Care Home: Homefield House Nursing Home

What the care home does well The home provides care in a stimulating pleasant and welcoming environment by a well managed supported, motivated, well trained and qualified staff team who work in a manner that recognises resident`s need for personal privacy and dignity. Areas of paticuar note where we assessed them as excellent were Health and Personal Care, Daily Life and Personal Activities, Envirronment and Management and Administration. What has improved since the last inspection? There were no areas of concern noted at the last inspection. What the care home could do better: Whilst we judged this to be an excellent home the home shold employ as soon as possible a pictorial menu to assist residents in understaning and choosing the food they eat . Satisfaction surveys shouls be expanded to include staff social care and health care professionals. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Homefield House Nursing Home Homefield Way Basingstoke Hampshire RG24 9HX     The quality rating for this care home is:   three star excellent 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: Peter McNeillie     Date: 0 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Homefield House Nursing Home Homefield Way Basingstoke Hampshire RG24 9HX 01256333433 Telephone number: Fax number: Email address: Provider web address: homefield-house@shaw.co.uk Name of registered provider(s): Name of registered manager (if applicable) Teresa Anne Mary Packer Type of registration: Number of places registered: Shaw healthcare (Homes) Limited care home 24 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Homefield House is purpose built single story registered care home owned and managed by Shaw Healthcare. The service is registered to provide nursing, care support and accomodation for up to 24 residents in the older person category some of whom may have dementia or mental health needs. The home is situated on the outskirts of Basingstoke close to Basingstoke General Hospital in an area that is currently undegoing considerable re development which includes domestic dwellings and we are told some shops and a pub. Accommodation for residents is divided into four units off a main communal area. The home has adequate communal space and enclosed gardens that are safe and accessible to residents. 24 24 Over 65 0 0 Care Homes for Older People Page 4 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: three star excellent 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 report was written after taking into consideration a number of sources of information and evidence including a site visit to the premises, previous reports, sampling residents, staff training and recruitment records and talking with management and staff. We also considered information provided by the manager in a pre inspection Annual Quality Assurance Assessment. (AQAA). During this inspection which took place on 08.12.08 between the hours of 8.45 am and 1.55 pm all of the key standards for older persons were inspected. The results and findings contained in this report will determine the frequency and type of future inspections. At the time of our visit charges were from six hundred and ninety and eight hundred and twenty nine pounds per week Care Homes for Older People Page 5 of 27 Care Homes for Older People Page 6 of 27 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.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 7 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 8 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. The home has a system of assessing and identifying residents needs which ensures residents safety and their assessed needs can be met. Intermediate care is not available. Evidence: We were informed by the manager that all residents are admitted in accordance with a corporate admissions policy and procedure. This requires no resident be admitted without a detailed assessment by the manager or another member of the homes management team being carried out. To check the above we viewed four residents pre admission assessments. All included details of health needs, social care needs, mobility aids required and Care Homes for Older People Page 9 of 27 Evidence: attendant risks including environmental factors that could have an affect on the quality and manner in which the service was to be delivered. Confirmation was also seen that the assessment had been carried out in consultation with the potential resident and or their representative and took into consideration any assessments available from health and social care professionals. Following admission after a period of time an in house multi disciplinary review of the placement would take place to evaluate whether all the individuals needs were being addressed in a safe manner and all parties were satisfied with the placement. If all needs had and could be met a permanent place in the home would be offered. A sample of three residents pre admission assessments were viewed. All of the assessments on which care plans would be based (section 7-11 of this report refers) were very detailed, easy to understand and included the signature of the person responsible for the assessment and written confirmation that the resident had been involved in and consulted about their assessment. Intermediate care is not available. Care Homes for Older People Page 10 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a well developed system of planning and reviewing care which involves residents and their representatives and ensures residents, wishes, aspirations, health care, social care and medication needs