Care Home: Westhampnett Nursing Home

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What the care home does well People feel well cared for and find staff attentive to their needs. The home is able to retain staff which helps provide a consistent level of care for people living there. Complaints are fairly investigated, and complainants are contacted concerning the outcome of the complaint and any action taken. What has improved since the last inspection? Medication systems have been updated and made more safe. Fire safety arrangements have been updated and made more robust. The safety of people in the home has been improved by increased staff training in safeguarding vulnerable adults, moving and handling, and food hygiene. What the care home could do better: There are few social activities that people can take part in. A system for one to one staff supervision is not fully in place to support staff in providing safe and quality care. Key inspection report Care homes for older people Name: Address: Westhampnett Nursing Home Westhampnett House Westhampnett Road Chichester West Sussex PO18 0NT     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: Edward McLeod     Date: 0 4 0 5 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 29 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 29 Information about the care home Name of care home: Address: Westhampnett Nursing Home Westhampnett House Westhampnett Road Chichester West Sussex PO18 0NT 01243782986 01243778935 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Philip Norman Davis,Mrs Mary Davis Name of registered manager (if applicable) Mr Ignatius Gilarty Type of registration: Number of places registered: care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 32 The registered person may provide the following category 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) Date of last inspection Brief description of the care home Westhampnett Nursing Home is a care home registered to provide nursing care for up to 32 older people. It is a two storey listed Georgian building located in Westhampnett Village, which is situated on the outskirts of Chichester, West Sussex. Care Homes for Older People Page 4 of 29 Over 65 32 0 0 8 0 6 2 0 0 9 Brief description of the care home The building has been thoughtfully converted to ensure the original features remain. Accommodation is provided on two floors, serviced by a passenger lift. There are 24 single and 4 double rooms. Large landscaped and beautifully kept gardens surround the property. These are accessible to the residents and seating is available. The current fees being charged by the home are: from 650 to 800 pounds per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was arranged to assess compliance with previous requirements made and of the homes compliance with the key national minimum standards for Care Homes for Older People In preparation for our visit we looked at all the information that we have received or asked for since the last key inspection and this has included The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service and staff working at the service. The previous key inspection report. Care Homes for Older People Page 6 of 29 The visit was commenced at 9:15 a.m. on 4th May 2010, lasted five and a half hours. and was attended by one inspector. At the visit we spoke with the owner Mrs Davis, the manager Mr Gilarty, three members of staff, and with three people who are receiving a service. We sampled care and health care records for six people, recruitment records for three staff, and training records for six staff. Other records sampled included records relating to complaints and health and safety. Care Homes for Older People Page 7 of 29 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 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People 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. Evidence: At our previous visit a requirement was made that the persons needs must be assessed before admission to ensure that the service can meet their needs. The manager tells us in their Care Quality Commission (CQC) AQAA report that trained and qualified nurses carry out detailed assessments of people in their own homes before admission is agreed. At this visit we looked at the pre-admission assessments for two people who have come to live at the home recently, and found that their needs had been assessed previous to admission. Care Homes for Older People Page 10 of 29 Evidence: We talked to one person recently admitted to the home, who told us that their needs had been discussed before they came to live there, and when they arrived staff were aware of the care and support they were in need of. A relative we spoke to also told us that an assessment was carried out prior to admission, and that when her mother moved to the home the staff knew what care and support her mother would need. The previous requirement was found to have been met. The seven people living in the home who responded to our Care Quality Commission (CQC) survey told us they had received enough information before they moved in to help them decide if the home was the right place for them. Six of those seven people said they had received written information or a contract about the homes terms and conditions, the seventh person responded that they didnt know. The manager tells us in their Care Quality Commission (CQC) AQAA report that trained and qualified nurses carry out detailed assessments of people in their own homes before admission is agreed. Care Homes for Older People Page 11 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social care needs are met. Each person has a plan of care that the person or someone close to them has been involved in making. If people cannot manage their medicine the care home supports them with it in a safe way. Peoples right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. Evidence: We sampled care records for six people living in the home, which indicated that the persons needs were being reviewed every two months. Records seen included some good information about how the person preferred their care to be provided, and Mr Gilarty said it was their intention to expand the use of Care Homes for Older People Page 12 of 29 Evidence: such information in the care plans. People living in the home who responded to our CQC survey told us that they were receiving the care and support they needed, and that staff always or usually listen to them and act on what they say. One person wrote in their survey form that the staff are always pleasant and helpful, and one persons relative wrote my mother is well looked after. One person living in the home told us in their survey form that staff are caring and considerate. Always treat patients with respect and humour. Discussion with staff indicated that they know the needs of the people they are caring for, and that consistent care is being provided during day and nights shifts. We are told in the AQAA that peoples dignity and privacy is respected - for example if the person does not wish to receive a particular treatment or medicine, or dont wish to receive visitors on a particular day, this is respected. A visiting professional we talked to told us that staff seem up to date with each persons care needs, staff communication is good, confidentiality is observed, and respect and privacy