Inspection on 12/02/09 for Tynedale House

This inspection was carried out on 12th February 2009.

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

Tynedale House 02/03/07

Tynedale House 14/01/06

Tynedale House 11/08/05

Tynedale House 09/03/05

Tynedale House 21/07/04

Tynedale House 23/03/04

Similar services:

22 Sandown Road

The Highlands

Turret Villa Retirement Home

Dilston College Of Further Education

West View House

Moor House

Blenheim House

Prince Bishop Court

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Tynedale House Tynedale Drive Blyth Northumberland NE24 4LH     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: Karena Reed     Date: 1 2 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Tynedale House Tynedale Drive Blyth Northumberland NE24 4LH 01670364660 01670365869 mfairbairn@northumberland.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Northumberland County Council SSD care home 30 Number of places (if applicable): Under 65 Over 65 0 30 0 learning disability old age, not falling within any other category physical disability Additional conditions: 30 0 3 The maximum number of service users who can be accommodated is: 30 The registered person may provide the following category of service only: Care Home only ? Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following categories: Old Age, not falling within any other category, Code OP - maximum number of places 30 Learning Disability, Code LD, maximum number of places 30 Physical Disability, Code PD, maximum number of places 3 Date of last inspection Brief description of the care home Tynedale House is a purpose built single storey home for older people, situated near to a number of shops and facilities on the outskirts of Blyth. A unit for adults under 65 years, with learning disabilities and a high level of physical dependency was created in 2008 in part of the home. A driveway and turning circle, with pathways offers safe vehicular access to the main entrance and reception area. The home provides 25 longCare Homes for Older People Page 4 of 28 Brief description of the care home term places. Tynedale House provides accommodation and care to people over 65 years of age in several care categories. There are a variety of aids and adaptations to allow residents to move freely around the home. All of the bedrooms are currently single occupancy and there ensuite facilities to six bedrooms, there are communal bathrooms and toilet facilities situated around the home. There are sufficient communal lounges and dining areas. There is public car parking opposite the front of the building. The home does not provide nursing care.The Local Authority provides the service. A Statement of Purpose and service user guide are available at the home. The guide describes the services and facilities provided by the home and how staff are trained to meet residents care and support needs. CSCI inspection reports are also available at the home detailing the quality of care provided. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. 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. How the inspection was carried out Care Homes for Older People Page 6 of 28 Before the visit: We looked at: information we have received since the last inspection,how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people,the views of people who use the service and their relatives, staff and other professionals. The visit An unannounced visit was made on February 12th 2009. The visit was made with an Expert by Experience. An Expert by Experience is someone who uses social care services. They are part of the inspection team and can help inspectors to get a picture of what it is like to use care services. Mrs Betty Fellowes, an Expert by Experience, talked with residents and staff, joined them for a lunchtime meal, and looked at parts of the home. Her comments are included in this report. During the visit we: talked with people who use the service, relatives, staff, the manager and visitors,looked at information about the people who use the service and how well their needs are met, looked at other records that must be kept,checked that staff had the knowledge, skills and training to meet the needs of the people they care for,looked around the building to make sure it was clean, safe and comfortable,checked what improvements had been made since the last inspection. We told the provider what we found. What the care home does well: What has improved since the last inspection? Risk assessments are in place for all residents and are included as part of their health care. One of the units at the home now provides respite care for adults with learning disabilities. The level of staff training continues to improve to help staff understand the different needs of the residents. New blinds and curtains have been purchased on two units. Bathrooms have been refurbished around the home. Carpets have been replaced on some units. Some bedrooms have been decorated and carpets replaced. Televisions have been replaced. Care Homes for Older People Page 8 of 28 A sensory garden has been created. The unit kitchens have ben refitted with new units. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good procedures in place to ensure that prospective residents are making an informed choice about the home and that the home can meet their needs. Evidence: The Homes Statement of Purpose and service user guide were examined. They contained the necessary information as required by the Care Homes Regulations 2001. They were not written in a way that might support people with dementai care needs or people with learning disabilities. A copy of the social services assessment and care plan for each person had been obtained before they moved into the home. The person living at the home and the relevant people who knew them were involved in the initial assessment. The assessment form encourages staff to explore issues relating to equality and diversity Care Homes for Older People Page 11 of 28 Evidence: as it refers to gender, culture, religion,spirituality, education and social history, preferred daily routine and preferences. It also looks at mood, speech, behaviour, mental health, risks, sexuality and living skills. This information and the care managers assessment of the residents care needs were used by the home to help ensure the needs of the resident could be met by staff. The records contained a range of information. Residents have the opportunity to visit the home as often as they need in order to decide if they want to live there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are very good arrangements in place to ensure the health and social care needs of residents are met by staff. Evidence: After a resident has moved to the home a care plan is designed around their assessed needs, this is so staff know how to provide the right amount support. The sample of care plans examined clearly outlined each residents needs and how these should be supported. Care plans are written in a