Inspection on 18/09/08 for South Church (Gloria) Nursing Home Limited

This inspection was carried out on 18th September 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

South Church (Gloria) Nursing... 27/07/09

South Church (Gloria) Nursing... 12/09/07

South Church (Gloria) Nursing... 08/03/07

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Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: South Church (Gloria) Nursing Home Limited 21 Auckland Road South Church Bishop Auckland Co Durham DL14 6SP     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: Clifford Renwick     Date: 1 8 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 32 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 32 Information about the care home Name of care home: Address: South Church (Gloria) Nursing Home Limited 21 Auckland Road South Church Bishop Auckland Co Durham DL14 6SP 01388604055 01388451268 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Susan Debbie Hogg Type of registration: Number of places registered: Gloria Healthcare Limited care home 38 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: Date of last inspection Brief description of the care home South Church Care Home provides both nursing and residential care to service users. The home has twenty-nine single bedrooms and four double rooms. There are no ensuite facilities; toilets and bathrooms are provided throughout the home, some are equipped with specialist equipment to provide additional support during personal care. The home is set over two floors; there is a dining area and lounge on each floor. There is a patio garden area to the upper floor of the home and a large car park on the ground floor. 0 0 Over 65 38 3 Care Homes for Older People Page 4 of 32 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: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. Before the visit: We looked at: Care Homes for Older People Page 5 of 32 Information since the last inspection on 17th September 2007. How the service dealt with any complaints & concerns since the last visit. Any changes to how the service is run. The providers view of how well they care for people. The provider in the annual quality assurance assessment (AQAA) submitted information to confirm what they are doing in the service. We looked at information we received in surveys from staff and residents. The Visit: An unannounced visit was made on the 18th September 2008. During the visit we: Talked with people who live in the home and also staff who were on duty. Held discussion with the administrator and registered manager. Observed staff working practices. Looked at information about the people who live in the home & how well their needs are met. Looked at other records, which must be kept in relation health and safety and staffing. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the home to make sure it was well maintained, safe and free of any hazards. Checked what improvements had been made since the last visit. Spoke with staff. We also gathered information from looking at care records to assess how staff supports the residents with their assessed needs. We also focused upon looking at care files for 4 residents as a part of the inspection we refer to this as case tracking. And this involves looking at all records of the care for a named individual. We told the manager what we had found. The people who live in this home prefer to be known as residents therefore this term of reference is used throughout the report. The fees for this home range from 382.21 to 603.98 per week. Care Homes for Older People Page 7 of 32 What the care home does well: What has improved since the last inspection? What they could do better: The written care plans need to contain more information that demonstrates how individual residents social needs are to be met by staff. Care Homes for Older People Page 8 of 32 Daily records that are used to record what happens on a day to day basis for each resident need to have more detail included. The practices in the dining room as to how tables are set and how meals are served require reviewing and menus that are in place should reflect accurately what is being offered on the day. Records must be kept of all fire drills and fire instruction that staff take part in and these must confirm that these are carried out with the frequency as advised by the fire authority. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 32 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 32 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. A full pre-admission assessment of needs ensures that new residents are offered the right type of care at the home. Intermediate care is not provided in the home so this standard was not assessed. Evidence: Prior to anyone being offered a service in the home an assessment is carried out by staff and a copy of the most recent assessment is also obtained from the Local Authority or Health Trust. During the assessment process a prospective resident is always seen by a member of the homes staff. A standardised form is in use and this also includes a dependency rating scale to assess a persons mental state to see if any additional support is needed. Once an admission has been arranged the home confirm in writing to the resident that Care Homes for Older People Page 11 of 32 Evidence: their needs can be met. A contract is issued and this includes information about the service and the fees to be paid and by whom. Two residents personal files were examined and both contained a full assessment and also a copy of the contract or terms and conditions of residence that sets out clearly the terms of residence in the home. Intermediate care is not provided so this standard was not assessed. Care Homes for Older People Page 12 of 32 