Care Home: Mayfield Residential Home

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What the care home does well The assessment process which the manager uses prior to anyone coming to live at the home is well-prepared, well documented and thorough to ensure that people`s needs will be met once they move in. The manager and staff provide the residents with a comfortable environment which suits their needs and creates a family-style atmosphere. The manager and staff are happy in their work and are a stable, committed team; there is very little turnover of staff. Visitors feel welcomed when they visit people who live in the home. What has improved since the last inspection? A new extension has been almost completed that will increase the bed number from ten to twenty-nine and provide extra communal areas. One of the former double bedrooms has been made into one large, single, ensuite bedroom. The owners have installed a new fitted, kitchen with stainless steel cupboards and surfaces, to provide easy-to-clean surfaces and maintain a clean, hygienic catering space. All the catering equipment is new. A new passenger lift has been fitted. Requirements made by the Fire Safety officer to improve the door-closing mechanisms in case of fire and put up fire safety signs, have been actioned upon. What the care home could do better: Activities need to be developed to suit the needs of all the people who live at the home. Training for staff needs to be organised to ensure all staff members are fully up-todate with changes to practice and ensure they are able to meet all the needs of the people who live at the home in a safe way. The manager needs to have enough shifts not undertaking care duties to give her time to complete her managerial duties and responsibilities. The home-owner needs to keep and maintain records of his regular visits to monitor the quality of the services being provided to show that he communicates with people and takes action to address the issues that people raise. Copies of these records need to be available for the manager. The residents, relatives and other professionals should be formally asked, in a questionnaire, for their opinions of the service. Their opinions need to be collected and a way found to understand what people want and how they want to live. The manager should make sure that all staff members receive formal supervision sessions, which are recorded with records maintained to show how their development needs are being addressed. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Mayfield Residential Home Fleet Street Holbeach Spalding Lincolnshire PE12 7AG     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: Vanessa Gent     Date: 1 5 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: Mayfield Residential Home Fleet Street Holbeach Spalding Lincolnshire PE12 7AG 01406426063 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) : swalden@lycos.co.uk Mayfield Residential Care Ltd care home 10 Number of places (if applicable): Under 65 Over 65 10 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Mayfield is a small care home with a new, large extension to the rear of the present property. The manager and staff provide personal care for up to ten people of both sexes over 65 years of age. The home is situated in a residential district of Holbeach, within a short walking distance of the centre of the market town. There are various shops and leisure facilities including pubs, church, doctors surgery, library, village hall, post office and restaurants. The village is on a bus route to the surrounding towns. The accommodation is currently all on the ground floor. There are eight single bedrooms, of which four are ensuite with toilet and washbasin, and one double bedroom. Communally, there is a main lounge, a dining room, two bathrooms and three toilets. The extension to the home will eventually provide an extra nineteen bedrooms as well as more communal rooms and space, four more toilets, an extra bathroom and a wetroom shower room. There is a car parking area and lawned garden Care Homes for Older People Page 4 of 28 Brief description of the care home to the front, a garden to the rear and in the centre of the home, an open air quadrangle. The owners philosophy of care is to give people as much independence, with support, as they want and choose, depending on individual capabilities. The weekly fees are between £351 and £450. People pay for their own hairdressing and chiropody charges, personal newspapers, magazines and toiletries. Information about the fees and and the day-to-day operation of the home, can be found in the statement of purpose and service user guide. These, and a copy of the last inspection report, are available to people who live there and for those interested in coming to live at 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 stars. This means the people who use this service experience good quality outcomes. An unannounced visit was made to the home as part of our key inspection. It started at 09:40 and lasted over 4 hours. As part of our review and assessment of the service the manager was asked to complete a self-assessment questionnaire called the Annual Quality Assurance Assessment (AQAA). The information it contained was brief and did not always fully explain how they are managing the service. This, as well as the information we hold about the service, was used to plan the visit and produce this report. Care Homes for Older People Page 6 of 28 The main method of inspection we used was called case-tracking. This involved choosing three residents, and checking the care they receive through looking at their records, chatting with them, the care staff, any visitors and observing care practices. Our visit to the home focused on whether key standards had been met and how people feel about the service provided. The care received by three people