respectful way that that promotes the individuality and dignity of each resident. The sample showed that care plans had been evaluated at least three monthly and showed there may be a change in need and the care plans reflected the amount of care and support that staff needed to give to residents. There was a system for the external reviews of residents by the Local Authority. Health care record showed that residents are supported to have good access to health Care Homes for Older People Page 13 of 28 Evidence: care services such as GPs, psychiatric services, and continence advisors. Risk assessments were in place for residents covering areas such as health care including prevention of falls, continence and nutrition but they were not dated. Moving and handling assessments have also been carried out to show the moving and asssiting needs of more dependent residents. Technical aids and equipment are available for residents who are unable to move independently. The staff are responsible for managing residents medication. This is delivered to the home by a pharmacy within individual blister packs or containers for each resident. Medication is securely stored, and only transported around the home in a locked medication trolley. Administration of medication was carried out correctly, and medication records were in good order. During the inspection visits there were many instances of good practice where staff supported residents in a sensitive and respectful way. For example, sitting with individual residents to provide sensitive support at mealtimes, and supporting people with their mobility at the residents own pace. Residents are supported with their personal grooming and appearance. A weekly hairdressing service is available at the home, which several residents use. In surveys staff and residents had many positive comments about the way that people who live at the home are supported. Their comments included: The home gives a high standard of care to everyone that needs it. The staff meet individual needs of clients. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall, residents have sufficient opportunities to make choices about activities, daily routines and menus so that they lead a lifestyle that matches their social care needs. Evidence: Residents are supported and encouraged to follow their own interests and hobbies. Some residents were watching television or listening to music in the communal areas, some residents prefer to spend time in their bedroom. Comments from residents include; I like to knit and watch tv. Another said;in the evening I would like to socialize more. A staff member said the service does well providing a caring home with staff who are up dated regularly on new ideas on how to provide stimulation and variety. A programme of activities is in place for residents within the home which includes: videos, sing-a-long, arts and crafts, cake decorating, manicurist, music making, sensory sessions, dominoes, cards, gardening, bingo, quizzes, crafts and hairdressing. Musical and theatrical entertainers also visit the home. Various seasonal parties are also arranged, which are well supported by relatives. The expert by experience said, There seemed to be a lot of activities going on over the time but I did not observe any. I was told they like their bingo, even cake decorating and card making although I did not observe this. There was a lot of videos and dvds about for Care Homes for Older People Page 15 of 28 Evidence: the residents to watch but most of all some of the residents like going out shopping and finding bargains or even a pub lunch. Having access to the mini bus helps with that. Im told the residents are standing waiting and when the mini-bus drops off the day care clients they climb aboard and shop until they drop. A staff member said;there should be more outings for clients and more social evenings. Church services take place within the home and some residents attend their local church. A resident commented;I go to church on Sundays and spend other evenings watching tv in my bedroom. Residents have the opportunity to go out with relatives or with staff into the local community . Some residents have enjoyed holidays to Berwick and Filey. Staff support residents to keep in touch with relatives. One resident said;my family visit every evening and I attend day centre Monday to Friday. Staff ask each resident about their wishes, interests and choices. Residents meetings do not take place currently. Residents and their families also receive questionnaires to complete as part of the homes quality assurance. Residents spoken to said that they are able to make decisions for themselves, and that they are happy with all aspects of the care that they receive. All were very complimentary about the staff and the support they receive. Comments include;Im treated with consideration. The homes menu is made up of the known likes and dislikes of the residents. The cook meets with residents to discuss new menus with them and get their suggestions. Residents are also asked daily what they wish to eat from the menu selection. The menu was on a board clearly displayed but pictorial menus were not available to help some residents make a choice. At least two hot meals are provided daily and an alternative is available. Residents were very positive about the food. The expert by experience observed at the mealtime, the meals are brought to each unit from the main kitchen and served by the staff in the dining room. The meals themselves were well cooked, hot and there were two choices. The portions were adequate and everybody cleared their plates. There was a choice of steak,mushrooms,potatoes and vegetables or cauliflower cheese followed by jelly and ice cream or fruit cocktail for lunch. Care Homes for Older People Page 16 of 28 Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a good, clear, complaints and protections system and residents views are listened to and acted upon which helps to protect residents. Evidence: The homes complaints procedure is given to new residents as they move into the home. The procedure assists and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. There is a complaints procedure on display within the home for the use of residents and their relatives. The home keeps a record of complaints. There have been no complaints or safe guarding incidents received since the last inspection . The home has a copy of the Local Authorities Vulnerable Adults procedures. This provides staff with clear guidance on how to deal with adult protection concerns. Staff have received training about Protection of Vulnerable adults. Staff have also received training about behaviour that may be difficult to work with as part of a Care Homes for Older People Page 18 of 28 Evidence: dementia awareness course. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable and safe environment for those living there and all areas are well maintained, clean, tidy and free from offensive odours. Evidence: There is an ongoing programme of decoration and refurbishment around the home.Since the last inspection one of the units has been totally refurbished and equipped to provide respite care to people with learning disabilities who may be physically dependent. A sensory garden has been made in the back garden of this unit. The Expert by experience said;the new unit is just amazing with large rooms and a hoist in track that can transfer from bed to the en-suite bathroom- another huge room with everything to hand- and I mean everything. Bathrooms around the home have been refurbished and new bathing equipment provided. Furniture has been replaced on some units and carpets have been replaced on the corridors and in some lounges.Televisions have been replaced with wide screen sets.Two units have new blinds and curtains.The reception area has been decorated and new furniture purchased. The home was clean,well decorated and well maintained. Care Homes for Older People Page 20 of 28 Evidence: The home is accessible and is placed in the centre of a local community surrounded by houses and shops. The home has an appropriate amount of sitting,recreational and dining space.There are enough rooms for a variety of activities to take place.One comment did say;there should be more space for those who wish to use it e.g. a conservatory for the units. Residents can also see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. Most room sizes meet the minimum required.Residents have their own bedrooms. The expert by experience said;The home is divided up into small units each catering for 68 residents. Each resident has their own room with some personal belongings. Each unit consists of bedrooms, a small lounge/dining area, kitchen and a bathroom complete with the necessary hoists an plenty of room for wheelchairs and staff ...very good space. There was emergency lighting throughout the home.The expert by experience said; the decor throughout the home is light and relaxing -plenty of windows-a huge enclosed garden outside, it will be lovely in the summer. Laundry facilities appeared well organised.The washing machines have the specified programme to meet disinfection standards. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff, who are appropriately recruited and well trained, to meet the needs of the residents. Evidence: Examination of staff rotas and discussion with the person in charge and members of the staff team showed that the numbers of staff are as follows: 7. 30 am - 4.00 pm 7 staff 4.00 pm - 10. 00 pm 5 staff 10.00 pm - 7.45 am 3 staff These numbers do not include the manager. There is a senior staff member on each shift. All the staff were over 18 years of age and those left in charge were at least 21. There are no staff vacancies currently. Other staff members are employed for duties such as food preparation, maintenance and cleaning. Care Homes for Older People Page 22 of 28 Evidence: Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. The expert by experience said, With the small units and their own staff it gives the feeling of family and I am sure if I had been able to speak to family members they would agree with me that this is a safe, happy environment where the staff really do care. A stable, committed staff team works at the home. The necessary checks are being carried out prior to the workers being appointed. Two written references were available on the staff files examined from the most recent employers. An application form had been completed for each staff member. CRB checks are carried out before a person is appointed. Staff receive Skills for Care induction. Training needs of staff are identified in supervision and appraisal sessions. 100 of the care staff team have achieved National Vocational Qualifications at level 2 and 16 staff members have achieved or are studying for levels 3 and 4. Staff and their records showed that they also receive advice and /or training in other areas such as fire training, moving and assisting, food hygiene, safe handling of medication, infection control, first aid and protection of vulnerable adults. Staff have also received training about; infection control, mental capacity, reminiscence,promoting independence, falls awareness, risk assessment, challenging behaviour, communication skills, deprivation of liberty, palliative care, sexual awareness, learning disability awareness, person centred planning,peg feeding, end of life care, conflict resolution, epilepsy,equality and diversity,continence, dementia awareness, diabetes and health and safety. Comments include;The service gives a high standard of care to everyone that needs it. Training is kept up to date to meet the needs of clients. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home that is well run and managed for the benefit of residents and where the welfare of all is promoted. Evidence: The manager has the necessary skills and qualifications needed to manage the home. Staff spoken to were clear about their duties and responsibilities. Residents are also involved in decision making in their daily living. Regular staff meetings take place.There are plans to create a resident forum for the new respite learning disability unit so residents may be consulted and involved in its day to day running. Lockable facilities are available for residents to keep their own money if they wish. If a resident does not wish to keep control of their own money, the home is able to provide the facility to hold a small amount of money on behalf of the resident for everyday living. Individual records show the home has a system for accounting any monies held Care Homes for Older People Page 24 of 28 Evidence: on behalf of residents. There was plenty of evidence of personal spending. Receipts are kept of any money spent on behalf of residents. All records as required by the Care Homes Regulations 2001 were well documented and completed. There is a health and safety policy and range of associated procedures. Staff receive training in health and safety and safe working practices (fire safety, moving and handling, first aid, food hygiene, and infection control). Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. Fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. Accident reporting was suitably recorded. Staff files showed staff are supervised regularly. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 1 The service user guide should be available in a more accessible format for people with memory loss and learning disabilities. Risk assessments should be dated to provide evidence of when they were written or evaluated. Pictorial menus should be made available to some residents to help them make a choice about the food available. Residents meetings should be introduced as another form of consultation with residents to help promote their choice and involvement in the running of the home and their lives. 2 3 4 8 14 14 Care Homes for Older People Page 27 of 28 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 © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!