Inspection on 30/03/09 for North Clifton Hall Nursing Home

This inspection was carried out on 30th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

North Clifton Hall Nursing Home 20/12/07

North Clifton Hall Nursing Home 22/07/06

North Clifton Hall Nursing Home 20/12/05

North Clifton Hall Nursing Home 02/12/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: North Clifton Hall Nursing Home Main Road North Clifton Newark Nottinghamshire NG23 7AZ     The quality rating for this care home is:   one star adequate 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: Meryl Bailey     Date: 3 0 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: North Clifton Hall Nursing Home Main Road North Clifton Newark Nottinghamshire NG23 7AZ 01777228229 01777228100 loyaltycare@btconnect.com loyaltycare@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Loyalty Care Limited care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability terminally ill Additional conditions: The home is registered to provide personal care for service users of both sexes, whose primary needs fall within the following categories: Old Age (OP) (27) Terminally Ill (TI) (3) Physically Disability (PD) (3) The maximum number of service users to be accommodated is 27 Date of last inspection Brief description of the care home North Clifton Hall is an adapted property situated in its own grounds near the village of North Clifton in north Nottinghamshire. Access to local shop or pub facilities is not possible without transport. There is a long driveway to the main road to reach the bus 0 3 3 Over 65 27 0 0 Care Homes for Older People Page 4 of 28 Brief description of the care home route to Gainsborough and Newark. The service provides personal and nursing care for up to twenty-seven older people of both sexes, with up to three places for younger adults with a physical disability. A qualified nurse is on duty at all times. There are twenty-five single rooms and two double bedrooms. A passenger lift provides access to the upper floor. There is one lounge and one dining room, which overlook the gardens. There are five toilets and two bathrooms, one with a jacuzzi and a shower room. The gardens provide a tranquil outdoor area for people to enjoy in good weather. There are car parking spaces at the front of the building. The fees range from £420 - £440 per week, the fees do not include hairdressing, chiropody, dental fees, papers or personal clothing. A full Service User Guide is available from the manager and this includes the last inspection report. 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: one star adequate 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 focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people using the service and their views on the service provided. This process considers the providers capacity to meet regulatory requirements and minimum standards of practice and it focuses on aspects of service provision that need further development. Prior to the inspection visit we sent out survey forms to a sample of people currently living at the home and we have used their comments for planning and to inform our judgments. We reviewed all of the information we have received about the home since the last report of our key inspection, which took place on 17 December 2007. Services are now required to fill in a document called an Annual Quality Assurance Assessment (AQAA), in which the registered manager identifies from their own quality monitoring what the service does well and what they need to improve. We received a completed AQAA form Care Homes for Older People Page 6 of 28 in October 2009. We considered this in planning the visit and deciding what areas to look at and the information has been taken into consideration within this report. We carried out the inspection visit with one inspector. It was unannounced and took place on one day in the daytime, including lunchtime. The main method of inspection we used during this visit is called case tracking which involved us choosing a sample of people who live at the home and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We looked at staffing records and other records connected with the running of the home. A partial tour of the premises included all shared areas and a sample of bedrooms. What the care home does well: What has improved since the last inspection? What they could do better: Ensure a full and complete assessment of needs is carried out prior to a person being admitted to the home. This is so that people can be assured that all their needs can be met at the home. Ensure assessments of health needs are completed in full. This is so that peoples specific needs in relation to their health are fully met. Review and amend care plans whenever incidents or accidents occur to ensure the plans meet changing needs. Destroy medication that is no longer needed to avoid any errors. Arrange transport to enable people to access the wider community as appropriate to their needs and preferences. Care Homes for Older People Page 8 of 28 Ensure all people living at the home, their visitors and all staff are fully aware of the complaints procedure and that all complaints are fully investigated. This is so that people can be assured action is taken to resolve complaints. We recommend the manager maintain clear records in a management file of all complaints. Ensure there are sufficient accessible and appropriately maintained toilets, wash basins, baths and showers. This is so that people have comfortable facilities to meet their needs and