Inspection on 27/04/09 for Clarendon Mews

This inspection was carried out on 27th April 2009.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Clarendon Mews 18/11/08

Clarendon Mews 29/04/08

Clarendon Mews 23/11/07

Clarendon Mews 20/09/06

Clarendon Mews 20/09/05

Clarendon Mews 29/06/05

Clarendon Mews 07/10/04

Clarendon Mews 19/05/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 20/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Clarendon Mews Grasmere Street Leicester LE2 7FS     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: Anthea Richards     Date: 2 7 0 4 2 0 0 9 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 © (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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Clarendon Mews Grasmere Street Leicester LE2 7FS 01162552774 01162552785 clarendon-mews@carehomes.uk.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Greentree Enterprises Ltd care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 40. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Dementia - Code DE. Old age, not falling within any other category - Code OP. Physical disability - Code PD. Date of last inspection Brief description of the care home Clarendon Mews is a residential care home. It is registered to provide accommodation for a total of forty older people. The registration also allows for up to forty people to live in the home that have dementia (under category DE). It also allows for people who are physically disabled (under category PD) to live in the home. Care Homes for Older People Page 4 of 28 Over 65 0 40 0 25 0 7 1 8 1 1 2 0 0 8 Brief description of the care home Clarendon Mews now rents 20 beds to the Primary Care Trust who staff them to care for patients needing intermediate care and rehabilitation. These beds are situated on the first and second floors of the building. Therefore only the 20 beds used by Clarendon Mews were inspected. Clarendon Mews opened in 2002, after a full refurbishment. The home is situated in Leicester, close to the Royal Infirmary. Bedrooms are located on three floors of the home; a passenger lift services all these levels. Thirty-eight bedrooms have en suite provision; some of those have a bath or shower as well. There are lounge and dining facilities on all three floors of the home. There is a large secure garden within the grounds of the home. The home is well situated for transport routes to the centre of Leicester, and there are local shops within a short distance of the home. Parking facilities are available on the premises. Fees are set according to the minimum (£309.00 per week) and maximum (£399.00 per week) banding levels of the local social services departments. The Commission for Social Care Inspection (CSCI) and Employers Liability certificates were displayed in the hallway near the entrance to the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we (throughout the report the use of we indicates the Care Quality Commission), spent four hours reviewing information received by the Care Quality Commission (CQC) since the last inspection on the 29th April 2008 and a Random inspection undertaken on 11th November 2008. The visit took place on the 27th April 2009 and lasted seven hours. During the visit we checked all the key standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to three of the residents. Care Homes for Older People Page 6 of 28 To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and their families. With their permission the residents bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. We checked the Annual Quality Assurance Audit (AQAA) that the home had sent to us. This describes the services provided at the home for the residents, how the home is hoping to improve services and statistics about the residents and the staff. During the visit we spoke with the homes manager, the staff, the residents and visitors to the home. What the care home does well: What has improved since the last inspection? What they could do better: The Statement of Purpose should be updated to include all the required information. The manager should complete a pre admission assessment of care needs for all prospective residents. Risk assessments should be personalised to reflect the risks for the resident and how to handle them. Care plans must be comprehensive and include all the care needs for a resident. Staff should be made aware of how to dispose of all wasted medicines. The application form for staff should contain enough space for the applicants full employment history to enable the interviewer to ask about any gaps in employment. Two written references must always be obtained before a member of staff is employed to make sure that they are a suitable person to work with the residents. Staff should be notified of the outcome of any disciplinary interview and the action to be taken. Care Homes for Older People Page 8 of 28 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 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. The residents needs are always assessed before moving into the home and they have good information to help them make the right choice about the home. Evidence: The residents and the families spoken with told us that they had seen the Statement of Purpose and had been given the terms and conditions. The Statement of Purpose contained thorough information that described the services that the home provided, it did need to be updated to reflect the new manager and the contact details for Social services. These documents are available in other formats including large print and other languages to give as many people as possible the opportunity to read them. Pre admission assessments are completed by Social services, but the manager has plans to visit all prospective residents to complete a pre assessment of their needs. This will make sure that the home has a full picture of the resident before they are admitted. Residents and/or their families have the opportunity to visit the home. The Care Homes for Older People Page 11 of 28 Evidence: social services assessments were seen in the residents care plans and the residents and the families spoken with told us that they had a visit before they came in. The staff spoken with told us that they always knew about the resident before they were admitted. The current registration certificate from the Commission for Social Care Inspection (CSCI) was displayed in the entrance of the home with the latest report from the CSCI and an up to date public liability insurance certificate. The registration certificate still displayed the name of the ex manager . 