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Inspection on 20/02/09 for Astbury Lodge

Also see our care home review for Astbury Lodge for more information

This is the latest available inspection report for this service, carried out on 20th February 2009.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Astbury Lodge Randle Meadow Hope Farm Estate Great Sutton Cheshire CH66 2LB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paul Ramsden     Date: 2 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Astbury Lodge Randle Meadow Hope Farm Estate Great Sutton Cheshire CH66 2LB 01513557043 01513569025 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): CLS Care Services Limited Name of registered manager (if applicable) Sharon Strain Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following categories of service only: Care home only- Code PC To people 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- Code OP (21) Dementia- Code DE (20) The maximum number of people who can be accommodated is: 41 Date of last inspection Brief description of the care home Astbury Lodge is a two-storey care home for people over 65 years of age; access between floors is via a shaft lift or the stairs. The home is owned by CLS care services, a registered charity and is located in Ellesmere Port. It is close to the local shops and other community facilities. There are a variety of garden and patio areas available for residents; these are accessible and well maintained. Care Homes for Older People Page 4 of 27 care home 41 Over 65 0 21 20 0 Brief description of the care home The home is registered to provide care for up to 21 older people and 20 older people with dementia who have their own separate accommodation, the Meadows and Poppies units. Residents accommodation consists of 39 single and one double bedroom. Three of the single bedrooms have en-suite facilities; the remaining rooms have wash hand basins fitted. There are a variety of lounge and dining areas with drink making facilities provided for residents. Astbury Lodge has an adequate number of toilets and a variety of bathrooms available. Aids to help independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The current fee range for the home is £455 - £550 per week. A copy of the inspection report can be made available upon request to the home or via CSCI. A copy is also contained within the homes Welcome Pack which is in each bedroom and the reception area. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit took place on the 20 February 2009 and lasted for a total of seven hours and ten minutes. Paul Ramsden, Inspector, undertook the visit on behalf of the Commission for Social Care Inspection. Any references to us or we in the report refer to the Commission. Feedback on the findings of the inspection was given to the home manager as it progressed and via a later telephone conversation. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment [AQAA] to provide up to date information about the service provided in the home. This is a very detailed questionnaire that provides us with a lot of information about the service before the visit. Survey forms were sent to a random sample of residents and staff members to Care Homes for Older People Page 6 of 27 find out their views prior to the inspection. Any other information received since the home was last inspected was also reviewed. To date five resident and one staff survey forms have been returned. During the visit various records and the premises were looked at. When looking at the documents relating to the type of care each person needs [assessments and care plans]we use a system called case tracking. This is a method that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. A number of residents and members and staff were spoken with; they gave their views about the home and the service provided. Some of these comments have been quoted in the report. What the care home does well: What has improved since the last inspection? What they could do better: Care Homes for Older People Page 8 of 27 We consider that Astbury Lodge is an excellent service so rather than state what they could improve we would expect that the home continues to review its practice in order to ensure that the very high standard of care provided to the residents at the present time is maintained and where possible improved upon. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information and opportunities to visit before moving in are available and residents are assessed before moving in to ensure their needs can be met at the home. Evidence: The home provides a range of information to new residents; this is presented in a Welcome Pack, this includes the statement of purpose and service user guide, a copy of the last inspection report, staff qualifications, a sample copy of the terms and conditions and the most recent quality assurance survey. This contains all of the information required and should provide newly admitted residents with enough details about the home and what is available there. This is available in a different format if needed. CLS have recently changed the company colours and logo and as part of this process have produced a new home profile brochure called, Our House that has general information about the organisation plus an insert about the specific home; this is the document that is usually sent to prospective residents; some copies of this are Care Homes for Older People Page 11 of 27 Evidence: also kept in the entrance area for visitors to take. People are free to visit and look around Astbury Lodge prior to choosing to live there if they want to; they can also stay for a meal and have a trial visit before deciding. If they have any queries they can contact the manager or