Inspection on 13/10/08 for Auburn Mere

This inspection was carried out on 13th October 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.

Other inspections for this house

Auburn Mere 04/06/08

Auburn Mere 06/06/07

Auburn Mere 20/06/06

Auburn Mere 08/11/05

Auburn Mere 05/05/05

Auburn Mere 22/11/04

Auburn Mere 01/06/04

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 06/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Auburn Mere Woodlands Oxhey Lane Watford Hertfordshire WD19 5RE     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: Jeffrey Orange     Date: 1 3 1 0 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Auburn Mere Oxhey Lane Woodlands Watford Hertfordshire WD19 5RE 01923247310 01923247311 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Trafalgar Health Care care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Auburn Mere is a residential care home providing accommodation and personal care for up to 34 older people. It is owned and operated by Trafalgar Healthcare Limited, which is a wholly owned subsidiary of J. Sai Country Homes Limited. Auburn Mere is located in Watford Heath, on the outskirts of Watford. The home is about ten minutes walk from Bushey railway station and 3-5 miles from either the M25 (J19) or M1(J5) there is also a local bus service that gives easy access to Watford and its amenities. Auburn Mere is situated in extensive grounds with accessible seating areas that benefit from outstanding rural views. Accommodation is offered on three floors in single occupancy rooms, with three bedrooms large enough for sharing on a positive choice basis. The majority of rooms have en-suite facilities and there are bathrooms and toilets on each floor. The communal areas are well situated throughout the home and are of varying sizes. All floors are served by a passenger lift. Weekly charges range from 570 pounds to 880 pounds, additional charges apply for newspapers, hairdressing and chiropody. (These details were correct at 13/10/08) The home has a service user guide and Care Homes for Older People Page 4 of 28 Over 65 34 0 Brief description of the care home statement of purpose that are provided to prospective service users. Copies of the latest report on the home from the Commission for Social Care Inspection (CSCI) are available in the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection began early in the morning and went through until late afternoon which gave us an opportunity to see both the routine as people living in Auburn Mere were getting ready to start the day and also to observe morning activities and the lunch time experience for them. We were able to speak to people who live in Auburn Mere about their experience and also to people visiting the home, including relatives and community nurses. We also spoke to members of the care staff team and to the registered manager. We also looked at some key records, including those for medication, staff recruitment and at care plans for people who live in Auburn Mere. This report also makes use of information provided to us by the home in their annual quality assurance assessment or AQAA. The AQAA is a self-assessment document that Care Homes for Older People Page 6 of 28 focuses on how well care outcomes are being achieved for people living in Auburn Mere, it also includes useful statistical information about the home. As part of this inspection we used case tracking which involves selecting some people who live in Auburn Mere and looking in detail at the care they receive by speaking to them, from observation and speaking to their care workers and looking at their individual records. We have also reviewed any information that we have received about Auburn Mere since our last key inspection in June 2008, including the action plan submitted by the home following that inspection. The rating for Auburn Mere is arrived at using the Commission for Social Care Inspections rules based approach, which ensures that care services are assessed fairly and consistently, using guidance that is readily available to care providers and other interested parties, to make sure that the process of assessment is open and transparent. 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. Care Homes for Older People Page 8 of 28 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 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering Auburn Mere as a home for themselves or someone they are responsible for can be assured that they will have the information they need to make a well-informed decision and that only those people whose care needs can be appropriately met will be admitted. Evidence: We looked at several homes and decided that Auburn Mere was best for Mum was the comment made by one relative of a person now living in the home. When we asked people in surveys Did you receive enough information about this home before you moved in so you could decide if it was the right place for you? 75 answered positively. When we spoke to relatives of people living in Auburn Mere, they told us that they had been able to visit the home before any decision was made about admission. This is important as in many cases the individuals concerned leave the choice of home to other people, often family carers, and they need to be confident that Care Homes for Older People Page 11 of 28 Evidence: they will be able to see what the home is like and if they feel that the person for whom they are making the decision will be happy there and that their needs will be met. The home told us in the AQAA that they are in the process of reviewing the homes basic information and Service Users Guide to make it clearer and more comprehensive. We have been told that this process involves people living in the home so that the revised documentation will reflect their views and experiences. When we looked at some pre-admission assessments for people who have recently moved into Auburn Mere we found that they were very full and detailed and provide confidence that only those people whose needs can be met appropriately are being admitted. The overall level of satisfaction with the care provided in Auburn Mere was very high;She thinks of this as her home and The carers are really excellent were comments made to us during this inspection visit. 