People Page 18 of 26 Evidence: staff have the necessary documentation to refer to, so that safety is maintained. The management have employed a full time handy man, so that if anything needs repairing it gets done quickly, aside from the priority repairs there is a rolling schedule of maintenance of the inside and outside environment. The manager/provider told us that suggestions about improvements are discussed at the residents and relatives meetings or in writing in their regular questionnaires sent out. We saw this was the case in minutes held and questionnaires looked through. Additionally environmental risk assessments were in place to provide safe areas for all residents. Prior to purchase of Poppy Lodge care Home, there was concerns raised by Southend social services regarding health and safety issues of the environment of the home (mainly from adaptations and repairs needed). From the tour we undertook and looking at subsequent documentation such as the maintenance log, records of refurbishment and redecoration we saw that these concerns have been dealt with and to a good standard. For instance, the management have re decorated most of the residents rooms (which are personalised and people had a choice of their furniture, colours used and textures); the kitchen, all bathrooms, the homes corridors and all outstanding repairs have been completed. Further lightings have been applied internally and externally so that people can see and use all areas safely. 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. Residents are offered positive relationships by well-supported and caring staff and are protected by staff recruitment, induction and training. Evidence: We were told by four residents and two relatives and the staff on duty are regular people they see and we saw that there is permanent staff team in place. We saw by the staff rota produced that there is adequate cover for each shift. We saw by looking through the training records that this had been increased and included specific training such as, palliative care, the Mental Capacity Act, special dietary needs and dementia awareness. Regular training consisted of health and safety, infection control, recognising abuse, first aid, fire prevention and medication. Full records of these training initiatives were available to us, including the attendance sheets, training evaluation records and each staffs personal development plans. Speaking with the manager/providers their aim is to increase the percentage of care staff and that they all achieve a minimum of a Level 2 NVQ qualification. (This is currently low) The manager maintains a robust recruitment procedure. The file of the 4 most recently recruited staff were sampled; the required information was available. CRB (police and safeguarding checks for staff) are in place before a contract of employment and start date was offered to staff. New staff shadows the more experienced staff for a period of weeks, this practice gave them a chance to build a Care Homes for Older People Page 20 of 26 Evidence: rapport with individuals and get to know their needs well, before working independently. This would aid new staff to further refresh and gain knowledge, which is essential to their role, and also enable the management to monitor staff performance and progress within the expected probationary period. Looking through 4 staff records we saw that they had received the skills for care induction criteria and had regular supervisions. We were told that all appraisals would be carried out at the end of their first year of managing Poppy Lodge. This shows that residents benefit from a well trained and well recruited staff team. All three staff spoken with stated to us that they felt, they had up-to-date information provided to them regarding the people they care for, had a good thorough induction and covered everything they needed to know before starting the job and that they were given training relevant to their role and that they were updated regularly. 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 management strategies of the home were stable which ensures the health, safety and welfare of all residents. Evidence: One of the Registered provider has over 7 years experience in management and holds the Registered Managers Award NVQ Level 4 and Master degree in business administration (M.B.A).He has regular appraisal and supervision and attends regular training updates and meets his continuous professional development. The deputy manager is retired nurse and has ward management experience for 20 years from Southend University Hospital. The other provider and deputy manager are both booked onto the NVQ4 in management and are starting in February 2010. ( Then one of the providers will be registered as the Manager of Poppy Lodge) When we visited the home we looked at the arrangements in place for obtaining the views of the people who live in the home, people who are important to them such as family and other people who are involved in their care. We saw that people were Care Homes for Older People Page 22 of 26 Evidence: provided with monthly questionnaires and that residents were asked if they were happy with their surroundings, lifestyles, meals and activities available. They were also asked if staff allow them privacy, dignity, independence and choice. During the inspection we were told by 4 residents and 2 relatives, that the new manager/provider has worked well with them, listens and that felt that their opinions matter. Similarly 3 of the staff (on duty) felt that they are supported well, and have confidence that the new owners and that they felt that they will do a good job of managing the home. We looked at how the home was managed and maintained. There were records and certificates to show that the home was maintained and fit for purpose. Checks were carried out to ensure that systems and equipment such as heating and hot water systems, fire detection installations and electrical equipment were maintained in good safe working order, the service has insurance cover for legal liabilities to employees, people using the service and third parties. We saw reports from the local environmental health officers and work completed indicated that the owners complied with their regulations. 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 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. 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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