Care Home: Sun Woodhouse

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What the care home does well The information given to us by the acting manager, both verbally and in record form, demonstrates that there are good systems and procedures in place to ensure that people`s needs are properly assessed prior to moving into the home, and that they are given to the opportunity to visit it before moving in. Very good information about how people`s needs should be met and how to minimize risks to people is available. Good support is given to help individuals make choices and decisions. Medicine management is good. People receive personal support in the way they prefer and require and the systems operated by the service realting to meeting people`s healthcare needs are very proactive and, people`s health care needs are met appropriately. People living at the home lead a reasonably active lifestyle, are well supported in this area. People are very well supported to keep in touch with family and friends, have their rights respected and have a healthy and varied diet. There are good systems in place for dealing with complaints appropriately. People live in a comfortable home with plenty of space, and activity areas that cater for people`s needs, and encourage independence and participation in social activities. All parts of the home are kept clean and tidy, and there is a programme for renewal and refurbishment. A well trained staff team supports the people living at the home and the recruitment practices are good, with good procedures in place that offer people protection. Good quality assurance systems are in place, and there are systems in place to protect the promote the health and safety of people living and working at the home. Development of management audit and monitoring systems would support the work of the manage and staff. What has improved since the last inspection? CAre plans and the progress for care planning has got better and is alot more person centred. Staff training is very very good. The systems and procedures in place to protect people from abuse and neglect are now more robust, and in line with those produced by the Local Authority, and the National Safeguarding Authority. What the care home could do better: The assessment system could be strengthened by way of a letter which could be sent to the person or their family offering them a place at the home and stating that the service can meet their needs. Greater attention should be paid to meeting the dietary requirements of people living in the home in more creative ways. Development of management audit and monitoring systems would support the work of the manager and staff. Increasing the frequency of medication audits and taking action to deal with any problems found as a result of the audit would help to ensure the outcomes for people living at the home remain positive. Ensuring that all the daily records are of a high standard would ensure that excellent records are maintained of ht e activities people are engaged in during the day, and the type of care and support they have received. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Sun Woodhouse Woodhouse Hall Road Fartown Huddersfield West Yorkshire HD2 1DJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tony Brindle-Wills     Date: 3 0 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Sun Woodhouse Woodhouse Hall Road Fartown Huddersfield West Yorkshire HD2 1DJ 01484424363 Telephone number: Fax number: Email address: Provider web address: sunwoodhouse@eldercare.org.uk Name of registered provider(s): Type of registration: Number of places registered: Eldercare (Halifax) Ltd care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Sun Woodhouse is registered to provide personal care and accommodation for up to 24 elderly people. The care home is owned by Eldercare (Halifax) Limited. Mr Brian Vincent is the responsible individual. There is no registered manager in post at the time of writing. Sun Woodhouse is an old detached stone building that has a modern extension dating from 2000. The home is situated part way up a hill in the Fartown area of Huddersfield, close to local amenities such as shops, churches and post office. Public transport is accessible from the home. Car parking is available. The Commission was informed that as at 31.08.08 the home?s weekly fees ranged from #342.00 to #405. Additional charges are made for chiropody and hairdressing. Information about the home and the latest Commission for Social Care Care Homes for Older People Page 4 of 27 Over 65 24 0 Brief description of the care home Inspection report are available from the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was positive and enjoyable. We spent some time having a look at the paperwork at the home, and we talked to people who live at the home, had a look round the home, checked the medication and money, and talked to the staff. The paperwork we looked at included peoples care plans and assessments, some staff personnel and training files, the medication, health and safety records, the menus and kitchen records, and the daily records made by the staff about the activities people had been involved in during the day. We would like to take the opportunity to thank the people living at the home, the acting manager and the staff for their hospitality and patient co-operation throughout the inspection. Since we last inspected this service, we have not received any complaints about the service. There has been no change to the manager of the home. The acting manager and staff continue to keep us informed of incidents and developments within the service. Care Homes for Older People Page 6 of 27 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 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 Care Homes for Older People Page 7 of 27 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information given to us by the acting manager, both verbally and in record form, demonstrates that there are good systems and procedures in place to ensure that peoples needs are properly assessed