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning process ensures that people receive care in a way that they prefer. And health care needs are effectively met and medication administration follows good practice. These ensure that residents general health and wellbeing are safeguarded and promoted. Furthermore, excellent staff interactions with residents confirms that residents are treated with dignity and respect at all times. Evidence: Three care files were looked at as part of a process we call case tracking. This involves examining the care records that are held for each person. Each person has an individual written plan of care that sets out in detail what staff must do to support people with their daily health needs. Regular weight checks are carried out as part of monitoring a residents ongoing Care Homes for Older People Page 13 of 32 Evidence: health. Risk assessments are also in place as well as a range of other assessments that look at nutritional needs. The care plans and assessments are reviewed monthly noting any changes and if the care plans need amending this is done by staff. The staff are in the process of developing a document that is known as Life History and this will include a good range of information about peoples lifestyles prior to moving in the home. The manager stated that staff will use these documents as part of the care process to demonstrate how they are meeting social needs as well as developing activities that residents are interested in. This is good as at present the care plans do not include sufficient detail to demonstrate how staff meet residents assessed social needs. One person has had to have some restrictions placed on them due to their health needs, as well as ensuring safety while smoking. This is set out clearly and confirms that the practices in place are correct and do not impose any unnecessary limitations on the person. For another person who is dependent upon the use of a hearing aid, appropriate checks are carried out by staff on a daily basis, to ensure that it is clean and it is working. And this is documented in the care plan so that staff have a clear procedure to follow. Records of health care confirm that where necessary the residents receive support from the community nurse and also the G.P. A daily records system is in place whereby staff record something at least every 24 hours about each resident to demonstrate how they spend their day in the home. In their current format they contain only basic information and have comments such as appears settled which does not give you enough information. And the detail as to why some is settled is not included. These need to be developed further in order to include more detailed information as to how someone has spent their day and this was discussed with the manager. Care Homes for Older People Page 14 of 32 Care Homes for Older People Page 15 of 32 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents lead fulfilling lifestyles through exercising choice and control over how they spend their day and regular contact is being maintained with relatives and friends. However some changes need to be made to confirm that the resident’s receive a wholesome appealing balanced diet. Evidence: Discussions with residents confirmed that the routines were flexible within the home, with people being able to choose when they got up and when they went to bed. This was noticeable during the visit when only a small number of people were up early for breakfast. In discussion with this group of people they said that they liked to be up early and staff gave them any assistance that they needed. Residents meetings are held three monthly or sooner if they request a meeting. Meetings have changed from being held on an evening to an afternoon so that they can include relatives who are visiting the home. Discussion with the manager confirmed that they are trying to involve families in these Care Homes for Older People Page 16 of 32 Evidence: meetings as much as possible so that they have the opportunity to offer their views and ideas on the service. An activities coordinator is employed 20 hours per week and is in the process of developing activities whilst at the same time establishing regular planned themed activities that all residents can take part in. A recent activity was a themed Food Tasting session of foods from around the world. And this involved residents having the opportunity to sample and taste food and biscuits from other counties. There have been recent outings to Aysgarth Falls and also a visit from an entertainer who performed a musical session in the home. In discussion with the manager it was confirmed that the home is attempting to ensure that once monthly a visiting entertainer will perform a show in the home. Staff are also trying to establish a monthly dominoes handicap with a prize, as a number of the residents like to play dominoes. One of the staff members often takes a resident to the local club to watch the live televised football. In discussion with this residents it was confirmed that this was a highlight of their week. Posters are on display throughout the home confirming what activities have been organised and this is still being developed as discussed above. During our visit the ice cream van called to the home and whilst in the car park played the musical chimes. Staff then bought ice creams for those residents who wanted one. The residents stated that this was a a nice event and it was nice to hear the chimes of the ice cream man as it brought back a lot of memories of when they were young. As the visit was carried out from an early morning, the opportunity was available to talk with residents whilst they had their breakfast. The residents confirmed that they could have anything they wanted to eat from