Inspection on 07/01/09 for Hilton Rest Home

This inspection was carried out on 7th 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

Hilton Rest Home 19/12/06

Hilton Rest Home 29/12/05

Hilton Rest Home 29/06/05

Hilton Rest Home 26/01/05

Hilton Rest Home 20/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Hilton Rest Home Quarry Street Padiham Burnley Lancashire BB12 8PH     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: Pat White     Date: 0 7 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 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: Hilton Rest Home Quarry Street Padiham Burnley Lancashire BB12 8PH 01282775016 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Julie Williams Type of registration: Number of places registered: Mr Joseph Robb Buirds,Mrs Marlene Joan Hyslop Buirds care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: 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 The maximum number of service users who can be accommodated is: 21 Date of last inspection Brief description of the care home Hilton Rest Home is registered to provide accommodation and personal care for 21 older people. The home is a detached premises set in a residential area approximately a quarter of a mile from Padiham town centre. The home is built on two levels, which are linked with a passenger lift; there are no internal stairs. Residents private accommodation is on both levels in 9 single bedrooms and 6 shared bedrooms. Four of the single bedrooms have an en suite facility. Shared space consisted of a two part Care Homes for Older People Page 4 of 27 Over 65 21 0 Brief description of the care home lounge and a conservatory. The lounge could be partitioned to make two rooms. The conservatory was used as a dining area. There was written information about the home to inform people about the services, the staff and the facilities. Fees charged per week ranged from £346 - £438, with extra charges for hairdressing, toiletries, newspapers/magazines, chiropody and holidays. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: A key inspection which included an unannounced visit to the home was carried out on the 7th January 2009. The purpose of this inspection was to determine an overall assessment on the quality of the care and services in the home. This included checking important areas of life in the home that should be checked against the National Minimum Standards for Older People, and checking the progress made on some matters that needed action following the previous inspection on 19th December 2006. This inspection included, looking at all the information received about the service since the last inspection, talking to residents and relatives, touring the premises, observation of life in the home, looking at residents care records and other documents and discussion with the manager Julie Williams. In addition we have used written Care Homes for Older People Page 6 of 27 information provided by the home prior to the site visit. This includes detailed information about the home, the staff and the facilities, and is also the homes own assessment about what they need to do to improve and develop. Survey questionnaires from the commission were also sent to some residents and staff before the site visit, and some questionnaires were left at the home for relatives to complete and return to the commission. Eight residents, five of whom were able to give their views on the home, and two relatives who were in the home at the time of the visit were spoken with. At the time of writing this report the commission had received completed questionnaires from 8 residents and 3 members of staff. Some of the views of all these people are included in the report. What the care home does well: What has improved since the last inspection? The home had improved most of the matters that the commission identified at the last inspection. The way people were admitted to the home for short term care had improved. Their needs were assessed before they were admitted to the home to make sure that Hilton was the right place for them, and that staff could meet these needs. The written care plans had been improved and developed, and now included useful information on all relevant matters of health, personal and social care. Also the way that risks associated with everyday life were assessed and written down had improved. This meant that there was better written information about this to help guide staff in how risks were to be reduced or eliminated (see below). Care Homes for Older People Page 8 of 27 Some parts of the premises had been improved since the last visit to the home. The conservatory/dining room had been tastefully refurbished and decorated and some bedrooms had been decorated. Since the previous inspection the manager had made sure that the commission was notified of all the significant events that happen to residents, such as falls which result in medical attention. This means that the commission can monitor this part of life in the home and can ensure that correct action is taken if need be. 