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Inspection on 22/12/08 for Ashton Grange Residential Home

Also see our care home review for Ashton Grange Residential Home for more information

This inspection was carried out on 22nd December 2008.

CSCI found this care home to be providing an Good 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Eight surveys were returned by residents all of which stated that they had no complaints about the service. Comments made in the surveys were as follows, "The home is lovely and the staff are very helpful". "Our relative is looked after very well". "Staff are always willing to help". "The food is excellent and plenty of it". "The home is always fresh and clean". Good training opportunities are available for staff. The building is in good decorative order and well maintained. The home respond quickly to any concerns or complaints. The home responds to any requirements and recommendations made in inspection reports.

What has improved since the last inspection?

A number of the records systems have improved particularly the individual written plans of care. The building has been undergoing refurbishment and this has brightened up all areas of the home. All bedrooms have been painted and the lounges on the ground and first floor have been decorated. Improved shower facilities have been developed on the ground floor from a bathroom that no one used. Staff morale is good and staff are confident in their work. Increased training opportunities have been made available to all staff. A separate office has been developed for the staff to store their day to day records that they use.

What the care home could do better:

The individual plans of care should continue to be developed so that more detail is included about how staff are supporting people with their needs.In order to ensure that the care plans are evaluated on a monthly basis some form of chart should be in place to assist with the monitoring process. Steps should be taken to ensure that in the absence of the activities coordinator a regular planned programme of activities is implemented. Comments from the surveys indicated the following as areas that could be improved, "My relative would be happy if their washing came back more often". "More activities and outings would be good".

