Inspection on 16/02/09 for Cubbington Mill

This inspection was carried out on 16th February 2009.

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

Cubbington Mill 12/07/07

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Cubbington Mill Church Lane Cubbington Leamington Spa Warwickshire CV32 7JT     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: Michelle McCarthy     Date: 1 6 0 2 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Cubbington Mill Church Lane Cubbington Leamington Spa Warwickshire CV32 7JT 01926430351 01926420854 cubbingtonmill@barchester.netor.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Barchester Healthcare Homes Ltd care home 56 Number of places (if applicable): Under 65 Over 65 56 0 old age, not falling within any other category physical disability Additional conditions: 0 10 The maximum number of service users who can be accommodated is: 56 The registered person may provide the following category of service only: Care Home with Nursing (Code N); To service users 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 (OP) 56 Physical disability (PD) 10 Date of last inspection Brief description of the care home Cubbington Mill Care Home is a purpose built home situated in the village of Cubbington, a few miles from Leamington Spa with all its amenities, a variety of shops, pubs and places of worship. The home is registered to provide accommodation and care for older people who may require nursing care and can accomodate up to 10 people with a physical disability. The homes decor, furniture and furnishings are of a high standard. The accommodation is provided on two floors with access to these via a passenger lift or Care Homes for Older People Page 4 of 28 Brief description of the care home stairs. The majority of the accommodation is single room with en suite facilities. Four shared rooms are provided for couples or people who choose share. These rooms are also available to let to residents who express a preference for a larger room in which case these rooms are let as single rooms. The gardens are mature and well maintained and accessible to all of the current residents. There is a vehicle at the home to transport the residents on trips and for appointments. Information about the home is given to prospective residents and their families in the Statement of Purpose and other information brochures. Written information about the cost of living in the home was not available on the day of our visit. 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: Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past and how it has improved. We looked at the Annual Quality Assurance Audit (AQAA) which the manager completed and returned to us before our visit. This is the managers review of the service and gives us information about how the service has progressed in the last 12 months. Care Homes for Older People Page 6 of 28 We visited the home on Monday 16th February 2009 between 11am and 5.30pm. We did not tell the home we were coming on that day. There were 49 people were living in the home during our visit. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We talked to people who use the service and observed their interaction with staff. We looked at the environment and facilities provided and checked records such as care plans and risk assessments. We sent questionnaires to people who use the service. Their comments are included in this report. We talked to the manager, a senior nurse and two care staff. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view some of the people who use them. We track peoples care to see whether the service meets their individual needs. We chatted informally with about half of the people living in the home and two of their relatives. At the end of the visit we discussed our preliminary findings with the home manager. What the care home does well: What has improved since the last inspection? The service has complied with the requirements we made at our last inspection, which has improved outcomes for people using the service. The pre-admission assessment process has improved so who people who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. Care plans are developed for each of the identified needs of people living in the home and contain details of the actions required to meet each need. This should make sure that people get the care they need. Systems are in place to identify any risk to the health or well being of people living in Care Homes for Older People Page 8 of 28 the home so that staff can take action to minimise any risk. This should promote the health and well being of people using the service. Systems for the management of medicines have improved which should minimise the risk of harm from medication errors. Systems have been developed to make sure equipment and essential services are checked to make sure they are safe. This should promote the safety of people in the home. Arrangements are in place to ensure the safety of essential services and equipment in the home. This should promote the safety of people in the home. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. Evidence: We looked at the case files of three people to assess the pre admission assessment process. The manager said that it was usual practice for a senior member of staff to visit people who are considering moving into the home to undertake an assessment of their needs and abilities. All three files contained a pre admission assessment of each persons needs and abilities. For example, staff identified that a person had a high risk of developing pressure sores and required a specialist, pressure relieving mattress. We saw this in Care Homes for Older People Page 11 of 28 Evidence: use for the person and their file contained a care plan to minimise the risks of pressure sores. This means that sufficient information was available so that the home could confirm they could meet each persons needs and develop care plans. Peoples comments about choosing the home included, The information given to me before I moved in was accurate and has kept its word. I visited the home before my relative was placed there. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are treated respectfully and are protected from harm by the safe management of medicines. Care plans are available for each of the identified needs of residents and staff recognise and respond to changes in the health and well being of people living in the home. This means that people living in the home can be confident their health and personal care needs will be met. Evidence: We looked at the care files for three people identified for case tracking. Care plans and daily records were available for each person. Care plans contained information to tell staff what they need to do to meet peoples needs. This should mean people get the care they need. For example, one person with complex needs had several pressure sores. Individual care plans were available to give Care Homes for Older People Page 13 of 28 Evidence: staff instructions about the treatment for each wound. There was evidence of a referral to the tissue viability nurse specialist. Wound mapping and evaluation records were included in the persons care file, but were not consistently completed. These should be completed so staff can monitor the progress of wound healing. We spoke to three staff. They were familiar with residents needs and abilities, and knew what care they needed. Peoples comments about the care they receive included, The doctor always comes when requested by nursing staff and treatment is administered appropriately. Some of the nursing staff are very reliable but I cant always be sure that actions are taken. For example, blood tests were forgotten to be done prior to a hospital appointment. The named nurse is very reliable, sympathetic and caring, both for physical, emotional and spiritual needs (if shes available on shift). We looked at the systems for managing medicines for people living on the first floor of the home. Documentation included a number of risk assessment tools to identify whether people were at risk of falls, poor nutrition and developing pressure sores. This should mean that risks to the health and well being of residents are identified so that staff can take appropriate action to minimise the risk. Peoples records show they are supported to access other health and social care professionals such as GP, optician, district nurses and the community mental health team. One person told us, The doctor always comes when requested by nursing staff and treatment is administered appropriately. This should mean that peoples healthcare needs are met. For example, staff referred one person to the Macmillan nurse to make sure effective pain relief was provided. We saw evidence of pain assessment charts which demonstrate that staff monitor the effectiveness of any treatment. People have their weight monitored and recorded regularly. The records of two people documented they were sustaining their weight. Care Homes for Older People Page 14 of 28 Evidence: We looked at the systems for managing medicines for people living on the first floor of the home. A monitored dosage (blister packed) system is used. Medication was safely stored in a locked trolley, which is kept in a locked clinical room. A medicine fridge was available with daily recordings of the temperature, which was within recommended limits. Daily room temperature recordings show that medicines are stored within recommended limits to maintain their stability. The facility for storing controlled drugs (CD) was satisfactory and complies with legislation. The contents of the controlled drug cabinets were audited against the controlled drug registers and the quantities were correct. We audited the medicines of two people involved in case tracking by comparing the quantity in stock against the signatures on the medicine administration records (MAR). The audits indicated that the medicines had been administered correctly. People living in the home were observed to be treated with respect. For example, personal care was provided in private and residents were spoken to respectfully. During observation of working practice it was evident that staff are knowledgeable about the likes and dislikes of people living in the home and were kind, caring and attentive towards them. One person told us, I feel that I have never in my life previously been so well looked after in every way. It makes me even lazier than I usually am! People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are supported to maintain their independence and enduring interests which enhances their quality of life. Residents benefit from a varied and nutritious diet and enjoy their meals as a social occasion. Evidence: The home employs an activities co-ordinator for 30 hours each week to provide a planned activity programme throughout the week The life histories of residents were seen in care files and gave staff information about peoples background, enduring interests and relationships. This should enable the activity co-ordinator to plan a programme that reflects the interests of the people living in the home. There is a regular activity programme available, which is changed and displayed weekly. People told us, Theres always something going on that you can join in with if you want. More expeditions would be welcome Care Homes for Older People Page 16 of 28 Evidence: It would be nice if staff took residents out into the suberb garden in fine weather Some residents cant take part in some activities because of their disabilities. All enjoy music, exercise and singing, especially visiting performers The home supports the people living there to have visitors at any time. We spoke with two relatives who told us they were always made to feel welcome. We observed the midday meal when residents attended the restaurant-like surroundings of the dining room. Some people were joined by their relatives and some residents chose to remain in the communal lounges or their own room. Tables were beautifully set with linen table cloths, flowers and condiments. Residents are told on a daily basis what is the choice of the day and their orders taken. Alternatives are also available if residents do not like the choice of the day. The choice of meal was beefsteak and mushroom pie or stir fried duck with noodles, green beans, carrots and creamed potatoes, followed by apple and date pancakes with cream. People were given discreet, sensitive assistance to eat their meals. There was a calm ambience at lunchtime and a feeling that the midday meal was an enjoyable, social occasion. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Evidence: The home has a formal complaints policy which is accessible to people living in the home and their families. People told us, Id leave it to my relative to find the appropriate staff to make a complaint to. Ive never found a problem that the home did not take care of. Anything that has been wanted, if discussed with the qualified nurse, is acted upon to my satisfaction. Information in the AQAA tells us the service has received eleven complaints in the last 12 months concerning care practices. We looked at the record of complaints and concerns maintained in the home documenting the action taken by the home regarding each issue raised. Evidence was available to confirm that concerns raised verbally are Care Homes for Older People Page 18 of 28 Evidence: taken as seriously as more formal, written complaints. The manager and provider makes a timely and objective response to concerns raised and the outcome is recorded. The home has an adult protection policy to give staff direction in how to respond to suspicion, allegations or incidences of abuse. Staff have received abuse awareness training and the manager is aware of her role and responsibilities in safeguarding residents. The manager has made appropriate referrals to social services in response to allegations or suspicion of abuse and has worked co-operatively with other agencies during investigations. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are provided with clean, attractive, well furnished and comfortable surroundings to live in and enjoy. Evidence: Cubbington Mill provides accommodation in mostly single rooms with ensuite facilities on the ground and first floor. The home is well presented with a good standard of decoration throughout. The home was clean and free from unpleasant odours. There are several communal lounges over the two floors and several other smaller seating areas. The ground floor lounge has been extended since the last inspection by the removal of the wall between the existing lounge and the adjacent quiet room. Residents and their relatives were seen making use of all the space available. The homes dedicated dining room, located on the ground floor, has a restaurant feel to it. We looked at the bedrooms of the people involved in case tracking. All rooms were furnished and decorated to a satisfactory standard although some have benefited from refurbishment. Electric or hydraulic variable height nursing beds were available appropriate to the needs for the people accommodating the room. Various types of Care Homes for Older People Page 20 of 28 Evidence: pressure relieving mattresses were observed in use. Most people had taken the opportunity to personalise their rooms with photographs or small items of soft furnishings. All rooms were clean and fresh. People told us, Great care is taken and discipline applied to ensure building and facility cleanliness and also residents personal clothing cleanliness. All rooms are fresh and aired The space in rooms is fairly limited Very hygienic and extremely well run cleanliness. Room needs decorating. The ceiling lampshade is broken. Bedside table needs to be a lot bigger to accomodate necessities such as a water jug and tissues etc. The home employs maintenance and gardening personnel. The home is well maintained, and the gardens are well kept and provide good additional outside space for residents to use. The homes large car park has been block paved since our last inspection. Systems are in place to manage the control of infection. Staff wore protective clothing when attending to peoples personal hygiene and dealing with soiled laundry. There are sufficient hand washing facilities for staff. The home has a modern, well-organised laundry room with dedicated laundry staff. All the residents seen on the day of our visit wore well laundered and pressed clothes. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient competent staff on duty to meet the needs of people living in the home. Residents are safeguarded by robust recruitment procedures. Evidence: The manager told us there are: 2 registered nurses and 10 care staff on duty between 7.30am and 2pm 2 registered nurses and 6 care staff on duty between 2pm and 8pm 2 registered nurses and 3 care staff on duty between 8pm and 7.30am It was evident from the appearance of people living in the home and information recorded in their care files that there are sufficient staff on duty to meet the health and personal care needs of people living in the home. People told us, Its not easy to get staff to attend to me at night, it depends if the bell is nearby Care Homes for Older People Page 22 of 28 Evidence: All levels of staff are of the highest quality - competent and effective Staffing can be a bit light overnight but adequate arrangements seem to be made for emergencies Sometimes staff problems do put pressure on those in attendance. This extends the time waiting for support but does not mean it doesnt come. The staff complement has recently been reviewed and a new 5pm till 10pm shift has been implemented so a further 2 care staff will be on duty during this period to support people to have their evening meal and retire to bed. The manager is supernumerary and there are sufficient laundry, catering, cleaning, maintenance and administrative staff to ensure that care staff do not spend undue lengths of time undertaking non-caring tasks. Information in the AQAA tells us that 55 of care staff have a National Vocational Qualification in Care at level 2 or above. This means that people can be confident they are cared for by competent staff. We looked at the personnel files of three recently recruited staff. Each file contained evidence that satisfactory pre-employment checks such as Criminal Record Bureau (CRB), Protection of Vulnerable Adult (PoVA), and references were obtained before staff started working in the home. These robust recruitment procedures should safeguard people living in the home. Staff training records demonstrate that staff complete an induction programme and receive mandatory training in health and safety, customer care, infection control, fire safety, manual handling, abuse awareness and food safety. Records showed that some staff require training or updates in mandatory training but the manager maintains an electronic monitoring system which identifies these staff, so that training can be arranged. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is competently managed and is run in the best interests of residents. People can be confident their health and safety are promoted. Evidence: The manager has been in post for 3 years and is registered with us. She is registered general nurse and has the Registered Managers Award (NVQ Level 4). Information in the AQAA tells us that monthly audits are carried out to measure how the home performs against the National Minimum Standards. We looked at the homes quality assurance file which demonstrates that action plans are developed to make improvements where they are identified as needed. The service has complied with all the requirements we made at the last inspection. People told us, Care Homes for Older People Page 24 of 28 Evidence: This is a well run establishment in my opinion. Staff deal with residents with kindness, care and competence. There are arranged meetings for residents and their relatives to meet with the manager and staff to discuss all aspects of care. This obviously keeps everyone aware of any problems and put them right. The service does not hold residents personal monies or valuables for safe keeping so standard 35 is not applicable and was not assessed. Service users are invoiced for additional costs such as hairdressing or chiropody. Information in the AQAA completed by the manager tells us there are effective systems for maintaining equipment and services to the home to promote the safety of people in the home. We sampled service and maintenance records, which we found to be up to date. For example, a certificate was available to confirm the fixed electrical installation in the home was satisfactory, certificates were available to confirm that hoists are serviced six monthly, labels on portable electrical appliances indicated they were checked in May 2008 and records document that fire alarms are tested weekly. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 Wound mapping and evaluation records should be completed so staff can monitor the progress of peoples wound healing. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. 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