Inspection on 18/08/09 for Tudor Lodge Nursing Home

This is the latest available inspection report for this service, carried out on 18th August 2009.

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

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

Other inspections for this house

Tudor Lodge Nursing Home 24/01/07

Tudor Lodge Nursing Home 11/11/05

Tudor Lodge Nursing Home 10/06/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Tudor Lodge Nursing Home Newgate Lane Fareham Hampshire PO14 1AU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Ian Craig     Date: 1 8 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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: Tudor Lodge Nursing Home Newgate Lane Fareham Hampshire PO14 1AU 01329220322 01329822075 pat@tudorlodgefareham.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Mark Colin Palmer,Mrs Jane Marie Palmer care home 56 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is 56. The registered person may provide the following category of service only: Care home with nursing - Code N to service users 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 Dementia - Code DE Date of last inspection Brief description of the care home Tudor Lodge is a registered to provide nursing and personal care to 56 service users in the older person category. The service is located in a residential area near Fareham, close to local amenities. The building has recently been extended and 25 bedrooms have been added to the new wing. Accommodation is provided on two floors and there two shaft lifts that provide access to all parts of the building. The home has fourteen single and five shared rooms in the old part of the service and there are 25 single rooms with en suite facilities. Care Homes for Older People Page 4 of 28 Over 65 0 56 56 0 Brief description of the care home There are ample communal rooms including lounges, dining rooms, conservatory and quiet sitting room that can be enjoyed by people using the service. The home is set in extensive gardens that are easily accessible. 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: The inspection consisted of a site visit of approximatley 5.5 hours. Discussions took place with the manager and 3 other staff were involved in the inspection. Two residents were also involved in the visit as well as 2 relatives of a resident. The homes facilities were seen including communal areas and bedrooms. Surveys were sent to residents, staff and health and social care professionals to ask their views on the service. These were returned by 14 residents, 10 staff and 4 health and social care professionals. Some of the residents surveys were completed by their relatives. Records, documents, policies and procedures were looked at. Care services are required to complete an Annual Quality Assurance Assessment Care Homes for Older People Page 6 of 28 (AQAA). This was completed by the home and returned to the Commission. Information contained in the AQAA has been used for this report. Care Homes for Older People Page 7 of 28 What the care home does well: What has improved since the last inspection? A system of monitoring any falls ocurring to residents has been introduced. Care planning monitoring now takes place every 3 months. The home has introduced an incident log to monitor any complaints or incidents, so that the home can improve its service. The staff and management have attended training courses on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Improvements have been made to environment with the creation of a new wing where each room has an en suite bathroom with one exception where there is an en suite toilet. Nurse profile beds ave been installed in a number of rooms. Regular audits of the environment are now completed. Care Homes for Older People Page 8 of 28 The manager has completed the Registred Managers Award (RMA) and is now studying to be an NVQ Assessor. 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 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 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. Prospective residents are able to make an informed choice about whether or not to move into the home. The home ensures that it accommodates only those whose needs it can meet. Evidence: The process of residents moving into the home was looked at. The home has a document called a Statement of Purpose which gives information about the home such as the staffing arrangements, complaints procedure and contract. This is given to residents and/or their relative. Each resident who completed a survey said that they received enough information to help them decide if the home was the right place for them to move into. One person said they did not receive enough information. Two residents said a relative had a look around the home to check its suitability. The home does not have a Service Users Guide, which is required by the care home regulations. The manager agreed to address this. Care Homes for Older People Page 11 of 28 Evidence: Once the home receives a referral for possible admission an assessment of the persons needs is carried out and recorded. These are comprehensive and include details of personal care needs, moving and handling, skin care, risks, communication, oral health, nutritional needs, sight, foot care, mobility, continence, respiration, mental health and medication. In addition to this, the home carries out nursing assessments using the barthel index, and pressure area risk assessments as well as other risk assessments. Each of the surveys returned by health and social care professsionals state that the homes assessment arrangements ensure that accurate information is gathered and that the right service is planned for people. It was noted that the assessment of need for those referred for possible admission could be expanded so that that there are more details of relevant mental heath needs so that these needs are fully understood. 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 needs of the residents are met. Residents are treated with dignity and respect. Evidence: Care plans awere looked at for 6 peole who live at the home. These are based on asessments of need. Clear guidance for staff to follow are recorded for nursing procedures and personal care such as dressing, continence and personal hygiene. Care plans also include details of each persons preferred times for getting up and going to bed as well as other personal preferences. Two residents spoken to on the day of the inspection said that they are able to go to bed and get up when they wish, although one survey from a member of staff said that the home could be improved by allowing residents to get up later. There is a brief social history of each person. Care plans could be improved so that staff have clearer details and actions to follow regarding mental health needs. Care Homes for Older People Page 13 of 28 Evidence: Each person who retuned a survey says that they receive the care and and support they need and that the home makes sure medical support is provided. Those spoke to on the day of the visit said that the homes