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 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes admission procedures, including the pre admission assessments and visits to the home by prospective residents and relatives, helped to determine whether or not the home could meet peoples needs and whether people felt it would be a suitable place to live. Evidence: Although the written information about the home (the Statement of Purpose and the Service User Guide) was not viewed for this inspection, we were told in the information provided to us by the home for the inspection that these documents were reviewed and updated annually. This meant that people had up to date information about the home. In the commissions questionnaire survey residents told us that they had enough information to help them make a decision about whether or not the home would be suitable for them. Care Homes for Older People Page 11 of 27 Evidence: Records viewed of some residents who had been admitted since the previous inspection two years ago, showed that the manager had undertaken an assessment of their needs to help decide whether or not the home could meet these needs. This involved meeting prospective residents and their relatives, and inviting them to visit the home, so that people could see for themselves what Hilton is like. Since the previous inspection this procedure had been extended to people wanting short term care in the home. However the written pre admission assessments for people having short term care were brief and did not include details on all the important matters of health personal and social care. This could mean that staff did not have sufficient written information to help them understand peoples needs, or for a basis from which to develop accurate care plans. Also one of the assessments viewed had not been dated and signed so it was not clear when it had been undertaken and by whom. However the inspection methods used, including discussions with people at the site visit and the completed questionnaire surveys, indicated that residents received the right care at the right time - there was no indication that their needs were not being met because of the gaps in written information. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans contained useful information about all aspects of residents health and personal care, and residents health was promoted. Medication practices and procedures ensured the safe handling and administration of medicines. Evidence: All residents had a written care plan to give instructions to staff on what care and support people needed, and how this should be provided. These had been developed and improved since the previous inspection and now included useful information on all aspects of health and personal care. Risk assessments underpinned essential aspects of the care plan, such as the risk of pressure areas, the risk of falls and nutrition risks. This helped to protect people from injury or ill health. There was good written information about pressure area care needed by one resident whose records were viewed and including the personal care needed whilst being cared for in bed. There was also useful information about peoples preferences, such as preferred rising and retiring times and likes and dislikes, and a useful social profile that included peoples religious interests. This information reflected peoples individuality and diversity. All Care Homes for Older People Page 13 of 27 Evidence: the care plans had recently been reviewed and updated so that staff had accurate information from which to work. Looking at records, talking to people and the completed questionnaires showed that the residents health, including mental health, was promoted. Residents had access to all the necessary health care services. All the residents who completed the commissions questionnaires said that they always had the medical attention that they needed. District nurses were involved as necessary, such as for pressure area care. Peoples weights were monitored if possible, though the scales in the home were not suitable for all residents, and those who could not use them were not weighed. Residents medication was well managed and good practices and procedures ensured the safe administration of medicines to residents. Accurate records were kept of medication received into the home, leaving the home and administered to residents, and this included those records relating to controlled drugs. Residents were supported to manage their own medication, and this was underpinned by suitable risk assessments. There had been developments in the requirements for the storage of controlled drugs since the previous inspection and the manager agreed to discuss this matter with the commissions pharmacy inspector and comply with any advice given. Residents spoken with said that staff treated them appropriately and with respect. One resident said she appreciated the fact that that she could spend time in her room if she wished, and one resident said that all the staff were very nice. However some written information about one resident was presented in a way that could be seen as not upholding privacy. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Routines were flexible enough to suit individual preferences and their were suitable leisure activities. The food served was healthy and appetising and suited peoples tastes. The visiting arrangements and contacts with relatives encouraged and supported people to keep in touch with their families and the outside community. Evidence: Residents in discussion confirmed that routines were flexible enough to suit some of their preferences. These included having meals in the place of their choosing, choice of rising and retiring times, support to go out alone and for their religious interests. There was useful information on the care plans about some of these preferences to assist staff to give the right support. The information supplied by the home for the inspection told us that leisure activities included, aromatherapy, movement to music, mobile library, church services, choir and entertainers. One resident organised games of dominoes. Some of these activities were confirmed in discussion with the residents, and those who completed the questionnaires felt that there were enough suitable activities to keep them occupied. Residents spoke positively about the recent Christmas activities and had enjoyed a Care Homes for Older People Page 15 of 27 Evidence: variety of events. Residents