Inspection on 18/12/08 for Ailsa House Residential Care Home

This inspection was carried out on 18th December 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ailsa House Residential Care Home 28/06/07

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ailsa House Residential Care Home 64-66 Genesta Road Westcliff On Sea Essex SS0 8DB     The quality rating for this care home is:   one star adequate 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: Carolyn Delaney     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Ailsa House Residential Care Home 64-66 Genesta Road Westcliff On Sea Essex SS0 8DB 01702346473 01702349313 ellisbarbara13@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Dr Ram Kishore Tandon Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Ailsa House is an established private care home that provides personal care and accommodation for 18 older people. It caters for people with low to moderate dependency needs and although it does not routinely provide care for people suffering with dementia, it has been registered for three places for people who have dementia. Ailsa House is a large traditional house, in keeping with other properties in the area, and is located in a residential area of Westcliff on Sea. It is close to public transport, sea front and local amenities. The home has twelve single bedrooms and three shared rooms situated on the ground and first floor, many with private en-suite facilities, and each with a call bell facility and a TV point. The home has a passenger shaft lift between the ground and first floor. Staff facilities and offices are on the second floor. The home is nicely decorated and has a homely atmosphere. There is a garden to the Care Homes for Older People Page 4 of 28 Over 65 3 18 0 0 Brief description of the care home rear of the house with a separate patio area. Residents living at the home are able to access facilities in the local community and leisure interests are encouraged with support from staff and relatives. A conservatory built to the side of the property is used as a day care facility for up to ten clients. This is not a registered facility and is run separately to the home, although residents in the home can join in activities with the day care clients and day care clients are able to mingle with the residents when they are invited. The most recent inspection report was available in the entrance hall of the home, with copies of the homes Statement of Purpose and Service User Guide. The current fees for the home range between 379.47 and 493.50 pounds per week. 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: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a routine unannounced inspection, which included a visit made to the home between the hours of 11.00 and 19.15 on 18th December 2008. As part of the inspection process we reviewed information we have received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment which the registered provider / owner tell us what they do well, how they evidence this and the improvements made within the previous twelve months. We sent 10 surveys each to the home to distribute to residents, their families and staff to complete and a further 5 for health care professionals to complete and tell us what they think about Care Homes for Older People Page 6 of 28 the home. At the time of writing this report we had not received any surveys back. During the inspection we spoke with two relatives and four members of staff. The views and comments expressed by these people were reflected in the report. We also observed how staff interacted with residents when supporting them with activities such as meals, mobilising and providing recreation and stimulation. During the site visit, records including residents care plans and assessments, and staff training files were examined. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. In addition some residents bedrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. 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. Care Homes for Older People Page 8 of 28 Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People cannot always be assured that they home will be suitable and their needs will met. Evidence: We were told in the Annual Quality Assurance Assessment that a detailed assessment is always completed before a person is admitted to the home. During the inspection we looked at the care files for three people who had moved into the home since the last inspection. We saw that there had been no assessment carried out for two of these people before they were offered a place in the home. The manager said that one of these people had been admitted from hospital as an emergency admission. We saw for this person that the hospital had provided detailed information about their needs and the manager had obtained information from the persons family to help them decide if the home would be suitable. For the other person there was some information which had been provided by the social worker who had arranged the placement. However Care Homes for Older People Page 11 of 28 Evidence: this information was very brief and did not give detailed account of the persons needs or the support they needed from staff. Since the last inspection we have received concerns from one relative. They told us that the manager refused to take a resident back from hospital despite a doctors decision that the persons needs could be met in a residential care setting. We discussed this with the owner and manager during our inspection. The manager told us that an assessment of the persons needs had been carried out and based upon this it was determined that due to the persons poor mobility that the home could not meet their needs. There was no evidence of the assessment carried out to support this decision. Two residents we spoke with and their relatives told us that they had attended the day care services at the home and on the basis of the care they received they had chosen to move into the home permanently. Both residents and their relatives said that they were happy with the home. 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. People living in the home know their assessed health and personal care needs will be met and they will be well cared for. Evidence: We were told in the Annual Quality Assurance Assessment that care planning had been improved and that plans reflect the needs of residents. We were told that residents are encouraged to remain as independent as possible. During the inspection we looked in depth at care plans for two people. We saw that an assessment of needs had been carried out for both people. However the format used was a checklist which staff tick a description which most matches the needs of the individual. No additional information was added to the assessment to make them more reflective of individuals needs. Both residents had care plans with information about their needs to help staff support them. Information in the care plans described the tasks which staff were to carry out and did not reflect each persons capabilities or how they like to be supported. This would help to promote each persons independence. Care Homes for Older People Page 13 of 28 Evidence: The manager told us that residents keep their general practitioners when they move into the home unless it is not practical to do so. Where there are issues for example where if a doctor refuses to keep a person on their books when they move, the manager will arrange for the person to be registered with a doctor in the area. We saw that staff