Inspection on 01/05/08 for The Homestead

This is the latest available inspection report for this service, carried out on 1st May 2008.

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

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

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Homestead 18 Heath Hill Road Crowthorne Berkshire RG45 7BX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Denise Debieux     Date: 0 1 0 5 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 25 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 25 Information about the care home Name of care home: Address: The Homestead 18 Heath Hill Road Crowthorne Berkshire RG45 7BX 01344 751498 01344 776270 thehomestead@farthingscare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): Type of registration: Number of places registered: The Homestead (Crowthorne) Ltd Ms Carole Elson care home 23 Conditions of registration: Category(ies) : People with Dementia Additional conditions: The maximum number of service users to be accommodated is 23. The registered person may provide the following category/ies 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 categories: Dementia (DE). Number of places (if applicable): 0 Date of last inspection Brief description of the care home N/A The Homestead provides care for up to twenty three older people with mild to moderate dementia. The home is a three storeyed adapted house with an enclosed and secure garden located off a quiet side road in Crowthorne. In September 2007 the provider company changed its name and had to re-register the home under the new company name. Although this was effectively a new registration, there was no change to the management or staff at the home. Copies of inspection reports prior to the new registration can be obtained from the provider. Care Homes for Older People Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This unannounced visit formed part of a ‘key’ inspection and was carried out by Denise Débieux, Regulation Inspector. The Registered Manager was present as the representative for the establishment. It was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and any information that CSCI has received about the service. Service users at this home prefer to be referred to as ‘residents’. For clarity and consistency this term will be used throughout this report. A tour of the premises took place. On the day of this visit the inspector spoke with five Care Homes for Older People Page 5 of 25 of the twenty one residents and four on-duty staff. Prior to the inspection, survey forms were sent to residents and to staff employed at the home. Survey forms were returned by four members of staff. Two resident survey forms had been completed and returned by their relatives. Some of the comments made to the inspector and made on the survey forms are quoted in this report. Not all residents are able to communicate verbally and observations of the interactions between staff and these residents were also used to form the judgements reached in this report. The home had completed an annual quality assurance assessment (AQAA) and residents’ care plans, staff recruitment and training records, menus, health and safety check lists, activity records, policies, procedures, medication records and storage were all sampled on the day of this visit. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Fees at the home range from £630 - £650 per week. This fee does not include hairdressing, chiropody and newspapers. This information was provided on 1st May 2008. The inspector would like to thank the residents and staff for their time, assistance and hospitality during this visit and the relatives and staff who participated in the surveys. 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.csci.org.uk.You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line – 0870 240 7535. 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 home Page 8 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each resident is only admitted to the home following a comprehensive needs assessment to ensure that the home can meet the resident’s identified needs. This home does not offer intermediate care. Evidence: The inspector was advised that, on the first enquiry from a prospective resident and/or their representative, the resident and/or their representative will be invited to visit the home. Following the initial visit to the home, and if the resident/representative wishes to continue, reports are requested from any involved health professionals, such as psycho geriatricians, community psychiatric nurses, GPs and care managers. Following this a second visit is arranged with the prospective resident and/or their representative, at this visit more in depth information is shared Care Homes for Older People Page 9 of 25 so that the home is sure the resident has as much information as possible to make an informed choice about moving to the home. After this second visit the manager will then arrange to visit the resident and carry out a pre-admission assessment to ensure that the home can fully meet the resident’s needs and expectations. Four care plans were sampled during this visit. In each case comprehensive preadmission assessments had been carried out to ensure that the home could meet the residents’ identified needs. In the AQAA, to demonstrate what the home does well, the manager stated that: ‘We dedicate a great deal of time in obtaining information about prospective clients to ensure we can support them. We have an excellent staff team who are recruited and trained to meet the needs of mentally frail residents requiring diverse care. We seek to avoid respite care or undertaking emergency admissions to the home. We use the first month as a trial period during which we make a full and comprehensive assessment of physical, emotional, social and care needs.’ Relatives who replied to our surveys both felt they had received enough information prior to choosing the home. Data provided in the home’s AQAA does not identify any residents with specific religious, racial or cultural needs at this time. However, from the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. In their AQAA the home identified the following plans for improvement in the next 12 months: ‘Continue with training program to include MRSA, Parkinson’s disease, diabetes and nutrition in the elderly and other courses. To initiate further Mental Capacity Act information, and to improve on the daily care documentation.’ care home Page 10 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Policies, procedures and practices are in place to ensure the safe administration of medication. Evidence: The home has a small and close care team and the staff demonstrate an in depth knowledge of each individual residents’ needs, abilities and preferences in how they wish their care to be delivered. On the day of this visit, residents were seen to be choosing what they did and where they went within the home. Staff were seen to be helpful and offered assistance where needed or requested. It was also observed that staff had a good rapport with residents that were not able to communicate their wishes verbally, where they indicated that they wanted assistance, this was quickly understood by the staff and the assistance provided. In the AQAA, to demonstrate what the home does well, the manager stated that: ‘We Care Homes for Older People Page 11 of 25 have introduced a new care plan system for residents, introduced mental capacity decision making profiles, together with a comprehensive mini mental health test, as used by visiting mental health professionals.’ The care plans sampled during this visit were all based on pre-admission assessments and had been drawn up shortly after each resident’s admission to the home and included appropriate risk assessments. These care plans set out the actions which need to be taken by care staff to meet the health and personal care needs of the residents. Care plans are reviewed on a monthly basis and daily notes are kept that reflect the care given. These daily notes demonstrated that any changes or new concerns are promptly acted upon. The manager stated that the care plans sampled are ‘a work in process’ with the new system only recently introduced. The home are working on incorporating more details of the residents’ known or indicated preferences in how they would like each aspect of their care delivered. The manager is also working on developing the care planning risk assessments used (e.g. assessments to identify risks related to falls, nutrition, skin breakdown, use of bed rails etc.) so that there are clear and agreed instructions for staff to follow for each level of identified risk (i.e. low, medium or high risk). The lunchtime medication round was observed and the medication administration records, medication storage, policies and procedures were all sampled and found to be in order. At present there are no residents prescribed controlled drugs. The manager is aware that the law on storage of controlled drugs has recently changed and that the home will need to purchase and fit a new controlled drugs cupboard, which meets the new requirements, should any residents be prescribed controlled drugs in the future. Of the staff surveyed, three said they were always given up to date information about the needs of the people they support and care for and one answered ‘usually’. During the tour of the home staff were observed to always knock before entering the residents’ bedrooms and all interactions observed between staff and residents were seen to be caring and respectful. care home Page 12 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with opportunities to participate in a range of leisure activities, are supported and encouraged to maintain contact with family and friends and to exercise choice and control over their lives. Meals are well-balanced and varied with individual choices and preferences catered for. Evidence: The home have an activity organiser who works from 9am – 12 noon, from Monday to Friday each week. Activities provided include reminiscence sessions, creative sessions, bingo and musical workshops. Planned events within the home include a summer garden party, entertainers, a visiting farm and weekly visits from a ‘pat a pet’ dog. During this visit some residents were enjoying a quiz bingo game, residents spoken with said they were enjoying the pastime and were seen to be fully engaged in the activity. Following discussion during this visit the manager plans to expand the individual activity care plans, with direct input from the activity organiser, so that staff are able Care Homes for Older People Page 13 of 25 to ensure that each resident has support to engage in meaningful activities throughout the week and at times when the activity organiser is not working. Contact information for the National Association for Providers of Activities for Older People (NAPA) was left with the home. Residents are able to choose which activities they attend or participate in and their individual rooms were all seen to contain many personal possessions which were arranged to suit their individual wishes. There are no restrictions to visiting times and staff support and encourage