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Care Home: Alexander Residential Home

  • Victoria Road Morley Leeds West Yorkshire LS27 9JJ
  • Tel: 01132532046
  • Fax: 01132527732

Alexander residential home is a large detached Victorian style house with an extension known as `the Cottage to the rear. The home provides residential care and accommodation for 32 older people including a number with dementia. It is located close to the community of Morley, to the south of Leeds. The building has a passenger lift and stair lift on one short flight of steps. All corridors are accessible via the passenger lift and stair lift. There are lounge areas which are also used for dining on both floors of the home. All but one bedroom is for single occupancy, some have en-suite facilities, others just a hand washbasin. The home is reasonably close to a range of suitable local amenities, including shops and pubs. There is good access to public transport with a bus stop right outside the entrance. There is a small area for off road parking. The garden is accessible both at the front ad rear of the home by older people. which has been designed for disabled access and has a secure private area with seating facilities to the rear of the home. Because of the proximity of the main road this area is to be made more secure with a gate and intercom system to reduce the risk for people.

  • Latitude: 53.754001617432
    Longitude: -1.6000000238419
  • Manager: Mrs Wendy Evered
  • Price p/w: £375
  • UK
  • Total Capacity: 39
  • Type: Care home only
  • Provider: Mr Peter Morris,Mrs Margaret Morris
  • Ownership: Private
  • Care Home ID: 1531
Residents Needs:
Dementia, Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Alexander Residential Home.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Alexander Residential Home Victoria Road Morley Leeds West Yorkshire LS27 9JJ     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 Francis     Date: 2 1 0 4 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 26 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Alexander Residential Home Victoria Road Morley Leeds West Yorkshire LS27 9JJ 01132532046 01132527732 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) : Mr Peter Morris,Mrs Margaret Morris care home 32 Number of places (if applicable): Under 65 Over 65 10 1 32 dementia learning disability old age, not falling within any other category Additional conditions: 0 0 0 That the category LD(E) be used for the individual named on the accompanying notice. Date of last inspection Brief description of the care home Alexander residential home is a large detached Victorian style house with an extension known as `the Cottage to the rear. The home provides residential care and accommodation for 32 older people including a number with dementia. It is located close to the community of Morley, to the south of Leeds. The building has a passenger lift and stair lift on one short flight of steps. All corridors are accessible via the passenger lift and stair lift. There are lounge areas which are also used for dining on both floors of the home. All but one bedroom is for single occupancy, some have en-suite facilities, others just a hand washbasin. The home is reasonably close to a range of suitable local amenities, including shops Care Homes for Older People Page 4 of 26 Brief description of the care home and pubs. There is good access to public transport with a bus stop right outside the entrance. There is a small area for off road parking. The garden is accessible both at the front ad rear of the home by older people. which has been designed for disabled access and has a secure private area with seating facilities to the rear of the home. Because of the proximity of the main road this area is to be made more secure with a gate and intercom system to reduce the risk for people. Care Homes for Older People Page 5 of 26 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 inspection process included looking at the information we received about the home since the last key inspection. This was an unannounced visit by one inspector who was at the home from 09.30 until 5.45 pm. The purpose of the key inspection is to make sure the home is operating and being managed for the benefit and well being of the people who live there. During the visit we spoke to people living in the home, their relatives, staff and management. We looked at various records relating to peoples care and the running of the home and inspected the premises. During the inspection all of the key standards were looked at to assess the standard of care that people receive. Care Homes for Older People Page 6 of 26 Before the visit we asked the home to complete a self-assessment form. An annual quality assurance assessment (AQAA),, this was returned to us in good time. We also sent surveys to people living in the home and staff. Some peoples relative completed the questionnaires on their behalf. We also received completed surveys from staff, their comments and information from the self-assessment form are included in this report. Care plans, risk assessments, health care records, minutes of meetings , staff recruitment and training records were looked at. Feedback of the findings of the inspection was given to the manager. The fees for the home range from 405. pounds 73 pence to 432 pounds per week. Chiropody, hairdressing, personal clothing and newspapers are not included in the fees. 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 the service 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. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 Care Homes for Older People Page 8 of 26 7535. Care Homes for Older People Page 9 of 26 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 26 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 are provided with enough information to enable them to make an informed choice about the home. The admission process is good and includes introductory visits. Evidence: We saw that the homes Statement of Purpose and Service User Guide contained information that people need to make an informed choice about whether or not the home is suitable for them. The statement of purpose had been reviewed to reflect the changes in the home. The information provides people with good information about the home and the service they provide. People and their relatives told us that they had been given good information about the home and were able to talk about their care and support needs. It was apparent from discussion with the manager and inspection of records of people who recently moved into the home, that all prospective people wanting to live in the Care Homes for Older People Page 11 of 26 Evidence: home receive a pre assessment of their needs before they move into the home. We were also told that part of the admission process is to encourage people to visit and spend time at the home before they make a decision to move in. This gives staff further opportunity to carry out assessment of the persons care and support needs. Although the home has some good assessment information about people, additional information is needed to show how people are affected by their dementia. This would provide staff with more information for a better understanding of the person. During the visit we spoke to several staff who said that they were able to meet people when they came on visit to the home, and information about peoples needs are shared with them before the person move in. Care Homes for Older People Page 12 of 26 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. Every effort is made to make sure peoples health and personal care needs are met. Evidence: The case records of three people were looked at in detail. We saw following admission to the home a more detailed assessment takes place covering all of the activities of daily living identifying peoples strengths and weakness. Although the standard of recording information about people in these documents were good, the action that staff must follow to meet peoples individual care should be more specific, so that people get the care and support they need. For example one persons care plan said that they must be supported to do as much as they can. The action needs to be clear about how staff must assist this person and at what stage the person needs support and guidance to help themselves. We saw that care plans are reviewed regularly and evaluated monthly. However some of the review information was brief and uninformative. Others had detail of how effective the plan had been and what progress or changes had occurred. Evaluation of care plans needs to be developed to provide meaningful feedback of the effectiveness of the care plan over the previous month. Care Homes for Older People Page 13 of 26 Evidence: There is a range of risk assessments some of which are completed showing the action to be taken to manage the risk. The home also seeks the advice of health care professionals whenever necessary. Medications are administered by the manager, deputy manager and other staff from the management team. The deputy manager oversees and take responsibility for the medicines and make sure that all returns are clearly documented. We were told that they liaise closely with the local pharmacist, who carries out annual audit. When we checked the storage of medication we found that the home was holding excess stocks of people medication. For example one person who had eye drops administered to them twice per day had a bottle in the medication trolley which lasted 28 days. However, we saw that there were four other bottles in the store cupboard. We were aware that medication had been delivered the day before our visit , and this excess was not a result of the new delivery. We were told that people have their medications reviewed regularly to make sure they were still effective. Visiting health care professionals told us that the home was compliant and they followed instruction and would ask for any help that they needed. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to take part in social and recreational activities in and outside of the home, according to their preferences and capabilities. People are provided with meals that are varied and wholesome. Evidence: The home encourages relatives and friends to visit. People told us that there are no restrictions when they can have visitors. Relatives also told us that they are made to feel welcome in the home at all times. The routines at the home are very flexible and generally meet the needs of those living there. People told us that they get up and go to bed when they wish. We saw in care files that peoples family had worked with the home in putting together life history, which gave staff information about peoples past life, thus providing them with information that would assist them in drawing up care plans that are person centered and reflecting peoples life style and preferences . the home has an activity files which covers activities such as board games, music and movement and the four weekly motivation and reminiscent group sessions. The home also have cultural awareness evenings, which involves food tasting and sharing information about the different countries and their cultras. On the day of the inspection two peoples relatives came and took them out for the day, one visited a Care Homes for Older People Page 15 of 26 Evidence: friend and the other went to the local Shopping Mall. Staff told us that they also take people out shopping. During the visit we saw that people were kept occupied, we saw people playing board games