Care Home: The Spinney

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What the care home does well The good assessment process ensured the needs of residents could be suitably placed at this care service. A person who used the service said, "I have been here six months. This was the only home I knew about. My son helped me to chose it". A visitor said, "My dad was in hospital and it was not a good experience. My mother knew someone who was here and thought it was brilliant". People who used the service did so out of choice. People case tracked said, "The male nurses protect my dignity. The give care very privately there is no public exposure because they close the doors and curtains" and "the care is very private". The good attitude of staff ensured people who used the service retained their dignity and were comfortable with their personal care. People case tracked said, "The room is all right but its rather small. I have too much stuff. My wheelchair is also big and cumbersome" and "if you saw my room you will be astonished it is lovely. I have a balcony and the room has four windows with lovely views". It was observed that in general the home was well decorated and furnished to provide a homely atmosphere for people who used the service. Several residents who used the service said the food was very good. Two people case tracked said, "The food I don`t enjoy because I had a stroke but it is very reasonable. They had to purify my food to begin with which I did not enjoy" and "the food is very good". People who used the service said the food was to their liking. People who used the service said, "My son visits with no problems. He lives local. He visits me - he was here last night. I have things to look forward to with my family" and "we get visitors and staff are very nice to them. I go out a lot. I can go out when I want to and use my own hairdressers. Visiting was encouraged for people who used the service to spend time with family and friends. Both people who used the service felt safe. Staff were trained in safeguarding topics and the recruitment procedures were robust. This meant that the care service took seriously the safety of individuals residing at the home. Both people who used the service said they would complain if they had to but initially to a family member. There was a complaints procedure which was accessible to people who used the service or their families. People who used the service had an outlet to voice their concerns. The staffing rota and staff files demonstrated there was a well trained staff team to meet the needs of people who used the service. People who used the service said, "the nurses treat me very well. They are very sweet" and "the staff are very pleasant, friendly and helpful. They look after us well, in fact excellent". There was a good deal of friendly banter and humour on the day of the inspection. Staff had a caring but friendly attitude which was appreciated by people who used the care service.I feel very safe here. We get visitors and staff are very nice to them. I go out a lot. I can go out when I want to and use my own hairdressers. He comes to visit me. A visitor said, "I am impressed with the managers attitude. He put me at ease when dad first came in. I am fussy. He helped us through the hospital meetings. I was anxious but could not fault the home. The staff are all very nice and treat my dad as an individual. They keep me informed. He has been here a week and we have close contact they keep me updated. The door is always open. He is improving here". This visitor was impressed with the caring attitude of the person in charge and had been fully informed of his progress. Staff said, "I think it has come along very well and we are trying to get it back to a good standard. We have a good staff team and get on well with each other and they support me. I get supervision. I get plenty of support" and "I think we have a good staff team. I get supported by senior staff, we all help each other out. There is enough staff here most of the time. We get chance to sit and talk to residents". The staff members felt supported and a valued member of the staff team. What has improved since the last inspection? The plans of care had been improved for staff to understand the needs of each individual. Plans of care had been reviewed on a regular basis to ensure their health care needs were being monitored. Risk assessments for specific health care needs had been undertaken to ensure each person was protected from possible harm. The gardens had been improved to allow better access and provide interest for people who used the service. The temperature of hot water outlets had been controlled to prevent the possibility of scalding people who used the service. What the care home could do better: The last wishes of people who use the service should be recorded so they receive the care they wish at this difficult time. The carpets in some areas of the home could be repaired or replaced to improve the facility. The plans of care should be person centred to ensure each individuals care needa are recorded. Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Spinney 16 College Road Upholland Wigan Lancashire WN8 0PY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Graham Oldham     Date: 1 3 0 5 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 26 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 26 Information about the care home Name of care home: Address: The Spinney 16 College Road Upholland Wigan Lancashire WN8 0PY 01695632771 01695625599 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bondcare (Spinney) Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 35 Number of places (if applicable): Under 65 Over 65 35 0 old age, not falling within any other category physical disability Additional conditions: 0 3 The home is registered for a maximum of 35 service users to include: Up to 3 service users in the category of PD (Physical Disability). Up to 35 service users in the category of OP (Old Age not falling within any other category). Date of last inspection Brief description of the care home The Spinney is a thirty-five bedded care home providing nursing and personal care. Accommodation is over three