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Inspection on 30/11/08 for BUPA Highclere Nursing Home

Also see our care home review for BUPA Highclere Nursing Home for more information

This inspection was carried out on 30th November 2008.

CSCI found this care home to be providing an Excellent 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

Potential service users receive a thorough needs assessment to ensure the home can meet the care needs of the service users. Detailed care plans have been produced for all people who use the service, and these inform the care staff what they must do to meet the needs of the individual. There is a motivated and established staff team that consists of nursing and care staff who respond to service users in a respectful and appropriate manner. The home provides a very pleasant and comfortable environment in which people can live. Individuals are encouraged to personalise their own rooms with their own furniture and personal belongings. Communication between people who use the service and staff was observed to be positive and open. The provision of meals and mealtimes are of a very high standard and much appreciated by the residents spoken to. Training for care staff is good and people who use the service benefit from a staff team who are appropriately trained to do the job. The care staff are undertaking National Vocational Qualifications training. There is a robust recruitment procedure in place that ensures service users are protected from harm. There is a good range of policies and procedures, providing staff with relevant information about all aspects of care and the home/organisation. Health and Safety procedures are thorough and records are well maintained. The evidence seen and comments received indicate that this service meets the diverse needs e.g. religious, racial, cultural, disability of individuals within the limits of its Statement of Purpose.

What has improved since the last inspection?

The new care planning documentation is now fully implemented. Unnwanted medication in the home are now disposed of approprietely.

What the care home could do better:

Where a medicine is prescribed to be given "as prescribed" wriiten guidance should be available that tells the staff when it should be given and why it should be given.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: BUPA Highclere Nursing Home Chapman Avenue Downs Barn Milton Keynes Buckinghamshire MK14 7NH     The quality rating for this care home is:   three star excellent 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: Barbara Mulligan     Date: 3 0 1 1 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 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: BUPA Highclere Nursing Home Chapman Avenue Downs Barn Milton Keynes Buckinghamshire MK14 7NH 01908667568 01908691366 edwardsca@bupa.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable): BUPA Care Homes (BNH) Ltd The registered provider is responsible for running the service care home 41 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Physical Illness ( Respite ) 40 years plus Date of last inspection Brief description of the care home BUPA Highclere Nursing Home is a two storey, purpose built Nursing Home owned by BUPA Care, and especially designed for older people, with easy access for wheelchairs. Access to the upper floor is via a service lift. BUPA Highclere offers long term care for older people who need daily nursing or respite care to enable carers to take a break, or convalescent or post-operative care for older people recovering from an accident, illness or operation. It is situated in a residential area of Milton Keynes, and is within a short distance of local shops, church and public house. The centre of Milton Keynes is close by offering a large shopping centre, cinema, a range of restaurants and Care Homes for Older People Page 4 of 27 Over 65 0 41 12 0 Brief description of the care home recreational activities. Public transport is accessible to service users living in their home. BUPA Highclere Nursing Home offers all single room accommodation but is able to cater for couples, and they have accommodated this in the past. Twenty-two rooms offer en-suite facilities, and those that dont, have toilet and bathing facilities close by. The home has several, tastefully decorated lounges and a light and spacious dining room, which overlooks the garden. There is an activities room where hairdressing, card games and other social activities take place. BUPA Highclere is set within its own gardens that offer peaceful and secluded surroundings. Prices range from £650 to £950 per weeks. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent 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 key inspection was conducted over the course of one day and covered all the key National Minimum Standards for older people. Prior to the visit, a detailed self-assessment questionnaire was sent to the manager for completion. Information received by the Commission since the last inspection was also taken into account. The Commission received nine CSCI surveys from people who use the service. The inspection officer was Barbara Mulligan. The registered manager is Cheryl-Ann Edwards. The inspection consisted of discussion with the registered manager and other staff, opportunities to meet with some people who use the service, examination of some of the homes required records, observation of practice and a tour of the premises. Care Homes for Older People Page 6 of 27 A number of relatives visiting the home took time to talk to the inspector. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and service users are thanked for their co-operation and hospitality during this unannounced visit. 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 Care Homes for Older People Page 8 of 27 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users needs are assessed prior to admission ensuring that staff are prepared for admission and have a clear understanding of the service users requirements. Evidence: Four completed needs assessments were examined, including those most newly admitted to the home. The home are using a new organisational assessment tool. This was seen in the files and was found to be comprehensive and completed assessments were detailed and informative. The assessment tool covers communication, lifestyle, skin integrity, maintaining a safe environment, mental state and cognition, breathing, eating and drinking, controlling body temperature, sleeping, pain, sleeping, medication and end of life wishes. This information is readily available to staff who are expected to refer to the documentation to meet service users care or nursing needs. It is noted that the service Care Homes for Older People Page 11 of 27 Evidence: users have been asked their preferred name which is indicated throughout any further documentation seen, this is noted as good practice. The assessment demonstrates that prospective service users, family members or representatives are included in the assessment process if this is appropriate. The home does not admit service users for intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people using the service are well met, with personal care delivered in a way that promotes respect and dignity. Evidence: Four care plans were examined during this inspection, including those most newly admitted to the home. The home has changed the care planning documentation to a new format. These are very detailed and informative and reflect the changing needs of the individual. Care needs are identified with a very detailed action plan setting out guidelines detailing how staff will meet those needs. All care plans observed are of a high standard. There was evidence that care plans are reviewed monthly and it is noted that this is a thorough process and not just no change written. Daily notes are detailed and informative and record the personal care received and activities that the individual has undertaken through out the day. Service users are registered with four local GP Practices. The registered manager said they can register with their own GP if this is practical and agreeable to both parties. All Care Homes for Older People Page 13 of 27 Evidence: have access to local NHS Services. Tissue viability assessments are in place for service users and these were seen to be reviewed on a monthly basis and pressure relieving equipment is in place for individuals who need it. A domiciliary optical service visits the home and referrals for a hearing test go through the service users G.P. Nutritional risk assessments are completed for each person and weight monitoring is undertaken on a monthly basis and recorded. This was evident in the four files examined. Chiropody services visit the home on a six weekly basis. The home provides Palliative Care and during the inspection a family were visiting the home following the recent death of their relative and