Care Home: Southlands Residential Home

What the care home does well Peoples needs are assessed before they move into the home, this helps to make sure that the home are aware of and are confident that they can meet peoples needs. People are supported through a system of care planning that identifies their needs and provides information on how these needs are to be met. People receive good support in the meeting of their health needs, this includes support to attend medical appointments. People are supported to participate in leisure and social activities of their choices, this helps to enable them to live their life as they choose. The staffing levels vary throughout the day to help to make sure that there are adequate numbers of staff when people need the highest amount of support in the meeting of their needs. People are supported by staff who receive various training programmes to help them have the skills to meet peoples needs. People live in a home that is clean and comfortable, they are able to personalise and make their rooms their own. What has improved since the last inspection? This is the first inspection of this service under this registration. Consequently there are no previously identified areas for improvement. What the care home could do better: There should be an up to date statement of purpose and service user guide that adequately reflects the current support offered in the home. This will help to make sure people are aware of the support on offer, increasing choices, prior to them moving into the home. Peoples care plans and medication files could include a photograph of them, this will help with consistency in care and help to reduce the risk of medication errors occurring. Records of the outcomes of complaints could be kept so that there is a clear audit trail of how peoples concerns are handled and if they are happy with the result. The temperature of the hot water supplied in the home should be maintained at a level that does not pose a risk of scalding to the people who live in the home. Key inspection report Care homes for older people Name: Address: Southlands Residential Home 15 Hobman Lane Cranswick Driffield N Humberside YO25 9PE     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sarah Rodmell     Date: 0 5 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Southlands Residential Home 15 Hobman Lane Cranswick Driffield N Humberside YO25 9PE 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Burlington Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 46 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who may be accommodated is: 46 The registered person may provide the following category of service only: care home with nursing-Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: DementiaCode DE; Physical Disability-Code PD; Old Age, not falling within any other categoryCode OP Date of last inspection Brief description of the care home Southlands Care Home is located in the village of Hutton Cranswick, between the towns of Beverley and Driffield. It is a short distance from local amenities and has Care Homes for Older People Page 4 of 28 Over 65 0 46 0 46 0 46 Brief description of the care home parking for several cars. It is accessible via road and the public transport system. Southlands is a large detached property with adjacent gardens and an internal courtyard area. The home is registered for 46 people who may suffer from dementia. The home is currently registered to provide nursing care and is owned by Burlington Care Ltd. The bedrooms are all en suite and are arranged on the ground and first floor with lift and staircase access provided for the people living there. There are several lounges, a sun room, activities room and a separate dining room. There are bathrooms and toilets on each floor. Information on the service would be available in a statement of purpose or service user guide. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use the service experience good quality outcomes. This inspection report is based on information received by the Care Quality Commission, (CQC) and includes information gathered during a site visit to the home. The unannounced visit was undertaken over one day by one inspector. It began at 9.30 am and finished at 5.30 pm. On the day of the visit the inspector spoke with people who live in the home, staff, the manager and the owners of the home. Inspection of the premises and close examination of a range of documentation, including three care plans were also undertaken. The manager told us that the current fee for residential care is £362.04- £475.00 per week. Care Homes for Older People Page 6 of 28 At the end of this visit, feedback was given to the manager on our findings, including any requirements and recommendations that may be in the key inspection report. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. Care Homes for Older People Page 8 of 28 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 28 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 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. We assessed standards 1,3 & 6. People are assessed prior to moving into the home to help make sure that the home can meet their needs. A lack of up to date information regarding the support offered in the home does not ensure that people are fully informed in the decision making process. Evidence: The owner and the manager told us that the home no longer offers nursing care and that no-one who lives in the home requires this type of support. They told us that this had been a very recent decision. Consequently there was not a statement of purpose available at this visit. There was a service user guide available, although this guide stated that the home still offered nursing and residential care. Up to date versions of these documents