Inspection on 12/01/09 for Eversley Rest Home

This inspection was carried out on 12th January 2009.

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

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

Other inspections for this house

Eversley Rest Home 22/02/08

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Eversley Rest Home 38 Bramshall Road Uttoxeter Staffordshire ST14 7PG     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: Jane Capron     Date: 1 2 0 1 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 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 29 Information about the care home Name of care home: Address: Eversley Rest Home 38 Bramshall Road Uttoxeter Staffordshire ST14 7PG 01889563681 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Anna Marie Kirkland Type of registration: Number of places registered: Mrs Johanna Barrett care home 22 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 22 The registered person may provide personal care and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 22 Dementia over 55 years of age (DE) 3 Date of last inspection Brief description of the care home Eversley is a care home providing a homely environment for 22 older people. It is owned by Mrs J Barrett who bought the service in May 2007. The service is located in a large Victorian property that has been extended at the side and rear. It is a short drive from the centre of Uttoxeter. The property is set back from the road behind trees and bushes. There is large car park at the front. There are grassed areas at the rear. The accommodation offers two large lounges and a separate dining room. The service Care Homes for Older People Page 4 of 29 Over 65 0 22 3 0 Brief description of the care home provides all single bedroom accommodation with 11 rooms having toilet and washbasin ensuite facilities. They service has a vertical lift installed. The fees are not identified in the service user guide and therefore anyone considering moving to the service should contact the service direct. The additional costs include toiletries, the installation of a personal telephone if wanted and hairdressing. Care Homes for Older People Page 5 of 29 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 inspection took place over a six hour period. The service did not know we were visiting. Prior to the visit we had information from the Annual Quality Assurance Assessment that the service sent us. This is a document that the service completes that tells us about the service they provide, improvements they have made and how they intend to improve the service in the future. We also looked at information that the service sends us about incidents that have occurred. These are a legal requirement. We also looked at information we have about any complaints or safeguarding incidents that have occurred. We received surveys from four health care professionals, two staff members and two people that live at the service. At the service we looked at how the service is meeting peoples health and personal Care Homes for Older People Page 6 of 29 care needs and whether peoples privacy and dignity is respected. We also looked at whether people can live the life they want and whether choice is promoted. We looked at how the service is protecting people and whether there are systems in place to listen to the views of people. As part of this inspection we looked around the service including a sample of bedrooms. During the inspection we spoke to people that live at the service, relatives, staff and the manager. What the care home does well: What has improved since the last inspection? What they could do better: We made no requirements at this inspection. Care Homes for Older People Page 8 of 29 We would recommend that the service further develop the opportunities for people to take part in social activities of their choice. 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 29 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 29 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 moving to the service can be confident that an assessment of their needs will be completed and that they will have enough information about the service to decide if it will meet their needs. Evidence: The services Annual Quality Assurance Assessment tells us they have updated the information provided to people about the service. It also says that the manager completes an assessment before the service decides whether they can meet peoples needs. An examination of two case files confirms that a pre admission assessment is completed by the service. These assessments cover peoples health and personal care needs including any dietary needs, mobility issues, communication needs as well as any spiritual needs. People we spoke to told us that they were involved in deciding to Care Homes for Older People Page 11 of 29 Evidence: move to the service. The two surveys we received also told us that people had chosen to move to the service and that they had enough information about the service to make an informed decision. One person said to us I chose to come here and I knew about the service before I came. