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Inspection on 06/10/08 for Clair Francis Retirement Home

Also see our care home review for Clair Francis Retirement Home for more information

This inspection was carried out on 6th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

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

People we spoke with, including visitors, said that the staff were "Very good and the care was "Second to none." One of the resident`s surveys said "The staff are very willing to help in difficulties and mishaps." There is a good standard of information to assist people in their decision where to live and the home makes sure that it can meet the needs of any person admitted to the home. People have opportunities to live a good quality of life. People are generally listened to and, on the whole, are safe from the risk of abuse. People can be confident that they are cared for by well trained and generally well recruited staff. People benefit from a well-managed home.

What has improved since the last inspection?

Both the requirements have been met with regards to weighing people and information about staff. The home has had new carpets, flooring and furniture. There is a ramp from the patio to the garden to help people who need help with their mobility.

What the care home could do better:

People receive safe and proper care although there is some risk to their health and safety due to the standard of record keeping. We expect the home to improve the current standard of care plan documentation. A requirement has been made about medication records. People live in a home that is clean and comfortable but could be made safer in some areas to include the call bell system and hot water temperatures. We expect the home to manage this, rather than we make a requirement on this occasion. The staff roster must include the full names of people working at the home.We expect the home to manage this, rather than we make a requirement on this occasion. Full information about staff must be obtained to ensure that they can legally work in this country. We expect the home to manage this, rather than we make a requirement on this occasion. We expect the home to receive at least one visit per month by a represenative of the registered owner as described in regulation 26, and a report made of these visits. We have made no requirement on this occasion.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clair Francis Retirement Home 237/239 Park Road Peterborough PE1 2UT     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: Elaine Boismier     Date: 0 6 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 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 26 Information about the care home Name of care home: Address: Clair Francis Retirement Home 237/239 Park Road Peterborough PE1 2UT 01733312670 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Christina Elizabeth Bentley Type of registration: Number of places registered: Mr Karim Bhanji care home 28 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Clair Francis was originally two separate houses, which have been connected by a twostorey extension. They are turn of the 19th century buildings, which have been adapted to provide suitable accommodation for 28 older people. The home is situated in a quiet residential area of Peterborough, close to the park, local amenities and transport routes. The current fees range from £431.94 to £490. Additional costs include those for private chiropody and hairdressing. Further information about the fees can be obtained from the home. A copy of the inspection report is available on request from the home or via our website at www.csci.org.uk 28 0 Over 65 0 28 Care Homes for Older People Page 4 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: 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 last key inspection took place on 18th May 2007. In May 2008 we carried out an Annual Service Review (ASR) of the home but as we had not received the Annual Quality Assurance Assessment (AQAA) before the ASR and we received no surveys, we were unable to make a fully informed judgment about the standard of care and the standard of management of Clair Francis. As a result we brought the key unannounced inspection forward. We, The Commission for Social Care Inspection, carried out this key unannounced inspection between 9:45 and 15:45, taking 6 hours to complete. We received some surveys from relatives and residents and staff, in May and again in September 2008. We also received a completed AQAA. We looked at the history from the home since our Care Homes for Older People Page 5 of 26 last inspection in 2007. During the visit to the home we spoke with some of the residents, visitors to the home, some of the staff, including the Manager. We watched staff working, had a look around the home and we looked at documentation. For the purpose of this inspection report people who live at the home are referred to as people, person or resident/s. What the care home does well: What has improved since the last inspection? What they could do better: People receive safe and proper care although there is some risk to their health and safety due to the standard of record keeping. We expect the home to improve the current standard of care plan documentation. A requirement has been made about medication records. People live in a home that is clean and comfortable but could be made safer in some areas to include the call bell system and hot water temperatures. We expect the home to manage this, rather than we make a requirement on this occasion. The staff roster must include the full names of people working at the home.We expect the home to manage this, rather than we make a requirement on this occasion. Full information about staff must be obtained to ensure that they