Inspection on 28/10/08 for Paxton Hall Care Home

This inspection was carried out on 28th October 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

Paxton Hall Care Home 08/06/07

Paxton Hall Care Home 07/07/06

Paxton Hall Care Home 11/01/06

Paxton Hall Care Home 24/11/04

Paxton Hall Care Home 22/06/04

Paxton Hall Care Home 21/01/04

Similar services:

Bilney Hall

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Paxton Hall Care Home Rampley Lane Little Paxton St Neots Cambridgeshire PE19 6EL     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 Boismier     Date: 2 8 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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: Paxton Hall Care Home Rampley Lane Little Paxton St Neots Cambridgeshire PE19 6EL 01480213036 01480477811 paxtonhall@kelam.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Karen Louise Napier Type of registration: Number of places registered: Kelam Health Care Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Paxton Hall is a listed building, dating back to Elizabethan times, on the outskirts of Little Paxton, between St Neots and Huntingdon. The old house was rebuilt and renovated in 1738 and converted into a care home in the early 1980s. Accommodation for residents in the old house is on two floors, accessed by a stair lift and passenger lift with a single floor extension at the back. A conservatory and communal areas are available and there is a large garden to the front of the house and courtyards with flowers and garden furniture. Current fees range from £357 to £630 depending on room size. Additional costs include those for personal shopping, toiletries, hairdressing and private chiropody. Further information about the fees can Care Homes for Older People Page 4 of 27 Over 65 16 3 39 0 0 0 Brief description of the care home be obtained from the home. A copy of the inspection report is available on request from the home or via our website at www.csci.org.uk 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: The last key inspection took place on the 8th June 2007. 27th May 2008: On the 27th May 2008 an Annual Service Review (ASR) was carried out. An ASR is review of information we have received about the home, including comments in surveys from residents and staff. We considered the information and, as a result of this, we decided to bring the next key unannounced inspection forward to the 28th October 2008. A copy of the ASR is available on request at our local office, in Cambridge. Care Homes for Older People Page 6 of 27 We, The Commission for Social Care Inspection, carried out this key unannounced inspection, by two Inspectors, between 10:20 and 15:10 and it took us just under 5 hours to complete. Before the inspection we looked at the results of surveys we received from some of the staff, some relatives and from some of the residents. During this inspection we spoke with the residents, visitors and the staff, including the Manager. We watched how staff were working and activities in the home. We examined documentation and we had a look around the premises. Before the ASR we received a completed Annual Quality Assurance Assessment (AQAA) from the home Manager. For the purpose of this report people who live at the home are referred to as people, person or resident/s. 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. Care Homes for Older People Page 8 of 27 The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs fully assessed to make sure the home is a suitable place for them to live in. Evidence: Examination of care records, of the two most recently admitted people, indicated that the home gathers as much information about the persons assessed needs from social and healthcare professionals. Where an emergency admission was considered necessary there was evidence that the Manager recorded information, that was obtained via the telephone, about this person, and this was kept on file. All of the 13 residents surveys said that the person had enough information about the home, before they moved in, to help them in their decision where to live. The AQAA told us We carry out a thorough pre-admissions needs, abilities, disabilities, religion and belief,sexual orientation, special preferences, mental capacity and special needs Care Homes for Older People Page 11 of 27 Evidence: assessment for every potential service user and these are recorded and taken into account when making a decision as to whether we can meet the service users needs prior to admission. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are generally safe as they receive good and safe care although their care records could be better to ensure that they are completely safe. Evidence: The AQAA told us A comprehensive care plan is prepared for each service user using a person centred approach and following a thorough assessment with the involvment (sic) of the service user and relative wherever possible. This is reviewed monthly or more often if required vis a vis, for example, risk assessment, nutritional assessment, independence, physical and mental needs etc and these are closely monitored. The care plans, that we saw, provided a clear and detailed life history about the person, including where they were born, about their parents and siblings, their education and work history and of their married and family life. The life histories also provided information about the persons interests, to include travelling. The care plan documentation provided assessments of peoples needs although these Care Homes for Older People