Latest Inspection
This is the latest available inspection report for this service, carried out on 20th March 2009. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.
For extracts, read the latest CQC inspection for Clare House.
What the care home does well This is an attractive, well-maintained home that is decorated and furnished to a high standard. The staff are knowledgeable about the needs of the people in their care and talk to them in a respectful manner. People living in the home say that they are well looked after and that the cooking is good. The provider is committed to providing a good service to the people living in the home. What has improved since the last inspection? The provider has decided to run the home personally because he had been unable to recruit a new manager since the previous one left. Since the last inspection he has undertaken our registration process and has become the registered manager and has undertaken training appropriate to a person running a care home for vulnerable people. He has put a lot of work into complying with the requirements that were made at previous inspections and has completed with the majority of them, those that are not met are in the process of being done. The statement of purpose and the users guide have been reviewed and improved and care plans have been completely rewritten using a new documentation system, for which he has taken advice on how to complete them. New menus have been produced, which offer a wider range of meals and they are now displayed in the dinning room and people are reminded that they can request an alternative if they don`t fancy the meal on offer. What the care home could do better: The manager has reviewed the staff files and is in the process of collecting information and carrying out checks that were missing at the previous inspection. Most of the work has been completed but there are a few outstanding documents that are still to be collected, this needs to be finished very soon so that people can be confident that the home`s recruitment process and safeguarding checks will protect them from abuse. Formal supervision sessions must be carried out so that staff know they are being listened to and feel supported. Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Clare House Whittlebury Road Silverstone Northants NN12 8UD 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: Ann Wiseman
Date: 2 5 0 3 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: Clare House Whittlebury Road Silverstone Northants NN12 8UD 01327857202 01327858976 apopat@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Atul Popat Type of registration: Number of places registered: Clarex Limited care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: 1 named person may be accommodated over the age of 62 years No one in the category of DE (E) may be admitted to the home if there are already 5 service users in this category accommodated within the home. To limit the number of service users in the categories DE (E) Date of last inspection 0 7 1 1 2 0 0 8 0 0 0 Over 65 5 25 25 Care Homes for Older People Page 4 of 26 Brief description of the care home Clare House is a detached property situated in the village of Silverstone to the south of Northampton and is set back from the road in pleasant gardens. The home is registered to provide personal care for up to 25 residents over the age of 65 years, including up to five people with a diagnosis of dementia. The home has several communal areas that are attractive and comfortable and bedrooms are over three floors with a passenger lift for access to the first floor. All bedrooms are single rooms. The current fees range from £380.00 for a standard bedroom to £520.00 per week for a large bedroom with en-suite facilities. A chiropody service is included in the weekly fee, hairdressing is provided at an additional cost. The registered provider, Mr Atul Popat, is also the registered manager. 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: This was an unannounced inspection; we arrived at 10am in the morning and stayed for three hours, this was the second inspection we had carried out in the last six months and the previous one had lasted for twelve hours. The manager was not at the home when we arrived but the care staff that was on duty showed us around the home and answered our questions, which they did in an open and helpful manner. When the provider arrived he facilitated the rest of the inspection. Whatever files and documents we asked to see were produced. During the day we had a look around the home and talked to some of the staff and the people living in the home. We looked at information belonging to three people and some of the of the staff files. We also assessed some of the homes policies and procedures and sampled a random selection of the health and safety files and records.
