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Inspection on 10/12/08 for Fallings Park Lodge

Also see our care home review for Fallings Park Lodge for more information

This is the latest available inspection report for this service, carried out on 10th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What the care home does well

The home has a good assessment and admission procedure, which means that people can be reassured that their needs will be met when they are admitted to the home. People who were spoken with during the inspection were pleased with the care they receive and were complementary regarding the service provided, level of care and the staffing and management arrangements. People living at the home stated they feel safe and confirmed that staff are always kind in their approaches with them. Individual bedrooms and communal areas such as lounges are spacious, which ensures that there is plenty of room for wheelchair access and also provides people with a choice of places to relax. Training opportunities within the home are good which ensures that people are cared for by a well-trained and committed staff group who work positively to improve people`s quality of life

What has improved since the last inspection?

We found that the home has improved where medication is stored and now ensures that it is stored at the correct temperature. The home has improved how it provides people with opportunities to comment on different aspects of the service and acts on the results to make improvements. Maintenance of the building and servicing of equipment has improved, which ensures people are provided with equipment and an environment that is safe. Since the last inspection a conservatory has been built and people who were able to communicate their views were pleased with this new facility, which is bright and provides a large amount of space.

What the care home could do better:

It is considered that the service is performing well, setting its own objectives for continual improvement and striving to ensure people receive a high standard of care. One requirement is made as a result of this inspection. The manager, Jacqui Whatling needs to apply to the Commission to enable the process of registration as manager to commence. Two recommendations are made. The home is advised to improve the way people are assessed for the use of bed rails, such as by ensuring that the risk assessment is based on current guidance and to ensure that heavier items of furniture such as wardrobes do not place a risk to people through being pulled over.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fallings Park Lodge 99a Old Fallings Lane Fallings Park Wolverhampton WV10 8BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rosalind Dennis     Date: 1 0 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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: Fallings Park Lodge 99a Old Fallings Lane Fallings Park Wolverhampton WV10 8BJ 01902722700 01902722700 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Aplin Care Homes Ltd care home 48 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: In the OP category Females 60 years and above and males 65 years and above The Second floor lounge and bedrooms are used for the thirteen service users with dementia. The home should only accommodate up to 13 service users with dementia. Up to seven service users aged 55 years plus, other service users must be over 60 years. Date of last inspection Brief description of the care home Fallings Park Lodge is a purpose built care home situated in the residential area of Fallings Park and is close to local shops and amenities. The home has three floors with wheelchair and disabled access throughout. There are 48 bedrooms all of which have en-suite and a modern nurse call system. There are large communal lounges each incorporating dining facilities for the residents. People with dementia generally live on the top floor, which has thirteen rooms. The home has extensive gardens and grounds, with raised flower-beds at the rear and there is car parking at the front of the building. Care Homes for Older People Page 4 of 27 Over 65 13 35 0 0 Brief description of the care home A local bus service stops nearby. Information on the fees charged by the home is included within the service user guides, where it is documented that weekly fees are £357 (residential) and £408 for people who need dementia residential care. The reader is advised to contact the home to obtain up date information on the fees charged. People can obtain information about this service from the homes Statement of Purpose and Service User Guide. Inspection reports produced by CSCI can be obtained direct from the provider or are available on CSCIs website at www.csci.org.uk. The last key inspection of this service was undertaken on 26th February 2008. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was unannounced, in that the home did not know we were coming and the inspection was conducted by one inspector over a period of around 7 hours. All key standards were assessed during the day- that is those areas of service delivery that are considered essential to the running of a care home. During the inspection time was spent speaking with people living at the home, as well as looking at documentation, speaking with staff and management and observing staff in their work. Sometime prior to this inspection an Annual Quality Assurance Assessment (AQAA) document was sent to the manager for completion. The AQAA is a self-assessment and a dataset that is filled in once a year by all providers. It informs us about how providers are meeting outcomes for people using their service and is an Care Homes for Older People Page 6 of 27 opportunity for providers to share with us areas that they believe they are doing well. It is a legal requirement that the AQAA is completed-Fallings Park Lodge returned their completed AQAA to us within the given timescale. Information provided within the AQAA has been used to supplement the inspection process. The inspection found the home functioning well, people living at the home appeared content and eager to provide their views on how their needs are met at Fallings Park Lodge. 