Inspection on 05/05/09 for Meadow Dean Residential Care Home

This is the latest available inspection report for this service, carried out on 5th May 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Meadow Dean Residential Care Home 27/02/06

Meadow Dean Residential Care Home 04/05/05

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meadow Dean Residential Care Home 35 Lower Road River Dover Kent CT17 0QT     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: Penny McMullan     Date: 0 5 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Meadow Dean Residential Care Home 35 Lower Road River Dover Kent CT17 0QT 01304822996 F/P01304822996 meadowdene@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Anandanadarajah Maheethan,Mrs Vidya Maheethan care home 26 Number of places (if applicable): Under 65 Over 65 26 old age, not falling within any other category Additional conditions: 0 The maximum number of service users to be accommodated is 26 The registered person may provide the following category of service only: Care home only(PC) 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 (OP) Date of last inspection Brief description of the care home Meadow Dean Residential Home is a large detached house, situated in the village of River. The home is registered for 26 older people and at the present time all bedrooms are being used as single rooms. Communal accommodation is located on the ground floor, and consists of three communal sitting areas. There is a dining room and some bedrooms are also located on the ground floor but the majority of bedrooms are on the first floor and this floor is serviced by a passenger lift. Care Homes for Older People Page 4 of 28 Brief description of the care home There is a small garden area at the rear of the building, which is backed by a river. Car parking is available on the road immediately in front of the home and to the side of the home. The village of River has local shops and a public house, there is a bus service from the village into the town of Dover, and the local railway station at Temple Ewell is approximately one mile from the home. The current fees for the service at the time of the visit are £425.00 per week. There are additional charges for chiropidy, hairdressing, newspapers and toiletries. Care Homes for Older People Page 5 of 28 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 was a key inspection carried out over a period of time and concluded with an unannounced visit to the home on 5th May 2009. We spoke to three relatives and nine people living in the home, together with members of staff and the management team. Feedback from the people using the service and relatives is positive and comments have been included in this report. The care of three people was tracked to help gain evidence as to what it is like to receive a service from the home. Various records were viewed during the inspection. The home returned the Annual Quality Assurance Assessment (AQAA) within the required timescale. Information within the AQAA was not completed fully and further Care Homes for Older People Page 6 of 28 detail would give a better indication of what the home has achieved and improved on since the last inspection. Improvements are therefore required when submitting the next AQAA. The last inspection on this service was completed on 16th May 2007. 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. 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 28 Care Homes for Older People Page 9 of 28 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 28 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. Peoples needs are thoroughly assessed to make sure that the home can meet their care needs. Standard 6 does not apply to this home. Evidence: The Registered Manager or Deputy carries out a thorough care needs assessments prior to the person being admitted into the home. This information is supported by a care plan from the placing authority to make sure all of the care needs are identified and met. The people, relative or representative sign to say they agree with the information and this forms part of the care plan. The assessments are very thorough; however there are minor shortfalls in the recording of the information, for example some forms are not fully completed. One assessment did not have the consent to care plan or the personal profile information recorded. Care Homes for Older People Page 11 of 28 Evidence: The people told us that someone from the home had spoken to them about their needs prior to coming to live in the home. A relative told us that her family had visited the home before her mother moved in. A detailed pack of information was also provided about the service to help them decide if it was the right place for her. Care Homes for Older People Page 12 of 28 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 health and personal care, which a person receives, is based on their individual needs. The people are treated with respect and their dignity and privacy is upheld. Arrangements are in place to ensure the safe administration of medication and health needs are well supported. Evidence: Each person has a care plan to make sure his or her full care needs are recorded and met. There are parts of the plan, which show exactly how to care for the individual, stating what and how they can achieve some of their own care needs. However there are other areas, which identify that the person needs support and reassurance but does not state how the staff achieve those aims. The moving and handling risk assessments do not have written guidelines for staff to follow to ensure that people are moved safely. The assessments do identify the number of carers and hazards but no Care Homes for Older People Page 13 of 28 Evidence: further information is recorded of how to complete the