Inspection on 27/02/09 for Ashleigh Rest Home,

This inspection was carried out on 27th February 2009.

CSCI found this care home to be providing an Adequate 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.

Other inspections for this house

Ashleigh Rest Home, 02/04/08

Ashleigh Rest Home, 24/08/06

Ashleigh Rest Home, 14/12/04

Ashleigh Rest Home, 01/07/04

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashleigh Rest Home, 19 Upper Walthamstow Road Walthamstow London E17 3QB     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: Robert Cole     Date: 2 7 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 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 27 Information about the care home Name of care home: Address: Ashleigh Rest Home, 19 Upper Walthamstow Road Walthamstow London E17 3QB 02085200671 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Yusuf Oomar Jooma,Mrs Rooksanah Jooma care home 10 Number of places (if applicable): Under 65 Over 65 10 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who can be accommodated is: 10 The registered person may provide the following category of service only: Care Home only - Code PC 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 Date of last inspection Brief description of the care home Ashleigh Rest Home is a privately owned care home registered to provide support and accommodation to 10 service users over the age of 65. The home is in a quiet residential road in the London Borough of Waltham Forest with easy access to local shops, transport networks and local amenities. Accommodation is provided on two floors with one shared bedroom on the top floor. Care Homes for Older People Page 4 of 27 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 inspection took place on the 27/02/09 and was unannounced. The inspector had the opportunity of speaking with service users, care and domestic staff, and the homes manager was present throughout the course of the inspection. The inspection also included an examination of records and other documents, and a tour of the premises. Prior to the inspection, the home completed an Annual Quality Assurance Assessment (AQAA) at the request if the CSCI. Surveys were issued to service users to gain their feedback on the home, three of these were completed and returned. All of this has contributed to the overall inspection process, and to judgements made within this report. Care Homes for Older People Page 5 of 27 Care Homes for Older People Page 6 of 27 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 7 of 27 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 8 of 27 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. It is the inspectors judgement that prospective service users would be give sufficient information about the home to enable them to make an informed choice as to move in or not. This information is provided through written documentation, and the opportunity of visiting the home. Evidence: The home has a Statement of Purpose in place. This includes the aims and objectives of the home and details of the facilities and services provided. Although the document was of a generally satisfactory standard, it was noted that it had not been reviewed within the past twelve months, and some of the information is now out of date, for example information about the manager, and the home should take steps to rectify this. The home also has a Service Users Guide in place. This is written in plain English, and Care Homes for Older People Page 9 of 27 Evidence: the homes manager informed the inspector that any prospective service users would be given their own copy. The Guide states Our aim is to encourage the service user to feel relaxed in a homely environment. To provide staff to help support the service user to achieve their physical, social and intellectual potential. The Guide also contains a copy of the homes complaints procedure. There have been no further admissions to the home since the previous inspection, so standards around pre admission assessments were not tested at this inspection, but will be tested at the next key inspection of the service. The home does however have an admissions procedure in place, which makes clear that service users would be able to visit the home before making a decision to move in. The home does not provide intermediate care. Care Homes for Older People Page 10 of 27 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. It is the inspectors judgement that the home is able to meet the health and personal care needs of service users. Care plans are of a satisfactory standard, and service users have access to health care professionals as appropriate. Evidence: Care plans are in place for all service users. These are subject to regular review, and are of a satisfactory standard. Plans are drawn up with the involvement of the service user, and include a person centred plan setting out how the person wishes to be supported, for example I like to bath myself but you have to wash my back for me. and I like roast dinners especially pork chops, but I dont like eggs. Plans also cover needs around personal care and social and leisure needs. Service users have an annual review meeting in conjunction with their placing authority, which feeds in to the overall care planning process. Risk assessments are in place for all service users, and as with care plans these are of Care Homes for Older People Page 11 of 27 Evidence: a satisfactory standard. Assessments identify any potential risk, and include strategies to manage and reduce those risks. They cover risks around challenging behaviour, personal care, mobility