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Inspection on 13/10/08 for Huyton Hey Manor Residential Care Home

Also see our care home review for Huyton Hey Manor Residential Care Home for more information

This inspection was carried out on 13th October 2008.

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

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

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

What the care home does well

Huyton Hey Manor is well managed and organized to ensure that people living there receive good services. People living in the home said they liked being there and that staff were kind and considerate to everyones needs. Comments included "The staff are kind and caring" "Staff are always around to help" "We have a good life here". Records show that people living in the home have their care needs fully assessed before being offered accommodation to make sure the home can meet their needs. People living in the home said that staff treat them with respect and deal with them all as individuals who have their own individual needs. Records show that staff are throughly vetted before they are employed and are provided with ongoing training upon appointment to make sure they are suitable to carry out their caring role within the home

What has improved since the last inspection?

Staff training has been developed to make sure that staff can access areas of specialized training if they choose. Residents meetings are held more frequently to ensure the views of the people living in the home are addressed. The activities program has been developed to ensure that the choices and abilities of the people living in the home are addressed. Menus have been reviewed after listening to residents comments about what they would like to see on the menu. Policies and procedures are monitored and reviewed annually to ensure that the home are up to date with any changes in legislation. The building continues to benefit form an ongoing refurbishment.

What the care home could do better:

Whilst the documentation in the home is of a good standard it was noted that on occasions care reviews do not always evidence when they have been held or who was in attendance. It is recommended that signautes of all who have contributed to reviews be held on file as a reference point if required for the future.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Huyton Hey Manor Residential Care Home Huyton Hey Road Huyton Knowsley Merseyside L36 5RZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lynn Paterson     Date: 1 3 1 0 2 0 0 8 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Huyton Hey Manor Residential Care Home Huyton Hey Road Huyton Knowsley Merseyside L36 5RZ 01514893636 01514266415 angharad-huytonhey1@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Cranford Care Homes Limited care home 30 Number of places (if applicable): Under 65 Over 65 30 30 old age, not falling within any other category physical disability Additional conditions: 0 0 Service users to include up to 30 OP and 30 PD(E) The service may admit one named service user under pensionable age. The service should employ a suitably qualified and experienced manager who is registered with the CSCI Date of last inspection Brief description of the care home Huyton Hey Manor is a care home registered to provide placements for 30 persons of the category old age. The home is situated in pleasant grounds in a residential area close to local amenities and Huyton Village centre. Accommodation is provided on three floors and there is a passenger lift to all levels. The home has a variety of aids and adaptations in place around the home to assist residents with mobility. Twentyfour of the bedrooms are single, three are double and none of the bedrooms have en suite facility. There are two communal toilets to the ground floor plus two bathrooms Care Homes for Older People Page 4 of 28 Brief description of the care home and toilet combined. There are two communal toilets to the first floor plus one shower and toilet combined and two communal toilets and one bathroom to the second floor. 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means that the people who use the service experience excellent quality outcomes. The inspection of Huyton Hey Manor was unannounced and was carried out over a one day period. During the inspection a number of documents were examined including care files, staff files, maintenance logs and medication records. Discussions were held with staff,people living in the home and their visitors and a tour of the building undertaken. Observations were made of staff carrying out their duties and their interactions with the people living in the home. Fieldwork included case tracking five residents which involved reading all the Care Homes for Older People Page 6 of 28 documentation relating to their daily living and speaking with them and any staff who were associated with their care. The above methods were only one part of the inspection process. Before the visit the home manager was asked to complete a self assessment document called an Annual Quality Assurance Assessment (AQAA). The AQAA is a detailed document that gives lots of information and update about the home and this together with any other information received since the last inspection is examined and assists greatly in focusing the inspection. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 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. Trained and knowledgeable staff carry out assessments of need and give clear information about the services provided by the home before any decisions are made about People being offered a placement. Evidence: The statement of purpose was quite extensive and gave much detail about the home and the services provided. The manager had drawn up a condensed version to be used as a service user guide. This document held all the information necessary to enable People who were considering going to live at the home to have clear details of the staff, services and philosophy of the home. The statement of purpose and residents guide is displayed in the foyer of the home and staff revealed that people are encouraged to visit the home with or without an appointment and look around, meet residents and get a general feel of the place. Care Homes for Older People Page 11 of 28 Evidence: People living in the home and their families said they had been given, lots of information about the home before they made any decisions about their future. The manager advised that she completed a needs led assessment prior to any person being admitted to the home and files showed that full pre admission assessments about what care and support the person needed to enable them to live comfortably in Huyton Hey Manor were held on file. Five care files viewed at random held full details of pre admission assessments being carried out and people spoken with confirmed that the manager or her deputy had been to assess them prior to them being offered accommodation at the home. The care files held full details of peoples diverse wishes and requirements and detailed if these needs would be met by the staff and services of the home before a decisions was made as to a placement offer.The manager revealed that she looks At the full needs of the person requesting accommodation at the home and only offers a service when she can identify that the home has all the facilities in place to meet all assessed needs. People living in the home said they had been given full details before they made tier mind UPI to come and comments included; Yes I got showed around the home and got introduced to staff and residents and had a meal here before I made my decision to stay I looked around twice before I decided to stay I came for half a day and had lunch, then the manager came to my house and assessed me. I had all the information about the home and when the manager said the home could meet my needs I was delighted. The home does not provide intermediate care. 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 general care and support for the People living in the home is good and records`are maintained about all health and social care needs to ensure any changes are noted and quickly dealt with. Evidence: Staff advised that care plans were available for all residents and said they are regularly reviewed. They said that Information from pre-admission assessments is recorded on the plans and this information was noted on all care plans viewed. One person spoken with said his/her care plan had been changed due to a deterioration in health care needs and the plan had been reviewed in full consultation with him/her and all other people involved with his/her care. Staff revealed the content of care plans and reviews were discussed and agreed with each resident and this was confirmed by signatures of each individual being held on file. Care Homes for Older People Page 13 of 28 Evidence: Residents spoken with all said they had been involved in the recording of the care plan and had given their agreement for all care and support to be carried out. Staff were observed assisting people with meals, assisting residents to bathrooms, spending time with residents in the garden and talking to visitors. From discussion with