Inspection on 08/10/08 for Cold Springs Park

This inspection was carried out on 8th October 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Cold Springs Park 27/11/07

Cold Springs Park 28/09/06

Cold Springs Park 20/10/05

Cold Springs Park 29/04/05

Cold Springs Park 25/10/04

Cold Springs Park 07/04/04

Cold Springs Park 27/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cold Springs Park Scaws Road Penrith Cumbria CA11 8EY     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: Jenny Donnelly     Date: 0 8 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 27 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 27 Information about the care home Name of care home: Address: Cold Springs Park Scaws Road Penrith Cumbria CA11 8EY 01768890360 Telephone number: Fax number: Email address: Provider web address: lannigab@bupa.com Name of registered provider(s): Type of registration: Number of places registered: BUPA Care Homes (CFC Homes) Ltd care home 60 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (maximum number of places: 38) Dementia - Code DE (maximum number of places: 22) The maximum number of people who can be accommodated is: 60 Date of last inspection Brief description of the care home BUPA Cold Springs Park provides accommodation and care for a total of 60 people. The home is divided into sections, one catering for 38 frail older people and a separate unit called Spring Lakes providing care for 22 people with dementia. The home is owned and run by Care Homes First Limited, a subsidiary of BUPA Care Services. The home is in a residential area approximately one mile from the centre of the market town of Penrith and local amenities. Single occupancy accommodation for residents is on ground floor level with en-suite toilet and hand wash facilities. Some bedrooms also Care Homes for Older People Page 4 of 27 Over 65 0 38 22 0 Brief description of the care home have an en suite shower. There are a number of dining rooms and lounges, which can be used for activities. The building and garden areas are very well maintained and there are sheltered patio areas. Car parking facilities are available for staff and visitors. People who use wheelchairs can access all parts of the home and grounds. At the time of this inspection the weekly fees ranged from £386.00 to £700.00, according to the level of care and support required. Information about Cold Springs Park, including a brochure, statement of purpose and copies of inspection reports could be obtained directly from the home. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 the key inspection of the service for the year. Jenny Donnelly inspector, made an unannounced visit to the care home on 8th October 2008. During the visit we (the commission) toured the building, spoke with residents, staff and management. We looked at care, medication, staffing and management records. We saw how people were spending their day, and observed lunch and the days activities. Prior to this inspection the manager had completed and returned an Annual Quality Assessment Audit (AQAA) that we had requested. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. We also sent surveys out to some of the people who live in the home, and to staff. The Care Homes for Older People Page 6 of 27 findings of the surveys are included in this report. What the care home does well: What has improved since the last inspection? Since the last inspection, the home had opened a newly built 22 bed dementia care unit called Spring Lakes. Two of the existing bathrooms had been upgraded with new assisted baths, and a new wet room shower facility had been provided. The laundry had been extended to cope with the increased numbers and a new system had been implemented for returning laundered items to people. The homes statement of purpose and brochures had been updated to include the new Spring Lakes unit. Management of medicines had improved, with records being much better organised and including photographs for identification and information about any allergies people have. Administration of medicines had improved and people were getting the right medicine at the right time. The date of opening was being recorded on products with short shelf life, so staff knew when they needed replacing. Care Homes for Older People Page 8 of 27 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had good admission arrangements in place that included a comprehensive assessment of peoples needs. This meant people were re-assured that the care home knew about, and could meet their individual needs before they moved in. Evidence: The homes statement of purpose and service user guide had been updated to include information on the new dementia care unit, Spring Lakes. Copies had been supplied to the commission as part of the homes registration of the new unit. Due to the relocation of the main reception desk on the day we visited, we could not find any copies available for people to look at. The manager agreed to rectify this. We looked at the files of two people quite new to the care home. These showed that comprehensive assessments had been completed to identify their individual personal, social and health care needs. The assessment process allowed everyone involved the opportunity to be sure the care home could meet each persons needs before they Care Homes for Older People Page 11 of 27 Evidence: moved in. It also helped staff prepare to greet new people with some knowledge of their needs, and to have any necessary aids or equipment ready for them. We saw that interested people were able to come and look around the home and meet with senior staff to ask about the service. New people had a trial period, followed by a review meeting, to check that the placement was working out well. People told us - My family viewed the home for me and had a meeting with the manager to discuss my needs My son visited many places before we chose this one. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were receiving a good standard of individual personal and health care that was delivered in the way they wanted, and that benefited their general health and well being. Evidence: The home had been using the QUEST care planning system for about a year, and this was working very well. We looked at four care plans, three on the older persons unit and one on the new dementia unit. The files contained up to date assessments and individualised care plans which clearly set out what support each person needed. There were detailed daily care records, and the older plans we saw had been kept regularly updated with new information. Records contained good information about peoples social needs and their personal preferences. The Map of Life sections had been really well completed and helped staff to know about peoples background and understand what was important to them. This was especially useful in the dementia care unit. One of the staff commented; All care plans are updated monthly so we know if there are any changes. Care Homes for Older People Page 13 of 27 Evidence: People told us they were happy with the care they received and said staff looked after them well. One person felt they needed more physiotherapy and walking practice. A number of people were up and dressed by 9 am, and they they told us they liked it this way. Other people were seen being assisted to get up much later and breakfast was still being served. We saw that staff treated people with respect and that peoples privacy and dignity were maintained. There were good arrangements for people to access health care services, and the home worked closely with the local doctors and community nurses. People who were assessed as needing specialist equipment, such as air mattresses or profiling beds, had this provided, either by the care home, or through the community nurse. There was evidence that people had access to a dentist and optician, and the more specialist services of speech and language therapy as needed. Peoples nutritional needs were assessed and people were weighed regularly to ensure they maintained a healthy weight. We looked at the management of medicines and saw a number of improvements since last time. The medicine records were fully and accurately completed and we saw no evidence of mistakes being made. The records were generally better organised and had photographs in place for identification purposes, as well as information about any allergies. Medicines that were prescribed in alternating doses or due at odd intervals were being well managed. Items with a short shelf life, such as eye drops, had been marked with opening dates, so staff would know when they had expired. Each person had a list of homely remedies that their doctor had agreed to. This meant people could be given simple over the counter treatments for things such as mild pain without having to see the doctor. Some people managed their own medicines, although this was mainly creams, and there was a suitable assessment framework in place to ensure people were safe doing this. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were offered freedom and choices about how to live their lives and were being provided with plenty of opportunities for activities and entertainment. People were pleased with the quality and choice of meals served. Evidence: The service was flexible to accommodate peoples needs and choices. We saw that people were assisted to get up when they wanted in the morning, and care plans showed peoples preferences as to when and how they liked their care delivered. We saw that people were welcome to use the lounges or remain in their bedrooms as they wished. The home employed an activity organiser who arranged a varied programme of activities and events. The programme for the week was widely displayed around the home and showed exercise sessions, visiting musicians and singers, church services, a slide show to music and visits by local school children. The home had made good links with the local community and enjoyed regular visits from primary school children and college students. The children visited with certain individuals to chat and share their news whilst the older students had helped some people put together their life stories. We observed a church service and a slide show taking place in the main lounge, and were pleased to see that people living in the dementia unit were welcomed at both Care Homes for Older People Page 15 of 27 Evidence: events. In addition to the main events, staff in the dementia unit provided individual activities for people using the butterfly technique. This involved spending just 5 to 10 minutes at intervals throughout the day on a short activity such as jigsaws, crafts, dancing, looking at pictures or having a hand massage. Working in this way meant people could be engaged in activities at times when they were most receptive and willing to participate. There were photographs on display of some of the events and outings that had taken place this year, and a trip to Blackpool lights was being planned. One person had been provided with a new wheelchair and hoped this would enable her to access the homes transport. People told us; The activities are very good, I especially like contact with the young children and enjoyed the community project with Ullswater college. I enjoy the activities, they are very important to me, I love going out. The activities orgainser is really good. People told us they were satisfied with the meals provided, saying there was always a choice and any special dietary needs were catered for. The menus showed a choice of two starters, two main courses and two desserts were offered for lunch every day. Staff said there was no problem if people changed their minds and did not want what they had ordered, as there was always enough food to accommodate this. We saw lunch being served in the three dining areas and saw that staff were on hand to give assistance as needed. One person told us the quality of the food had gone down, but other people said the quality was very good, and everyone enjoyed their lunch on the day. We received the following comments in our surveys; Meals are very good The cooks are marvelous and really look after me. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People knew how to raise concerns and complaints and told us staff would listen to them and address any worries quickly. People told us they felt safe living in this care home. Evidence: The home had a complaints procedure that was prominently displayed, along with complaint forms. People told us they knew how to complain and would speak to the manager if there was a problem. We looked at complaint records and the manager had received three complaints since the last inspection a year ago. One of these was a copy of a complaint to an outside agency who had provided optical services to a person in the home and did not require any action from the manager. One care related complaint had been appropriately responded to and the matter rectified. The third complaint was about building work blocking the view and the person concerned was offered another bedroom. We found the records of complaints within the service were much improved. Previously some complaints had been dealt with by head office and the manager had no copies of the outcome for her own information. Two staff had completed a council run course in safeguarding adults last year, and further in-house training for staff was anticipated. We saw that there were suitable written procedures in place to guide staff on what to do in the event of any allegation being made. Some senior staff were not sure about the safeguarding referral process Care Homes for Older People Page 17 of 27 Evidence: and said they would have to take advice from senior management. It is recommended that staff receive some training on this. Care staff told us they were aware of the whistle blowing procedure and would use this to report anything that concerned them. The staff surveys told us; The service does a great deal to ensure people feel safe and secure and cared for in a happy atmosphere. I was not allowed to start work until all my checks were done. People we spoke with said they felt safe and protected in the care home, and thought that if they had any complaint, this would be listened to and acted on. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable, clean, well designed and spacious home that met their physical needs. Evidence: Cold Springs Park is a purpose built care home with all accommodation situated on one level. A recent extension has provided a separate 22 bed dementia care unit called Spring Lakes. All 60 bedrooms are single with en suite hand basins and toilet. All 22 rooms in the dementia unit also have en suite showers. We saw that the majority of bedrooms had been personalised and made individual by the people using them. There was plenty of communal space throughout the home, consisting of large lounges, dining rooms and smaller seating areas. The manager told us there were plans to refurbish one of the lounges. There was access to outside courtyards and gardens. Spring Lakes had an enclosed courtyard, where people could enjoy being outside safely. There were plans to provide additional signage and pictures in Spring Lakes to help people find their way round, and to provide a range of textured items for people with dementia to touch and feel. The original care home had five bathrooms, and since the last inspection two of these had been upgraded with new assisted baths and a new wet room shower facility had been provided. Spring Lakes had its own assisted bathroom. There were spacious toilets situated near the lounges. Care Homes for Older People Page 19 of 27 Evidence: The home was well equipped with hoists and other aids to help people with mobility problems. There was also adapted cutlery and crockery available. Specialist beds and mattresses were obtained via the community nurses as needed, and some people had their own equipment. There were handrails in the corridors and all accommodation was on one level. The laundry was situated in the basement and had been extended to cope with the increased number of people. The laundry is well laid out using a one way system so that dirty laundry comes in through one door, moves through the system, and clean laundry leaves by another door. This laundry is also used by another BUPA care home in the town, and each service has separate time slots and different staff to manage their laundry. The additional space provided had extended the ironing area and created space for a new named box system for peoples clothes to be sorted into for returning to their bedrooms. One person told us they had often lost laundry despite it being named, we felt the new box system would help with this. We saw that the home was clean and fresh smelling throughout, and many people said it was always like this. We received two surveys that said the home needed better cleaning and it sometimes smelt. Sixteen staff had done infection control training, and we saw staff using aprons and gloves and handling soiled linen and clinical waste properly to reduce risks from infection. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported and cared for by competent and caring staff, and sound recruitment practices mean staff have been thoroughly checked before being allowed to work with people. Evidence: Staffing arrangements in the home were good and people said their care needs were met, even if they sometimes had to wait for attention. The two units were separately staffed, with five staff in the general unit and three or four in the dementia unit during the day. Each unit had two staff at night. The dementia unit was currently overstaffed because new staff were being inducted and the unit was not at full occupancy yet. The majority of surveys we received, told us people received good attention from staff, although one said the home was short of staff and this caused people to have to wait. During the day we observed that people were attended to promptly and staff were available to spend a little time chatting with people as they went about their work. The home employed a number of ancillary staff including domestic, catering, activity, administrative and maintenance staff. The registered manager and the dementia unit manager were not counted in the care staff numbers, but were available to assist if necessary. Care Homes for Older People Page 21 of 27 Evidence: The service provided a good level of staff training starting with an induction for new staff, followed by ongoing mandatory and optional training. The manager told us that 63 of care staff held a National Vocational Qualification in care at level 2 or above, with a further 27 working towards this, which is very good. Recent training had included safe moving and handling, dementia care, food safety, infection control, fire safety and activities. Training records were held in individual staff files and the manager had a training matrix for the current year in her office. It was quite difficult to for the manager to check, and to evidence to us, who had attended what training and when, and to know when updates were due. It is recommended that the system to manage this be reviewed. Staff told us; You receive a lot of good training, which means you can give good standards to each client, and I had a very good induction course which gave me the information I needed. The home has sound procedures in place to ensure any new staff recruited are suitable to work with vulnerable people. We checked the files of two newly recruited staff and these confirmed that all necessary checks including criminal records bureau checks and references had been in place before they started work in the home. This serves to protect people from having unsuitable staff employed. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience 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 care home that is well managed and where managers listen to, and act on, their views. Evidence: Cold Springs Park has a registered manager working on site, Lynne Stanely, who has been in post for a number of years. She is now supported by a new unit manager for the Spring Lakes dementia care unit. The service also has a general manager who oversees two BUPA care homes in the town, and there is an area operations manager who visits the service at least monthly. People told us they have periodic residents meetings where they can raise any issues or make suggestions. These meetings are led by the activity organiser who feeds back any comments to the manager without naming the people who commented. This is a good way of enabling people to voice their opinions without fear of comeback. The meetings are held roughly every six weeks and we saw that general minutes of the discussion were kept, and distributed in large print. Care Homes for Older People Page 23 of 27 Evidence: The home had quality assurance processes in place for the manager to check that things were being done correctly and in line with company policy. The manager checked a set number of care plans and medication records each month, to ensure they were correct and up to date. She audited accident records monthly to see if there were any patterns or trends to be addressed. The area operations manager checked all this during her monthly visits and also audited the kitchen and checked on health and safety matters. The home assisted a number of people to manage their spending money, and managed their hairdressing and newspaper accounts. The administrator managed this, with all transactions being authorised through the BUPA finance department. Money was held in a bank account with individual interest being added monthly. The service had an annual business and financial plan in place, which included funding for any planned refurbishment and renewal of equipment. Staff received regular documented supervision and had an annual appraisal. We saw that care practices, performance, and training needs were discussed and recorded during supervision. Staff had received regular training updates in health and safety matters and we saw the fire log, maintenance and service records were up to date. The kitchen had been awarded four stars from the environmental health officer in April 2008, meaning the standards of food safety were very good. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 18 It is recommended that staff receive refresher training on the local multi agency safeguarding referral process, so they will feel more confident if they have to use it. It is recommended that staff training records be organised so that the manager can clearly see who has done what training when, and know when updates are due. 2 30 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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