Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Cedar Lodge Hope Corner Lane Taunton Somerset TA2 7PB 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: Jane Poole
Date: 1 0 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 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: Cedar Lodge Hope Corner Lane Taunton Somerset TA2 7PB 01823286158 Telephone number: Fax number: Email address: Provider web address: claire@notarohomes.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Matthew Parrish Type of registration: Number of places registered: N Notaro Homes Limited care home 57 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is 57 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Dementia (Code DE) Maximum of 42 places Mental Disorder (Code MD) - Maximum of 15 places Date of last inspection Brief description of the care home Cedar Lodge is a large, detached, extended property, set in good size grounds in a quiet residential area, approximately 1.5 miles from Taunton town centre. The home is Registered with the Commission for Social Care Inspection (CSCI) for up to 57 people. The home has been split into two areas. The Limes provides care to people who have a mental health difficulty and the main part of the home cares for people over the age of 65 years who require personal care due to a dementia. Notaro Homes Ltd owns the Care Homes for Older People
Page 4 of 28 Over 65 0 0 42 15 Brief description of the care home home. The registered manager is Matthew Parrish. Amenities are close at hand, including a Post Office, shops and pubs. Personal accommodation is on three floors. Bedrooms are found on all three floors, a lift gives access to all but 3 of the bedrooms, which are approached by a staircase. The current fee level at the home ranges from 390 pounds to 675 pounds per week. 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: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: -excellent, good, adequate and poor. This inspection was carried out over one day. During this time the inspector was able to talk with people living, working and visiting the home, observe care practices and view records. Care Homes for Older People
Page 6 of 28 The management and staff were fully co-operative with the inspection process and made available all records requested. Prior to the inspection the registered manager completed an Annual Quality Assurance Assessment giving details of the homes achievements in the past year and their plans for the future. 7 people living at the home, 4 members of staff and 1 health and social care professional completed questionnaires before the inspection and some of their comments have been incorporated into this report. The following is a brief summary of the inspection findings and should be read in conjunction with the whole report. What the care home does well: What has improved since the last inspection? There have been many changes to Cedar Lodge since the last inspection, which was carried out on the 8th January 2008. The home has been split to create two areas which are separated by an electronic keypad. The two areas, The Limes and the main house mean that people now live in smaller groups. Both areas have become more homely and people now have objects around them to provide stimulation and occupation. Additional signage and points of reference have been placed around the home to assist people to orientate themselves and enhance independence. Each area has its own staffing team and there are deputy managers that take on specific responsibilities in each part of the house. This means that there is now clearer leadership and vision within the home. During the inspection it was observed that staff are now less task focused and more person centred in their approach. There is much more stimulation for people living at the home and it was noted that as well as organised activities many people were able to occupy themselves with the items provided around the home. People living at The Limes have begun to take on more personal responsibilities within the home and some people have independent living skill care plans to ensure that they maintain and develop their skills. Additional staffing has been provided to ensure that people have access to activities at weekends as well as during the week. Everyone now has access to cold drinks, biscuits and fresh fruit throughout the day. Staff who completed questionnaires felt that training opportunities had improved and Care Homes for Older People Page 8 of 28 65 of care staff have now achieved a National Vocational Qualification in care at level 2 or above. Staff spoken with during the inspection thought that training in how to care for people who have a dementia had also improved. People felt that the Yesterday, Today and Tomorrow training had been particularly good and had improved their understanding of the people they worked with. Staff also felt that the managers knowledge and support had improved practices within the home. Both areas of the home had a calm and friendly atmosphere and people appeared content and relaxed. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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. Anyone wishing to move into Cedar Lodge has their needs assessed to ensure that it is the right place for them. Intermediate care is not provided. Evidence: Copies of pre-admission assessments carried out by the home and other professionals were seen in personal files. This demonstrated that anyone wishing to move in has their needs fully assessed to ensure that Cedar Lodge is the right place for them. Once the assessment has been completed the manager writes to the prospective resident offering a placement. The contract states that the first four weeks of any stay is a trial period for both the home and the new resident. If during this trial period either party decides that the home is not an appropriate place then only one weeks notice is required to end the residency.
