Inspection on 13/03/09 for Four Seasons

This inspection was carried out on 13th March 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

Four Seasons 12/03/07

Four Seasons 07/03/06

Four Seasons 30/12/04

Four Seasons 21/07/04

Four Seasons 29/03/04

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 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Four Seasons 77 The Wood Meir Stoke on Trent Staffordshire ST3 6HR     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: Pam Grace     Date: 1 3 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: Four Seasons 77 The Wood Meir Stoke on Trent Staffordshire ST3 6HR 01782336670 F/P01782343133 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Day Care Services Limited Name of registered manager (if applicable) Lynne Chetwynd Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: To accommodate one named person with a diagnosed mental disorder admitted in June 2006. Date of last inspection Brief description of the care home Four Seasons is a detached property, in a semi-rural setting in Stoke on Trent (south). It was opened in 1990 for up to 8 people and two years later extended to accommodate up to 17 people over 65 years. More recently a further extension was completed, increasing the number of beds to 22. The extension provides additional Care Homes for Older People Page 4 of 28 care home 22 Over 65 6 1 22 6 0 0 0 0 Brief description of the care home bedrooms, spacious and excellent lounge facilities, a conservatory and additional dining room. All but 2 bedrooms have en-suite facilities. Two bedrooms are for shared use. There are now 3 lounges, 2 separate dining areas and a conservatory. The first floor is accessible by staircase and shaft lift. Nursing care is not provided. The home is a family run business, which has been built upon its reputation for providing good quality care in a homely atmosphere. Information regarding the fees charged for the service at Four Seasons was not available, and have not been included in this report. The reader may wish to obtain more up to date information directly from the care service. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was 12 March 2007. This inspection visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over eight hours by one inspector who used the National Minimum Standards for Older Persons as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Assessment for us. Seven Have Your Say surveys were received from people using the service. Care Homes for Older People Page 6 of 28 On the day of the inspection, the home was accommodating 19 people, including one person on a short term basis. We spoke with staff, people using the service and their visiting relatives. We also examined records, carried out indirect observation of three people who use the service, and three staff on duty. Three plans of care and three staff records were examined, we also directly observed daily events. We looked at four bedrooms, two communal lounge areas, the dining areas, kitchen, and bathing facilities on all floors. We inspected the system of medication administration and storage. What the care home does well: What has improved since the last inspection? The Annual Quality Assurance Assessment (AQAA) document completed by the care manager confirmed the following improvements: The grounds and patio area rooms decorated when required the dining rooms, hallway, and several individual bedrooms have been decorated new carpet in the front lounge total refurbishment of the kitchen electric chairs have been purchased for people who have difficulty standing to transfer larger televisions have been purchased for communal areas, and portable televisions purchased for people who have no television in their room. We have retained staff, which is in the best interests of the home and our service users Staff have gained knowledge in health and safety Senior staff have attended accredited courses in regard to Medication, Team Leadership and Customer Services. The Manager and a staff member attended a Train the Trainer course in regard to POVA first. Almost all staff have attended dementia training, mental health training and recognition and response to abuse training. All staff attended a seminar on the Mental Capacity Act, and the Manager attended a course on deprivation of liberty (DOL). We have well over 50 per cent of our target, for staff having NVQ training We have gained knowledge in new legislation and have obtained a new code of practice Care Homes for Older People Page 8 of 28 We have formulated a procedure for deprivation of liberty safeguards. 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.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 considering using the service should be provided with helpful up to date information. People are invited to spend time in the home, which helps them to decide if the service is suitable to meet their needs. No person moves into the service without firstly having their needs assessed. Evidence: The Annual Quality Assurance Assessment document which was completed by the care manager told us We ensure that prior to admission, a comprehensive assessment is carrried out, either in the service users own home, hospital or where possible. We encourage the service user to view the home, at which time we carry out the assessment. When admitting service users we ensure that this is done in a confident friendly manner by trained staff. We ensure that the room is to standard, has all equipment and meets Care Homes for Older People Page 11 of 28 Evidence: their needs, for example extra pillows, or raised toilet seats. We also provide a service user guide, which explains at their level of understanding all of the records and documentation. The majority of surveys received from people using the service confirmed that they had received a Contract and or Terms and Conditions of Service, and that they had been given enough information about the home prior to making a decision to move in. Comments received included the following, my relative was already resident at Four Seasons, and happily so, I was made to feel welcome when shown around, and they answered all my questions, after about nine visits to different homes, we found Four Seasons to be sound. We found that the Statement of Purpose and Service User Guide had not been reviewed, and information contained within those documents did not fully meet the National Minimum Standard. This was discussed with the Care Manager, and advice was given. We examined three care plans, these showed that pre admission assessments had been undertaken prior to admission to the home. 