Care Homes for Older People Page 6 of 26 The manager had sent us the Annual Quality Assurance Assessment (AQAA) he had completed prior to the previous inspection. The AQAA is a self-assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the service. The detail given to us in the AQAA would benefit from being more detailed and it needs to include examples to back up the information given in it. We discussed what improvements that could be be expected in next years AQAA and the importance of giving us the information asked for in it as we use this document in making decisions about future inspections. The home was clean and tidy and the atmosphere was friendly and congenial, interaction between the staff and the people living in the home was observed to be friendly and open. When talking about the people they did so in a supportive and respectful manner. 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 7535. Care Homes for Older People Page 8 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 9 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 given information to help them make an informed choice about the home and assessments are carried out before people move in. People are able to visit to assure themselves the home can meet their needs. This home does not offer intermediate care. Evidence: The home has a statement of purpose, which has been updated since the last inspection, it contains all the information required. Consideration should also be given to producing the document in different formats and languages to make it accessible to a wider range of people. There is a coloured picture brochure, which contains photographs of the home and is an attractive document. Care Homes for Older People Page 10 of 26 Evidence: A user guide has been written and it contains the information we ask for but it could be made more attractive to potential customers if it contained photographs of the home, information about the surrounding area, and an introduction to some of the staff and the amenities on offer at the home. A folder has been put together that tells people about Clare House, which is given to people who are interested in moving into the home, it is kept in a draw at the entrance, visitors and residents still have to ask to see the folder, consideration should be given to condensing the contents and providing a copy to people when they move in. Assessments are carried out by the manager and a senior carer before people move in and the manager told us that he encourages people to visit with their relatives and assesses whether the home can meet their needs, he told us that he also asks people to consider carefully if they feel the home is right for them. This home does not offer intermediate care. Care Homes for Older People Page 11 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. Care plans are in place, healthcare needs are met and medication is managed as required. People say they are treated in a respectful way but the way that personal information is handled needs to be improved. Evidence: The manager has invested in a completely new assessment and care planning system, the spandex system. A representative of the company came to the house and gave the manager advice on completing the files and the manager is in the process of transferring the care plans to this system. We examined some of the files that has been done and found they were up to standard and enabled a detailed record of peoples needs to be produced. Since the last inspection it has become practice for the staff to complete care notes at the end of every shift instead of only completing them when they felt there was something to record. This will help in continuity of care, making sure things dont get forgotten and will enable staff who have been on holiday or rest days to find out about changes to daily care needs when they return to work.
Care Homes for Older People Page 12 of 26 Evidence: During this visit we noticed that care notes and other personal information was left on the counter in the dinning room. This means that everyone had access to peoples personal records. This is not acceptable as people seeing that their personal files are left lying around will have little confidence that their privacy will be upheld or respected. A locked cupboard has been provided for their safe storage and both the manager and the senior carer on duty told us that they remind staff to put files away after use and that it is normally done. Both intend to bring it to their attention again. Records show that peoples health needs are met, doctors visits are recorded and people are referred for specialist medical care when needed. Peoples files also show that they have opportunities to see dentists, opticians etc. when they need to. We examined the medication, its storage, management and its records and found that is dispensed and kept as required. There were no mistakes or gaps in the records. It is stored in a locked cabinet that is secured to the wall in a room that is kept locked when not in use. The pharmacy that provides this home with their medication also carried out a complacence check a few days before our inspection. We saw the report that was produced. It highlighted a couple of areas of improvement, which were immediately addressed by the manager. Training packs have been provided by the pharmacy, for staff to complete, when they are done they will be marked and staff who pass will receive certificates. We spoke to several people while we were in their home and they told us that the staff treated them well and were kind to them. One person said, The girls are so good to me, I dont know how I would manage without them. another person said, I am comfortable here and I have everything I need. Care Homes for Older People Page 13 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. This home offers activities and the routine is flexible enough to allow people to exercise choice in all aspects of their life and they are able to maintain contact with family and friends. Meals are served in comfortable surroundings and are well prepared and varied. Evidence: People are asked to consider