Care Homes for Older People Page 11 of 28 Evidence: Some people spoken with had been able to view the home before deciding to move in, others had relied on family members to view the home on their behalf. Relatives spoken with said that they had visited the home and received adequate information before their relative moved in. One person living at the home wrote on their questionnaire that they had been able to choose their room before they moved in, another said that someone from the home had visited them and explained clearly. 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 have access to health care services and professionals in line with their individual needs. Staff support people in a respectful manner that promotes independence and values personal privacy. Evidence: Everyone living at the home has a care plan that is personal to them. 5 care plans were viewed in detail, 2 in The Limes and 3 in the main part of Cedar Lodge. Care plans have been up graded and now give clearer information about peoples individual needs and preferences. Each care plan seen had a basic assessment which included a short life history, levels of assistance required with physical care and gave details of some personal preferences, for example if people preferred to be assisted by a male or female carer. Care plan sheets have been devised to give further information about how specific needs should be met by the home. Care Homes for Older People Page 13 of 28 Evidence: In The Limes some care plans have been created to assist people to maintain and develop independent living skills. In addition to care plans some risk assessments have been put in place. These need to be clearer and demonstrate the control measures that have been developed to minimise risk whilst ensuring that people are able to take part in activities. In some instances information is recorded in different places making the care plans and risk assessments disjointed. For example for someone who self medicates the control measures and monitoring details were not with the risk assessment. There was evidence in personal files that people have access to health care professionals in line with their individual needs. Visitors spoken with said that the home kept them informed of the health of their relative and they were happy with the actions taken to address any issues. One health and social care professional completed a questionnaire prior to the inspection. They answered ALWAYS to the questions Does the care service seek advice and act upon it to manage and improve individuals health care needs? and Are individuals health care needs met by the care service?. All appointments with health and social care professionals are recorded. Weights are recorded monthly and records seen demonstrated that people are maintaining stable weights. One person has a care plan for staff to assist them to loose weight and records show that the care plan is effective in assisting this person to achieve their aim. Throughout the inspection it was observed that staff interacted with people living at the home in a kind and respectful manner. It was noted that people were able to spend time in communal areas or in the privacy of their rooms. Staff were seen knocking on doors before entering to promote peoples privacy. People who required assistance were supported in a discreet and sensitive manner. The home uses a Monitored Dosage System for medication. Since the last inspection a new treatment room has been created in the main part of the home which provides suitable storage for medication. In the Limes each bedroom has its own discreet lockable cupboard where their personal medication is stored and this is then administered in the privacy of the persons room. A sample of Medication Administration Records (MARs) were viewed. These were well maintained and showed that medication is checked and signed for when it enters the home and when administered or refused, this gives a clear audit trail. The home should also record the amount of medication passed over to individuals to self administer. Some protocols are in place in respect of medication that is prescribed on an as
Care Homes for Older People Page 14 of 28 Evidence: required basis but some were not in place. This is particularly important when prescribed for people who may be unable to request additional medication or describe their state of well being. 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. Staff are now much less task focused creating a warm and comfortable environment for the people who live there. Staff assist and encourage people to make choices about their day to day lives. Evidence: Much of the day was spent talking to people living and working at the home and observing care practices. Since the last inspection the culture in the home has changed, staff are much less task focused and spend time interacting with people in a relaxed and informal manner. Routines are now much more flexible enabling people to have greater choice over their day to day lives. There are no set times to get up or go to bed and people are able to choose how they spend their day. It was noted that people spent time in communal areas or in their personal rooms according to their choice. Both areas are now very homely with ornaments and objects, including musical instruments, around for people to occupy themselves with. In the main part of the home there is a full time activities worker and a part time person who ensures that activities are available at the weekend. In The Limes support staff assist people to take part in activities and some people are able to go out without staff supervision. It was