preferences. Prepare a maintenance plan with timescales and keep people informed of when work will be carried out. Fit temperature controls to water outlets to ensure water is always produced at safe temperatures. Identify specific needs for training and development of staff to enable them to meet peoples additional needs as they arise. A director of the company must visit the home unannounced at least once each month to interview people and inspect the premises. A written report must be produced of the visit. This is so that the quality of the conduct of the home is continuously reviewed. They should produce a report of the results of the relatives survey to inform people about action being taken to improve the quality of the service. Provide training for the manager in supervision skills to enable her to provide appropriate supervision of staff. All records in respect of people living in the home must be held securely. This is in order to respect the privacy of personal information and to comply with the Data Protection Act 1998. Risks to safety should be assessed prior to people moving into rooms that are currently vacant and action taken to restrict the opening of windows as appropriate. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear information is available about the care provided, so that people know if their needs can be met at the home. Where assessment is incomplete needs may not be met. Evidence: A full copy of the Service User Guide was available and this gave clear information about the service. We saw that people living in the home each had their own copy of the guide in their own rooms, together with a copy of the last inspection report. We looked at the files of four people and found full assessments on three of them, but some information missing from the assessment of the fourth person. From the information available and from daily notes, we could establish that this person had needs in addition to old age that the staff were not trained to meet and were not covered by the registration nor mentioned in the Statement of Purpose. We saw that other older people and people with nursing needs were appropriately cared for and Care Homes for Older People Page 11 of 28 Evidence: some were being nursed in bed. There were charts that confirmed needs were being met. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care needs are generally met and peoples dignity is respected. However, incomplete assessments and the absence of reviews following incidents may pose a risk that changing needs are not met. Evidence: More detail had been added to care plans than at the previous inspection and they were more individual, but changes in actions staff need to take were not all clear from the plans. Staff said they know what is needed as they talk to each other and most people were able to direct them anyway. Care plans files and daily notes were kept on an open shelves, which were easily accessible to people living at the home and any visitors and this does not meet with the Data Protection Act (see Standard 34). There were records to show that care plans had been reviewed systematically on a monthly basis. Some adjustments had been made. However, some daily notes regarding an incident indicated an adjustment was needed in a care plan, but it had not been changed. People told us they usually received the care and support they needed and the staff Care Homes for Older People Page 13 of 28 Evidence: were always respectful. Those who were more independent spent alot of time in their own rooms and did not see staff frequently, but they could use the alarm call system if personal care was required. They said staff attended within a few minutes when called. Other people spent most of their time in the communal areas and staff were in attendance for the majority of the time. There were various assessment tools to assess actions staff were to take in relation to meeting health needs. Some forms were complete and others had been started, but overall scores were not completed and most form we saw were not signed or dated. There was always at least one qualified nurse on duty on the premises. We saw two people who were looked after in their beds and turning charts were used. The records showed that attention was given at least three hourly throughout the day and night. There were other records of visits from and contact with other medical professionals. Medication was stored securely and records were fairly well kept. Most medication is administered directly from a Monitored Dosage System. We counted the controlled drugs and found them accurately recorded, but there were some for a person who is no longer living in the home. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at North Clifton Hall have a quiet lifestyle, with suitable activities provided. Access to the wider community is restricted. Meals are enjoyed. Evidence: An activities worker is employed at the home on five days each week. We saw her working with some people in the dining room. Other staff joined in to help people to make Easter cards. There was a plan posted on the wall showing activities planned for the week. Some people stayed in their own rooms and did not want to take part in the activities planned. They told us that sometimes outside entertainers came into the home. One person told us that the information given prior to admission was that a minibus would be available to take people to the local village, but this has not happened and was disappointing. The home is situated in the countryside away from the main roads. There