whether the home matches their lifestyle expectations when they visit the home and have talked to the proprietor. There is an activities coordinator who works on weekdays and there is a program of activities on the notice board. People we spoke to said they were happy with the activities they were offered. There are several areas in the home where people can sit if they dont want to take part in the group activities or listen to the television and there is a library of books for people to borrow. On a previous visit we observed the activities coordinator visiting people individually, including those who stayed in their bedrooms. We also saw staff sitting and chatting to people during this visit. There are several tabletop activities, such as puzzles and board games, stored in the dinning room that people can take away to do. A church service is held at the home monthly and the manager assured us that if anyone wanted to attend a different faith
Care Homes for Older People Page 14 of 26 Evidence: service it would be arranged. A notice in the entrance lobby says that visitors are welcome at all times and we saw visitors come and go throughout the day. The dinning room is a large, bright and airy room that is attractively decorated. The dinning chairs are sturdy and have armrests that give people leverage when standing up and support when sitting down. Menus are displayed in the dinning room, they have been reviewed since the last inspection and are varied and offer a healthy diet. There is a note on the menu that invites people to request an alternative meal if they dont like what is no offer. Arrangements are in place to supply good quality meals to one person who has special eating requirements. Care Homes for Older People Page 15 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. Complaints and concerns are recorded in line with the homes policies and procedures and staff training protects people from abuse. Evidence: The homes complaints procedure was available within the front entrance. It provided information on how to raise any concerns or complaints about the service, the CSCI contact details were also available. There is a recording system for complaints with is set out in a way that enables people to see that the complaints policy is followed. All Complaints and concerns are recorded no matter how minor, this is considered good practice and shows that the home takes them seriously and listens to what people have to say. It was required in the previous report that the provider should attend safeguarding training for managers in this area, which he has now done. All the staff have undergone SOVA training and there are policies in place around recognising and reporting abuse. Care Homes for Older People Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This home offers a safe, well maintained environment with comfortable communal facilities designed to maintain independence. Bedrooms suit peoples needs and are individual to each person and contain personal possessions. The whole building is ventilated, warm and well lit. It is clean and hygienic. Evidence: During a tour of the building the bedrooms viewed were clean, pleasantly decorated and furnished to a good standard. The rooms contained items of personal furniture, TVs, ornaments, photographs and pictures etc. Furnishings throughout the home were pleasant and of a good standard and suitable to the needs of the people living there. New bedding has be provided that is individual to each room so people dont have to share bedding and keep their own ready for use in their room. Recent building and refurbishment work has greatly enhanced the internal and external communal space available for people and new carpets have been laid in some of the rooms. All of the bedrooms have recently been fitted with mechanical doorstops that allow the door to close when the fire alarm is sounded. This lets people leave their door open if the want to but will keep them safe in the event of a fire. There is a second conservatory, which is fitted with an environment control unit to keep the temperature at a comfortable level. This room provides an attractive and
Care Homes for Older People Page 17 of 26 Evidence: comfortable area for people to receive visitors and also provides an additional communal facility. The bathrooms and toilets are sufficient in number and were clean and decorated to a good standard. A bathroom that was being refitted during the last inspection has been completed. All of the bathrooms and toilets have specialist equipment and adaptations to meet the needs of the people living in the home. Personal protective equipment was available for staff use to enable them to maintain infection control. A large conservatory operates as the main entrance of the home, and a ramp is available to assist residents and visitors with limited mobility and those who require the use of a wheelchair to access the building safely. A large patio area with tables and chairs provides a pleasant outdoors area for people and their visitors to sit in and enjoy the garden. The home employs a gardener to keep the grounds tidy. Care Homes for Older People Page 18 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from being cared for by a sufficient number of staff that are qualified, trained and are competent to do their jobs, but work still needs to be done to make sure that personnel files contain all the information they should have. Evidence: The number of staff on duty when we arrived was adequate to meet the needs of the people living in the home and their names corresponded to those on the rota. The layout of the rota has been changed to show who the designated person in charge is, so everyone on duty knows who has responsibility for the running of each shift and who to look to for guidance in an emergency situation. The carers we spoke with talked about people in a respectful manner and were knowledgeable about their needs. It was obvious, from the interaction between the staff and the people being cared for, that there was a good rapport and there was an easy atmosphere in the home. Staff told us that they undertake training and that many have an NVQ in care and we saw certificates to evidence this in the staff files. The manager has made great improvement in carrying out safeguarding checks on all his staff and has begun collecting all the required information and the personnel records have greatly improved since the last inspection. However the work is still in progress and the task