specific manoeuvres. Staff spoken to demonstrated their awareness of moving and handling in a safe manner but this is not reflected in the plan. This risk is minimised as the staff are trained and the Registered Manager is a moving and handling risk assessor, however a recommendation will be made in this report to ensure that staff have a written guideline in place to move people safely. A key worker system is in place and monthly reviews are taking place. The keyworker, head of care, registered manager and service user sign off the reviews. In some cases the service user had not signed to confirm they had participated in the review process. Daily records are in place, duly signed and dated, and in some cases further detail is required to record the care provided. For example one entry states woke early and wanted to wash, it does not clarify what care and support was provided at that time. Health care needs are monitored in the care plan. They work closely with the local GPs, District Nurses, specialised nurses and mental health team. All visits from health professionals are recorded and the people who use the service confirm they see the chiropodist, dentist and optician when required. Peoples medication needs are recorded and currently all of the people living in the home are supported with their medication. The records to confirm that each person receives their mediation are in good order and the Deputy Manager audits these on a regular basis. Senior Staff are currently receiving in house medication trainin, however medication training should be accredited. It is therefore recommended that a review of the in house medication training course be carried out so that the home can be sure that the staff are receiving the appropriate content of medication training. The people told us that the staff are polite and respectful. When asked if the staff respect their privacy and dignity, people said definitely, always. Staff were seen knocking on doors and talking to the individual when entering rooms. All of the people spoken to at the time of the inspection told us that they can get up and go to bed when they wish and are supported to make choices in their daily life. The people comment: The care staff are respectful and polite, they are very good. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The review of the actitives in the home will provide all of the people with an opportunity to participate in social activites. The people are supported and encouraged to maintain their own routines and lifestyles. The food in the home is good, offering choice and variety to meet individual preferences. Evidence: The Registered Manager is looking at ways to improve the activity programme as currently there is no dedicated activity person to manage the activity programme. Individual interests and preferences are recorded in the care plan, but there is no evidence to show that these have been taken into consideration when planning activities. There is weekly entertainment, including music for health and entertainers. The church visits on a monthly basis and communion is held for those who wish to participate. Bingo and quizzes are also provided and recently a party was held in the Care Homes for Older People Page 15 of 28 Evidence: home. The people would benefit from a more organised activity programme, which is flexible to give the people an opportunity to participate in a social activity of their choice. The people who use the service comment: Sometimes there are activities, I dont play bingo and choose to do my own things. There is a music man sometimes. I get bored some days and will just read a book. Visitors are made welcome in the home and the people can choose to see them in the lounge, dining room or their own bedroom. A relative confirms that the staff are always welcoming and they can have coffee or tea if required. Family can stay for meals or have snacks with their relative. One person has specifically recorded what visitors he prefers to see in the care plan. A person comments: My son visits every other day and the home make him welcome, sometimes I go out with him to the local parks. The people who use the service told us that they could do what they wish in the home. Four of the people spoken to say they get up and go to bed when they wish and can go to watch television in their room or in the communal lounge. Some people prefer to stay in their rooms and make their own entertainment. This is clearly recorded in their individual care plans to ensure they are supported with their choices. The people in the dining room told us that the food is good. There was a choice of juice or water and alternatives to the menu if required. People were observed being assisted sensitively to eat their meals and are asked what they would prefer to eat each day. The meals served were varied according to choice and are well presented. The people told us that there is always choice and if they want they can choose a cooked breakfast in the morning. The people comment: I have never had to complain, the staff are good. My room is nice and I enjoy the food. I am a little difficult to feed but they cater for my needs. The food is good, with two choices per day. It is gammon today, there is always plenty of food and sometimes I have a cooked brekfast. Care Homes for Older People Page 16 of 28 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 people can be confident that their complaints will be listened to and acted on. Arrangements are in place to ensure that the people who use the service are protected from abuse. Evidence: The complaints procedure is on display in the hallway and all of the people are given a copy on admission to the home. There have been no formal complaints made since the last inspection. The people and their relatives spoken to at the time of the