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. The staff meet the care needs of the residents, with privacy, dignity and respect. Evidence: The records for the residents who were case tracked were found to contain good individual evidence of the care being given to the residents and mainly reflected the care that the residents needed. One care plan looked at had no record of a need for one of the residents. The care plans contains a nutritional assessment and a record of the residents weights. to make sure that the residents are eating well. There was evidence that the residents and/or their relatives have been involved in planning the care. The residents and the families spoken with told us about the care that they needed and that they were happy that they received it. Comments received included: Very happy in the home, staff are excellent. There are records of the involvement of G.P.s, district nurses, chiropodist and optician, Care Homes for Older People Page 13 of 28 Evidence: where needed in the care plans, showing that thorough health care is being provided for the residents. The residents and their families spoken with said that they could see the doctor and other health professionals when they needed to. There was evidence that the care plans are regularly reviewed and the residents and the families spoken with confirmed that they could be involved with them and were aware of the care to be given and that they were happy with it. The daily record of care was up to date and contained details about the residents day and night. This makes sure that the staff know what has happened to the resident at all times. We saw residents being treated with dignity and respect when staff spoke with them and undertook their care, particularly when moving them. They were seen to be knocking on the residents bedroom doors before they went into them. There were risk assessments in place to cover all the identified risks for the residents and how the staff should manage those risks. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. A risk assessment for how to avoid falls was not found to have been written to reflect individual residents particular needs, but remained very general. Medication records for the case tracked residents were in order. Medicines are given by senior care staff who have regular updating in medicines. We saw that the medicines were administered individually and the residents were seen to be taking them. Medicines are supplied in a monitored dosage system where each tablet is in a separate pop out card, which is a safe method of administration, helping to make sure that the resident is always given the right medicines. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of most medicines. They were advised about the disposal of liquid medicines. The controlled drugs were checked and correct. Controlled drugs were being stored in a cupboard inside the drug trolley, they were advised that they should be stored in a locked cupboard bolted to the wall. This was done immediately. There is a self-medicating policy in place with one resident looking after his own medicines at that time, there was the facility of a locked cupboard for him to keep his medicines. The manager audits these once a week. Care Homes for Older People Page 14 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. The residents enjoy the activities that they want to and have their spiritual and nutritional needs met. Evidence: The staff were seen to be spending individual time with the residents, talking with them and discussing the programme on the T.V., which the residents told us that they were enjoying. Four of the residents were enjoying playing cards in the activities room. Activities that were enjoyed by the residents included: board games, hand massage and manicures, singing, music, memory games and music. The residents, families and the staff told us about the activities and how they enjoyed them. They told us about the recent St. Georges Day party that the home held and that they really enjoyed. The home produces a monthly newsletter telling the residents and the families about what is happening in the home. The clergy can visit whenever the residents would like. A hairdresser visits weekly, which the residents enjoy. Care Homes for Older People Page 15 of 28 Evidence: The staff, the residents and the families spoken with told us that they were happy with the amount of activities. All the families spoken with said that they were made very welcome in the home, which we saw whilst we were there. The residents spoken with said that the food was good and that they had a choice of what they had. The menus were varied and were discussed with the residents at residents meetings. Comments made by the residents included: The food is excellent and we can choose what we want to eat. We couldnt be in a better place. We spoke with the residents during their lunch, which was served attractively and they told us that they were enjoying. Care Homes for Older People Page 16 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. There are systems in place to support and protect residents and staff are aware of the processes. Evidence: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. This could be made available in a large print and other languages if it was needed, which would make sure that as many people as possible could read it. The contact details for Social Services were not in the policy and the manager told us that she would include them immediately. The residents and the families spoken with were aware of the policy, of how to complain and who to complain to. They were happy that their concerns would be listened to and acted on. The staff spoken with were aware of how to handle any complaints. The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the manager and the records seen supported this. All of the staff have either got an National Vocational Award at Care Homes for Older People Page 17 of 28 Evidence: least at level 2 or have started the award, during which they receive training in safeguarding as well as the training given in the home. They were confident that the management would handle any issues correctly. We looked at the accident book, which had been completed correctly. These practices make sure that the residents are safe from any abuse and that any concerns are handled correctly. Care Homes for Older People Page 18 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. The residents are protected by the policies and procedures in the home to provide a safe and pleasant environment. Evidence: Clarendon Mews is a large purpose built care home situated close to Leicester centre. The home was warm, clean, homely and welcoming on our arrival. There was a board in the main entrance with a description of the activities and the menu for the day. There is a comments book for the residents and visitors to make remarks about the home. This had a lot of complimentary comments in it, includig how much the home had improved since the new home manager had been in post. There are lounges on the ground and first floors with a large bright dining room on the ground floor. The lounges were clean, bright, well decorated and