was followed in detail to check that their health, safety and welfare needs were fully met and that they were supported to maintain their dignity, autonomy and choice. We spoke with the manager, staff on duty, a relative and most of the people living in the home, including those whose care we were following closely. People talked about their experience of living at the home. Any comments we received are mentioned in the main body of this report. Some personal records, known as care plans, general house records and staff records were looked at, and the way care was given to the people was noticed. We saw some areas of the home and watched the lunch being served to and taken by the people who live there. The manager was present throughout our inspection visit. What the care home does well: What has improved since the last inspection? What they could do better: Activities need to be developed to suit the needs of all the people who live at the home. Training for staff needs to be organised to ensure all staff members are fully up-todate with changes to practice and ensure they are able to meet all the needs of the people who live at the home in a safe way. The manager needs to have enough shifts not undertaking care duties to give her time to complete her managerial duties and responsibilities. The home-owner needs to keep and maintain records of his regular visits to monitor the quality of the services being provided to show that he communicates with people and takes action to address the issues that people raise. Copies of these records need to be available for the manager. The residents, relatives and other professionals should be formally asked, in a questionnaire, for their opinions of the service. Their opinions need to be collected and a way found to understand what people want and how they want to live. The manager should make sure that all staff members receive formal supervision sessions, which are recorded with records maintained to show how their development needs are being addressed. Care Homes for Older People Page 8 of 28 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 have enough information for them to choose if they want to live at the home. The comprehensive first assessment helps the care team to know that they can meet each new persons individual needs. Evidence: We saw the homes statement of purpose and service user guide. We were told that they, along with a copy of the latest inspection report, are given to all people interested in moving into the home. People told us that they had enough information before they moved into the home to believe they would be comfortable. The manager travels to wherever the person is, however far away, to do the assessment prior to them moving in, to ensure they can meet the persons needs if they accept a place in the home. We spoke with one person who had moved from a far distance to live at Mayfield House, who confirmed that the manager had visited her in Care Homes for Older People Page 11 of 28 Evidence: her previous place. The care plans created by the care team showed that comprehensive pre-admission assessments are completed with anyone choosing to come to live at the home. The owners of Mayfield Care Home do not provide a specific intermediate care service but respite care is available and provided for people whose needs they can meet. 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 are cared for with dignity and as they wish. Their needs are met by a staff team who use clear care plans and appropriately liaise with other professionals. Evidence: We looked at the care plans of three people. They all contained risk assessments, and told how the peoples health and personal needs were to be met. Care staff said they know from the care plans how to provide the appropriate care and support for the residents. People told us they are happy with the care given by the manager and staff. A relative said, they are very good at caring. The care plans showed that the staff review peoples plans regularly, with the person where they want to be involved. One persons care plans showed us they are involved with reviewing their care plans as they want. People told us that staff call a doctor if they become poorly. One persons care plans showed that the doctor was called regularly when they were very poorly. A relative Care Homes for Older People Page 13 of 28 Evidence: told us they come to visit regularly but know the staff would keep them fully informed of any changes that might occur. Staff have not had training in caring for someone with diabetes but stated that they know how to care appropriately for them. All of the people living in the home wanted or needed help with their medications. Staff said that although they were originally trained to safely give medicines, they have not had any update training. However, the manager said training had been arranged to take place on 4th February this year for all staff. We saw evidence to confirm this. Records showed that the supplying pharmacist audits the medication practices regularly and reports back to the manager. People said they are treated with respect. We saw the staff behaving in a considerate, gentle, friendly way with people when giving support, especially to people who were very poorly. One person said,Theyre very kind, helpful and pleasant. Care Homes for Older People Page 14 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. People are given respect and choice by the manager and staff team in most aspects of their lives at the home and they enjoy the food. They do not currently have enough activities or community links to keep them occupied during the day although plans are being made to rectify this. Evidence: People told us that there are no organised activities although they would like some things to do during the day. Some said they preferred more one-to-one attention when the staff