senior staff members. A variety of other information including a newsletter called, The Companion is also readily available. We believe that the information produced by CLS is of a very high standard and provides sufficient information for people who may either be choosing to move in or who have recently arrived. One resident has written on a survey form; We visited the home and were shown all areas, [we were] made very welcome. Pre-admission assessments demonstrating that the residents individual needs had been assessed in an accurate and consistent way had been carried out for the residents whose files were looked at. The care team leaders or the manager usually carry out the assessments and they will visit people in their own home, another care home or hospital to gather the necessary information before admitting someone. As far as possible the prospective resident or their relatives are involved in both the assessment and care planning process. This provides an opportunity to make sure the home can accommodate the person and their individual needs. One of the newly admitted residents confirmed that this had happened, he told us that his first impressions were good. When someone is funded by the Local Authority they also provide an assessment of the persons needs prior to admission. This provides background information as to the reasons why a move to the home is needed and is very useful when combined with the homes own assessment. Intermediate care is not provided at Astbury Lodge. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents care plans seen were well maintained and provided all of the information needed for staff members to be able to take appropriate action to meet an individuals needs. Evidence: The care team leaders are responsible for drawing up a residents plan of care. All of the care plans seen were of a very good standard and provided the staff with all of the tools needed to identify any assessed need and how it is to be met. The care plans seen were all up to date and were written in a style that would enable someone reading it to have a good idea of what help and assistance someone needed at that time. We felt that they provided staff members with all of the necessary information for them to look after a persons needs. Care plans were being reviewed, with input from the residents or their representatives and where necessary re-written on a regular basis. As part of CLSs internal monitoring process a regular audit of the care planning system within the home is undertaken. Care Homes for Older People Page 13 of 27 Evidence: Staff members spoken with could show that they had a good understanding of the people they were supporting and they were able to meet their diverse needs. Care staff work to a high standard in order to ensure that residents receive the care they need. They monitor a residents health and emotional needs daily and there was evidence to show that people were receiving the appropriate support from district nurses, GPs etc. A key worker system is in place [This is a system used in the majority of homes and involves particular staff members working more closely with certain residents]. The changing needs of individuals are discussed as and when required. We were able to see this in practice during the visit when information about an individual was passed onto the care team leader. CLS have introduced a new communication book for staff members; this is very detailed and helps to ensure that any issues that have been identified are addressed promptly. It was seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. They were seen to be interacting with individuals in an appropriate way, knocking on bedroom doors before entering and addressing people according to their wishes. The residents spoken with made a number of positive comments about the home and the staff members supporting them. All personal care is carried out in the privacy of a residents bedroom or one of the bathrooms. CLS has a written policy on the receipt, administration [including self administration], safekeeping, handling, recording and disposal of medication within its homes. Since the previous inspection the organisation has appointed a company called Pharmacy Plus to supply medication to all of its homes and new medicine trolleys, blister packs and documentation have been provided. The arrangements for the administration of medicines during this inspection visit were considered to be good and the residents were being given their medication as prescribed. All senior staff members have received medication training and the home manager audits this regularly. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents using the service are able to maintain contact with family and friends and those spoken with were positive about the home and the support they received. Evidence: Residents were able to move freely around the home and a choice of sitting and dining areas were available. They confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living; for example, times of rising and retiring, whether or not to join in with planned activities and where to spend time and with whom. Residents meetings are held on a regular basis and the minutes are displayed on the notice boards next to each lounge entrance. We saw that one resident had been able to bring her dog into one of the small units; it was really at home and it was obvious that the other residents in the unit were very fond of it; we think this is a really positive action on the homes behalf. The home has an activities co-ordinator whose role is to work with residents, both individually or in groups. A variety of social and other activities are organised and information about these are on the notice boards throughout the home. Other