Page 13 of 27 Evidence: could be better. The following evidence provides examples of where these records could be better. For one person, who was recently admitted to the home, there was insufficient assessment of this person to provide any clear guidance for staff in how to meet the persons needs, including information about their medication. Currently the home provides care for just under 50 of people who have a diagnosis of dementia. Reading some of these peoples care records provided some information about their needs although these could have been expanded further. For example we do not know how a person, who had been assessed as being agitated and anxious, as to how such emotions affected the person and how staff were to ameliorate such emotions, to make the person feel better. We found little evidence as to how the persons dementia affected the persons abilities, including their strengths and weaknesses, in living from day to day. In addition we found little evidence, in those care plans that we saw, how people respond to any validation and what works for them and what does not. For one person, who was prescribed a sedative (lorazepam), as required, their care plan indicated lack of information about this medication and there was no guidelines for when the staff should give the person this medication. In addition when this medication was given on 3rd October, and again on the 18th October 2008, the daily notes do not justify its use. We have made a requirement about care records. All of the 13 residents surveys said that the person always/usually received the care and support, including medical support, that they needed. Comments included My mother and I feel all people living here are treated as an individual and their needs are seen to accordingly and (The staff are ) always very helpful and attentive. In another of these surveys we read I cannot praise the care given enough. We saw people were well dressed and their personal care was of an acceptable standard, with clean clothes, generally clean hair and clean finger nails. A visiting healthcare professional had high praise for the standard of care provided at the home and considered that the home would always call the general practitioner or district nurse when a resident needed this attention. Care records indicated people have access to other healthcare professionals including community psychiatric nurses and chiropodists. Currently the home has one person with pressure sores, and these were acquired before the person moved into the home. Observation of a discussion between a member of the staff and the Manager indicated that pressure-relieving aids were being provided for this person with pressure sores. Some of the visitors told us how very satisfied they were with the standard of care provided to their relative: they had noticed a significant improvement in their sense of well-being, as their previous anxiety levels had decreased and the person was much happier, since moving to Paxton Hall. The medication policy and procedures are in place but these are brief. Care Homes for Older People Page 14 of 27 Evidence: A back up stock of medication was stored, in a cupboard, located on the ground floor. Medication was also kept in a trolley and in a fridge in the large conservatory. There was another trolley in the entrance hall. All of these were locked and the trolleys were secured to a wall. No room temperatures were recorded, which is of concern, as the storage of one of the trolleys is in a conservatory although the current temperatures (it was a cool autumn day) were satisfactory. The drug fridge temperature was showing minus 2 degrees centigrade and no records of the fridge temperatures were kept, and this was also confirmed by a member of senior staff, and verified by the manager. The storage of controlled drugs and the related records were generally satisfactory although this register still carried entries for medication that had been disposed of. A record of this was made in the general disposal record but not in the controlled drug register. Backup stocks of medicines were at an acceptable level. Records of receipt of medicines were satisfactory but could be improved especially where medication is received outside the normal monthly cycle. Medication records are completed by the home from a computer generated record. When hand-written additions or changes, had been made, these were not signed and dated or checked for accuracy. Records of disposal of medication were good as were the records for the receipt, carry forward total, administration and disposal of medication thus providing a good audit trail. Stocks are audited monthly on receipt. For two people prescribed alendronic acid, they were not given this medication with regard to special instructions [one of these had been labelled incorrectly by the supplying pharmacy and the other label carried the instruction read enclosed instruction leaflet.] This was discussed with the Manager about the need to resolve this before the next dose is given. We saw how staff interacted with the people and we saw that this was done in a kind, caring and respectful manner. Care Homes for Older People Page 15 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have opportunities to live a good quality of life. Evidence: Eleven of the 13 residents surveys said that the home always/usually provided suitable activities that the person could take part in whereas the two remaining residents surveys said that the home sometimes provided such activities. Comments, about the activities, included