Inspection on 18/12/08 for Doubleday Lodge LSC

This inspection was carried out on 18th December 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

Doubleday Lodge LSC 08/01/07

Doubleday Lodge LSC 14/02/06

Doubleday Lodge LSC 22/07/05

Doubleday Lodge LSC 03/12/04

Doubleday Lodge LSC 14/07/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Doubleday Lodge LSC Glebe Lane Sittingbourne Kent ME10 4JW     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: Lisbeth Scoones     Date: 1 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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 27 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 27 Information about the care home Name of care home: Address: Doubleday Lodge LSC Glebe Lane Sittingbourne Kent ME10 4JW 01795423444 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jenny.langthorne@kent.gov.uk Kent County Council Name of registered manager (if applicable) Mrs Jennifer Langthorne Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 36. The registered person may provide the following category/ies of service only: Care home only - (PC) 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). Date of last inspection Brief description of the care home Doubleday Lodge is owned and run by Kent County Council. It is an Old Persons Direct Service Unit (OPDSU). It is located on the edge of a large residential estate to the east of Sittingbourne and offers accommodation on two floors for up to 36 older people, all in single rooms. It is close to a bus route and there are small shops within walking distance. There is ample parking to the front and the side. There are two garden areas to the rear of the building. The home has 36 bedrooms, 9 of which are on the ground 0 Over 65 36 care home 36 Care Homes for Older People Page 4 of 27 Brief description of the care home floor and 27 on the first floor, 13 of these have en-suite facilities. Current weekly fees are £379.02. 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 key inspection was carried out on 18th December 2008. It comprised discussions with the senior team leader, other care staff on duty, the cook and her assistant, receptionist, volunteers and conversations with a number of residents and two visiting relatives. An accompanied tour of the premises was carried out, a lunchtime session observed and documentation examined in respect of care plans and risk assessments, staff rota, menus, staff and training files, training matrix, complaints and medication records. The registered manager was not present but feedback was provided after the inspection. The senior team leader and other staff provided assistance in a professional and helpful manner. Key Lines of Regulatory Assessment (KLORA) have informed the judgements made Care Homes for Older People Page 6 of 27 based on records viewed, observations made and written and verbal responses received. KLORA are guidelines that enable The Commission for Social Care Inspection (CSCI) to make an informed decision about each outcome area. The inspection was further informed by an AQAA (annual quality and audit) completed by the manager and by returned comment cards from 10 residents and 7 members of staff. These were completed in great detail for which all are to be commended. Information thus received is incorporated in the report. The registered manager reported in the AQAA that the home had received 4 complaints, which were investigated and resolved. No Safeguarding vulnerable adult referrals were made. The last Key unannounced inspection was carried out on 8th January 2007 and an Annual Service Review on 27th February 2008. All placements are commissioned by social services. What the care home does well: What has improved since the last inspection? What they could do better: The registered manager must ensure that the complaints file evidences the action taken following investigation. The issue of oversubscribed training events should be addressed to ensure that all staff have up to date knowledge. Care Homes for Older People Page 8 of 27 An infection control audit is recommended to ensure that universal precautions may be practised in all communal areas and sluices. Two uncovered radiators should be made safe to protect the residents. The home must ensure that the smoking policy is adhered to. 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. Prospective residents are provided with the information they need to make an informed choice about moving into the home. A written statement of terms and conditions protects residents legal rights to occupancy. Residents benefit from a comprehensive needs assessment prior to moving into the home to ensure these can be met. Evidence: Prior to admission, prospective residents are given a Welcome Pack. The home has recently updated its comprehensive Statement of Purpose and Service User Guide. The update was necessary to reflect the homes move towards admitting residents for short-term care. A pictorial version is being prepared. Occupation at the time of the Care Homes for Older People Page 11 of 27 Evidence: inspection was 4 respite and 10 permanent residents. Two recently admitted residents were spoken with. A sample of permanent and some short-term care residents files was viewed. These contained detailed information about the residents including core assessment or a joint assessment carried out by a care manager and hospital or community nurse. This enables dependency levels to be accurately assessed and ensures