staff pay close attention to detail in providing care, highlighting that personal care is of a very good standard, that daily records are kept of personal care routines and food and fluid intake. Relatives also reported that they are kept informed of any changes to their next of kin living in the home. A relative made the following comment: I am confident in the nursing care provided to my mother. Staff are very helpful and demonstrate care and concern. Surveys from health and social care professionals state that residents social and health care needs are properly monitored, reviewed and met by the home. The home is reported to seek advice and act on meeting health care needs. Comments from heath and social care professionals include the following: I have been impressed by the skill of assessment by the various staff members, and how they have always called me appropriately if any input has been needed. I have also been impressed by the way they are able to care for the various needs of patients. Generally a professional home that cares well for its residents. Staff confirmed that they are given up to date information about residents care needs and that the home looks after the residents well. Staff receive training in personal care and in working with people with dementia. The homes medication procedures were looked at. Medication is administered by one of the nurses on duty. A signature is recorded each time this happens. Stocks of medication show that residents receive medication as prescribed. A controlled drug register is used when controlled medication is adminsitered. Controlled medication is stored in a controlled drug cupboard. Individual care plans give details of when medication as required should be administred. For two people it was noted that more detail is needed so that staff have clearer guidance of the exact circumstances that the medication should be given. Residents described the staff as kind and helpful. A relative said, We always feel the residents are treated with respect. Another relative said, The staff, at all levels, show respect to residents and family. Surveys show that staff are available when residents need help although one person said that the saff could respond quicker when the call bell is used. Residents are able to have a key to their bedroom door if they wish. At the time of the visit no residents had a door key; the manager said that one person resident recently locked his/her door. A number of residents have their own telephone and line in their Care Homes for Older People Page 14 of 28 Evidence: room. At the time of the visit this facility was limited to those residing in the new part of the home. The manager said that there are plans to extend this to the remaining area of the home. Care Homes for Older People Page 15 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. Residents benefit from a programme of activities and stimulation. Varied and nutritious meals are provided. Evidence: The home has an activities programme, which is given to residents and includes details of daily events for the week ahead. These include music and movement, bingo, a film club, arts and crafts and reminiscence. Residents confirmed in surveys and conversation that activities are provided. One person said that he/she enjoys 1960s music played by a visiting musician. A resident said that he/she goes out with his/her relatives. Two surveys made reference to improving the level of activities and outings for residents. A group of residents were observed singing songs with a member of staff in one of the lounges. Residents said how they are able to spend their time as they wish. Some choose to spend time in their rooms and others in the communal lounges. Care Homes for Older People Page 16 of 28 Evidence: Several residents have a newspaper delivered. Residents were observed reading or completing crosswords in their rooms or in the communal areas. Relatives commented that for those who are not able to leave their room, that staff will engage residents in impromptu activities and stimulation. Residents rooms contain numerous items of personal possession such as pictures, radio and television. Residents were observed receiving visitors. A member of staff was seen asking each resident what he or she would like to eat for the midday meal. On the day of the visit this was a choice of either chicken and mushroom pie or breaded fish served with potatoes and vegetables. Dessert was lemon meringue pie or fruit and ice cream. Residents described the food as good. Specialist diets are provided including pureed food. Relatives confirmed that the home plays close attention to ensuring that sufficient fluids and food are provided for those that need help. The serving of the midday meal was observed on one of the dining rooms. This could be improved as one meal was left on a table for over 10 minutes before being taken to a resident. Cutlery was placed on the dining tables only when residents were given their meal. Care Homes for Older People Page 17 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 home has an effective way of dealing with any concerns. Residents are protected from possible harm although more training in this area is needed. Evidence: The AQAA states that there have been 7 complaints in the last 12 months. The home has a record of these alongside the managements own investigation, any outcome and an action plan to improve. These records show that the home is monitoring not just complaints but any incident of significance where there may be a need to improve the service. Of the 14 surveys returned by residents, or their relative, each said that there is someone they can speak to informally if they are not happy, but, 4 people said that they do not know how to make a formal complaint, indicating that people need to be informed more fully about the procedure. The home has literature on safeguarding and adult protection procedures. The manager and training records show that there has not been any recent training in adult protection procedures. Staff stated that this was included in the National Vocational Qualifications they have studied. The manager stated that there is a need for staff to have more recent training in safeguarding vulnerable adults. Care Homes for Older People Page 18 of 28 Evidence: Care plans include details of how staff should deal with residents behaviour. There was a comment from a health care professional that staff need more training in this area, which was also acknowledged by the the manager. Care Homes for Older People Page 19 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. Residents benefit from a clean, homely and well maintained home with good facilities. Evidence: Since the last key inspection an additional wing called, Elizabeth has been built. This offers 33 single and 1 double bedrooms each with an en suite bathroom with a walk in shower, except for one room which has an en suite toilet. The remaining bedrooms are in the Henry wing, which provides 4 double and 14 single bedrooms, 4 of which have an en suite toilet. A number of bedrooms were seen. These are fitted