and falling. All service users are registered with a GP, dentist and optician. Records are maintained of medical appointments, including details of any follow up action necessary. Records indicated that service users have access to health care professionals as appropriate, including psychiatrists and chiropodists. The home carries out various health related checks, for instance checking service users weight, and service users have access to a gentle exercise class to promote their health and fitness. The home makes use of the Continence Advisory Service, who supply both advice and continence products. The inspector was pleased to note that since the last inspection, used continence products are now stored in a bin with a secure lid prior to their collection. The home has a medication policy in place, and only staff who have undertaken training are able to administer medications. Medications are stored in a locked cabinet, and in a locked cash box inside the fridge. The temperature of the fridge is checked daily. Records are maintained of mediations entering the home, and of those that are returned to the pharmacist. Medication Administration Record charts are maintained, those examined by the inspector were accurate and up to date. No service users currently self medicate, or are on any controlled drugs. Service users spoken to said that staff treated them with dignity and respect. The inspector observed staff interacting well with service users throughout the day. Care plans make clear that service users are supported to manage their own personal care as much as possible, which helps to promote independence and dignity. Care Homes for Older People Page 12 of 27 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. It is the inspectors judgement that that service users are supported to have access to varied activities within the home, and that food was of a satisfactory standard. However, the home should give some consideration to supporting service users to access the community. Evidence: Service users have access to a variety of social and leisure activities in-house, such as board games, cards, dominoes, TV, DVD and music. There is a fortnightly visit by someone who provides a gentle exercise class for service users. The acting manager informed the inspector that the home is currently looking in to setting up reminiscence sessions. A visiting library provides audio books for one service user who has a visual impairment, thus helping to meet their needs around equality and diversity issues. There was an activities chart on the wall, this indicated that service users have access to activities outside the home, such as pub lunches and theatre trips. However, the acting manager informed the inspector that service users did not like to go out anymore. It is recommended that the home takes steps to encourage service users to access the community, and to take part in community based social and leisure Care Homes for Older People Page 13 of 27 Evidence: activities. Friends and relatives are welcome to visit the home at any reasonable time, and service users can see visitors in private if they so wish. Service users are able to use the phone in the office. Service users are given their own mail to open where appropriate, where service users need support with this, staff will read their mail to them. Records are maintained of menus, these indicated that service users are offered a varied, balanced and nutritious diet. Staff were seen to offer service users a choice for lunch on the day of inspection. The kitchen was clean and tidy, and food was stored appropriately. There was evidence that fresh produce was used in cooking, and that fresh fruit was available. Mealtimes were observed to be unhurried and relaxed, and support with eating was provided in a sensitive manner. Records are maintained of fridge and freezer temperatures. Care Homes for Older People Page 14 of 27 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. It is the inspectors judgement that the home should be doing more to ensure that service users are protected from the risk of abuse. All staff must undertake adult protection training, and there must be robust procedures in place to help ensure that service users are safeguarded from the risk of financial abuse. Evidence: The home has a complaints log, and all service users are given their own copy of this included within the Service Users Guide. The procedure includes timescales for responding to any complaints received. The home also has a complaints log in place, although the manager informed the inspector that no complaints have been received since the last inspection. There was evidence that the home seeks to promote the legal rights of service users. As mentioned, all service users are registered with a GP, and service users are on the electoral register. The home has a copy of the local authorities adult protection procedure, and since the last inspection it now also has its own adult protection procedure in place. The inspector was disappointed to note that according to the homes records, no staff have undertaken training around safeguarding issues, and staff spoken to during the course of the inspection confirmed that this was indeed the case. In order to help ensure that Care Homes for Older People Page 15 of 27 Evidence: service users are protected from the risk of abuse, it is required that all staff undertake appropriate training in adult protection issues. The home holds money on behalf of service users in a locked cupboard. The proprietor handles service users monies, and periodically brings money in to the home for service