information such as the dates of the mobile library visits was also displayed on the Care Homes for Older People Page 15 of 27 Evidence: boards. Residents spoken with made positive comments about the activities available. One person has written on a survey form; I would like more activities, maybe something in the nightime. Various religious denominations conduct services in the home. People also confirmed that they were free to attend a local church if they wished to do so. Links with the local community are maintained and residents are free to go out on their own [If they are able to] or with their families. We saw one resident using an electric buggy to go across to the local shops, he had told us earlier that he did this regularly. We are aware that CLS as an organisation were looking at introducing a volunteer scheme that would enable people to participate in specific activities. Visitors are free to call into the home at any reasonable time and mail is given to residents unopened. A computer, with internet access is also available for residents if they choose to use it. Meals can be eaten in the main dining room or in the privacy of a residents own room. Both Meadows and Poppies have their own kitchen/dining areas. The dining room is well furnished and laid out and provides a very pleasant dining experience. There is a menu that has the flexibility to meet individual needs and choices. The catering staff members have a very good understanding of each persons preferences and all of the residents that commented said that the quality of food provided to them was of a very good quality and that choices were available. Special diets can be provided if needed. CLS as an organisation has invested a lot of time and effort under its Marvellous Mealtimes strategy in order to ensure mealtimes are both a social and pleasant experience for the residents in its homes. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives are able to complain/make suggestions and action would be taken to respond to their concerns. Adult protection training is provided for staff in order to ensure the continued safety of residents. Evidence: There is a written complaints procedure for the home, this is displayed in the entrance area. Information about complaints is also included in the Welcome Pack that is given to all of the residents. A comments book is in the entrance area. The ethos of the home is that it will deal with any complaints/suggestions positively and will learn from them. Those residents that commented said they would inform the manager or another senior staff member of any issues. They also said that they felt confident that appropriate action would be taken. Any complaints received by the home have been appropriately dealt with. The home has an adult protection [now referred to as safeguarding] procedure that complies with all of the relevant legislation and good practice guidelines. This is designed to ensure that any possible problems that arise are dealt with openly and people are protected from possible harm. Staff members undertake training in this area. Care Homes for Older People Page 17 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The facilities and accommodation within the home are of a very good standard, this means that residents live in a very comfortable and homely environment. Evidence: A tour of the premises was undertaken; this included communal [lounges/dining room]areas and a number of bedrooms. The home is well maintained and provides an environment that can fully meet the needs of the residents that live there. Since the previous inspection visit a new dementia care unit has been opened in one of the wings of the home. Prior to opening the unit was completely refurbished and a kitchen/diner created. Some of the areas in other parts of the home have/or are due to be improved. This includes the replacement of two baths that were no longer being used, the redecoration of some bedrooms and the planned redecoration of the lounges. A new area for residents to smoke has been created outside following the introduction of the smoking ban. The quality of decor, furnishings and fittings provide residents with a homely and comfortable environment to live in. The bedrooms seen during the visit were all personalised, comfortable, well furnished and contained items of furniture belonging to the resident. Care Homes for Older People Page 18 of 27 Evidence: The home provides adaptations for use by residents with mobility problems. These include bath and toilet aids, hoists, grab rails and other aids to help maintain independence. There are accessible garden areas available for residents to use; these include safe areas for the people who may be at risk of wandering. These are well maintained. The laundry within the home is well equipped and good systems are in place for the care of peoples clothes. The laundry was well organised and we did not receive any negative comments about the quality of the laundry service. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff members work positively with residents and families to improve the quality of life of residents living in the home. A robust staff recruitment process is in place to protect residents from possible harm. Evidence: Care staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff was able to meet the needs of the residents within the home. The staff members were cheerful and friendly and the residents spoken with were complimentary about their attitude and competence. We saw that the staff team worked well together and relationships between them were relaxed and positive. The manager, home services manager, administrator, activity co-ordinator and separate ancillary staff such as kitchen and laundry staff members are in addition to the care staff members on duty at any one time. This means that there is always plenty of staff on duty to meet the various needs of the people living in the home. According to the AQAA at the time of its completion 32 of the 49 care staff members are either qualified [20] or are working towards [12] a National Vocational Qualification [NVQ] level 2 or 3 in care, a recognised qualification for people working in the care profession. Care Homes for Older People Page 20 of 27 Evidence: The staff files seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. The homes manager confirmed that all new staff are checked against the POVA list and that a satisfactory CRB disclosure must be obtained before employment commences. The management team at Astbury Lodge consider that the recruitment of good quality staff members is an integral component in delivering a high quality of care. The result of this is that the current team have the skills, knowledge and experience to meet the diverse needs of the residents. New staff members undertake a thorough induction training programme which meets the Skills for Care Induction Standards. The manager explained that this process has changed recently and a new four day in- depth induction [including safeguarding] had been introduced. This would be followed by a rolling plan, with the support of a CLS locality trainer that would help to ensure that all new starters had the most up to date information whilst still meeting the Skills for Care standards. CLS provides a range of training courses for staff members; these include, safer manual handling, first aid, adult protection and fire safety. The staff members spoken with confirmed that regular training was readily available. Training is monitored through the computerised training database; Resource Link and through records maintained by the manager. Staff meetings are held on a regular basis. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is being very well run and managed on a day to day basis, this helps to ensure that the needs of the residents are met and that there are appropriate procedures in place to maintain their safety. Evidence: The home manager attends courses/training in order develop the skills to fulfil her management responsibilities. She has her NVQ 4 and Registered managers Award. She is very experienced and knowlegeable and was able to display a clear sense of direction and best practice. The manager can clearly demonstrate an awareness of the needs of the residents living in the home and how to manage the staff team. A home services manager, administrator, care team leaders and senior carers support the manager. This is a strong and committed team who work hard to ensure that the quality of care provided is maintained at as high a level as possible. The staff members spoken with were complimentary about the home and the quality of Care Homes for Older People Page 22 of 27 Evidence: care being provided. One of them said, It is a good team and the home is well managed. Another staff member has written on a survey form, All training opportunities are made available to us. Various senior staff members have taken over responsibility for particular tasks within the home; these include the medication, rota and the reviewing of the care plans. CLS fully recognises the importance of a quality assurance system in order to ascertain whether residents, relatives/representatives and health and social care professionals are happy with the standards of care being provided. The results from the three sources above have been collated and a separate report has been produced for each. All three are very positive and show that the quality of care being provided by Astbury Lodge is of a very high standard. This process is undertaken annually. CLS is a proactive company that acts upon the results of consultation with people; this helps to ensure that good practice is developed and maintained. There are comment cards available in the reception area and these can either be posted in the box in the same area or Freepost to the head office. The form states; We aim to provide the best possible care for our residents. If there is anything that has been particularly enjoyed or you feel we could improve please let us know. Your comments will receive our immediate attention. In addition to the forms a customer feedback book is also available in the reception area, this enables people to make a comment and other people to see the reply, the last recorded entry had been made on the 14 February 2009. Residents personal allowances were being handled well and any monies were kept in a safe. Those looked at had accurate records, receipts and correct balances. All staff members are supervised on a continuous basis; in addition they all receive formal supervision on a regular basis. This helps to ensure that the high quality of care provided to residents is maintained. Any accidents are recorded and the home manager regularly audits these in order to ensure that any trends, for example, a resident having a number of falls are identified and addressed. The home has a comprehensive range of policies and procedures to promote and protect both residents and staff members health and safety. The maintenance records seen demonstrated that the appropriate service contracts were in place. These included, bathing aids, the fire alarm system and the gas and electrical installations. The fire safety log book showed that the tests on the system and emergency lighting were being carried out at the recommended intervals and that drills and training were Care Homes for Older People Page 23 of 27 Evidence: also up to date. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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