A varied programme is arranged and They encourage (my relative) to join in what (they) can and the stimulation has made a wonderful difference to (them). According to the AQAA The activities co-coordinator has been trained in chair based exercises and is sharing the information with selective staff members and We have had visits to Paxton Hall by local schools, local dancing troups, a Wildlife Trust representative and a Womens Institute representative.Surplus plants grown from seed by service users are displayed in the porch and visitors are able to purchase these. Information, provided by a visitor, told us that some of the people had recently attended a spice smelling event that stimulated memories and discussion among each other. We observed the activities going on in one of the main lounge areas and we found that a range of activities were provided, at the same time, depending on peoples individual interests and abilities. Care Homes for Older People Page 16 of 27 Evidence: We observed visitors coming to the home and the interaction between them, other residents and the staff, indicated that the home is a welcoming,warm and friendly place for people to live and visit. We saw also that some of the residents were freely talking to each other, in a friendly way. During the tour of the premises we saw peoples rooms had the residents personal possessions such as furniture, photographs and ornaments. How people wished to live, such as getting up and going to bed, were recorded in their care records. All of the 13 residents surveys said that the person always or usually liked the meals. Comments included Appetite has improved greatly since arriving at Paxton Hall and Good home cooking. The AQAA told us that there is now a choice of a cooked breakfast and breakfast is now served a little later as per the request of service users. Our findings from listening to the staff and examination of peoples care records, indicated that there is the option of a cooked breakfast. Menus were on display and at the time we visited people said that they were enjoying their meal of meatballs and vegetables. We saw that the staff were helping people with their food on a 1:1 basis. The standard of protection of peoples clothes, when they eat, could be better. Currently the home provides plastic aprons, for this purpose, the same as what the care staff wear. We discussed this with the Manager, indicating that there are more pleasant looking forms of protection, that people can wear, when eating their food. Care Homes for Older People Page 17 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 are listened to and are safe from the risk of abuse. Evidence: The AQAA said that the home has received no complaints (and this was confirmed again by the Manager) and we have received no complaints about the home. All of the 13 residents surveys said that the person knew who to speak to if they were unhappy about something and all of these surveys said that the person knew how to make a complaint. All of the 5 surveys from staff said that if a concern, about the home, was made by a visitor or resident, the member of staff would know what to do, with this information. The AQAA told us that all of the staff have attended training in safeguarding awareness. Examination of the staff training records and discussion with the staff indicated that this was the case. The staff correctly told us what they would do if they became aware of any incident of abuse against a resident. The contact number, for any safeguarding referrals was, available in the staff room. (Safeguarding was previously referred to as protection of vulnerable adults or POVA). 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 live in a comfortable, clean and safe place. Evidence: According to the AQAA,within the last 12 months, there has been a great investment in continuing to improve the environment of the home: We have purchased additional Profile beds. We have replaced the previous stairlift with a brand new one. We have purchased and installed two LCD televisions with DVD players. We have replaced the hoist slings. We have purchased 12 additional lounge chairs. We have refloored one of the bathrooms. We have replaced one of the boilers with a new one. We have purchased additional bedroom furniture and carpets. We have continued with a replanting programme of shrubs to provide service users and staff with all round colour and interest in the garden and courtyard. According to the Manager arrangements have been made to replace some of the bedroom carpets, that were showing signs of wear, caused by the (fire) door guards. We found the home to be well-maintained, clean and well-decorated with pictures along the walls of the corridors. The AQAA said All staff are trained in infection control and use protective aids such as aprons, gloves and alcohol gel to ensure that infection and cross infection is kept at Care Homes for Older People Page 19 of 27 Evidence: bay. We saw staff carrying out procedures that reduced the risk of any spread of infection, including washing of their hands and having bottles of alcohol gel on their person. All of the 13 residents surveys said that the home was always or usually clean and fresh. Comments included Rooms cleaned thoroughly daily and Never smells, perfectly clean. 