Inspection on 29/01/08 for The Tudors Residential Home For The Elderly

This inspection was carried out on 29th January 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

The Tudors Residential Home For... 02/04/07

The Tudors Residential Home For... 10/04/06

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Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE The Tudors Residential Home For The Elderly Rayners Way North Street Stanground Peterborough PE2 8HR Lead Inspector Andy Green Unannounced Inspection 29th January 2008 10:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Tudors Residential Home For The Elderly Address Rayners Way North Street Stanground Peterborough PE2 8HR 01733 892844 01733 554306 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.goldcarehomes.com RS and SS Gidar T/A Tudors Residential Home vacant post Care Home 43 Category(ies) of Dementia - over 65 years of age (43), Old age, registration, with number not falling within any other category (43) of places The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd April 2007 Brief Description of the Service: The Tudors is a large detached property situated in a quiet cul-de-sac in a residential area near to the city of Peterborough. Care and support is provided to 43 residents with elderly and dementia care needs. Four communal lounges and two dining rooms are provided for residents. A passenger lift to the first floor is provided. There are 43 bedrooms provided. There are well-maintained gardens to the front and rear of the property. The fees range from £400 to £575 per week. Copies of CSCI reports are made available to residents and their relatives upon request. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. CSCI carried out this unannounced key inspection on 29th January 2008. We were assisted by an Expert by Experience who spent time with residents to give a valuable insight into life in the home. The home completed an AQAA (Annual Quality Assurance Assessment) and CSCI received a number of surveys from residents, staff and relatives giving comments about the home. A variety of procedures and policy documents were inspected including assessment/care planning, the medication policy, staff files, health and safety policies and complaints and safeguarding adults. A tour of the building was also undertaken. Discussions were also held with members of care staff and a number of residents. What the service does well: What has improved since the last inspection? The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 6 The care planning process has been improved giving clearer guidelines to staff regarding the individual care and support that is required during the day. The testing of fire safety equipment in the home has improved. Decoration to one of the lounges and reception area has been completed The large rear garden has been re-landscaped with raised flowerbeds and paths to improve access for residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assessed to ensure that the home can meet their care and support needs. EVIDENCE: The home receives assessment information regarding residents referred via the local authority including a copy of their care plan. Resident’s files contained evidence of detailed assessments as part of the care management process outlining the individuals care and support requirements. Reports from other healthcare professionals are sought where possible including CPN’s and GPs. The manager and deputy manager carry out an assessment visit to the prospective resident and the homes own pre assessment form is completed. The prospective resident’s dementia care needs are assessed and this was evidenced in care files seen during the day. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 9 The prospective resident’s family are encouraged to visit during the assessment period as much as possible. There is a six-week trial period followed by a review to ensure that the placement is meeting the needs of the resident. The Expert by Experience commented; “J found the staff friendly and liked to have a joke with them, clearly feeling at home only ten days after having moved in. R doesn’t like onions, so her meals are prepared without them, showing great individual care on the part of the catering team. Her family said the food was very good – they had stayed for lunch one day at the weekend. R had expressed a desire for teacakes and, as there were none on the premises, someone went out and bought some – another example of special, personalised care. Resident B had not long moved in, but was settling in well and feeling at home. Her daughter had had an issue with the home regarding B’s levels of medication on her discharge from hospital to the care home. This matter was immediately relayed to the GP and action put in place to resolve it without delay. Needless to say, the daughter felt pleased with the outcome”. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are in sufficient detail to meet the resident’s assessed needs. EVIDENCE: Improvements have been made to the care planning process since the last inspection. Five care plans were seen and they contained clear documentation including assessments, healthcare, weight and nutritional screening charts, personal profiles and risk assessments. Evidence of regular reviews of care were in place. Care plans have improved with specific guidelines to ensure that the staff are clear regarding the assistance that residents require. The manager and care staff have worked hard to improve care plans to ensure a consistent approach is being taken. The families of residents continue to provide a personal profile, where possible, regarding their relatives past life and personal history to give staff a wider understanding of individual residents. Evidence of this was seen in care plans. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 11 The Expert by Experience commented; “My observations showed The Tudors to offer a safe, comfortable, caring environment, in which residents feel at home and well fed and looked after. There was a warm, welcoming ambience and my feeling was that nothing was too much trouble for the staff to deal with”. Medication records were accurately recorded and a local pharmacist continues to provide medication awareness and administration training. It was noted however that medication in one side of the home is being stored in a cupboard, which also houses a hot water tank. Consequently the temperature can exceed 25C. The manager stated that all medication would be moved from this cupboard to an adjacent locked cupboard where the temperature would be below the recommended 25C level. It is also recommended that each bedroom has a cupboard installed to store creams and liquids rather than being left on tops of cupboards etc. The manager stated that she would action this as soon as possible. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff provide support to ensure that residents have access to activities appropriate to their needs. EVIDENCE: The home has cheerful and atmosphere in the home was lively and busy and residents were socialising with each other and their relatives in the lounge. The Expert by Experience commented, “The Tudors comes across as a warm and welcoming home, where residents are comfortable and very well cared for. On asking G and N, the next two residents I met with, what they would like that they didn’t already have at the home, neither could think of anything. We talked about what they did all day and, although N said, “Nothing!” she qualified that by saying, “I like it here”, and G, on reflection, said “Yes, it’s alright here”, implying that it was actually very good! G said the carers were very kind and were never far away if she needed one. An activities coordinator organises events, entertainment and outings on a regular basis, ranging from manicures and pedicures to planned trips to Sandringham and Hunstanton, and dog racing locally. As I left the The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 13 home, a party of residents was crossing the road outside en route to the pub!! Brilliant! “ The Activities Co-ordinator has developed a programme of activities throughout the home. There was evidence of regular activities, which are recorded, in an activities record book. Activities include: music, bingo, paid entertainers, dancing to music, quizzes, listening to book tapes, hairdressing, nail care, skittles and walks in the garden and in the local community. However, some comment cards received did state that activities could be improved. The dementia care unit was well organised and the staff were attentive to resident’s needs on a social level and when giving personal care. Staff were also observed to knock on the door of resident’s bedrooms before entering. The Expert by Experience commented; “The home is currently divided into two units and my first chat was with a resident in the DCU, who was very friendly and showed off her bedroom, as well as assuring me that she was very happy there; the girls were very good and respectful; she was taken out in a wheelchair for an hour on fine days; and the food was pretty good. She enjoyed the weekly fish and chips on Fridays and commended the laundry service, saying her clothes were always clean and properly looked after”. The manager stated that she was consulting with The Alzheimer’s Society regarding decoration and colour schemes in the home to assist residents with dementia care needs The Expert by Experience commented, “At all times staff-to-resident interaction was observed as easy, familiar, yet respectful. My single, but serious, concern is for the meeting of residents’ spiritual needs. I spoke with a Methodist and a Baptist, both of whom agreed they would take part in a service if it were offered. The Methodist loves to sing hymns. These were just two out of potentially 43, and, although at least two others said they hadn’t gone to church previous to coming to the home and weren’t interested, my fear is that, if nothing is made available to residents, and if they perhaps feel it rather too private or personal a matter to discuss, their spiritual and worship/fellowship needs cannot be met”. The comments regarding religious preferences were discussed with the manager who stated that she had contacted local ministers and churches but had not received a positive response. The Expert by Experience stated that she would forward information, which the home may find useful regarding contacts with ministers and local churches. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 14 A varied range of meals is available. At lunch time residents had a choice of two main courses and alternatives to the suggested menu choices could be served on request. Residents spoken to confirmed that there was a choice of food and that meals were of good quality and that drinks and snacks were available throughout the day. The Expert by Experience commented, “The dining room was bright and homely, with pretty plates on the wall and flowers at each table. In the DCU it was good to note that the dining chairs were on ‘skis’ to aid the movement of residents to sit comfortably, once transferred from wheelchairs. The food was superb! Everything was home prepared and a good selection of freshly cooked seasonal vegetables accompanied the choice of meat or vegetarian main courses. Second helpings were offered, and a choice of dessert including fresh fruit. None of the residents I shared lunch with needed any special assistance, but one was particularly slow. No attempt was made to rush her and thus she was assured of taking a full meal without having to bolt her food”. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints process to make sure that residents and their representatives are able to raise concerns and have them dealt with appropriately. EVIDENCE: The home has a complaints procedure to ensure that all complaints are fully investigated and responded to appropriately. The home has received three complaints since the last inspection all of which have been responded to appropriately. Evidence of this was seen in the complaints logbook. The home has a satisfactory policy regarding Safeguarding Adults, which is in line with the Local Authority policies. Staff receive ongoing training regarding Safeguarding Adults to ensure that residents are protected from abuse. A recent Safeguarding Adults issue has been resolved regarding a resident’s challenging behaviour in the home. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,24,26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home meets the needs of residents but improvements need to be made to ensure that residents have a safe and comfortable place in which to live. EVIDENCE: There are a number of improvements being made to the environment; • • • • Redecoration has been completed in one of the lounges and reception area. Carpets are being renewed in five bedrooms and one of the lounges. Sixteen armchairs have recently been replaced. A new toilet is being constructed which will improve facilities in an area of the home for residents. DS0000065754.V358915.R01.S.doc Version 5.2 Page 17 The Tudors Residential Home For The Elderly There are however, a number of areas that need to be improved; • • • • The lift must be repaired to ensure that it can reliably reach all areas of the home. Decoration needs to be carried out to the walls in the main kitchen. Work must be completed to the upstairs shower room, which has been out of service since September 2007. Carpets in the dementia unit corridor and lounge need to be cleaned as they are stained in a number of areas. A number of bedrooms were seen and they were clean and free from odours. Residents are encouraged to personalise their rooms with items of furniture, television, pictures and personal items. This was evident in a number of bedrooms seen during the inspection. Additional cupboard space has been created to provide linen storage. The gardens are well maintained and accessible to residents. The main garden area has been re-landscaped with raised flowerbeds, new seating areas and new pathways to assist residents’ mobility. A full time maintenance person is employed who carries out ongoing repairs and renewals in the home. He also has responsibility for the maintenance of the lawns and garden areas. The Expert by Experience commented; “R’s family was impressed with the logging of her belongings in a comprehensive inventory, including all her clothing, personal items and even her own furniture. Other residents also spoke of the comfort of having their own favourite armchair or other piece of furniture in their room. The gardens are attractive and fully accessible. Inside, the newly decorated parts are bright and homely, and it would be unfair to comment on aspects of shabbiness in some areas, as the home is currently undergoing an extensive programme of refurbishment. My overall high regard for most aspects of this home was slightly marred by the initial impression, on arrival, which took in several overflowing refuse mini-skips in full view on entering the drive.” The above comments were discussed with the manager who stated that she would discuss possibilities regarding a fenced area for waste bins to improve the presentation of the home. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes recruitment and training processes ensure that the care staff are competent and that residents are protected from harm. EVIDENCE: There are four staff on each side of the home, including a senior worker, in the morning and three in the afternoon/evening. There are two night staff on each side of the home during the night time. There are also catering, cleaning and laundry staff. Observations showed that there were sufficient staff to meet the needs of the residents. The Expert by Experience commented; “The number of staff appeared to be optimal; while there were plenty of carers about, none was either idle or rushed off her feet. The relatives, visitors and staff members spoken with maintained that there was always enough staff. Individual staff had noticed improvements, particularly in staffing levels, since the change of ownership and management, and all were positive in their opinions of the home and working there”. Training is well co-ordinated in the home and three staff spoken to confirmed The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 19 that they had received training regarding moving & handling, fire, first aid, dementia awareness and POVA. Updates are organised throughout the year, which was evidenced in the home’s training files. Four staff files were seen and they contained CRB/POVA checks , application forms, and references. The manager has audited all staff files to ensure that the required documents are all in place. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provides supportive leadership and guidance to staff to ensure that residents receive high quality care. EVIDENCE: Since the last inspection a new manager has been appointed. In the short time that she has been in post the manager has created a positive approach and communicates a clear sense of leadership and direction to ensure that the home is well managed. Staff spoken to during the inspection confirmed that the manager was supportive and inclusive and that they were encouraged to participate in the development of the service and to raise any concerns or issues without hesitation. They also stated that the manager has created a tighter structure The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 21 to ensure that tasks are completed and that staff are clear about their responsibilities. This is reflected in care plans where a document detailing the expected daily routines for individual residents has been implemented. Another document entitled Staff Routine has also been implemented which details the overall responsibilities during the day. Supervision arrangements are in place for all staff and evidence was seen of regular recorded sessions in staff files. The manager stated that she receives regular support from her line manager and also from the managers group within the organisation. There have been improvements in fire testing since the last inspection and records of weekly fire alarm and emergency lights testing were accurate. The personal money and associated records for five residents were checked and were accurate. Service contracts continue to be in place ensuring that equipment and services in the home are regularly maintained. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 2 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 24 STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement Arrangements must be in place for the safe storage of medication including adherence to temperature guidelines. The renovations to the upstairs shower room must be completed to ensure that residents have access to facilities. Repairs must be made to the passenger lift to ensure that residents can safely access all areas of the home. Timescale for action 29/02/08 2 OP19 23(2)(b) 31/03/08 3 OP22 23(2)(c) 31/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP9 OP13 Good Practice Recommendations It is recommended that residents’ bedrooms have a storage facility for medication. It is recommended that the home contact local churches and ministers to ensure that residents are able to have their spiritual and religious preferences met. The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Tudors Residential Home For The Elderly DS0000065754.V358915.R01.S.doc Version 5.2 Page 26 - 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!