floors, which can be accessed by a lift. Thirty-one rooms are single, six of which have en-suite facilities. Two shared rooms are also available. Twenty-three residents were accommodated on the day of the inspection. Care Homes for Older People Page 4 of 26 Brief description of the care home Lounges are provided on the ground and first floor. The ground floor lounge is large and spacious. The first floor lounge is smaller, but comfortable and furnished nicely. There is a dining room on the ground floor. The home is furnished to a satisfactory standard, and has a friendly ambiance. The most recent inspection report is available in the reception area of the home. A statement of purpose and service users guide are available for residents or their families to be informed of the facilities and services the home provides. The fees for The Spinney range from £386 to 606 per week. This does not include hairdressing, newspapers or magazines and toiletries. Outings are subsidised and residents may have to contribute. Care Homes for Older People Page 5 of 26 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: A key unannounced inspection, which included a visit to the home was conducted on the 13th May 2009. Three residents were case tracked. Case tracking gave the inspector an overall view of the specific care of each individual by checking the plans of care and other documentation. Two staff were questioned about the residents case tracked to ensure they were familiar with the care required for each individual. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted to assess the decor and furnishings. Prior to the Care Homes for Older People Page 6 of 26 visit the person in charge had submitted a pre inspection questionnaire. This gave information This gave information that was used in the planning of the inspection. Wherever possible the views of people who used the service were obtained about life at the home and their comments included in the report. What the care home does well: The good assessment process ensured the needs of residents could be suitably placed at this care service. A person who used the service said, I have been here six months. This was the only home I knew about. My son helped me to chose it. A visitor said, My dad was in hospital and it was not a good experience. My mother knew someone who was here and thought it was brilliant. People who used the service did so out of choice. People case tracked said, The male nurses protect my dignity. The give care very privately there is no public exposure because they close the doors and curtains and the care is very private. The good attitude of staff ensured people who used the service retained their dignity and were comfortable with their personal care. People case tracked said, The room is all right but its rather small. I have too much stuff. My wheelchair is also big and cumbersome and if you saw my room you will be astonished it is lovely. I have a balcony and the room has four windows with lovely views. It was observed that in general the home was well decorated and furnished to provide a homely atmosphere for people who used the service. Several residents who used the service said the food was very good. Two people case tracked said, The food I dont enjoy because I had a stroke but it is very reasonable. They had to purify my food to begin with which I did not enjoy and the food is very good. People who used the service said the food was to their liking. People who used the service said, My son visits with no problems. He lives local. He visits me - he was here last night. I have things to look forward to with my family and we get visitors and staff are very nice to them. I go out a lot. I can go out when I want to and use my own hairdressers. Visiting was encouraged for people who used the service to spend time with family and friends. Both people who used the service felt safe. Staff were trained in safeguarding topics and the recruitment procedures were robust. This meant that the care service took seriously the safety of individuals residing at the home. Both people who used the service said they would complain if they had to but initially to a family member. There was a complaints procedure which was accessible to people who used the service or their families. People who used the service had an outlet to voice their concerns. The staffing rota and staff files demonstrated there was a well trained staff team to meet the needs of people who used the service. People who used the service said, the nurses treat me very well. They are very sweet and the staff are very pleasant, friendly and helpful. They look after us well, in fact excellent. There was a good deal of friendly banter and humour on the day of the inspection. Staff had a caring but friendly attitude which was appreciated by people who used the care service. Care Homes for Older People Page 8 of 26 I feel very safe here. We get visitors and staff are very nice to them. I go out a lot. I can go out when I want to and use my own hairdressers. He comes to visit me. A visitor said, I am impressed with the managers attitude. He put me at ease when dad first came in. I am fussy. He helped us through the hospital meetings. I was anxious but could not fault the home. The staff are all very nice and treat my dad as an individual. They keep me informed. He has been here a week and we have close contact they keep me updated. The door is always open. He is improving here. This visitor was impressed with the caring attitude of the person in charge and had been fully informed of his progress. Staff said, I think it has come along very well and we are trying to get it back to a good standard. We have a good staff team and get on well with each other and they support me. I get supervision. I get plenty of support and I think we have a good staff team. I get supported by senior staff, we all help each other out. There is enough staff here most of the time. We get chance to sit and talk to residents. The staff members felt supported and a valued member of the staff team. 