cereal and toast to a full cooked English breakfast. Though if they wanted the cooked breakfast they did have to wait until the cook came in whereas cereal and tea could be provided by the staff from the moment you got out of bed. Care Homes for Older People Page 17 of 32 Evidence: Lunch was taken with the residents during the visit in the first floor dining room. The lunch was tasty, hot and of sufficient quantity, however what was served did not match with the menus and in discussion with staff they were unsure as to what meat was served in the casserole. This could cause some confusion for residents if menus are not accurate and the current practice does not support people when making their choices. Some of the tables did not have all of the necessary condiments with one table having two salt pots and no pepper pot and residents did not have a choice of drinks offered to them. Discussion was held with the manager about how the lunch time experience could be improved and the steps that need to be taken to achieve this. It was positive to note that for those residents who required some support whilst eating, staff provided this in a sensitive way. The mealtime was unhurried and it was good to note that people used the mealtime to engage in conversation. In the evening one of the residents on the ground floor was celebrating a birthday and the cook made a birthday cake complete with candles. This was presented at the table at teatime and all of the residents and staff joined in singing to celebrate the persons birthday. Staff stated that this was a regular occurrence and they always celebrated the birthdays of the residents making the mealtime on that particular evening a special occasion. Throughout the visit a number of relatives were in and out of the home and they confirmed that their are no restrictions on visiting times. Residents are encouraged and supported to maintain contact with their relatives and one person regularly goes to a relatives house. In discussion with the residents it was evident that some of them have formed good friendships and as a result spend times in each others rooms. One resident that we spoke with said that the staff are very good, if you are spending time in your room they will still pop in to see if you are ok. The atmosphere in the home was good and there a was a nice rapport between staff Care Homes for Older People Page 18 of 32 Evidence: and the residents and also the visitors who visited the home during the day. Care Homes for Older People Page 19 of 32 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. A accessible complaints procedure gives residents and their relatives confidence that they will be listened to and taken seriously. And staff has a good understanding of local adult protection procedures which helps to ensure the protection of residents from abuse. Evidence: The home have a complaints procedure and this is on display in the main lobby. A copy of the complaints procedure is also contained within the Service User Guide that has been issued to every resident. It does explain in detail on how to make a complaint and what happens once a complaint has been made to the manager. And in discussion with the residents they were clear as to who they would complain to if they had any concerns about the service. Though it explains how to make a complaint, the process does not include any details of the Local Authority or the Commission for Social Care Inspection and how a complaint can also be referred directly to them. In discussion with staff they confirmed that if any resident raised concerns this would Care Homes for Older People Page 20 of 32 Evidence: be reported to the manager immediately and appropriate actions would be taken to investigate this. The manager confirmed that staff are currently undergoing training on safeguarding adults. This is taking place over a ten week period and is being carried out by an external training agency. Once the safeguarding training has been completed the manager will arrange for staff to have training in dealing with complaints as part of their ongoing development. There has been one safeguarding alert made since the last inspection and this was dealt with in accordance with policies and procedures issued by Durham social services department. Care Homes for Older People Page 21 of 32 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building is generally in good order and the ongoing refurbishment ensures that residents have a safe and well maintained home in which to live. Evidence: During this visit we looked at all communal areas and a number of bedrooms throughout the building. In discussion with the manager she confirmed that she was in the process of carrying out refurbishment in the home and part of this would include replacing soft furnishings every month until all items had been renewed. Twenty bedrooms have been decorated and provided with new curtains. The home has its own maintenance person who is allocated 20 hours per week to deal with any maintenance issues. There were no unpleasant odours in the home with the exception of the entrance lobby where there was a distinct smell. The manager confirmed that she was aware of this and stated that over cleaning of the carpet in this area had resulted in an unpleasant smell. It was confirmed by the manager that steps were in place to deal with this. Care Homes for Older People Page 22 of 32 Care Homes for Older People Page 23 of 32 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. Staffing levels are sufficient to ensure that residents needs are met. And staff receives sufficient training to support them in their work, to ensure residents receive good quality care. Evidence: Sufficient staff were on duty during the visit to meet the residents needs.There is a good