Care Home: The Cotswold Home

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What the care home does well Prospective service users are encouraged to visit the home before making a decision to move in for a trial period. Service users expressed their satisfaction of the accommodation, facilities and garden. The home is run in the best interests of the service users. Service users are confident that any complaints will be listened to, taken seriously and acted upon. The home is maintained to a high standard, clean and free from unpleasant odours. This is a well managed home, run by an qualified and experienced manager. What has improved since the last inspection? A new general manager has been recruited and is preparing her application for registration with the commission. Night staffing levels on the residential unit have been increased. What the care home could do better: No requirements or good practice recommendations have been made following this inspection. The general manager is aware of the areas needing attention and further development, this is clearly evidenced in the AQAA and recent three day internal audit. Action is in progress. Key inspection report Care homes for older people Name: Address: The Cotswold Home Woodside Drive Bradwell Village Burford Oxfordshire OX18 4XA     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: Marie Carvell     Date: 0 8 0 4 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 27 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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: The Cotswold Home Woodside Drive Bradwell Village Burford Oxfordshire OX18 4XA 01993824225 01993824226 pat.hamilton@efhl.co.uk www.efhl.co.uk Elizabeth Finn Homes Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Type of registration: Number of places registered: care home 51 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 51 The registered person may provide the following category/ies of service only: Care home with nursing - N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Physical disability - PD Date of last inspection Brief description of the care home The Cotswold Home was purpose built in 1998 and is situated in open countryside two miles from Burford. The Cotswold Wildlife Park is nearby and service users who have the mobility and independence to walk to the Wildlife Park can do so if they wish. Country walks are also accessible from the home. The home is registered for 51 Care Homes for Older People Page 4 of 27 Over 65 51 0 0 51 Brief description of the care home service users with a maximum of 30 places for people requiring nursing care. Two GP surgeries provide medical cover and on admission residents are asked which surgery they wish to be registered with. A dentist visits the home to assess service users but treatment is carried out at the dental surgery. Transport can be arranged in the homes minibus. Physiotherapy is available twice a week. The services of an optician and chiropodist are also available. Accommodation is provided on two floors. The ground floor has 30 single bedrooms and these are for those service users requiring nursing care. The first floor provides 21 single rooms for service users with low to moderate dependency levels. Some of the service users on the first floor are fully independent. All bedrooms are equipped with en-suite toilet and hand basin. A passenger lift provides access to the first floor. There is a wide range of recreational activities available including a library and art room for service user use and the home has a group of committed volunteers who help the residents in a variety of ways. The Cotswold Home has a delightful courtyard garden, as well as a garden at the rear of the home, providing pleasant outdoor space for service users and their visitors. The fees for this home range from 895.00 per week for residential care to 1120.00 per week for nursing care. 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: 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 last key inspection of this service was completed in May 2007. This inspection was an unannounced key inspection. We ( the commission) arrived at the service at 9:45 and we were in the service until 17:30. It was a thorough look at how well the service is doing. It took into account detailed information provided by the newly appointed general manager in March 2010 and any other information that we have received about the services since the last inspection. Nine service users and seven members of staff completed surveys sent to the home to distribute. We looked at how well the service is meeting the standards set out by the government and have in this report made judgements about the standards of the service. Time was spent with the general manager, service users and staff on duty. We looked at communal areas of the home, examined a sample of records required to be kept in the home, including service users and staff records. We spent time talking to service users and members of staff in communal areas of the home and in private. We spent time Care Homes for Older People Page 6 of 27 observing how care was being delivered to service users in each of the two units and joined service users for lunch in the communal dining room. Care Homes for Older People Page 7 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 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 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. Service users are provided with enough information to help them decide if the home is the the right place for them. Service users are provided with a contract/terms and conditions. Service users are fully assessed prior to admission, to ensure that their needs can be met by the care home. Evidence: All prospective service users are provided with