with each other and staff. We saw that people are visited by their relatives and friends. However, we were told in surveys the home could provide a better range of activities. People were given a choice of food at meal times. We were told that menus are put together by the cook with discussions with people. People told us that if they did not like what was on the menu they could have something different. The main meal is served at lunch time, with a lighter meal during the evening which consist of individual choice. From discussion with the cook it was evident that she knew what to do for people who needed any special diet or who needed their food liquidised. We were told that when people move into the home they are given a questionnaire, which would give staff information about their likes and dislikes. We notice that nutritional risk assessments are not carried out for people, which would help staff identify if people were at risk of malnutrition. The manager said on admission people are weighed and any problem with their eating are recorded in their care plan and a referral made to the GP and the community dietitian. Those people who are at risk have their weight checked weekly, which is recorded their medication administration sheet.We were told that most staff have been trained in nutritional and healthy eating, which was part of the palliative care programme through CHESS ( Care Homes for Older People Page 16 of 26 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 appropriate policies and procedures to safeguarding people. People and their relatives know that their concerns will be listened to and dealt with. Evidence: The home told us that when they get a complaint they see it as a way of reviewing their service and all complaints are discussed with staff and they ensures that there is a satisfactory outcome for the person and the home. From discussion with staff it was apparent that not all staff had received Safeguarding Adult training. The manager said that arrangements had been made for for all staff to have this training. The complaint procedure is made readily available and is displayed in on the wall near the visitors signing in book. The policy was also included in the statement of purpose and the service user guide. The records provided showed evidence that complaints were responded to in a timely and objective manner, showing people and visitors that their complaint and concerns were listened to and acted upon. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and pleasant surrounding, which are generally well maintained. There are systems in place for peoples safety. Evidence: During the visit we looked around the building, looking at bedrooms, communal sitting rooms , bathrooms and toilets. We found that generally the sitting areas were seen to be comfortable for peoples use. The furnitures and fitments are suitable for the people living there. We saw that people had taken the opportunity to bring with them many of their personal effects. Since the last key inspection some of the bedrooms have been refurbished and furniture replaced, most bedrooms have en-suite facilities. We were told that bedrooms are refurbished as required and carpets are replaced when worn or badly stained. A risk assessment needs to be undertaken and a restrictor may need to be applied to make sure that the occupant was not at risk of falling out of the window which could be fully opened. This was brought to the attention of the manager. At time of this visit there was major building work going on for an additional nine bedrooms, bathrooms and sitting areas. The home told us that all new bedrooms will have a wet room which provide people Care Homes for Older People Page 18 of 26 Evidence: with a shower, which would give the occupant more privacy of bathing in their own room. We also told that there were plans in place for an additional lounge and conservatory which would give people more choice where to sit. People have access to the decking sitting area which they can use in the good weather. The manager told us that when the building work is completed the home plans to landscape the garden and provide a ramped area to the grounds which would give people access to the garden giving them the opportunity to use the grounds . In the laundry room there is a sluice cycle washing machine and dryer. Peoples clothing appeared to be suitably laundered. Peoples clothing are marked with their names to make sure they wear their own clothing. During our inspection of the premises although we found it to be homely, we saw in some bedrooms and hallways debris and dust and cobwebs. this was brought to the attention of the manager. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are cared for by experienced staff who are trained and qualified for the job. Evidence: Since the last inspection there have been changes in the way the staff are organised on each shift. There is now additional staff during the evening to ensure that people have a member of staff available to support and reassure them. The manager said that people often appeared to get upset during the evening and need support and reassurance. The combination of evidence from rotas seen, watching staff at work, comments made in the surveys and conversations during the visit, suggest that there are enough staff on duty and that they are able to give people the care and attention they need. Communication systems are in place for sharing information. At the end and the beginning of shifts there is an hand over when staff pass on information of what had happened during their shift. Staff said The manager passes on information. During the visit we observed staff interaction with people and visitors and found them to be very personable but professional. Most of the staff have worked at the