Care Home: Sandalwood Court

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What the care home does well Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 The service user guide is available in large print to make it easier for older people to read There was evidence that the home have taken action to address the shortfalls in administration of medication to ensure that medication is given as prescribed such as all of the team leaders being assessed to ensure that they are competent to administer medication. The manager explained that the home has recently established an activities committee which is made up of people who live in the home, family members and some of the staff. One person told us that "the new manager is very keen." One relative who was visiting told us that she was always made to feel welcome. She told us that the home has "a good atmosphere." What has improved since the last inspection? The current manager is applying to the Care Quality Commission to become the registered manager. The home has now recruited staff to fill all of the vacant posts. All new staff have a full Criminal Records Bureaux (CRB) check prior to starting to work at the home. Staff have received training and a competency assessment to ensure that they administer medication in the right way. An activities committee has been established and a programme of activities is being made available to people. The manager has identified a number of areas for development within the home which she is in the process of implementing such as improved auditing of care plans and medication systems. The home is sending `notifications` to the Care Quality Commission as required by the Care Homes regulations when notifiable incidents occur. What the care home could do better: In some cases the instructions on the medication administration record were unclear in terms of how and where prescribed creams should be applied.Sandalwood CourtDS0000070474.V376472.R01.S.docVersion 5.2Care plans need to contain sufficient information to enable the staff to know how to care for people. Staff need to access the information in people`s care plans and to ensure that they care for people in the right way. People gave mixed feedback about the food with some people saying it was good while others told us, "The food is not so good." One person told us that she had spoken to the cook to request salad but had only been given this once. Assessments are needed to ensure that reclining chairs are appropriate to meet the individual`s needs. Key inspection report CARE HOMES FOR OLDER PEOPLE Sandalwood Court Butland Road Oakley Vale Corby Northants NN18 8QA Lead Inspector Catherine Perrins Key Unannounced Inspection 8th July 2009 10:00 DS0000070474.V376472.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 2 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 Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandalwood Court Address Butland Road Oakley Vale Corby Northants NN18 8QA 01536 424040 01536 747890 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.shaw.co.uk Shaw Healthcare (de Montfort) Ltd Manager post vacant Care Home 60 Category(ies) of Dementia (60), Dementia - over 65 years of age registration, with number (60), Old age, not falling within any other of places category (60) Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: 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 and DE(E) The maximum number of service users who can be acommodated is: 60 30th July 2008 2. Date of last inspection Brief Description of the Service: Sandalwood Court is a purpose built residential home opened in August 2007. The home provides personal care for up to 60 older people including people with dementia. There are bedrooms, lounges and dining rooms on each of the three floors with twenty residents accommodated on each floor. There is a passenger lift, which provides people with access to all floors. Sandalwood Court is situated in the centre of a new housing estate on the outskirts of the town of Corby. Northamptonshire County Council has a contract with Shaw Healthcare to block book the majority of beds in the home. The fees agreed as part of the contract with Northamptonshire County Council are based upon the assessed level of need. Currently there are three fee levels, which are linked to the people’s assessed needs as follows: Low £444.84 per week, medium £465.54 and high £486.24. The fee paid by Northamptonshire County Council includes the cost of accommodation, meals, laundry and personal care. Additional costs were identified as personal items, such as toiletries, clothing, newspaper and private chiropody treatment. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was an unannounced key inspection which means that we focussed on the key national standards. The key standards are those considered by the Commission to have the most impact on outcomes for residents. As part of the preparation for this inspection a period of four hours was spent reviewing the information that CQC has about this service. We looked at all the information that we have received, or asked for, since the last key inspection. This included: Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection report and the results of a further visit that we made to the home on 15th October, 2008 following a number of medication errors. Relevant information from other organisations. The inspection visit lasted eight hours during the morning and afternoon of a weekday. During the inspection three people were case tracked. This involves looking in detail at all aspects of their care and experiences at the Sandalwood Court, including looking as their individual plans of care and other records, talking to them and talking to their care staff. Because people with dementia are not always able to tell us about their experiences we also used observations of people’s state of well being and how they interacted with staff members and others. A sample of staff files were also viewed as part of the inspection. The home manager was present for the majority of the inspection. The Area manager was present for part of the inspection. What the service does well: Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 6 The service user guide is available in large print to make it easier for older people to read There was evidence that the home have taken action to address the shortfalls in administration of medication to ensure that medication is given as prescribed such as all of the team leaders being assessed to ensure that they are competent to administer medication. The manager explained that the home has recently established an activities committee which is made up of people who live in the home, family members and some of the staff. One person told us that “the new manager is very keen.” One relative who was visiting told us that she was always made to feel welcome. She told us that the home has “a good atmosphere.” What has improved since the last inspection? What they could do better: In some cases the instructions on the medication administration record were unclear in terms of how and where prescribed creams should be applied. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 7 Care plans need to contain sufficient information to enable the staff to know how to care for people. Staff need to access the information in people’s care plans and to ensure that they care for people in the right way. People gave mixed feedback about the food with some people saying it was good while others told us, “The food is not so good.” One person told us that she had spoken to the cook to request salad but had only been given this once. Assessments are needed to ensure that reclining chairs are appropriate to meet the individual’s needs. 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. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 People using the 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 are given good information and their needs are assessed before they move to Sandalwood Court to ensure that it is the right move for them. EVIDENCE: The home has a statement of purpose and service user guide which give people good information about the home and the services it offers. Both documents are available in the reception area of the home. The service user guide is available in large print to make it easier for older people to read Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 10 The manager told us that people are able to visit the home before they move in. If they are not able to visit, their relatives or friends can do so on their behalf. The manager explained that the home is in the process of developing a pictorial service user guide that could made available to people who are unable to visit the home themselves before they move in. This would help them see what the home is like. Records show that peoples needs are assessed before they move to Sandalwood to make sure that the home is right for them. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 People using the 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 can be confident that their health and personal care needs will be generally well met. EVIDENCE: Each person who lives at the home has an individual plan of care. This contains their care plans and other information that staff need to care for people in the right way. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 12 Care plans seen covered areas such as communication, eating and drinking, personal care, mobility, culture and religion, health and continence. They contained some detail about peoples preferences such as what time they liked to get up and go to bed, whether they liked the light on or off at night time and their morning and night time routines. The care plan for one person details how she liked to have her nails painted however she told us that this had not happened and showed us that her nail varnish was chipped. The manager explained that she was planning to arrange for a beautician to come into the home to provide manicures for people. There was some evidence of people being helped to make choices such as what clothes they wanted to wear. One person who was admitted to the home as a short term emergency admission was noted to have some pressure care needs. The home had contacted the District nurse for advice but had not developed a pressure care care plan to inform staff of anything specific that they needed to do to with regard to her pressure care needs during her stay at the home. The manager stated that as she had only stayed at the home for a few days this had not been done, but that if she had stayed any longer it would have been completed. On the 15th October, 2008 an inspection was carried out at the home which specifically focused on the administration of medication. This followed a number of drug errors which resulted in a referral to the local authority under the locally agreed safeguarding adults procedures. There was evidence that the home have taken action to address the shortfalls in administration of medication to ensure that medication is given as prescribed such as all of the team leaders being assessed to ensure that they are competent to administer medication. A spot check showed that entries on the medication record are being signed to show that people are receiving their medication as prescribed. The medication administration record for one person showed that she had refused the laxative medication that she had been prescribed all month but there was no evidence that this medication had been reviewed to see if it was still required. The home dates prescribed creams when they are opened but in some cases the instructions on the medication administration record were unclear in terms of how and where the cream should be applied stating “as directed, apply to affected area.” Records show that people are assessed for their ability to self medicate. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 People using the 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 will benefit from recent developments in the programme of activities available in the home. EVIDENCE: The manager explained that the home has recently established an activities committee which is made up of people who live in the home, family members and some of the staff. One person who is on the committee told us that the committee were planning a classical music evening, painting and discussions about old Corby. She explained that the day before a group of people had gone for a picnic to the local country park. She told us that previously there “had been nothing” and went on to say that, “the new manager is very keen but she needs to do things gradually.” Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 14 The manager explained that the activity committee are going to put together a newsletter telling people about the activities coming up in the home. People’s individual plans of care did contain some information about their interests and hobbies. This is important as it means that activities can be offered that reflect the interests of the individuals who live at the home. Activities sheets were seen which contained a record of the activities that people had taken part in such as watching films, listening to music, quiz, church service at home, carpet bowls and looking at newspapers. On the day of inspection a holistic therapist was visiting the home. The manager explained that this was being done as a trial and if it proved popular would be offered on a regular basis. One relative who was visiting told us that she was always made to feel welcome. She told us that the home has “a good atmosphere.” The area manager explained that, where they are able to, the home offer relatives the opportunity to stay in one of the vacant bedrooms if their loved ones are unwell. Lunch was observed during the inspection. People gave mixed feedback about the food with some people saying it was good while others told us, “The food is not so good.” One person told us that she had spoken to the cook to request salad but had only been given this once. Menus seen appeared varied although some of the meals offered may not be traditional for the age group of people living in the home, such as ‘turkey drummers’. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 People using the 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 can be confident that the home will respond to address any concerns raised. EVIDENCE: The home has a complaints procedure which outlines what people should do if they wish to raise a concern about the home and the response that they can expect. Several concerns have been raised in relation to this home since the last inspection some from people contacting the Commission anonymously. There was evidence that the home has taken steps to address the areas of concern identified for example one area related to staffing levels and the home has now recruited staff to fill all of the vacant posts; Another area was recruitment checks and the home now ensures that all new staff have a full Criminal Records Bureaux (CRB) check prior to starting to work at the home; Another area was the administration of medication and staff have received training and Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 16 a competency assessment to ensure that they administer medication in the right way. Staff spoken to knew how to raise any concerns that they may have. The manager explained that she now keeps a record of all informal complaints to ensure that concerns are addressed before they escalate. One person was observed sitting in a reclining chair. These chairs can be very difficult to get out of when reclined and can also increase people’s risk of choking. Assessments are needed to ensure that the chair is the right type to meet the persons needs. The manager told us that this assessment had not yet been completed. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 People using the 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 benefit from having spacious, clean and purpose built accommodation. EVIDENCE: Sandalwood Court is built over three floors with accommodation for up to twenty people on each floor. Each floor has two lounge / dining areas and two bathrooms which are accessible to people with restricted mobility. The home was clean and hygienic throughout and generally well maintained although the carpet in some areas was showing some signs of wear and tear. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 18 Communal arrears were spacious and comfortable with some ornaments and effects to make the space feel a little more homely although some areas did look quite impersonal. Bedrooms seen had been made personal with people being able to bring in furniture and personal effects when they move in. All of the bedrooms have an en suite wet room. The home has a ‘reminiscence’ room which has been decorated and furnished to resemble a 1950’s lounge. The reminiscence room is used for some activities and meetings. On the top floor there is a smoking room for the use of any residents who wish to smoke. There was no smell of cigarette smoke noted in the corridor outside this room. On the first floor there is a separate area for staff including facilities to shower and get changed. Two passenger lifts as well as stairs provide access to all floors. Outside the property there is an enclosed garden and patio area which the manager told us that people use in the good weather. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 People using the 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 recruitment of new staff to fill current vacancies will ensure that people’s needs are met by a consistent approach to their care. EVIDENCE: The recruitment of staff is well managed with all of the necessary pre recruitment checks being carried out to ensure that staff are suitable to work with older people. The manager explained that the home has a policy of not starting any new staff until they have had full Criminal Records Bureaux (CRB) clearance. Staff spoken to expressed some concerns about staffing levels within the home. The manager explained that all vacant posts have been filled and that the home is in the process of completing pre appointment checks before the new staff could start working in the home. She confirmed that the home had Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 20 been using high levels of agency staff but that they try to book ‘regular’ agency workers to minimise the disruption to the service. Staff told us that they had an induction when they first started working at the home which included working alongside an experienced colleague to make sure that they had all of the information that they need to do their job in the right way. Staff explained that they attend training courses such as food hygiene, safeguarding of adults, dementia care, infection control, fire safety and moving and handling. The manager explained that some staff needed to have a refresher course for moving and handling. The home have recently had four staff complete training to deliver the moving and handling course to ensure that all staff are appropriately trained in this area. Staff interactions with the people who live in the home observed during the inspection were generally positive. One interaction seen however, did demonstrate a lack of understanding of the needs of someone with dementia. This was brought to the attention of the manager who said that she would address this issue with the staff team. Discussions with other staff members showed that they had a good understanding of how to relate to and care for of people with dementia. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 People using the 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 manager is making improvements to the service to ensure that the home is run in the best interests of the people who live there. EVIDENCE: The current manager had been in post for eight weeks at the time of inspection. She is in the process of applying to be the registered manager for the home. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 22 The regional manager outlined a number of areas that the manager had improved since her appointment as well as other areas that she had identified for improvement. Staff told us that the “home is getting better”. The manager explained that she is introducing a system where senior staff carry out audits of medication and care plans in areas of the home that they do not usually work in. The manager told us that the home carries out a satisfaction surveys. The results of the most recent survey competed by people who live in the home was viewed. Feedback was generally positive however there were some negative comments about the quality of the food. Records show that the necessary safety checks such as fire checks, checks on the water system and portable appliance testing have all been carried out recently. Hoists and lifting equipment has been serviced as per manufacturer’s recommendations. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP18 Good Practice Recommendations Where people use reclining chairs assessments should be conducted to ensure that the chair is right for the individual and that it does not restrict their ability to move around the home as they wish. The home should review people’s care plans to ensure that they contain all of the information that staff need to support people in the right way. The home should review their menus and presentation of food in response to feedback from the people who live at the home. Clear instructions should be given to staff to ensure that prescription creams are administered as prescribed. 2 3 4 OP7 OP15 OP9 Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 25 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. Sandalwood Court DS0000070474.V376472.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!