Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Northern Counties 36 Lancaster Road Birkdale Southport Merseyside PR8 2LE 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: Michael Perry
Date: 0 8 1 0 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 29 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 29 Information about the care home
Name of care home: Address: Northern Counties 36 Lancaster Road Birkdale Southport Merseyside PR8 2LE 01704568019 Telephone number: Fax number: Email address: Provider web address: mail@eventidehome.co.uk Name of registered provider(s): Type of registration: Number of places registered: Northern Counties Management Commitee care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category 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 The maximum number of people who can be accommodated is 29 Date of last inspection Brief description of the care home Eventide is a voluntary run Home providing 31 registered places for both male and female Service Users with strong Christian faith. The Home provides personal care; nursing care is provided directly through the district nursing services when required. The Registered Manager is Mr David Swan. The Registered Provider is Northern Counties Management Committee. The Home is situated in Southport close to the town centre and with access to public transport on the Liverpool Road. Eventide is situated over 4 floors, the ground and upper floors accessible by stairs and a passenger lift (there are no bedrooms on the lower/basement floor). The Home has 2 spacious lounges, 1 small quiet lounge and 1 dining room. Single and double accommodation is Care Homes for Older People Page 4 of 29 0 Over 65 29 Brief description of the care home provided though at present the double rooms are being used as single rooms. The gardens at the front and rear of the building are well maintained and accessible for wheelchair users. A ramp with handrails is in place at the main entrance to the Home. There is car parking space to the front of the premises where the Home?s minibus is parked when not in use. Care Homes for Older People Page 5 of 29 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection over two days (7 hours in total). During this time residents in the home were spoken to and members of staff on duty as well as the registered manager and assistant manager. Prior to the visit the manager completed a pre inspection information document called the annual quality assurance assessment (AQAA), which provided evidence of the daily running of the home. Care Homes for Older People
Page 6 of 29 A sample of service users care plans and risk assessments were inspected as well as staffing and other health and safety records. Also a tour of the building was made and all day areas and some (not all) residents bedrooms were seen. The fees for the service in the home are 400 pounds to 519 pounds per week. What the care home does well: What has improved since the last inspection? Care Homes for Older People Page 8 of 29 Medication records and practice were seen and administration is safe. This has improved since the last inspection when there was one unsafe issue reported. What they could do better: The assessments varied in detail. One resident did not have any recorded assessment by the home but managers had relied on the assessment from the hospital (from where the resident had originally been). It would be recommended that an assessment is completed by the home so that care needs are summarized and also the home can be sure that they can meet these needs. There is currently no assessment of the persons social background so it is not possible at the time of admission to assess any care needs in this area. It is important that disability aids are used safely. One resident was observed to be moved in a wheelchair without footrests in place, which puts the resident at risk of injury. We reviewed the medicines and would recommend that any person who is having medication on a give when necessary basis has this recorded and monitored through the care plan so that this can be administered consistently. Residents appreciated staffs efforts to keep them active and alert but some stated that they felt more could be done. There was some discussion with the managers around further improving the provision of activity in the home. the care notes do not contain any references to social care or activity and this should be addressed as a base line so that peoples individual social care needs can be better understood. The homes policy around protection of vulnerable people needs to be updated with reference to the locally agreed social services policies and procedures. This it to ensure that managers and staff are fully aware of how to report any allegations of abuse. Individual staff records did not contain any detail around individual training needs or individual supervision. Both of these are important to support staff in their continued development and it is recommended that these areas are further developed. We discussed the future developments regarding how social care staff will be registered in the future and managers need to be aware of and update staff around this so that the values and principals of care can be reinforced. One staff record did not have any evidence of a POVA check (check of the protection of vulnerable adults register) prior to employment. This was discussed and the need for the manager to be certain of a clear check prior to commencing duty was reinforced so that the manager is certain that the record is clear and the person is fit to commence duty and residents are protected. Staff felt supported by the general approach of the managers but currently do not have regular formal supervision which would be important to further develop their role in the home. Care Homes for Older People Page 9 of 29 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 10 of 29 Details of our findings
Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 11 of 29 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are addmitted following an assessment so that their care needs can be met by the home. Evidence: We reviewed the care files of some of the residents and found that in general they had been admitted following an assessment of their care needs. The manager explained that as much as possible residents are encouraged to spend time on respite prior to being fully admitted so that they can get a good feel for the home and its facilities. Residents spoken to had generally had prior knowledge of the home and had spent this period usefully. The assessments varied in detail. It was not always clear when they had been carried out as the dates were not clear. One resident did not have any recorded assessment by the home but managers had relied on the assessment from the hospital (from where the resident had originally been). This was discussed and it would be recommended that an assessment is completed by the home so that care
Care Homes for Older People Page 12 of 29 Evidence: needs are summarized and also the home can be sure that they can meet these needs. This would also form the basis of the plan of care for the person. The assessments cover health, medication, intellect, and self care. There was no assessment of the persons social backgound so it is not possible at this point to assess any care needs in this area. Residents spoken with confirmed that they had been given sufficient information as they were admitted so that they could make an informed choice as to whether to stay in the home. Copies of the homes information is kept in the hallway and also each person is given an individual copy. Care Homes for Older People Page 13 of 29 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs are well monitored so that people are cared for with dignity and respect. Evidence: The full diversity of each resident was not always represented in the care plans. There was no reference to any needs around social care recorded. For example one resident has specific concerns around going out of the home due to a medical condition which means there is a lack of confidence to go outside the home. This was explored with the resident and also staff but there is no reference on the care plan so that the resident could be supported by some specific interventions. Other care plans covered the health care needs of residents very well but again there was little reference to social care needs. Residents spoken with were very comfortable with the support around health care and also the staffs approach to personal care. One resident said, Its very good. Staff are excellent. I have assistance with bathing otherwise they support me to be fairly independent. Care Homes for Older People Page 14 of 29 Evidence: Another commented that the staff are quick to call for a doctor when required. During the inspection a GP was seen visiting one of the residents. Residents were observed to be appropiatly dressed and standards around personal hygiene are very high and well monitored so that people maintain dignity and respect. Residents are supplied with necessary disability aids such as walking aids and bath aids. The facilities seen in the home were of a high standard including a variety of bathing facilities, which help support people with a diverse range of disability needs. It is important that disability aids are used safely. One resident was observed to be moved in a wheelchair without footrests in place, which puts the resident at risk of injury. Medication records were seen and administration is safe. Residents are encouraged to self medicate if possible and there are appropriate assessments in place to ensure this is carried out safely. We reviewed one resident who is on medication that is given when necessary PRN. This was not mentioned in the care plan so that it was not clear when the medication should be given and for what reason. This is important to record and monitor so that staff are administering these medications for consistent reasons. Care Homes for Older People Page 15 of 29 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The social life of the home is well established and residents are suported but there could be further developments around inhouse activities to further enhance residents quality of life. Evidence: The home has a very strong Christian ethos and residents are made very aware of this in choosing the home. We found the general atmosphere to be very relaxed and the daily activity is planned around a routine that does not outpace the residents. Residents can choose where to spend there time and many stay in their bedrooms. The more dependant residents tend to congregate in the main lounge. Those residents spoken with were very settled in the home and felt that they were well supported. One commented: Staff are very good and helpful. I spend a lot of time in my room. There is not a lot to do. Did exercises this morning in the day room. This is every Wednesday. There is also a quiz team. We have trips out, half days, not as many this year. Have been to Blackpool. Currently booking for xmas meal. We have more meals out now. We also
