Care Home: Field House Care Home

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What the care home does well The home provides a pleasant, homely and clean environment for people who live there. People gave positive comments about their care and services received, comments included, `the staff are marvellous` and `the staff are so kind`. The visiting district nurse told us she feels people are well cared for, staff carry out any instructions from her and always seek appropriate advice. People are able to take part in various recreational activities and maintain contact with family and friends as they wish. Activities include, one to one time, old time fun and games, beetle drive, arts and crafts and discussion groups. The service has recently won a bid for a residents computer from Nottinghamshire County Council and this is being used extensively for people to keep in touch with their relatives abroad. People told us they were very satisfied with the activities and events offered. Leadership in the home is good and quality monitoring systems are in place to ensure the home is run in the best interest of people living there. This includes a robust complaints procedure and quality assurance system. The training programme offers staff a variety of courses and over 50% of staff have achieved an NVQ (National Vocational Qualification) in care. What has improved since the last inspection? The providers have updated information given to people about the service to tell them the current fee rate and where they can obtain independent advice should this be needed. Care plans have begun to be developed to ensure they are more person centred and records what is important to the person and how best to support this. Letters have been sent to people and their representatives regarding the cause and detection of abuse and the manager and deputy manager have attended a referrers course. Improvements to the environment have included; purchasing new furniture for the dining room and some bedrooms, new beds, slings and slide sheets and refurbishing the kitchen. One double room has also been changed to two single rooms. The providers have taken action to address the previous requirements and recommendations by ensuring risks assessments are in place regarding the use of bed rails and the appropriate measures are in place regarding the risk of entrapment, completing relevant documentation in respect of training records and fire safety and monitoring the temperature of the clinic room. What the care home could do better: Care plans could be improved further by including the action staff need to take to show that the mental capacity of people has been considered. They should also record peoples` preferences relating to male and female carer and show that people have the opportunity to be involved in writing their plan of care and all subsequent reviews.Records should show that staff have the opportunity to discuss any issues arising from their practical one to one sessions and that these form part of their formal supervision. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Field House Care Home 11 Main Road Radcliffe On Trent Nottingham NG12 2FD     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: Elisabeth Pinder     Date: 2 5 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Field House Care Home 11 Main Road Radcliffe On Trent Nottingham NG12 2FD 01159335811 01159335811 staff@fhnursing.freeserve.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr R C Pring,Mrs P A Pring care home 50 Number of places (if applicable): Under 65 Over 65 50 0 old age, not falling within any other category terminally ill Additional conditions: 0 4 Mr R C Pring and Mrs P A Pring are registered to provide accommodation, nursing and personal care for persons of both sexes whose primary needs fall within the following category: Older Persons, not falling in any other category (OP) One person aged 64 years, as described in an application dated 22 February 2007 may be admitted. The maximum number of service users is 50. Date of last inspection Brief description of the care home Field House Care Home provides residential and nursing care for older people. The home is located approximately five minutes walk from Radcliffe on Trent town centre. Accommodation is arranged on two floors with forty-six (46) single bedrooms and two (2) double bedrooms. There is a passenger lift and the home is accessible to wheelchair users throughout. There are six bathrooms with specialist lifting equipment in place and sufficient well-sited toilets to meet peoples need. In addition there are safe enclosed gardens. Care Homes for Older People Page 4 of 27 Brief description of the care home At the time of the inspection the manager confirmed that the weekly fees ranged from £560 to £600 depending on the persons assessed needs. Additional charges are made for chiropody and hairdressing. Information about these costs, as well as the day-to-day operation of the home, including a copy of the last inspection report, is available in the reception area or from the office. 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: This was an unannounced visit and it formed part of a key inspection, focusing on key standards which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Commission for Social Care Inspection (CSCI). The visit lasted just over seven hours and took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since our last visit. Before we made our visit the manager had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent out surveys to people living at the home and to staff before we visited, however, due Care Homes for Older People Page 6 of 27 to the short time given to plan this visit surveys have not yet been returned. Once we receive these we will look at them and contact the providers and manager should any issues need clarification. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of people through their care records and assessing their care. We spoke to people who use the service and saw rooms of those who said we could and to two members of staff, two visitors and a district nurse. What the care home does well: What has improved since the last inspection? What they could do better: Care plans could be improved further by including the action staff need to take to show that the mental capacity of people has been considered. They should also record peoples preferences relating to male and female carer and show that people have the opportunity to be involved in writing their plan of care and all subsequent reviews. Care Homes for Older People Page 8 of 27 Records should show that staff have the opportunity to discuss any issues arising from their practical one to one sessions and that these form part of their formal supervision. 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 coming into this service have access to a range of information to help them make a decision about moving into the home and procedures are in place to ensure people are only admitted after a full needs assessment has been carried out. Evidence: Information sent to us prior to the inspection told us that people have access to a range of information about the service and are able to visit the home and spend time there before making a decision about moving in. This was confirmed during our visit. One person told us he and his wife visited and met staff and other people living there and this had helped him make his decision. Information is available in an information pack given to people on their initial enquiry, including a Statement of Purpose and Service User Guide. The Service User Guide tells people how they can access a copy of the last inspection report and gives information about the current fee rates and where they can obtain independent advice should this be needed. It tells people how differing Care Homes for Older People Page 11 of 27 Evidence: needs, such as religion and culture will be met but does not say how the service considers the Mental Capacity Act and the manager agreed to include this. Care records of two people who had recently been admitted were looked at and these showed that a needs assessment had been carried out. Contracts/terms and conditions of residency are kept in the administrators office and a sample of these were looked at. During the visit people told us they were happy with the home and the services offered, one person told us she had previously stayed for a period of respite care and had no doubts that this was the best place for her. A relative told us its absolutely brilliant. The service does not cater for people with intermediate care needs. 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. Peoples personal care and health care needs are being met by staff who understand their needs and deliver care in a respectful manner. There are satisfactory policies and procedures in place about the administration of medication and peoples privacy and dignity is respected. Evidence: We continued to case track a further three people and looked at their care plans and risk assessments. We were told that within the last twelve months care plans have begun to be developed to ensure they are more person centred and the manager showed us what has been done so far. These were clear and were easy to follow, they included medical profiles, life histories including hobbies and interests, detailed risk assessments and appointments with other healthcare professionals. Care records did not record peoples personal preferences with regards to male or female carer, however, all but one person spoken to said they did not mind. This was discussed with the manager who said she would include this information on admission. Care plans did not show that, where able, people had been involved in drawing up their plan of care, Care Homes for Older People Page 13 of 27 Evidence: although records showed an annual review meeting was held with them and their relatives. Various assessments had been completed on subjects such as, manual handling, pressure risk and nutrition. Daily notes were written and these showed that people were receiving the correct level of care. The manager told us that consideration is given regarding the Mental Capacity Act and care plans will record the action staff must take if a person does not have capacity. A requirement given during the previous inspection regarding the risk of entrapment in respect of bed rails has been addressed and risk assessments and signed consent forms were available for us to look at. People were happy with the level of support given and told us they felt their needs were being met and they are treated with respect. Staff spoken to had a good knowledge of the needs of people who use the service and how to meet them and were observed to be responsive to needs and were respectful and kind. A visiting nurse told us she visits the home at least three times a week, sometimes every day and feels people are well cared for. Staff carry out any instructions from her and always seek appropriate advice. Information taken from the AQAA told us that policies and procedures concerning the receipt, storage, administration and disposal of medications were available. We looked at medication records of the people whose care was being followed and observed medications being administered at lunchtime, these showed that the people were receiving their medications correctly. A recommendation was made during the last visit that the temperature of the clinic room should be monitored, records showed this is now being done and a thermometer has been put on the wall. 