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. Care Homes for Older People Page 9 of 26 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 10 of 26 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 11 of 26 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. Prior to admission assessments were undertaken by an experienced staff member to decide if the care home could meet peoples needs. Evidence: Three people who used the service were involved in the case tracking process. Social services or the local hospital trust had supplied the home with information about each person. An assessment had been undertaken by an experienced staff member to gain sufficient information to formulate a plan of care. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The plans of care were up to date and accurate to help meet the needs of people who used the service. People had access to specialists to meet their health care needs. The administration of medication was safe for people who used the service. The good attitude of staff helped preserve the dignity of people who used the service. Evidence: Three people who used the service were involved in the case tracking process. This involved checking the plans of care, talking to staff about the care they gave these people and talking to the three people to check they received the care they desired. Plans of care accurately described the care residents needed to meet their needs. One plan of care had not been developed with the person who used the service but this was completed on the day of the inspection. All plans of care had been reviewed on a regular basis and the daily notes in particular informed staff of each persons care. The service was about to change the style of the plan and it was recommended that all plans must be person centered and the form used needed to be modified for this to be Care Homes for Older People Page 13 of 26 Evidence: accomplished. Risk assessments had been completed and reviewed for falls, nutrition and tissue viability. The last wishes of people had not been recorded and their wishes must be known to ensure the care they receive is as they wish. In general this meant the plans of care had been much improved and now meet the Care Quality Commissions standard. The plans of care examined during the case tracking process demonstrated that people had access to a wide range of hospital and other specialists to keep their treatment up to date. Staff were trained in the administration of medication. There were policies and procedures for the administration of medication for staff to follow good practice. There was a system for recording, storing and disposal of medication which meant staff were able to audit the system. There were facilities for recording and storing controlled drugs. The person in charge said the local pharmacist was available for advice and staff had access to the British National Formulary (a compendium of medication and their effects) to gain knowledge of the effects of drugs. The system used was sufficiently robust to minimise medication errors and protect the health and welfare of people who used the service. Staff were discreetly observed giving residents personal care. Staff had a nice manner and treated residents with respect although there was a good deal of friendly banter which made a pleasant atmosphere. People who used the service said staff were nice. The friendly but professional attitude of staff ensured people who used the service were comfortable with the personal care they received. Care Homes for Older People Page 14 of 26 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. Suitable activities were provided to keep people who used the service stimulated. Visiting was unrestricted and encouraged to allow people who used the service to socialise with their family and friends. The food served at the care home was nutritious and met the tastes of people who used the service. People were allowed choice to help them retain some independent living. Evidence: There were two activities coordinators to provide entertainment for people who used the service. Activities included outings, pamper sessions, bingo, quizzes and other stimulating games. People who used the service were able to enjoy activities if they wished for to for their enjoyment. One visitor and two people who used the service said visiting was unrestricted so they could meet with their friends and relatives. It was documented in the plans of care that choice was part of the care package. Staff were encouraged to let residents choose clothes and perform tasks when they could do to help promote independence. People who used the service were able to sit where Care Homes for Older People Page 15 of 26 Evidence: they liked and several had formed good friendships. The meal served on the day of the inspection was warm, nutritious and tasteful. The kitchen was clean and tidy and the cook carried out environmental health checks to maintain a good standard. There was a choice of food so people who used the service had at least two items they could enjoy. Staff were observed feeding people in a discreet and caring way. The dining room was well laid out and was comfortable for people who used the service. In general dining was sociable and the food was suitable for people who used the service. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who used the service were able to raise any issues they had with the care home manager. The robust safeguarding systems helped keep residents safe. Evidence: The complaints procedure was issued to people who used the service with other documentation on admission. There was a copy in the hallway which informed the public how to complain if they wished. The complaints procedure told people how the care home would respond and how long each stage would take. No complaints had been made to the Care Quality Commission since the last key inspection. The availability of the complaints procedure ensured people who used the service ware able to voice their concerns. There were policies and procedures for the protection of vulnerable adults. There had been a safeguarding issue since the last key inspection but this was wholly unsubstantiated. Most staff employed at the care home had received safeguarding training. There was a copy of the Lancashire Social Services protection of vulnerable adults procedures for staff