must be Care Homes for Older People Page 11 of 28 Evidence: available to people so that they have a full picture of what support they will receive if they move into the home prior to them actually moving in. This will help to make sure that people have informed choices. We looked at the files for three of the people who live in the home. All of these included an assessment of need undertaken by the home prior to the person moving in. Only one persons file also included an assessment of need undertaken by the Local Authority and although other people were placed by the Local Authority the manager told us that sometimes there are delays in receiving this information. The assessment undertaken in the home covered a variety of areas that included, Personal care, Mobility, Hearing, Sight,Medication, Spiritual needs and Social needs. The assessment information has then been used by the home to complete a care plan that addresses the individuals areas of need and how these are to be met in the home. The manager told us that intermediate care is not provided in the home. Care Homes for Older People Page 12 of 28 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. We assessed standards 7,8,9 & 10. People receive good support through a care planning process to have their personal care, health and medication needs met. Evidence: We looked at the files for three of the people who live in the home. The files included a variety of information about the individual including their personal details and a plan of care. The care plan covered the areas of need identified in the assessment, each area had an aim and details of what staff need to do to meet this persons need in this area. Records were seen of monthly key worker meetings that reviewed the persons areas of care. When we talked to staff they knew how to keep up to date about the people that they support and that this information is held in the persons care plan or shared at the shift handover. The care files did not all include a photograph of the individual and the manager told us that these have been taken but have yet to be printed and put in peoples files. Care Homes for Older People Page 13 of 28 Evidence: The care records also included details that the person had been consulted about their care being provided, for example, Discussed care plan, x has no preference to the age or gender of their carer. It also included details of peoples preferences, for example what time they like to get up or go to bed. Additional records were seen for monitoring and supporting people with their health needs, these included risk assessments for, Nutrition, The risk of falls, The risk of pressure sores, and Moving and Handling risks. Monitoring charts, for example, for food or fluid intake are also completed as necessary to help people maintain a healthy life. Records are kept of visits or contact with doctors and other professionals, the reasons for the visit and the outcome of this. A service user confirmed to us that they had been supported to visit their GP and we observed another person receiving support to meet a hospital appointment. We looked at the medication systems in the home. There is a separate room and lockable facilities for the safe storage of medicines, and medication records. There is a fridge for medicines that require to be kept cool and records are kept of the temperature of the fridge to help make sure that it is working at the required temperature. We looked at the receipt and administration records for medicines, and saw that some but not all of the files held photographs of each individual to help with identification when administering medicines. The manager told us that replacement photos have recently been taken and that they will shortly be in peoples files. This is good as this practice helps to reduce the risk of errors occurring. Some medication has been transcribed onto peoples Medication Administration records (MAR), by the staff in the home. Good practice is that two people should complete this task to reduce the risk of errors and that both of these people should sign to confirm the details. Although the manager told us that two people do complete this check there was no evidence of this and records must be made and kept at the time of transcribing to provide a clear audit trail of this. Records held for medication described as Controlled were correct and records of medicines returned to the pharmacist also appeared correct. The deputy manager completes a weekly audit check of the medication systems to help prevent errors and Care Homes for Older People Page 14 of 28 Evidence: this is good practice. The medication cabinet is sometimes used to store non medical items and it is recommended that to ensure that the security of the medicines is not compromised another form of safe storage is found for these items. Staff who administer medicines have undertaken training in the administration of medicines approximately 4 years ago, and it is recommended good practice that they complete a refresher course for this training. One person who lives in the home administers there own medication and a risk assessment has been completed to support them to do this safely. We observed that people were spoken to respectfully and when we asked people told us that the staff listen to them and help them with their care. Peoples appearances reflected their individual personalities, people told us they were happy in the home. Care Homes for Older People Page 15 of 28 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. We assessed standards 12,13,14 & 15. People are supported to live their lives as they choose and to maintain important relationships. Evidence: There is a separate area in the home that appeared well equipped with different things for people to use when relaxing, for example