that the home can meet the residents needs. Residents and relatives are encouraged to be involved in the development of care plans. A resident spoken with said he was fully aware of the content of his care plan. Residents and families have the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. All files contained written statements of terms and conditions. An admission procedure checklist ensures a smooth admission into the home. The home is sometimes asked to take emergency or urgent admissions. There are guidelines to staff about this and checklists that need to be used to ensure that the home does not admit residents out of category. Several residents said that they regularly return to the home for respite care. Some people have identified their preferred room. Some respite care clients, when they are assessed as needing permanent care are disappointed that they cannot stay at Doubleday Lodge. During the visit two family members confirmed that they had visited the home prior to admission of their relative. The home does not offer intermediate care. 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. Residents health and social care needs are clearly set out in care plans ensuring that their assessed needs will be met. Residents are protected by the homes policies and procedures regarding medication and they can be confident that their privacy and dignity will be considered important and their independence promoted. Evidence: A sample of regularly reviewed care plans was viewed. These contain all the relevant information to ensure that a high level of care is offered. Care plans are informed by a range of risk assessments such as for reducing the risk of developing pressure ulcers, nutrition, falls and moving and handling. Residents (when able) or relatives sign the care plan. Within the care plans there is a record denoting that residents are seen by their GP and other health care professionals such as the district nursing team, optician and chiropodist as required. The senior team leader said that there is a very good working relationship with local community nurses who regularly come into the home. Care Homes for Older People Page 13 of 27 Evidence: The home operates according to sound medication procedures. No errors were found on the recording sheets and the home has a robust system in place when re-ordering medication to ensure that regular supplies were maintained. Residents are encouraged to self medicate following risk assessment. A CD (controlled drug) medication audit was carried out and was satisfactory. Records are in place for the signing of prescribed creams, inhalers and eye drops. The registered manager carries out medication audits. It was noted during the visit that staff spoke with the residents in a respectful and courteous manner. All residents spoken with were very happy with the way they were treated at Doubleday Lodge and commented I am well looked after, all the carers know me and know what I like. I could not wish for anything better. I have felt very comfortable during my stay at Doubleday Lodge. Staff are friendly and helpful making each day enjoyable. I feel my confidence has been built up. I am very happy here. Staff confirmed that they always encourage residents to make as many decisions about their personal lives and choices where possible. Support would be given when choices were difficult to make. All residents have single rooms. Residents preferences as to how they wish to be addressed are recorded in their care plans. The facilities for making phone calls in private are no longer available, but residents may use the phone at reception or in the office. There are facilities for meeting with visitors in private. The home has policies and procedures for the care of the dying and staff training is booked in this important area of care. 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 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 a range of activities that meet their expectations and preferences. They are supported to maintain contact with family/friends and are able to exercise choice giving them control over their lives. Residents receive a wholesome, appealing and balanced diet in pleasant surroundings. Evidence: Since the previous inspection, two volunteers have been recruited who regularly visit the home. They have made a big difference in providing activities and one to one conversations. Both volunteers were in the home at the time of the visit. One was assisting residents in making craft work (seasonal stained glass pictures), the other was chatting to residents. Residents were enjoying the interaction. A volunteer said how much the quizzes and sing-alongs are enjoyed. The home also provides a small shop where items such as toiletries, chocolate and cards may be purchased. Care staff are providing activities in the afternoon. The home is currently not fully occupied and staff are not as busy as they would have been during full occupancy. All residents spoken with stated how much they enjoyed the recent Christmas party Care Homes for Older People Page 15 of 27 Evidence: and the Beach party organised in the summer. I enjoy social evening and like to join in with darts, said a resident. Residents are able to practise their religion. A catholic priest visits weekly, the Salvation Army visits monthly and a lay preacher holds a monthly church service. Relatives said that they were always made welcome when they visited and they could visit their relative in