can legally work in this country. We expect the home to manage this, rather than we make a requirement on this occasion. We expect the home to receive at least one visit per month by a represenative of the registered owner as described in regulation 26, and a report made of these visits. We have made no requirement on this occasion. Care Homes for Older People Page 7 of 26 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 8 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a good standard of information to assist people in their decision where to live and the home makes sure that it can meet the needs of any person admitted to the home. Evidence: All of the 4 residents surveys, received in May 2008 and 3 of the 4 residents surveys, received in September 2008, said that the person had enough information about the home before they moved in.The Annual Quality Assurance Assessment (AQAA) said that the home carries out pre-admission assessments on people, in hospitals and in their own homes, before they move into Clair Francis. 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. People receive safe and proper care although there is some risk to their health and safety due to the standard of record keeping. Evidence: We spoke and observed some of the people and we compared our findings to their care plans. Evidence suggests that currently the care plans are not person centred as they are inclined to be more task orientated. For example for a person registered blind there was no indication how this condition effected the person in their ability to carry out personal care tasks. For another person, who had very swollen feet and had some difficulties in communication, there were no care plans for these particular needs. In addition for a person who was on strong pain-killers, there was no assessment of their pain, how this pain effected their activities of daily living and there was no monitoring of their pain control . Some of the care plans were confused in what action was to be taken and the desired goal/outcome. For example where a person was assessed to have help with having enough to drink the goal/outcome was recorded as Encourage plenty of fluid intake. This is an action not a goal. Goals/outcomes were sometimes of Care Homes for Older People Page 11 of 26 Evidence: a general nature and not always measurable. For example the use of words such as plenty and regular need to be more specific in amount and times respectively to provide clear guidance for the staff. Due to the administrative work load of the Manager we have taken a reasonable view to allow the home 6 months to ensure that the care plans are accurate, person centred, measurable and to give good guidance for staff in how to meet the needs of the people living at the home. People we spoke with, including visitors to the home, said that the care provided was good. One person told us that The care is second to none. One of the residents surveys said The staff are very willing to help in difficulties and mishaps. A residents survey, completed on behalf of the resident and received in May 2008, said The carers in this home are very good. Occasionally when visiting (my relative) in the afternoon he still has not been shaved. These little things are very important for a persons dignity. A requirement made following the last inspection, in 2007, has been met, as according to the Manager a new set of weighing equipment has been acquired. Records of peoples weights were seen and evidence suggests that action is taken when a person has been assessed as at high risk to their health, due to unintentional weight loss and a decrease in their body mass index. According to the AQAA and during discussion with the Manager, residents benefit from the home being able to make direct referrals to health care professionals such as requesting supplementary foods from the general practitioners. Examination of some of the peoples care records, and discussion with some of the people indicated that residents have access to specialist nursing services, physiotherapy services, speech and language therapy services, opticians and chiropody services. We observed how the medication is given out and we noted that this was done in a hygienic and sensitive manner. Medication administration records (MARs) were signed after the medication was given. Although records for the temperatures of the room (where medication is stored) and the records for the temperatures of the drug fridge were not available for inspection, the air temperature was not in excess of 25 degrees centigrade and the temperature of the fridge was showing a record of the 4 degrees centigrade. Eye drops were labeled with the date of opening and all were in date. Examination of stock levels indicated that there is a control of the amount of medication coming into the home, thereby ensuring medication is in date and there is no unnecessary wastage. Examination of the MARs indicated that there were some omissions in the records such as for when prescribed creams were to be applied. For variable doses, such as paracetamol, there was no indication how much the person was given, therefore there is a risk of a person not being given enough of their medication or being given more than it is safe to do so. Records for the controlled Care Homes for Older People Page 12 of 26 Evidence: drugs kept in the home were incomplete in a number of places. For example for each numbered page of the register there was no name or strength of the medication that was being entered in the record bellow this heading and there was no full name and address of the dispensing pharmacy. In addition there was no record on one of the persons current MARS, or within the controlled drug register, for controlled drugs received on two separate occasions, one in August 2008 and one in September 2008. It was not clear, due to the lack of records, how the medication that had been used (fentanyl patches) had been disposed of. Our findings, with particular regard to the recording of the fentanyl patches, were confirmed by a member of staff. A requirement has been made about medication records. People we spoke with said that the staff were very good and we noted that the staff interacted with the people in an appropriate manner. We noted also the staff knocking on peoples doors before they entered. 