Care Homes for Older People Page 16 of 28 Evidence: noted in The Limes that there was constant interaction between the people who live and work there. Everyone who completed a questionnaire said that they were able to choose what they did during the day, in the evenings and at weekends. An activities programme is displayed each week to inform people what is going on so they can choose what they would like to join in with. This gives a wide variety of activities from live music to visiting donkeys. The home provides transport to enable people to access the wider community. Since the last inspection a group called The Friends of Cedar lodge has been formed and these people have been able to take part in activities with people who live at the home. The Limes holds its own food budget and people prepare their own breakfast and light lunch. One person spoken with said that they enjoyed doing this and sometimes helped staff to prepare the main evening meal. In the main part of the home all food is provided by the main kitchen. Lunch and tea was observed and it was noted that this was a relaxed and pleasant time. People were able to eat wherever they chose, most people went to the dining room but others ate in lounges or in their personal rooms. The main meal was served plated giving people limited choice about the food they ate or portion size. Drinks and condiments were available on tables. Food seen was well presented and appeared appetising. Some people required a soft diet and these meals too were well presented. For people who required assistance to eat their meal staff offered support in a discreet manner that maintained peoples dignity. Cold Drinks, biscuits and fresh fruit are available in lounges for people to help themselves to and hot drinks are served by staff throughout the day. There is now a very calm and relaxed atmosphere in the home with people being assisted to take part in activities or occupying themselves with the numerous objects available for people to help themselves to. 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. Appropriate measures are in place to minimise the risks of abuse to people living at the home. People living at the home and their representatives feel able to raise any worries or concerns with staff or a member of the management team. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Staff spoken with were aware of the ability to take serious concerns outside the home. Everyone who completed a questionnaire said that they knew who to talk to if they were not happy and all staff answered YES to the question Do you know what to do if a service user or advocate has concerns about the home?. Staff have all received training in the protection of vulnerable adults and the manager demonstrated that they are aware of the local safeguarding procedures to be followed if an incident of abuse occurs or is suspected. People living at the home said that staff were kind and easy to talk to. Visitors spoken with said that the management and staff were very approachable and they would be
Care Homes for Older People Page 18 of 28 Evidence: comfortable to raise any concerns. 1 complaint has been received since the last inspection. All new staff are checked against the Protection Of Vulnerable Adults (POVA) register before they begin work 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cedar Lodge provides a comfortable homely environment appropriate to the needs of the people who live there. Standards of cleanliness throughout the home are very good. Evidence: Since the last inspection there have been many changes to the building which has produced a much more homely environment. The home is now divided into two separate areas. The Limes which is able to accommodate up to 15 people with mental health difficulties and the the main part of the home which accommodates 42 older people who have a dementia. Some areas have been decorated and the home have begun to theme lounges to assist people with orientation. In the main part of the home there is a variety of communal lounges and a large dining room. This enables people to move around the home and spend time taking part in activities, socialising in company or quietly in a smaller lounge. In The Limes there is a dining room and a conservatory/lounge area. The lounge area appeared very crowded and if people wish to sit quietly in comfort then there is no alternative comfortable space except their rooms. Care Homes for Older People Page 20 of 28 Evidence: All bedrooms are for single occupancy and those seen were pleasantly furnished and decorated. People are able to bring personal possessions with them when they move in which gives rooms an individual homely appearance. Various aids and adaptations have been put in place. These include hand rails, signage and assisted bathing facilities. The Limes has a tiny utility area with a domestic washing machine and tumble drier where people can do their own laundry and therefore enhance their independent living skills. One member of staff said that the area and equipment was not appropriate to the needs of the people living at the home and that they were hoping to re-site these facilities. Laundry from the main part of the house is taken to a large industrial type laundry in a separate building that is shared with the nursing home on the same site, owned by the same providers. On the day of the inspection all areas seen were clean and fresh. Everyone who completed a questionnaire said that the home was always clean and fresh. 