are observed. People living in the home who responded to our CQC survey told us that the home was making sure they were getting the medical care they needed. Care records we sampled indicated that people are receiving the medical care they are in need of. Staff we spoke to discussed with us the medical support being provided for individual people. At our previous visit requirements were made concerning the need to ensure medication administration is safe, that people receive their prescribed medication, and that medication to be given as required is properly recorded. At this visit we sampled the medication records for six people, and looked at the arrangements in place for storing medication, for receiving and returning medicines, for controlled medicines, for as required medicines, and for where people administer their own medicines. We found that improvements have been made to how as required medicines are Care Homes for Older People Page 13 of 29 Evidence: recorded, and a system has been put in place for risk assessments to be regularly carried out where a person manages their own medicines. We found that the service is ensuring that medicines are not running out of stock, and that arrangements are in place to ensure it is recorded when medicine boxes are commenced so that staff can check that the correct medication cycle is being observed. The manager advised us that he carries out audits of the medication records. We discussed with the manager Mr Gilarty how end of life care is provided in the home. He advised us that there is good contact with a local hospice who will be providing training for staff in the Liverpool Care Pathway approach. Care Homes for Older People Page 14 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care home could do more to support people to follow personal interests, and to take part in activities which interest them. People are able to keep in touch with family, friends and representatives. People have nutritious and attractive meals at a time and place to suit them. Evidence: The manager told us that there is a musical afternoon once per month, and that peoples birthdays and occasions like Easter and Christmas are celebrated. We were told by the manager that when people come initially to visit the home they are advised that the home doesnt have a lot of social events arranged. We are told in the AQAA that suggestions from residents and families taken up by the service have included arranging for a monthly communion to be held in the home, supporting people to attend church, and arranging various social events at Christmas. During our visit, one person was assisted to sit in the garden for a while. However, Care Homes for Older People Page 15 of 29 Evidence: apart from the interaction with staff when receiving care, people were left on their own for long periods of time and communal sitting rooms were not being used much. The service does not at present employ staff who would be responsible for arranging activities in the home and to develop one to one activities for people unable to take part in communal activities. Members of staff who responded to our CQC survey wrote comments such as the care of patients is excellent, but could do with more time to talk to patients and do little things for them, and that there was a need for more entertainment and social events. One member of staff wrote that they could do with more time to spend sitting talking to clients and interacting with them. A relative we spoke to said that the care in the home was good, but that residents would appreciate things like staff doing a crossword puzzle or chatting with them. Pre-admission assessments were seen to include an assessment of the persons interests, but care plans sampled did not set out how the persons social needs were to be met, and no individual activities plans were in place. A requirement has been made concerning this. A member of staff wrote in their survey form that one of the things the home does well is providing up to date information to their relatives and families. Another member of staff wrote in the CQC survey form that relatives, visitors comment on always feeling informed. The manager told us that breakfast was served between eight oclock and nine oclock in the morning, and for the three people living in the home who we spent time with this fitted in with when they were ready for breakfast. People living in the home who responded to our CQC survey gave a mixed response about the meals provided. For example one person wrote that the food was excellent, while another person wrote that there was need for more variety in the meals provided. We spent time with two people who were on soft food diets and needed assistance with eating. We found the soft food was presented well, and that they were assisted in a relaxed and unhurried manner with staff chatting to them and encouraging them. Care Homes for Older People Page 16 of 29 Evidence: We are told in the AQAA that nutritional screening has been introduced so that peoples nutrition needs are better understood. The AQAA tells us that two staff have received training in malnutrition care. Care Homes for Older People Page 17 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. If people have concerns about 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 protects people from abuse and neglect and takes action to follow up any allegations. Evidence: We are told in the AQAA that each person has been given a copy of the complaints proceedure. People living in the home who responded to our CQC survey told us that there was someone they can speak to informally if they were not happy, and that they knew how to make a formal complaint. The seven members of staff who responded to our CQC survey told us that they know what to do if someone has concerns about the home. We sampled the records of two complaints, and found that these had been investigated and the outcomes and action taken recorded and shared with the complainants. At our previous visit a requirement was made that staff receive training in Care Homes for Older People Page 18 of 29 Evidence: safeguarding the people they care for. Staff training records we sampled indicated that staff have been updating their training in safeguarding vulnerable adults. This requirement was found to have been met. The AQAA advises us that there have been no safeguarding alerts or investigations in the home since our previous visit, and the Commission is not aware of any such alerts or investigations at the time of writing. Care Homes for Older People Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: At our visit we found that improvements to the premises in the past year have included refurbishing the bathroom downstairs and equipping it with a battery operated hoist. The gardens are extensive and are maintained to a high standard, and a number of people have bedrooms which give them a good view of the garden. We looked at records for the maintenance of the building and spoke with the homes maintenance man. We found that maintenance issues are being appropriately recorded and dealt with in a timely fashion. Arrangements are in place for regular health and safety checks to be carried out in the home. Care Homes for Older People Page 20 of 29 Evidence: The home is generally being well maintained. We found there to be some wear to the upstairs hallway