Care Homes for Older People Page 16 of 29 Evidence: have a morning and evening service (religious) and reading from the bible. Others commented: I am very happy here Staff are very helpful and kind We have exercises weekly There is a trip this afternoon. We have meetings with Mr Swan, he asks us for suggestions. Staff are very helpful I feel useless. Tend to spend a lot of time just sitting around. I am not complaining though. It is a nice home and they do their best. The last comment was a feeling other people had as well. One resident commented that there is not a lot to do. Staff were observed to be very supportive of residents when assisting them in a task such as eating but were not observed to interact other than this during the inspection. Staff interviewed said that there were various jobs to do in the home but that during the afternoon there is time to socialise. There was some discussion with the managers around further improving the provision of activity in the home. This could be developed with designated activities coordinators amongst staff and also the further development of the key worker system so that the care can be further individualised. The care notes do not contain any references to social care or activity and this should be addressed as a base line so that peoples individual social care needs can be better understood. The meal times and provision of food was widely praised by residents. The dining room is well appointed and offers an opportunity for socialisation. The meals are well prepared and appetising. The care documentation was consistent in referring to residents dietary needs. We observed staff to be supporting residents at this time. Care Homes for Older People Page 17 of 29 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a complaints process and staff are aware of the need to report any allegations of abuse so that people living in the home are protected. Evidence: We saw that the complaints procedure for the home is available in the written material supplied by the home and also in the homes Statement of Purpose document, which is kept in the main entrance to the home. The file also contains self addressed envelopes for use if any body wishes to complain in writing. There have been no complaints recorded since the last inspection but the manager stated that any complaints would be investigated and managed through records in personal care files. Those resident spoken with felt that staff were approachable and felt that they could see the manager if they were concerned about anything. This indicates that residents feel safe in the home. There were no complaints by people spoken with on the inspection. We discussed the homes policies and procedures around safeguarding of vulnerable adults and how to report any allegations of abuse. Staff interviewed said they had completed some training in this and records confirmed staff attendance. Staff were
Care Homes for Older People Page 18 of 29 Evidence: aware of the definitions of abuse and so could recognise mistreatment and abuse if they witnessed it. They were also clear about the need to report any concerns and allegations to the managers. Staff were not aware of any external policies such as Seftons local procedures (the home does have a copy of this) on safeguarding and were unsure as to the role of statutory bodies in any investigation. The homes policy on managing and reporting abuse does not reference the locally agreed policies and is unclear as to who to report allegations to and also the homes role in any investigation. This needs clarification so that staff and managers and are clear and fully aware of the wider management of allegations of abuse. Care Homes for Older People Page 19 of 29 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home maintains hgh standards of maintainance and decor and attention has been paid to disability access and facilities so that esidents are living in comfortable surroundings. Evidence: We found the accommodation to be of a very high standard. All areas seen were well maintained and homily. The day areas were well appointed and maintained and comfortable. Bedrooms seen were also well personalised and lived in and residents felt that they could maintain their lifestyle and independence. For example some residents had their own telephone and also personal possessions that they had brought into the home. The home have been careful to supply accessible facilities for those people who have physical disability. For example there are disabled bath and toilet facilities as well as easy access to the home on all levels including ramped access to the front of the home. The homes mini bus also has disabled facilities for wheel chair users. This shows that the home are considering peoples diverse care needs in terms of disability. The standard of cleanliness throughout was of a high standard. Care Homes for Older People Page 20 of 29 Care Homes for Older People Page 21 of 29 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is staffed appropriately so that the care needs of the residents can be met consistently but there needs to be evidence of all recruitment checks so that that the manager is sure staff are fit to commence work in the home. Evidence: We found the home to be staffed appropriately so that care can be of a consistent standard. Staffing numbers vary through the day from eight care staff in the morning to 3 during the evening. Staff are allocated where managers see most need so that care needs can be met. There is also ancillary staff employed such as domestic staff and kitchen staff. Residents reported that the staff are consistent and always available when needed. Staff where observed to be supporting residents during the day. The AQQA completed by the manager tells us that 61 per cent of the care staff are trained to NVQ standard. All of the staff spoken with have this qualification which shows that there is a strong core of staff in the home who have competencies to meet the care needs of the residents. This training is ongoing. The manager was able to show how staff have attended other training and regular