are met within a risk management policy that respects their privacy and dignity. Evidence: As part of our inspection plan, we viewed a random sample of four residents care plans. All of the care plans which were reviewed at least monthly and re written annually were based on pre admission assessments to identify what help and support individuals needed and any attendant risks. (The previous section of this report; standards 1-6 refers). Apart from day to day issues highlighted any areas of special need, any additional help, aids required and a life history which details major events in the residents life Care Homes for Older People Page 11 of 27 Evidence: and important people by name eg Partner, Mother, Father, Siblings etc were included. A summary of the care plan which is kept in the residents own room is also produced, this enables staff to update themselves any changes without having to read the complete file and and ensures the continuity and quality of the service given. Residents right, and the opportunity to take risks is seen as fundamental. Residents were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. This process identified individual risks and how they were to be managed however due to their dementia all of residents would have difficult in understanding the concept of risk. Staff who had a good understanding of the contents of the care plans and risk assessments and were able to explain how the care plan was put into day-to-day practice. Residents are able to see the doctor of their choice or any other health and social care professional when they needed to. The records viewed indicated that apart from doctors, district nurses, community psychiatric nurses, psychiatrists, physiotherapists, occupational therapists, other specialists had been consulted when required. Records were kept of appointments with GPs, dentist, optician, chiropodist and any other external health and social care professional and included details of any advice and treatment given. Due to their dementia we were not able to ascertain directly from residents their views on the home however from out observations we formed the view that staff were respectful, caring, pleasant and always willing to help, staff were seen to deal with residents in a kindly, professional friendly and pleasant manner, knock on bedroom doors and wait before entering and treat residents with respect, and dignity in accordance with training received during their induction. In speaking to the manager and senior staff we were told that the manner in which residents are treated, addressed and spoken to was given as high a priority as the quality of the hands on care provided. A procedure was in place to enable residents who wish to assume responsibility for their own medication. At the time of the inspection no resident was managing their own medication in accordance with an individual risk assessment which was recorded in the care plan. Care Homes for Older People Page 12 of 27 Evidence: Medication records confirmed all prescribed drugs, which are securely stored are administered in accordance with the homes medication policy and procedure by qualified nurses all of whom have received training in recording and handling residents drugs and medication. Some care staff have also received the appropriate training to enable tham to administer residents drugs and medication but none had yet taken on this task. The record of drugs and medicines administered to residents and unwanted drugs disposed of were complete and accurate. To ensure that race, gender identity, disability, sexual orientation, age, religion and belief are promoted and incorporated into what we do, in their AQAA the home told us: We continue to promote equal opportunities through training and re enforcement, listen and react to preferences that are communicated to us both verbally and a non verbal manner, speak to advocates, friends and relatives as to the persons prior beliefs choices and decisions. Care Homes for Older People Page 13 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. Family contacts, the availability of excellent social and recreational activities and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: A varied and busy social activities programme, which is regularly updated and reflects residents choices was available. The homes management and consider the provision of appropriate activities and stimuli are very important and key in ensuring the health and welfare of residents. Consequently a great deal of time and expertise goes into ensuring a programme of activities is available that meet residents needs and choices. Whilst residents were unable to confirm they enjoyed the activities we observed them taking part in bowling. If the noise and laughter were an indication of the enjoyment being had this activity could only assessed as a success. Staff were seen to help and assist residents in a calm, gentle and encouraging manner adding very much to the enjoyment of the occasion. Care Homes for Older People Page 14 of 27 Evidence: The staff and management were clearly committed to the welfare of their residents and saw themselves as enablers rather than carers. They tended to focus in on the residents ability rather than the disability irrespective of how high or complex the individuals needs were. A number of activities and trips that had taken place were recorded and displayed in an impressive array of photographs. One of the most unusual was a photographic progress diary of chicks that had hatched from eggs to the eight week old birds we saw during our visit. Those responsible for this unusual and creative project