Inspection on 20/10/08 for White Rose Court

This inspection was carried out on 20th October 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

White Rose Court 30/10/07

White Rose Court 08/02/07

White Rose Court 15/03/06

White Rose Court 01/02/05

White Rose Court 06/08/04

White Rose Court 02/03/04

Similar services:

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Snydale Care Home

Hawkhills

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Beeches The - North Yorkshire County Council

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

Inspecting for better lives Key inspection report Care homes for older people Name: Address: White Rose Court 40-42 Clifton Avenue Sheffield South Yorkshire S9 4BA     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: Valerie Hoyle     Date: 2 0 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: White Rose Court 40-42 Clifton Avenue Sheffield South Yorkshire S9 4BA 01142442310 01142619410 DES2@hotmail.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Christopher Spencer Cousins Type of registration: Number of places registered: Fisherbell Limited care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home White Rose court is an older adapted building with a modern extensions providing accommodation on two floors accessible by stairs and lift. The home provides both single and double bedrooms and comfortable lounge and dining areas. The home is registered to provide care for 21 older people over the age of 65, for both short term and long term stays. The home is situated in a residential area close to amenities and public transport. Information gained on the 20th October 2008 indicate the current fees range from 366 pounds; to 377 pounds; there are additional charges for hairdressing, chiropody, bingo, toiletries and pub lunches. The home provides information to people and their relatives prior to admission into the home. Service Users Guides are available in all bedrooms or on request from the manager. The last published inspection report is available on request and a copy is available in the entrance for visitors to read. Care Homes for Older People Page 4 of 27 Over 65 21 0 Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use this service experience good quality outcomes. This unannounced inspection of this service took place over 6.5 hours starting at 09:00 finishing at 15:30, this included a partial inspection of the home. Five people who use the service, three staff and a visiting district nurse were spoken to during the visit; their views were included throughout the report. Information from one relative’s survey and five surveys from people who use the service is also contained in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been Care Homes for Older People Page 6 of 27 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. Occupancy at this home has been consistently high. 18 beds were occupied on the day of the inspection. Two peoples care plans were looked at. Policies relating to medication, complaints, protection of vulnerable adults and handling of people’s monies were looked at. Three staff recruitment and training records were examined to assess how people were protected. Procedures and risk assessments relating to health and safety were looked at and discussed with the manager. The registered manager is Christopher Cousins, he was appointed in 2006. He has achieved the Registered Managers Award and is working towards the NVQ Level 4 award in management. The AQAA was sent to the home in August 2008, this was returned to us on time, which demonstrates responsiveness and cooperation. An annual quality assurance assessment is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The inspector would like to thank everyone who agreed to being interviewed as part of the inspection process, and the friendliness of staff. What the care home does well: What has improved since the last inspection? What they could do better: Although medication procedures had improved staff have not received the required accredited medication training, therefore there remains a requirement for this to be completed. The manager said he completes a medication audit and the local pharmacist also visits regularly to ensure medication is stored, recorded and administered correctly. Staff had achieved the required level of NVQ qualifications and training is provided to make sure they have the skills and competencies to provide good standards of care. The induction programme could be improved so that it meets the Skills for Care standards. A new member of staff requires formal training to safely moving and handling people who use the service. The registered manager could be sent on a course to provide the training, as he does not have the required competencies to provide the training at this time. He should be sent on a fire warden course as he has responsibility for providing fire instruction to staff. Quality assurance systems could be improved so that the views of people who use the Care Homes for Older People Page 8 of 27 service are gained annually. Data should be collated and an action plan should be completed to demonstrate how services can be improved. The décor in the lounge is showing signs of wear and should be included in the refurbishment programme. Some of the lounge chairs could be replaced to improve the environment. 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 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs can be met. Evidence: All new people receive a full comprehensive needs assessment before admission, this was carried out by the manager who had the required skills and competencies. The service was efficient in obtaining a summary of assessments undertaken by the placing authority, and insists on receiving a copy of the care plan before admission. Staff confirmed that information contained in the assessment was essential to understand what staff needed to do to ensure people’s needs were met. Two assessments were looked at and they focused on achieving positive outcomes for people who use the service. Before agreeing admission the manager and staff carefully considers the needs assessment for each individual prospective person and the Care Homes for Older People Page 11 of 27 Evidence: capacity of the home to meet their needs. Surveys received confirmed people received sufficient information before moving into the home, and people said staff helped them to settle into the home. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide staff with sufficient information to meet the needs of people who use the service. Medication policies and procedures were well managed ensuring the safe administration of medication. Evidence: Two care plans were looked at to ensure care was delivered as described. The information was comprehensive, and included daily records which described the support provided throughout the day. Risk assessments ensure people can maintain their independence, while remaining safe. Reviews take place regularly and social services staff had recently undertaken annual reviews on all people placed by the local authority. Staff were able to describe in detail the care needs of people, including how to maintain peoples independence and wellbeing. Surveys confirmed peoples needs were met and staff had the required skills and competencies to keep people safe. People said staff were very caring and always treated them with respect. Care Homes for Older People Page 13 of 27 Evidence: Peoples healthcare needs were met and there was clear evidence to confirm regular visits from health professionals. Staff had a good understanding of how to ensure peoples nutritional needs were met, including supplements and the importance of fluids to keep people hydrated. The staff have regular contact with the district nursing services, they offer advice and support. A visiting district nurse said staff was very good, they always keep them informed about health issues and they always follow instructions about how to maintain healthy skin. The district nurse said arrangements had been made to give people the influencer injection, and staff had gained peoples permission to give the injection. Medication procedures have improved since the last inspection, although staff had not yet received the required training to confirm they have the necessary competencies to administer medication safely. The manager said the training was booked and he undertakes regular monitoring of the procedures to ensure medication was administered as prescribed. The manager said the home had adopted good practice guidance for the management of medicines and the local pharmacist undertakes regular audits to ensure procedures were followed. Medication was stored securely, there were separate, locked room for storing medication which contained a fridge and a controlled drugs cabinet. Records confirmed the fridge temperatures were taken daily and the controlled drugs were recorded correctly. Medication administration records were fully completed, although one persons eye drops were still being used past the date when they should have been discontinued. The manager was made aware of the error and took steps to discontinue the medication. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. All people were referred to by their first name and this was agreed in the care plans examined. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Excellent social activities were organised which were appropriate to the needs of the people who use the service. Mealtimes were well managed and people were encouraged to make choices and control over their own lives. People who use the service could maintain contact with family and friends, and have good opportunities to maintain links with the local community. Evidence: There was a warm and friendly atmosphere on entering the home and a sense of wellbeing throughout the home. Staff were commended for creating a pleasant ambiance in the lounges. People who live at the home said activities and outings were very good. One person said they liked going for walks to the local supermarket, while others said games of bingo were their favourite pass-time. Activities were arranged to meet the needs of the people who live at the home and staff frequently ask people what they want to do and where they want to go. Staff were preparing to host a Halloween and bonfire party. The home employed a staff member who had responsibility to organise activities, including trips to the theatre, and pub lunches, while movie nights and parties inside the home. She completes a social care plan which includes every activity offered to people. Arts and crafts, quizzes, bingo and Care Homes for Older People Page 15 of 27 Evidence: dominoes were observed throughout this inspection, and staff interacted throughout the day. Plans were well underway for Christmas including parties, choirs and religious events. People said there was always something going on, one person had made a personalised birthday card for her daughter who was due to visit later in the week. Staff asks people what foods they liked and the meals were included in the menus. The meals were served directly to the dining room from the kitchen. Mealtimes were well managed by staff who have a good understanding of peoples dietary needs. Staff were seen giving assistance in an unobtrusive way, and meals served to people in their bedrooms were accompanied with a drink. People said they had enjoyed their meal of meat pie and vegetables followed by treacle sponge and custard. The quality was very good and plentiful. People said the food was excellent, one person said we get all the food we want including their favourite meal of fish and chips. The home had gained a four star award from Environmental Health department in March 2008. The award is given for good hygiene standards and food preparation. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service could access the complaints procedures and the manager ensures any concerns were recorded and investigated appropriately. Adult protection policies, procedures although training of staff is needed to promote the protection of service users from abuse. Evidence: The home had a complaints procedure that was available to people and visitors. The procedure was also referred to in the information given to new people, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection was included in the procedure, although the address and telephone number needed to be updated. The manager and information contained in the Annual Quality Assurance Assessment confirmed that two complaints had been made in the last twelve months. Records were looked at and they confirmed that procedures were followed, and action was taken to resolve the complaints. Surveys confirmed that they were aware of the complaints procedure and who to speak to if they had a concern. Regular residents meetings were also used to enable people to raise any concerns, and the manager has one to one meetings with people to encourage people to talk about things they would like improved. The home had there own Safeguarding Adults and Whistleblowing policy, which would Care Homes for Older People Page 17 of 27 Evidence: be followed if any incidents of abuse was raised. The manager said the new safeguarding adults procedures had been obtained although they were not on site on the day of the inspection. The AQAA confirmed that there had not been any safeguarding referrals. The manager said he would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The manager holds discussions with staff to talk over issues and how to recognise different forms of abuse, although staff requires training in the protection of vulnerable adults. The manger said the training would be arranged as soon as practicable. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service were provided with a clean, comfortable environment, although some refurbishment was planned to improve furnishings and carpets. There were sufficient staff to maintain good hygiene standards. Evidence: The registered providers continue to refurbish the home, and a redecoration programme has improved peoples bedrooms. A number of the requirements from the previous inspection had been completed. A new call system had been installed and wardrobes had been secured to the wall to make them safe. The lounge area has not been decorated and although some of the lounge chairs had been thoroughly cleaned they should be replaced as they are quite shabby. New co-ordinated bedding and curtains were on order and they will improve individual bedroom areas. The home was clean and fresh and people said the home was always clean and tidy, they said staff worked very hard to maintain good hygiene standards. Care Homes for Older People Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. staff have the required skills and competencies, although the induction programme could be improved to meet skills for care standards Evidence: Training records examined show the staff have the required skills and competencies to deliver a good service. Discussion with the manager and staff confirmed that there was a stable staff group who had worked at the home for a good number of years. Staff said they enjoy working at the home, and felt supported by the manager. The Partnership for Older Peoples Project provide valuable support to the home, through training and advice which helps staff to develop new skills which helps them do their job better. The manager said staff had recently attended training including falls awareness and risk reduction, end of life care and a 3 module diabetes course. The home has recently gained a training grant and a training organisation has been identified to undertake a skills audit for all staff at the home. There was an adequate induction and probationary package, which was service specific, although it does not meet the ‘Skills for Care’ standard. One induction programme for a new member of staff had not been fully completed. It indicated that the member of staff had not received training in moving and handling of people. The manager confirmed he had given the training although he did not hold a qualification Care Homes for Older People Page 20 of 27 Evidence: to deliver the training. This means that people were at risk if not moved and handled appropriately. The manager confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their standards. Staff rotas and observation during this visit showed there were sufficient staff to meet the needs of people who live in the home. People said there was always enough staff and they were good at their job. Staff had the required skills to meet the needs of people, and they are commended for meeting the requirement of 50 NVQ level two qualified staff. A number of staff are progressing with NVQ level two and three. There were robust recruitment and selection procedures that ensure people who use the service are safe and protected. A number of staff recruitment files were examined, and there was evidence that all the required employment checks have been undertaken prior to commencing work at the home. Evidence confirmed all staff had a Criminal Records Bureau check. The manager should check the date on all existing CRB’s as good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. Care Homes for Older People Page 21 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed well for the benefit of people who use the service. Health and safety procedures are followed to keep people safe. Evidence: The manager has worked at the home for over two years and recently became the registered manager. He has successfully completed the Registered Managers Award and continues to work towards NVQ level 4 in management. He is very much a hands on manager and is respected by people who use the service and the long standing staff team. He operates an open door policy and surveys confirmed peoples confidence in him to develop and maintain a good service. The manager has some responsibility for delivering some aspects of training including fire safety and induction. The organisation should consider providing him with some formal training to enable him to deliver moving and handling training within the home. A fire warden course would be beneficial to the manager to ensure he can deliver the training to all staff. Care Homes for Older People Page 22 of 27 Evidence: The manager was able to demonstrate how the organisation gains the views of people who use the service. A quality survey was sent to relatives, and he also spends time speaking to people to find out what they like about living at the home. Surveys confirmed that people feel that they were kept informed about changes to their relative care. The quality assurance system could be developed further, by analysing the information to create an action plan, to identify areas, which need to be improved. People who use the service were able to manage their own finances, although some prefer the manager to assist with dealing with their personal monies. Records were looked at and they confirmed good practise with regular audits and two signatures for all transactions, this ensures people’s money was protected. Accident reports were analysed by the manager to ensure risk assessments were developed where required to protect people who use the service. Maintenance and service records examined were up to date and current to the services provided. The manager had the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures were in place and service records were examined and were current, ensuring the safety of people who use the service. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ 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 1 9 13 All staff that administers medication must undertake appropriate accredited training, and be deemed competent. 01/01/2008 Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 All staff that administers medication must undertake appropriate accredited training, and be deemed competent. to ensure medication is administered safely 21/11/2008 2 18 13 Staff must receive training in safeguarding adults to ensure people are safe and protected 19/12/2008 3 29 18 new staff must receive formal moving and handling training before they use equipment. the training must be provided by a qualified trainer to ensure they have the skills and competencies to move and handle people safely 28/11/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards Care Homes for Older People Page 25 of 27 and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 19 All furniture in the care home should be in good condition therefore the easy chairs in the lounges should be replaced. the lounges should be decorated, as there is some damaged areas caused by lounge chairs Good practise suggests that a new CRB check should be carried out every three years, to ensure the information is up to date. the induction programme should be reviewed so that it meets the Skills for Care Standards People who use the service should be surveyed annually and an action plan should be formulated to identify where improvements are needed Consideration should be given to enable the manager to attend a accredited course on moving and handling and a course to be a fire warden. 2 29 3 4 30 33 5 38 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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