and relatives spoken with confirmed that visitors were made welcome in the home at any reasonable time and that visits could take place in private. Relatives could also have a meal in the home if necessary and residents were encouraged and supported to go out with their relatives. Two relatives spoken with at the time of the site visit said that communication between them and the staff in the home was good and that they were notified of all the important events affecting their relative. Menus showed that the food served was wholesome and varied, with a good mix of traditional foods. There was the option of a cooked breakfast every day, and a choice of two main cooked meals at midday. There were numerous choices for the snack meal at tea time. Most residents ate in the conservatory, but some of those needing assistance ate at individual tables in the lounge. Nutrition assessments indicated if people had any dietary requirements such as for soft foods. Residents spoken with praised the food. One said it was very good, and another said she always looked forward to the meals. Residents who completed the questionnaires stated that the food suited their tastes and preferences. 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 knew who to speak to if they had any concerns, and residents and relatives felt confident that their concerns would be dealt with properly. There were satisfactory policies and procedures to help protect residents from abuse. Evidence: Records and information supplied by the home for the inspection showed that no complaints had been made to the home since the last inspection, and none had been made to the commission. However discussion with the manager, and the records kept, showed that the manager had taken appropriate action when a relative had expressed concerns about the number of falls experienced by a resident. This indicated that peoples concerns were taken seriously. Residents and relatives spoken with said that they had no complaints and all said they would speak to the manager if they were not happy with something. All the questionnaires completed by the residents supported these views. There were policies to help protect people from abuse and there had been no suspicions or allegations of abuse since the previous inspection. Discussion with the manager showed that she would take appropriate action if this occurred. At the time of the site visit staff had not undertaken appropriate training in this matter which could mean they did not know the correct action to take. However we were informed shortly after the site visit that suitable training had been arranged. Care Homes for Older People Page 17 of 27 Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Hilton Rest Home provided comfortable well - maintained private and communal accommodation that suited residents/ needs. The home was clean and hygienic. Evidence: The premises were well maintained and decorated. Some areas of the home had been improved and decorated since the previous inspection in 2006. The conservatory/dining area had been tastefully refurbished and redecorated, and some bedrooms had been decorated. The home had a relatively new fire alrm system which had made the homes fire precautions safer. Maintence and repairs were completed as and when required, and bedrooms were decorated when they became vacant if need be. There were car-parking facilities at the front of the building and outdoor areas to the front and rear of the building which residents could enjoy in fine weather. The communal space consisted of a two part lounge, which could be made into 2 separate rooms with sliding dividing doors if need be, and a conservatory used as a dining room. All the areas were bright and pleasantly furnished. However a safety matter concerning the runners on the floor for the dividing doors was highlighted to the manager at the site visit. The maintenance person made this safe before the end of the visit but further work was required for a permanent solution. Care Homes for Older People Page 19 of 27 Evidence: The homes heating system included electric storage heaters that could be controlled in residents rooms. Some of these were covered and others were not, and in the bedrooms this was based on whether or not residents were at risk from hot surface temperatutes. Since the previous inspection work had been done to ensure that residents safety in this respect was underpinned by risk assessments which aimed to further protect people from the hazards of hot surfaces. However not all were completed sufficiently accurately or clearly and one looked at had not been reviewed and updated when the heater cover had been removed at the residents request. This was rectified immediately after the site visit and we were assured that further work would be done to make sure that the risk assessments helped to protect people. Hot water outlets tested at random showed the temperatures were of a safe range and records showed that this was monitored effectively so that residents were not at risk from scalding water. The home was clean and fresh at the time of the site visit and residents who completed the questionnaires confirmed that this was always the case. There were suitable laundry facilities sited in the basement, and a new washing machine had recently been fitted which had a programme suitable for washing soiled laundry. 