are not too busy. The manager said that when the extension had been opened, and there were more residents, they would be able to take on extra staff to provide activities. In the meantime, she said they would discuss with the residents what activities they wanted and would provide them accordingly. The owner has, immediately following the inspection visit, joined the charity NAPA, National Association of the Provision of Activities for Older People, to help them find ways to occupy the residents time and give them some choice of activities they might like to take part in. Visitors told us that staff are easy to talk with and the manager is often around for a Care Homes for Older People Page 15 of 28 Evidence: chat. People all told us that they have independence and choice and can stay in their rooms as long as or whenever they want. One person told us they watch people going by all day and sometimes sit outside. When asked what the food was like, people told us, it is OK, its homemade. Enough to eat. A resident told us, The food is good. Theres enough of it. We can choose what we want if we dont like the food offered. Care Homes for Older People Page 16 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 feel able to voice any concerns, are taken notice of, and feel safe from harm with staff who are committed and caring, within a family-centred environment. Evidence: People told us that they would feel able to raise any concerns with the manager although they said they have had no concerns or complaints. No-one has made any complaints to either the manager or directly to us. People told us, Ive never had to complain. We can always talk to the manager and she will sort things out. We saw that documents are in place to inform staff how to keep people safe and comfortable. One staff member explained appropriately how they keep people safe. Although we could see that some initial training had been undertaken, their training records were not up-to-date for this. Also, none of the staff had undertaken training on the The Mental Capacity Act 2005 including the Deprivation of Liberty safeguards (incorporated into the Mental Health Act 2007) and how these can impact on the vulnerable people in their care. Staff told us they always put the residents first and know how to keep them safe at all times. People told us this was so. One person told us, The staff and the manager are lovely. They are very attentive and happy in their work. We discussed this with the provider who said that they would review the whole training programme and that Care Homes for Older People Page 17 of 28 Evidence: training would be put in place as a matter of urgency. Care Homes for Older People Page 18 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. People live in a comfortable, clean, well-maintained environment, and are cared for as they wish to help them feel at home. Evidence: We saw that all areas of the home had been pleasantly decorated. Residents and a visitor told us that the home is always clean, tidy and smells fresh and pleasant. One person said, I like my room and being able to be there as long as I want and Im free to go where I want. Since the last inspection, the kitchen has been newly built, with all the surfaces, cupboards and worktops made of stainless steel to provide easy-clean surfaces. All new catering equipment has been installed. A new laundry has been installed with new equipment for maintaining hygiene and infection control in the home. Some curtains and carpets have been replaced as necessary. The new extension for a further nineteen people has been carpeted and almost finished but is not yet fully furnished. The owner has not yet applied for it to be registered by us to take in more residents. During our visit the owner confirmed that the new extension will only be used once it has been fully registered. Care Homes for Older People Page 19 of 28 Evidence: The Environmental Health Officer last year gave the home a good report. They said the health and safety elements of the home were satisfactory. The fire safety officer gave two requirements on his last visit to the home for door stops and signs. Both of these have been completed and were in evidence during our visit. Outside the front of the home the area is mostly lawn with flower borders and garden ornaments. The driveway is made of pebbles and chippings which would be difficult to push a person using a wheelchair from the road to the front door of the home. We spoke with the manager who confirmed she has brought the matter to the attention of the home-owner. We were told that this would be followed up and addressed. At the rear is a garden and an enclosed, secure outside area in the centre of the homes old and new buildings, in a quadrangle. It has yet to be landscaped. There is car parking space in front and at the side of the property. Care Homes for Older People Page 20 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. Staff are safely recruited and have an initial induction. However, the training programme needs to be reviewed to ensure all the staffs working practices are safe and meet the needs of the people living at the home at all times. Evidence: The manager and staff told us, We have a really good staff team and we enjoy coming to work. We get on well together, like a close family. One staff said she has worked at the home for over five years. She said she loves the job and is happy coming to work. A visitor said that she comes to the home often and has noticed that the staff always get on well with each other. Staff said they were happy working at the home and enjoyed coming to work. There are currently seven staff in total, including the manager, working at the home. Staff said they do all the cooking, cleaning and laundry themselves as well as the caring shifts. They said, This doesnt give you the opportunity to stop and chat with the