inspection told us that they did not have any complaints but would raise an issue if they had any concerns. They told us that they would tell the staff and are confident they would listen and do something about it. Safeguarding procedures are in place and staff spoken to demonstrated their knowledge of reporting any concerns. The Registered Manager told us that all staff had received adult protection training but this was some time ago. She is currently in the process of updating the training and not all staff have received such training. This is given in house and the materials used are over two years old. It is therefore recommended that the home update their training to ensure that staff are aware of current practice and changes in legislation. The person delivering the training must also be competent and trained to do so. Good recruitment procedures ensure that staff Care Homes for Older People Page 17 of 28 Evidence: have been checked and are safe to provide care to the people. Care Homes for Older People Page 18 of 28 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 is well maintained, providing the people with a comfotable and homely place to live. Laundry facilities are satisfactory and policies and procedures are in place to control the risk of infection. Improvements are required to ensure the home is protected from fire. Evidence: Since the last inspection the dining room and conservatory area and five bedrooms have been redecorated. Carpets have been replaced in two rooms, and three new beds have been purchased. The tables and chairs in the dining room have also been replaced. Two new large screen televisions have also been purchased. The home has an informal maintenance plan to ensure that all minor repairs are completed. The people told us that they have personalised their rooms to their choice with small items of their own furniture and personal photographs of family and friends. A person comments: My room is fine and I have my personal things, I dont have a key but could lock it if I wish. At the last inspection there was a requirement made under standard 38 with regard to fire risk safety in the home. This requirement was not complied with and further Care Homes for Older People Page 19 of 28 Evidence: information on this issue can be found in the management and administration outcome of this report. The Registered Manager told us that work on the unused bathroom is starting in May and this will ensure that there is one bathroom/shower room for every eight residents. Laundry facilities are at the back of the home and the washing machine has a sluicing facility. There are infection control systems in place to reduce the risk of infection and the Registered Manager is in the process of arranging updated infection control training for all staff. The people who use the service, their relatives and visitors confirm the home always smells pleasant. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient staff on duty to meet the needs of the people living in the home. Improvements are requred in the training programme to make sure that staff have the skills and knowledge to do their jobs well. Recruitment systems are in place to ensure that the people using the service are receiving care from staff who have been appropriately checked. Evidence: At the time of the inspection the home was appropriately staffed to meet the needs of the people. Feedback from relatives and staff indicate there is always enough staff on duty, but one person said that on rare occasions the home is short, in such times as sickness and holidays. The people using the service told us that the staff always come quickly when they call them. Staff files seen contained appropriate documents, proof of identity and written references, with completed application forms to confirm previous full employment history. The criminal record and prevention of vulnerable adult checks are in place to ensure that the staff have been vetted and are safe to care for the people. Care Homes for Older People Page 21 of 28 Evidence: The home has a programme of NVQ in place and when the current staff have completed the award there will be over the fifty per cent required. Although the staff have received mandatory training in the past, there are shortfalls in updating the training. For example nine members of staff require updating in moving and handling, 17 in first aid awareness, 12 in Health and Safety, 2 in Food Hygiene, 6 in Fire Safety and 10 in Infection Control. There are also shortfalls in First Aid at Work training and the Registered Provider must ensure that a first aid appointed person is on duty at all times. The Registered Manager has already identified these shortfalls and is in the process of accessing courses to bring the training up to date. Therefore a requirement will not be made in this report, however a recommendation will be made to ensure that this training is provided. Some of the training is completed in house and the Registered Manager must ensure that the training information is up to date with current practice and the trainers are competent to provide the training. The Registered Manager told us that there is a twelve week distance learning training programme in place and there are small numbers of staff completing Palliative Care, Nutrition and Health, Equality and Diversity and Dementia Awareness training. All senior staff will also receive Mental Capacity training. A member of staff told us that she completed her induction last year and was fully supported by her colleagues and Manager. She said that she completed competency tests and shadowed other carers until she felt confident to do her job well. Staff files show evidence of the induction programme. Care Homes for Older People Page 22 of 28 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 has an awareness