Care Home: White Rose House

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What the care home does well Comments from people who live at the home include:- "The new nursing staff is excellent, they put resident`s needs above everything, and you feel residents are treated as individuals, and their dignity and rights respected." "Treat me very well." "As soon as some carers walk into your room they smile and chat, it gives you a lift. It`s not just routine to them." "As care homes go, personally I rate this as one of the best." The home has recently been accredited with the Gold Standard Framework in relation to palliative care, this will ensure that the wishes of peoples about dying and terminal care are discussed in a sensitive manner, and are clearly documented within their care plan. The majority of care staff have completed an NVQ (National Vocational Qualification) level 2 in care which helps them to have a better understanding of peoples needs. What has improved since the last inspection? Pre-admission assessments are now dated and signed by the person completing it, and the care plans include the social care needs of people to ensure they receive the right level of support in respect of their interests and preferences. The home has a new manager, she is highly motivated, and has many years experience in a range of care environments. What the care home could do better: Peoples care plans should contain the necessary information to ensure that they receive the appropriate care. Robust medication procedures must be followed to ensure that the storage, recording and safe administration of medication is maintained. To keep people safe, ensure that when the fire facilitator is on holiday the fire alarm is tested weekly, and is in working order. Key inspection report Care homes for older people Name: Address: White Rose House 165 Huddersfield Road Thongsbridge Huddersfield HD9 3TQ     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: Karen Summers     Date: 1 5 0 7 2 0 0 9 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 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: White Rose House 165 Huddersfield Road Thongsbridge Huddersfield HD9 3TQ 01484690100 01484690101 whiterosehouse@meridiancare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Meridian Care Limited care home 62 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: 62 The registered person may provide the following category of service only: Care home with Nursing - Code N, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home White Rose House Nursing and Care Centre is a new, purpose built care home owned by Meridian Care Limited. The home is located behind the Holme Valley Hospital in Holmfirth and is built into the hillside. There are 60 single en-suite rooms for older people requiring nursing and personal care. Bedrooms are located on two floors, which are serviced by a passenger lift. People living in the home requiring personal care are accommodated on the ground floor and part of the first floor, while people requiring nursing care are accommodated on the second floor. Communal lounges and dining areas are also provided on each floor. The lower ground floor area provides service facilities, kitchen, laundry, staff areas and storage. The home is located just off the Care Homes for Older People Page 4 of 26 Over 65 62 0 Brief description of the care home main Huddersfield road, along which public transport travels. There is a relatively short walk up a steep hill to the home. There is ample car parking at the home and a garden and patio area to the side of the home. The manager informed the Commission for Social Care Inspection on 15/07/09 that fees range from £397.65 to £500.00 per week. Additional charges include hairdressing, private chiropody, newspapers, toiletries, sweets, clothing and some selected activities/ hobbies materials. Information about the home and the services provided are available from the home in the statement of purpose and service users guide. 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: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. Date of the last inspection of this service was 17th July 2007. This report refers to an inspection, which included an unannounced visit on the 15th July 2009, and the length of the inspection was 7.5 hours. There were 57 people living at the home on the day of this visit. To enable people who use the service to comment on the care it provides, we sent surveys to people living in the home, staff, doctors and health care workers (social workers, community nurses). Two health care workers, five staff and seventeen people who live in the home returned their surveys. Care Homes for Older People Page 6 of 26 We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 7 of 26 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 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 9 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. People are assessed prior to them moving into the home to ensure that their needs can be met, and they are able to visit the home to establish whether or not it is the right place for them. Evidence: This home does not provide intermediate care. The information received from the home prior to inspection said that they encourage prospective people who use the service and their families, to visit the home and spend some time there before they make a decision to move in. People living in the home also confirmed that they had received enough information about the home before they moved in so they could decide if it was the right place for them. Care Homes for Older People Page 10 of 26 Evidence: The records of four people were looked at, all of which contained a pre admission assessment carried out by the home. The purpose of the assessment is to make sure that the home will be able to meet the persons needs. Care Homes for Older People Page 11 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. Peoples care plans generally outline the level of support and care each person requires in ensuring their health and welfare needs will be met. The recording and administration of medication has not always been carried out satisfactorily however the manager has taken steps to address this. People are treated with respect. Evidence: The manager explained that the staff are in the process of introducing new care documentation. Four peoples care records were looked at, two from the residential side of the home and two from the nursing side. The quality of the documentation varied depending on who had written the records and whether the new or old documentation had been used. The new documentation was written in greater detail however, where a short term need had been identified the care plan had not been updated. This was discussed with Care Homes for Older People Page 12 of 26 Evidence: the manager who said she would ensure that the care plan was up dated to reflect this, also that all of the staff are to be offered training on record keeping in August this year, and the new documentation would continue to be introduced for everyone within the home. There was evidence to suggest that reviews of peoples care had taken place and this was with the involvement of the person or their relative/ advocate where appropriate to ensure that their needs continue to be met. The social, cultural, religious needs, and likes and dislikes were recorded, and people confirmed that