users. Records are maintained of this money coming in to the home, and records and receipts are then maintained of any financial transaction carried out by the home involving service users money. However, the audit trail is not complete, in that there are no records available for inspection of how much money the service user receives before it is brought in to the home. In order to help ensure that service users are protected from the risk of financial abuse, clear records must be available for inspection of service users finances, including how much money they receive, before money is brought in to the home. Care Homes for Older People Page 16 of 27 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. It is the judgement of the inspector that the home is suitable to meet its stated purpose with regard to its physical environment. Service users have access to adequate communal and private space, and the home was generally well maintained. Evidence: The home is situated in the Walthamstow area of the London Borough of Waltham Forest. The home is in a quiet residential area, close to shops, transport networks and other local amenities, and is in keeping with other homes in the vicinity. The communal areas of the home consist of a dining room, sitting room, conservatory, kitchen and garden. The home was generally well maintained, both internally and externally. Fixtures and fitting around the home were domestic in character and generally well maintained. The home has an adequate number of toilets and bathrooms to meet the needs of service users. Toilet and bathing facilities have been adapted to make them more accessible to service users, thus helping to meet needs around equality and diversity issues. Bathrooms were found to be clean, tidy and free from offensive odours. However, the ground floor bathroom does not have a lock fitted to it. In order to promote the dignity and privacy of service users all bathrooms and toilets must be Care Homes for Older People Page 17 of 27 Evidence: fitted with a working lock, which includes an emergency override device. It was further noted that the radiator in the ground floor bathroom did not have any protective covering fitted, and this too must be addressed. The home has eight single bedrooms and one double bedroom. None of the bedrooms are ensuite, but all have a hand basin. Bedrooms had adequate natural light and ventilation, and all are centrally heated. Bedding, carpets and curtains are well maintained and domestic in character. Rooms have been personalised to service users personal tastes, for example with family photographs, and one service user has recently had their bedroom decorated, and they were able to be involved in choosing the new decor. Bedrooms contained adequate furniture, including table, chair, wardrobe and chest of draws. Bedrooms meet National Minimum Standards on size requirements. Laundry facilities in the home were of an appropriate scale, and hand washing facilities are situated around the home. Protective clothing is available to staff to help prevent the spread of infection, and COSHH products were stored securely. Care Homes for Older People Page 18 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgement that the home is staffed in sufficient numbers to meet the needs of service users. However, the home must ensure that all staff receive relevant and appropriate training on a regular basis. Evidence: The home provides 24-hour support, including waking night staff. However, there was no staff rota in the home. Staff informed the inspector that the proprietor had the staff rota at the time of inspection. It is required that the home has a copy of the staff rota available for inspection, to verify that it is been staffed appropriately. On the day of inspection the manager was on duty, working on shift carrying out care duties. In addition to this, a cook was also working on the day of inspection. Staff informed the inspector that for much of the time the home operates with just one staff member on duty. However, as the home currently only has three service users, the inspector considers staffing levels to be adequate, although they would need to be reviewed if there were any further admissions to the home. Through observation and discussion there was evidence that staff have built up good relations with service users, and were seen to interact with them in a friendly and respectful manner. Positive examples of staff interactions with service uses were Care Homes for Older People Page 19 of 27 Evidence: witnessed during the inspection, for instance around supporting service users with personal care and eating a meal. The AQAA supplied by the home indicates that they have all necessary employment related polices in place, including on recruitment and selection and equal opportunities. The inspector checked several staff files at random, these were found to contain references and proof of ID, and since the last inspection the home now carries out CRB checks for all its staff. The level of staff training provided is very poor indeed. Records indicated that most staff had not received any training at all since the last inspection. The National Minimum Standards clearly state that care staff are entitled to a minimum of three days paid training a year. Staff spoken to confirmed that they had not received any training in the past year. The home must ensure that staff are appropriately trained to carry out their duties. It is required that all staff receive appropriate statutory health and safety training, and any other training relevant to meeting the needs of service users. Care Homes for