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. People have opportunities to live a good quality of life. Evidence: The AQAA, and this was confirmed in some of the peoples care records that we saw, told us that the people have access to a wide range of activities and this included quizzes and visits from outside entertainers, such as Sporting Chance. People we spoke with,including a visitor, said that the recent fete, held at the home, was very enjoyable with games such as guess the weight of the cake and a tombola. Monies raised by the fete are intended to improve the activities in the home. People said that they would like to go out more and we understand, from discussions with the people, including the Manager, that there has been some difficulties in accessing suitable transport for people who need help of a wheelchair. According to the staff and a visitor, arrangements have been made to discuss this issue at a forthcoming residents/relatives committee meeting. There was a range of views about the suitability of activities provided, in the residents surveys we received in both May and September 2008. Some of the surveys said that the home always provided suitable activities whereas some of these surveys said that the home sometimes provided suitable activities. The comments ranged from Well, is not bad really here and I Care Homes for Older People Page 14 of 26 Evidence: think the activities are very good to Activities are few and far between and More entertainment would be help the residents fill the long hours. People said that they could get up and go to bed when they wanted. The care records that we saw noted that people were to be offered the choice of what they would like to wear. We saw people receiving their guests and the visitors record book indicated that there is no restriction during the day, for people to receive their guests. According to the AQAA the home obtains food from local butchers and examination of the current menus indicated that there is a range of choice the exception of the main course at lunchtime. According to the Manager the cook is taking action to introduce a choice at lunch time. 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. People are generally listened to and, on the whole, are safe from the risk of abuse. Evidence: The AQAA told us that within the last 12 months the home has received 4 complaints of which all had been resolved within the 28 required timescale and all of these complaints had been proven. The record of complaints was examined and we found that the written responses to the complaints were of a listening nature. Information about how to make a complaint was available in those bedrooms that we visited. People we spoke with said that they knew what to do if they were unhappy about something. Three of the 4 residents surveys, that we received in September 2008, said that the person knew who to speak to if they were unhappy about something and all of these surveys, and all of the 3 surveys from relatives, said that the person knew how to make a complaint. Three of the 4 residents surveys said that staff listened and acted on what was said to them. Both of the surveys we received from staff said that they would know what to do if any person or visitor had made a concern, to them, about the home. The home followed correct reporting procedures following an allegation of abuse made against a resident, took action to ensure any risk of abuse was reduced and cooperated with the safeguarding team (Safeguarding was previously known as protection of vulnerable adults or POVA). Examination of some of the staff files Care Homes for Older People Page 16 of 26 Evidence: indicated that they had attended safegurding awareness training and discussion with some of the staff indicated that they, too, had attended such training. Although the staff told us what they would do if they witnessed, or were suspicious of, an incident of abuse against any of the residents, their response was not as spontaneous as we would have expected and the correct responses were made after some prompts from us. We discussed this issue with the Manager and we considered information to be more available, for the staff, about who to contact should any safeguarding issue occur at the home. 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. People live in a home that is clean and comfortable but could be made safer in some areas. Evidence: The AQAA told us that there has been replacement of carpets, flooring and furniture in lounges and dining areas and we saw that this was the case. We also noted that, since our last inspection, there has been a ramp provided from the patio area down into the garden, to help those people who require help with their mobility. A visitor told us that when people are sitting in the conservatory they have no means to call for assistance. We noted that the nearest call bell is located in the adjacent lounge area. We discussed this issue with the Manager and it was considered that action would be taken to address this issue without our making a requirement. The record of hot water temperatures were examined and up to August 2008 the records indicated that the temperatures of the hot water, in bathrooms, were delivered at a safe temperature. The records for August and September 2008 indicated that there had been a change in these temperatures and that they were in excess of the safe 43 degrees centigrade. We tested the hot water temperatures in 2 bathrooms and found that in one of these (the blue bathroom) the hot water was 57.6 degrees Care Homes for Older People Page 18 of 26 Evidence: centigrade. According to the Manager the person who currently uses this bathroom chooses to have their hot water in excess of the safe 43 degrees centigrade. It was confirmed, however, no risk assessment had been carried out for this person, to make sure that they were protected from any risk of harm, whilst respecting their choice. We expect the home to manage this issue rather than we make a requirement on this occasion. The home was clean and fresh smelling. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they are cared for by well trained and generally well recruited staff. Evidence: In response to complaints about the laundry and condition of peoples personal clothing the Manager has advertised for additional staff to work in the laundry area. According to her and the staff there is a difficulty in sometimes recruiting staff due to a greater competition elsewhere in the local job market. Examination of the staff roster indicated that there is sufficient number of staff on duty at all times and agency staff are used to compensate for any staff hour vacancies/absences. Both of the surveys from staff and all of the 4 surveys from residents said that there was always/usually enough staff on duty to meet the needs of the residents.The staff roster had only the first names of the people working, including agency staff. Full names of the staff must be recorded in full on this legal document. We expect the home to manage this issue, rather than we make a requirement on this occasion. According to the AQAA the home has 66.65 of the care staff with a National Vocational Qualification (NVQ) level 2 or equivalent in care. A requirement was made for all the required information about staff to be obtained. Care Homes for Older People Page 20 of 26 Evidence: We examined 2 staff files and we found that all the required information had been obtained with one exception. In one of the 2 files we noted that a persons work permit had expired in August 2008. The Manager told us that the member of staff had married a person from the EU, although there was no copy of the persons marriage certificate. We, however, have taken the reasonable view to consider this requirement has been met and action to be taken by the home to obtain a copy of the member of staffs marriage certificate, to prove they can legally work in this country. Discussion with the staff and evidence in the staff training records indicated that the staff have opportunities to attend a range of training to include care of a person with dementia, infection control, person centred care planning and care of a person with challenging behaviours. The staff surveys we received indicated that there was satsfaction with the induction training and ongoing training. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a generally well-managed home. Evidence: According to the AQAA the Manager has 15 years managerial experience in care homes and she is a NVQ assessor. We receive required notifications from her, such as any person requiring inpatient hospital treatment. Due to no administrative support she operates the business part of the home with the help of a clinical manager. Although surveys have been sent out from the home, the Manager told us that more responses are awaited before she can begin to collate the responses from residents and their families/friends. The AQAA was completed in a satisfactory manner and it identified areas that the home does well in, what areas the home could improve upon and what has beenplanned, for the next 12 months, to improve the standard of the service. Care Homes for Older People Page 22 of 26 Evidence: We examined the regulation 26 report for July 2008 and this contained information about the standard of the home. The regulation 26 report was made by a representative of the registered owner. We understand that this was the only report produced within the last 12 months and we understand that the required monthly visits are not carried out by any person by a represenative of the registered owner. The regulation 26 visits are part of a quality assurance and demonstrates that the responsibilities of the registered are recognised and acted on. We will make no requirement on this occasion. Two peoples monies were counted and the amounts reconciled with the balances. Receipts are obtained and we saw a record of these for another of the people. The AQAA told us that safety checks have been carried, during 2008, on fire detection and fire fighting equipment, portable appliance equipment and hoists and lifts and records of these we saw confirmed what the AQAA told us. Evidence provided by the staff and in some of their training records, indicated they have attended training in fire safety, food hygiene and safe moving and handling. We observed some of the staff assisting a person to transfer with the use of the hoist and although their communication with the person could have been better, to explain each step of the procedure, we saw that the techniques used were safe and the person showed no sign of discomfort or distress during this procedure. Care Homes for Older People Page 23 of 26 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 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 1 9 13 Medication administration records must be accurate and up to date. This is to ensure that peoples helath and welfare is protected from the risk of harm 21/10/2008 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: 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 26 of 26 - 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!