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the service can be confident that they will be involved in planning their own care and that their health and medication needs will be met. People will have their privacy respected and dignity promoted by the staff. Evidence: The services AQAA states that each person has a care plan and that the person concerned and their relatives are involved in putting this together. It also states that the service gets good support from health care staff. The care plans we looked at contained the information staff needed to provide them with the support they needed. For example they cover personal care, health care, dietary needs, oral and foot care as well as spiritual and social care needs. People living at the service and their relatives had signed the care plans. Plans show that they are reviewed and updated. Talking to staff shows us that they are supporting people to have their needs met. For example one person needs support with managing their diabetes and the service supports them to have a diabetic diet. Another person Care Homes for Older People Page 13 of 29 Evidence: requires support stockings and staff were making sure these were put on. The service also monitors peoples risk of pressure sores and pressure relieving equipment was in place. People living at the service said they received good care. One person said they look after me well and another person said that she would recommend the service to anyone. Observing people living at the service confirms that they are well dressed and that they receive hair and nail care. The health care surveys we received state that people are always clean and well cared for and happy. Surveys that we received from health care professionals show that the service is meeting peoples health care needs. They report that the service refers people appropriately and acts upon any advice they give. Comments include: Patients needs are put first by care staff, very conscientious and quick to ask for help when required , Care service is of a high standard and care staff do seem to respond to individuals needs Records confirm that people receive health care services when needed and that staff are alert to changes in peoples health. Example of this include when one person had redness to the eyes and the service contacted the doctor and another person was seen to be quite tearful and an immediate health referral was made. Records also confirm that people receive specialist services. One person with diabetes has regular check ups with the diabetic nurse and another persons mental health is reviewed by a psychiatrist. People we spoke to said that the staff respected their privacy and treated them with respect. One person said the staff are good and treat us with respect. A health survey we received included the comment Patients are shown consideration and respect by care staff. Staff could describe how they respect peoples privacy and dignity through for example always knocking on bedroom doors and gaining permission before entering and making sure when doing personal care they always explain what they are doing and making sure they are always kept covered. The manager told us that since the last inspection she had changed the medication procedures and had put in place a monitoring and auditing system. This includes checking prescriptions and maintaining records of medication received and disposed of. The service operates a monitored dosage medication procedure. Medication is kept securely in a locked cabinet in a locked room. Controlled medication is kept in a Controlled Drugs cabinet. Looking at the records confirms that medication is being administered and there are no gaps in the records. A check of the controlled drugs confirms that correct records are kept and that entries are double signed. We did Care Homes for Older People Page 14 of 29 Evidence: observe a staff member administering medication and saw she made the necessary checks before giving people their medication. People we spoke to said they got the medication they had been prescribed. Records confirm that staff are provided with training in managing medication. Care Homes for Older People Page 15 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the service will encourage them to live the lifestyle they choose. People can take part in some activities although this is an area that could be further developed. People can be confident that meals are varied and that choice is always provided. Evidence: The services AQAA states that the manager meets with people moving to the service to discuss their daily life and social activities. It also states that discussions take place over their right to bring furniture and possessions into the service. Examination of care plans shows that peoples social care and spiritual needs are included. People told us they can live the lifestyle they want with one person saying you can do whatever you want to do. Surveys from people living there state that they have choice over their lives. People can spend time in the lounges or in their bedrooms. They can choose to take part in activities if they want to. People can choose to bring in their own furniture and possessions and when we visited bedrooms we saw that most people had brought in a range of possessions. People said that a choice of meals is provided and we were told if people wanted something else the cook would try and provide it. Care Homes for Older People Page 16 of 29 Evidence: People can choose where to have their meals. On the day we visited one person had chosen to eat in their bedroom and another to eat in the lounge. We saw evidence that some social activities are available to people. These include gentle exercise, bingo and dominoes. Records also confirm that people had the opportunity to go on occasional trips. Some people had been out for a Christmas lunch and some people had been to see Walsall illuminations followed by a fish and chip supper. The service also has some entertainment brought in, for example local schools visited to sing carols, an indoor gardener visited as well as a musical entertainer. The staff also told us that some of the people living at the service helped to plant tubs earlier in the year. We saw that the hairdresser visits weekly. The service did tell us that the development of social activities was one area they intended to address over the next year. This was the one area that staff surveys highlighted feeling improvements could be made. We agreed with this and made some suggestions of how this area could be improved. We did feel that the service