Care Homes for Older People Page 19 of 26 Evidence: must be completed. Care Homes for Older People Page 20 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. Clare House is run in the best interests of the people living in it by a manager who is qualified and trained to do the job. A quality assurance process is being put in place and peoples finances are not dealt with by the home. Record keeping has been improved but staff are not receiving adequate supervision. Evidence: Since the last manager left the provider has not been able to recruit the right person so he has decided to manage the home himself, he applied to us for registration as the manager and has successfully completed our safeguarding checks and the fit person interview and has received his new registration certificate. He has also undertaken training appropriate to the managers role and has told us that he has now completed his registered managers award. He needs to make sure that he regularly updates his training so that he can offer support and direction to his staff. The manager acknowledged that he is still putting plans in place to offer staff formal 1
Care Homes for Older People Page 21 of 26 Evidence: to 1 supervision, and told us that he has plans to ask his senior staff team to help by supervising care staff. It is important that this is done quickly so that staff feel supported and that they are given an opportunity to receive guidance, to discuss ideas, to raise concerns and discuss career development. It is expected that all staff will have supervision at least six times a year. One senior staff member we talked to told us that the manager has introduced regular meetings with the senior staff team, which she has found very useful in passing on information. The manager confirmed that the meetings take place but said that notes are not kept, we asked him to formalise the meetings and keep a record of them. The home has introduced a formal quality assurance process, where the people living there, their relatives and the staff are asked how they feel the home supports them and meets their needs by way of a confidential survey. The home doesnt manage peoples money. Occasionally relatives will give money to staff to pay a hairdressers bill or something similar. This money is stored in a lockable box, fixed to a shelf in the medication room, which is kept locked, and records are kept of what money is in the box. Staff spoken to in private confirmed that the registered provider puts the residents needs first and always has their best interests at heart, comments from residents confirmed that the registered manager treats them well and observations made during the visit of the managers interactions with people and visitors indicated that there was a good rapport, one person enjoyed a laugh and a joke with him and it was clear that relationship were good. Through observations of care practice and discussions with staff and people living in the home it was evident that the staff and the manager know the residents individual needs very well, and that the health and personal care needs are being met. There were a lot of requirements made at the last inspection and the manager has worked hard in complying with most of them, those outstanding are in the process of being done. This has made a big improvement in the management of the home and shows the commitment the manager has to providing a good quality outcome to the people in his care. He has recently recruited a person that he hopes will support him manage the home and keep up to date with paperwork once she has completed her safeguarding checks. Care Homes for Older People Page 22 of 26 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 10 18 Personal information must be 09/03/2009 stored in a way that will make sure it will be kept confidential. People will have little confidence that their privacy and dignity will be protected if they see that their private files are left out for everyone to see. 2 36 18 (2) All staff must be 31/12/2007 appropriately supervised and care staff receive formal supervision at least six times a year. Care Homes for Older People Page 23 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 1 29 19 Current work must be 23/06/2009 completed so that staff files hold all the information as set out in schedule 2 of the national minimum standards. The files must also include proof that the provider has followed the proper recruitment process as asked for in standard 29 and that the worker is suitable for the post as covered in regulations 18 and 19. Only people who are of good character, have the right aptitude and is of integrity should work with older people, as they are often vulnerable and need to be protected from abuse. Care Homes for Older People Page 24 of 26 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 Consideration should be given to produce the statement of purpose in a range of formats to make it accessible to more people. By writing the document in a larger font or in braille and by advertising a willingness to get it translated into other languages will indicate that the home is prepared be inclusive and flexible. We recommend that people are each given a copy of the users guide that they can keep for reference. Storage facilities have been provided so that personal information can be stored in a way that will make sure it will be kept confidential when not in use but staff are not always using it. People will have little confidence that their privacy and dignity will be protected if they see that their private files are left out for everyone to see. It is recommended that staff receive training on the importance of protecting peoples confidences and private information. 2 3 3 10 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!