keep records of visits residents made to doctors, opticians and other health care professionals, and of any changes to the treatment prescribed for them. Relatives we spoke with said they were happy with the home and felt that staff cared for residents well. One person told us their relative gets the care and support they need. We looked at the arrangements in place for assessing and minimising risks to the health and safety of residents. We saw that where risks such as injuries, falls, weight loss or development of pressure sores were identified that a plan to monitor and minimise these risks was developed and reviewed regularly. We looked at records maintained when there are accidents in the home and these indicated that there had been few accidents and no serious injuries to residents within the past twelve months. We were told in the Annual Quality Assurance Assessment that medicines are stored securely. During the inspection we saw that medicines were stored safely in an appropriate medicine trolley. Controlled drugs (such as some strong painkillers and sleeping tablets) were stored in an appropriate cabinet. However this was not secured appropriately and the manager and owners were advised that it should be secured to a solid wall. The owner undertook to have this dealt with immediately. We saw that staff receive training to enable them to store, administer and dispose of medicines safely. We looked at how staff keep records and saw that medication administration records were well maintained and that staff complete records when they administer medicines. At the time of the inspection none of the residents were administering their medicines. We looked at care plans and there was no evidence that residents had been offered the opportunity to do so or if they would be capable of retaining control of medicines as part of maintaining independence. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can make decisions about the way they spend their time. Evidence: We were told in the Annual Quality Assurance Assessment that residents make choices about their daily lives. We were told that people are supported in going out to church, shopping, day trips and going out with family and friends. During the inspection we saw that there are a range of planned activities and opportunities for residents to socialise and to remain occupied. This included entertainment from outside entertainers who come to the home approximately three times each week. Residents who wish to participate in these activities are charged a fee of four pounds per person per session. On the day of the inspection two music entertainers visited the home in the afternoon and put on a show of seasonal songs and jokes, which residents and visitors appeared to enjoy. We saw that staff provide some activities on a daily basis including exercises, reminiscence sessions, music and support more able residents to go out shopping. Most people we spoke with during the inspection felt that there were good opportunities for residents to be kept stimulated. One relative told us there could be more activities provided. Relatives we spoke with told us they are always welcomed to the home when they visit. Care Homes for Older People Page 15 of 28 Evidence: The manager told us that there is a choice of meals for residents. During the inspection we saw that weekly menus were displayed on each table and that there was a choice of meals available. On the day of the inspection we saw that dining tables were laid nicely with festive napkins and tablecloths. Residents were offered a choice of either mushroom omelette or savory minced beef served with potatoes and a selection of vegetables. The meal looked appetising and residents we spoke with said the food was good. One person said Meals are always nice and there is plenty to eat. The lunch time meal was served at 12pm and staff were available to assist and support residents as needed. The evening meal is served at 4pm. At the time of the last inspection the inspector suggested that this be reviewed as it was very early and left a long gap between the evening meal and breakfast. The deputy managers told us that sandwiches and cakes are offered to residents at 7pm. We saw that residents had been consulted about the times of meals and were happy. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are well cared for and safeguarded from harm. Complaints and concerns are not always dealt with appropriately. Evidence: We were told in the Annual Quality Assurance Assessment that there is a procedure for dealing with complaints, which is displayed where residents and visitors can access it. We were told that there had not been any complaints made within the previous twelve months and that all complaints would be dealt with within the time frames as set out in the complaints procedure. When we visited we saw that information was available, which described how a person may complain and how concerns would be dealt with. We had received one complaint from a relative within the past twelve months. This complaint had been sent to the manager of the home but had not been investigated or responded to in line with the homes policy and procedure. People who we spoke with during the inspection and those who completed surveys told us that they knew who to speak with if they are unhappy and how to make a complaint. We looked at the measures in place to help safeguard residents from abuse. Staff have training to help them recognise and report any ill treatment of vulnerable people. The home has a policy and procedure for staff to follow and the two deputy managers could demonstrate that they would act appropriately and inform the local safeguarding team in the event of any allegations being made. We saw that staff were recruited Care Homes for Older People Page 17 of 28 Evidence: thoroughly and that all of the relevant checks were carried to determine a persons fitness before they were employed at the home. This helps to ensure that only people who are suited to work caring for older people are employed and that residents are protected from harm. We had received no allegations or concerns since the last inspection. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, comfortable and well maintained to meet the needs of residents. Evidence: We were told in the Annual Quality Assurance Assessment that the home is clean and there are measures in place to control the spread of infection. We were told the home is well maintained and there is a programme for ongoing maintenance. The owner told us that they comply with any requirements made by the local environmental health and fire authority. Shortly before we visited the home we were advised by the local Environmental Health department of some concerns about hot water temperatures and the lack of suitable slings for hoists. They told us when they visited the home that hot water temperatures were regularly recorded by staff and that hot water was in excess of fifty degrees, which could cause scalds or burns to residents. They also told us that there was only one size of sling available for use with the homes lifting hoist and that this was unsuitable for the person whom it was used for as it was too big. When we visited the home we saw evidence that thermostatic valves had been installed so as to regulate the temperature of hot water so that it was delivered at approximately 43 degrees, which is the recommended temperature. A range of new slings had been purchased for use with the hoist. Care Homes for Older People Page 19 of 28 Evidence: During the inspection we saw that all areas of the home were clean and free from unpleasant odours. Cleaners were employed to clean the home each day. There were policies in place for staff to adhere to so as to minimise the spread of infection and there were sufficient hand washing facilities for staff. Residents bedrooms, which we saw were clean, warm and personalised. Residents have access to comfortable communal lounge and dining areas. There is a separate area to accommodate day care clients. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are cared for by staff who are recruited thoroughly and trained to meet residents needs. Evidence: We were told in the Annual Quality Assurance Assessment that staff are recruited thoroughly and all of the required checks are carried out before a person starts work at the home. We were told that extra staff had been employed to cover absences due to sickness or planned holidays. During the inspection visit we looked at how staff were recruited to work in the home. We looked at the files for two members of staff who had commenced work since the last inspection. We saw that before both these people started work that satisfactory references had been obtained from their previous employers. PoVA First checks and Criminal Records Bureau disclosures had been obtained. These checks and references help to ensure that only people who are suited to work with older people are employed in the home. We were told that staff complete a period of induction and undertake training in health and safety, safe moving and handling and food hygiene before they commence work in the home. During the inspection we saw evidence that once staff are employed to work in the home that they complete a period of induction, which includes training to familiarise themselves with the homes policies and procedures and the needs of Care Homes for Older People Page 21 of 28 Evidence: residents. We requested and were provided with a copy of the training programme for staff. From this we saw that staff undertake training, which includes caring for people who have dementia, fire safety, first aid and safeguarding people from abuse. Staff who we spoke with during the inspection told us they receive training and support to look after residents. Relatives told us carers are wonderful and staff are always attentive to residents needs. During the inspection the deputy managers told us that four staff are employed to support residents during the day and two staff cover the night shift including one sleep in person who will be called upon if needed. We looked at staff rotas for a twelve week period and these showed us that staffing levels are maintained and that staff usually have a minimum of one day off per week. However one person regularly works a late shift after working a night duty and another person regularly works without a day off during the week. This practice may impact upon the care and support provided to residents. Following the inspection the homes owner contacted us and told us that this had occurred due to unforeseen circumstances and that extra staff had been employed so as to help ensure that this did not did not happen again. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and run in the interests of the people who live there. Evidence: We were told in the Annual Quality Assurance Assessment that a new manager had been appointed and they were settling into their role. This person was being supported by one of the organisations partners who was overseeing the running of the home. During the inspection we met with both people who were responsible for the day to day running of the home. The manager told us that they had commenced a leadership and management course to help equip them in managing the care home. We looked at how residents, their families and other stakeholders views were obtained and used to monitor and improve the quality of care provided by the home. The manager told us that there are resident meetings held every three months and that relatives are invited. We saw the minutes from two meetings which had been held earlier in the year. These indicated that residents and their relatives were happy with Care Homes for Older People Page 23 of 28 Evidence: the home and how it was managed. We observed my suggestion is boxes situated in communal areas of the home, which were easily accessible by residents and visitors. People can use these to make comments and suggestions anonymously if they wish. The manager said that these were checked regularly but that they were not well used. As part of the process for monitoring the quality of the service there is a questionnaire given to residents, their families and other visitors to the home to complete. The manager told us she was in the process of developing a more user friendly format and one which encouraged people to comment on the service. There is a system in place for regularly supervising staff and monitoring their practice. We saw that staff were supervised regularly by the manager. Residents may hand over money and valuables to the manager for safe storage on their behalf. We looked at the arrangements for ensuring that monies were kept safely and saw that they were stored securely. We saw that accurate records were maintained in respect of receipt of money and any financial transactions such as payment for activities, hairdressing etc. We looked at how the home is maintained and at evidence of the routine maintenance, servicing and repair to essential installations and systems such as heating and hot water systems and equipment used for detecting and warning of an outbreak of fire. We saw certificates which evidenced that equipment was regularly serviced, repaired and renewed as needed. We observed that the annual check for the hot water boiler was overdue and there was no evidence that the tests on electrical equipment had been carried out by an approved electrical engineer. We discussed these issues with the manager and owner at the time of the inspection. Care Homes for Older People Page 24 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 25 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 3 14 A detailed assessment of each persons needs must be carried out before they are offered a place in the home. This must be done to ensure that the home will be suitable and staff will be able to meet individuals assessed needs. 12/01/2009 2 16 22 All complaints received must 23/01/2009 be investigated and responded to in accordance with the homes policy and procedure. This must be done so as to ensure that all complaints are dealt with appropriately and concerns are taken seriously. 3 38 23 All of the equipment necessary for the needs of the home and residents must be maintained and regularly checked and serviced. 16/01/2009 Care Homes for Older People Page 26 of 28 This must be done to ensure that equipment is maintained in safe working order. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 The terms and conditions should be reviewed so it is clear under what circumstances the contract between the provider and service user may be terminated. The plan of care should reflect the needs of each individual and include details of the persons capabilities and their preferences for how they like to be supported. Staffing levels should be reviewed and monitored so that staff do not work excessive hours without appropriate time off. 2 7 3 27 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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. 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