with specialist beds in the Elizabeth wing. Furniture is clean and intact. It was noted that in the Henry wing that there are some areas of wear and tear on doors and door frames and that not all residents have lockable storage space in their rooms. Residents have lockable storage in the Elizabeth wing. Several residents have their own telephone line in their room. Residents names are displayed on bedroom doors. Residents said that they like the environment. Bedrooms are personalised with belongings. The home has a number of communal areas including several lounges and dining areas. Residents were seen using these areas. Care Homes for Older People Page 20 of 28 Evidence: The home has a hairdressing salon. There is ramped access in the home and out to the garden for those with mobility needs. There are 2 lifts one of which can accommodate a bed. The home has 2 bathrooms with a specialist bath as well as 2 other bathrooms with a bath hoist. Gardens are well maintained and can be used by the residents. Some of the bedrooms have a patio door which opens onto the garden. The home was found to be clean. Staff receive training in infection control. Residents said that the home is clean and well maintained. Care Homes for Older People Page 21 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. Sufficient numbers of staff are provided to meet residents needs. Whilst staff have access to a variety of training courses improvements are needed so that staff have the right type of training so that they have the right skills for dealing with residents needs. The staff recruitment procedures protect residents. Evidence: The home aims to provide the following staff: 8am to 2pm each day, 11 care staff and 3 Registered General Nurses; 2pm to 8pm, 8 care staff and 2 Registered General Nurses (RGN), and, 8pm to 8 am the next day, 5 care staff and 2 RGNs to 12pm and 1 RGN midnight to 8 am. The manager and deputy managers working hours are in addition to this. Observation and the staff rota shows that these staffing hours are being maintained. There was a mixed view from staff about whether the home has sufficient staff to meet residents needs. From the 10 surveys returned by staff, 1 person said there are never enough staff, 4 answered sometimes and 5 said there are usually enough staff. One person said there should be additional nursing staff at night. Staff involved in the inspection said that there are enough staff with the exceptions when there are absences due to leave or sickness. Residents and their relatives said that staff are available when needed, although 2 people made reference to delays in staff responding to the call points . Care Homes for Older People Page 22 of 28 Evidence: Residents described the staff as kind and helpful. A relative said that the nursing staff are approachable and reassuring and another relative said the staff demonstrate care and concern. 7 of the 10 surveys returned by staff said that they received an induction which prepared them for the job. 2 staff said they never received an induction. Two staff said that newly appointed staff are not always put on the rota on a supernumerary basis making it difficult for them to learn the job and that the induction should be longer. This was discussed with the manager who acknowledged that the homes induction has not been of a satisfactory standard in the recent past but that a new induction procedure is being introduced based on nationally recognised standards. The recorded induction for a recently appointed staff consisted of a two page checklist on an induction form. The manager explained that there is a system whereby new staff have a named link staff member to support them. 8 of the 10 staff who returned a survey said that they receive relevant training. Two staff said that they received training but that this did give them enough knowledge about health care and medication. 37 of the 42 care staff have the National Vocational Qualification (NVQ) in care at level 2 and 12 staff also have the NVQ level 3 in care. Staff said that they work as a team and that there are regular team meetings. Staff recruitment procedures were looked at for 4 people. Records show that staff only start work after the required checks have been completed, including, criminal record bureau (CRB), protection of vulnerable adults (POVA) checks and references. The home has not recruited any registered nurses since the last inspection. The manager is aware of the need to check that nurses are currently registered with the National Nursing and Midwifery Council (NMC). Care Homes for Older People Page 23 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 home is well managed and run in the best interest of the residents. Evidence: The manager is a Registered General nurse and has the District Nursing Diploma. She is holds a NVQ Assessors Award and a number of post qualifications in nursing. Since the last inspection she has completed the Registered Managers Award. Staff generally said that they feel supported in their work and that they meet with their manager to discuss their work. 2 surveys from staff said that this only happens sometimes and one person said this never happens. The manager acknowledged that the supervision sessions should increase form every 3 months to at least once every 2 months. A health care professional made the following comment about the manager: I believe a key strength is the committment and dedication of the manager, who sets high standards of care, and supports her staff extremely well. She is always happy to release staff for teaching sessions. Care Homes for Older People Page 24 of 28 Evidence: The home uses questionnaires to ask residents and their relatives their views of the service provided. The results of these are summarised. Residents meetings also take place where views can be expressed. The homes management also carries out audits of care planning, the environment and random checks of nursing procedures. The home also has a business plan for the years plans for the home. The home looks after small amounts of residents belongings. Records are kept of any amounts depositted or withdrawn plus a corresponding balance. A random check showed the balance matched the amount held. Staff check hot bath water temperatures to prevent possible scalding. The AQAA gives details of when the homes appliances and equipment were serviced. The garden has a pond and there is a risk assessment regarding its risk to visitors and residents. A relative expressed concern about the safety of the pond. Care Homes for Older People Page 25 of 28 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 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 1 36 18 Staff must receive adequate induction, training and supervision in their work. So that staff have the skills to meet residents needs. 19/10/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 38 The home should seek the advice of the local Environmental Health Officer regarding the risks posed by the unguarded pond. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC 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!