residents all very positive comments received about their support and how staff treated them with dignity and respect Residents revealed that they were asked their wishes about what they felt was the care they needed and comments included: The staff always ask if we are comfortable with the care they give us, The staff chat with us all the time to make sure we are OK with the way they look after us, The staff give us choices of how we want to be looked after, for instance I did not want any help with dressing today so they left me to do it myself. The level of detail in each care plan was such that it was felt that this standard had been exceeded. Records showed that health needs were monitored on a daily basis and care plans viewed and discussions with service users confirmed that health needs had been met, Two care plans examined did not have details of care reviews or signatures of the popele wo had attended them,although records show that reviews had taken placed. Recording of tick box and date on sheet identified that reviews had taken place. Discussion with the residents confirmed they had been spoken with by staff and care reviews had taken place. It is recommended that signatures should be held of all people involved with reviews to show their involvement. Medication systems were good and provided independence for those who wished to deal with their own medication as well as systems for those who rely on staff assistance. Discussion was held with the deputy manager who had the responsibility for medication management at the time of the visit and she displayed excellent knowledge and understanding of all aspects of medication to include, administration, recording, storage and disposal. Staff observed carrying out their duties showed they assisted and supported each resident in a way that maximized independence and retained dignity and residents comments included: The staff are kind and really care for us What a great bunch of staff work here They are always cheerful and make us feel good They are angels, they look after our every need. Care Homes for Older People Page 14 of 28 Care Homes for Older People Page 15 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 living in the home are provided with wholesome food and a good range of activities and interests to help ensure they have a good life quality Evidence: Staff advised that activities are provided on a daily basis. These are audited with the views of people who use the service being gained as to their preferences as well as the standard of activities provided . An activities pro gramme was seen in the home and it was noted that it held full information about daily activity input. Discussion with the people living in the home confirmed that they were invited to participate in activities and that they were not compulsory , comments includedyou can either join in or stay in your room as you want. We can take part in anything that goes on here, you can just sit and watch if you like or you can get out of the Way and go to your room or the other areas of the home I have been here sometime - like the staff especially DH. Good company but some residents can get on my nerves. Activities OK if you like that sort of thing but you can live as you like and get choices. food OK and room is fine. Choices available for Care Homes for Older People Page 16 of 28 Evidence: everything. I cannot be bothered to do too much but you can if you like. -been here 2 years - good home, good activities, good people and the home is comfortable and safe staff good - enjoy the company of friends and visits, can do what I like, I can get up when I like, go to bed when I like, eat my food when I like good home, don;t really want to be here would rather be at home but they wont let me/. Staff are kind, room is good, food is good cant get to the pub as much as I like as I drink too much when Im there. However, staff let me have a drink here when I like and monitor my intake for my own good. It was noted that the home had a clear activities pro gramme and staff advised that activities were offered each day and at the time of the visit it was noted that some residents were about to undertake an arranged outing to The Museum of Life at the Albert Dock, Liverpool. . It was noted that the home had full information of daily activities in the main foyer of the home and staff said they constantly reminded the residents of the activity of the day to ensure they did not forget and miss out participating in social and interesting events. Residents said they were encouraged to bring in person possessions to make them feel that they could make their own accommodation as home - like as possible. Staff said Advocacy services are also used on a regular basis and residents spoken with said they were aware that they could use advocates with one resident revealing that she/he was currently using external advocacy services which had been facilitated by the home. The provision of food was found to be satisfactory. Residents comments ranged from no complaints, reasonably varied, excellent, The chef is good, food is well presented and, you put pounds on. A menu is available. Staff revealed that every effort is made to ensure that meals provided meet the needs and preferences of individuals. Care Homes for Older People Page 17 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. There is a complaints procedure in the home which is known to the people living there and their families. Staff are trained in all aspects of safeguarding vulnerable people and fully understand the process of keeping people safe. Evidence: There is a complaints procedure in the home and the manager advised that she has received one complaint since the last inspection. The manager said she encourages the people in the home and their families to voice their concerns at all times and she details any complaints in the complaints book which was available for examination. The complaint book held details of the one complaint received within the last twelve months and identified that the manager had utilized the home complaints procedure to process the complaint. Discussion with people living in the home and feedback from surveys confirmed that people know about the complaints systems and would be comfortable using this if they needed to express feelings of dissatisfaction about the staff or services provided by the home. Staff have received training in respect of safeguarding and abuse awareness and records seen indicated that all staff have received training in identifying and reporting abuse. Discusisons with staff identified they had sound knowledge of what constitues abuse and had fuuly undersood the content of thier training in these matters. Care Homes for Older People Page 18 of 28 Care Homes for Older People Page 19 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 general environment continues to improve and the maintenance is well managed to ensure that the residents live in a safe well maintained home. Evidence: The home is purpose built. People are able to mobilize around the building, assisted if required by the provision of aids and adaptations. A tour of the building found the premises to be clean and hygienic and records showed that the home utilize two domestic personnel who work alternative shifts to maintain a clean environment paying great attention to infection control. Records show that the home employ the services of a maintenance person who carries out the necessary checks and completes daily records to demonstrate that the home is safe and well maintained. The registered provided of Huyton Hey Manor undertakes monthly checks on the premises and through discussions with the manager identifies any areas of the home and its fabrics and furnishings that are in need of refurbishment or replacement. It was noted that window and roof blinds and flooring has been replaced and redecoration has taken place since the lat inspection. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are appropriately recruited and trained to ensure residents are safe supported and feel secure. Evidence: Records show that the home has an exceptionally low turn over of staff. Staff said this is because they like working in the home and feel that the atmosphere is almost one of family. Comments from staff included: The manager and deputy are very good, its the best home I have ever worked in The home is homely and good entertainment is provided for the people who live here and there is plenty for them to do. We help them to remain as active as possible and make it a good place for all of us to be Staff meetings are regular, training is good, we all feel supported and valued in this home We are trained and supported and have enough staff on duty to eet all needs Staffing levels are good and records show that the skill mix of staff is varied on each shift and staff say they work well together in the best interests of the residents. Care Homes for Older People Page 21 of 28 Evidence: Staff recruitment files examined focused on recent appointments and records revealed that all references and appropriate safety checks had been carried out prior to people being offered employment at the home.Files also contained induction and training certificates and supervision records.. Staff said that when they had been appointed they were subject to a thorough induction in which they accompanied a senior member of staff for 2 days before they carried out any care practices and then they were shadowed to make sure they had understood their training and the needs of the people in their care. The manager said staff were exceptionally well skilled and carry out their duties to an excellent standard. She said she can qualify these remarks by feedback received via the home quality assurance systems and from discussion with people living in the home and their representatives. Comments from people living in the home and their families included: Staff are always around when I want them The staff are wonderful, I would not be around without them The staff know what they are doing, they are good at what they do, they are kind caring and wonderful people. Training was discussed with staff and they revealed they were provided with lots of training through from induction to access to NVQ. Records show that to date thirteen of the eighteen permanent care workers have achieved NVQ level 2 or above which provides a good staff base for the care of the residents. Records show that all staff have received statutory updates in manual handling, safeguarding and health and safety issues. Through discussion and observation it was apparent that staff are well thought of by people living in the home and their representatives and many positive comments were made about the quality of care provided within Huyton Hey Manor. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The consistent management of the home ensure that staff and people who live there feel safe, supported and gain great benefits from a home which is well run in their best interests. Evidence: The manager is experienced and qualified for the position and continues to receive training in respect of her role. She has recently obtained the Registered Managers Award. The management structure of the home is supplemented by the addition of a deputy manager. Ongoing maintenance plan is in place and improvement in the home continues in the best interests of the people living there. The manager advised that QA surveys assist her to build on existing services. The Care Homes for Older People Page 23 of 28 Evidence: Manager said she ensures staff do not work excessive hours and monitors this to ensure that staff are always fully fit to carry out their duties. The home demonstrates an open philosophy with residents views being canvassed on a regular basis through the use of questionnaires in respect of food, activities and general support and the provision of regular residents meetings and newsletters in which the residents are encouraged to contribute articles about their lives, interests or any interesting facts. Staff supervision continues with all staff receiving this on a regular basis. Staff said they enjoy one to one supervisions as they say they fell comfortable discussing issues related to both their work and their own continuous personal development. Residents who have chosen to have their monies looked after by the care home staff are provided with individual pocket money ledgers. Receipts and transactions were seen to be held in this book with double signatures being in place to evidence the paying in and paying out of money. All money is kept in a locked safe within a locked room and can only be accessed by senior staff who have been designated this role. At the time of the visit, there were 28 residents living in Huyton Hey Manor. All residents were spoken with and they all stated their contentment with the staff and services provided. All service users said they were happy with the service and comments included:- A marvelous place Cant fault it You could go a long way to find anywhere as good as this Staff are helpful very good Staff spoken with said they felt the home was well managed by people who knew what they were doing. Comments included, The manager and deputy delegate responsibilities to the staff. This makes us feel valued and part of the team. We are supported well by the managers, they are good at what they do and create a good atmosphere for us to work in. It is a nice place to work in, we all work together for the good of the residents. The home is run smoothly because of good management and good staff who work together to make it a safe environment for people to call their home. We provide a safe`environment and take care of their needs,solve their problems make them laugh and be happy. Care Homes for Older People Page 24 of 28 Evidence: Records show that all health and safety training is carried out as appropriate and all essential service checks are carried out by people who are competent to do so. Care Homes for Older People Page 25 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 26 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 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 It is recommended that the signatures of all people who attend care reviews are recorded to ensure that their contributions are noted. Care Homes for Older People Page 27 of 28 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 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!