could address activities suitable for people with dementia care needs. People told us they took part in exercise sessions and one person said that he enjoyed bingo and dominoes and he took part in these activities. This persons plan also told us that he also liked reading the newspaper and we saw that he had one in his bedroom and that the service has a daily newspaper delivered. We also saw that the service has a range of books both belonging to the service and large print copies from the local library. During the day we saw two people reading. People are able to have their spiritual needs met. Church of England and Roman Catholic services are held in the service. One person also told us that she always watches Songs of Praise on the television. Visitors came to the service throughout the day, with one person having about six visitors including small children. Comments they made about the service include: I always feel welcomed and offered a drink, and I think the service is marvelous. Another relative we spoke to said that she is very happy with the care. The service encourages people to be involved in their relatives care. For example on the day we visited one person was taken to a health appointment by their relative. Care plans also show that relatives are involved in planning their relatives care. Good food, choice available are comments made by people about the meals provided. The service provides a choice of meals and on the day we visited the menu included cottage pie and vegetables or fish followed by rice pudding, ice cream or yoghurts. The tea menu was a choice of soup, sandwiches and oat cakes followed by fruit and jelly and homemade cakes. We saw that the choice is offered to people and people are asked if they want all parts of a meal including the size of portion they Care Homes for Older People Page 17 of 29 Evidence: want. Snacks and drinks are offered between meals. The service provides specialist diets for those that require them including, on the day we visited, a diabetic diet. People are supported to remain as independent as possible through the provision of aids for eating. For example we saw lipped plates and adapted cutlery being used. Records confirm that peoples dietary needs are assessed and that weight is monitored. Care Homes for Older People Page 18 of 29 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 assured that the service listens to them and has procedures in place to address any complaints they raise. People can be confident that the staff are aware of safeguarding issues and know how to respond to such incidents. Evidence: The services AQAA states that a comprehensive complaints policy and procedures is in place and that all people have a copy in the Service User Guide. We saw that the procedure is displayed in the service. People we spoke to know how to raise issues and to make a complaint. A relative said that she has never needed to complain but is aware of the process and is confident that the staff would address any issues she raised. The surveys we received from people living at the service also show that people know how to make a complaint. The surveys also said that they feel that staff listen to them and act upon what they say. Neither, we the commission or the service have received any complaints since the last inspection. The AQAA says that the service has procedures in place to address issues of adult protection. Most staff have received formal training in safeguarding people and the owner of the service said this has been discussed at staff meetings. The two staff we spoke to were aware of symptons of abuse and knew how to respond. Our discussions with them made us confident that they would address issues of abuse and poor Care Homes for Older People Page 19 of 29 Evidence: practice. Care Homes for Older People Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at the service are provided with suitable communal and private accommodation. People can be assured that the service is clean and that staff are aware of good infection control practices. Evidence: The services AQAA states that the service provides a comfortable, safe and secure environment. The AQAA states that over the last 12 months it has upgraded the premises. These changes include a number of bedrooms being redecorated, new kitchen and laundry equipment and improvements to the garden although these are ongoing. The service provides good communal rooms including two lounges and a seperate dining room. These rooms provide people with good accommodation. The bedrooms we looked at provides people with overall good private accommodation. Some are of a very high standard. Two bedrooms we saw are like bedsitting rooms with the occupant having brought in their own furniture including one with a settee and one with a sideboard. Some of the other rooms we saw would benefit from redecoration and the service tells us that it has plans to upgrade some bedrooms and to redecorate some rooms when they become vacant. Care Homes for Older People Page 21 of 29 Evidence: The service provides satisfactory bathing facilities. Eleven bedrooms have ensuite toilet and basins with two of these having showers. The service provides one assisted bath and a level access shower. Toilets are available around the service. Observation shows the service to be clean throughout. This view is confirmed by the responses to the surveys from people living there that say that the service is always clean and fresh. The service tells us that staff have training in infection control and the two staff we spoke to are aware of good infection control practices. They confirm that there are plenty of supplies of protective equipment. Care Homes for Older People Page 22 of 29 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 living at the service can be confident that they will be supported by a consistent staff group