information about the home, including the last inspection report, homes brochure and service user guide. Service users confirmed that they had received enough information to help them decide if the home was the right place for them before moving in. Service users are invited to visit the home, before moving in for a trial period to look at the facilities and accommodation and to meet other service users and the staff team. Care Homes for Older People Page 10 of 27 Evidence: A detailed assessment of care need is carried out prior to admission by a member of the senior staff team, this may include input from healthcare professionals, relatives and advocates as well as the service user. Once the assessment is completed, written confirmation is sent to the service user that the home is able to meet their individuals care needs. All service users are provided with a contract/terms and conditions. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users should be involved in the drawing up of their care plan. Care plans should be in sufficient detail regarding lifestyle choices and the preferences of the service user in relation to when care is to be provided and how. The healthcare needs of service users are fully met. Medication administrative procedures need to be more robust to ensure that service users receive their medication in accordance with the homes policies. Evidence: Care plans are drawn up from information recorded on the pre-admission documentation. A sample of care plans and daily records were examined with the general manager. Information relating to health and physical care is well documented. However, it was not clear that service users had been involved in the care planning process. Care plans seen were not in sufficient detail regarding lifestyle choices or the preferences of the service user in relation to when care is to be provided or how, this was discussed with the general manager, who agreed that care plans need to be more Care Homes for Older People Page 12 of 27 Evidence: person centred. Daily record do not necessarily validate care plans. Following the inspection we received an action plan from the general manager confirming that additional care planning training is to take place by June 2010. Nine surveys were completed by service users, five surveys stated that the service user always received the care and support they needed and four surveys stated that the service user usually received the care and support they needed. Comments made on surveys included Bells at night could be answered more promptly, I am usually seated last in the dining room, More care is needed in some cases, Answer call bells more quickly. The healthcare needs of service users are met by two local GP practices. The care needs of the service users receiving nursing care are met by the registered nurses(RN) employed in the home. The community nursing team are responsible for meeting the nursing care needs of service users receiving personal care only. The home employs a part time physiotherapist and other healthcare professionals visit as necessary. Six surveys stated that the home always made sure that they received the medical care needed, two surveys stated that the home usually made sure that they received the medical care needed and one survey stated that the home never made sure that the service user received the medical care needed. Service users are encouraged to take responsibility for their own medication, following an appropriate risk assessment. Medication is administered by the RNs on duty on the nursing unit or by care staff who have undertaken accredited medication training and a competency assessment on the residential unit. During an internal medication audit in March 2010, several areas of medication storage and recording were found to be not maintained in accordance with the homes policies. The general manager confirmed that as a result of the medication audit, immediate action was taken to address the issues. Following the inspection we have received an action plan confirming action to be taken including the planning of regular meetings with the two GP practices, with a date for the first meeting already agreed. A pharmacy visit was undertaken in March from the dispensing chemist who supplies medication to the home. Time was spent with service users in private and communal areas, all expressed their satisfaction of the care provided. Staff were observed to interact with service users in a calm, respectful and kind manner. Service users expressed their satisfaction of the care provided. Comments made on surveys to the question Are staff available when you need them, three surveys completed by service users stated always, four surveys stated usually and two stated sometimes. Care Homes for Older People Page 13 of 27 Evidence: Service users confirmed that they are always addressed by their preferred term of address and felt that their privacy and dignity was maintained at all times. From discussion with staff on duty, we consider that the care home is able to provide a service to meet the needs of individual service users with various religious, racial or cultural needs. 