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Inspection on 11/03/09 for Eden Court Nursing Home

Also see our care home review for Eden Court Nursing Home for more information

This inspection was carried out on 11th March 2009.

CSCI found this care home to be providing an Adequate 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This report refers to an inspection, part of which included an unannounced visit, on the 11th March 2009, commencing at 9 am, and the length of the inspection was 8.25 hours. There were 44 people living at the home on the day of the visit. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment document. This he did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. To enable people who use the service to comment on the care it provides, we sent surveys to ten people living at the home, nine of which were returned, ten to staff, one was returned, and five to local doctors and health care workers (social workers, community nurses), two were returned at the time of writing this report. The comments in the surveys were positive about the standard of care provided by the staff at the home. We would like to thank all people who gave feedback about the home, and would like to thank the manager and staff for their co-operation throughout the inspection process.

What has improved since the last inspection?

The management and recording of medication has improved and medication is not kept safely within the home. Where risks have been identified, there was evidence of risk assessments and regular reviews.

What the care home could do better:

The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This report refers to an inspection, part of which included an unannounced visit, on the 11th March 2009, commencing at 9 am, and the length of the inspection was 8.25 hours. There were 44 people living at the home on the day of the visit. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment document. This he did, and the document provided the Commission forSocial Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. To enable people who use the service to comment on the care it provides, we sent surveys to ten people living at the home, nine of which were returned, ten to staff, one was returned, and five to local doctors and health care workers (social workers, community nurses), two were returned at the time of writing this report. The comments in the surveys were positive about the standard of care provided by the staff at the home. We would like to thank all people who gave feedback about the home, and would like to thank the manager and staff for their co-operation throughout the inspection process.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Eden Court Nursing Home Ghyllroyd Drive Birkenshaw Bradford West Yorkshire BD11 2ES     The quality rating for this care home is:   one star adequate 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: Karen Summers     Date: 1 1 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Eden Court Nursing Home Ghyllroyd Drive Birkenshaw Bradford West Yorkshire BD11 2ES 01274652002 01274689054 eden.court@craegmoor.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Speciality Care (UK Lease Homes) Limited Name of registered manager (if applicable) Mr David Philip Alderson 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 physical disability Additional conditions: The maximum number of service users who can be accommodated is: 45 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, Code OP, maximum number of places 45. Physical disability, Code PD, maximum number of places 45. Date of last inspection Brief description of the care home Eden Court provides care, nursing and accommodation for up to forty-five people. The home is purpose built. It has thirty-seven single rooms, four double rooms and ten of these bedrooms have en-suite facilities. There is a large lounge, one quiet lounge, a Care Homes for Older People Page 4 of 28 care home 45 Over 65 45 0 0 45 Brief description of the care home small smoking lounge and a quiet sitting area on the upstairs landing. There is a large garden at the home, where residents are able to sit in the better weather. The home is situated within close proximity of the A58 Leeds Road, with access to public transport links and local shops. Ample car parking is available at the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This report refers to an inspection, part of which included an unannounced visit, on the 11th March 2009, commencing at 9 am, and the length of the inspection was 8.25 hours. There were 44 people living at the home on the day of the visit. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality Care Homes for Older People Page 6 of 28 assessment document. This he did, and the document provided the Commission for Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. To enable people who use the service to comment on the care it provides, we sent surveys to ten people living at the home, nine of which were returned, ten to staff, one was returned, and five to local doctors and health care workers (social workers, community nurses), two were returned at the time of writing this report. The comments in the surveys were positive about the standard of care provided by the staff at the home. We would like to thank all people who gave feedback about the home, and would like to thank the manager and staff for their co-operation throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: The quality rating for this service is one star. This means the people who use this service experience adequate quality outcomes. This report refers to an inspection, part of which included an unannounced visit, on the 11th March 2009, commencing at 9 am, and the length of the inspection was 8.25 hours. There were 44 people living at the home on the day of the visit. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment document. This he did, and the document provided the Commission for Care Homes for Older People Page 8 of 28 Social Care Inspection (CSCI) with a lot of information about the way the home is run, and what they hope to achieve in the future. To enable people who use the service to comment on the care it provides, we sent surveys to ten people living at the home, nine of which were returned, ten to staff, one was returned, and five to local doctors and health care workers (social workers, community nurses), two were returned at the time of writing this report. The comments in the surveys were positive about the standard of care provided by the staff at the home. We would like to thank all people who gave feedback about the home, and would like to thank the manager and staff for their co-operation throughout the inspection process. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assessed prior to them moving into the home to ensure that their needs can be met, and are able to visit the home to establish whether or not it is the right place for them. Evidence: The information received from the home prior to inspection said that they encourage prospective people who use the service and their families, to visit the home and spend some time there speaking to visitors and people who live there, to gain an insight of how they view the service. The manager also said that when people do visit, a member of staff is allocated to the visitor to ensure that someone is on hand to answer any questions that they may have. The records of three people were looked at, all of which contained a pre admission assessment carried out by the home, and the funding local authority. There was also Care Homes for Older People Page 11 of 28 Evidence: information to suggest that after six weeks, a review of the care is carried out to ensure it is still relevant. People living in the home confirmed that they had received enough information about the home before they moved in so they could decide if it was the right place for them. 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. Peoples care plans outline the level of support and care each person requires in ensuring their health and welfare needs will be met. The recording and administration of medication is satisfactory. People are treated with respect. Evidence: Three peoples care plans were seen, and there was evidence to suggest that people receive personal and healthcare support in a person centered way, and that their social, cultural, religious needs, and likes and dislikes were recorded. There was also information in the care records of involvement from peoples doctors, social workers, opticians and other health care professionals where needed, and people confirmed that they received the medical support that they need. We discussed with the manager at the time, that where movement and handling slings are needed for individuals, then the size of sling to be used should be recorded. People should also have their own sling to reduce the risk of cross infection. Care Homes for Older People Page 13 of 28 Evidence: Care reviews had taken place, and the care plans had been updated monthly or as the needs of the person changed, and this was with the involvement of the person or their relative. Three out of nine people who use the service said that they receive the care and support they need, and six people said that they usually did. Everyone said that staff listen and act on what they say, and were available when they need them. One person said that the staff are, Generally very good. In relation to staff respecting individuals privacy and dignity, comments from health care professionals (doctors, pharmacist, social workers etc.) include, I very much can support that those essential qualities have been thoroughly met. And the same person replied to the question, Does the care service support individuals to live the life they choose Yes, with a multidisciplinary team approach noted at all times. On the day of the visit, samples of three peoples medication were checked, and the storage, administration and recording of the medication were done correctly. Evidence was seen to suggest that nursing staff carry out monthly checks on the medication to ensure that there are no discrepancies and safe practices are maintained. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was no recorded evidence to suggest that people living at the home are offered a range of activities, or that their social needs are been met. Meals provided are good, varied and served in a pleasant environment. Evidence: The home employs a person who is responsible for activities and also some care duties within this role, and who works between 8.15am and 2.45pm five days a week. She has also begun a distance-learning course which when completed, will result in her achieving a certificate in activities. The information provided by the manager prior to inspection states, The home has an activity programme that is well planned, appropriate and delivered in such a way as to ensure maximum uptake. We publish information of activities so families and relatives can attend where possible. A sample of care records were inspected, and the activities that people have taken part in had not been recorded. Also the lists of activities that are usually displayed about the home, including in the entrance, were not on display. The activities person said that she did not always have time to record the activities that have taken place, and she also said that there had been problems with the photocopying machine, and Care Homes for Older People Page 15 of 28 Evidence: that is why the activities had not been displayed. We discussed with the manager that the activities that individuals take part in should be recorded and also their enjoyment of the activity, as this will show evidence that people are having their social needs met. A programme of activities should also be displayed to ensure that people know what activities are taking place that day. The activities person said that the activities start around 10am in one of the lounges, and includes, bingo, ball games, reminiscence, baking, arts and crafts etc. A visitor said that she had been around when entertainers were visiting, and believed that they visited at least once a month. People were asked in the surveys, Are there activities arranged by the home that you can take part in? Six people said that there were always activities that they could take part in. One person said that there usually were, one person said, Sometimes and made the comment, I am registered blind so have difficulty with some activities. Whilst another person said, Not always, but I dont want to join in anyway. The menus offered a variety of food, and the food preferences and diets of people were also taken into consideration. People said that they were asked their choice of food, and that the meals were very nice. One person said that the meals were excellent, and that they did not have any complaints. Two people commented in the surveys that the meals were always nice. Two said that they usually were, and five people said that they sometimes were. Relatives who were visiting said that they were always made to feel welcome, and always offered a drink. As a tribute to the standard of food provided the home has received a four star, Good award in association with Kirklees Councils Choice Award, Scores on the doors. The staff have recently attended training regarding Protected meal times, and this was in practice on the day, as the atmosphere in the dining room was relaxed, with minimal interruptions, and staff were available to assist people with their meal in a dignified manner. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that their complaints will be listened to and acted upon. Staff have received suitable training and understand the adult protection policies and procedures, which makes sure that the people they support are safe. Evidence: The home has a complaints procedure and the manager confirmed that a copy of the procedure is made available to people living at the home and their relatives. The procedure was displayed in the entrance of the home for visitors to see should they need to make a complaint, and also available in the Service User Guide. The manager also said that he has an open door policy for relatives and visitors to see him or his deputy, on a daily basis should they have any concerns, and that he tries to visit people in the home each day. One of the people living in the home confirmed this. People said that they knew who to speak to if they were not happy and that they knew how to make a complaint. Compliments received by the home include, Thank you for the excellent care that our mother received during her stay. Good facilities and individual accommodation, excellent. Staff are always willing to talk over any problems. There was evidence in the training records to suggest that staff have had safeguarding Care Homes for Older People Page 17 of 28 Evidence: (adult protection) training, and staff confirmed this at the time of the visit. Staff who were spoken with knew the procedure to follow if they suspected abuse of a person. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home offers people a homely, comfortable and clean environment. Evidence: As part of the inspection a tour of the home took place, which included the communal areas, a number of bedrooms and the laundry. The atmosphere on the day of the visit was warm and friendly and people looked comfortable whilst sitting in various parts of the home. Since the last inspection the home has had a conservatory fitted, new flooring laid in this room and the main lounge, and have purchased a tropical fish tank. In addition to this, ongoing refurbishment continues to take place. The manager also said that the company are looking to renew the floor covering in the down stairs corridors in the near future. The chairs in the smoke room were dirty and worn, and the carpet was not complete in one area of the room. The wall covering in part of the room was also worn/ dirty. At the time of the visit a new carpet was ordered, and the other issues identified, were addressed. Out of the nine people who completed the surveys, seven said that the home is always Care Homes for Older People Page 19 of 28 Evidence: fresh and clean. One person said, Usually and one person said, Mostly fresh and clean. Within the dining room the wood sideboard cupboard was also damaged and could not be cleaned properly. The manager said that the furniture was to be replaced. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient numbers of staff to meet peoples needs. Staff receive training to assist them to carry out their responsibilities and they have had all the necessary checks before working with people so they are kept safe. Evidence: There were forty-four people in residence, and the duty rota confirmed that there were sufficient staff on duty to care for the number of people living at the home, and the manager also confirmed this. When asked if the care staff have the right skills and experience to look after people properly, health care professionals said that they did, and one person made the comment, Yes, witnessed the present professional and skilled acumen of staff present at various levels. They also said that staff respond to the different needs of individuals in relation to race, ethnicity, age, disability, gender, and faith. People receiving care said that staff were available when they needed them. Care practice observed during this visit, and the relationship between staff and people being cared for was positive. Samples of recruitment records were inspected and the correct information and checks had been carried out. There was also evidence in the staff records and staff confirmed Care Homes for Older People Page 21 of 28 Evidence: that they had induction training. Information provided by the agency indicates that more than 50 of care staff have an NVQ level 2 or 3 qualification. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is of good character, and is competent to run the home, and the home is run in the best interest of people living there. Without staff being kept up to date in movement and handling practices, and fire, people and staff could be potentially put at risk. Evidence: The manager is a nurse and has a number of years experience. He is also working toward the Registered Managers Award. Staff and people living at the home spoke positively about the approach of the manager and how he is available should they need to speak with him. The home has a quality monitoring system in place that seeks the views of people who use the service and their relatives. There are Your Voice meeting held for people who use the service and their relatives, and staff meetings held regularly. A sample of Care Homes for Older People Page 23 of 28 Evidence: minutes from the Your Voice meetings were seen and included topics relating to activities and entertainment, gardening, staffing and food etc. In addition to this people are encouraged to write comments in a Food Comment book that is located in the dining room, and this is to enable the cook to improve on the meals provided and therefore customer satisfaction. Discussion was held with the manager of the need for staff to have supervision a minimum of six times a year to ensure that they are competent to do their job. The manager said that he would ensure that regular supervision takes place for all care staff. Routine health and safety and maintenance are carried out and appropriate records were seen of those looked at. According to the training records and also confirmed by staff that they have not all had movement and handling training annually, and up to date fire lectures. This was discussed with the manager at the time of the inspection, and following the inspection we were notified of dates for all staff to have up to date training in movement and handling, and fire. Care Homes for Older People Page 24 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 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action 1 38 13 All staff to have up to date movement and handling training. To make sure that staff are aware of current practice and therefore reduce the risk of injury to themselves or people in their care. 06/05/2009 2 38 23 All staff to have up to date fire lectures. To make sure that staff know the procedure to follow in the event of a fire. 27/04/2009 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 7 There should be a record of each persons size of movement and handling sling to ensure that the correct one used. People should also have their own sling to reduce the risk of cross infection. The activities that individuals take part in should be recorded and also their enjoyment of the activity, as this will show evidence that people are having their social needs Page 26 of 28 2 12 Care Homes for Older People met. A programme of activities should also be displayed to ensure that people know what activities are taking place that day. 3 36 Ensure that all care staff has formal supervision to discuss their work at least 6 times a year, to make sure they are working to their full potential. To ensure that staff are up to date with fire procedures it its good practice for them to have regular fire lectures and drills, a minimum of twice per year. 4 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!