residents to maintain family links and friendships inside and outside the home. Menus sampled showed that the home offers a varied and well-balanced menu. The lunchtime meal was taking place during this visit, the food was well presented, the atmosphere in the dining room was pleasant and relaxed and there were ample staff available to offer help and assistance as needed. Residents spoken with told the inspector how much they were enjoying their lunch with a number particularly mentioning the dessert that day. In the AQAA, to demonstrate what the home does well, the manager stated that: ‘The ethos of the home is to provide residents with a normal and meaningful life. We have routines to maintain oriented daily patterns of life, to meet their individual diverse needs and abilities in leisure, social activities and cultural interests of mentally frail residents. However, there is scope for individuals who are not able to or who do not choose to follow a routine pattern over a 24-hour period. Activities are planned to meet the varying levels and abilities of residents with Alzheimers disease/dementia and other cognitive impairments within our home while promoting individual person centred needs.’ In their AQAA the home identified the following plans for improvement in the next 12 months: ‘To create a specific dining area for the people who have high level of observation and assistance at meal times. Introduce a more varied programme of outside age and frailty appropriate entertainment.’ care home Page 14 of 25 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 simple, clear and accessible complaints procedure which includes timescales for the process. Policies and procedures are in place to protect residents from potential harm or abuse. Evidence: The home has a complaint’s procedure in place that is available to all residents and their relatives and is also included in the home’s statement of purpose. No complainant has contacted the Commission with information regarding a complaint or allegation made to the service since the last inspection. Relatives who returned surveys both said they always knew who to talk to if they were not happy and all staff surveyed were aware of the procedure to follow if a relative or resident raised concerns. There is a whistle blowing policy in place and the home have a copy of the latest Berkshire Multi-agency Procedure for the Protection of Vulnerable Adults. Training in safeguarding adults is included in the home’s staff induction and all staff surveyed were aware of the procedures to follow. In the AQAA, to demonstrate what the home does well, the manager stated that: ‘All staff have achieved an external ‘safeguarding adults’ training course through Bracknell Care Homes for Older People Page 15 of 25 Forest Social Services. We also include this subject in our bi-annual in-house training sessions. We have included mental capacity decision making profiles in care plans.’ In their AQAA the home identified the following plans for improvement in the next 12 months: ‘Improve our understanding of the changes in power of attorney rule and the advocacy service. Review new legislation in relation to the Mental Capacity Act. We are currently implementing Mental Capacity Act care plans in relation to vulnerable residents who are unable to leave the home safely without supervision (‘Deprivation of Liberty Safeguards’, manager to go on a course in May 08.)’ care home Page 16 of 25 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 location and layout of the home and gardens are suitable for their stated purpose. An ongoing maintenance and redecoration programme provides the residents with clean, pleasant and homely surroundings in which to live. Evidence: Residents spoken with expressed their satisfaction with the accommodation provided at the home. Relatives surveyed both said that the home is always fresh and clean. The home was toured during this visit. The furniture and furnishings were seen to be of a good quality and personal bedrooms were all seen to be personalised to the individual resident’s wishes. The maintenance and redecoration programme for the home was seen to be ongoing. Since the last inspection there have been many improvements to the communal and individual areas of the home. Further improvements are planned for the coming year including building work to extend a number of the communal areas. In their AQAA the manager stated that improvements in the past year have included: installing a macerator; ozone washing system; air conditioning units; individual clean/dirty areas in laundry; set in motion the hand gel system; staff training on infection control courses; continued the ongoing programme of re-furnishing residents’ Care Homes for Older People Page 17 of 25 rooms. In their AQAA the home identified the following plans for improvement in the next 12 months: ‘Extensive re-furbishing of communal relaxation areas within the home, on going re-decoration of individual rooms.’ On the day of this visit the home was found to be warm and bright with a homely atmosphere and a high standard of housekeeping apparent. care home Page 18 of 25 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. The numbers and skill mix of the staff meets residents needs. The home has a comprehensive staff recruitment and training programme which incorporates all areas needed to ensure, as far as reasonably possible, that residents are in safe hands at all times. Evidence: The staff rota evidenced that staff are provided in sufficient numbers to meet the needs of the residents at the home. The morning (8am – 2pm) shift is covered by four care workers, three care workers cover the afternoon/evening shift (2pm – 9pm) and the night staff consists of two waking care workers with a member of management on call. Of the eleven care staff, nine hold a National Vocational Qualification (NVQ) level 2 in care, with a further one member of staff currently working towards the qualification. During this visit the files of three recently recruited members of staff were sampled. All files were seen to contain proof of identity, two references, a completed application form and enhanced Criminal Record Bureau (CRB) and Protection of Vulnerable Adult (POVA) list checks had been obtained. However, the home were unaware of new Care Homes for Older People Page 19 of 25 regulations that came into force in July 2004 and there were some gaps in employment that had not been fully explained or explored. The manager was advised how to obtain a copy of updated regulations from the CSCI website and plans to recheck the staff recruitment documentation to ensure that they have obtained all the required information. Staff are given a copy of the General Social Care Council (GSCC) code of conduct and practice at their induction, which covers the topics required by the new, mandatory Skills for Care common induction standards. Staff are booked on additional training and updates as the courses become available. The staff training log was sampled and showed that all staff have received mandatory safe working practice training and updates. Staff surveyed all confirmed that they felt they receive training that is relevant to their role and keeps them up to date with new ways of working. In the AQAA, to demonstrate what the home does well, the manager stated that: ‘Our staff are a mixture of long serving carers and European registered nurses, who have a good level of English and are knowledgeable about elderly care. We have a detailed induction programme covering all aspects of work in our home focusing on care and the safeguarding of vulnerable adults, caring for confusion, dementia awareness, infection control, fire safety, health and safety and first aid. We have a buddy system in place for new staff so they are confident to ask questions from a strong role model.’ Of the two relatives who completed survey forms, both felt that the staff always listened and acted on what their relative said, one felt there were always enough staff available when needed and one answered ‘usually’. care home Page 20 of 25 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. Residents benefit from the clear management approach at the home providing an open, positive and inclusive atmosphere. The home has a quality assurance system in place that is based on seeking the views of the residents. Policies and procedures are in place to protect residents’ financial interests. All policies, procedures and practices are in place to ensure, so far as is reasonably practicable, the health safety and welfare of residents and staff. Evidence: The manager has over thirty years experience and has achieved her Registered Manager’s Award. Her management style is inclusive and the residents benefit from Care Homes for Older People Page 21 of 25 the ethos, leadership and clear management approach at the home. A total of four care staff survey forms were returned to the inspector prior to this visit. From observations made on the day and from comments made on the staff survey forms it is clear that the home has a close and happy staff team. Staff comments on the survey forms returned included: ‘Support is always available’, ‘We discuss residents regularly and are always updating our care for them’ and ‘The service actively supports people to be independent and involved in all areas of daily living in the home.’ One relative commented that: ‘The home is extremely well managed by the manager. She runs a wonderful team, many of whom have worked together for years. There is warmth, laughter and a great understanding.’ The home has a quality assurance system in place that is based on seeking the views of the residents and their relatives. The inspector was advised that each month the provider sends customer questionnaires to two resident’s relatives in rotation. Action is then taken to explore the response and address any issues that may be raised. Ways of expanding the current system to include other stakeholders in the community (e.g. GPs, district nurses, care managers etc) were discussed during the inspection. Policies and procedures are in place to protect residents’ financial interests. The manager stated that the home does not hold funds for any residents, a billing system is used for any sundries or services such as hairdressing. Health and safety monitoring check sheets were sampled and found to be wellmaintained and up to date. All staff have received required safe working practice training and updates. Staff were observed to be following appropriate health and safety practices as they went about their work. In the AQAA, to demonstrate what the home does well, the manager stated that: ‘We look after very mentally frail and vulnerable residents who sometimes pose challenging behaviour. Through robust procedures and training of staff, we provide a safe and harmonious environment for them to live in. We attempt to provide as much normality as possible, encompassing the ethos of promoting independence and dignity.’ care home Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 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 25 of 25 - 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. 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