Inspection on 23/02/09 for Lea Green Court

This inspection was carried out on 23rd February 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

Lea Green Court 25/06/09

Lea Green Court 29/10/08

Lea Green Court 01/07/08

Lea Green Court 17/07/07

Lea Green Court 10/07/06

Lea Green Court 24/10/05

Lea Green Court 13/06/05

Lea Green Court 23/09/04

Lea Green Court 10/05/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Lea Green Court Kenton Road Gosforth Newcastle Upon Tyne NE3 3UW     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: Elaine Charlton     Date: 2 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 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 30 Information about the care home Name of care home: Address: Lea Green Court Kenton Road Gosforth Newcastle Upon Tyne NE3 3UW 01912851720 01912851960 lea_green.court@fshc.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Tamaris Healthcare (England) Ltd Name of registered manager (if applicable) Ms Lynne Lilian Doyle Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: One named service user is under 65 years of age, category DE. No further admissions are permitted in this category without the prior agreement of CSCI. Date of last inspection Brief description of the care home Lea Green Court care home provides nursing care for older people with enduring mental health problems. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is owned and managed by Four Seasons Healthcare Limited a large provider of care services to vulnerable client groups. It is situated in Gosforth on the outskirts of Newcastle upon Tyne close to local shops and good public transport links. There are 45 single bedrooms located at ground or first floor levels, and there is a passenger lift to help people who may have difficulty with stairs. Most bedrooms have en-suite facilities, those that do not have a wash hand basin and are close to bathroom, toilet and shower facilities. On each floor there are separate lounge and dining room areas, and a number of toilets and bathrooms. The home also has its own kitchen and laundry facilities. Fees in the home are between £421 - £616 per Care Homes for Older People Page 4 of 30 care home 45 Over 65 45 0 Brief description of the care home week. They are dependent on they type of service provided and whether the placement is privately funded or not. Care Homes for Older People Page 5 of 30 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: An unannounced visit was made on the 23 February 2009. A total of seven hours were spent in the service. The manager was present throughout the inspection. Before the visit we looked at Information we have received since the last visit on the 29 October 2008. The Annual Quality Assurance Assessment (AQAA) that gives CSCI evidence to support what the service says it does well, and gives them an opportunity to say what they feel they could do better and what their future plans are was that provided for a previous inspection. How the service has dealt with any complaints and concerns since our last visit. The providers view of how well they care for people, and the views of people who Care Homes for Older People Page 6 of 30 use the service, their relatives, staff and other professionals who visit the service. We have also reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. During the visit we Talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Other records which must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building/parts of the building to make sure it was clean, safe and comfortable and checked what improvements had been made since our last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? What they could do better: Make sure that assessment information is used to prepare care plans and that any changes are properly recorded. Remind staff that medication administration records are fully and properly completed, helping to keep residents safe and well. Continue to carry out the programme of staff supervision and support, making sure it Care Homes for Older People Page 8 of 30 meets the minimum level of six sessions per year. Increase the number of care staff who have achieved a National Vocational Qualification at a minimum of level 2. Increase the frequency of provider visits to the home under Regulation 26 of the Care Homes Regulations 2001, helping to keep residents and staff safe and well. 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 30 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 30 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 who wish to move into the home, and their relatives, are given good information to help them decide about moving into the home, and their needs and wishes are fully assessed so that everyone is sure they can be met. Evidence: The home continues to get full professional assessments from local authority, healthcare professionals and hospital based staff before people are admitted into the home. The company has introduced its own updated assessment tool called the Care and Health Assessment Profile (CHAP). This is completed as part of the homes assessment of its own ability to meet the needs of people who may want to move into the home. We looked at the records for four people most recently admitted to the home. Two Care Homes for Older People Page 11 of 30 Evidence: were for people needing nursing beds, and two for residential. In each of the records we saw that staff carrying out the assessments had made limited use of the CHAP other than to complete the scoring sections. The manager told us that she had already identified this issue and had spoken to staff about the need to record additional information. We saw that assessments are carried out and recorded using recognised assessment tools to see what level of support people moving into the home might need with pressure area care, continence, nutrition and any deteriorating or enduirng mental health issues. In the records we looked at we saw that not all the information collected through the assessment process was used in the care planning process. The home does not provide intermediate care. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are asked how they wish their personal care to be provided and by whom but some records that contain this information are not always legible or complete which could place people at risk. Evidence: As well as the records for people recently admitted to the home we looked at two care files for people who have lived in the home for some time. Records are now kept in a standard way with information being found in the same place in each file. Care plan evaluations continue to improve but the writing in some is still not clear. This makes it difficult for anyone reading the records to be sure what care and support should be provided. We saw evidence of the advice, support and intervention of healthcare professionals being sought to support people with their illnesses, changes in their healthcare needs, behaviours that may challenge normal daily routines and dietry needs. Care Homes for Older People Page 13 of 30 Evidence: For the people newly admitted to the home care plans were in place to meet their personal hygiene, dietry, mobility and weight loss needs. A more extensive range of care plans had been put in place for the residents who had lived in the home for some time. These included managing confusion and disorientation, anxiety and depression, social interaction, absconding, self-harm, continence, falls and night care. Care plans are now more person centred giving good information about how people expect to be cared for. There are still some differences between the information in assessment documents and care plans. Examples of these differences were an assessment said the person was allergic to mustard, nothing was noted in the allergies section of the service user plan. Information from another home identified weight loss issues and said the person should be weighed weekly and needed the intevention of the dietician if they lost more than 3.4 kilograms. There was nothing in the Lea Green care plan about this and only monthly weights were being recorded. The records did show however that the person had had a small increase in weight since moving into the home. We talked to the manager about the need for assessment information to be properly checked when the person is admitted to the home and for care plans and other documents to reflect any changes or differences between the two. Evaluations are being carried out on a regular basis and we saw examples of person centred, sensitive and informative recordings such as be aware that excess information may increase confusion, and always refer to H by name, this is his chosen form of address. One resident said, about the staff, the ladies here are lovely. Throughout the inspection we saw people being supported in a calm, quite and sensitive way, with personal care taking place in bedrooms or locked bathrooms. Privacy and dignity is also promoted through care plans, knocking on doors before entering rooms and people having their own, private bedroom. We carried out checks on the medication administration routines in the home to make sure that requirements and recommendations made during the last inspection had been met. We also checked the stock of, and recording systems for controlled drugs. Care Homes for Older People Page 14 of 30 Evidence: No issues were identified. During a check of medication administration records (MAR) we saw that they were not all up to date. Some MAR sheets contained gaps where staff should have signed to say whether they had administered medication or whether it had not been taken. Most of the gaps we identified were for night time medications. Care Homes for Older People Page 15 of 30 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 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 use all areas of the home as they wish and relatives are encouraged to visit and join in events. Activities and social opportunities are increasing to provide people who live in the home with interesting and stimulating opportunities. Evidence: The activities organiser who had just joined the home at the last inspection did not stay in post. A member of the care team has just been appointed to take on this full time role. She is spending time with residents on a one to one basis to get to know them, their likes and dislikes. The home held a Christmas Fayre, a coffee morning with the tenants of the sheltered housing scheme next door, and a shopping trip to the Metro Centre. There was a carol service and visit by the Salvation Army Band as well as family joining residents for Christmas lunch and New Year lunch. The hairdresser continues to attend every week. Zoolab, who bring unusual animals, snakes and reptiles for people to meet, have also Care Homes for Older People Page 16 of 30 Evidence: visited the home. People are able to receive communion on a regular basis if they wish or join in sing songs from song sheets left by the church visitors. We saw a large connect 4 game in one of the lounges and were told that residents enjoyed this and regularly won games against staff. The manager showed us one of the therapy dolls that have been bought to help engage with residents. Nice photographs, picutres, posters and old advertising posters