to follow a local initiative. Staff had access to the No Secrets and whistle blowing policy to know how to raise any safeguarding issues. The systems used helped protect the health and welfare of the people who used the service. Care Homes for Older People Page 17 of 26 Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was sufficiently well decorated and furnished to provide people who used the service with a homely atmosphere. Evidence: The garden area had been improved and people who used the service had been encouraged to participate in growing flowers. The inclusion of raised flower beds also meant that people with disabilities could enjoy this activity. On the day of the inspection a room was being redecorated. There was a recorded system for maintaining the home which ensured equipment, decor and furniture was in good order. A our of the building was conducted on the day of the inspection. The home was warm, clean and there were no offensive odours. In general the home was in good order but some carpets had been taped, which look unsightly and need replacing to keep up the good standard in the rest of the home. All furnishings and fittings are domestic in character and provided people who used the service with a homely atmosphere. The communal areas were bright and spacious. People who used the service were sat in small groups and were observed to be socialising with each other and staff. There Care Homes for Older People Page 19 of 26 Evidence: was a quiet lounge where people who wished could receive visitors in private. Televisions were placed where people could enjoy their programs. The communal areas provided a good opportunity for people to enjoy mixing with others and joining in activities. Bedrooms visited had been personalised to each persons tastes and contained reminders of home life. There was sufficient furniture for people to comfortably remain in their rooms if they wished. There was a lift to access all floors. There were grab rails and disability equipment such as mechanical baths to help people get around. Radiators were and hot water guarded outlets did not pose a threat of scalding and windows were restricted to prevent accidents. There was an infection control policy for staff to follow safe practice. The laundry was suitably placed and had sufficient equipment to clean the clothes of people who used the service. Care Homes for Older People Page 20 of 26 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. There were sufficient numbers of well trained staff to meet the needs of people who used the service. The recruitment procedures were robust and protected the people who used the service from possible harm. The induction and foundation training provided new staff with an opportunity to learn and care for the people who used the service. Evidence: There was a person in charge of the home who was acting as a manager. There was a nurse and four care staff to look after the people who used the service and this was supplemented by domestic staff. More then 50 of staff had completed NVQ2 or better training. Two staff files showed staff had undertaken mandatory training in health and safety, moving and handling, infection control, food hygiene and fire safety. Two staff members confirmed that training was provided by the care service. The training provided staff with confidence and knowledge to look after the people who lived at the home. Care Homes for Older People Page 21 of 26 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 registered person needed to ensure the new manager is registered with the Care Quality Commission to meet current requirements. The finances of people who used the service were safely controlled at the care home. Quality assurance systems allowed management to react to the views of people who used the service. Health and safety policies, staff training and the maintenance of equipment helped protect the health and welfare of staff and people who used the service. Evidence: The registered manager had left the post some weeks earlier. A new manager had been found and was due to take up the post the week following the inspection. This person must be registered with the Care Quality Commission as soon as possible and attain the necessary qualifications to meet current guidelines. The care service did not handle the finances of any person who used the service. The financial administrator demonstrated the system for holding residents pocket monies. Care Homes for Older People Page 22 of 26 Evidence: The system was safe and protected people who used the service from possible abuse. The person in charge said that regular meetings were held with staff and the views of residents and their families had been obtained via a questionnaire. The views of people who used the service had been summarised for interested parties to see how the care home was performing. Management conducted a regular audit of the facilities and services of the home to help maintain standards. There was a health and safety policy to guide staff in safe practice. All gas and electrical supply and equipment had been maintained and the certificates were examined during the inspection. Staff had been trained in health and safety related topics. This provided staff and people who used the service with a safe environment. Care Homes for Older People Page 23 of 26 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 26 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 2 7 11 The registered person should ensure plans of care are person centered and not just a generic form. The registered person should ensure the last wishes of all people who use the service are recorded so their wishes are known at this difficult time. The registered provider should ensure that carpets are replaced or repaired and the tape is removed to provide a more homely atmosphere for people who use the service. The registered provider must ensure there is a person to manage the home who is registered with the Care Quality Commission and has the qualifications necessary to meet current requirements. 3 19 4 31 Care Homes for Older People Page 25 of 26 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. 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