prior to moving into the home, and that they are given to the opportunity to visit it before moving in. The system could be strengthened by way of a letter which could be sent to the person or their family offering them a place at the home and stating that the service can meet their needs. Evidence: A discussion took place with the acting manager about what would happen if people wanted to move into the home. She explained that if someone wanted to move into the home, then she or a member of staff with experience of assessments, would visit the person, and their family or representative, and undertake an assessment of their needs. The acting manager showed us the files of people who had recently moved into the home, and these records were found to contain assessments about persons needs and desires, their health and personal care needs, and information about their life Care Homes for Older People Page 10 of 27 Evidence: history. There were written details of how these needs should be met, and the acting manager explained that this information had been gathered through meeting the person, talking to them, their family and the health and social care professionals involved in their life. Information contained within the care records confirmed that people with experience of undertaking assessments go to visit people to gather information about their on going health and personal care needs. The acting manager made it clear that if people wanted to visit the home, and meet the people and staff, then they would be able to do this. The records show that once an assessment is made, then a decision based on that information is made as to whether the service can meet that persons needs. A discussion took place about the need for a letter to be sent to the person or their family explaining the decision, and if the service can meet their needs. The acting manager said that she would ensure that letters are sent out in the future. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Very good information about how peoples needs should be met and how to minimize risks to people is available. Good support is given to help individuals make choices and decisions. Medicine management is good. People receive personal support in the way they prefer and require and the systems operated by the service realting to meeting peoples healthcare needs are very proactive and, peoples health care needs are met appropriately. Evidence: The acting manager showed us the care plan files of 3 people living at the home. She was able to explain the care planning process in great detail. She added that the staff involved in the care planning process, find out what the health and safety risks are to each person by talking to them and their families, and by undertaking a risk assessment, which is documented. Information contained within the care plan files confirmed what the acting manager had spoken about. She added that wherever possible, the person themselves, and or their family members (if appropriate) are involved in the care planning process. The care plans that we looked contained signatures of either the person themselves or their relative. The information contained Care Homes for Older People Page 12 of 27 Evidence: within the care plans were found to be accurate, detailed and written in a sensitive manner. The care plans were seen to be person centred in their approach with people being included, consulted and involved in their care. People living at the home said that the staff ask them about what they like to do, about what their interests are and about how they like to be supported to undertake certain activities such as washing, dressing, shopping and socializing. Staff at the home confirmed that they are involved in care planning, and were able to speak about the process in a manner that indicated that they saw it as an important part of what they do, and not just a task to be completed. We looked at the daily records which were found to contain information about what people had been doing during the day and night. The information was seen to be factual and non-judge-mental, and when decisions had been made to participate in different activities, the reasons for this had been recorded. The acting manager explained that for some people, decision making can be difficult due to their level of cognitive ability, adding that when decisions are made on a persons behalf, to engage in a social activity for example, then the staff always ensure that good records are kept so that the reasons why and when decisions are made by others can be clearly demonstrated. Information contained within the daily records confirmed this. Despite this, some of the daily records were found lacking in detail, and the acting manager explained that she would be undertaking training in relation to this. The acting manager explained that personal supported is always provided to people in private, and that routines such as the times for going to bed, having baths, meals and other activities are flexible. She added that people are encouraged to choose their own clothes and hairstyle, and where possible peoples appearance reflects their personality. Discussions with people living at the home confirmed this. Observations made on the day of the visit confirmed that staff work with people in a sensitive manner, providing flexible personal support in ways that promote peoples privacy and dignity and where possible their independence. Information contained within peoples care files indicated that peoples health is monitored and any potential complications and problems are identified and dealt with at an early stage, including referral to the appropriate health-care professional. The acting manager explained that people with specific health-care needs are supported to visit a specialist, and if they are unable to make their own appointments, the staff do this on their behalf. This was supported by way of information contained peoples care plans showing when appointment had been made, the outcome, and any action that needs to be taken by the person, or the staff at the home to promote peoples health and wellbeing. Feedback from relatives indicated that they were satisfied with the way in which staff at the home support people with their health-care needs. A sample of the medications held at the home were looked at and everything was Care Homes for Older People Page 13 of 27 Evidence: found to be in good order. The staff training records show that staff have had training in the use and medication, and the acting manager explained that she is looking at ways in which she can increase the frequency of her medication audits. At the moment audits take place on a monthly basis. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home lead a reasonably active lifestyle, are well supported in this area. People are very well supported to keep in touch with family and friends, have their rights respected and have a healthy and varied diet. Greater attention should be paid to meeting the dietary requirements of people living in the home in more creative ways. Evidence: The acting manager explained that the people who live at the home have differing interests and preferences as to how they spend their day. One member of staff said that there are activities put on in the home, and that people do get the opportunity to go out and take part in recreational activities such as shopping and occasional meals outand visits to see family. One person living at the home said that they really enjoyed singing and dancing with the staff. Information contained peoples care plans indicated that people do get the opportunity to engage in a range of activities inside the home, and the feedback we received from both people living at the home, concerning the types of activities people are engaged in and lifestyle they lead was positive. The menus were looked at, and were found to offer people a varied and nutritious diet. One person said that there was always plenty to choose from, and that if they didnt like what was on the menu, then the staff would make them something Care Homes for Older People Page 15 of 27 Evidence: different. One person spoke about the fact that they would like to eat different foods, and foods more in line with their own cultural requirements. The acting manager explained that the service has obtained cultural based food items, and have cooked these. She added that obtaining takeaways from local outlets could be a way forward to meet this persons dietary requirements. People confirmed that they are supported to keep in touch with their families and friends, and the daily records show when family and friends. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place for dealing with complaints appropriately. The systems and procedures in place to protect people from abuse and neglect are now more robust, and in line with those produced by the Local Authority, and the National Safeguarding Authority. Evidence: The acting manager explained that the home has a complaints procedure, which is available for all to see as it is posted in the entrance hall of the home. She added that the service welcomes complaints from all parties; if the service have got something wrong or are doing doing something right, then she wants to know so that changes can be made and peoples concerns can be addressed. The procedure was seen to be satisfactory. The records show that the service has had 4 complaints within the last year which have been dealt with appropriately and to the satisfaction of the complainants. People who responded to our survey indicated that they knew who to speak to if they had a concern or complaint, and that they felt confident that their concern of complaint would be dealt with quickly and appropriately. One person living at the home who was spoken with said that they would speak to a staff member if they were worried about anything, and that they felt sure the staff would support them and deal with their worries properly. The acting manager explained that staff have had adult safeguarding training, and added that the service has a adult safeguarding policy and procedure, which is Care Homes for Older People Page 17 of 27 Evidence: displayed within the home, given to staff, and used as a basis for staff training. The records show that the acting manager is a trainer in the area of safeguarding adults . She added that the organization has a whistle blowing procedure. These policies and procedures were looked at the found to be in good order and in line with the local authority safeguarding procedures. One member of staff who was spoken with was able to talk about what they would do if they suspected or witness abuse, and their explanation was found to be in line with the policies and procedures operated by the service. The personnel records held at the home show that the Protection of Vulnerable Adults register is checked before staff are appointed to work in the home. The records show that there was a recent safeguarding investigation within the home, after it was alleged a staff member had handled a person in a rough manner. An investigation took place, and the allegation was upheld. The staff member was disciplined, and eventually dismissed from the service. The service referred this person onto the Local Authority as they believed, it was the Local Authoritys responsibility to refer them to the National Safeguarding Authority. However, it was pointed out to the acting manager and responsible person, that it was their responsibility to do this. The responsible person immediately got hold of the referral forms, and made the referral on the day of the site visit. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable home with plenty of space, and activity areas that cater for peoples needs, and encourage independence and participation in social activities. All parts of the home are kept clean and tidy, and there is a programme for renewal and refurbishment. Evidence: The acting manager explained that the comments she regularly gets back from people living at the home, their relatives and visitors state that people see the home as being comfortable, roomy, bright, cheerful and clean. On the day of the visit, the home was found to clean and tidy, with the furnishings and fittings being seen to be of a good quality and in good working order. People living at the home said that think it is kept clean and tidy. This was confirmed on having a look around the building. Hand washing facilities were found to be located appropriately throughout the building, and the acting manager explained that laundry facilities are sited so that soiled articles and clothing are not carried through areas where food is stored and prepared. This was confirmed on having a look around the building. It ws noted that some bedroom doors did not have Door Guards on them, which help to close the door in the event of a fire. The acting manager immediately got hold of some new Door Guards, and the Commission were informed the following day, that the handyman had fitted them to all the doors in the home that needed them. It was noted that a carpet in a toilet needed to be removed and replaced with a more appropriate floor covering, and the Care Homes for Older People Page 19 of 27 Evidence: acting manager explained that the bathgrooms, and shower rooms are in the process of being refurbished. The acting manager also pointed out that a small room has been cleared and is to be used as a activity room and pamper room. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well trained staff team supports the people living at the home and the recruitment practices are good, with good procedures in place that offer people protection. Evidence: The acting manager explained that the comments she regularly gets back from people living at the home, their relatives and visitors state that people believe the staff team to be approachable, reliable, honest and motivated to make sure people are cared for properly. Observations made on the day supported this, with staff being seen to work sensitively with people, communicating with people effectively and showing an interest in individuals. Feedback from people who completed our survey showed that they too believed the staff to be good at what they do, friendly and enthusiastic about the work they undertake. The personnel and employment records that were looked at contained good levels of information. Information contained within the records show that new starters are only confirmed into post once a satisfactory Criminal records Bureau check has been undertaken, and a check against the Protection of Vulnerable Adults register is made. The staff training records show that staff received esxcellent levels of training in all aspects of work within a care setting. Feedback from people who completed our survey indicated that they believed the staff to be well trained. Staff working at the home spoke about the training they had received, giving details of scenarios that come up from time to time, and details of what they would do, how they would deal with issues, and how they could do things differently if needs be. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good quality assurance systems are in place, and there are systems in place to protect the promote the health and safety of people living and working at the home. Development of management audit and monitoring systems would support the work of the manage and staff. Evidence: The records held by the Commission show that the manager is not yet registered with us, but she explained that she is in the process of getting her application pack ready to be sent to us. The acting manager explained that she obtains feedback from people using the service, their relatives, and other relevant parties about the services provided by way of user satisfaction questionnaires. The records of these were seen, and the feedback supplied by people was seen to be positive. She added that she has in place audit and monitoring systems for various practices within the home such as medication, money, accidents and incidents. Again, the records of these were seen, and there were found Care Homes for Older People Page 22 of 27 Evidence: to be satisfactory, however,l the acting manager has plans to increase the frequency of some the audits. The records relating to the health and welfare of people living and working in the home were seen, and were found to be satisfactory. These included records relating to weekly alarm system tests, food hygiene control measures, infection control systems, the regulation of water temperatures and the maintenance of equipment Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 3 The assessment system could be strengthened by way of a letter which could be sent to the person or their family offering them a place at the home and stating that the service can meet their needs. Ensuring that all the daily records are of a high standard would ensure that excellent records are maintained of ht e activities people are engaged in during the day, and the type of care and support they have received. Increasing the frequency of medication audits and taking action to deal with any problems found as a result of the audit would help to ensure the outcomes for people living at the home remain positive. Looking at alternative ways to meet peoples dietary requirements with take-aways for example, would help to support people in a positive manner. The bathrooms and shower rooms they have been identified as needing to be refurbished should be done as soon as possible so as to improve the living environment for people at the home. 2 7 3 9 4 15 5 19 Care Homes for Older People Page 25 of 27 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 6 19 Progress should be made on developing the activity room/ pamper room so as to improve the living environment for people at the home.. A carpet in a toilet should be replaced with a more appropriate floor covering so as to improve the living environment for people at the home. Development of management audit and monitoring systems would support the work of the manager and staff. 7 19 8 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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