have been put up in the corridors. Some are coloured and some are black and white. These provide talking points. The posters have been mounted on wood so that they can be secured to the wall and will not tear. This has proved very effective. The manager told us that they also have some musical instruments that people can use. She was also making arrangements for the new activities organiser to spend time with a colleague in another home as part of her induction to her new role. People are encouraged to bring personal items into the home with them to make their room more familiar to them. The home is aware of local advocacy services, and promotes family involvement, to support residents. Relatives were seen coming and going all through the inspection and people are able to have a meal with their relative should they wish. We were told that the menus are being reviewed. The corporate menus are being used as a base but these are being adapted to meet local tastes and residents wishes, likes and dislikes. There is a full choice of a cooked breakfast, porridge, cereals, and toast in the morning, two hot meal choices at lunchtime and one at teatime. The choices on the day of the inspection were lamb casserole or omlette. We saw examples of the soft and pureed meals that were being offered to residents who needed these. There is a new staff team in the kitchen who are enthusiastic and were keen to talk about the changes being made, the new menus and return to home cooked meals, puddings and cakes. Scones had been baked for afternoon tea and two corn beef casseroles were ready to Care Homes for Older People Page 17 of 30 Evidence: be cooked. Both looked very appetising. Care Homes for Older People Page 18 of 30 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 who live in the home are protected from harm through policies, procedures and staff training in complaints and safeguarding adults. They know who to speak to if they are unhappy or wish to make a complaint and can be confident that issues will be properly dealt with. Evidence: The company has policies and procedures in place for the acceptance, recording and investigation of complaints, concerns and allegations. Monthly summaries of complaints and compliments are sent to the Regional Manager. These are also checked as part of the providers Regulation 26 visits. The programme of protection of vulnerable adult training for all staff is almost complete. We were told that the manager was also waiting for dates for staff to attend training on the Mental Health Capacity Act and Deprivation of Liberty legislation. The organisation also has a whistle blowing policy that encourages people to disclose any poor practice that they may witness. There have been no complaints since the last inspection and there are no on-going protection of vulnerable adult issues. The manager is aware of the need to report people considered unsuitable to work with vulnerable adults to the appropriate Care Homes for Older People Page 19 of 30 Evidence: register. Staff are required to have a Criminal Records Bureau (CRB) check at an enhanced level to make sure that they are able to work with vulnerable people. Regular checks are also carried out to check that nurses working in the home have current registrations. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is warm, comfortable and clean, where they can spend time in private or with other people and move about safely both inside and in the enclosed garden. Evidence: During the inspection we walked around the home to check whether the requirements and recommendations made at the last inspection had been met. No issues were found to be outstanding although work continues to improve decoration around the home and bathing/shower facilities. We randomly identified five bedrooms to look at. These were all found to be clean, tidy and nicely personalised. Where we had seen information in a residents assessments about the need for equipment or adpated beds to be provided these were in place. Corridors on both floors are light, spacious and have been newly carpeted. New chairs, and sofas have been purchased for the lounges on both floors. We were told that residents had been involved in selecting the colours for these furnishings. One shower room was in the process of being re-painted in a much lighter colour and Care Homes for Older People Page 21 of 30 Evidence: even though this was not complete the room was much pleasanter. We were told that one bathroom has been identified for refurbishment and redecoration and another is going to be converted into a shower/wet room which will give people a better choice of where they have a bath or shower, or which they choose to have. The manager said that sluices, communal toilets, some bedrooms and lounges were due to be measured for new floor coverings by the end of February. Everywhere was clean, tidy and odour free. Care Homes for Older People Page 22 of 30 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 working in the home are properly recruited and the residents know that their staff receive training to help them provide the care and support they need, although some training is still in need of updating. Evidence: The company has comprehensive policies and procedures in place to support the proper recruitment and selection of staff. We looked at the records for two people newly recruited to the staff team. The records showed that they had completed an application form and health questionnaire, that references had been obtained, evidence of identification and criminal records bureau checks had been seen and carried out. Staff records are now kept in a consistent way and in