Care Home: Southernhay Retirement Home

Similar services:

• Fairfields Country Rest Home
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home
• Belma
• Hunters Care Centre
• Manor Lodge

What the care home does well The needs of people considering using the service are assessed by the home and written confirmation is given that the home will be able to meet the prospective residents individual needs before they are offered a place at the home. Individual plans of care are drawn up and regularly reviewed to ensure that the staff understand the residents individual needs and how to meet them. In house social activities are provided on a daily basis. The people who use the service enjoy good home cooked meals and special diets can be catered for. The rights of people to make complaints about the service are respected and all concerns and complaints will be listened to and acted upon. The communal areas are spacious and comfortably furnished. The bedrooms are well presented. Most of them are single and have en-suite toilet facilities. A stair lift is provided to help people to access the bedrooms that are on the first floor. One of the bathrooms has been fitted with a hoist so that the staff can help people who have poor mobility to bathe safely. The staffing levels are high enough to meet the assessed needs of the people who use the service and there are always two waking night staff on duty throughout the night. Dedicated cooks, housekeepers and maintenance staff are employed. The care staff are well trained and safe staff recruitment practices are used to employ new staff. The owner/manager is experienced and qualified and the home is well managed. What has improved since the last inspection? The Statement of Purpose and Service Users Guide have been revised although further revision is necessary to ensure that they contain all of the required and recommended information. Copies of the Service Users Guide and individual statements of Terms and Conditions are now being given to the residents. Several bedrooms have been refurbished since the last inspection and all of the bedrooms are now well presented. Considerable improvements have been made in the provision of staff training, includingspecialist training to help the staff to understand and meet the needs of people with dementia. Age Concern have been commissioned to carry out Quality Assurance Reviews. Additional policies, procedures and codes of practice have been written up to fill in previous gaps. What the care home could do better: The Statement of Purpose and Service Users Guide need further revision to ensure that people have access to all of the information they need about the service provided. All of the people involved in planning the care people will receive and reviewing care plans, including the residents and their representatives, should sign and date the records to show that they have been involved in the process. The registered provider must ensure that the staff initial the medication administration sheets at the same time as they see each of the residents taking their medication. This will reduce the risk of staff forgetting to sign the record sheets and ensure that an accurate record is kept. Better use could be made of the garden, which is safe and enclosed, as the residents may benefit from fresh air, exercise and a change of scenery. The Conservatory could be kept accessible to the residents for use as an extra sitting room. For reasons of hygiene, communal toilets should be provided with liquid soap and hot air driers or disposable towels. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Southernhay Retirement Home Second Drive Landscore Road Teignmouth Devon TQ14 9JS     The quality rating for this care home is:   two star good 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: Judy Hill     Date: 0 4 0 6 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 29 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 29 Information about the care home Name of care home: Address: Southernhay Retirement Home Second Drive Landscore Road Teignmouth Devon TQ14 9JS 01626773578 01626772834 southernhay2002@yahoo.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Mary Crook care home 20 Number of places (if applicable): Under 65 Over 65 0 20 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 20 0 Southernhay is registered to provide accommodation and care for a maximum of twenty people who are elderly and people who have dementia. The home is situated in a quiet residential area of Teignmouth and is less than a mile from the town centre, beach and railway station. Information about the service can be obtained from the home in a Statement of Purpose and a Service Users Guide. Copies of inspection reports are available on request from the home and/or can be found on the CQC Website. The current fees range from 391 to 420 pounds a week. Extra is charged for professional hairdressing, chiropody and items of a personal nature. Care Homes for Older People Page 4 of 29 Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection finished with a site visit that was carried out on 4th June 2009 by one inspector. The information contained in this report was gained in conversations with the registered provider, staff and residents during the site visit. From an Annual Quality Assurance Assessment that was completed and returned to Care Quality Commission by the registered provider prior to the inspection. From the previous key inspection report, dated 27th and 28th May 2008. From ten surveys that were completed and returned to us by some of the people living at the home , five surveys completed and returned by staff and one survey completed and returned by a relative of one of the residents. Care Homes for Older People Page 6 of 29 Additional information was gained during the site visit from a tour of the premises, private interviews with two care assistants, direct and indirect observation of the way that the management, staff and residents interact with each other, including observing a meal being served and a game of Bingo being played, an inspection of the medication records, an inspection of a sample of staff recruitment and staff training records and a sample of residents needs assessments and care plans. What the care home does well: What has improved since the last inspection? The Statement of Purpose and Service Users Guide have been revised although further revision is necessary to ensure that they contain all of the required and recommended information. Copies of the Service Users Guide and individual statements of Terms and Conditions are now being given to the residents. Several bedrooms have been refurbished since the last inspection and all of the bedrooms are now well presented. Considerable improvements have been made in the provision of staff training, including Care Homes for Older People Page 8 of 29 specialist training to help the staff to understand and meet the needs of people with dementia. Age Concern have been commissioned to carry out Quality Assurance Reviews. Additional policies, procedures and codes of practice have been written up to fill in previous gaps. 