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. Service users are encouraged to make lifestyle choices and remain independent for as long as possible. A range of age appropriate activities and community involvement is made available to meet the social needs of service users. Service users are provided with a varied, wholesome and nutritional diet. Evidence: The home employs two social events coordinators, who provide activities over six days. In addition one care assistant provides outings alternate Fridays. There is a varied, activities programme in place. The service users benefit from a wide circle of volunteers including Friends of the Cotswold Home, who assist with fund raising, flower arranging in the home and organise a drinks reception before lunch on Tuesdays. The home has a minibus and a well stocked shop. Four surveys stated that the home always arranged activities that they are able to take part in if you wish, four surveys stated usually the home arranged activities that they were able to take part in and one survey stated that sometimes the home arranged activities that the service user could take part in. Comments made on surveys included More visits to Care Homes for Older People Page 15 of 27 Evidence: shops, Bradwell village has no shops or buses, it is too far for elderly people to walk into Burford. You could say that we are disadvantaged because of the isolation, we have a shop, but this is for essentials only,The reception desk is especially welcoming and helpful. Several service users expressed concern that the home is not longer able to cash personal cheques. Many service users have friends and family who are able to visit on a regular basis. The home is able to provide accommodation for a visitor overnight for a reasonable charge. Service users are encouraged as far as possible, to maintain contact with membership of clubs and organisations. There is a computer for service user use, with a specially designed programme for older people, to enable them to send and receive e-mails. An hairdresser visits the home twice weekly. manicures and hand massages are available. An aromatherapist visits weekly. The home has a small chapel, which is used twice per month for a religious service and religious ministers from several denominations visit the home regularly. Meetings including the residents committee are held regularly to seek the views of service users. Service users confirmed that the new general manager was always available to chat to them as the home has a open door policy. Service users confirmed that the routines in the home are flexible, such as being able to choose how they spend their day, when to retire to bed or when to get up in the mornings. We joined service users for lunch in the main dining room. Service users confirmed that there is always a choice of meals. The menu demonstrated that there is always a wide range of food choices and at lunch time there is a choice of meat, fish or vegetarian dishes. Service users are provided with a varied, wholesome and nutritional diet. The meal was hot, tasty and attractively served. Staff were attentive and assisted service users in a quiet, discreet and dignified manner. Two surveys received from service users stated that they always liked the meals at the home and seven surveys stated that service users usually liked the meals at the home. Comments were made by some service users that the supper trays were being sent out too early at 17:30, following a three course lunch at 12:30. The general manager has agreed to seek the views of all service users regarding supper times. 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. Service users can be confident that any concerns or complaints will be listened to, taken seriously and acted upon. All staff receive training in protecting vulnerable adults from possible harm. Evidence: The home has a clear, detailed complaints procedure, which is displayed prominently in the home and a copy is given to all service users on admission to the home. The complaints procedure is also available in large print and CD format. In the last twelve months the home as received nine complaints, all were resolved within twenty eight days and two of the complaints were partially upheld. The recordings of complaints were seen to be clear, detailed and included action taken and outcomes. The general manager confirmed that verbal complaints are recorded. Five surveys completed by service users confirmed that they knew how to make a formal complaint. This was confirmed in discussion with service users. Four surveys completed by service users stated that they did not know how to make a formal complaint. Service users stated that they were confident that any complaints or concerns would be listened to, taken seriously and acted upon. Since the last inspection we have not received any information regarding complaints about this home. Care Homes for Older People Page 17 of 27 Evidence: All staff receive training in safeguarding vulnerable adults from abuse, including whistle blowing procedure during their initial induction training and updated on a regular basis. This was evidenced from training records and confirmed in discussion with staff. One safeguarding referral and one safeguarding investigation has taken place in the last twelve months. No referrals have been made for inclusion of staff on the protection of vulnerable adults list ( POVA). All volunteers and self employed staff working in the home, complete police checks. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides safe, well maintained accommodation. Service users expressed their satisfaction of the accommodation, facilities and gardens. The housekeeping staff work hard to ensure that the home is clean, pleasant and free from odours. Evidence: The location and layout of the building is suitable for its stated purpose. Service users expressed their satisfaction of the accommodation, facilities and gardens. The home and gardens are maintained to a high standard. There is an ongoing refurbishment and redecoration programme in place. The housekeeping staff work hard to ensuring that the home is clean, pleasant and free from odours. Service users expressed their appreciation of the beautiful flower arrangements throughout the communal areas provided by the Friends of the Cotswold Home. Seven surveys completed by service users stated that the home is always fresh and clean and two surveys completed by service users stated that the home is usually fresh and clean. Comments made on surveys included There is a pretty courtyard garden which is very well looked after and flowers in large vases are placed in and around reception, These are always most beautiful arrangements, Good decor, redecorated as needed, very good laundry service and maintenance Care Homes for Older People Page 19 of 27 Evidence: staff. 