addition to their basic recruitment file there is one where training is recorded and copies of certificates are kept. Only a small number of care staff have achieved a National Vocational Qualification at a minimum of level 2. Four more staff have just registered to work towards this qualification. Care Homes for Older People Page 23 of 30 Evidence: Some areas of mandatory training, including health and safety, is in need of updating, but all staff have received refresher training in fire safety and moving and handling since the last inspection. Nursing staff have completed safe handling of medication training. Other training that has taken place includes tissue viability, verification of death, mental capacity and appraisal. The staff team has been strengthened with additional hours for the domestic team and a full time activities co-ordinator. We were told that new staff work through the Four Seasons Healthcare Limited induction book that then provides evidence towards their NVQ. Fire training is delivered on the first day a person is at work and they are not allowed to carry out moving and transferring duties until they have completed the training. It was the first day at work for one person we met. We saw them being shown around by another member of staff who was also pointing out fire points. The manager told us that she was in the middle of re-issuing staff with contracts of employment to make sure that everyone had received one. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from living in a home that is being run in an open and inclusive way, promoting their best interests, safety and well being. Evidence: The manager has almost completed the process of registration with CSCI. She has, with the assistance of the staff team, worked to meet all the requirements and recommendations made at the last inspection. We were told that quality assurance quesitonnaires are due to be sent out from Headquarters in March. These will be returned to Headquarters who will then provide the home with a summary report. We saw accident records and the monthly monitor sheet which were both up to date. A number of accident follow up actions had been noted. Care Homes for Older People Page 25 of 30 Evidence: During our review of records we identified some entries that were difficult to read and one body map did not have the name of the resident on it and it had not been signed by the person filling it in. We spoke to the administrator about financial procedures and the checks that are carried out to safeguard residents monies. She told us that random, unannounced checks are carried out by regionally based staff, this is usually every two to four weeks. She also regularly completes a personal allowance report that goes to Headquarters. The organisation has a computer system where all pesonal monies and fees are logged and staff cannot delete entries from the system. There have been some changes to the Regional staff who visit the home which is now supported from the organisations Newcastle office. We noted that recently the providers regulation 26 visits have not been carried out and recorded on a monthly basis. The programme of supervision is continuing but has not yet achieved the National Minimum Standard of six one to one sessions per year. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 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 Staff should make better recordings in the CHAP assessment, in addition to scoring the areas, to help and support staff to provide the right care and support that people need. Staff writing in residents records should take time to ensure that the information they are recording is legible so that it can be easily read and understood by the staff giving care and support. Information contained in assessments should be fully used to produce care plans and any changes in needs between these documents should be clearly noted. This will make it clear what a persons current care and support needs are. Staff should initial or complete the MAR with the appropriate code, to show whether they have administered medication or not. This will help to keep people who live in the home safe and well. The home should continue to promote and introduce a wider range of activities and social opportunities for people who live in the home. This will mean that they lead a more interesting life. Contact with the local community both inside and outside Page 28 of 30 2 7 3 7 4 9 5 12 6 13 Care Homes for Older People the home should be promoted giving people the chance to keep in touch with what is going on around them. 7 18 The programme of protection of vulnerable adults training should continue to make sure that everyone has had their skills and knowledge brought up to date. This will help to keep people who live in the home safe. 50 care of staff should achieve a National Vocational Qualification at a minimum of level 2. This will help and support them to do their job. Staff should continue to receive training in all mandatory areas until this is up to date. This will help to keep people who live and work in the home safe and well. The frequency of Regulation 26 visits should increase to monthly to help support people who live and work in the home and to monitor the premises and the quality of care and support people are getting. Staff should continue to receive regular, recorded supervision, at a frequency that meets the National Minimum Standard of six sessions a year. This will support them to do their job. 8 28 9 30 10 36 11 36 Care Homes for Older People Page 29 of 30 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 30 of 30 - 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!