wished to tell the inspector about their experiences. They felt very much a part of the team and very well supported by the staff. Their relative received the best possible care from the staff and comments made were, the staff are angels and I wished my relative had come to this home sooner. The inspector observed staff assisting people who use the service in a kindly and respectful manner. Staff are obviously aware of the importance of privacy and dignity and were seen to always knock on doors before entering and always addressing the individual by their preferred term of address. At the time of the inspection there were no service users who were able to selfadminister their medication. Medicines are stored in two mobile, lockable trolleys. The home has recently changed their supplying pharmacist and are using a monitored dosage system. All medicines are administered by qualified nurses. There were no out of date medications held in the service users home. The home were using controlled drugs at the time of the inspection and there are systems in place to ensure that controlled drugs are handled in line with the Misuse of Drugs Regulations 1973. The Controlled drugs register was examined and this was up to date with no omissions noted. The Medication Administration Records (MAR) were examined. Photographs of service users, on medication charts, are used for identification. There were no omissions noted on the MAR charts. Handwritten entries seen on MAR charts were signed or dated by two staff. When medicines are prescribed to be given when required there are no specific guidelines in place for staff to follow which detail why and when these should be given. This is strongly recommended. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are given opportunities to engage in appropriate leisure activities which meet their social, leisure and spiritual needs. The present meal time regime ensures service users receive a varied and balanced diet, in a congenial setting, which is unrushed and suited to the needs of the people living in the home. Evidence: Care plans show that routines in the home are flexible and show that individuals have a choice as to when they get up and when they go to bed. They are able to have meals in their room if they wish. Relatives and friends are welcome at any time and visiting relatives spoken to on the day were able to confirm this. As part of the admission process the home obtains, wherever possible a map of life about the individual and a residents diary outlining the social and recreational activities that had been enjoyed.This is good practice and ensures that the residents individual lifestyles are considered. The home employs two activity co-ordinators who both work 15 hours a week. The inspector was provided with a Compact Disc of recent activities and these include Care Homes for Older People Page 15 of 27 Evidence: theme events such as a cruise week where the home visited a different country each day and activities and meals where provided in relation with each country. There was also a French theme when the long standing maintenence staff retired to live in France. There are organised activities available and some of these include massage and relaxation and the ladies can have a manicure. There is a luncheon club which is attended by some residents and there is a visiting hairdresser, church service and various entertainers who visit the home. The activities co-ordinators produce a monthly newsletter and the inspector was given a copy of this. The newsletter provides information about any up and coming activities, a quiz, any events affecting the home, for example any refurbishment or redecoration and any other newsworthy items about the home. Service users are able to receive visitors in the privacy of their own rooms and are able to choose whom they see and do not see. There are no restrictions on visiting, and this is documented in the Service Users Guide. Family and friends are invited to participate in some of the social event organised and one relative spoken to on the day of the inspection said, I live locally and am able to pop in to visit whenever I can. Even if its meal time, I am asked if I would like to have dinner with my relative. Service users and/or their families are encouraged to look after their own financial affairs whenever possible. If this is not practicable the home employs a bursar who ensures finances are dealt with appropriately. An invitation to bring in personal items of furniture and other belongings is included in the service users guide and this was evident during a tour of the premises. The inspector was able to observe a lunch time meal on the day of the inspection. The dining room is spacious and attractive with tables laid with attractive tablecloths and napkins, and a vase of flowers. The lunch served was attractively presented and the vegetables were served at the table. People who responded to the CSCI survey and spoken to on the day all responded positively about the food provided in the home. Comments made include,the food is lovely, just how mum used to cook them and they try really hard with the food, there is always a choice and the home try to make each meal time a special event. The catering staff are aware of service users individual likes and dislikes and these are also documented in care plans. At the time of the visit there were a high number of people who needed assistance with feeding. This was carried out by staff with patience and in a respectful manner. The menus have recently changed and are on a five weekly changing cycle. All meals are cooked using fresh ingredients, and vegetables. An audit of the food consumed and the nutritional value is recorded showing that the residents always have a well balanced wholesome diet. As a result of a satisfaction Care Homes for Older People Page 16 of 27 Evidence: survey recently carried out changes were made to the timing of the main meal of the day. This proved to be unsatisfactory after a trial period and the main meal has been returned to lunch time.This is good practice in that the residents wishes are being carried out rather than them having to conform with what is easiest for the home. The home recently held a theme cruise week. Each day the cruise would visit a different European country and the food would be reflective of the country visited. There is evidence in care plans of nutritional screening and weights are recorded on a monthly basis. Care Homes for Older People Page 17 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience 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 able to effectively manage complaints and safeguard service users ensuring people are listened to and kept safe from harm and abuse. Evidence: The home has a complaints procedure, which is accessible to service users and their representatives. A record of all complaints is maintained, and the complaints log was viewed during this inspection. The home has received two complaints in the last year. These are well recorded and responded to within stated timescales. A summary of the complaints procedure is included in the Statement of Purpose and Service Users Guide. No complaints or concerns have been received by the Commission for Social Care Inspection. Procedures are in place for the protection of vulnerable adults and staff have access to a whistle blowing policy. The home has a copy of the local authority Safeguarding policy. Training records demonstrate that staff have undertaken training in adult protection. There have been no safeguarding issues about this service. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within the home is good, providing people who use the service with an attractive and homely place to live. Evidence: The inspector undertook a tour of the home. Overall all areas were found to be cleaned to a high standard, and the furnishings and fittings are of a good quality.There were no offensive odours, and the rest of the building and grounds are well maintained.Residents individual rooms are personalised with the persons own items of furniture, pictures, and photographs. Plans have been confirmed for major refurbishment to the home and it is hoped this will take place in the new Year. This will include redecoration of the dining room with new sky light windows to allow more natural light and a refurbishment of the small satellite kitchen, bathrooms will be redecorated with new tiles and flooring, the small bar area in the pre dinner lounge will be modernised and the upstairs kitchen area will be refurbished to become a tea house where service users can sit and enjoy a tea and cake with their relatives. There are plans to upgrade the reception area and provide an electronic front door. All bedrooms will have automatic fire closure doors installed and an new nurse call system is to be fitted. Care Homes for Older People Page 19 of 27 Evidence: Further improvements are to be made to the storage of medicines,the nurses office, the gardens, and all bedrooms are to be redecorated. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are looked after by appropriate numbers and skill mix of staff, who are trained to carry out their duties. Robust recruitment policy and practices in place to support and protect the residents. Evidence: The homes staff rota demonstrates that there are adequate numbers of staff on duty.This consists of two nurses and seven carers in the morning, two nurses and four carers in the afternoon and two nurses and two carers on a night shift. There are adequate numbers of ancillary staff including 2 chefs, and kitchen assistants, two laundry staff, one senior housekeeper and a team of housekeeping staff. The home continues to support care staff on NVQ training and at the time of this inspection and the percentage of care staff who have achieved a national vocational qualification in care has exceeded the 50 target as set out in the national minimum standards. Other staff including housekeepers, catering and laundry staff have also undertaken training to achieve national vocational qualifications. The recruitment files for four staff were examined including those new to the service. All files looked at contain the necessary documentation as detailed in schedule 2. There is evidence that all staff CRB checks had been obtained. Care Homes for Older People Page 21 of 27 Evidence: There is an induction programme in place and these vary Dependant on the role of the staff. For example the nurses induction is different to that of the care staff and ancillary staff have a different induction programme. Each newly employed staff member is allocated a mentor and the Registered Manager will carry out a meeting at the end of their probationary period. Training records reflect that staff have received mandatory training and this is up to date for all staff. There is specialist training available for staff, an example of this is palliative care, nutrition, PEG feeding and tissue viability. Staff spoken to confirmed that there are regular staff meetings. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and the good systems are in place to safeguard the residents and staff working in the home. Evidence: The manager has been in post since June 2006 and has completed the Registered Managers Award. Further training completed by the Registered Manager include Teaching and Assessment training so the home can accept student nurses, tissue viability training,Huntingdons and palliative care. The manager said that staff receive regular one-to-one supervision meetings and the inspector saw the dates recorded for these meetings. The company has a quality assurance system in place that requires the manager to audit all aspects of running a care home and to report back on a regular basis. Customer surveys are carried out and these have recently been sent out and returned to the home. The Registered Manager said that the results are sent to a consultancy Care Homes for Older People Page 23 of 27 Evidence: company to summarise the results.The outcome of the survey is shared with the residents and staff and an action plan is produced. The manager does not undertake the role of appointee for any service users. Most families look after their relatives money and only a small number of individuals require the home to look after personal money. Relatives will bring in small amounts of personal money and written records are maintained of all transactions. Secure facilities are available for the safekeeping of valuables if required. Records were seen for fire safety. These cover the homes fire procedures, practice fire drills, fire prevention, fire alarm testing and emergency lighting testing. Testing of the homes fire alarm system is undertaken on a weekly basis and evidence was seen of this. There is a fire based risk assessment and this was upto date. Health and safety training demonstrates that staff are up to date with all mandatory training. Service reports are in place for the maintenance of hoists and the lift. There are service certificates for the gas appliances dated 20/05/2008, PAT testing 22/09/2008 and electrical installation in 2008. There are records for water chlorination and kitchen hygiene. COSHH sheets are up to date and accurate. The inspector looked at Infection Control guidelines that are available for all staff. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 10 It is strongly recommended that where medicines are prescribed to be given, when required written guidance should be in place to instruct staff when and how often it should be given. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!