staff respect individuals privacy and dignity. The daily record was an account of the persons day and any untoward incidents. Comments from people who live at the home include:The new nursing staff are excellent, they put residents needs above everything, and you feel residents are treated as individuals, and their dignity and rights respected. Treat me very well. As soon as some carers walk into your room they smile and chat, it gives you a lift. Its not just routine to them. With some carers though, its just mundane. As care homes go, personally I rate this as one of the best. There was evidence of involvement from peoples doctors, physiotherapists, opticians, dentists and other health care professionals where needed. People said that the home makes sure that they get the medical care they need, and the information received from the home prior to inspection confirmed this. The manager also said that the home has developed good working relationships with the doctors and that every week doctors carry out a mini health check of people that are registered with them. One of the doctors said that the weekly visits to the home have improved care and working relationships. Health professionals when asked, what does the service do well. They said that people and their relatives are encouraged to be involved in planning their care, and that staff treat everyone with dignity and respect. They also said that the care manager was very approachable, and that the communication between the care home, doctors and district nurses was excellent, which helps provide better quality care. Care Homes for Older People Page 13 of 26 Evidence: The home has recently been accredited with the Gold Standard Framework in relation to palliative care, which will give the staff the necessary knowledge and skills to look after people who need end of life care. On the day of the visit, samples of four peoples medication were checked on both the residential and nursing side of the home. On the nursing side staff were routinely ordering repeat prescriptions of medication when they were not always needed. Also the medication was not been stored at the correct temperature. However the manager had identified this problem and contacted the pharmacist who was now working with the manager to improve the medication systems to ensure that any discrepancies would be addressed and safe medication practices would be maintained. There was no guidance for staff about medication prescribed to be given as required. It would be good practice to include information for staff so that they are clear about when and why this medication should be given. There was evidence on the residential side of the home that staff had already contacted a number of peoples doctors to ensure that the guidance regarding as required medication met their individual medical needs. On the nursing side of the home the medication storage room temperature had been recorded daily and ranged between 27 degree Celsius and 31 degrees Celsius, and on the residential side of the home the temperature of this room was between 25 degrees Celsius and 27 degrees Celsius. The temperature of these rooms should not be above 26 degrees Celsius for the storage of medication. There was documented evidence to suggest that arrangements had been made for the room to be mechanically ventilated to the desired temperature. In the interim period, staff said that the pharmacist had arranged for medication that needed to be stored below this temperature, to be kept at the pharmacy and delivered to the home as needed. The training records showed that staff who handle medication have received training, and this was confirmed by the staff on duty. Should people wish to administer their own medication then there were procedures for this to be carried out safely. 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. People living at the home are offered a range of activities and are able to make their own choices about how they spend their time. Meals provided are generally good, varied and served in a pleasant environment. Evidence: The information received from the home prior to inspection states that they have a full time activities coordinator who provides activities both within and outside of the home, and this was confirmed by people who live there. People said that they received a printed list of what activities take place each day, and the home also uses a newsletters and communication boards to display forth coming events. Activities that take place include, quizzes, ball games, visiting entertainers, exercises, visiting places of interest, pampering, nail care, hair etc. Comments from people who receives the service include; The activities lady is a star. There are lots of things to do - including singers and entertainers, and she arranges outside visits with other staff volunteering to help. People said that church services were held weekly and the manager confirmed this. Care Homes for Older People Page 15 of 26 Evidence: The library services visit every other week, and they deliver large print and talking books for those who wish. Daily newspapers are also delivered on request. Menus offered a variety and choice of food taking into consideration the food preferences and likes and dislikes of people living in the home. The meal time was seen to be a relaxing time and staff were seen to be assisting people sensitively and in a dignified manner. Comments from people about the food were mixed and included; Food, no complaints about food. Always plenty. Generally the food is to my liking. Whilst another person said. The food is very poor - there is little variety. It feels processed and very often there is not enough. People who were spoken with on the day generally said that the food was very nice. The lunch time meal was seen and it looked plentiful and appetizing. 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 can be confident that their complaints will be listened to and acted upon. Staff have received suitable training and understand the adult protection policies and procedures, which helps to make sure that the people they support are safe. Evidence: Responses received from people living at the home indicate that they know how to make a complaint and who to speak to when they are not happy about something. People spoken with on the day said that if they werent happy about something then they would speak to the person in charge. The complaints procedure is located in each of the bedroom and in the service user guide which is given to each person on admission. The manager keeps a log of any complaints received and there was evidence that peoples concerns had been taken seriously and the appropriate action had been taken. Records showed that in February this year all staff had safeguarding (adult protection) training which provides information on how to protect people from abuse. Staff who were spoken with confirmed that they had attended safeguarding training and they were aware of the procedure to follow, and that they were also aware of the homes Whistle blowing policy. Procedures were seen relating to the protection of people from abuse. Care Homes for Older People Page 17 of 26 Evidence: Information was also seen in relation to contacting advocates, and the information received from the home states that they allocate an advocate wherever possible in order to assist people with their rights as individuals. 