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 Auburn Mere can be confident that they will be able to access the health care services they require, either in the home or the community and that they are well protected by the way that the home administers medication for them when they are unwilling or unable to do that safely for themselves. People living in Auburn Mere can be assured that staff think in a person-centred way when meeting their care needs and that consequently care will be provided in a way that respects their dignity and rights and reflects their own preferences. Evidence: When people living in Auburn Mere returned surveys to us they told us that they either usually or always receive the medical care they need and that staff listen to and act on what they say. Whilst we were on this inspection visit we observed hospital transport arriving to take a person living in the home for a routine hospital appointment. Care Homes for Older People Page 13 of 28 Evidence: When we spoke to community nurses about Auburn Mere they indicated to us that they felt the standard of care provided was good, that they were involved appropriately by the home, that communication was good and that they did not have any issues or concerns. When we looked at care plans we found evidence that people living in the home can and do access local community health services such as hospitals, clinics and that where a visit to the home is required to provide care this is facilitated. Throughout this inspection visit we saw care staff treating people who live in the home appropriately, with respect and involving them in decisions about their care and how it is given. Carers are wonderful, they look after me very well Whilst we were in the home we were made aware of one person who was reaching the end of their life in the home. The appropriate specialist support services were in place, staff had been given additional training and support and counselling was to be made available to them as required. This enabled the person concerned to end their life in the place they chose, in familiar surroundings receiving sensitive care from familiar staff. We found that care plans contain the information that care staff need to be able to understand what the current needs of people living in the home are. We found that regular reviews of peoples care needs are carried out and recorded in care plans. If it is found that those needs have changed to the extent that they can no longer be appropriately met, typically for example when the person now requires nursing care, action is taken by the home, in consultation with the person concerned, their family and associated health and social care professionals, in order to find an alternative placement. This reflects very positively on Auburn Mere and should provide people living there with confidence that if their needs change significantly this will be identified and that the home will be proactive in ensuring that their care needs are met within the best care setting for them. We found that since the last inspection visit there have been significant improvements in the way that medication is administered in the home. There is a new medication room, which ensures that all medication is safely and appropriately stored, staff have received additional training and the system of monitoring and audit has been strengthened. There were no errors found in medication records seen and no gaps in records. This means that people who live in Auburn Mere are being well-protected by the way medication is administered. It was particularly positive to find examples where people living in the home are able to either fully or partly self-medicate, which enables them to retain independence and control in this significant area of their lives. In each case there were appropriate risk assessments in place to ensure that self-medication was safe and was being monitored Care Homes for Older People Page 14 of 28 Evidence: appropriately to ensure it remained so. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Auburn Mere can be confident that they will be able to take part in meaningful daytime activities of their own choice in line with their individual interests and preferences. They can be assured that they will be encouraged and assisted to develop and maintain important personal and family relationships and that they will be encouraged to retain control over decisions that affect them. People who live in Auburn Mere can be confident that they will be offered varied and satisfying food and that they will have opportunities to influence the choices offered. Evidence: When we looked at surveys returned to us, they told us that There is usually something arranged for every day. We were able to observe activities on the day of this visit and we were given copies of the activity programme. As well as regular events there were some specials such as a forthcoming Halloween and Firework party. When we looked at care plans there was evidence that where people want one to one attention from the care and activity staff this can be arranged, for example one person likes to have the crossword done with them in their room. Excellent activities