Inspection on 17/09/08 for Orchard House

This inspection was carried out on 17th September 2008.

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

Orchard House 13/02/07

Orchard House 18/10/05

Orchard House 13/12/04

Orchard House 04/05/04

Orchard House 27/01/03

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 05/12/2008.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Orchard House 4 Orchard Road Havant Hampshire PO9 1AU     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: Laurie Stride     Date: 1 7 0 9 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Orchard House 4 Orchard Road Havant Hampshire PO9 1AU 02392475038 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Margaret J Tompkin Type of registration: Number of places registered: Ms Margaret J Tompkin care home 15 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Orchard House provides residential accommodation for a maximum of fifteen older people, of either sex, with mental health problems. The home is a detached building situated in a residential area of Havant and has benefited from several improvements to include expanded car parking and garden area. Accommodation is provided for by way of eleven single bedrooms, one of which has an en-suite facility, and two double bedrooms. There is a lounge/day room and a separate dining room, and seating is provided in the large landscaped garden. The home is within walking distance of the town centre, where the residents can access the local shops and amenities, and access public transport. Care Homes for Older People Page 4 of 27 Over 65 0 0 15 15 15 0 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit, which took place as part of a key inspection of the service. The visit lasted approximately six hours, during which we (the commission) met the people who use the service. We spoke briefly with some service users, however our communication was limited due to the nature of the individuals disabilities. We spoke with the registered manager, four members of staff and visitors to the home. We also received comments from staff, care managers and health professionals who visit the service, through our survey questionnaire. Further evidence used in this report was taken from the homes annual quality assurance assessment (AQAA) and the previous inspection report for the service dated 13th February 2007. The current fee is four hundred and fifty pounds sterling per week. This information Care Homes for Older People Page 6 of 27 was obtained at the time of the inspection visit. Members of the public may wish to contact the care home for up-to-date information about fees. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to use the service benefit from having a comprehensive pre-admission assessment of their needs before moving into the home. Evidence: The previous inspection report for 13/02/07 identified that the needs of people were being properly assessed before admission was agreed. For this inspection, the homes annual quality assurance assessment (AQAA) told us that there is a good preadmission process. Prospective residents and/or their representatives are able to visit the home first, which gives the opportunity for them and the service to assess the suitability of a placement. External agencies are also involved in the process and support is given to residents and their families while the individual is moving in. During this visit we looked at the records relating to the admission of two people since the last inspection. These showed that the home combines its own assessment with Care Homes for Older People Page 10 of 27 Evidence: that of the placing authority and the information is used to develop a care plan, once admission is agreed. We spoke with the relative of one of the individuals, who confirmed that they had been able to visit and view the accommodation and had received a copy of the Service User Guide, which gives information about the service provided. Staff from the home had also visited the person as part of the assessment prior to their admission. We spoke with another relative of a person who had used the service who also confirmed they were able to visit. This relative told us that they had been impressed by the homes personal approach to providing care and that the service had also put them in touch with a support group. Both relatives said that the home kept them informed of any changes. Three care managers who had completed our survey questionnaire indicated that the services assessment arrangements ensure that accurate information is gathered and that the right service is planned and given to individuals. One care manager also told us that there is good communication and discussion with the residents, family and agencies involved. Specialised intermediate care is not being provided, therefore standard 6 is not applicable to this service. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans now provide more information to ensure that the people in the home have all their needs met. Staff medication administration practices protect people who use the service. Evidence: The previous inspection report identified that, in general, care plans set out individuals needs and how they will be met and regular reviews of the care plan were being carried out. In one persons care plan, guidelines for staff were not provided for dealing with aggression or unwelcome visitors and a requirement was made in relation to this. The service provider had advised us following the inspection that a risk assessment had been put in place. The homes annual quality assurance assessment (AQAA) told us that the home get to know each resident well and obtains details of their past history, involving external agencies and