Care Home: Fountain Nursing Home

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What the care home does well There are good systems in place to make sure that people`s needs are assessed before they move in to the home. People living in the home are treated respectfully. Each person has a plan of care and access to health care services so that their health and personal care needs are met. The lifestyle people experience in the home matches their preferences. They are supported to maintain their independence and enduring interests that enhances their quality of life. Meals are varied and nutritious. One person commented, "The meals are always good." People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. The home is well maintained providing a safe, attractive, homely and clean place to live. There are sufficient competent staff on duty to meet the needs of people living in the home. People are protected by robust recruitment procedures. The atmosphere in the home was friendly and relaxed and staff were available to meet peoples needs as they required. Staff interacted well with people living at the home and their visitors and this will promote a happy living environment. People commented, "The staff are all very kind and friendly," and "They (the staff) can`t do enough for my relative, very patient." The home is managed by an experienced and competent person to ensure the service is run in the best interests of people living in the home. What has improved since the last inspection? The home has taken steps to address all of the outstanding requirements from the last inspection. Care plans contain current and accurate information about the actions staff need to take to meet the identified needs of people living in the home. This should make sure people get the care they require. There have been further improvements to the home environment including redecoration and new flooring to enhance the environment that people live in. Recruitment procedures have improved which means that people living in the home are safeguarded. What the care home could do better: The findings of this inspection indicated that the service is currently performing well.We made one recommendation as a result of this inspection visit. All staff should receive safeguarding adults training to ensure they have the knowledge and skills to protect vulnerable people living at the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Fountain Nursing Home 11-17 Fountain Road Edgbaston Birmingham B17 8NJ     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: Patricia Flanaghan     Date: 0 9 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Fountain Nursing Home 11-17 Fountain Road Edgbaston Birmingham B17 8NJ 01214296559 01214296559 fountainl@fsmail.net 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) : Fountain Nursing & Care Ltd care home 27 Number of places (if applicable): Under 65 Over 65 0 27 dementia old age, not falling within any other category Additional conditions: 27 0 The maximum number of service users to be accommodated is 27. The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: Old age not falling within any other category (OP) 27 Dementia (55 years and over) (DE) 27 Date of last inspection Brief description of the care home The Fountain Nursing Home is a large converted detached property, which is registered to provide nursing care for twenty-seven people who may also have dementia care needs. The home has been established for a number of years but has new owners since June 2007. The home is situated relatively close to Birmingham town centre and is within easy reach of public transport facilities. There is a large, enclosed garden to the rear and limited off road parking to the front of the property. Accommodation is provided in 11 single bedrooms and eight double rooms with some having en-suite facilities. Communal accommodation consists of three separate lounges, a dining room, porch and a visitor?s room. The home has hoisting equipment and specialised Care Homes for Older People Page 4 of 28 Brief description of the care home mattresses for people who may develop sore skin. People who use wheelchairs can access the building as a ramp is provided to the front and back entrance and a passenger lift enables people to reach all floors of the home. The home has five toilets, two bathrooms and two showers in addition to en-suite facilities. One shower would require people to negotiate a small step however staff are available to assist as required. There is a notice board in the entrance of the home, which displays articles and information about forthcoming events, which may be of interest to people. Information about fee rates is available from the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This was an unannounced inspection visit which took place on Friday 9th January between 8:30am and 3:00pm. The previous key inspection to Fountain Nursing Home was on 4th October 2007. Before the inspection, we looked at all the information we have about this service, such as information about concerns, complaints or allegations, incidents and previous inspection reports. We do this to see how well the service has performed in the past Care Homes for Older People Page 6 of 28 and how it has improved. We looked at the Annual Quality Assurance Audit (AQAA) which the manager completed and returned to us before our visit. This is the managers review of the service and gives us information about how the service has progressed in the last 12 months. We used a range of methods to gather evidence about how well the service meets the needs of people who use it. We talked to people who use the service and observed their interaction with staff. Three people using the service were identified for case tracking. This is a way of inspecting that helps us to look at