Care Homes for Older People Page 22 of 29 Evidence: updates in moving and handling and health and safety issues. Also that there will be extra sessions planned around the needs of the residents such as diabetes. Individual staff records did not contain any detail around individual training needs or individual supervision. Both of these are important to support staff in their continued development. The manager reported that supervision was to be discussed at the staff meeting and that this would be formally introduced in the near future. We discussed the future developments regarding how social care staff will be registered with the General Social Care Council (GSCC) and how staff need to be aware of this and also the Code Of Practice published by the Council which outlines the values and principals of care that are expected. It is recommended that managers update themselves and staff so that they are aware of future developments in this area. Staff reported that they felt supported in their role and that the care manager was approachable and helpful but that formal supervision was not currently available. One staff commented: I feel the care is very good. Staffing is consistent and we always know who we are working with and what to do. The staff records seen showed that the managers check staff prior to employment so that they are fit to work with vulnerable adults. One staff record did not have any evidence of a POVA check (check of the protection of vulnerable adults register) prior to employment. The manager was able to show the application for this but reported that the people who apply for and monitor the checks only contact the home if there is a problem with the check. This was discussed and the need for the manager to be certain of a clear check prior to commencing duty was made clear so that the manager is certain that the record is clear and the person is fit to commence duty and residents are protected. Care Homes for Older People Page 23 of 29 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a consistent management approach which acts to seek the views of residents so that any developments can be planned in the best interests of the residents. Evidence: Mr David Swan was approved by the Commission as the Registered Manager of Northern Counties in 2006 although he has worked in the home for a number of years. He is experienced and has a number of relevant qualifications that are required to meet the stated purpose and aims and objectives of the Home. David is supported by a care manager and an administrator. The management of the home is made clear in the information supplied by the home Staff spoken with felt supported by the managers. None of the staff reported any formal supervision to support them in their role but the manager reported that this had been discussed at the staff meeting and would now be introduced. The need to
Care Homes for Older People Page 24 of 29 Evidence: record this is staff files was discussed so that staff would have a record of continual development and support. Information detailed in the pre inspection questionnaire (AQAA) and examination of a selection of records during the inspection showed that records required by regulation are available, up to date and accurate. Residents and staff spoken with during the inspection were complimentary of the manager and the way he runs the home. Mr Swan is the manager and he is very approachable. The home has various quality assurance processes, which help the management plan the home with reference to the needs of the residents. For example an external quality assurance audit is carried out yearly and residents are consulted as to their opinions of the home and how it might be improved. The general satisfaction of residents in the home is very high. The board of trustees also visit the home regularly and provide feedback to the manager on a monthly basis, which again is valuable in both monitoring of standards but also in planning any changes. The manager also meets with the residents and residents spoken with confirmed this. The health safety and welfare of residents are well protected this was supported by a comprehensive set of policies and procedures, which were detailed in the preinspection questionnaire and available at the home. Information provided in the pre-inspection questionnaire and examination of a selection of health and safety records showed that the required health and safety checks have been carried out on the environment at the required intervals, for example fire system checks, gas and electricity checks and environmental risk assessments. Some of the issues discussed around the future of staff registration, recruitment checks for staff and policies around safeguarding of vulnerable adults mentioned earlier in the report do not always meet the most up-to-date practice and managers should be aware of the need to updated themselves regularly of any developments in the general field of care so that best practice is always maintained. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 29 19 A CRB must be obtained but if starting new staff prior to the CRB being in place a POVA first check must be obtained and made available. this is to ensure that staff are fit to work with vulnerable people 28/11/2008 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 3 The home should always complete there own assessment of care needs for each person prior being admitted to the home. The assessments should also incude reference to social care needs. The full range of peoples diverse needs to be reflected in the care planning. This includes social care needs. it is strongly recommended that all wheel chairs are used with footrests in place to ensure saftey. The provision of activity in the home could be further improved. This could be developed with designated activities coordinators amongst staff and also the further
Page 27 of 29 2 3 4 7 8 12 Care Homes for Older People development of the key worker system so that the care can be further individualised. The care notes do not contain any references to social care or activity and this should be addressed as a base line so that peoples individual, diverse social care needs can be better understood. 5 18 The homes policy on managment of abuse needs to be updated with reference to the locally agreed policys from social services. Managers and staff make themselves aware of the code of practice issued by the general social care council. The planned formal supervision of staff should be introduced and recorded. 6 7 29 36 Care Homes for Older People Page 28 of 29 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 © (2008) 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 29 of 29 - 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!
