Inspection on 01/03/10 for Broadhurst Residential Home

This inspection was carried out on 1st March 2010.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Broadhurst Residential Home 09/02/09

Broadhurst Residential Home 14/08/08

Broadhurst Residential Home 15/08/07

Similar services:

Flint House

Hillview Farm

St Vincents

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Extracts from inspection reports are licensed from CQC, this page was updated on 16/05/2010.

Key inspection report Care homes for older people Name: Address: Broadhurst Residential Home 35 Broadway Sandown Isle Of Wight PO36 9BD     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Craig Willis     Date: 0 1 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Broadhurst Residential Home 35 Broadway Sandown Isle Of Wight PO36 9BD 01983403686 01983568705 broadhurstreshome@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): PKC Care Ltd Name of registered manager (if applicable) Ms Francoise Patricia Savrimootoo Type of registration: Number of places registered: care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability 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 to be accommodated is 25. The registered person may provide the following category/ies of service only: Care home only - (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 (OP) Dementia (DE) - maximum number of places 8 Learning disability (LD) - maximum number of places 2 Physical disability (PD) maximum number of places 2 Mental disorder, excluding learning disability or dementia (M)D - maximum number of places 3. Care Homes for Older People Page 4 of 26 Over 65 0 0 0 0 0 0 0 0 0 0 Date of last inspection Brief description of the care home Broadhurst is a home providing care and accommodation for up to 25 older people, with some capacity for people with illness associated with mental health, learning disability and dementia. The condition of registration denotes the maximum number that can be accommodated in each category. The home was registered under the Company PKC Holdings in July 2007.The home is a three storey detached house located on a prominent site along Broadway, a main road through the coastal town of Sandown, about a quarter of a mile from the shops and amenities of the town. All rooms except two are for single occupancy and arranged over three floors, all but one having an en-suite toilet facility. There is a passenger lift that allows access to all but two rooms on the upper floors. Care Homes for Older People Page 5 of 26 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: The evidence used to write this report was gained from a review of all the information we have received since the last key inspection, including the outcome of random inspections of the service on 9 June 2009, 21 July 2009 and 28 September 2009. We completed an unannounced inspection of the home on 28 January 2010 by 3 inspectors, including a specialist pharmacist inspector. During the visit we spoke to people who live in the home and their relatives, observed the way staff were working with people, spoke to staff on duty, inspected communal areas of the home and inspected documents relating to the running of the home. Before the visit the registered person submitted an annual quality assurance assessment. Since the last key inspection we have served statutory requirement notices and a notice of proposal to cancel the registration of the service. Care Homes for Older People Page 6 of 26 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 26 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 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not provided with accurate information in the statement of purpose about how the home is managed, although there is information about other aspects of the service provided. The home has a system in place to assess peoples needs before they move into the service. Evidence: At the last key inspection of the service we made a requirement that the homes statement of purpose must be up to date and made available to people who use the service. This requirement was repeated following random inspections of the home on 9 June 2009, 21 July 2009 and 28 September 2009. The registered person has failed to taken action to address the issue. During this visit we inspected the homes statement of purpose. The statement of purpose was displayed in the entrance hallway and available to all visitors. The Care Homes for Older People Page 9 of 26 Evidence: document was dated November 2009 and contained information on all of the areas that are required. The document listed the home manager as a person who is currently working as the homes administrator. The registered person has reported that she is currently working as the manager of the service and therefore the statement of purpose should reflect this. This requirement has not been complied with and the information available continues to be misleading to prospective service users and their representatives. The registered person reported during the visit that no-one has moved into the home since the last random inspection of the service. The registered person reported in the annual quality assurance assessment that there are new systems in place to assess peoples needs before they are offered a place at the home. We looked at the records of two people who have moved into the home since our last key inspection. Both people had an assessment of their needs that was completed before they moved in. The assessment set out details of their needs including personal care, mobility, health conditions and social needs. These assessments were used to develop the care plans and risk assessments that set out how their needs should be met. Care Homes for Older People Page 10 of 26 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 home now has good care planning, risk assessment and medicine administration systems. This helps to ensure staff provide the right support to meet peoples health and personal care needs. These systems are not yet embedded in practice to ensure that peoples needs are responded to over time. Evidence: At the last key inspection of the service we made requirements regarding information in the care plans and risk assessments for people who live in the home. We carried out random inspections of the home on 9 June 2009, 21 July 2009 and 28 September 2009 and found that these requirements had not been complied with. During this visit we inspected the records of six people who live in the home. The registered person reported in the annual quality assurance assessment that over the last year comprehensive care plans have been developed and that they are planning to improve on the consistency of reviews and updates of plans over the next year. We found that all six people had a set of care plans and a risk management plan. These plans set out the support that staff should provide to meet their assessed needs. The Care Homes for Older People Page 11 of 26 Evidence: plans were regularly reviewed and updated where peoples needs had changed. The plans for one person had been reviewed and amended the day after they were discharged from hospital, setting out how changes in their needs had affected the support needed with mobility, nutrition and personal care. Staff spoken with demonstrated a good understanding of peoples needs and how they should meet them. Records were available of consultations with health professionals. These records showed that people were being supported