home for some time and knew the people they were caring for and their colleagues they work with. One person visiting the home told us that she had worked at the home some years ago and had recently reapplied to come back to work, she Care Homes for Older People Page 20 of 26 Evidence: said she found it a very homely place providing people with a good standard of care and staff are well supported. The home has a training plan in place, and staff files showed that they had attended several courses and receive updated training. We were also told by staff training is an important part of my role.I can gain knowledge and keep up to date with any changes or new legislation. Our manager makes sure we have lots of in house training. Some of the training given to staff included safe handling and administration of medication and nutrition and health. The home has exceeds targets set in the National Minimum Standards for the numbers of staff who should achieve a (NVQ) National Vocational Qualification. We looked at the recruitment files of three staff one had recently been employed . We saw information that all the required checks were completed before they started working in the home. One staff told us they had not been allowed to start work until POVA (Protection of Vulnerable Adults) first and CRB (Criminal Record Bureau) checks, and the receipt of two written references had been obtained. Although we saw that the home carries out all the required checks, this is only done at the initial start of the employment with the home, for some staff they have not had a CRB check for many years, This was discussed with the manager and we were told that plans are in place for the home to carry out random selection of staff to have a CRB check, to make sure they are still safe to work with vulnerable people. All other recruitment records were checked and found to meet the standards. It is acknowledged that there is a good induction programme for new staff and that they are never left unsupervised during this period. For example the person works with a senior member of staff and they get one week induction training and will only work alone when the manager feel that they are competent in their role. The manager told us that she is now looking at the skill mix of the staff team to make sure that they have staff who are trained and have experience to meet the needs of people living in the home. We were told by visiting health care professionals that staff always ask for help and always act on the advice given. Visitors told us that staff are friendly helpful and caring and always wiling to help. Care Homes for Older People Page 21 of 26 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 well managed. The interests of the people who live there are seen as very important to the manager and staff. Evidence: The manager has been employed in the home for many years, she is supported by a deputy manager, two assistant managers and two senior care workers. The proprietors also visit the home on a regular basis and monthly reports are made at the visit on the conduct of the home. The manager spoke with good knowledge of the home and the people living there, there are good systems in place to protect people. The home do not keep money for people or handle their financial affairs. This we were told is done by people, relatives advocates or solicitors. People, their relatives and health care professionals are able to comment on the service provided at the home. For example in house meetings, involving people and relatives in their care and through taking part in the annual quality audit. Questionnaires are sent to people, relatives and professionals involved in the home. We were told that letters of the outcome is sent to Care Homes for Older People Page 22 of 26 Evidence: all involved in the audit. Any action for improvements are discussed with staff at their meetings. Staff are trained in health and safety, infection control, safe handling of people and food safety. There are systems in place for recording and monitoring accidents, so that any possibility of accidents can be recognised and an arrangement put in place to reduce the potential risk. We found that regular checks are carried out of the fire equipments, and all staff take part in fire safety training. The maintenance records we looked at were up to date and showed that equipment are maintained and serviced at the required intervals. Risk assessments were in place for the building work that was in progress, and there is a general systems in place for risk assessment of any potential risk around the building. to make sure people are safe at all times. Care Homes for Older People Page 23 of 26 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 24 of 26 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 3 Additional assessment information about peoples dementia and how it effects them, should be obtained. So that staff have good information to put together a care plan that are person centered and would help them in the delivery of the persons care. The home should consider the way in which they order peoples medication to stop excess medication in the home. which could cause people having out of date medication administered to them. A nutritional risk assessments should be completed when a person is admitted to the home and later as necessary. This will make sure that those people at risk are identified and appropriate preventative action can be taken. Some consideration should be given to make sure that the home is kept clean to a good standard, so that people live in a home that is clean and well maintained. 2 9 3 15 4 19 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 26 of 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!

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