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. Sufficient qualified and trained staff were on duty to ensure that the needs of the residents were met. Staff recruitment procedures would help to ensure that suitable staff worked in the home but could be improved according to guidance. Evidence: The inspection methods, including discussion with staff, the residents and relatives, indicated that the staffing levels in the home were satisfactory for meeting the needs of the residents. Two relatives said in conversation that there were always enough staff on duty and one said that the staff seemed to cope well. There was also a relatively low turn over of staff which helped to ensure a continuity of care for the residents. Most residents spoken with spoke highly of the staff though one said that some were better than others. Staff were completing relevant qualifications and training. Information supplied by the home for the inspection said that 14 out of 15 carers were qualified to at least National Vocation Qualification level 2. At the time of the site visit the manager was organising up dated training in moving and handling, first aid, food hygiene, medication and the protection of vulnerable adults. Immediately following the visit dates had been agreed with the training provider so we were assured that this training would take place. Since the previous inspection staff had undertaken training in dementia which helped Care Homes for Older People Page 21 of 27 Evidence: them understand the needs of people with confusion and mild dementia. The homes induction programme was in accordance with government guidance and should ensure that new staff were confident and competent. Staff spoken with and those who completed questionnaires felt that they had good training oppoprtunities and support from the management. The records looked at of two members of staff indicated that people did not start work until the necessary Criminal Records Bureau (CRB) and Protection of Vulnerable Adult checks had been obtained. However the original CRB disclosures were not kept in the home, only recorded details on a tracking form were available as evidence, and some CRBs were destroyed before being seen by the inspector. Therefore there was no original evidence of this aspect of staff recruitment, and this practice is not fully in accordance with the commissions guidance on this. Also the references of the most recently appointed member of staff were not the most suitable. There was no written evidence that the references were genuine and one was from a friend rather than a suitable character referee. The induction checklist completed for this person had not been signed or dated so there was no evidence that it belonged to this person. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well managed by an experienced and qualified manager and the development of the home took into account the views of residents and relatives. The health and safety of the residents and staff were promoted. Evidence: The registered manager had worked in the home for a number of years and had the relevant qualifications, skills and experience. She worked shifts with the staff and was therefore accessible, and knew the staff and the residents. She had specific designated management hours, though these would benefit from reviewing to ensure they are sufficient. The registered providers visited the home frequently and supported the manager. Residents and relatives benefited from a stable management and staff team, and those spoken with confirmed that the management was approachable and supportive. The home had internal service quality monitoring systems that involved seeking the Care Homes for Older People Page 23 of 27 Evidence: views of residents through questionnaires and residents meetings. Each year this results in a report with an action plan which demonstrates how the residents influenced some developments in the home. Residents and relatives were encouraged to manage residents finances and there were a number of residents who had their own money to purchase things that they needed such as newspapers and to pay the hairdresser. As such there was no money belonging to residents being held in the home at the time of the site visit. The home was a safe place for the residents and staff. The home told us in the information supplied for the inspection that all maintenance and servicing of installations, applicances and equipment had been carried out appropriately. Records showed that there were satisfactory fire precautions and a recent fire safety inspection resulted in no recommendations. Staff were undertaking updated training in helath and safety matters (see Staffing section). Since the previous inspection the manager was notifying the commission of all incidents affecting the health and welfare of the residents, including falls. This enabled us to monitor such events and to ensure the home was managing these events properly. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 3 The pre admission assesssment, including for those requesting short term care, should include sufficient details in all relevant matters of health, personal and social care. All care records including the pre admission assessment should be signed by the person completing it, and dated. Suitable scales should be available so that all residents can be weighed. The way the written information about the resident referred to in the report should be presented in a more appropriate way in order to uphold their privacy. The risk assessments used to help protect people from hot surface temperatures should be developed so that they are all accurate, clear and up to date. The Criminal Records bureau checks should be kept in the home and retained till they have been seen at the next inspection following recruitment if this is more than 6 months from its receipt. References obtained should be verified either through the written forms available for obtaining references or through records of the telephone calls made to verify them. Genuine character references should be sought rather than using friends. Page 26 of 27 2 3 4 3 8 10 5 25 6 29 7 29 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!