peoples families as appropriate. Care plans are updated monthly or as changes occur. The AQAA also said that the service does well at promoting Care Homes for Older People Page 12 of 27 Evidence: independence and monitoring levels of individual need on a daily basis. The home continues to encourage staff to spend quality time with people who use the service. During this visit we looked at a sample of three individual care plans and risk assessments. These contained details of each persons assessed needs, abilities and personal preferences together with the type of care required and method of providing support. Guidelines were given for staff members on how to deal with any aggressive behaviour and a policy statement was in place relating to the home supporting individuals to decline visitors or phone calls if they wished. There are designated members of staff, clearly indicated on the rota, who are responsible for ensuring that care plans and risk assessments are updated as necessary. We also saw that records were dated to indicate when monthly reviews had taken place. Staff we spoke to demonstrated a good understanding of the importance of good communication to make sure that any changes in peoples needs and support are shared with the team. They also gave examples of how individuals health and wellbeing is monitored and supported. We spoke with one persons relative, who told us that the home provides good care and that there are regular visits to the home by the doctor and district nurse, so they have no worries about health issues. We saw that visits by healthcare professionals were documented in peoples care plans and the office diary showed when further appointments were made. Another relative of a person who had used the service provided further confirmation that peoples health care needs were met by the service. They also told us that peoples privacy is respected in the home. We observed staff members interacting with people who use the service in manner that ensured that the individuals privacy and dignity was respected. Three care managers who had completed our survey questionnaire indicated that individuals health care needs are always properly monitored and attended to by the service. All three said that the care service provided always respect individuals privacy and dignity. This was further confirmed by survey comments from three health care professionals. Three members of staff who completed a survey questionnaire indicated that they are always given up-to-date information about the needs of the people they support or care for (for example, in the care plan). The registered manager told us that no individual is currently assessed as being able to hold or manage their own medication, with the exception of one individual who holds their inhaler. Medication policies and procedures are in place and there are generally suitable storage facilities for medication. We advised the registered manager of recent changes to the regulations about the storage of controlled drugs and that the home needs to obtain a suitable storage facility. This is so that the home is properly Care Homes for Older People Page 13 of 27 Evidence: equipped in the event that someone is prescribed a controlled drug. Records and discussion with staff members showed that staff received training in medication administration. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does very well at providing a flexible and varied activities programme to suit the needs and capabilities of people who use the service. Individual dietary needs and preferences are well catered for. Evidence: The previous inspection report commended the home for making sure that the routines of daily living and activities available were flexible and varied to suit individuals expectations, preferences and capacities. The homes annual quality assurance assessment (AQAA) stated that this continues to be the case and evidence of this can be found in the monthly diary and activities log. The AQAA also told us that visitors are made welcome and there are good communications with the community – schools, churches, neighbours and a local radio station. Good quality home cooked food is provided. The start of our visit coincided with musical entertainment being provided in the lounge, which was enjoyed by a large number of the people who live in the home. We spoke with the entertainer, who visits frequently, and also with a visitor who does hairdressing for people who use the service. Both spoke highly of the homes Care Homes for Older People Page 15 of 27 Evidence: management and staff. A member of staff was giving manicures to individual residents throughout our visit. We saw that the homes activities log keeps a record of the activities and who likes to take part in them. One person who lives in the home prefers to go out independently. Examples of the activities included craft, quizzes and music for health sessions, which encourage people to participate and also provides gentle exercise. The homes diary showed that regular church services are provided and a Harvest Festival event involving the local school was scheduled in October. Visitors we spoke with told us about fund-raising events such as garden parties that are held by the home. One care manager who took part in our survey said the home does well at providing fun and days for the families to enjoy with the clients, such as fetes, fireworks and parties. Another care manager said there are High levels of activities and encouragement for clients to participate both within the home and community. We observed that a tea tray is provided for visitors and those we spoke with confirmed that they are always made welcome. There is a sign near the front door asking that visitors avoid coming at mealtimes. The manager and staff members gave examples of how the daily routines are flexible to suit individuals, for example the times when people get up and have breakfast. At lunchtime we saw that staff members were available to give support if needed and did so in a sensitive manner that suited the pace of the individual. There was a calm and unhurried atmosphere in the dining room. Appetising home cooked meals are served each day and the home keeps records of menus and alternatives provided. Care plans contain information about individual needs for special diets and any religious and cultural preferences. We spoke with one of the cooks who told us she was aware of individuals likes and dislikes and is kept informed of any changes by the care staff. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confident that any concerns they have will be taken seriously and acted upon. The homes policies and procedures protect people who live in the home from abuse and this would be further enhanced through further guidance and training for staff members. Evidence: The homes annual quality assurance assessment (AQAA) stated that people are protected and all complaints are dealt with professionally and sensitively and within the guidelines of the service policies and procedures. The AQAA told us that in the last twelve months there had been fourteen complaints, all resolved within 28 days. The manager told us that they are looking at ways of reducing repetitive complaints relating to the loss or misplacing of peoples laundry. We saw that the home has a complaints logbook where the nature of the complaint is recorded, what action has been taken and the outcome. We have not received any concerns or complaints about the service. We spoke with two visiting relatives who confirmed that they had received a copy of the homes Service User Guide and complaints procedure. One relative told us that the manager and staff are approachable and they were confident that they would deal with any concerns and that their relative receiving care is safe. Care Homes for Older People Page 17 of 27 Evidence: The three care managers who took part in our survey indicated that the home has always responded appropriately if they or a person using the service have raised any concerns about their care. One also said that Responses have always been prompt and professional, with any concerns acted upon within reasonable time scales. This was further confirmed through comments by three health professionals, one of whom said There is an open approach regarding patient care. Ive never had any problems. The three members of staff who returned a survey form all indicated that they know what to do if someone has concerns about the home. The previous report identified that the home has policies and procedures in relation to responding to abuse. There have been no safeguarding issues and the manager told us that the whistle blowing policy is discussed at staff meetings. We spoke with three staff members who told us they would report any suspected abuse to a senior staff member. Staff members were not clear what should happen once an incident was reported and we advised the manager that the procedures should be re-visited at subsequent staff meetings. The manager agreed to do this. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from having a clean, homely and comfortable environment to live in, which meets their individual needs. Evidence: The previous inspection report showed that the home provided a clean, pleasant and well-maintained environment. At the time of the previous visit hot water temperature valves were being introduced to all hot water outlets to ensure safe hot water. Prior to this visit the homes annual quality assurance assessment (AQAA) stated that there is ongoing decoration and maintenance work that is logged in a monthly report. The service has re-vamped the lounge, decorated two bathrooms and two bedrooms since the last inspection. The home had received a good Environmental Health report with no requirements. During our visit we saw the communal areas and a number of bedrooms. The dining room had been refurbished and decorated and there was new furniture and pictures on the walls. We saw further evidence of a continuing programme of maintenance and renewal in other areas of the home, including the bedrooms and bathrooms. The home is suitably equipped to assist people with their mobility and promote their independence. One of the homes neighbours regularly brings in fresh flowers to decorate the communal spaces. Care Homes for Older People Page 19 of 27 Evidence: We observed a good standard of cleanliness throughout the building. The home has infection control policies and procedures and records showed that staff members receive training in these matters. The laundry room is in a separate building in the garden and is equipped with industrial washing machines with a sluice cycle, which are serviced regularly. The laundry has readily washable floor and walls. We observed that people who live in the home are able to go for walks in the garden, which is well maintained and secure. A health professional told us in our survey questionnaire This is a nice tidy home and the staff are always friendly and helpful. Asked what does the service do well, one staff member said provides good care and a safe environment. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are supported by a well-motivated and trained staff team and are protected by the homes recruitment procedures. Evidence: The staff rota showed four staff members on duty during the morning and two care staff plus the cook on duty in the afternoon. The manager pointed out that this varies according to the activities that are planned and the needs of people who use the service. We noted that during the afternoon of our visit there were three care staff on duty. Another member of staff was also present, giving manicures to female residents. The manager is on-call when not in the home. The numbers of staff enabled care and other tasks to be performed in a calm and unhurried way. The three members of staff we spoke with during our visit were well motivated, knowledgeable and understanding of the personalities and needs of individuals living in the home. The previous inspection report identified that the home had thorough recruitment procedures in place to safeguard people who use the service. For this inspection, three members of staff who completed survey questionnaires confirmed that their employer carried out checks before they started work. We looked at a sample of recruitment records in relation to three staff members. These contained all the required information, such as dates of employment and completed job application forms, two Care Homes for Older People Page 21 of 27 Evidence: written references and evidence of satisfactory Protection of Vulnerable Adults (POVA) and Criminal Records Bureau (CRB) checks. This demonstrates that people who use the service are being protected. The homes annual quality assurance assessment (AQAA) stated that staff members are now given more opportunity to participate in the running of home. During our visit we saw that responsibility for various tasks are rotated among the staff team, which encourages the development of peoples knowledge and skills. The AQAA also told us that seven out of fourteen care staff have obtained National Vocational Qualifications (NVQ) at level 2 or above, while another four staff are working towards achieving the award. We saw there is a staff training record showing that regular training is provided in core subjects such as moving and handling, fire safety, first aid, food hygiene, infection control, medication administration, nutrition and diet, dying, death and bereavement, dementia care, and caring for people with challenging behaviour. We also saw evidence that structured induction training is being provided for new staff. Care managers and health professionals indicated in our survey that the homes manager and staff have the right skills and experience to support individuals social and health care needs. One also said in my experience the level of staffing has always been good, with a high calibre of skill levels for staff. Another told us Staff always appear caring and professional whenever I visit the home. Survey results from members of staff indicated that their induction covered everything they needed to know to do the job when they started. They also confirmed that they receive training which is relevant to their role, helps them understand and meet the individual needs of people who use the service and keep up to date with new ways of working. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well run and management practices promote the wellbeing and best interests of the people who use the service. Evidence: The previous inspection report identified that the home is well run and in the best interests of the people who use the service. The homes annual quality assurance assessment (AQAA) told us that there is a good rapport between staff, families and residents, which we observed during our visit. We saw that the manager is accessible to her staff and people who use the service and there is a relaxed and supportive atmosphere in the home. The manager continues to update her knowledge and skills and has been undertaking the registered managers award (RMA) at NVQ level 4. We saw that a quality assurance system is in place, which includes obtaining the views of people who use the service, relatives and other stakeholders. The results of the homes recent survey of relatives and visiting professionals were available and these Care Homes for Older People Page 23 of 27 Evidence: were overwhelmingly positive about the service. Examples of peoples comments were: very pleased with all services provided for my mother, and Margaret and staff has made mum and family feel like its home from home, which makes us very happy for mum and to know she is happy too. These positive responses were backed up by the results of our own survey conducted just prior to our visit, as well as by discussion with visitors and staff during the inspection. The manager also undertakes a monthly inspection report on the service. The manager said that the home does not manage the financial affairs of any resident, and that cash is not generally held on behalf of people who use the service. We saw evidence that safe working practices were being upheld in the home. For example, records of up-to-date fire drills, fire alarm tests and checks on the emergency lighting and other equipment. Mobility equipment such as hoists and stair lifts are serviced regularly and staff members receive mandatory health and safety training. Risk assessments were being kept under review, which meets a previous requirement. Since the last inspection the manager has obtained a copy of the most recent food safety legislation and implemented the Safer Food system, which meets another requirement. The most recent local authority food safety inspection gave the home a good report with no requirements. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 18 The manager and staff members re-visit the safeguarding procedures to make sure that everyone has a clear knowledge and understanding of their roles within the procedure. Care Homes for Older People Page 26 of 27 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!