to see their GP, district nurse, chiropodist and other health services regularly and included details of any advice from the practitioner. The home had consulted with health professionals for input into the care planning documents, for example a learning disability nurse had worked with one person who lives at the home to develop a health action plan. Peoples weight was being monitored and there was evidence of GP consultation where one person had lost weight. The safe handling of medicines was assessed by a Commission specialist pharmacist inspector. In addition to participating in this inspection they had visited the home twice since the last key inspection. On those occasions we found that the requirement to ensure that staff follow procedures for the safe handling, safe administration, recording and disposal of all medicines was not being fully complied with. On this occasion we looked at the safe storage of medicines, the medication administration records and medicines for nine people, the care plans for some of these people and the homes policies and procedures. Most people have their medicines given to them by designated trained care staff. Written procedures are available to staff to provide guidance. On one of our visits to the service we watched a carer giving medicines to people and saw that they followed appropriate and safe procedures. One of the people whose records we looked at was looking after their own medicines. An assessment of the risks associated with this practice had been made. Staff are keeping records that show they are monitoring this person and that they are taking their medicines correctly. The records and medicines supplies are able to show that people are receiving their routine medicines correctly. Records were kept of medicines coming into and leaving the home and of medicines given to people. When people are prescribed medicines to be given only when needed there was information in the care plans describing to staff when to give these medicines. These Care Homes for Older People Page 12 of 26 Evidence: were updated when needed. Medicines were stored securely and at the correct temperature, for the protection of people who use the service. There were no Controlled Drugs in the home. These are medicines that are liable to be misused and must be stored and recorded in a specific way. A cabinet that complies with the law and a Controlled Drugs register were available should any be prescribed. People we spoke with during the visit said they were treated well by staff, in a manner that maintained their privacy and dignity. During the visit we observed staff interacting with people in a friendly and respectful manner and responding to requests for assistance. We found that the home had complied with the requirements made relating to care planning, risk assessments and storage and administration of medicines that have been repeated in recent inspection reports of visits to the service. This progress now needs to be sustained. Care Homes for Older People Page 13 of 26 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. Peoples social and cultural needs are met by the home and people are supported to make choices. This helps people to retain control over their lives. Evidence: The registered person reported in the annual quality assurance assessment that there is a programme of social activities that is developed following consultation with people who use the service. There was a timetable of activities displayed in the home, which included exercises, live music, shopping trips, bingo and arts and crafts. A Christian service is held in the home each month. People who live in the home we spoke with reported that there were activities organised each day that they can participate in if they want to. One relative spoken with said they had been able to join in a recent activity with her mother making flower decorations. The activities that people participate in are recorded and monitored. Meetings have been held with people who live in the home and their relatives to plan the activities programme. The home has an open visiting policy and a record was kept of visitors. Visitors spoken with reported that they are made to feel welcome. The home has a planned menu in place that is displayed in the dining room. The menu Care Homes for Older People Page 14 of 26 Evidence: offers people a choice of main meals at lunchtime and a choice of hot snacks and sandwiches for tea. People spoken with reported that they enjoyed the meals and confirmed that a choice of dishes was available. Details of peoples dietary needs were included in the care plans we inspected. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home now has effective systems to investigate complaints and respond to allegations of abuse. This will help to ensure that people are protected. Evidence: Following the last key inspection we made a requirement that the home must ensure there are clear records of referrals to the local authority under the safeguarding procedures and action taken to protect people. During this visit we looked at the homes complaints records. There have been seven complaints recorded in the last year. The records indicated that these complaints were all responded to promptly and action was taken to address the concerns raised. The complaints procedure is displayed in the entrance hallway. People we spoke with during the visit reported that they were aware of the complaints procedures and were confident that any complaints would be taken seriously and investigated. The home keeps a record of safeguarding alerts made to the local authority, including details of any investigations or safeguarding meetings. The accident and incident reports and daily records indicated that incidents were being reported to the local authority as necessary. Staff spoken with confirmed they had completed training in abuse issues and the safeguarding procedures. Staff demonstrated a good understanding of the action they should take if abuse is reported, witnessed or Care Homes for Older People Page 16 of 26 Evidence: suspected. We found that the requirement relating to safeguarding procedures had been complied with. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is now clean and well maintained and provides a comfortable environment for people. Evidence: Following the last inspection we made requirements relating to bedroom door locks and the laundry facilities. At the random inspection of 9 June 2009 we found that the requirement about laundry facilities had been complied with, however the issue of bedroom door locks was outstanding then and this was also the case at the random inspections of 21 July 2009 and 28 September 2009. During this visit we observed that all occupied bedrooms were fitted with locks to the door. The registered person reported that other bedrooms would be fitted with locks once they were occupied. However, this needs to be in place before people move in so that they have the option to lock their door when they come to Broadhurst. We looked at all communal areas of the home during the visit and a sample of the bedrooms. We found that all areas were clean and well maintained. People spoken with reported that the home was always kept clean. The bedrooms we saw had been personalised with items of furniture and personal belongings. Some of the communal areas of the home have been re-decorated, for example the main hallway and staircase and there are plans for re-decoration of other areas. The registered