residents, especially in the mornings. But we sometimes can in the afternoon. They said the manager works with them on the floor so they often chat together informally. The duty rotas showed that during the day there are usually two staff, often including the manager, but sometimes only one staff on duty at quiet times, such as the afternoons. At night, there is usually one sleeping staff on duty, but the Care Homes for Older People Page 21 of 28 Evidence: manager said she monitors this regularly, and can adjust the staffing levels, depending on the health and dependency needs of the residents. The recruitment and induction procedures were seen to be in order, as confirmed in the staff files and in talking with staff. We were told by the owner and staff that there is a low turnover of staff. The staff member on duty said she had taken a nationally-recognised qualification some years earlier and would like to take further qualifications. Staff told us they have not had any update in training recently. This was confirmed by the certificates in their staff files. The owner told us that this is an area that will receive their immediate attention, with all the mandatory training being updated as soon as courses can be arranged. He has agreed to inform us as and when staff have accessed the training necessary to ensure they care for the residents knowledgeably and safely. Care Homes for Older People Page 22 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 manager and home-owner ensure the upkeep of the home is maintained to provide the residents with a comfortable, safe environment, which people like living in. Staff work in a close team with a caring manager. The current lack of a formal system for finding out and recording peoples opinions on how they want to live and their wishes for running the home means that they are not always fully taken into account or their wishes or choices acknowledged. However, subsequent to the inspection visit, we were told by the owner that he and the manager are addressing this. Evidence: The manager has been in post for ten years, is registered by us and has achieved her Registered Managers Award. Staff told us they appreciate the manager and get on well with her. The door is always open to the manager. Staff, residents and relatives all said how much a family they are. People said they have frequent chats with the Care Homes for Older People Page 23 of 28 Evidence: manager but have not been asked to complete a questionnaire or survey or say how they would like things to be run at the home. The owner visits at least every fortnight and he and the manager have confirmed, following the inspection visit, that a written report has been compiled after he interviewed people in a monthly monitoring of the service provided. The owner said he will continue to formalise the monthly visits by completing a regular, written report for his manager and for us, as required, to obtain the views of residents, relatives, other healthcare professionals and staff members, check on the quality of the home, the care provided and the service as a whole. People told us they have seen the owner but have not been given a survey to get their views. They also told us there are no regular resident meetings for them to say what they want. We asked a visitor if they felt the service was monitored sufficiently. They said, Not really but there are no problems with the service. Theyre lovely staff here and always look after us well. People said either they or their relatives look after their own monies. The manager confirmed that this is the case. Staff told us, and we confirmed in their files, that they do not meet on a regular, formal one-to-one basis with their manager. But they said they felt that working with the manager, in close contact every day, was supportive and that they give a good service to the people who live there. The Environmental Health Officers report was satisfactory. Maintenance records we saw were kept in order and showed that regular testing and annual servicing of equipment in the home takes place to protect people. The requirements in the Fire Safety Officers report have been actioned upon. Care Homes for Older People Page 24 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 25 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 12 It is recommended that activities are provided that are varied and in accordance with peoples wishes and capabilities. It is recommended that the owner and manager organise training in Safeguarding Adults and the Mental Capacity Act 2005 (including the Deprivation of Liberty, incorporated into the Mental Health Act 2007) in order to provide all the staff with the knowledge to care safely for the residents at all times. It is recommended that the provider re-assesses the driveway to the home for people who use wheelchairs, to ensure they have full access to and from the building. It is recommended that the owner and manager make sure that all staff are updated in their training and that records are kept to enable them to be fully knowledgeable in all aspects of the care of the residents at all times. It is recommended that the owner and manager seek the views and wishes of the residents, relatives, staff and other healthcare professionals in order to improve their service and meet the needs and wishes of the people who live in the home. 2 18 3 19 4 30 5 33 Care Homes for Older People Page 26 of 28 6 36 It is recommended that staff receive up to six one-to-one, supervisory meetings per year, with the manager or a senior member of staff, to discuss issues that relate to their work and how best they can meet the residents needs and wishes. 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. 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 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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