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. People are able to take part in various recreational activities and maintain contact with family and friends as they wish. Meals provided are well balanced and take into account personal preferences and special dietary requirements. Evidence: Information sent to us prior to the visit indicated that a range of activities are provided to meet individual needs and five activity co-ordinators are employed to ensure everyone has the opportunity to join in if they choose. Two members of staff have recently attended a NAPA course (National Association for Providers on Activities for Older People) and on admission an activity profile is written recording peoples interests and what type of activity they would like, including spiritual needs. People who are unable to join in with activities have one to one time with a member of staff and the manager told us that one carer had completed a hand massage course and she now plans to facilitate this. There are regular meetings with people to discuss activities, including community events. One of the activity co-ordinators has recently written dignity questionnaires for people to complete and the results of these were positive. During the visit people were taking part in a Chinese Day where people were Care Homes for Older People Page 15 of 27 Evidence: able to dress in Chinese costume, sample food and watch a percussion band and dragon dance. Activities and events were displayed in various areas in the home and other activities planned for the week included; old time fun and games, beetle drive, arts and crafts and discussion groups. The service has recently won a bid for a residents computer from Nottinghamshire County Council and this is being used extensively for people to keep in touch with their relatives abroad. People told us they were very satisfied with the activities and events offered, one person told us she prefers not to join in but appreciated always being asked and another person said she loved the quizzes as she likes to keep her brain active. People told us they were able to keep in touch with family and friends and have visitors whenever they choose and this was evident throughout our visit. People told us they are able to have their meals wherever they choose, there are a number of small dining areas throughout the home and we saw people chatting with each other as they ate. All told us they were very happy with the food, menus were varied and a choice offered. Specific comments were the food is very pleasant, and the food is good, the cook knows what I like and we are always asked what we would like to eat. Alternatives and specialist diets, such as a diabetic diet were also available. The meal of the day looked appetising, tables were nicely laid with placemats/napkins and condiments. 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 are protected by the procedures in place for handling complaints and allegations of abuse. Staff have received training in these subjects to help them protect the people they support. Evidence: Information taken from the AQAA tells us that clear procedures are in place for dealing with complaints and safeguarding referrals. The complaints policy is on display and is included in the Service User Guide. Specific questions about complaints are asked as part of the quality monitoring process and within the last twelve months letters have been sent to people and their representatives regarding the cause and detection of abuse. The manager and deputy have attended a referrers course. During the visit people told us they felt confident to raise issues with the manager and were sure these would be taken seriously. Within the last twelve months two complaints have been made, both have been resolved and records were available to show that these had been dealt with appropriately. No referrals have been made to Nottinghamshires Safeguarding Adults team. Training records for two members of staff were looked at and these showed safeguarding training had been completed in 2007. Both people were spoken to and generally had a good knowledge of what to do should they receive a complaint or an allegation of abuse be made, however, one member of staff needed some prompting Care Homes for Older People Page 17 of 27 Evidence: regarding the reporting process. 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 live in a well-maintained, clean, comfortable and homely environment, which offers a good standard of decor and furnishings. Evidence: We took a partial tour of the home which included looking at the bedrooms of the people whose care was being followed and some communal areas. Bedrooms had been personalised with photographs, mementos and small items of furniture. All bedrooms have been fitted with telephone points giving people the facility to have their own phone if they choose. Bedroom doors are lockable and we were told that no one has requested their own key, however, there was no record of people being asked if they would like this facility and the manager agreed to do this. There were no unpleasant odours in the home, communal areas were bright and nicely decorated. Specialist equipment is providered such as hoists, moving belts, rotundas, profiling beds and supportive chairs. Information taken from the AQAA told us that within the last twelve months improvements have included; purchasing new furniture for the dining room and some bedrooms, new beds, slings and slide sheets and refurbishing the kitchen. One double room has also been changed to two single rooms. The manager told us that their Environmental Health Officer visited recently, however, refurbishment was being carried out so they did not undertake their inspection and will Care Homes for Older People Page 19 of 27 Evidence: re-visit. Care Homes for Older People Page 20 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. Staffing numbers are in sufficient quantity for them to be able to care for people currently living at the home. The service recognises the importance of training to ensure staff are knowledgeable and equipped to meet the needs of people living here. Evidence: On the day of the visit 44 people were living at the home. Duty rotas looked at for the month of February showed that there were generally seven or eight carers