are to be commended. Staff commented on how residents much they enjoyed the activities as well as the Special eventssuch as birthday parties, garden parties, Christmas and Easter. All of the activities were well attended as evidenced by the activities records and no one was forced to join in. Apart from the activities home has regular visits from local clergy who conduct services in the home.where the spititual needs of members from all Christian denominations can be catered for. No members from other faiths are currently residing in the home. We were informed if a member of other faiths were resident, arrangements would be made to meet their needs. We were informed visitors are always welcome, all are encouraged to feel at home, and make drinks freely. The homes management place a very high priority on the quality quantity choice and presentation of food available in the home. Vegetarian options are always available and persons on special diets for religious or medical reasons can also be catered for, following individual written nutritional assessments, which are carried out, for all residents. A written daily menu based on residents likes and dislikes was displayed. Although a daily menu is displayed, we highlighted the need to ensure that the menu was displayed in format that all residents would understand. This is of prime importance for persons with dementia who may find the addition of pictures would be beneficial to understanding the daily menu and when making choices The manager in agreeing with our comments showed us work currently in progress involving photographs that will address the above deficiencies, she also gave a verbal undertaking he would look into the way menus were displayed in future. At lunchtime we observed residents taking their mid day meal. We would commend Care Homes for Older People Page 15 of 27 Evidence: the staff for the way they assisted residents to take their meal in a calm, unhurried dignified, patient and caring manner. Tea and coffee and cold drinks are available at all times. 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. The complaints procedure was satisfactory and ensures that residents or their representatives will be listened to and any concerns taken seriously and acted upon. The home has clear policies and procedures in place including a whistle blowing policy which ensures residents are protected from abuse. Evidence: The complaints procedure, which is also included in the service users guide included information on how to contact The Commission for Social Care Inspection (CSCI), was seen, as was the record of complaints. CSCI have received no complaints since the last inspection. Due to their dementia we were unable to confirm with residents whether they were aware of the complaints procedure,however staff spoken with spoken with of stated they felt confident in discussing any concerns, complaints with management either in house or external on behalf of any resident and were confident any issued raised would be dealt with promptly and fairly. The homes corporate adult protection policy is works in tandem with the procedure produced by Hampshire County Council which could not be located when asked for. A Care Homes for Older People Page 17 of 27 Evidence: replacement copy was ordered from Hampshire C.C. during our visit. We have since been notified this is now available in the home. Management and staff who were spoken with confirmed they had all received training in recognizing various types of abuse, this was confirmed by records viewed. All were able to demonstrate after slight prompting they knew the procedure to follow should they witness or suspect the abuse of any resident. We discussed with the manager that in view of the responses received by us, refresher training would seem to be indicated. A verbal undertaking was given by the manager that staff training would be reviewed to ensure all staff understood 100 the procedure to follow. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A safe, well maintained, clean, suitably furnished purpose built home is provided for residents, which meets their needs. Evidence: On entering the home we were immediately made aware of an infection control policy due to the availability of antiseptic hand gel and the notice requesting all visitors to use it.Our initial feelings were how warm and welcoming and stimulating the home was. Furniture was comfortable, homely and in a good state of repair and met residents individual and collective needs and the decor with many photographs and displays interesting and stimulating. All areas of the home were clean and free from unpleasant odors and obvious hazards. Staff confirmed the home is always clean and smells fresh.All communal areas were safe and accessible by residents including the central patio area. The whole central area of the home known locally as The Street was ablaze with colour due to the work by staff in putting up a superb display of Christmas decorations Care Homes for Older People Page 19 of 27 Evidence: that must have taken many hours.This we felt was yet another example of how staff viewed the residents and by making extra efforts on the residents behalf ensured Christmas was not forgotten. We were pleased to to see residents wandering up and down The Street clearly enjoying themselves and the freedom the design of the house afforded them. Off the main communal area (the street), further accommodation was available in the form of four separate lounges and kitchens and residents personal accomodation. Each lounge had its own theme based on the decades of the 40s, 50s, 60s and 70s. Each contained photographs, pictures and memorabilia from the decade. Again we would commend those responsible for this innovative and interesting addition to the home. Apart from personal mobility aids a number of communal aids had also been provided to assist residents, these included special beds, hoists, grab rails, toilets,chairs etc all of which had been taken into consideration at the initial pre admission assessment as describe in sections 1 to 6 of this report. The manager informed us a major refurbisment was due to take place within the home. Contingency plans would ensure all residents would continue to receive a high level of care and support with little or no disruption to their day to day lives. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. Evidence: The Manager informed us the planned daily staffing levels in the for each day is: 7am to 2.30pm: The Manager, one nurse eight care staff, one administrator, one cook, one kitchen assiatant and two cleaners. 1.30pm to 9.15pm: The Manager (for part) plus one nurse, 7 care staff and an administrator (part). 9.15pm to 7.15am one nurse and three carers. At the time of this visit, in our view the number of management, care and support staff available met residents needs a view confirmed by the homes management and staff. Staff told us they had time to offer one to one support to residents if required.This was very important at meal times when individuals required help in feeding as previously commented on earlier in this report. As part of our inspection plan we viewed four staff recruitment. training and one to one supervision files selected at random. Care Homes for Older People Page 21 of 27 Evidence: All files viewed included evidence that staff who receive regular one to one supervision at least six weekly are employed in accordance with a robust recruitment, equal opportunities and selection procedure designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB), Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment, records seen confirmed that all staff are subject to an in house corporate induction and a training programme base on a skills for care model that include first aid, handling medication, food handling, moving and handling, safeguarding, infection control and dementia. Apart from individual training records a composite electronic matrix was also kept using a traffic light arrangement to indicate when training had taken place and refresher training was due. All staff are expected to undertake a National Vocational Qualification N .V. Q.) training. course. Information provided by the manager indicated that 17.6 of staff were trained nurses,and 64.7 of staff were qualified to at least NVQ level two in care a total of 82.3 of the staff team with some type of qualification. Of the 64.7 with NVQ level two 36.6 had also achieved NVQ level 3 with a further 13.6 currently on a level three course. A very commendable result. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. Evidence: From our observations and information received from staff ,we are satisfied the service is well managed by a registered, committed,experience manager who is a qualified mental health nurse who also holds diplomas in caring for persons with dementia and management. We were informed that in a recent corporate competition the manager came second out of approximately twenty homes in the best manager category and her senior carer third in the team leader category. The philosophy of the management team and staff puts the welfare of all of the residents first. This is reflected in all of the policies and procedures in place,the staff recruitment and training, the activities programme and the creative use of the building Care Homes for Older People Page 23 of 27 Evidence: and the environment and the respect all residents receive as commented on earlier in this report. In talking with staff we were satisfied that the home has a clearly defined management structure and staff were aware all of their responsibilities and the limits of their authority. Staff who said they felt valued, enjoyed their jobs described the management as approachable and accessible and willing to listen to any ideas they may have for the improvement of the service. As part of the homes quality monitoring system, residents and residents representatives are invited to participate in satisfaction surveys. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future development of this service. Currently whilst an external corporate staff survey is carried out internal staff or health and social care professionals are canvassed for their views on the service.The manager gave a verbal undertaking she would raise this matter with her external line management. We were informed by the manager that she was responsible for a number of residents monies given to her for safekeeping.We checked the monies of four residents chosen at random and confirmed cash balances held agreed with the records and receipts were available for all monies spent. An in house health and safety policy was in place to ensure the day-to-day safety of staff and residents. Procedures include, weekly health and and safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling infection control, control of substances hazardous to health (C.O.S.H.H.) first aid, health and safety, reporting accidents, procedures to follow in the event of fire (including evacuation). We were also informed that all of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered to prevent residents or staff being burnt. 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 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!