Care Home: Presentation Sisters Care Centre

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What the care home does well People told us "Everything I need is done well", "It`s wonderful here!", "My Mum is well cared for in every way. I could not ask for a better service for her". People told us they, or their relatives, were treated with respect by the staff. They said "carers could not be more kind and helpful", "they are cheerful and friendly", and "they are caring, considerate and kind". People told us that staff always listened to them and acted on what they said. People were pleased with the quality and choice offered. They said "the meals are always very good" and "meals always well cooked, well served and tasty". Staff told us they enjoyed working at the home. They said "good working atmosphere", "we`re good at working as a team", and, "It`s a pleasure to come to work". 22 out of 37 care staff had a relevant National Vocational Qualification (NVQ) at level 2 or above. This exceeded the national minimum standard of 50% of care staff with a relevant NVQ. We found that the home was well managed with good systems in place to ensure the health and safety of people in the home was promoted. The views of people in the home and their representatives were listened to and used to make changes and improvements. What has improved since the last inspection? The Statement of Purpose and Service User Guide had been recently revised and updated. The home had recently achieved the Investors in People award again following reassessment. Upgrading had taken place in the home, including fitting all fire doors with self-closing devices, refurbishing many of the bedrooms, and installing a new telephone system. What the care home could do better: People in the home, and / or their representatives, should be more actively involved in care planning and review. This will help to ensure individual needs and preferences are known and met. Care plans and risk assessments should be reviewed monthly to ensure people`s changing needs are monitored and met. There should be a more structured approach to provision of activities for people in the home, including more planned hours for activities staff. This will help to ensure a wider range of activities to meet the needs and preferences of all people in the home. All staff should have training about the control of infection to ensure the health and safety of people in the home is fully protected and promoted. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Presentation Sisters Care Centre Chesterfield Road Matlock Derbyshire DE4 3FT     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rose Moffatt     Date: 1 3 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Presentation Sisters Care Centre Chesterfield Road Matlock Derbyshire DE4 3FT 01629582953 0162955140 linda@presentationcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Presentation Sisters care home 36 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home The Presentation Care Centre is situated on the outskirts of Matlock, where a range of local amenities and public transport are available. The home provides personal and nursing care for up to 36 residents. Residents are all accommodated in single rooms on three floors of the home. Only one room is en suite, but there is ample provision of bathrooms and toilets. The home is fully accessible for residents and well maintained. There are extensive grounds to the home with magnificent views over local countryside. The home is attached to the Presentation Sisters Convent, but operates independently. There is a complex fee structure and detailed information is available from the administration manager. The fees for this home at the time of inspection ranged from Care Homes for Older People Page 4 of 27 Over 65 36 0 Brief description of the care home £404.37 to £657.07 (including nursing contribution). There are additional variable charges for hairdressing, chiropody, and newspapers. Information about the extra charges are given in each residents letter of contract. Information about the home, including CQC inspection reports, is available from the main office. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 quality rating for this service is 3 star. This means the people who use the service experience excellent quality outcomes. The focus of our inspection is on outcomes for people who live in the home and their views on the service provided. The inspection process looks at the providers ability to meet regulatory requirements and national minimum standards. Our inspections also focus on aspects of the service that need further development. We looked at all the information we have received, or asked for, since the last key inspection or annual service review. This included: the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also has some numerical information about the service; surveys returned to us by people Care Homes for Older People Page 6 of 27 using the service and from other people with an interest in the service; information we have about how the service has managed any complaints; what the service has told us about things that have happened - these are called notifications and are a legal requirement; the previous key inspection and the results of any other visits we have made to the service in the last 12 months; relevant information from other organisations; and what other people have told us about the service. The previous key inspection of the home was on 28th August 2007. We carried out an annual service review (ASR) of the home in August 2008. The ASR looked at all the above information. The ASR showed us the home continued to provide good outcomes for people living there. We carried out an unannounced inspection visit that took place over 7 hours on 13th July 2009. The inspection visit focused on assessing compliance with requirements made at the previous inspection and assessing all the key standards. We sent out 10 surveys to people living in the home and received 7 completed responses. We sent out 10 surveys to the relatives or representatives of people living in the home and received 5 completed responses. We sent out 10 surveys to staff employed at the home and received 7 completed responses. There were 34 people accommodated in the home on the day of the inspection visit. 