Inspection on 16/02/09 for Elmside

This inspection was carried out on 16th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Elmside 24/04/07

Elmside 31/10/05

Elmside 12/04/05

Elmside 05/11/04

Elmside 09/07/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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: Elmside Elmside Walk Hitchin Hertfordshire SG5 1HB     The quality rating for this care home is:   three star excellent 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: Jeffrey Orange     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 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: Elmside Elmside Walk Hitchin Hertfordshire SG5 1HB 01462451737 01462454298 home.hit@mha.org.uk 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) : Methodist Homes for the Aged care home 66 Number of places (if applicable): Under 65 Over 65 0 66 dementia old age, not falling within any other category Additional conditions: 66 0 The maximum number of service users who can be accommodated is: 66 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home In July 2007 the new, purpose- built Elmside Care Centre was opened on the same site as the previous home of the same name that had been operating since 1985. Elmside is now registered to provide personal care and accommodation for 66 older people. It is owned by MHA Care Group, which is a voluntary organisation. The home is located in a quiet cul-de-sac in the centre of Hitchin, close to town centre shops, churches, the post office and other amenities. The home consists of a two-storey building with parking to the front and an extensive landscaped garden to the rear that includes seating areas, a sensory garden and raised flower beds. All the homes bedrooms are single and ensuite and there are a limited number of larger suites, that include a Care Homes for Older People Page 4 of 27 Brief description of the care home kitchenette/ lounge and separate sleeping area. There are a number of communal areas including a coffee shop, an IT suite, library, activity rooms and hairdressing/therapy rooms. The home has a Service User Guide, which gives contact details for the CSCI, and copies of the latest inspection report are available in the home. Current fees range from £500 to £615 for standard rooms, depending on the assessed level of care required. Care suites are £786 per week.( As at February 2009). These fees include hotel services and personal care but exclude newspapers, hairdressing, chiropody and personal toiletries, which are provided at additional cost. 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: three star excellent 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 last key inspection on this service was completed on 24th April 2007. We also carried out an Annual Service Review in April 2008. We do an annual service review when there has been no key inspection of a service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to or collected by us since the last key inspection or annual service review. This inspection was carried out by one inspector, where this report refers to we it recognises that it is written on behalf of the CSCI. The inspection started early in the morning, which enabled the routine of the home to be observed as people who live in the home were getting ready for the day ahead. During this inspection we spoke to people who live in the home, members of the care, ancillary and administrative staff, together with visiting friends, relatives and health care professionals. We had very useful discussions with the Care Homes for Older People Page 6 of 27 registered manager and were able to look at some key records, including those for staff recruitment, care plans, records for financial transactions made on behalf of people living in the home and medication administration records. We also received a number of surveys from people living in the home, health care professionals, relatives and members of the care staff team. This report also makes use of information provided to us by the home in their Annual Quality Assurance Assessment or AQAA. The AQAA is a self assessment document that assesses the care outcomes for people living in Elmside, it also includes some useful statistical information for example on complaints and staff training. What the care home does well: What has improved since the last inspection? 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 8 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 9 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. People considering Elmside as their home can be confident that they will only be admitted to Elmside after a thorough assessment process has established that their individual needs can be fully and appropriately met. People considering Elmside as their home are provided with a good level of detailed information about fees and facilities and are encouraged to both visit and stay in the home for a trial period in order to help them make a well-informed decision about moving in permanently. Evidence: When people living in the home returned surveys to us, over 90 said that they had a contract setting out the terms and conditions covering their stay at Elmside and 70 said that they had enough information to help them decide if it was the right place for them. When we saw details of the homes Residential Care Agreement we found that it Care Homes for Older People Page 10 of 27 Evidence: contains a full breakdown of fees,what is covered by them and what may be provided at additional charge. This should mean that people living in the home will know exactly how much they will have to pay and what is and is not included in their basic fee. One person told us that they had stayed at the home for a time before moving in permanently; It is very important to be able to come and stay for a week so you can see how things really are, it is no good just coming as a visitor for part of a day In their AQAA the home told us that the first eight weeks after admission are regarded as a trial period; To ensure that the services are fully adequate and satisfactory to all parties and we were also told that short stays prior to admission are encouraged and facilitated. When we looked at assessments of the care needs completed for people being considered for admission to Elmside we found that they were comprehensive and included the information required to ensure that only those people whose care needs can be met in a way that takes full account of their individual circumstances and preferences are admitted into the home. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Elmside can be confident that they will receive effective health and personal care support, that they will be treated with respect and as an individual and that the systems and records for medication are generally of a good standard and protect their health and well-being. Evidence: The care is good, I am amazed at their patience, If I cant live in my own home, I cant think of a better home to be in Staff have readily and sensitively responded to my Fathers increased need of personal care My mother is now very frail, her needs are monitored by the staff who give her excellent care and attention. These comments, from people living in the home or those responsible for them, are quite typical of a very high level of satisfaction at the quality and standard of care experienced in the home. When people responded to our surveys, 100 said that the home always or usually meets their care needs and that they receive the medical support they need. Care Homes for Older People Page 12 of 27 Evidence: When we looked at care plans of people who live in Elmside we found that they were clear, well completed, setting out their individual health care needs and how they were to be met in line with their own preferences and choices. They contained evidence of regular reviews to ensure that where care needs had changed this could be identified and action taken to revise the care plan, to ensure those needs were met. Care plans that we looked at included details of the involvement of a range of health care services with people living in the home and this confirms the findings of the surveys referred to above. Throughout this inspection, whenever we saw staff helping people who live in the home or when we saw or heard them talking to or about them, they always did so with appropriate respect and courtesy. When we looked at medication records and talked to one of the senior care staff responsible for the administration and recording of medication for those people who live in the home and require assistance, we found a generally good standard of medication, records and hygiene. There were no gaps found in those records seen, however there were a few instances where when we checked the total of medication that is only taken as and when it is needed, like some painkillers, these did not always agree with the records. We also noted that the temperature of the medication area sometimes exceeds that recommended for the medication stored there, which could potentially make it less effective. When we checked the way that controlled drugs are recorded and stored, we found that this is done well and in line with guidance. When we saw care plans we found that they contained details of peoples wishes in the vent of their death. We read many compliments from people following the death of their relatives, expressing gratitude for the way their funeral arrangements had been made, including in many cases thanksgiving receptions and services at the home following the funeral. When we spoke to relatives and the homes chaplain, we found that there is an exceptional level of pastoral support offered to those close to and affected by the death of people who lived in Elmside. Care Homes for Older People Page 13 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Elmside can be confident that they will be encouraged and helped to exercise choice and control over their lives, including their daily activities and meals and that they will be able to maintain contact with the community, family and friends. Evidence: When we asked people living in the home about activities, 90 told us that there were always activities arranged by the home for them to take part in, the other 10 said that there usually were. The homes AQAA told us about facilities in the home that enable people living there to make drinks and snacks at any time of day or night and also about the development of what they call; A more natural community with plants, animals and children more evident in the life of the home. We saw that the library in the home includes computer provision to enable people who live in the home to use the web and associated resources. Care Homes for Older People Page 14 of 27 Evidence: We saw the activities programme which includes activities at evenings and weekends and we saw reports in the homes newsletter about some recent trips outside the home including one to the London Eye, where one person who lives in the home recited Wordsworths poem about Westminster Bridge as they reached the top! The activities organiser was not present at the inspection, however several people living in the home paid specific tribute to their dedication and enthusiasm and similar comments were received in several surveys returned from relatives; The entertainments coordinator uses her vast experience to arrange a worthwhile programme of activities, her positive and helpful attitude make them an asset to Elmside. During our visit to Elmside we saw a number of visitors to the home and when we spoke to people living in the home they were able to tell us about visits to community facilities