services from the point of view of some of the people who use them. We looked at the environment and facilities provided and checked records such as care plans and risk assessments. We talked to the manager, a nurse and two care staff. We also spoke with two visitors to the home. At the end of the visit we discussed our preliminary findings with the manager. What the care home does well: What has improved since the last inspection? What they could do better: The findings of this inspection indicated that the service is currently performing well. Care Homes for Older People Page 8 of 28 We made one recommendation as a result of this inspection visit. All staff should receive safeguarding adults training to ensure they have the knowledge and skills to protect vulnerable people living at the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving into Fountain Nursing Home benefit from having their care needs assessed so that they can be sure the home can meet their needs Evidence: We looked at the files of a person who had recently been admitted to the home to assess the admission process. The file contained information gathered during a pre-admission assessment that identified all of the persons needs. The pre-admission assessment is supplemented by a further assessment of long term needs on the day of admission. The file also contained pre-admission information provided by professional health and social care agencies and incorporated into care plans. Information gathered about the needs and abilities of people living in the home is used to develop care plans to meet these needs. Care Homes for Older People Page 11 of 28 Evidence: The manager had written to the person to confirm that the home could meet their identified needs, which is good practice. People have an opportunity to visit the home before they move in. We saw people visiting the home on the day of our inspection. They said they were looking for a good home for their relative. The manager showed them around the home and gave them a service user guide about the service, so they had sufficient information to help them make a decision. Care Homes for Older People Page 12 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are treated respectfully. Each person has a plan of care and access to health care services so that their health and personal care needs are met. Evidence: We looked at the care files for of three people as part of our case tracking process. This process enables us to make decisions about how the home is meeting the needs of the people living there. Each person had a care plan, daily records and monitoring records. Care plans were based on information secured during the initial care needs assessment and were developed as staff got to know the individuals strengths and limitations. Care plans were available for the identified needs and abilities of each person and supplied staff with the information needed to make sure the persons needs were met safely and appropriately. The home develop care plans for short term care needs. For example, one person had Care Homes for Older People Page 13 of 28 Evidence: a chest infection which necessitated a visit from the GP and a course of antibiotics was prescribed. We also saw a short term care plan for another person who had developed cellulitis in one leg. Comprehensive short term plans were developed to ensure staff meet the persons needs. Care plans in relation to wound care were available and provided clear details for staff to follow. This included details of specialist equipment, sizes and descriptions of wounds so that there progress could be monitored. A range of risk assessments are in place for activities that may place people at risk and includes pressure sores, falls and nutrition. For example, a risk assessment used for one person identified a high risk of developing pressure sores. A care plan was developed and implemented to minimise this risk. This included the use of a pressure relieving mattress which we observed in use. We also saw that the home had asked the community diabetes nurse specialist for advice, who visited the home and audited all the care plans for diabetic residents. The home keeps a record of contacts that each person has with health care professionals and this showed that they have regular contact with them. The home also has visiting outside professionals who provide optical, auditory and chiropody care. We examined systems for the management of medication. A monitored dosage (blister packed) system is used. Medication was safely stored in locked trolleys, which are kept in locked clinical rooms. Medicine fridges were available with daily recordings of the temperature, which was within recommended limits. Daily room temperature recordings show that medicines are stored within recommended limits to maintain their stability. The facility for storing controlled drugs (CD) was satisfactory and complies with legislation. The contents of the controlled drug cabinet were audited against the controlled drug register and the quantities were correct. Medication Administration Record (MAR) sheets maintained an accurate record of medicines administered to residents. We audited the medicines of three people involved in case tracking by comparing the quantity in stock against the signatures on the MAR. The audits indicated that the medicines had been administered correctly. Care Homes for Older People Page 14 of 28 Evidence: We also saw medication audits undertaken by the Primary Care Trust pharmacist. These audits are completed on a three monthly basis and allow the manager to take action if any shortfalls are highlighted. People appeared to be well supported by staff to choose clothing appropriate for the time of year which reflected individual cultural, gender and personal preferences. We watched staff treating people with kindness and respect during the time we were in the home. Visitors confirmed that they thought the staff were very kind and understanding with the residents. One person visiting the home commented on how patient the staff were with their relative who they acknowledged could challenge the service. We saw in the care plan that there was written guidance available for staff about how to manage these challenging behaviours. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A planned activity programme provides opportunities for meaningful stimulation for people who are able to participate. People are supported by the home in maintaining contact with their families and friends. Meals are well balanced and nutritious. Evidence: The home does not have a dedicated activities coordinator and staff assist residents with activities. There are a variety of in house activities on offer including, games, arts and crafts, gardening, flower arranging and computer lessons. A number of people have their own choice of newspapers delivered and the library visits so that people can choose books, which interest them. A monthly entertainer is provided and exercises to music for those who wish to join in. Bingo and a film night are held once a week. People are supported to continue with their religious beliefs, two local churches visit the home and the Roman catholic priest visits to give Holy Communion to those who wish to receive it. The home recognises the importance of maintaining contact with family and friends and welcomes visitors. Relatives are encouraged to vist when they want to and we saw Care Homes for Older People Page 16 of 28 Evidence: visitors come and go throughout our inspection. One person told us, I am here every day and I am always made welcome. I am offered refreshments and lunch. They couldnt be kinder to me. The home told us in their AQAA that they have created a new lounge to allow quiet, private time for residents and their families. We saw visitors using this lounge and one person told us they enjoy sitting here quietly with their relative away from the two main lounges. People are encouraged to personalise their own rooms with their own possessions. Some of the rooms we saw had been decorated in this way and were homely and welcoming. The home recognises the importance of supporting people with making choices about their lives. We observed a midday meal in the dining room and chatted with people at their tables. Tables were attractively set with table cloths and condiments. The main meal of the day was served at 1pm. Lamb, mashed potatoes and a selection of vegetables were served on the day of our visit, followed by a dessert of sponge and custard. People said they enjoyed dinners, one person told us I can have as much or as little as I like. Another person said The meals are always good. Care Homes for Older People Page 17 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home can be confident that their concerns will be listened to and acted upon. There are systems in place to respond to suspicion or allegations of abuse to make sure people living in the home are protected from harm. Evidence: There is a comprehensive complaints procedure on display in the reception of the home. This is available in large print to assist people with visual impairments to access the information and is included in the statement of purpose. There are a number of thank you cards and letters on display, which suggests satisfaction with the service provided. A suggestion box has been implemented so that people can voice their opinions on any aspect of the home. Since our last inspection the home has recorded three grumbles. These had been appropriately investigated and the outcomes recorded. For example, one person grumbled that they found the food bland and would like more spicy food. The manager arranged for this to be done specifically for this person, meeting the persons cultural needs. People who use the service and visitors told us they would have no hesitation complaining about the service if necessary. A visitor said, I know how to complain, but the occasion has never arisen. Care Homes for Older People Page 18 of 28 Evidence: The home has a copy of the Birmingham Multi Agency guidelines and an adult protection policy, which gives staff guidelines to follow, should there be an allegation of abuse. We spoke to staff and they were able to tell us what action they would take if an allegation of abuse was made and this should ensure that people are safeguarded from harm. One safeguarding referral had recently been made to the local Adult Safeguarding Team. It concerned the treatment of a residents pressure sore. This has been investigated and closed by the Safeguarding team. No action was taken as the investigation found the home to have acted appropriately. Not all staff have yet received training on safeguarding vulnerable people. It is recommended that all staff receive training in this to ensure that they have the knowledge to safeguard the people who live at the home from harm. The home has a whistle blowing policy in place so that staff can raise concerns without the fear of reprisals. Care Homes for Older People Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained providing a safe, attractive, homely and clean place to live. Evidence: Communal areas in the home consist of an 3 main lounges, a quiet lounge and a dining room. Bedrooms are located over two floors. Communal areas are bright, homely and look lived in with lots of peoples personal possessions scattered around the home. People pottered about in all areas of the home. The home smelt fresh and clean. Several bedrooms, including those belonging to the people involved in case tracking, were viewed. Rooms were comfortable, well decorated and had furniture and coordinating soft furnishings. Some rooms have ensuite facilities. Rooms viewed were personalised with peoples own belongings. Equipment is available to assist residents and staff in the delivery of personal care, which includes assisted baths, moving and handling equipment including hoists. Pressure relieving equipment such as cushions and various types of mattress are available for people who have an identified need for them. Care Homes for Older People Page 20 of 28 Evidence: The laundry room, although small, has sufficient commercial equipment to provide an effective laundry service to people. It was clean and tidy on the day of the inspection visit. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are sufficient competent staff on duty to meet the needs of people living in the home. People are protected by robust recruitment procedures. Evidence: There is one nurse and five care assistants on duty throughout the day and one nurse and two care assistants throughout the night. In addition to care and nursing staff the home also employs kitchen, housekeeping, laundry and maintenance staff to ensure that all aspects of peoples needs are met whilst living at the home. Two staff files were reviewed and these were found to contain all of the relevant information including two written references, POVA first checks (Protection Of Vulnerable Adults) and Criminal Records Bureau checks. Robust recruitment procedures and pre-employment checks should protect the vulnerable people living in the home All care staff have a National Vocational Qualification in Care. This should ensure that a knowledgeable and skilled workforce can meet peoples needs individually and collectively. There was evidence that staff receive an induction into the home and that staff receive Care Homes for Older People Page 22 of 28 Evidence: training in topics such as tissue viability (sore skin), care planning, challenging behaviour, dementia awareness, diabetes, supportive care pathway, bed rail safety, first aid, fire, protection of vulnerable adults and moving and handling. This should ensure that staff have up to date knowledge in order to care for people living at the home. People told us, The staff are all very kind and helpful, they cant do enough for my relative, very patient, and I feel secure knowing my relative is here and well looked after. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced and competent person to ensure the service is run in the best interests of people living in the home. Evidence: The Registered Manager has many years experience within care of older people and management She is a registered nurse and has completed the Registered Managers Award, which will assist her knowledge in supporting and leading the staff team. Prior to the inspection the manager had completed an Annual Quality Assurance Assessment (AQAA) and returned it to us. This gave us some information about the home, staff and people who live there, improvements and plans for further improvements, which was taken into consideration. There is a quality assurance and monitoring process which is based on ensuring the home is meeting the needs of the people living in the home. This involves an internal Care Homes for Older People Page 24 of 28 Evidence: audit against identified standards. Quality monitoring covers all areas of the service and includes, infection control, training and development of staff, food provision, staffing levels and complaints. The views of residents and relatives were surveyed in September 2008. Their opinions on all aspects of the service have not been collated by the manager. There was also no evidence that any of the information from the surveys has been used to assist in the development of action plans. The opinion of people using the service should be considered during the development of action plans so people know the home is run in their best interest. The manager should also include views of external stakeholders and the people who use the service when reviewing the quality. While some feedback is being obtained the home must now work towards formalising this information into a quality assurance system and produce an annual report on its findings, including an action plan to address any areas where improvements could be made. Some of the comments received from relatives include, dont think they can do anything better, very pleased with care. and overall the care standard is excellent. The registered provider also visits the home and completes a regulation 26 report on their findings. These are quality monitoring reports. Residents and staff meetings are held and these give people the opportunity to share their ideas about the home, while providing a social activity. Minutes of these meetings were reviewed following the visit and were detailed. It appeared from the minutes that actions are taken to try and resolve any concerns raised in the interests of the people living at the home. The home does not keep any personal monies; all items are invoiced to the residents or those responsible for the reimbursement of the fees. Staff from the home shop for toiletries and invoices are issued accordingly. The home has effective systems for maintaining equipment and services to the home to promote the safety of people in the home. The home confirmed in the AQAA forwarded to us that health and safety checks had been completed. A sample of service and maintenance records were examined and found to be up to date. The homes programme of mandatory training further protects the safety of people in the home. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 All staff should receive safeguarding vulnerable adults training to ensure they have the knowledge to protect people from harm. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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