that are trained to be able to provide them with the support they need. The way the service recruits staff is protecting the people that live there. Evidence: The services AQAA tells us that all staff have pre employment checks and that there are always sufficient staff on duty. It states that the service values its staff and that it provides them with training. People living at the service are complimentary about the staff. They tell us that the staff are good and one person said they treat us with respect. Relatives we spoke to confirm this view with comments including the girls are good and the staff are brilliant. We also received positive comments from health care staff that responded to our survey. Comments they made include Eversley is a caring home with very caring staff, and patients are shown consideration and respect by care staff. When we spoke to staff they are aware of people as individuals knowing about their specific needs, their preferences, their family and their preferred lifestyle. The service provides sufficient staff to meet peoples needs. Examination of the roster shows three staff on duty during the morning and two and the manager in the Care Homes for Older People Page 23 of 29 Evidence: afternoon. During the evening and throughout the night two staff are on duty. The service does not use any agency staff and many of the staff have worked at the service for many years. This makes sure that people receive a consistent service and that staff know people well. Two staff we spoke to had worked at the service for over eight years. The service makes sure that peoples key workers are on duty to support them with bathing. One person we spoke to said that when she recently had 24 hour flu staff were available to regularly check on her. She also said that the staff come if you ring the buzzer. Staff told us that they receive training to improve their knowledge and skills. Currently a number of staff are doing distance learning training in infection control and dementia care. Other training the service provides includes mental capacity, safeguarding, medication as well as training in relevent health related issues. A survey from a health care professional said that the staff appear confident and competent in dealing with health care issues. Information from the service confirms that new staff undertake induction training and that over 50 of staff are qualified to at least NVQ level two. Examination of a sample of three staff files confirms that the service makes the necessary pre-employment checks in order to safeguard the people that live there. All files contain copies of two references and satisfactory Criminal Record Bureau (CRB) and Protection of Vulneralbe Adult (POVA) checks. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People that live at the service can be confident that the service is run in their interests and that their views are taken into account. People can be assured that the services health and safety practices are protecting them. Evidence: The AQAA states that the current manager has the correct qualifications and extensive experience. The manager is registered with us and has been at the service for some years and suitably trained and qualified. She undertakes periodic training to ensure she is up to date with current good practice. She has responsiblility for the day to day management of the service. We received positive comments about the management of the service from a health care professional in the survey they completed. It stated The care manager is very competent and manages the care of residents well. She is aware of residents needs and appears to do her best to meet their needs and interests. A relative we spoke to said that she had confidence in the manager and would have no hesitation in raising concerns with her, being confident that she would sort them out. Care Homes for Older People Page 25 of 29 Evidence: The service provided us with an AQAA that tells us about the service and its plans for the furture. We did give some advice about how this document could be improved and provide a better picture of what the service offers. The services AQAA states that it has procedures in place to monitor and review the service. Records confirm that the views of the people that live there and their relatives are sought about their experiences of the service. Examples we saw gave positive comments about the service. The service did say that they are looking to develop this system by gaining the views of health care staff that visit the service. The manager also completes regular audits on aspects of the service including the environment, health and safety issues and medication procedures. The records confirm that the service is providing staff with Health and Safety training that will protect the people that live there. Training includes moving and handling, first aid, food safety and fire prevention. Records show that fire training was provided by a fire specialst in June 2008. A fire risk assesmsent is in place and the service has developed an evacuation plan. Examination of the fire records shows that the fire alarm and the emergency lighting is tested as required. Since we visited last time a new fire panel has been installed and records show staff have been trainied in its use. The services AQAA tells us that the service tests its equipment to ensure its safety. Care Homes for Older People Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 To further develop the opportunities for social activities including activities that will meet the needs of people with dementia care needs. This will provide people with a more stimulating and varied lifestyle. Care Homes for Older People Page 28 of 29 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 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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