private if they wished. There are no restrictions on visiting times although people were asked to avoid mealtimes if possible. There was information on display about advocacy services, which could be provided to residents and/or their relatives if required. As reported at the previous inspection, the registered manager is fully aware of her responsibilities under the Data protection Act (1998) and there are policies in place regarding access to personal records. Residents may bring personal items into the home if they wish but this had to be agreed with the home prior to admission. Residents are supported to manage their own finances if they wish. See also standard 35. During lunchtime it was observed that staff respond to individuals wishes and preferences. Drinks and snacks are available throughout the day and night. Records are maintained of the foods chosen and eaten. The atmosphere during lunch was pleasant and unhurried with lots of interaction and festive background music. The food is excellent and the quality according to your appetite. We are given a choice. Wonderful meals, were comments made. 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. Residents and their representatives can be confident that their concerns are listened to, taken seriously and responded to. Residents are protected by staff who are aware and well informed of safeguarding adults procedures and by current reporting procedures. However, staff training has been delayed due to over-subscription. The manager said this delay has been reported. Evidence: It is evident that the home encourages residents to raise any issue of concern they may have. The home has a clear complaints procedure with appropriate timescales for resolution of complaints and concerns. The home maintains records of complaints received. Since the last inspection the home has received four complaints. Records of these were viewed. It is recommended that the action taken be recorded as well as evidence that the complainant is satisfied with the outcome. A robust Adult Protection policy in place. Staff spoken with were aware of safeguarding procedures and how to raise an adult protection alert and who they needed to contact. Staff are provided with awareness training of the Mental Capacity Act. The manager ensures that staff continue to be trained in safeguarding of vulnerable adults. Staff wrote on comment cards that due to over-subscription, such training is sometimes Care Homes for Older People Page 17 of 27 Evidence: delayed. The 2008 training matrix had no dates recorded for adult protection training. The registered manager said that this issue has been flagged up. See also standard 30. 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. The environment within the home is mostly satisfactory but there is a need for further redecoration, furniture replacement and refurbishment of some areas. Residents can be confident that they have access to outdoor areas and comfortable communal areas. Th home is clean and hygienic but some infection control issues need to be reviewed. Evidence: Residents benefit from living in a home that is spacious, clean, pleasant, hygienic and well maintained. The general internal environment has much improved since the previous inspection. Many bedrooms have been redecorated, re-carpeted and new curtains provided. The dining room and kitchenette area have been redecorated. Residents have access to a pleasant inner garden with raised flower beds and seating. There is a well-stocked library and several small lounges. Several profile beds were noted. These are specialist beds with an up and down mechanism as well as integral bed rails. The registered manager reported in the AQAA that plans exist for the updating and replacement of existing furniture. Care Homes for Older People Page 19 of 27 Evidence: Since the previous inspection, the ceiling in the bathrooms with the Parker bath has been replaced and the room is back in full use. In addition to this there are other specialist bathrooms available such as a Malibu bath. A Madison bath has been commissioned. There are 13 rooms with an en suite facility and a number of communal toilets. Some of these on the ground floor are in need of refurbishment in respect of old and stained floors and peeling wall paper. Residents spoken with said they were happy with their bedrooms and they felt they met their needs. A resident said, I love it here. It is quiet and private. The furnishings and lighting in the communal rooms are domestic in style and generally the home looked homely. Several residents said how much they liked the library. The home operates a smoking policy for the benefit of all residents and staff. A smoking lounge is provided and smoking is not permitted in any other areas in the home. At this visit it was noted that smoke was drifting into the corridor as the door to the smoking lounge was open. The senior team leader agreed that this was contravening the homes policy and said it would be addressed. The home provides sufficient moving and handling equipment to meet the needs of the residents. The home was clean and tidy on the day of the inspection and free from offensive odours. Several residents said, The cleaners do a good job. It always smells fresh. The home employs 4 domestic staff who take pride in their work and maintain a high standard of cleanliness. The home has two sluice rooms. One of these has no hand wash facilities. It was further noted that two toilets have no hand wash facility. Some bins have missing lids. It was recommended that an infection control audit be carried out and action taken were needed. Staff are trained in infection control and other relevant training such as Control of Substances Hazardous to Health (COSHH). The laundry and kitchen were visited. Both provide a clean and efficient environment. Floor damage was however noted in the kitchen area. This could cause a trip hazard and would compromise effective cleaning. It is recommended that this be replaced. 