rapport between staff and the residents and the residents spoke highly of staff. One resident was full of praise of one particular member of staff as they had recently rearranged the furniture in their room so that it was easier to move around. This person went on to say that the staff cannot do enough for you and they were always there for you. Discussion with staff confirmed that they undergo training relevant to their work. A training matrix is on display in the office that confirms what training courses have been organised for the year 2008. Though the manager stated that staff are taking part in fire drills, the records available in the home could not confirm this and this is discussed more fully in sections 31 - 38 Care Homes for Older People Page 24 of 32 Evidence: of this report. It was confirmed by the manager that fire training has been arranged for staff to take place in November. Since the last inspection four new staff have been recruited to work in the home and their individual staff files confirmed that all of the necessary employment checks were carried out before they commenced work in the home. The only item that was not in the files was a photograph of each individual and this was discussed with the manager who confirmed that steps were in place to address this. Care Homes for Older People Page 25 of 32 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. An experienced and qualified manager is in post and this ensures that the service is effectively run in the best interests of the residents that they are safe and well cared for and their rights are safeguarded. However the absence of regular fire drills and fire instruction can put residents and staff at risk. Evidence: The manager currently works 25 hours per week spread over 4 days but if needed will work additional hours. A deputy manager who is a qualified nurse takes responsibility for the management of the service in the absence of the manager. The manager has been positive in developing a number of areas within the home and Care Homes for Older People Page 26 of 32 Evidence: this has included the refurbishment of the home which was discussed in sections 19 26 of this report. The manager has a range of mechanisms in place to offer her support in the day to day running of the service. And once weekly a visit is carried out to the home by a company representative. Once monthly this representative compiles a report on the running of the home. In addition to this the manager has access to the managing director. The monthly report is a form of in house quality assurance and focuses upon how the service is run and what improvements if any need to be made by the manager. The manager has responsibility for the homes budgets so is able to act on matters quickly if developments are needed. The home hold monies on behalf of 19 residents and good records are in place to confirm that this is dealt with satisfactorily. Records are kept of any accidents in the home and these confirmed that staff take appropriate actions in the event of any resident who has an accident. Records are in place to confirm that all electrical items in the home undergo testing to confirm that they are safe to use. In discussion with the manager it was confirmed that as a result of staff not responding appropriately during a fire drill fire training has been arranged for November. The fire drills and fire instruction for staff was not being recorded in the fire log book though records are available to confirm that the fire alarm is tested each week. In order to ensure that staff are confident of what to do in the event of a fire the manager was advised that the fire training for all staff must be carried out immediately. With all staff taking part in at least one fire drill and receiving one period of fire instruction. Written confirmation was received from the manager that this was carried out immediately following our visit with all staff working in the home having taken part in fire drills and receiving fire instruction. Care Homes for Older People Page 27 of 32 Evidence: The manager has ensured that staff receive other training that is appropriate to their work and training in moving and handling is arranged to take place in November. This will ensure that staff are up to date with health and safety practises. Care Homes for Older People Page 28 of 32 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 29 of 32 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 7 15 The individual plan of care for each service user must be kept under review. And include information as to how individual social needs are to be met. This will ensure that staff are taking into consideration all aspects of a persons individual care. 18/12/2008 2 38 23 A record must be kept that confirms that all staff are taking part in regular fire drills and fire instruction. This will confirm that staff are receiving regular fire safety training. 18/10/2008 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 15 The mealtime practices as discussed during the inspection visit and as identified in this report should be addressed. Care Homes for Older People Page 30 of 32 2 16 Consideration should be given to making the complaints process more visual and also only showing the steps that are to be taken if someone needs to make a complaint. Reference should also be included as to how at any stage a complainant may refer their complaint to the Local Authority and also the Commission. This will then assist people in having a clear understanding of the process. Steps should be taken to eradicate the unpleasant odour from the main entrance lobby. 3 19 Care Homes for Older People Page 31 of 32 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 32 of 32 - 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!