jigsaw puzzles. Peoples individual notes recorded the different activities that they had undertaken and when they had declined an activity, for example, Didnt feel up to joining activities, declined discussion group, Declined Reminiscence Group. This is good practice as it clearly records that people are able to make decisions and choose when to decline or participate in an activity. Records of activities on offer included, Communal Crosswords, Bingo, Dough shapes and Manicure. Additionally, when asked staff told us about activities that occur in the home and that these include, singing, trips out, and Christmas decorations. That there is a pop in Care Homes for Older People Page 16 of 28 Evidence: centre available every Tuesday and a day centre on a Friday, were people who live in the home may go and meet up with other people. Gardening also takes place in the home. People who live in the home undertook gardening to the patio area and achieved a Yorkshire in Bloom award for their work. Staff also told us that people are supported with their spiritual needs as a communion type service is undertaken in the home that is well attended. Additionally there was a Christmas service and the local church choir came and sang carols to the people in the home prior to Christmas. There were some records of the activities undertaken between the person and their key worker, although these were limited in their content and the manager is aware of the need to improve these. Peoples records included reference to contact with their family and friends, this included that people had been able to telephone or visit their relative. We observed the manager offering good support with this helping someone to understand why someone could not visit and answering any worries that they had about this. When we spoke to staff they also told us that they offer people the opportunity for people to visit in private and they consider the personalities of people when sitting together, to try and encourage friendships. We saw that people were able to choose what to do throughout the day. Some people spent time alone in their room and others sat in the lounges. When asked staff told us of some of the choices that people make, these included what to wear, what to eat and who to sit with. We looked at the menus offered in the home. People have a choice of different food throughout the week with two choices of their main meal and alternatives on offer if they do not like these. The manager told us that the cook would also cook something separate to the main meal if this was requested. We saw that lunchtime was a relaxed and social occasion with tables set with condiments and people able to choose at the time of dining which main course they would prefer. The meal was well presented and people we spoke to told us that they liked the food provided. Care Homes for Older People Page 17 of 28 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. We assessed standards 16 & 18. People are supported to raise concerns and policies are in place to help protect people from the risk of harm. Evidence: The Commission has not received any complaints regarding the service. Records are kept of any complaints received by the home. The details included the circumstances leading to the complaint, the actions to be taken immediately to address this and any future actions to be taken. However, it did not include the details of the outcome of the complaint, including if the complainant was content with the outcome. There was a copy of the complaints policy held in this file which included the old contact details of the Commission for Social Care Inspection. The manager forwarded a copy of an up to date complaints policy following this visit and this included the correct contact details of the CQC. There is a policy for the protection of vulnerable people and staff records reflected that people have attended training on Safeguarding Vulnerable Adults. When we spoke to staff about protecting vulnerable people they were clear that they would seek Care Homes for Older People Page 18 of 28 Evidence: guidance from the manager and from policies in the home. They reflected knowledge of different areas of potential abuse and were positive in the actions they would take should an incident or allegation of harm be raised. Care Homes for Older People Page 19 of 28 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. We assessed standards 19 & 26. People live in a clean and comfortable home that on the whole is well maintained. Evidence: The home comprises of a traditional large house with modern extensions. The ground floor includes the office, kitchen, four lounges, a sun room, activities room and dining room, with bedrooms and bathrooms adjacent to this. Upstairs there are further bedrooms and bathrooms, including a hair dressing salon. Peoples rooms were well decorated and people had brought in items from home to personalise their rooms. We undertook a tour of the premises and found that it was well maintained throughout. The home was clean and there were no offensive aromas. Some of the bedrooms were vacant and these had been kept clean and tidy. One of the owners initially assisted us with the tour of the premises and showed us some of the bedrooms. Although window opening restrictors are in place throughout the home, the en-suite window of a vacant bedroom did not have an opening restrictor in place and the owner confirmed that they would address this. Care Homes for Older People Page 20 of 28 Evidence: We checked the temperatures of the hot water and found that the majority of outlets were at an acceptable level. However the hot water supply to three bedrooms, (two that are vacant) had hot water that was too hot, with the potential for injury. The manager confirmed to the CQC that this has been