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Ashton Grange Residential Home St Lukes Road Pallion Sunderland SR4 6QU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Clifford Renwick     Date: 2 2 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 29 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 29 Information about the care home Name of care home: Address: Ashton Grange Residential Home St Lukes Road Pallion Sunderland SR4 6QU 01915674003 01915674690 ashtongrange@schealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Joseph Patterson Type of registration: Number of places registered: Southern Cross Care Homes No 3 Limited care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is: 40 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 - maximum number of places 40 Physical Disability, Code PD, maximum number of places 13 Mental Disorder, excluding learning disability or dementia, Code MD maximum number of places 9 Dementia Code DE, maximum number of places 22 Date of last inspection Care Homes for Older People Page 4 of 29 Over 65 0 0 40 0 22 9 0 13 Brief description of the care home Ashton Grange provides care to 40 older people over the age of 65 years who may have dementia or mental health needs. It provides personal care only and any health needs are dealt with by the Community Nursing Services. It is also registered to provide care for a maximum of 10 people with a physical disability. The home is purpose built and is located in the Pallion area of Sunderland. The building has two storeys, with accommodation provided on both floors. It has its own drive with parking area and a fully enclosed garden. All areas are accessible to people who use a wheelchair. It is adjacent to the local church and community centre and it is only a short walk to a busy shopping parade, which has a range of facilities. It is on a bus route offering easy access to the city centre as well as the surrounding areas. Fees range from 402 - 500 per week. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: CSCI are trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are currently using a method of working where experts by experience are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term experts by experience used in this report describes people whose knowledge about social care services comes directly from using them. We have reviewed our practice when making requirements, to improve national Care Homes for Older People Page 6 of 29 consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. The last inspection of this service was carried out in January 2008. Before the visit. We looked at. Information we have received since the last visits in January. How the service dealt with any complaints & concerns since the last visit. Any changes to how the service is run. The providers view of how well they care for people. The Visit. An unannounced visit was made on the 12th December 2008. During the visit we. Talked with all of the people who live in the home and also staff who were on duty. Held discussion with the manager. Observed staff working practices. Looked at information about the people who live in the home & how well their needs are met. Looked at other records, which must be kept in relation to health and safety and staffing. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the home to make sure it was well maintained, safe and free of any hazards. We also gathered information from looking at care records to assess how staff supports the residents with their assessed needs. We also focused upon looking at care files for 3 residents as a part of the inspection we refer to this as case tracking. And this involves looking at all records of the care for a named individual. What the care home does well: What has improved since the last inspection? What they could do better: The individual plans of care should continue to be developed so that more detail is included about how staff are supporting people with their needs. Care Homes for Older People Page 8 of 29 In order to ensure that the care plans are evaluated on a monthly basis some form of chart should be in place to assist with the monitoring process. Steps should be taken to ensure that in the absence of the activities coordinator a regular planned programme of activities is implemented. Comments from the surveys indicated the following as areas that could be improved, My relative would be happy if their washing came back more often. More activities and outings would be good. 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 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are assessed before they move into the home this ensures that the home is an appropriate place to provide the care that they need. Evidence: Discussion with the manager and looking at information held in service users files it was confirmed that no one is admitted unless an comprehensive assessment is carried out. In addition to the home completing their own assessment document they also obtain an assessment from the placing authority. Once the assessment is completed staff use this information to develop an individual written plan of care and this shows how staff will support people with their assessed needs. Care Homes for Older People Page 11 of 29 Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users have satisfactory support with their health care, and are adequately supported in a way that upholds their dignity. Evidence: Four written care plans that staff use to demonstrate how residents assessed needs are to be met were looked at. Some of the areas of care were detailed and offered clear guidance to staff in order to ensure consistency of care, these mainly related to the physical care needs such as bathing and hygiene. Other areas of care that related to social needs did not include a lot of detail as to how these would be met but in discussion with staff it was clear that they had strategies in place to deal with this. For example one person is supported to go out in the community unaccompanied and staff are aware of the risks involved in this. And in discussion with this person they said that it was good that they were still able to go out. Care Homes for Older People Page 13 of 29 Evidence: However the care plan does not clearly state how staff are managing this. Another service user is actively involved in carrying our work in the garden and helps with planting and cutting the grass. This is a good area of practice as staff have supported the service user to continue doing something that they enjoy. A risk management plan is in place and includes the home providing appropriate safety footwear as well as supervising some of the tasks. Some of the care plans required updating as information that was contained in them did not reflect current needs and neither did it reflect the progress that service users had made. Overall however care plans are much improved and discussion with staff confirmed that they had a good understanding of individual residents needs and how they were to be met. In discussion with the manager it was confirmed that he had been carrying out additional training with staff in how to write a care plan. The manager stated that this had been beneficial in making positive developments in this area of work. Staff are currently compiling a life history document for each resident and this will include information about their previous lifestyles, employment and family information. Though these are not fully completed for each resident, for those that have been completed these provide a good source of information for staff. Part of the life history has included the use of photographs of resents when they were younger. Once the life history has been completed the information is used to assist with the care process. Good records are in place to confirm that residents health needs are met and information is available to confirm when people have been visited by a health professional. It was positive to note that medication is kept under review and any concerns are referred to the appropriate professional. No one self administers their prescribed medication and this is administered by designated staff. All staff who are designated to administer medication have received appropriate training. Care Homes for Older People Page 14 of 29 Evidence: Good systems are in place for the administration, ordering and storing of prescribed medication. The manager has implemented a tracker system for ordering medicines and this ensures that the potential for errors is reduced. It also ensures that all items ordered are delivered safely to the home and if there are any shortfalls then this can be addressed immediately. Observations made and discussions held confirmed that staff refer to residents by their preferred term of address. And personal and intimate care tasks are carried out in the privacy of residents bedrooms. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lead fulfilling lifestyles through exercising choice and control over how they spend their day. And good contact is made with relatives and friends. Residents receive a wholesome, appealing and balanced diet in pleasing surroundings at times that is convenient to them. Evidence: At the time of the visit work had been carried out decorating the home for Christmas with decorations. The residents spoke of a recent visit carried out to the home by the stars of the local pantomime some of whom included actors from the television. This had been a positive event in the home and some of the residents had had their photographs taken with the performers. A Christmas party for the residents was planned for mid December and a Halloween party had been held in the home and staff had dressed up for the party to make it a Care Homes for Older People Page 16 of 29 Evidence: special event. Photographs were available of the Halloween party and discussions with the residents confirmed that it had been a good party. The activities coordinator was on sick leave at the time of the visit due to a family bereavement. In their absence staff were responsible for organising activities for the residents. Part of the activities programme has been the introduction of indoor bowling and staff confirmed that this had been well received by the residents. Two residents continue to make use of community facilities unaccompanied by staff and they confirmed that staff had been supportive in this area. The home have access to a shared mini bus and photographs on display confirmed that recent outings had been held to the beach, Hartlepool Marina and the garden centre for refreshments. A recent residents meeting had been held and positive comments had been made to the manager by the residents about the premises were much improved following the decoration. The residents also commented on the staff and said that the staff were very good and always there when you needed them. For those residents who are able and have the capacity staff support them to manage their own finances. As well as helping them to exercise choice and control over how they spend their day. Routines in the home were relaxed and there was a pleasant atmosphere. A number of the residents have brought personal possessions into the home and this has helped in personalising their rooms. Discussions held with relatives who were visiting at the time of the visit confirmed that there are no restrictions on visiting the home and staff always made them feel welcome when visiting. Menus are available on the dining room tables in both small and large print and confirmed that a good range of meals are provided. Care Homes for Older People Page 17 of 29 Evidence: Lunch was taken with the residents and this was well presented, hot and tasty with a range of hot and cold drinks to accompany the meal. Tables were nicely set and the mealtime experience was unhurried making eating in the home a pleasurable experience. In discussion with the residents they stated that the food is always nice and there is a good choice. For those residents who required support to eat their meals this was provided by staff who sat with residents. The expert by experience said, The dining area was very bright and clean with Christmas decorations. Background music was playing. All of the tables had tablecloths. Some tables were without condiments but these were available on a trolley. The food was of good quality. The staff showed me a picture menu, this is an excellent resource giving clear illustrations/photographs of what food was available in order for clients to indicate their choice with ease. Discussions held with families confirmed that they are pleased with the care given to their relative. There had been outings on the minibus but only 3 times this year and families felt this could be more often . The family were however able to take their relative out whenever they wanted. Care Homes for Older People Page 18 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All complaints are acted upon and procedures are in place to ensure that residents are protected from potential abuse. Evidence: The home have suitable policies and procedures on complaints and information is available in the home that advises people how to raise any concerns. The manager has been active and responsive to two concerns raised by families and records show that these were dealt with quickly to the satisfaction of both complainants. The manager also makes sure that if a complaint is received that staff are made aware of it in a meeting and also advised as to what action the home needs to take. In addition to the manager dealing with complaints the operations manager as part of their monthly visit also assesses whether any complaints have been made. And if so checks to see that they have been dealt with in the appropriate timescales. The manager has completed updated training in safeguarding adults and some of the staff team have also completed similar training. Care Homes for Older People Page 19 of 29 Evidence: Policies and procedures are in place that deal with safeguarding adults and discussion with the manager and staff confirmed that they are familiar with them. They know how to make an alert if they suspect abuse is occurring and to whom it should be reported. The expert by experience said, Discussions with the family confirmed that they were fully satisfied with the care delivered. They had open channels of communication with the staff and would always feel comfortable in raising any issues/queries. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a homely, clean and comfortable environment, which promotes their privacy, independence and comfort during their stay. The home is clean, pleasant and hygienic, which supports the lifestyles of people living there. Evidence: All communal areas of the home were viewed as well as a number of bedrooms on each floor. A good standard of housekeeping is in place and there were no unpleasant odours. A bathroom on the ground floor that was not used by the residents has been converted to a shower. This now offers a range of bathing facilities on the ground floor. Some areas of the home were in the process of being decorated during the visit. Work is also being carried out to personalise the lounges and one lounge has been fitted with a fireplace. Care Homes for Older People Page 21 of 29 Evidence: In discussion with the manager it was confirmed that 2 bedrooms that do not have an ensuite toilet facility and which are vacant are being used for other purposes. One has been fitted with special sinks and is now used for hairdressing and the other is going to be made into family room where residents can get involved in tasks such as ironing. The manager also stated that the home are going to install facilities for making hot drinks that can be used by both residents and their relatives. The building is in good decorative order and a good state of repair and any repairs are dealt with immediately by the homes maintenance person. The expert by experience said, I arrived at the home at 11.45am. I was greeted by one of the staff. The general appearance of the foyer was very pleasant, clean and welcoming with Christmas decorations throughout. The upstairs rooms are pleasant and well decorated and furnished. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by experienced and trained staff and robust recruitment procedures are in place to ensure only staff who are suitable to work in the home are employed. Evidence: At the time of our visit there were sufficient numbers of staff on duty to meet the needs of the residents. Staff have been developed into four teams and in each team staff have individual responsibility as a key worker for a named resident. This is a good system as it allocates staff to hold responsibility for carrying out key personal tasks as well as developing a relationship with the relative and their family. Good training opportunities are available for staff and a range of training courses have been organised. Staff have completed training in dementia awareness, palliative care and training is ongoing in food hygiene. There is a positive commitment by the company to all staff undergoing NVQ training and 88 of the staff have achieved NVQ Level 2 training. Care Homes for Older People Page 23 of 29 Evidence: Steps are in place for senior staff to commence NVQ Level 3 training within the next month. Robust procedures are in place for recruitment and files are in good order. Staff morale is good and observations made confirmed that good staff practices are in place. In discussion with staff they spoke in detail of how they were supporting residents with their assessed needs and identified the training courses as being helpful in developing their understanding of dementia. The expert by experience said, I had a discussion with a care assistant. They had worked at the home for over 4 years. They confirmed that they were happy working in the home. They had a good relationship with the manager and felt that he was approachable and was able to talk freely. Throughout the lunch period there was not great deal of staff presence and Little interaction with the clients. One member of staff used lip balm but did not use hand gel, this was discussed due to the unhygienic perspective. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced person who ensures that the home is run in the best interests of service users. And the necessary supervision is in place to ensure the health, safety and welfare of service users is promoted. Evidence: Since our last visit the manager applied for registration with the commission and this was approved. The manager has implemented a range of changes all of which are aimed at improving the service for those people who live there. Discussions with residents, their relatives and staff confirmed that the manager is approachable and always available to listen to any views that are expressed. One of the staff members is a designated person for dealing with fire instructions and Care Homes for Older People Page 25 of 29 Evidence: ensuring that fire fighting equipment in the home is in good order. All staff receive regular fire instruction and take part in regular fire drills and appropriate records are kept. Records confirmed that over the last 3 months a series of drills had been carried out with all staff. Good records are in place to demonstrate how staff deal with any accidents in the home. In discussion with the manager it was confirmed that work is taken place to ensure that residents are fully involved in contributing to how the service is developed and questionnaires and meetings are used in order to obtain their views. Records of monies held on behalf of service users were not looked at during this visit but discussion with the manager confirmed that robust systems are in place and this involves the manager carrying our regular audits. Care staff have their own office that and this enables them to have their own work station whereby they can have access to all records that they need to do their job effectively. Health and safety practices are robust and ensure that residents and staff are not exposed to any unnecessary risks. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 7 7 Care plans should be reviewed at least once monthly and updated to reflect the current level of care. Care plans should continue to be developed as discussed and advised during the inspection. Care Homes for Older People Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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