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 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 29 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 29 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. People who may use the service and their representatives are given the information they need to choose a home that will meet their needs. Evidence: The home has a Statement of Purpose is available to current and prospective residents and their representatives on request. Although this document provides good information about what people can expect from the home and the service provided, it does need further revision to ensure that it includes all of the required and recommended information. Each of the people who live at the home has been given a Service Users Guide which includes an individual statement of Terms and Conditions. The Service Users Guide is clearly written and well presented and tells people about the aims and objectives of the service providers and how their rights will be respected. Again some further Care Homes for Older People Page 11 of 29 Evidence: revision will be necessary to include all of the required and recommended information. An inspection of records showed us that the people who are placed at the home through Social Services or the Care Trust have their needs assessed by the contracting authority and that this assessment is forwarded to the home. We also saw records to show that the home carries out an assessment of people needs and provides them with written confirmation that their assessed needs can meet before they are admitted. Care Homes for Older People Page 12 of 29 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. The health and personal care that people receive is based on their individual needs. The principles of respect and dignity are put into practice. Evidence: We looked at two peoples individual plans of care and saw that these were well documented, clearly presented and reviewed regularly to record their changing needs. The care plans showed us that in addition to identifying peoples individual personal care needs, their health is also being monitored to enable the staff to identify if a resident may be unwell and need to see their GP or a District Nurse. Individual risk assessments are carried out and recorded along with the action that the staff may need to take to minimise risk. A key worker system is in place which enables a named worker to work closely with a small number of people and develop a closer working relationship with them. Care Homes for Older People Page 13 of 29 Evidence: We did note that although the care planning practises are good, records are not always signed and dated to show which members of staff had been involved in the care planning and reviews and whether or not the people who use the service or their representatives had been directly involved. The home specialises in providing care for people who have dementia and most of the care staff had recently attended a training course in Dementia Care to help them to understand the condition and how best to care for people. Some of the staff had also received training on Tissue Viability, to help them to identify when people may be at risk of developing pressure sores and how to reduce the risk. Some staff had also attended a training course on Malnutrition, to raise their awareness of the importance of ensuring that people eat and drink enough to keep them well. Twelve of the residents are singly incontinent and two are doubly incontinent. The people we saw during the site visit were clean and well presented, which indicates that the staff are good at helping them to maintain their personal hygiene. None of the obvious signs of incontinence were detected in the communal areas but two or three of the bedrooms did smell of urine. Two of the residents need two people to assist them with their personal care and there are always enough staff on duty during the day and two waking night staff on duty to ensure that their needs can be met. Bath aids, including hoists are provided to ensure that people who need help to get in and out of the bath can be helped safely. There is also a walk in shower to enable people to take a shower if they prefer to do so. Suitable facilities provided to store the residents medicines safely. The medication administration record sheets are kept with pictures of the resident and information sheets which include information of what each item of medication is used for and possible side effects. The medication administration records were spot checked and some gaps were found in them. We were told that the staff administering the medication had received training to do so safely but further training or monitoring is needed to ensure that the staff initial the record sheets at the same time as they see each of the residents taking their medication. Care Homes for Older People Page 14 of 29 Evidence: The staff were observed working with the residents and seen to be treating them with dignity and respect. Care Homes for Older People Page 15 of 29 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. Activities are provided to ensure that the people who use the service are able to participate in exercise and social activities if they choose to do so. The people who use the service are provided with good homecooked meals. Evidence: The are usually four care assistance on duty during the day