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. Recruitment practices are robust which minimises the risk of abuse to people who live at the home. Staff receive training that is appropriate to their role which ensures that the team are able to meet the needs of the people who live at Cedar Lodge. Evidence: The home employs 43 care staff, 28 (65 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. In addition to care staff 14 ancillary staff are employed. There is a clear staffing structure in the home with 3 deputy managers, all with specific responsibilities, and a team of senior carers as well as other care staff. This gives clear lines of accountability and responsibility and means that senior staff are always available to give guidance and support to less experienced staff. Everyone asked felt that there were always adequate numbers of staff on duty. It was observed that people who required assistance were attended to quickly and people living at the home did not appear to be rushed. Care Homes for Older People Page 22 of 28 Evidence: All staff complete a thorough induction programme when they begin work and there are ongoing training opportunities. Records seen showed that, as well as statutory training in health and safety matters, staff have received training including working with people who have a dementia, the Mental Capacity Act and recognising and reporting abuse. All staff who completed a questionnaire said that they received training that was relevant to their job. Staff spoken with during the inspection were very happy with the training that they received and felt that the dementia training Yesterday, Today and Tomorrow had been particularly valuable. All 4 staff who completed questionnaires answered ALWAYS to the question Do you feel you have the right support, experience and knowledge to meet the different needs of the people who live at the home? People living at, and visiting the home, praised the staff saying that they were kind, patient and always willing to help. One visitor said staff are brilliant and always cheerful. The health and social care professional who completed a questionnaire answered ALWAYS to the question Do the care staff have the right skills and experience to support individuals health and social care needs?. Staff spoken with said that there was good communication in the home and everyone now worked together as a team. The recruitment files of the four most recently employed members of staff were viewed. These gave evidence of a robust recruitment procedure that included obtaining written references and checking people against the Protection Of Vulnerable Adults (POVA) register before they began work. 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. The home is effectively managed taking account of the views of all interested parties. There are systems in place to ensure the health and safety of people living and working at the home. Evidence: The registered manager of the home is Matthew Parrish, he holds the Registered Managers Award (NVQ level 4 ) and has many years experience of working with older people and people who have a mental health difficulty. The Annual Quality Assurance Assessment was well completed giving details of the homes achievements over the last year and their plans for further improvements in the future. The manager is supported by three deputies, one who takes a lead role in The Limes
Care Homes for Older People Page 24 of 28 Evidence: and two who work in the main part of the home. There is also a team of senior carers. Everyone spoken with said that the management in the home was open and approachable and people felt that they were always listened to. There are various systems in place to monitor the quality of care and seek peoples views on the quality of the service. The company sends out questionnaires to interested parties on a regular basis and meetings are held at the home for the people who live and work there. Staff said that they always felt comfortable to give their opinion or raise any issues during meetings. The operations manager for the company carries out thorough regulation 26 visits and provides written feedback on these visits to the CSCI. The home assists some people with personal finance and clear records are kept of all transactions. Personal finance systems were sampled in The Limes. Records maintained correlated with monies held. To promote the health and safety of people living and working at the home a full time maintenance person is employed who maintains the building to a high and safe standard. Since the last inspection additional lighting has been installed of the landing in the main part of the home. A fire log is maintained which shows that alarms are tested on a weekly basis and emergency lighting is tested monthly. The system is regularly serviced by outside contractors and staff receive training in fire safety. All lifting equipment is regularly tested and certificates of safety were seen. The gas and electrical installations have been tested for safety and all portable electrical appliances are tested annually. Any accidents in the home are recorded, these accidents are audited by the manager and there is evidence that appropriate action is taken when necessary. Up to date certificates of insurance and registration are displayed in the entrance hall. 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 1 2 7 9 The home should review the care plan format to ensure that they are well organised and clear. Individual protocols should be in place for all as required medication to ensure that it is administered in a consistent manner, promotes well being and alleviates discomfort. The home should consider how people can be assisted to make choices at meal-times including controlling their portion sizes. The home should consider providing additional comfortable communal space in The Limes. 3 14 4 20 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!