are no footpaths and the local village is not easily accessible without transport. We observed the staff talking to people about the birds and other wildlife in the garden. People who enjoyed a quiet life told us they liked the setting. We spoke with one visitor who told us that the staff are always welcoming. Other people told us that their relatives visit regularly and some people were taken out for trips with their families. Care Homes for Older People Page 15 of 28 Evidence: There was a 4-week rotating menu. There were two options on one day each week, otherwise one option was shown. the manager and cook said that people could always have an alternative if they didnt like the main course. We saw some people eating Shepherds Pie and others had Pasta Bolognese. People told us the food was very good, we can have what we want and they had a wider choice at teatime. Some told us that they could choose to have their meals in their own rooms or in the dining room. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples concerns are listened to, but the lack of clear records does not guarantee that all complaints are investigated and resolved. Staff are trained to safeguard people from abuse. Evidence: The complaints record consisted of a short list of serious concerns about safety that the manager told us had been dealt with. The date they were resolved was recorded, but there was no management file with detail of how they were dealt with or of the final outcome. Two people told us they did not know how to complain. There was a copy of the complaints procedure in the information pack in each persons room, but they had not realised it was there. One person had recently told a carer about a complaint and was expecting the manager to deal with it. With the persons permission we passed information about this to the manager, who was not previously aware of it. Another person said, You just have to speak up about it. Another person said, Ive never been told who to speak to, so I just try to speak to the person in charge. There were records of staff training in Safeguarding Adults that was given in November 2008 and January 2009. The manager now has obtained a copy of Nottinghamshire Safeguarding Adults procedures. Staff said they would inform the nurse on duty or a manager of any concerns or suspicions. Care Homes for Older People Page 17 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are clean and maintenance work is on going to improve the environment for people living there. Evidence: The main communal areas had been recently carpeted and the lounge was furnished with comfortable chairs. One bathroom has been out of use since November 2008 when an Environmental Health Officer found the water was too hot. The manager explained that work had been carried out to control the temperature, but the Environmental Health Officer had not yet visited again to confirm it can be used. There was another bathroom and a shower room so that people had some choice, but the manager told us people prefer a bath. An assisted bath was used and we saw a label to confirm that this had been serviced in January 2009. This bathroom was in need of redecoration and we saw that one ground floor toilet was in a poor state with the rear wall covered in mould and damaged following a previous leak. In another toilet there was a wash basin with a top missing from a tap and one person told us a tap in a bedroom was the same. There was no written regular maintenance plan, but there was a handyman who visited from time to time to carry out work needed. Work was being carried out to repair and replace external window sills during this inspection. Some bedrooms had been decorated and the manager had identified the next bedroom to be decorated Care Homes for Older People Page 18 of 28 Evidence: when the handyman was next available. All communal areas seemed clean and people told us that the home is always kept clean. There was a current problem with the sluice and the manager had arranged for a leak to be repaired the following day. Care Homes for Older People Page 19 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are a sufficient number of competent staff to meet the needs of older people in the home, but the lack of specific training means additional needs may not be met. Evidence: There was a staffing rota that showed there would be a nurse and three carers each morning and a nurse and two carers each afternoon. The Activities Worker was in addition to this. The manager covered some nursing shifts herself. On carer was not available for the following day and we heard arrangements being put in place for another person to cover the shift. At night there was one nurse and one carer. People told us they felt there were enough staff to assist with their care. One person said the regular staff were always very good, but temporary staff did not seem to know what was needed. Another person said that night staff were very helpful and attended to personal care efficiently. Staffing records were stored securely in folders in a locked cabinet. We sampled three of these and found they each contained an application form, two references and appropriate checks made through the Criminal Records Bureau. The manager told us that most staff have now achieved their National Vocational Qualification Level 2 and some are still working towards it. Records of other staff training were on a matrix table. There were also some certificates of recent training on Care Homes for Older People Page 20 of 28 Evidence: the individual staff files that we looked