and they are encouraged to spend time talking to people who use the service and providing in house activities for them. During the site visit we observed the staff playing Bingo with a group of residents in the afternoon and were told that activities are arranged by the staff every day. Outside entertainers also provide activities. These include Tranquil Moments, which is a musical entertainment with plenty of opportunity for the residents to participate in and a group of Belly Dancers. A survey completed by a relative of one of the people who uses the service states that she would like to see the garden used more to enable the residents to sit outside or for exercise. This was discussed with the service provider as the garden, which is well Care Homes for Older People Page 16 of 29 Evidence: kept and safely enclosed does appear to be under utilised. The home has a minibus with a tailgate to enable it to be used to transport people in wheelchairs. We were told that occasional group outings are arranged when the weather is good. A curate visits the home once a month to provide Holy Communion. Arrangements could be made for people to attend Church Services if they wanted to but the registered provider said that no-one had expressed a wish to go to Church. The Service Users Guide tells us that there are no restrictions on visitors and that they are welcome at all times. The chef told us that the home does not provide people with a choice of meals because all of the residents have short term memory loss and would forget what they had ordered. A list is kept in the kitchen of the residents likes and dislikes and any special dietary needs that they may have. At the time of the site visit the home was catering for several people who are diabetic and not experiencing any problems in catering for their needs. Feedback from the people who use the service, both in their surveys and verbal feedback gained during the site visit tells us that the residents enjoy their meals. Dinner was observed being served and we saw the staff helping people who needed help enjoy their meal. Care Homes for Older People Page 17 of 29 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. People can be confident that any concerns or complaints they may have about the service will be dealt with appropriately and that policies and procedures are in place to protect the residents from the threat of abuse. Evidence: The complaints procedure is displayed in the entrance hall and a summary is included in the Statement of Purpose, although not in the Service Users Guide. Surveys completed and returned to us by five of the staff all told us that they would know what to do if a resident or someone acting on behalf of a resident raised a concern or complaint. Care Quality Commission has not received any concerns, complaints or allegations about this service since the last key inspection. We looked at the homes complaints record and this told us that only one complaint, which had been dealt with appropriately, had been recorded. The Annual Quality Assurance Assessment told us that most of the staff have completed a training course on the Protection of Vulnerable Adults. Two care assistants were interviewed in private and both of them told us that they would know what to do if they thought that a resident may be at risk of abuse. Care Homes for Older People Page 18 of 29 Evidence: Policies and procedures are kept at the home to protect the residents from the threat of abuse and kept accessible to the staff, who are asked to record that they have read and understood them. Care Homes for Older People Page 19 of 29 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 people who use the service benefit from living in a clean and comfortably furnished home. Evidence: Southernhay Residential Home is situated in a quiet residential area of Teignmouth. It is within a mile of the town centre, beach and railway station. The home has three double bedrooms and fourteen single bedrooms. All but two of the bedrooms have en-suite toilet facilities. We saw that since the last key inspection several bedrooms have been refurbished and all of the bedrooms are now well furnished and attractively presented. There is a bathroom with a hoist to enable the staff to assist people with poor mobility safely on the ground floor, a bathroom that was in the process of being renovated on the first floor and a wet room on the upper first floor. In addition to en-suite toilet facilities there are conveniently situated communal toilets, although these are not hygienically equipped with liquid soap and hot air driers or disposable towels. Care Homes for Older People Page 20 of 29 Evidence: Communal space is made up of two large interconnecting lounges and a dining room. There is also a conservatory that provides access to the garden, which is safely enclosed. However, the conservatory and the garden are not always kept accessible for the residents to use and enjoy. A key pad is used on the front door to prevent the residents, all of whom have dementia, from leaving the premises unescorted. Consideration could be given to replacing this with an alarm to alert the staff if a resident has left the building. A second key pad has been fitted in a hallway which prevents some of the residents from accessing their bedrooms independently and this should be removed. The kitchen is well positioned and meets the needs of the home. There are plans to improve the office, laundry facilities and storage rooms. Overall the standard of cleanliness maintained within the home is good. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff are trained and employed in sufficient numbers to meet the needs of the people who use the service. Evidence: During the site visit we observed that four care workers were on duty during the morning and four in the afternoon. In addition the owner/manager works at the home on a full time basis and employs dedicated chefs, housekeepers and her partner, who assists with the management and administration and does most of the maintenance work. The good staffing levels enable the care staff to devote most of their time to the residents and they are encouraged to spend time talking with them and facilitating activities to keep active. Two waking staff are employed to care for the residents during the night. Five of the staff completed and returned surveys to us and all of the responses tell us that the staff think the home provides a good standard of care and that they find their work enjoyable and rewarding. Private interviews and informal conversations carried out with the staff during the site visit indicate that the staff are committed to providing Care Homes for Older People Page 22 of 29 Evidence: the best care they can. Of the thirteen care staff employed, nine have gained or are working towards gaining a National Vocational Qualification in Care and one is currently training to be a nurse. We looked at the recruitment records for the two most recently recruited members of staff and these told us that safe practices are being used to recruit new staff. This provides protection against unsuitable staff being employed. All new staff are required to complete an induction training programme that meets Skills for Care guidelines and we saw some of the completed records of this. The provision of on-going training has improved since the last key inspection. The home is using the Red Crier correspondence training programmes, which provide a wide range of courses as well as making use of the training facilities provided in the community. We were told that some of the care staff had recently attended a seminar on the Deprivation of Liberties Act and completed a training course with North Devon College on Dementia Care. Surveys completed and returned to us by five members of staff all tell us that the training that is provided is helping the staff to understand and to meet the needs of the people who use the service. Care Homes for Older People Page 23 of 29 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 people who use the service benefit from living in a well managed home. Evidence: Mrs Mary Crook is the registered provider and registered manager of the home. She has many years experience and has completed her National Vocational Qualification in Care at Level 4 and her Registered Managers Award. Mary has also attended on-going training courses to keep her skills and knowledge up to date. Since the last inspection Age Concern have been commissioned by the home to carry out a Quality Assurance Review and have provided the home with a written report. This report is kept available in the entrance hall for the residents, their representatives and the staff to read. Age Concern used questionnaires to gain feedback from people who work with the residents in a professional capacity and we were told that a further review is planned using questionnaires to relatives of the residents. Care Homes for Older People Page 24 of 29 Evidence: The manager is approachable and does listen to the view of the staff on an informal basis, as well as during staff meetings and formal one to one supervision. All of the people who use the service are helped with their financial affairs by their families or a legal representative but the home does hold small amounts of personal spending money for two of the residents. We saw that clear records are kept of any income or expenditure. The Annual Quality Assurance Assessment tells us that all of the required and recommended policies, procedures and codes of practice are kept at the home and are up to date with the exception of one. This is a policy on the discharge of residents, including planned discharge, and termination or self-discharge at short notice. The policies, procedures and codes of practice are kept in a filing cabinet in the managers office and are accessible to the staff who are encouraged to read them and to sign a record sheet to confirm that they have read them and understand their contents. A programme of maintenance and renewal is in place and considerable work has been carried out to improve the premises since the last key inspection. All of the maintenance checks required to be carried out periodically to ensure that the electrical and gas appliances and the stair lifts, hoists and fire safety and detection equipment is kept in good working order are up to date. Care Homes for Older People Page 25 of 29 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 26 of 29 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 1 9 13 The registered provider must ensure that the staff initial the medication administration sheets at the same time as they see each of the residents taking their medication. This will reduce the risk of staff forgetting to sign the record sheets and ensure that an accurate record is kept. 04/07/2009 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 1 The Statement of Purpose and Service Users Guide need to be revised to ensure that all of the information that is required to be included under regulations 4 and 5 and Schedule 1 of the Care Homes Regulations and recommended under National Minimum Standard 1 is included. The members of staff, residents and, where applicable their representatives should sign and date the care planning and Page 27 of 29 2 7 Care Homes for Older People review records to provide evidence of their involvement. 3 8 The carpets in the bedrooms that smell of urine should be thoroughly cleaned or taken up and replaced with a suitable non slip floor covering. People should have better access to the garden, which is safe and enclosed, to enable them to exercise or just sit outside and enjoy a change of scenery. Include a summary of the Complaints Procedure in the Service Users Guide. Consider alternatives to the use of a keypad on the front door of the home and remove the keypad from the inner door in the ground floor hall. Patterned carpets are not suitable for use in homes caring for people with dementia and should replaced with plain carpets. The Conservatory and the garden should be available for use by the residents at all times. Communal toilets should be provided with liquid soap and hot air driers or disposable towels. Write up a policy on Discharge of residents, including planned discharge, and termination or self-discharge at short notice. 4 12 5 6 16 19 7 19 8 9 10 20 21 38 Care Homes for Older People Page 28 of 29 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. Care Homes for Older People Page 29 of 29 - 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!