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 can be confident that they are cared for by kind, well-trained and generally well-recruited staff. Evidence: Comments about the staff included how kind and caring the staff were, such as The staff are all very kind, cheerful and caring and I am very content here and Very friendly and caring staff. All of the 13 residents surveys said that there was always or usually enough staff on duty to meet the needs of the residents. One of the surveys said We can always find someone to help us and speak to us. All of the 5 staff surveys said that there was always or usually there is enough staff on duty to meet the individual needs of the residents. One of these surveys said that All staff work as a team. We timed the interval between when a person summoned help, by the use of their call bell, and when this was responded to: the response time was 2 minutes. We saw people receiving care in an unhurried and individualised way, including at lunch time. The AQAA informed us that 61 of the care staff have a National Vocational Qualification (NVQ) level 2, or equivalent, in care and this was again confirmed by the Manager. Care Homes for Older People Page 21 of 27 Evidence: Examination of two staff files was carried out and the required information was available in both of the files. We noted, however that there were some areas that could be improved upon. Both of these files had a second reference from a referee, such as a friend, who might not be objective in their opinion about the person. In one of the two files were noted that a person had been unable to work, due to a medical condition, although the persons medical history was not explored at the time of their interview. We expect the home to improve these two areas to ensure the recruitment procedures are fully robust. All of the 5 staff surveys said that the induction training they received covered everything very well to prepare the member of staff for the work that they were appointed to do. All of these surveys said that the person attended training that was relevant, up to date and helped them to meet the individual needs of the residents. We noted, from our examination of a staff file, that the home uses the Skills for Care induction training and the staff competencies are checked and signed off by the Manager. Examination of other staff records, discussion with the staff and the Manager, indicated that staff have attended training (such as caring for a person with dementia in 2007) to ensure that their practice is current and can meet the changing needs of the people they look after. 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. People benefit from a well-managed and safe home. Evidence: The AQAA told us that the Registered Manager ... has almost completed her RMA.The Manager has been associated with Paxton Hall for several years now, has a vast knowledge and experience of working with the elderly and is aware of conditions associated with old age. Discussion with the Manager indicated that she has now completed her Registered Managers Award (RMA) and this was confirmed in one of the two reports made by a representative of the registered owner, during their visits to the home during August and September 2008. The AQAA was completed in a detailed manner and it clearly told us what the home does well in, what has improved within the last 12 months and it identified areas where the home can improve upon. The AQAA informed us that, as part of the homes quality assurance, all of the policies and procedures have been reviewed in August Care Homes for Older People Page 23 of 27 Evidence: 2007. Results of a survey, carried out by the home in 2007, were seen and comments and views from residents, relatives and healthcare and social care professionals were recorded. These included I think Paxton Hall has been excellent at the way they have managed and cared for my (relative) Where less than positive comments had been made, such as the cleanliness of the home, these were highlighted for action to be taken to improve such noted areas. Minutes of the last two residents meetings recorded peoples views about their life at the home, such as activities and the food. Action taken was recorded in response to any dissatisfaction expressed at these meetings. Three peoples monies were counted and the amounts available reconciled with the record of balances. Receipts of expenses incurred, such as those for shopping, toiletries and eating out, were kept. The last fire drill was carried out in April 2008 and the record of this had the full names of those staff who were present during this fire safety exercise. According to the Manager arrangements are in place to carry out another fire drill, before the end of October 2008. The AQAA said that 100 of kitchen staff and 100 of care staff have attended training in safe food handling. Safety checks for portable appliance equipment and temperatures of hot water in bathrooms were satisfactory as were service checks on hoists, lifts and assisted baths. Weekly tests had been carried out for fire alarms and emergency lights. Staff told us, and staff training records confirmed that they have attended training in fire safety, emergency first aid and safe moving and handling. Arrangements have been made for refresher training and one of these, for safe moving and handling, was taking place when we were at the home. 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 1 7 15 The care plan must provide clear and accurate guidance for staff in how to meet the individual needs of the residents. To ensure that people receive safe care by wellinformed staff. 28/11/2008 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 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. 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