at. These were for some of the regular safe working topics and Safeguarding Adults. There were also Induction Workbooks being used by new staff and these were in line with common induction standards. There had been no training arranged in specific areas of need and one of the staff told us in the survey that she had arranged her own training. Care Homes for Older People Page 21 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager is approachable and some management systems are effective, but the quality of the service is not fully monitored by the providers and storage systems do not protect peoples personal information. Evidence: Since the last inspection the manager has been registered with the Commission. People living at the home told us they know who she is and find it easy to talk to her. However they were not sure who owns the home now. The manager said there had been some changes in the directors for the company and the responsible person known to the Commission has left the company. One director had visited the home at least monthly, but there were no copies of any report of his findings about the conduct of the home during those visits. The manager told us that there had been a survey carried out at the end of 2008, when questionnaires were sent to relatives. Seven replies were received, but the manager had not produced a report of the outcomes. Care Homes for Older People Page 22 of 28 Evidence: Some money was held on behalf of some people and we found that arrangements for safe keeping had changed since the last inspection. There was an individual wallet envelope for each individual and an individual record of all transactions was held. These were filed away securely. We checked the amounts and records for two people and found them accurate. There were no supervision notes for any of the staff that we sampled, but the manager said she had just started to have individual supervision meetings with the staff. She was not sure how to record them and we saw a partly completed record of one supervision meeting. She had not undertaken any training in supervision skills. There were records held in respect of each person accommodated in the care home. However, full care plans were stored on an open shelf in an unlocked room and daily notes about each person living in the home were kept on another open shelf within a corridor. There were records of staff training in the safe working topics of Moving and Handling and Fire Safety. We saw fire equipment in place and some records of temperatures and tests on equipment to ensure safety. The manager showed us some rooms ready for occupation on the upper floor, but we noticed that the windows opened widely and could pose a danger to people. Care Homes for Older People Page 23 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 24 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 1 3 14 Ensure a full and complete 30/04/2009 assessment of needs is carried out prior to a person being admitted to the home. This is so that people can be assured that all their needs can be met at the home. 2 8 15 Ensure assessments are completed in full to determine health needs. This is so that peoples needs are fully met. 30/06/2009 3 16 22 Ensure all people living at the home, their visitors and all staff are fully aware of the complaints procedure and that all complaints are fully investigated. This is so that people can be assured action is taken to resolve complaints. 30/06/2009 Care Homes for Older People Page 25 of 28 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 4 21 23 Ensure there are sufficient accessible and appropriately maintained toilets, wash basins, baths and showers. This is so that people have comfortable facilities to meet there needs and preferences. 30/06/2009 5 33 26 A director of the company must visit the home unannounced at least once each month to interview people and inspect the premises. A written report must be produced of the visit. This is so that the quality of the conduct of the home is continuously reviewed. 31/05/2009 6 37 17 All records in respect of people living in the home must be held securely. This is in order to respect the privacy of personal information and to comply with the Data Protection Act 1998. 31/05/2009 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 Review and amend care plans whenever incidents or Page 26 of 28 Care Homes for Older People 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 accidents occur to ensure the plans meet changing needs. 2 3 4 5 6 7 9 13 16 19 21 30 Destroy medication that is no longer needed. Arrange transport to enable people to access the wider community as appropriate to their needs and preferences. Maintain clear records in a management file of all complaints. Prepare a maintenance plan with timescales and keep people informed of when work will be carried out. Fit temperature controls to water outlets to ensure water is always produced at safe temperatures. Identify specific needs for training and development of staff to enable them to meet peoples additional needs as they arise. Produce a report of the results of the relatives survey to inform people about action being taken to improve the quality of the service. Provide training for the manager in supervision skills to enable her to provide appropriate supervision of staff. Risks to safety should be assessed prior to people moving into rooms that are currently vacant and action taken to restrict the opening of windows as appropriate. 8 33 9 10 36 38 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!