3 people who live in the home, 2 visitors and 5 staff were spoken with during the visit. The manager and administration manager were available and helpful throughout the inspection visit. Some people were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. Case tracking was used during the inspection visit to look at the quality of care received by people living in the home. 4 people were selected and the quality of the care they received was assessed by speaking to them and / or their relatives, observation, reading their records, and talking to staff. What the care home does well: What has improved since the last inspection? What they could do better: People in the home, and / or their representatives, should be more actively involved in care planning and review. This will help to ensure individual needs and preferences are known and met. Care plans and risk assessments should be reviewed monthly to ensure peoples changing needs are monitored and met. There should be a more structured approach to provision of activities for people in the home, including more planned hours for activities staff. This will help to ensure a wider range of activities to meet the needs and preferences of all people in the home. All staff should have training about the control of infection to ensure the health and safety of people in the home is fully protected and promoted. Care Homes for Older People Page 8 of 27 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 set out 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was a comprehensive assessment of needs prior to admission and sufficient information provided about the home so that people were confident the home could meet their needs. Evidence: People told us they had received enough information about the home to decide if it was the right place for them. People said they always received the care and support they needed. They said Everything I need is done well, Its wonderful here!, My Mum is well cared for in every way. I could not ask for a better service for her. Some people said they had chosen the home based on its good local reputation. The Statement of Purpose and Service User Guide had been recently revised and updated. We looked at the care records for 4 people and all had a detailed pre-admission Care Homes for Older People Page 11 of 27 Evidence: assessment carried out by the manager or senior staff. The assessment covered all activities of daily living and had good details of the persons needs and preferences. There was also assessment information from social services/ hospital/ Primary Care Trust staff as appropriate. The home was suitably equipped to meet peoples needs. The pre-admission assessment included looking at any additional equipment or staffing necessary to meet the persons needs. The admission processes did not include recording if the person had made an advance decision on receiving medical treatment, a lasting power of attorney (LPA), or an Independent Mental Capacity Advocate (IMCA). However, the manager was already looking at ways of incorporating this into the pre-admission assessment and admission procedures. The AQAA said that the home maintained high levels of occupancy. They planned to develop a website to provide wider access to information about the home. Standard 6 did not apply as there were no people in the home receiving intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received care and support to meet their individual needs and preferences. Evidence: People told us they always had the care and they support they needed, including medical care. A relative said the home was excellent at communicating with my husbands doctor. We found that each person had an individual care plan that covered all of their assessed needs and included details of their preferences regarding daily routines. There were good details in the care plans of the action required by staff to meet the persons needs. The review of care plans seen was varied - 1 had been reviewed monthly up to date, 1 had been reviewed monthly up to May 2009, 1 had not been reviewed since the person was admitted in May 2009, and 1 had been reviewed once in June since the admission of the person in January 2009. We found assessments of each persons health care needs and any associated risks, for example, nutritional needs, manual handling assessments, and assessment of the Care Homes for Older People Page 13 of 27 Evidence: risk of developing pressure sores. Again, as for the care plans, there appeared to be no consistent approach to the review of these assessments. We found that people were appropriately referred for medical and specialist support to their GP, or to other healthcare professionals such as physiotherapist and tissue viability nurse. Medication was well managed in the home with satisfactory records of receipt, administration and disposal. People told us they, or their relatives, were treated with respect by the staff. They said carers could not be more kind and helpful, they are cheerful and friendly, and they are caring, considerate and kind. People told us that staff always listened to them and acted on what they said. The AQAA said that people in the home were happy and contented with their care and all aspects of daily living, as evidenced by the internal quality assurance system. They planned to continue making improvements based on suggestions and comments made by people in the home and their relatives. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were generally satisfied with the flexibility of routines and the activities provided, and the lifestyle in the home met their preferences and expectations. Evidence: Most people told us there were always activities they could take part in. One person said there were Good activities: music, crafts, concerts and pantomimes. There were some comments that there should be more activities provided and also the opportunity for people to have trips out. Two people commented that they, or their relative, would like more time in the garden in good weather. People told us they could usually follow their preferred routines. There was an activities coordinator employed at the home working on 2 mornings per week. The manager said that other members of staff had also become involved in providing activities. In addition, the First Taste organisation provided music, reminiscence and craft activities once a week. People could attend a daily mass in the convent or receive communion privately in their rooms, or a visiting minister could be arranged. The care records included a form with details of the persons life history, family, and Care Homes for Older People Page 15 of 27 Evidence: social interests. Some forms were not completed, and some had more detail than others. People living in the home and their relatives were able to be part of the fund raising committee. There were no meetings for people in the home. and/or their relatives, to give their opinions and ideas, although there were annual surveys to check satisfaction with the service provided. Visitors told us they were always made welcome and could visit at any reasonable time. One visitor told us they were pleased they could share a meal with the person in the home. Most people told us they always liked the meals provided at the home. They were pleased with the quality and choice offered. They said the meals are always very good and meals always well cooked, well served and tasty. The dining rooms were bright and pleasant and there appeared to be sufficient staff available to provide the help needed. The AQAA said that more activities had been provided in the last 12 months, but recognised that this was limited by budgetary contraints and by the complex nursing needs of some people in the home. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were satisfactory systems in place and good staff awareness so that people were protected and their concerns effectively dealt with. Evidence: All of the people who returned our surveys and who we spoke with said they knew how to make a complaint. People said they would take any concerns to the senior staff or the manager and were confident that appropriate action would be taken. Most people said the staff usually listened to them and acted on what they said. The manager said there were few complaints made and the records showed that none had been recorded since 2007. The manager said that most minor complaints were dealt with as they arose and were documented in the persons daily records. The complaints procedure in the Service User Guide did not have the correct contact details for CQC. No complaints had been received by CQC, or their predecessor CSCI, since the last inspection. There were suitable policies and procedures in place about safeguarding vulnerable adults. Most staff had received appropriate training and were aware of the correct procedures to follow if abuse was suspected. Some staff were not aware of the Mental Capacity Act 2005 and the implications for people in care homes. The manager said training about safeguarding vulnerable adults now included information about the Mental Capacity Act 2005. Care Homes for Older People Page 17 of 27 Evidence: The AQAA said We take complaints very seriously and these are investigated and answered thoroughly. The number of complaints is low and therefore given deep consideration particularly if these matters which can be improved. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean, suitably equipped and well maintained so that people lived in a safe, comfortable and pleasant environment appropriate to their needs. Evidence: People told us the home was always fresh and clean. They said it is always fresh and bright and there are no residual smells, and, a clean, well decorated care home...and well kept grounds. One person said The cleaning staff are pleasant, hardworking and obliging, and if asked will spend extra time to clean ones room, but I wonder if there is enough housekeeping staff, or if those we have are given enough time to do a thorough job. Another person said that the housekeeping staff should check regularly that there were enough toilet rolls in the toilets. Suitable equipment was provided to meet peoples needs, such as lifting hoists, specialist accessible baths and showers, and profiling beds. Equipment was considered as part of the pre-admission assessment to ensure the persons needs could be met at the home. Two bathrooms in the home had recently been converted to use as storage rooms, but there were no smoke detectors installed and it was not clear if the doors were suitably fire resistant for the change of use of the rooms. During the inspection visit, the administration manager arranged for a visit from the fire service to ensure the correct Care Homes for Older People Page 19 of 27 Evidence: equipment was in place. There were suitable policies and procedures in place about infection control. Most of the staff had received some training about infection control as part of their induction and informally since then. The manager said a programme of training was planned to start soon that included infection control. We observed staff using disposable gloves and aprons appropriately. Staff spoken with were aware of infection control issues and good practice. The AQAA said that the home had an in-house maintenance team to undertake regular repairs and maintenance. Upgrading had taken place in the home, including fitting all fire doors with self-closing devices, refurbishing many of the bedrooms, and installing a new telephone system. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There were sound recruitment practices, a good staff training programme and satisfactory staffing levels so that people were protected and were supported by well motivated staff. Evidence: People said The staff work hard. They are cheerful and friendly, Carers could not be more kind and helpful, and, pleasant and competent staff. Most people told us there were staff available when they needed them. There were some comments that At certain times of the day the home could do with more staff, I feel sometimes carers are overworked and short staffed, and, There should be more staff on St Xaviers ground floor, since when the two staff are putting people to bed on the 1st floor, the remaining residents are left alone. We observed that there appeared to be sufficient staff available to meet peoples needs. Staff told us that staffing levels were generally sufficient to meet the needs of people in the home. There were usually 7 care assistants for the morning shift, 6 in the afternoon and 3 at night. In addition, there were an extra 10 - 12 care hours per day provided for people who needed higher levels of care and support. Extra staff hours were planned as part of the pre-admission process where people had more complex Care Homes for Older People Page 21 of 27 Evidence: care needs. There were 2 registered nurses on duty for the morning shift, 1 in the afternoon and 1 at night. There was some reliance on using agency staff to cover shifts. We looked at the records for 4 members of staff and found all the required documents and information were in place. New staff had started an induction programme that met Skills For Care standards. New staff were supernumerary for about 2 weeks when first starting so they could shadow more experienced staff. Staff told us they had training that was relevant to their role and helped them to understand and meet the needs of people in the home. They said there were excellent training opportunities and good training days. Training records showed that most staff were up to date with required training, such as fire safety and manual handling. Staff told us they enjoyed working at the home. They said good working atmosphere, were good at working as a team, and, Its a pleasure to come to work. The AQAA said that 22 out of 37 care staff had a relevant National Vocational Qualification (NVQ) at level 2 or above. This exceeded the national minimum standard of 50 of care staff with a relevant NVQ. The AQAA said the home had improved in the last 12 months by having more staff trained to NVQ level 3 in care, and also NVQ level 2 in team leading. The home had recently achieved Investors in People again following reassessment. The AQAA said this showed their continued commitment to developing staff. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well managed and the views of people in the home were taken into account to make changes and improvements. There were robust systems in place so that the health, safety and welfare of people was promoted and protected. Evidence: People told us the home was well organised. Staff told us the manager was approachable, and ,caring and supportive. They said, when there is a problem, it is discussed and most of the time sorted out, and, the home is run to a very high standard. The manager had been in post for several years and was suitably qualified and experienced to run the home. The AQAA was completed by the manager and contained clear, relevant information supported by a good range of evidence. The AQAA gave us details of changes made in the home and where they still need to make improvements. For some areas, there Care Homes for Older People Page 23 of 27 Evidence: was limited detail of how improvements were to be made. The data section of the AQAA was fully and accurately completed. The quality assurance system included annual surveys sent out to people in the home and their relatives/friends. The manager said they were considering also sending out surveys to staff. The results of the surveys were made available to people in the home and their representatives with details of any action taken to address issues raised. Improvements had been made as a result of previous surveys, such as new televisions and upgraded bathrooms. Relatives were involved in the homes fund raising committee. There were no other meetings for people in the home and their representatives. The home had recently acheived the Investors in People award again following reassessment. There was a suitable system in place to ensure any personal money held for people in the home was secure and all transactions were recorded. The home had a health and safety committee that met monthly. Health and safety audits were carried out twice a year. Accidents in the home were recorded and were audited monthly to see if action could be taken to address any issues or trends. Fire safety records were up to date. Staff had received relevant training, such as manual handling and fire safety. The AQAA showed that all maintenance and servicing of equipment and systems was up to date, and that all relevant policies and procedures were in place. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 People in the home, and / or their representatives, should be more actively involved in care planning and review. This will help to ensure individual needs and preferences are known and met. Care plans and risk assessments should be reviewed monthly to ensure peoples changing needs are monitored and met. There should be a more structured approach to provision of activities for people in the home, including more planned hours for activities staff. This will help to ensure a wider range of activities to meet the needs and preferences of all people in the home. The complaints procedure should include the up to date contact details for CQC so that people have full and correct information about making complaints. All staff should have training about the control of infection to ensure the health and safety of people in the home is fully protected and promoted. 2 7 3 12 4 16 5 26 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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