available to stimulate residents was one comment received from a relative The activity organiser informed us that since the acquisition of the homes new miniCare Homes for Older People Page 16 of 28 Evidence: bus, it had been possible to take trips into the community, which helps reduce the sense of isolation for people living in the home. We observed two mealtimes whilst we were in the home and noted that where assistance was needed from care staff this was done in a calm, unhurried and respectful manner. One comment received previously in a survey noted; An attractive restaurant like dining room with small friendly tables and settings. Generally people told us that they liked the food, there was evidence of choices being available and offered to people, and the topic of food is often if not always discussed at residents meetings, the minutes of which have been seen. When we spoke to one person living in the home they told us that the chef comes round to see them from time to time so that they can discuss food choices. We were able to try one meal and found it tasty and well presented and it appeared to us to be nutritionally well-balanced. We have been told by people who live in the home and by those who care for them that they feel much more satisfied with the way they are now able to communicate with the home and the manager. This has given them additional reassurance and support and promotes a sense of well being for people living in the home, who feel they are being kept up to date with issues about their care and the routines of the home. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Auburn Mere and those who are responsible for them can be assured that the home offers a safe and understanding environment in which they can freely express their views and any concerns they may have, without repercussions to themselves or those they are responsible for. The home has an open and supportive ethos which should provide people who live in the home with confidence that any complaint they make will be listened to and taken seriously. Staff working in Auburn Mere are supported through training to be able to recognise actual or potential abuse and to know what action to take if it is seen or suspected and this should safeguard the well being of people living in the home. Evidence: When we looked at staff training records we found that they include details of safeguarding training and we saw that the Hertfordshire County Council Safeguarding procedure is available in the home and when we spoke to staff about it, we found that they understood it and were able to say when a referral should be made. This level of awareness provides confidence that the people who live in the home are not at risk from care staff not knowing how to recognise abuse or what to do if it is seen or suspected. When we spoke to people who live in Auburn Mere they told us that they feel safe and Care Homes for Older People Page 18 of 28 Evidence: well-looked after and that they would feel able to speak to care staff or the manager about any concerns they might have. When people returned their surveys, ninety five percent told us that they knew how to make a complaint if they needed to. The manager and some of her senior staff have attended training in the new Mental capacity Act. This should enable them to ensure that those living in the home who are not able to make decisions on their own behalf are offered appropriate protection, whilst preserving the rights of all those that are capable to take decisions about their own lives. When we looked at the AQAA we found that the home had recorded twenty two complaints during the previous twelve months, all of which were recorded appropriately and all were resolved within twenty eight days with none being upheld. When we spoke to the manager about the number of complaints, she explained that she had been concerned at how low the number had been previously and that now staff record as a complaint all concerns or complaints however minor they might appear. We have not been made aware of any recent safeguarding issues neither have we received any complaints about Auburn Mere from any source. The way complaints are recorded enables the manager to identify any trends or patterns and ensure they are dealt with promptly and this helps promote the well-being of people living in the home. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical environment of the home provides well for the individual requirements of the people who live in Auburn Mere. People who live or work in Auburn Mere can be assured that the built environment is homely, safe and well-maintained. Evidence: People who either live in or visit the home were very positive about the standard of cleanliness and the lack of unpleasant odours. One hundered percent of people who responded to our surveys said that the home was either always or usually fresh and clean. When we visited the home for this inspection, there was no unpleasant smell in the home and it was clean and tidy throughout. When we walked round the home we found that there was a particularly good selection of communal areas throughout the home, of different sizes which means that they and their visitors will have somewhere appropraite and comfortable for them to sit and talk and relax or to have their meals either on their own or with others. The home told us in their AQAA about redecoration already undertaken as well as that planned for the next twelve months which should ensure that the home remains a pleasant place for people to live and work. Since the last inspection the home have provided cleaning staff with lockable storage trolleys so that cleaning materials can be kept secure in the home whilst cleaning is in progress. This provides additional security for people who live in the home. Care Homes for Older People Page 20 of 28 Evidence: When we spoke to housekeeping staff they told us about the training they have received in safely dealing with any cleaning materials that could be potentially hazardous for people living in the home and the manager was able to confirm in the homes AQAA both that the home has an infection control policy that is put into practice and that staff have received infection control training to help them promote the health and safety of the people they care for. The home benefits from a new medication rooms, which enables medication to be correctly stored which in turn promotes the well-being of people who live in the home. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Auburn Mere can be assured that the care they need will be provided by well-trained and supported staff, in the numbers necessary to achieve good care outcomes for them and who have been subject to a robust recruitment process to ensure that they are fit to do so. Evidence: When we looked at training records and spoke to care staff about the training they have received, we found that staff are actively encouraged to undertake the training they need to update and maintain their skills,including National Vocational Training at level three in care. This helps ensure that the quality of care that people who live in Auburn Mere receive is high and that care staff feel supported and valued by their access to the appropriate training they need. When we spoke to people who live in the home about the standard of care they receive from care staff, they were very positive; The girls (sic) are wonderful ,Staff very supportive and The carers are marvellous were some of the comments recorded. Ninety five percent of the people who returned surveys to us said that staff had the skills and experience needed to care for them. Seventy five percent said that staff are usually available when they need them, with twenty five percent saying that they were always available. When we were in the home we found that call bells were responded Care Homes for Older People Page 22 of 28 Evidence: to promptly and this was not raised as a concern by people living in the home that we spoke to on the day. The manager told us that staffing levels are kept under review so that any change in the care needs of people who live in the home can be reflected in the number of staff available to meet those needs. When we looked at staff supervision records and talked to staff about the supervision and support they receive, we found that supervision is regular and care staff said it was in depth. They also said that they worked well as a team, that they all worked well together and that the manager was very supportive and that they felt that the standard of care experienced by people who live in the home had improved because of this. When we looked at records for the recruitment of staff, we found that the process of recruitment is thorough and comprehensive and that people who live in the home are therefore protected from the employment of unsuitable people to care for them. When we asked realtives what they felt the home did well, one noted; Staff selection, they are very careful in the quality and type of staff they emply as carers Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Auburn Mere can be confident that they live in a well-managed home where their wellbeing and best interests are paramount in decisions made. Staff working in the home can be confident that they will be well supervised and supported to help them effectively meet the care needs of people living in the home. Evidence: The manager is most approachable and keen to make improvements that will benefit all parties was the assessment of one relative. When people returned surveys to us and when we spoke to them both in June and during this current inspection visit they were all very positive and were able to identify improvements in the running of the home that had benefited people who live there. The action plan that was submitted to the CSCI following our last key inspection of Auburn Mere in June was thorough and robust and has been fully implemented. All outstanding requirements have been met in full and there are no requirements made following this inspection. Things are much better said one member of staff and all of the staff spoken to said how well-supported Care Homes for Older People Page 24 of 28 Evidence: they are by the manager. When we spoke to other health and social care professionals about Auburn Mere either during this inspection visit or afterwards, they all identified the management of the home as one reason for the noticed improvement of care outcomes for people who live there. The standard of record keeping is now very good and the manager takes care to remain abreast of and take account of current best practise and developments in care, putting them into practise in a way that recognises the particular care needs of people living in the home. The AQAA was comprehensively completed and represents a realistic view of the home that has been fully borne out by the evidence seen during this inspection. It remains the case that the home is not involved with the personal finances of people who live in Auburn Mere. The manager has been supported and encouraged by the proprietor who does not create any confusion of roles and responsibilities whilst taking an appropriate interest in the care outcomes experienced by people who live in Auburn Mere. All of the above directly benefits people who live and work in Auburn Mere and contributes significantly to the high standard of care outcomes achieved. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!