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. Residents are cared for by sufficient numbers of well-qualified, motivated, competent and supervised staff. Residents are supported and protected by the homes recruitment procedures. Evidence: Rotas are flexible and staffing levels adjusted to meet the needs of the client group and occupancy levels. The previous report recorded that there were not always sufficient numbers of staff on duty. A vacant team leader post has been filled and 4 care workers recruited. As evidenced on the duty rota and the number of staff on duty on the day residents are being cared for by adequate numbers of staff. The senior team leader said that, while planning the rota,and shifts were not covered, permanent or relief staff would provide cover. It is further acknowledged that currently the home is not operating with full occupancy. Volunteers provide many activities leaving the care staff free to provide personal care. Staff records indicated that robust recruitment procedures are in place with all the required documentation completed. New staff are provided with Skills for Care compliant induction training. Care Homes for Older People Page 21 of 27 Evidence: 68 of care staff have achieved NVQ level 2. The registered managers aim is to achieve 100 . All senior staff have completed a twelve-week course in Safe Administration of Medication and Infection Control. Mandatory training is mostly up to date as evidenced on the training matrix and in staff files seen. As already indicated under standard 18, staff confirmed that training was offered but sometimes they cannot get on the course. Applications are returned as courses are oversubscribed. Although courses are then re-applied for, inevitable delays occur. In addition to mandatory training, staff are provided with opportunities for specialist training such as palliative care and Equality and Diversity. In view of the fact that some residents have dementia, it is recommended that staff are provided with dementia care training. This was discussed with the registered manager. 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. The residents benefit from having a competent manager who is supported well by senior staff. Clear leadership is provided throughout the home and staff demonstrate an awareness of their roles and responsibilities. The home is run in the best interests of the residents. Sound financial procedures protect residents. Residents and staff health, safety and welfare are protected. Evidence: The home is managed by the registered manager who has 30 years experience in the care of the elderly and has been the registered manager for 10 years. She has a level 4 NVQ qualification in care and the RMA (Registered Managers Award). She is supported by a senior and other team leaders. There are clear lines of accountability within and external to the home. Care Homes for Older People Page 23 of 27 Evidence: Policies and procedures are regularly reviewed and the AQAA demonstrated that the registered manager has a good knowledge of up to date legislation and good practice. She has access to the Internet within the home and uses this for maintaining knowledge about specific areas of care. On comment cards staff said that they feel well supported by the manager. Residents spoken with were very complimentary about the registered manager and senior staff. Management are always very good and helpful, said a resident. It was evident that regular client meeting were held and that action was taken as a result of these meetings. Since the previous inspection, systems for evaluating the quality of the service have been put in place. Annual surveys are carried out providing permanent residents with a formal opportunity to express their opinion on how the home is run. Exit questionnaires are given to short term care residents. Regulation 26 visits are carried out. The management of residents finances was discussed with the administrator and a sound system is in place. The previous inspection reported that, following the completion of risk assessments, eight radiators required guarding to make them safe. Whilst it was said that the work has been completed, at this inspection it was noted that two radiators, one in a corridor and one is a small lounge, were uncovered and hot. This was discussed with the senior team leader who said that this would be acted upon. The registered manager confirmed that action had been taken. The home has robust systems in place to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. The AQAA evidenced that services and equipment are regularly checked and maintained within appropriate time scales. In relation to mandatory training, see standard 30. 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 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 © (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 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. 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!