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are upheld and put into practice. Medication systems and processes should be safe and secure. Evidence: The Annual Quality Assurance Assessment document (AQAA), which was completed by the care manager told us : We ensure we at all times maintain and promote all our service users independence, dignity and respect, ensuring all health needs are monitored and met accordingly. Liaising with other professionals when and if required to support us with a service user. Designated senior staff carry out certain roles for example administering medication. Identifying risks and formulating risk assessments. To ensure elements of risk are known by all staff who support. Surveys received from people using the service told us that they received the health Care Homes for Older People Page 13 of 28 Evidence: care and support they needed. Comments received included the following, my friend is very happy, Im very happy with how Im being looked after, staff are always there on hand to support you. We looked at three care plans, and spoke with staff and people using the service. Staff spoken with could tell us how each of these people were to be cared for. What those staff told us reflected what was written in individual care plans. All three care plans contained evidence of pre admission assessments, which had informed the care plan. There was also clear evidence of health professionals involvement, for example General Practitioner and District Nurse visits. One individual risk assessment was highlighted as being out of date, and did not contain all of the relevant details required. We discussed the need for risk assessments to be comprehensive, and up to date, to ensure peoples safety. The mobile hoist required an annual service check to ensure the safety of people using the service, this was highlighted at the time of the inspection, and will be undertaken within the next few weeks. A spot check of medication administration systems, which included controlled medication, Medication Administration Records (MAR), storage and disposal of medication, revealed that there were anomalies in regard to missing signatures from Controlled Medication records, and cabinets used by the home to administer medication, do not comply with the Misuse of Drugs (Safe Custody) Regulations 1973. This was highlighted and discussed at the time. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved in regular, organised, daytime activities of their own choice, which are tailored to meet their needs. They also have access to the local community. Family and friends are made welcome at the home. Evidence: The Annual Quality Assurance Assessment (AQAA) completed by the care manager told us We ensure our service users have the opportunity to socialise with their family and friends in private if they so wish. We provide a frendly atmosphere and offer refreshments to enable pleasant visits. We provide daily activities this may be in small groups or one to one. We welcome our local church the first Sunday in every month, and book entertainers for most birthdays. We also have access to the local school and several service users have visited the school for different events. We also take them out shopping in small groups, when the weather is good. Surveys returned to us by people using the service told us that they liked the meals at the home, and that there are activities arranged by the home that they can take part Care Homes for Older People Page 15 of 28 Evidence: in. Comments received included the following, I would rather read, I had a stroke which took my right side. I cant really do anything on my own. But they always ask if I want to take part or take me to the activities, I enjoy my meals, If there was a problem with a meal, they would cook something else. Menu plans were available for us to view in the kitchen, and the cook confirmed that she knows people well, and what food they prefer. On the day of the inspection it was Red Nose day, and staff were dressed in red and white and wore a red nose, there were games and activities organised all day, and some people watched the red nose day on television. This event proved very popular with the people using the service. Activities undertaken include the following, shopping and outings, local church minister visits once monthly, local school holds regular events that people attend, entertainers are booked for individual birthdays. Musical instruments have been purchased by the home, so that musical activities can be undertaken. We spoke with people who use the service about their daily life, activities, and their outings. They confirmed their involvement in the activities organised by the home, these included games, art, crafts, puzzles, discussion, and reminiscence groups. Communal areas were well used. We saw relatives and visitors freely entering and leaving the building, visitors can also be seen in private if people so wish. 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 using the service and their family, friends and representatives are given information on how to make a complaint. Complaints and grumbles are acted upon and resolved straight away. The services protection processes ensure that people are not at risk from harm or abuse. Evidence: The Annual Quality Assurance Assessment (AQAA) completed by the care manager told us: We ensure that all service users on admission are made fully aware of our complaints procedure, and where they can access it. They are provided with a copy of the service user guide, and the statement of purpose is on display for all to access. We ensure that all staff are aware of policies and procedures. We ensure that all staff are CRB and POVA checked prior to commencement of employment, and all are trained in the protection of vulnerable adults. Surveys returned to us by people using the service told us that they know who to speak to if they are not happy. Comments received included the following I dont like to be a nuisance, I know who to speak to. Staff spoken with knew how individuals with communication difficulties were able to communicate their feelings. Care Homes for Older People Page 17 of 28 Evidence: The complaints folder showed that no complaints and or Safeguarding referrals had been received either by the home or by us since the previous inspection. Staff spoken with confirmed that they had received appropriate training in relation to abuse and the protection of vulnerable adults, and that they would have no hesitation reporting any concerns to the care manager. Three staff recruitment records were examined, these showed that security checks had been undertaken in regard to new staff. For example, two written references, a full employment history, identification and Criminal Records Bureau checks. Finances were spot checked for two people using the service, and in regard to personal monies held by the home. Monies held, tallied with amounts recorded. Receipts are held for all purchases undertaken, these included hairdressing and chiropody services. 