carpet. The manager advised us that the issue had been identified, and a carpet fitter was visiting the home to measure for a new carpet and show carpet samples on the day of our visit. The owner advised us that the carpet was being replaced, therefore no requirement was made concerning this. The AQAA tells us that the provider is planning to modernise and improve the upstairs communal bathroom, and to instal hoists in en suite bathrooms and two bedrooms. We found the home to be furnished, decorated and maintained to a good standard. There are comfortable communal areas for people to use, although on the day of our visit these rooms were not often being used. We visited some bedrooms, which people had personalised and made their own by bringing in items of furniture, pictures and possessions. We are told in the AQAA that all rooms have been provided with antibacterial soap dispensers and alcohol gel to improve handwashing practice. People living in the home who responded to our CQC survey told us that the home was always or usually fresh and clean. Care Homes for Older People Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty at all times. Checks are done to make sure staff are suitable to care for them. The service needs to ensure that staff receive the relevant support from their managers, for example regular and recorded supervision, so that the needs of people being cared for will be met. Evidence: Our survey form asks if staff are available when needed, and the seven people living in the home responding to our survey responded always or usually. Members of staff who responded to our CQC survey told us that there were usually enough staff to meet the individual needs of all the people who use the service. Discussion with staff and the manager indicated that there is not often the need to bring in temporary or agency staff, and that this helps ensure that the care provided is consistent. At our previous visit requirements were made that staff receive the required training, including training in food hygiene, moving and handling, and fire safety. Care Homes for Older People Page 22 of 29 Evidence: Training certificates and training recrords which we sampled indicated that most staff are now up to date with most of the training they are required to undertake including manual handling and safeguarding. Mr Gilarty advised us that training in food hygiene has been arranged, and showed us a training DVD which had been obtained for that purpose. Members of staff who responded to our CQC survey told us that they are receiving training relevant to their role, that their induction covered everything they needed to know to do the job when they started, and that they feel they have enough support, experience and knowledge to meet the different needs of people who live at the home. We spoke with a member of staff who told us that manual handling training had been completed the week previously, which had included demonstrations in the use of lifting equipment. She said it had been useful for staff to find out what it was like being lifted. Training records sampled indicate that nursing staff continue to update their training. The previous requirements concerning staff training were found to have been met. Asked what the home could do better, one member of staff wrote on their survey form have more supervision and training for individual staff. Another member of staff wrote that the home need to provide more supervision with junior colleagues. At our visit we found that there to be a lack of records to evidence that staff were receiving the one to one sit down staff supervision which will help them develop their skills. Mr Gilarty said that recent supervision carried out had mainly been with new staff to assist them through their induction training. Mr Gilarty advised that he would be setting up regular supervision arrangements for all staff within the next month. A requirement concerning this has been made in the Management section of this report. We are told in the AQAA that six of the twelve care assistants employed in the home have achieved the National Vocational Qualification (NVQ) in care at least to level 2, and that in the past year one member of staff has completed NVQ2, one completed NVQ3, and one completed NVQ4. Care Homes for Older People Page 23 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have confidence in the care home because it is led and managed appropriately. The environment is safe for people and staff because appropriate health and safety practices are carried out. Evidence: We are told in the AQAA that the manager is a qualified registered nurse and has completed NVQ4. At our visit the manager advised us of the training he has undertaken to update his knowledge and skills. Visitors we spoke to on the day of our visit told us there was a good atmosphere in the home. One person said her mother trusted the staff and had a good relationship with them. Care Homes for Older People Page 24 of 29 Evidence: The manager tells us in the AQAA that questionnaires are given to people living in the home so that they can make known their views on the service. We looked at some of these, and the manager gave examples of improvements that had been made in response to comments made in the questionnaires. We are also told in the AQAA that suggestions taken up by the service have included arranging for a monthly communion to be held in the home, supporting people to attend church, and arranging various social events at Christmas. We are advised in the AQAA of the most recent services and tests done on equipment used in the home, and that hazardous substances assessments are in place. At our previous visit requirements were made that the service consult with the county Fire Officer, that they ensure that fire equipment is checked and records are kept of the checks, and that staff receive training in fire safety. The manager told us that they had consulted with the countys Fire Service, and were advised that fire risk assessments be carried out annually. Annual fire risk assessments have now been commenced. At our visit we found that fire safety training has been updated for all staff and that fire equipment has been checked. We found that staff who had undertaken night duties on the 1st and 2nd May 2010 were receiving fire safety training every three months. Other staff training records we looked at indicated that staff are undertaking fire training regularly. Required fire safety records were found to be in place. Previous requirements concerning fire safety were found to have been met. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 12 16 The service must consult with service users about their social interests and make arrangements to enable them to engage in social and communal activities. The home has not been setting out how each persons social care needs will be met. 06/08/2010 2 36 18 The registered person shall 06/08/2010 ensure that persons working in the care home are appropriately supervised. Staff supervision would contribute to the quality of care provided to people living in the home. Care Homes for Older People Page 27 of 29 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 28 of 29 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. © 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. 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