including churches and local parks and they also confirmed that their families and friends are able to visit them freely. The home have recruited a number of volunteer helpers, who make a significant contribution to the life of the home, including helping in the coffee bar and taking some activities, for example we saw one morning crossword session being run by a volunteer. The home has an attractive and convenient shop and coffee bar, which enables people living in the home and those visiting to have drinks or make purchases independently. Because the coffee bar and shop are adjacent to a pleasant seating area, there was seen to be a very positive social atmosphere as people used those facilities. When we observed the mealtime routine in the home, we saw that it was a sociable experience for people who live there. The tables were attractively laid and care staff helped anyone who needed assistance with their meals respectfully and sensitively, making sure the person was not rushed or made to feel hurried over their meal. When we shared a meal with people living in the home, we saw that choices were given for each course. In the morning, when we observed breakfast, we saw that People were coming down from early to late which suggests that mealtimes are reasonably flexible allowing people who live in the home genuine choice as to when and where they eat. When people returned surveys to us, most said they always liked the meals, some said they usually did and only a few said sometimes they did. When we spoke to people who Care Homes for Older People Page 15 of 27 Evidence: live in the home about food, we received a range of assessments from excellent to terrible. We noticed that the chef went round to the tables during lunch, to ask how people had found the meal and food is discussed both at residents meetings and also covered in the homes own quality assurance questionnaire, so that people are able to make their views and opinions known. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in Elmside can be assured that they are able to make a complaint if they wish to do so and that it will be dealt with appropriately without any adverse repercussions for them. They can also be confident that they will be protected from any form of abuse and that were it seen or suspected, action would be taken to address it. Evidence: The homes complaints policy and procedure is included in the material provided to all people living in the home and is also clearly displayed in the home. When we spoke to people living in the home or received survey responses from them or those who are responsible for them, they all agreed that they knew how to make a complaint if they needed to and that they knew who to speak to if they were not happy about something, although most agreed with the person who said; Although I cant think why I should need to complain. The homes AQAA told us that there were 2 complaints in the preceding 12 months, of which 1 was upheld and all were dealt with within 28 days. The home also made 3 referrals under Hertfordshire County Councils Safeguarding Adults process and have both kept the CSCI fully informed in each case and co-operated fully in the process. Care Homes for Older People Page 17 of 27 Evidence: Staff receive regular training about safeguarding and how to recognise and respond to any abuse seen. There are designated independent and anonymous 24 hour telephone lines available for staff and people living in the home to make use of to report any concerns in the home. When we spoke to the homes administrator they were able to confirm that they would take appropriate action to protect the financial interests of any person living in the home if it appeared that they were being deprived of the financial resources to which they were entitled. All of the above should provide those who live in the home and those who are responsible for them with confidence that they are being protected from any form of abuse and that if it were seen or suspected robust and appropriate action would be taken. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and working in Elmside can be assured that the environment is safe, comfortable, clean and well maintained and that it will meet their needs. Evidence: When we asked people who live in the home Is the home fresh and clean? the vast majority answered that it always was. When we walked around the home and with their permission went into the bedrooms of people living in the home, we found that the standard of cleanliness was very high. The home is purpose built and new, having only been opened in July 2007. It is well designed and includes some exceptional facilities such as the coffee bar and shop and has a number of different sized and configured communal areas. There is a library and several lounges, including a hobby room and quiet lounge. The library includes computer facilities available for people living in the home. We were surprised to find that washing was being aired in some communal areas at the start of the inspection. We were told that this is because there is insufficient provision for the safe drying of items of clothing that require drying at reduced temperature to avoid spoiling them. Although we understand that this drying laundry is cleared away before the communal areas are likely to be used, it does detract from Care Homes for Older People Page 19 of 27 Evidence: the appearance of the home at the time. Those bedrooms seen were personalised by the individuals concerned and included pictures, ornaments and photographs reflecting their interests, personal tastes and the things that are important to them. The grounds of the home are well laid out and kept and are understood to be wellused when the weather permits. During our visit we saw the hones maintenance staff actively ensuring the homes environment was in good working order and domestic and laundry staff were able to describe their routines to us. The homes AQAA informs us that the fabric of the building and equipment within it are closely monitored by the maintenance staff and that an estates management team is available for guidance and assistance when required. Inevitably there are some people who moved to the new home from the old one who regret the loss of what was a very distinct and homely building. Most of them spoken to said that they were coming to terms with the new building and that they could see that, in its own way, it is special and has many benefits not available in the old home. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in Elmside can be assured that they are protected by the recruitment policies and procedures followed by the home and that there are sufficient numbers of care staff, with the training, skills and support required to enable them to meet their care needs. Evidence: I would like to place on record that all members of staff could not be bettered with their thoughtfulness and kindness , The staff provide sensitive and reliable care and I am hugely grateful to the manager and the staff for the attention and care my mother receives were only some of the very positive comments made about the staff in Elmside when we asked people about the standard of care either they or those they are responsible for received in the home. When people responded to our surveys, they said overwhelmingly that they always received the care they need and that equally they told us that the staff are usually available when they need them. When we asked staff, they also told us that there are usually enough staff to meet the individual needs of all the people who use the service. Care Homes for Older People Page 21 of 27 Evidence: When we spoke to care staff, they told us that they felt well supported by the training and supervision that they receive and when we looked at staff training and supervision schedules, we saw that this was confirmed. This means that people living in the home benefit from receiving care from a well trained and supported care staff team. When we looked at staff recruitment files we found that all the checks required to protect people who live in the home from the recruitment of unsuitable care staff were in place and that recruitment policies and procedures were followed robustly. In their AQAA the home told us that when people currently studying at level two for the national vocational qualification in care are successful, over 70 of all care staff will hold that qualification or its equivalent. Throughout this inspection we saw a high standard of care practice and very good and effective interaction between care staff and people living in the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Elmside is well managed and has an effective administrative and support infrastructure in place. This helps people who live in the home to be confident that they will receive a high level of care within a safe environment provided by well motivated and supported staff. Evidence: When we spoke to care staff, people living in the home, relatives and visitors they were all very positive about the way the home is run and managed and also about the manager and her team. The manager cannot do enough for us was one typical comment made by a person living in the home. Since the last key inspection of Elmside the manager has been registered as a fit person to manage a residential care home by the CSCI and she tells us in the homes AQAA that she is currently working toward her Registered Managers Award. Care Homes for Older People Page 23 of 27 Evidence: We found that the AQAA was well completed,was a realistic assessment of the home and was borne out by what we saw and heard during our visit. This, together with a robust system of quality assurance undertaken by Methodist Homes gives confidence that the home is genuinely committed to a process of continual assessment, review and improvement. When we looked at the process of risk assessment is place we found that it is thorough, comprehensive and subject to regular review in order to make sure that it remains relevant and up to date, continuing to protect people who live in the home from avoidable risks, whilst maintaining their independence and autonomy. When we spoke with the homes administrator responsible for dealing with the financial records of people living in the home, we found that she had a good understanding of the safeguarding implications of her role and we found that there was a robust, well-audited system in place to protect the financial interests of people living in the home. When we looked at supervision records and spoke to care staff, we found that staff are regularly supervised and staff also told us that they felt able to approach the manager to discuss any concerns or issues at any time. This is a positive benefit both to staff and indirectly to the people they provide care and support to. 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 1 9 13 The temperature of the 27/02/2009 medication storage area must be regularly monitored and recorded to ensure that when it exceeds that recommended for the medication that is stored there, this will be identified and appropriate action taken to reduce it. This is because when medication is stored above the temperature recommended it can make it less effective. 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 9 To improve the accuracy of records for those medicines that are only taken as and when required, more regular monitoring should be undertaken and the results of this should always be recorded to enable any trends or patterns to be identified and acted upon. Page 26 of 27 Care Homes for Older People 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!