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 physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The Annual Quality Assurance Assessment (AQAA) completed by the care manager told us We ensure that standards are met and that we have clear cleaning regimes for all duties for all shifts to maintain and reduce risks of harm or infections. We maintain good records for cleaning, cooking and all other duties. All staff have the required training, and are fully aware of the need to wear uniforms and protective clothing when required. All COSHH items are stored in a locked cupboard, safe guidelines are adhered to. Data sheets and COSHH records are provided, the home is kept clean, warm and free from odour. Surveys received from people using the service confirmed that the home is always fresh and clean, one person said it never smells, and I see the staff cleaning every day. Care Homes for Older People Page 19 of 28 Evidence: Our observations of the building confirmed that some areas of the home had been redecorated, including all communal areas. The home was clean and hygienic. The kitchen was in the process of refurbishment, and was due for completion within a week. The laundry was fully functioning and fit for purpose. Bedrooms all have locks, and people using the service are offered keys. There were some safety maintenance checks still needing to be undertaken, to ensure the safety of the people using the service. These included maintaining the mobile hoist, and portable appliance testing (PAT) of appliances. These were highlighted and discussed with the care manager at the time. The AQAA document confirmed that routine maintenance and safety checks had been carried out. Plans have been submitted to us by the provider in relation to change of usage of an upstairs bathroom (which is no longer used), into a bedroom and ensuite. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to have confidence in the service provided as staff receive ongoing and appropriate training according to their role. There is a good recruitment procedure in place. Staff update and mandatory training needs to be recorded, consistent, and in keeping with their role and responsibilities. Evidence: The Annual Quality Assurance Assessment (AQAA) completed by the care manager told us We have maintained good staffing levels which instills confidence in our service users as they know them, and not seeing different staff on duty. If recruiting staff CRBs and POVA 1st checks done along with references prior to employement. All are provided with a variable training programme to enable high standards of care service provided. All staff have done NVQ level 2, or are in the process. All seniors have achieved NVQ level 3, and all staff have supervisions and appraisals. Surveys received from people using the service told us that staff are available when they are needed, people receive the care and support they need, and that staff listen and act on what they say. Comments received included the following, Staff are very good, they do try their best, but its not home, Staff are very easy to talk to, and Care Homes for Older People Page 21 of 28 Evidence: they do listen, like I have said, Im not the only person in the home, but the staff try their best, and that is all we can ask from people. We confirmed the staff that were on duty during the inspection, this tallied with the homes staff rota. We spoke with three staff and examined three staff recruitment records. It was not clear from our discussions, or from records, what specific training staff had actually undertaken, and the care manager was asked to provide us with an up to date training matrix to establish this. She reported that certificates for courses undertaken were not always provided. Staff spoken with confirmed that they had received regular formal supervision as per the National Minimum Standards. Staff recruitment records confirmed that the home has a good system in place for checking identification, two references, employment history, Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA). 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. Effective quality assurance systems need to be implemented to demonstrate that the service is operating in the best interests of the people who us it. Evidence: The Annual Quality Assurance Assessment (AQAA) document completed by the care manager told us: The manager ensures that all staff have the opportunity to update and refresh all required training, which includes herself. Senior staff have designated roles. All staff receive supervisions and appraisals to identify any issues or areas of concern along with training. Policies and procedures are reviewed annually, audits done monthly. Surveys received from people using the service told us, Im quite happy here, I am the next of kin of a lady in this home, she has been in there for about 2 years, the Care Homes for Older People Page 23 of 28 Evidence: staff have looked after her, loved her, supported me, and my family. Her needs have changed over the two years, however the staff have adapted their care to suit her needs, and I cant thank them enough. I can go home knowing she is being safely looked after, in a friendly place. Im very pleased with the conditions. We found that safe systems are in place for the protection of people using the service, however, medication procedures require reviewing and monitoring, cabinets currently used for the purpose of storage and administration of medication do not meet regulations. Care plans were up to date and had been reviewed, however, individual risk assessments showed a need for a more comprehensive assessment, which is regularly reviewed. Staffing levels have been maintained, and records in relation to the recruitment of staff are in place and show that a good system is in place. However, it was not possible to clarify what training had or had not taken place for staff, certificates were not up to date, and there was no staff training matrix in place. Formal and regular staff supervision is being undertaken by staff. There had been no complaints and or Safeguarding referrals made to the home since the previous inspection. Some health and safety maintenance checks were still outstanding. Quality Assurance systems in place are not consistent, and there was little evidence that outcomes from surveys undertaken by the home are audited, recorded, and fedback to staff and people using the service. The AQAA document which is completed by the care manager prior to the inspection visit was adequately completed and returned on time. Finances were spot checked for two people using the service, and in regard to personal monies held by the home. Monies held, tallied with amounts recorded. Receipts are held for all purchases undertaken, these included hairdressing and chiropody services. 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 9 13 All prescribed medication must be securely stored to ensure peoples safety The home should be using medication cabinets that meet the Misuse of Drugs (Safe Custody) Regulations 1973. This is to ensure peoples safety. 29/05/2009 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 1 People wishing to use the service should be provided with up to date information, prior to making a decision to move into the home. The care manager should implement a system of regularly monitoring medication records, to ensure the safety of people using the service. An up to date staff matrix should be implemented to ensure that staff do receive the mandatory and refresher training they need. Staff should be offered updates in administration of medication, moving and handling, protection of vulnerable adults and fire. Attendance at these courses should be Page 26 of 28 2 9 3 30 4 30 Care Homes for Older People signed for by the individual staff member. 5 33 Quality Assurance systems should be consistently implemented and audited. Feedback should be given to staff and people using the service. 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!