well furnished with suitable seating for the residents. Clarendon Mews has bedrooms on both floors whilst the Primary Care Trust have 20 bedrooms on the first and second floors. These are used for intermediate care and rehabilitation and are staffed by health service staff. All of the bedrooms seen had been personalised and were found to be clean and well decorated. The residents spoken with were happy with their rooms and said that they were able to bring their own belongings in with them. Care Homes for Older People Page 19 of 28 Evidence: There was evidence of equipment in the home to help the residents, such as wheelchairs, special mattresses and hoists. There was a good provision of bathrooms in the home and these were found to be clean and clear of any items that could cause a hazard for the residents. On the ground floor there was a hairdressing room where the hairdresser was working and the residents told that they appreciated having their hair done. There was a patio area and grounds that were easily reached by the residents and made a pleasant place to sit and walk for them. The residents and the families spoken with were happy with the cleanliness of the home, and told us that the staff worked hard to keep it clean. There are staff employed to complete the cleaning in the home and they have had training in health and safety. The cleaning products are stored in a locked cupboard, which we saw. The kitchen was large and bright and had recently had an environmental health officer check that was found to be good. The records for hot water testing were being completed regularly and all the temperatures were within the recommended levels. The fire records for testing alarms and fire drills and training were looked at and found to be up to date. The staff spoken with told us that they had regular training and fire drills. There was an up to date public liability insurance certificate displayed in the entrance. The registration certificate still had the ex managers name on it. Care Homes for Older People Page 20 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. The recruitment policy and the staff training meet the residents needs and protect their safety. Evidence: We looked at three staff files and the required information was only complete in two of them. This included evidence of identification, adequately completed application forms, two written references, a Criminal Records Bureau (CRB) check and a Protection of Vulnerable Adults check. The other one only contained one reference and another did not have a reference from the previous employer. Getting a work reference makes sure that recent work practice is confirmed. The manager should make sure that all the required documentation is in place before an employee starts work. Staff spoken with thought that they did not start work until all the paperwork was in place. The staff spoken with confirmed that they had received recent training in moving, fire, dementia awareness, safeguarding of vulnerable adults, Control of Substances hazardous to health (COSHH), first aid, care planning, infection control and equality and diversity. Care Homes for Older People Page 21 of 28 Evidence: The manager has a matrix with all the training courses that are arranged and when the staff need to attend them. The residents and the families spoken with felt that the staff were well trained to do their job and that there were enough staff to look after them. Most of the care staff either hold a National Vocational Qualification (NVQ) at least at level 2 or are in the process of completing it. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. Care Homes for Older People Page 22 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 residents safety is protected by the practices in a home that is run in their best interests. Evidence: The manager has been in post since Nov 2008 and has applied to be registered with the Care Quality Commission. She is an experienced manager who has worked in several homes in Leicester. There are regular meetings held for the residents and for their families, to discuss activities and menus in addition as to how the home is meeting their needs. The manager is available to talk with the residents and the visitors every day that she is in the home. The residents and the families spoken with told us that they saw her regularly. There were quality questionnaires sent to the residents and their families every year and the questionnaires that we saw on the visit confirmed this. The families and the Care Homes for Older People Page 23 of 28 Evidence: residents told us that they had completed the questionnaires. We received positive comments from the residents and the families at the visit and from the surveys that we sent them, amongst which were that the staff were very supportive of them and their relative and that the home had improved recently. The home does not hold any accounts for the residents. There are regular staff meetings held, confirmed by records held and by the staff spoken with. All the areas of health and safety such as hot water temperatures and fire drills and alarm testing were found to be in order. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 8 14 (2) (b) It is important to ensure that 30/06/2008 information relating to the people living at the home is evaluated as necessary to reflect their current needs as potentially the wrong diagnosis and treatment could be offered. Care Homes for Older People Page 25 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 1 29 19 (b)(i) That the homes manager makes sure that the documentation required in paragraphs 1-7 of schedule 2 before employment is offered. To make sure that all employees are are as safe as is possible to care for the residents. 30/05/2009 2 29 19 (b)(i) That the homes manager makes sure that the documentation required in paragraphs 1-7 of schedule 2 before employment is offered. That a complete employment history is obtained so that the interviewer can explore any gaps in employment. 30/05/2009 Care Homes for Older People Page 26 of 28 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 1 3 That the Statement of Purpose is updated to include the new managers details and the details for Social services. That the manager or a senior member of staff visits all prospective new residents to complete a pre admission assessment in addition to the the one from Social Services. That the falls risk assessment reflects individual needs and difficulties. That a full assessment of care is carried out and a plan is put in place for every care need. That all of the staff are made aware of how to dispose of liquid medicines. That following a disciplinary hearing the results and action to be taken are documented and the member of staff informed of the result. 3 4 5 6 7 7 9 30 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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!