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 set out on page 4. Care Homes for Older People Page 8 of 27 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. Fallings Park Lodge has a good assessment and admission procedure, which ensures that people are only admitted to the home if the service is confident that it can meet their needs. Evidence: During the inspection we spoke with two people who had moved to the home earlier this year and they described how they were made to feel welcome when they first arrived at the home and how they have been pleased with all aspects of their care since moving to Fallings park Lodge. We looked at a selection of care files, which shows that the manager conducts detailed assessments of peoples needs prior to their admission to the home. These assessments show the home seeks detailed information about the individuals care needs and any other matters that are important to them. Where applicable the manager also obtains a copy of the assessment undertaken by a social work professional and also uses this information to plan peoples care needs. Care Homes for Older People Page 11 of 27 Evidence: We saw that copies of the homes Statement of Purpose and Service User guide were available throughout the home, and both documents provide people with information about the home, facilities and services offered. Information on the homes fees is included within the Service User guide. 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. People who are able to comment on the service are pleased with the care they receive and care plans and risk assessments provide staff with the information they need to meet peoples needs. Evidence: People we spoke with during our inspection gave very positive feedback on how they are cared for at Fallings Park Lodge. Comments included:- Im happy, no problems, staff look after me, Im very happy, pleased with everything, its great, carers kind and helpful and couldnt ask for anything more. People described how, if they need any additional assistance, staff are always willing to help them. Staff were seen throughout the inspection checking if people were comfortable and needed anything. We observed staff interacting well with people who are less able to communicate their views. We looked at a selection of care files which shows people have care plans and risk assessments in place, which provide staff with information on how people want their needs to be met taking into account any risks to the individual. People were able to confirm to us that their needs are met as described within their assessment and Care Homes for Older People Page 13 of 27 Evidence: care plan. We discussed with the manager that the care planning process should be kept under review to ensure that the actual care plan is updated with new information and not just where staff evaluate care, so that the care plan is always an accurate description of the care people need. We also advised that the home should consider improving the process it uses to assess people for the use of bed rails, by developing the risk assessment so that it is based on current guidance. Information was present on the files to demonstrate that the home seeks advice as necessary from relevant healthcare professionals, such as District Nurses and the people we spoke with confirmed that district nurses visit them to attend to their healthcare needs. All people spoken with confirmed that their privacy is maintained and that staff respect them as individuals. Since the last inspection the room used to store medication has changed and we saw documentation, which demonstrates that medication is now stored at the correct temperature both within this room and the medication storage fridge. The cupboard used to store controlled drugs is also housed within this room and meets legislative requirements. A staff member seen administering medication at the time of inspection appeared competent with this procedure and certificates were available to show that staff who administer medication have attended training in the safe handling of medicines. A selection of Medication Administration Record sheets that were observed showed that staff had completely these accurately, apart from one occasion when staff had not signed to confirm that medication had been administered and this was brought to the managers attention for action. 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. People are able to take part in activities and events which meet their needs, capabilities and preferences and they are supported to maintain their independence as far as possible. The home provides meals that offer variety and cater for different nutritional needs. Evidence: Since the last inspection the home has appointed a staff member to organise activities and events at the home. Discussions with this person demonstrate their enthusiasm for this role and a commitment to ensure people are provided with opportunities to enhance their social well-being. People spoke of how they enjoyed going out for a meal the previous evening and how they are looking forward to a Christmas Party. People confirmed that regular entertainment and activities take place at the home, which they can take part in if they choose-one person showed the Christmas decorations they had recently made for the conservatory and two people spoke of how they always enjoy taking part in Bingo and board games. Written records of individual attendance at activities are maintained, and observation of these records show that people are provided with a range of activities including specific activities for people who have Care Homes for Older People Page 15 of 27 Evidence: memory