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 continues to be decorated to a good standard and offers people a homely, comfortable and clean environment. Evidence: As part of the inspection a tour of the home took place, which included the communal areas and a number of bedrooms. The home continues to be decorated and furnished to a good standard. The atmosphere on the day of the visit was warm and friendly and people looked comfortable whilst sitting in various parts of the home. Without exception people said that the home was always fresh and clean. One person said that they liked their own room and the privacy that it gave them. They also said that they liked the view and surroundings. However, a relative made a comment in a survey, The standard of cleanliness has dropped. Have complained about my fathers laundry. My fathers room in looking tatty When asked what the home does well, the same person said that their relative Looks clean and tidy. Aids and equipment needed to care for people were seen and included hoists, adjustable beds, specialist mattresses. Care Homes for Older People Page 19 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. Peoples needs are met by trained staff who have undergone a thorough recruitment process before they are allowed to work in the home. Evidence: The information supplied by the manager prior to the visit states that the staffing levels are based on the needs of the people and are increased at busy times of the day. The manager also confirmed that staffing levels are continually under review and there was evidence of this in the monthly audits that are carried out by the operations manager. The home is also advertising for an additional nurse to work over the nursing and residential parts of the home. The clinical manager has a minimum of 18 hours which are supernumerary and the manager is full time supernumerary. Since the last inspection a number of staff including the manager and senior nurses has changed. A health care professional made the comment, I am concerned by the recent increased turnover of staff especially nurses and senior care staff as well as management. This is having a destabilizing effect on an otherwise excellent home. The company acknowledges that there has been staff turnover within the last twelve months, which they have been addressing and as a result have introduced the employees merit award scheme in which staff can be nominated for an award, certificated and gifts. Also the company pays an hourly bonus. Both of these are to try Care Homes for Older People Page 20 of 26 Evidence: and promote staff moral and encourage staff to feel valued in attempts to reduce staff turnover. Four out of five staff said in the surveys that there are always or usually enough staff to meet the individual needs of people, one person said that there sometimes were. Comments include, the home should, Provide adequate staff so we can provide quality care for our resident. Whilst other person said, The staff are working well as a team and work timely to achieve a happy and comfortable environment. Communication between residents, families and staff has vastly improved. The duty rota showed there are sufficient staff on duty to care for the number of people living at the home, and the manager confirmed this. Surveys received from people who live at the home commented that there is always or usually enough staff available when they need them and one person said that there sometimes were. Comments from people using the service include:- Night staff are busy when I need to go to the toilet but never have to wait too long. There is always a carer on hand. People also said that the standard of care was very good. Although two other people who live at the home said that more staff should be employed. Comments from a relatives include:- There are not enough care workers to cover sick colleagues. We have frequently been understaffed in frequent months. There is currently 75 percent of the care staff who have a NVQ (National Vocational Qualification) level 2 in care, and trained staff have a better understanding of peoples needs. A sample of recruitment records was inspected and they contained the required information and employment checks. These checks are necessary to help protect people from potentially unsuitable staff. There was also evidence in the staff records and staff confirmed that they had induction training when they came to work at the home, which provides them with the knowledge and skill to look after people in their care. They also said that during their induction they worked a number of shifts supernumerary until they were familiar with the care practices in 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. People benefit from the management approach of the home, and the home is run in the best interests of people who live there. Evidence: The home has a new manager who is highly motivated, and has many years experience in a range of care environments. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This she did, and the document provided the Care Quality Commission (CQC) with a lot of information about the way the home is run, and what they hope to achieve in the future. The document states that the company provides quality assurance by carrying out customer surveys and this includes surveys to people who live at the home, staff, relatives, doctors and health care professionals, on an annual basis, and they also Care Homes for Older People Page 22 of 26 Evidence: promote the use of feedback cards, care reviews and welcome any suggestions. The results of these surveys are then published and available in the home. This years surveys are due to be sent out this month. Meetings for relatives and people who live at the home have taken place in February, April and June this year and minutes of those meetings were seen. Information discussed at those meetings include, activities, staffing, catering, cleaning, laundry etc. An open day and meeting has been planned for later this week and the information about it was seen on the notice board in the entrance to the home. Routine health and safety checks are carried out and appropriate records were seen of those looked at. The operations manager visits the home monthly and writes a report on their visit and it is used to monitor the quality of the service. With the exception of one member of staff, everyone said that the manager gives them enough support and meets with them to discuss how they are working. Satisfactory records were also seen of movement and handling training, fire lectures and drills, and staff confirmed that they had received the training. On one occasions the fire alarm system had not been tested when the person who test the alarm system was on holiday. The manager was aware of this issue and had taken steps to ensure that the situation does not happen again. 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 7 Peoples care plans should contain the necessary information to ensure that they receive the appropriate care. Guidance should be available for staff when as required medication is to be given. Medication should not be stored above 26 degrees Celsius as per manufacturers instructions. Ensure that fire alarm is tested weekly to make sure that the system is in working order and that people are kept safe. 2 3 4 8 8 38 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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