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. Staffing levels appear to be adequate to meet the needs of the service users. Recruitment procedures are robust. Staff are well trained and are able to carry out their duties in a professional manner. Evidence: From discussion with the general manager, staff on duty, examination of duty rosters and observation there appears to be adequate staffing levels to meet the needs of the current forty eight service users. In the last twelve months sixteen care/nursing staff have resigned for a variety of reasons. The home currently has a vacancy for a full time unit manager/senior nurse post. Three surveys completed by service users stated that there were always staff available when they were needed, four surveys completed by service users stated that usually staff were available when they were needed and two surveys completed by service users stated that sometimes staff were available when they were needed. Comments made on surveys included Friendly staff and good care, The carers are always patient, cheerful and helpful ( on the whole). There is a very good relationship between residents and staff, The home employs first rate carers. Care staff are encouraged to undertake national vocational qualification ( NVQ) Care Homes for Older People Page 21 of 27 Evidence: training. At present 55 percent of the care team have achieved NVQ at levels 2/3 with an additional five care staff undertaking the training. From examination of a sample of staff personnel files and the homes recruitment procedures, robust recruitment procedures are in place. The seven surveys completed by members of staff confirmed that police checks and references had been requested before they started work in the home. Each member of staff has a training and development programme in place. All staff complete mandatory training and undertake specialist training as appropriate. Nursing staff are assisted with their continuous professional development. Two surveys completed by members of staff stated that their induction covered everything very well that they needed to know to do their job when then they started working in the home, four surveys stated that induction mostly covered everything that they needed to know to do their job when they started working in the home and one survey stated that their induction partly covered everything they needed to know to do their job when they started work in the home. Six surveys completed by members of staff confirmed that they received up to date training that was relevant to their role and kept up to date with new ways of working. One survey completed by a member of staff, stated that this did not happen. In-house training in safeguarding procedures was taking place on the day of this inspection. Staff spoken to said that they enjoyed working in the home, felt valued and well supported. Communication systems in the home are well organised, with clear lines of accountability and a robust structure of line management. Staff handovers take place at the beginning of each shift. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the quality of care for service users is monitored regularly by senior managers of the company. The general manager is to address the lack of staff 1-1 formal supervision and annnual appraisals. Evidence: The general manager has been in post since the 23rd of January 2010, following the retirement of the previous registered manager. She is in the process of applying to the commission for registration as the homes manager and is an experienced and qualified manager as well as a registered nurse. Service users and members of staff expressed the view that the home was being run in the best interests of the service users. There are clear lines of accountability in the home. Policies and procedures are in place and reviewed and updated as necessary. Staff are kept informed of any changes and these are discussed at team meetings. Care Homes for Older People Page 23 of 27 Evidence: There is an detailed business plan in place, which is reviewed annually and includes measures for success in both finance and quality of service delivery. Twice yearly satisfaction surveys are sent out to all service users, relatives and stakeholders. The results are published and recommended actions are implemented. Procedures are in place for dealing with service users monies and valuables, these are in line with company procedures are are audited annually. It was not evidenced that staff are receiving formal 1-1 supervision at least six times per year or an annual appraisal as is company policy. The general manager has agreed to address this as a matter of urgency. Reports written by a provider Representative, following a monthly unannounced visit to the home, were available for examination. Quality assurance systems are in place as well as monthly and annual internal audits. These are detailed and well documented. Evidence was seen that the views of service users, relatives and stakeholders are obtained to measure the homes success in meeting the aims, objectives and statement of purpose. A sample of records relating to health, safety and welfare were examined and found to be well maintained and up to date. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 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. 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