related difficulties, such as dementia. The activities person described how she adapts activities so that everyone is able to participate, such as using pictures and symbols to assist those less able to communicate through speech. Throughout the inspection there was a relaxed, friendly atmosphere where people felt able to share their views and people confirmed that families and friends are able to pop in to see them when they wish. At the start of the inspection we received varying opinions on the meals served at the home, most people were very complementary in their comments others viewed that improvements could be made and gave examples of too many potatoes and portions too big- we informed the manager of these comments. During the inspection we heard staff asking people what they would like for their lunch and when the meal was served showed that peoples requests had been listened too. The meal was hot and looked appetising. We observed staff making people regular drinks and people confirmed that staff will always make them another drink as and when they want one. 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. The home has a clear complaints procedure, which provides people with information so that they know how to complain and ensures concerns or complaints are dealt with promptly and professionally. Staff are provided with training to equip them with the knowledge and skills to safeguard adults from the risk of abuse or neglect. Evidence: All people spoken with during the inspection confirmed they would feel comfortable in raising any concerns with either the manager or other staff at the home. The complaints procedure is clearly displayed in the Reception area and within the Service User guide. We looked at the method used by the home to record and respond to complaints and this showed there is a good process in place. The home has received five complaints since January 2008 and the manager had responded to these complaints appropriately. We have not received any recent complaints about the home. People living at the home stated they feel safe and confirmed that staff are always kind in their approaches with them. Information was available to show that staff receive training in adult protection and abuse awareness and discussions with three care staff confirmed their awareness of the process to follow should an incident of abuse occur. We observed questionnaires, which the manager had recently distributed Care Homes for Older People Page 17 of 27 Evidence: to staff to ascertain their awareness of adult protection procedures following a safeguarding incident at the home. The manager demonstrates a good knowledge of the procedures for safeguarding adults and the home has a copy of the local area multi agency adult protection policy. The manager and deputy manager are aware of the Mental Capacity Act (MCA) 2005 and are planning to cascade this training to other members of staff. The Act governs decision-making on behalf of adults, and applies where people lose mental capacity at some point in their lives or where the incapacitating condition has been present since birth. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Fallings Park Lodge provides people with an attractive and clean place to live and further planned improvements will continue to enhance the appearance of the home. Evidence: The home offers spacious individual bedrooms, all of which have an en-suite facility and communal lounges provide people with a range of places to relax. People who we spoke with were satisfied with their bedrooms and en-suites and viewed that their rooms are kept clean, warm and there is sufficient hot water. Since the last inspection the home has made some changes to the environment: a lounge and dining area on the top floor are no longer in use, people who live on this floor are now usually cared for during the day in a large, conservatory. People who were able to communicate their views were pleased with this new facility, which provides a large amount of space. We observed a selection of bedrooms and found these to be clean and the decoration generally good, although we observed that attention was needed to gaps, which have occurred in plasterwork, particularly around doorframes. Observation of the environment and relevant documentation shows an improvement with the maintenance and servicing of building and equipment, for example carpets which we observed to be loose at the last inspection had been attended to, call bells have been Care Homes for Older People Page 19 of 27 Evidence: fitted in the lounge and records show that the temperature of the hot water is satisfactory. Information provided by the manager in the AQAA, describes how the decoration and refurbishment of the home is ongoing and during our feedback the manager was able to inform us of intended improvements to the environment, including replacing items of furniture. The home was advised to ensure that heavier items of furniture such as wardrobes do not place a risk to people through being pulled over, as they are not secured to the wall. The home recently had an infection control audit undertaken by a local infection control specialist and achieved a good score overall. The homes action plan demonstrates they have noted where action is needed and observations made during the inspection shows that action has already been taken in some areas. Observation of staff training files and the homes training matrix shows that most staff have received training in infection control. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs met by staff who have the skills and knowledge to meet their needs. Recruitment practices are good and safeguard people from the risk of being cared for by staff who should not be working with vulnerable adults. Evidence: We observed staff working in different parts of the home and this indicated sufficient care staff were on duty. The people we spoke with confirmed their needs are met during the day and at night and if they need assistance carers are usually quick to respond to their requests. Staff spoken with during the inspection felt that staffing levels are generally sufficient to meet the needs of the people currently living at the home, commenting that short notice sickness absence can occasionally cause difficulties. The manager is aware that staffing levels need to be kept under review according to the needs and number of people accommodated. We looked at three personnel files for staff employed at the home, which showed that all required pre-employment checks had been obtained and an induction provided. We also saw evidence, which demonstrates that the manager seeks information to ensure that agency workers and volunteers are suitable to work in the home and provides agency workers with an induction. Care Homes for Older People Page 21 of 27 Evidence: The manager confirmed that almost all care staff have achieved a recognised qualification in care (NVQ level 2) and some staff have achieved NVQ Level3. We looked at a selection of individual staff training records and the homes training matrix which shows that a wide range of training is provided-this includes training in safe working practices such as fire safety, as well as more specific training, for example Dementia care. The deputy manager has a good awareness of staff training needs and discussed plans for staff training in palliative care and equality and diversity training, which shows that the home is continually looking at training to improve staff knowledge and skills to meet the varying needs of people living at the home. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager, Jacqui Whatling has the skills and knowledge to manage the home and to lead the staff team to ensure peoples needs are met. Evidence: The manager, Ms Jacqui Whatling has worked at Fallings Park Lodge for around twelve months and it is apparent that since the last inspection in February 2008 she has continued to make improvements and develop the service to improve outcomes for people. During this inspection Jacqui Whatling demonstrated a good knowledge of the management systems and processes, which need to be in place to manage a care home. The deputy manager also demonstrated a good awareness of the day to day running of the home and provides continuity if the manager is not available. Jacqui Whatling is aware that an application needs to be submitted to the Commission to enable the process of registration as manager to commence and a requirement is made for this to take place. Care Homes for Older People Page 23 of 27 Evidence: The home has processes in place to monitor quality within the home. We looked at surveys, distributed by the home in July 2008 which showed that most people and their significant others were very satisfied with the service at that time. The manager discussed how the service acted on the results of the surveys and gave an example of how changes were made to menus and times of meals and fed back to people on the changes, which were made through discussion. The manager was informed that it would be good practice to formalise this process and produce an action plan in response to results from surveys so that all people are informed of the action taken by the home to make improvements. We looked at documents, which demonstrate that meetings are held for people living at the home and for staff to keep them informed of changes within the service, implementing good practice and where changes to practice are needed. Observation of staff files and discussion with staff confirms they have access to formal supervision sessions, which provide opportunity to reflect on their practice and to discuss training and development needs. A representative from the company also monitors quality assurance at regular intervals with monthly unannounced visits. A report is then formulated with the findings of the visit. For the purpose of this inspection Jacqui Whatling had responded to a request by the Commission to complete an annual quality assessment document (AQAA)- this is an opportunity for providers to share with us areas that they believe they are doing well, and where they could improve. The information contained within the AQAA shows that Jacqui Whatling has some good ideas for improving and enhancing various aspects of the service. Records relating to the management of small amounts of residents personal monies appeared satisfactory, although we advised that it would be beneficial to introduce a practice of having two staff signatures for transactions for people who lack capacity or who are otherwise unable to sign. Information was provided within the AQAA to confirm that servicing and maintenance of equipment is undertaken and policies and procedures are reviewed. The selection of records we looked at, including fire safety and water temperature checks, were all up to date. We observed that two people had bed rails in place and these appeared to be fitted correctly although we advised the manager to re-check the distance between the bed rail and the head end of one bed to ensure that it had remained within recommended limit. 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 1 31 8 The manager must apply for registration with the Commission. This is to ensure compliance with the Care Standards Act 2000 02/03/2009 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 8 The home is advised to improve the way people are assessed for the use of bed rails, such as ensuring that the risk assessment is based on current guidance. The home was advised to ensure that heavier items of furniture such as wardrobes do not place a risk to people through being pulled over. If people are identified to be at risk then the home must take appropriate action to ensure people are not placed at risk of harm. 2 19 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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