of service shortfalls and is taking action to address these issues. The people in the home are encouraged to express their views to influence the day to day running of the home. Arrangements are in place to ensure the people who use the service finances are protected. Further improvements are required to protect the health and safety of the people who use the service and the staff. Evidence: The Registered Manager has been in post for several years and is qualified and experienced. Staff surveyed and spoken to told us that they feel supported by the Care Homes for Older People Page 23 of 28 Evidence: management team. However there has been some slippage in the management of the fire safety in the home. A requirement from the previous inspection with regard to fire safety has not been met. The home did not consult with the local fire and rescue office with regard to the wedging of fire doors in the lounge and in bedrooms where the people like to leave their bedroom door open during the night. Although the Registered Manager told us that the fire drills had taken place there is no evidence recorded of when this was or the names of staff on duty. In line with our enforcement process we issued a Code B Notice and a warning letter was sent to the Registered Provider to make sure that action will be taken. This letter tells the owner that enforcement action may be taken if they do not address the issues and make the home safe. The day after this inspection the Registered Manager took action to address these issues and it was arranged for the fire office to visit the home. As a result of this visit to the home, individual fire door guards have been purchased for communal areas, and every residents bedroom will be fitted with this device so that they can choose to have their door open if they wish. This ensures that they are safe and the doors will automatically close should the fire alarm be triggered. Documentation for the fire drills is now in place and the Registered Manager has arranged for a drill to take place. The fire risk assessment for the home has also been updated. The management of the home for all other areas has been rated as good and we are confident that the Registered Manager will continue to ensure the home is safe. They have taken prompt action to address the issues. For this reason the rating for this home will remain as good, however we can inspect or take further action should there be any cause for concern with regard to the safety of the people living in the home. As a result of a quality assurance questionnaire sent to the people the menus of the home were reviewed to make sure they included dishes that the people enjoy. The questionnaires were sent to health care professionals and relatives. Although it is evident that the people have been involved in the changes of the menu, the information on the surveys should be summarised and all of the people involved should be advised of the outcomes so that they are able to be involved in the running of the home. The Registered Manager and Deputy Manager look after personal allowance monies and ensure that the relevant records are in place. Records were viewed and were found to be accurate and in good order. Receipts are in place and some service users are able to sign for any monies issued. The Registered Manager has recognised that the supervision programme is not up to date and is working to improve this. Staff spoken to and surveyed say they receive Care Homes for Older People Page 24 of 28 Evidence: supervision and there is evidence on file that this takes place. One to one supervision supports the staff to do their jobs well and identifies any training needs or development. A training programme is in place to make sure staff receive training to be provide them with the skills to do their job well. The Registered Manager is in the process of updating all training as previously reported in the staffing outcome of this report. At the time of the inspection the Registered Manager was unable to evidence that an appointed qualified first aider is on duty at all times in the home. Although staff had received the training the records did not evidence that this had been updated and staff had a current first aid certificate. It is recommended that the home makes sure that the training is up to date so that a qualified person is on duty at all times to provide first aid as and when required. Appropriate safety checks on equipment in the home have been carried out. Environmental risk assessments are in place but had not been updated since 2006. The Registered Manager told us that these would be updated the day after the inspection and confirmed that this had been carried out. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 38 13 To carry out fire drills, record 30/06/2007 the call point when testing the fire points and to consult the local fire office with regard to the installation of individual fir door devices To review the fire risk assessment in line with the new fire legislation Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 To ensure that full details are recorded on the assessment forms in order that staff have the information they need to meet the peoples needs. The Registered Provider to ensure that moving and handling risk assessments contain written guidelines of how to move pople safely. To complete the review of activities and take into account individual preferences to provide social stimulation for all of the people. To ensure that all staff receive an update in safeguarding training to ensure that staff are aware of current practice. To ensure that all staff receive supervision on a regular basis. The Registered Provider to ensure that a qualified appointed first aider is on duty at all times. 2 7 3 12 4 5 6 16 36 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!