Older People Page 20 of 27 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. It is the inspectors judgment that the home must appoint a permanent manager who is registered with the CSCI, and that appropriate quality assurance systems must be implemented. Evidence: As at the last inspection, the inspector was disappointed to note that the home still does not have a registered manager in place. The home has a manager, who was in place at the previous inspection, but no attempt has yet been made to apply for their registration with the CSCI, and a repeat requirement is made around this. It was further disappointing to note the the manager does not receive any formal supervision, and this too must be addressed. Other staff in the home do however receive regular supervision from the manager, and records are maintained of these meetings. These included discussions around performance and service user issues. Care Homes for Older People Page 21 of 27 Evidence: The home does not have appropriate quality assurance systems in place, there was no record of any Regulation 26 visits having been completed since the previous inspection, and the home does not have a quality assurance system in place which involved seeking the views of service users. To help ensure the home is meeting the needs of service users, both of these issues must be addressed. Fire extinguishers were situated around the home. However, these have not been serviced since October 2007, and it is required that they are serviced at least once every twelve months. The home has a fire alarm system installed, and this was last serviced on the 25/03/08. The staff in the home test the fire alarm on a weekly basis. Hot water and fridge/freezer temperatures are tested as appropriate. COSHH products are stored securely. The home has in date employers liability insurance cover. The home has in date safety certificates for PAT testing and electrical installation. However, the homes landlords gas safety certificate dates from May 2007, and it is required that the home has a gas safety test carried out at least once every twelve months. Care Homes for Older People Page 22 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 18 13 and 18 The registered person must 30/06/2008 ensure that all staff working at the home undertake appropriate training in adult protection issues. (Timescale 31/08/07 not met) The registered person must ensure that a permanent manager is appointed to the home, and that they apply for registration with the CSCI. (Timescale 31/08/07 not met) The registered person must ensure that monthly unannounced Regulation 26 visits are carried out, and that a copy of the report of these visits is forwarded to the CSCI, and a copy retained within the home. (Timescale 30/06/07 not met) 30/06/2008 2 31 8 3 33 26 30/04/2008 Care Homes for Older People Page 23 of 27 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 18 13 The registered person must ensure that all staff working at the home undertake appropriate training in adult protection. To help ensure that service users are protected from the risk of abuse. 30/06/2009 2 18 13 The registered person must ensure that comprehensive records are available for inspection within the home around service users finances, including how much money service users receive. To help ensure that service users are safeguarded from the risk of abuse. 30/04/2009 3 21 23 The registered person must 30/06/2009 ensure that the ground floor bathroom has a working lock fitted which includes an emergency override device. The registered person must ensure that the radiator in Page 24 of 27 Care Homes for Older People the downstairs bathroom has a protective covering fitted. To help promote the dignity and privacy of service users. To help promote the health, safety and welfare of service users. 4 31 8 The registered person must ensure that a permanent manager is appointed to the home, and that they apply for registration with the CSCI. To help ensure that the home is run effectively, in the best interests of service users. 5 33 24 The registered person must ensure that the home implements quality assurance systems which includes seeking the views of service users. To help ensure that the home is able to meet the needs of service users. 6 33 26 The registered person must ensure that monthly unannounced Regulation 26 visits take place, and that a copy of the report of these visits is forwarded to the CSCI, and a copy retained within the home. To help ensure the home is meeting service users needs. 30/04/2009 31/05/2009 30/06/2009 Care Homes for Older People Page 25 of 27 7 36 18 The registered person must ensure that all staff, including the homes manager, receive regular formal supervision as appropriate at least six times a year. To help ensure that staff have a good understanding of their roles and responsibilities, and to give them a chance to discuss matters of relevance. 30/04/2009 8 38 13 The registered person must 30/04/2009 ensure that all health and safety checks are carried out as appropriate, including ensuring that fire alarms are serviced at least once every twelve months, and ensuring that the home has a gas safety check carried out at least once every twelve months. To help ensure the health safety and welfare of service users and others. 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 13 It is recommended that the home considers ways in which it can support service users to access the community. Care Homes for Older People Page 26 of 27 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 27 of 27 - 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!