on duty throughout the day time period and two registered nurses. Throughout the night one registered nurse and three carers are on duty. In addition to this there is a registered manager, deputy manager, training manager and administrator on duty. The provider also visits the home most days. During our visit a mixed response was received regarding the availability of staff, one person said she occasionally had to wait for staff to answer her call bell and another said staff are very busy and sometimes I have to wait for them to attend to me. However, this was discussed with the manager and provider who told us the response to the call bells is frequently looked at as responses are recorded and confirmed that staff always go to the person to establish if it is an emergency or urgent and if it is not they ask if they could come back to them as soon as possible. Other people told us the staff are marvellous and the staff are so kind. Relatives told us that generally speaking staff are kind and considerate and excellent. Staff spoken to said they felt they had enough time to complete their tasks Care Homes for Older People Page 21 of 27 Evidence: without rushing and observation of care practises during the visit showed staff caring for people in an appropriate manner. They were visible in communal areas and responded well to peoples needs. The records of two staff recently employed were looked at and these showed that essential checks such as written references and C.R.B. (Criminal Records Bureau) checks are being undertaken and records showed both had received induction training which meets current standards. Information received prior to the visit told us that over 50 of staff have achieved a nationally recognised vocational award in care. One requirement was given during the last inspection regarding records that were kept to confirm staff had undertaken specific training and during our visit accurate up to date records were available. A training manager is employed, her main responsibility is to look at the needs of people being cared for and access training to ensure staff have the skills and knowledge to meet those needs. Training records for the two members spoken to were looked at and these showed they had recently completed training in equality and diversity, mental capacity, dementia awareness, risk assessments and an up date in moving and handling. Care Homes for Older People Page 22 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. This home is well managed and the staff are supported and supervised in carrying out their roles. The audit and policy systems ensure that peoples views are listened to and acted upon. Evidence: The registered manager is suitably qualified and experienced to run this home. She has been in post since 2004 and previously worked in the home as a registered nurse from 1999. She completed the Registered Managers Award in 2007. Staff told us they feel the manager is approachable, very supportive and always available. People living in the home spoke highly of the manager and all felt the home was well run. The manager has taken action to address the recommendation given during the previous inspection regarding documentation that should be available for inspection relating to fire safety and records we looked at were up to date. These showed dates staff had received fire training, the date of fire safety checks and the date of fire drills. Supervision records were looked at and these were generally up to date, formal Care Homes for Older People Page 23 of 27 Evidence: supervision is recorded including practical sessions. However, the latter did not show that staff had been given the opportunity to discuss any issues during these sessions and the training manager agreed to action this. Discussion and records showed that there are various systems in place to monitor the quality of the service being provided. This includes seeking the views of people through meetings and three monthly questionnaires, the results of the last surveys are currently being collated and once the report is written a copy will be displayed on the notice board. We were told that a quality audit had been completed in October 2008 from Nottinghamshire County Council giving an overall score of excellent. The provider showed us records to support that she visits the home at least once a month to carry out an unannounced visit and complete a report on her findings to evaluate how the home was operating and visits included talking to people living at the home and to staff. Information provided in the AQAA told us that there are a range of policies and procedures in place and the majority of these had been reviewed and updated in 2008. We were also told of equipment maintenance and service dates. Building risk assessments are in place and regular health and safety audits are completed. The Department of Health Essential Steps is used to assess infection control and records showed staff receive health and safety training. Peoples personal finances are not held on the premises, should a cost be incurred relevant others are invoiced for this charge. Care Homes for Older People Page 24 of 27 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 25 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 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 7 Care plans should show that, where able, people are given the opportunity to be involved in writing their plan of care and involved in subsequent reviews. Care records should record peoples personal preferences with regards to male or female carer. Staff should receive an update regarding the process to take to report any safeguarding referrals. Records should show that people have been offered a key to their own room. 2 3 4 7 18 19 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 © (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 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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