addressed and that the two bedrooms that are vacant are not to be used until the hot water temperatures are safe. Due to the individuals needs the hot water in the third room is accessed only by the staff when supporting this person :additionally they have been notified of the potential for injury with warning notices in place until this is rectified. We looked at the fire safety records in the home. There is a fire risk assessment that has been reviewed and weekly fire audits are completed to help make sure that alarms and emergency equipment remain in good working order. There were certificates to show that the fire alarm and emergency lighting had been maintained and a letter from the fire officer following a visit in November 2009 stating that everything was satisfactory. Care Homes for Older People Page 21 of 28 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. We assessed standards 27,28,29 & 30. People are supported by adequate numbers of correctly recruited staff who undertake training for their role. Evidence: We looked at the duty rota and found that there are four staff rostered for a morning shift with a fifth member of staff on duty until 11 am.In an afternoon there are also four staff available with two waking night staff. Additionally there is an activities person employed three afternoons a week and catering and cleaning staff. We looked at the recruitment files for three of the people who are employed in the home. All of these people commenced working in the home in the last year. Two of these people had received a Criminal Records Bureau (CRB) check prior to their employment and one person had undertaken a Protection of Vulnerable Adults (POVA) first check. These checks help to make sure that people are suitable to work with vulnerable people. POVA first checks offer an initial check so that people can commence employment in the home, although they must work under supervision until a satisfactory CRB check is received. The manager told us that people employed following a POVA first check but before a satisfactory CRB check has been received only work on shift with their mentor so that they are supervised; they wear a white tCare Homes for Older People Page 22 of 28 Evidence: shirt to assist with recognition as a new starter in the home. All of the staff had received references to confirm their suitability for the role prior to their employment. We looked at the training and development files for the staff employed in the home. Staff had undertaken inductions into the home and their role, although at the visit we did not see evidence that the training met the Skills for Care requirements, the manager later forwarded these details to the CQC. The manager showed us the staff training matrix, this included information on the courses that people have attended and further identified training. 5 of the staff hold a National Vocational Qualification (NVQ) level 2, with over 75 per cent of the staff team having attended a Safeguarding Adults course. Other courses included Moving and Handling, Fire, Nutrition, First Aid, Continence and Catheter care. Additionally it identified other courses that some people need to attend and this included, continence care, nutrition and catheter care. Care Homes for Older People Page 23 of 28 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. We assessed standards 31,33, 35 & 38. People live in a home that is overall well managed, where they are able to be involved in its development and where overall their safety needs are met. Evidence: The manager has worked in the home for a number of years and is experienced in her role. She told us that she has continued to update her training and has in the last year completed Safeguarding Vulnerable Adults training, Fire safety, Infection control training and has attended as Dementia Care conference. There is a quality assurance system in the home that takes into account the views of the people who live in the home, their relatives and other professionals. The information from this has been formatted into a report to be used for the ongoing Care Homes for Older People Page 24 of 28 Evidence: development of the home. Some meetings have taken place over the last year for both the people who live in the home and for the staff team. It is recommended that the frequency of these be increased. There have not been any issues raised regarding the handling of peoples finances in the home and we did not look at files for this at this visit. There is a risk assessment file that includes risk assessments for safe working practices in the home. Additionally there is a health and safety manual that includes polices and procedures for safe working. Records are kept of any accidents in the home with an audit of these undertaken monthly. We saw certificates to show that the Gas and electrical wiring systems in the home are maintained. Care Homes for Older People Page 25 of 28 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 28 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 26 13 The hot water supply must 10/02/2010 be provided at a temperature that is safe and does not pose a risk of scalding. This is to help make sure that people are safe and are not placed at the risk of injury. 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 There should be an up to date statement of purpose and service user guide, that accurately reflect the current support offered in the home. Care files should include a photograph of the individual service user. Individual medication records should include a photograph of the service user. The outcome of any complaints including if the complainant is satisfied with the investigation should be recorded. 2 3 4 7 9 16 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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