person reported that infection control procedures are in place, although Care Homes for Older People Page 18 of 26 Evidence: we did not inspect these during the visit. Staff spoken with confirmed they had completed infection control training and we did not note any concerns regarding infection control during the visit. Care Homes for Older People Page 19 of 26 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. The home now has sufficient staff who have been thoroughly checked before working in the home. This helps to ensure staff have the skills and experience necessary to meet peoples needs. The training systems are not yet fully developed to ensure people receive a consistent and effective service over time. Evidence: Following the last key inspection we made a requirement that the registered person must ensure there are sufficient staff working in the home at all times. Following the random inspection of 28 September we made a further requirement that the provider must ensure staff are thoroughly checked before they start work in the home. During this visit we looked at the staffing rotas, which indicated there were three care staff between 8am and 6pm, with two care staff between 6pm and 8am. In addition to the care staff there is a chef and cleaning staff. People spoken with said they thought there were sufficient staff working in the home. One person commented that their call bell is answered in a reasonable time when used and that staff are available to provide assistance when they need them. Other people who live in the home and relatives spoken with said they thought there were enough staff. Staff spoken with said they thought the staffing levels were sufficient to meet peoples needs. The registered person reported in the annual quality assurance assessment that 9 of the 22 care staff members have completed the National Vocational Qualification in Care Homes for Older People Page 20 of 26 Evidence: care at level 2 or above. During the visit the registered person reported that 4 further staff members are currently completing the award. The home has a training programme in place, with staff completing courses in moving and positioning, fire safety, food hygiene, supervision, first aid, dementia, infection control, falls prevention, medication, mental health and adult protection. These courses will help to ensure that staff develop the skills to meet the diverse needs of people living at the service. The registered person reported that a learning disability nurse provides information to staff during the induction period. Staff complete an induction based on the skills for care common induction standards. At the time of the visit the registered person did not yet have an overview of training in place. This was in the process of collation and when completed will ensure that training needs can be effectively responded to. This will enable more effective management of the training programme. Staff spoken with reported that they received good training. We inspected the recruitment records of two staff members who have started working at the home since the last random inspection. Both records demonstrated that the home had obtained a check that the person was not on a list of people deemed unsuitable to work in care homes and had applied for an enhanced Criminal Records Bureau (CRB) disclosure. Both records contained two written references that had been supplied by former employers and details of identification documents that were checked. Both staff members were working under supervision until their full CRB disclosure was received, with regular meetings with a supervisor and they were not providing one to one personal care for people. Care Homes for Older People Page 21 of 26 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. The home does not benefit from a registered manager. Improvements to the organisation and management of the service are recent and need to be sustained so that the service is consistently run in peoples best interests. There is not a robust system to assess the quality of the service provided and plan improvements to ensure that the service effectively meets peoples needs. Evidence: Since the last random inspection we have been advised by the registered person that they are working as the manager of the home and that the homes administrator intended to submit an application for registration as the manager. The administrator has applied previously and then withdrawn their application. The statement of purpose indicates that the administrator is the manager. This has been highlighted previously. However, this information has not been updated so that people who want to know about the service receive clear and accurate information about the management arrangements. Care Homes for Older People Page 22 of 26 Evidence: At the time of the visit there was not a current application for registration as manager of the home and the home did not have a registered manager. The staffing rotas showed that the registered person was working in the home on a full time basis. Most staff spoken with were aware of the management arrangements, although one new staff member reported that the homes administrator was the manager. This lack of clarity regarding management arrangements could be misleading to residents and staff. Staff spoken with said they received good support from the management team. Following the last key inspection we made a requirement that the provider or their representative must visit the home each month to assess the quality of the service being provided. The registered person reported that these visits had been taking place until she took up the role of the manager of the service. The most recent report of a providers visit that was available was dated August 2009. This means that the service has not been scrutinised from people not involved in the day to day management of the home. The registered person reported that the home has a business plan that sets out objectives for the year; however, this could not be opened on the homes computer system at the time of the visit and was therefore not inspected. Some surveys have been carried out with people who live in the home regarding social and leisure activities, although these have not been collated to identify trends and action points. Since the last key inspection we have carried out random inspections on 9 June 2009, 21 July 2009 and 28 September 2009. On each occasion we found that requirements from previous inspections had not been complied with. Progress therefore is recent and needs to be maintained to support positive outcomes for people living at Broadhurst. Records inspected during the visit demonstrated that the fire alarm system, fire fighting equipment and lifting equipment was being regularly serviced and maintained. Care Homes for Older People Page 23 of 26 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 1 4(1) (2) The registered person must 30/07/2009 ensure that an up to date statement of purpose and service users guide, that meet with legislation is put in place and available to the service users. Requirement outstanding from 25/03/09 2 33 Regulation 26 The registered person is required to ensure that as part of their internal audit, unannounced visits are completed and records of these are maintained at the home. Requirement outstanding from 25/03/09 15/07/2009 Care Homes for Older People Page 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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