Care Home: Meadow View Care Home

Similar services:

• Chirnside House
• Keer Sands Residential Home
• Ruskin Lodge
• Bushell House
• Langrigg House
• Parkside
• Dystlegh Grange
• Thornton Lodge

What the care home does well Meadowview presents as a very warm, caring and friendly care home and residents appeared relaxed and comfortable with the staff. It was evident through interviews, general observations and discussions that staff had a good knowledge of the residents` individual care needs and the level of support required. During our visit staff were observed spending a great deal of time with residents, either on an individual basis or within a group. Care was seen to be given in a discrete, sensitive manner and staff were patient and gentle in their approach. Feedback from residents was very good; comments regarding the service included:"Staff are excellent" and "The care is really good". Prior to admission the manager assesses residents` health and social needs. Information collected is then used to form the basis for the plan of care. Assessment documentation seen had been completed to a very good standard and included key areas regarding the residents` health and general well being. Lots of different types of activities were arranged, both in the home and out in the community. The physical accommodation is of a good standard, with appropriate aids and adaptations available for the residents. The home has an experienced and enthusiastic team of staff who work well together and enjoy taking part in training and development sessions. The staff are motivated and keen to ensure that residents receive high standards of care. The manager was experienced and ran the home well. She made sure she checked out staff before they started working at the home and gave them training and support to make sure they did the job to the best of their ability. The manager communicates a clear sense of direction, is able to evidence a sound understanding and application of `good practice`, particularly in relation to continuous improvement, staff training, resident satisfaction and quality assurance. What has improved since the last inspection? There were no requirements made at the last inspection but the manager and staff have paid particular attention to improving the decoration, furnishings and improvements to the personal living accommodation for the people who live in the home. The staff development programme introduced by the manager has been greeted with enthusiasm by the staff and will further help to increase the knowledge and skills of the home`s workers. What the care home could do better: Moe care needs to be taken to ensure that the amount of medicines kept in the home are accurately counted and recorded The manager should continue to implement the planned maintenance and decoration programme to ensure all areas of the home are upgraded. There are no requirements made following this inspection. Key inspection report Care homes for older people Name: Address: Meadow View Care Home Rear Of 1072 Manchester Road Castleton Rochdale Lancashire OL11 2XJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Bernard Tracey     Date: 0 2 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Meadow View Care Home Rear Of 1072 Manchester Road Castleton Rochdale Lancashire OL11 2XJ 01706711620 01706711157 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: East and West Health Care Limited care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To people of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of people who can be accommodated is: 39 Date of last inspection Brief description of the care home Meadowview Care Home is a purpose built residential home providing accommodation and personal care to 39 residents on both a permanent and respite stay basis. All rooms are single although four bedrooms have inter-connecting doors which may be locked if not occupied by couples. A passenger lift is provided to the 1st floor. The home is situated approximately half a mile from Castleton, which has a variety of shops and other community facilities. A large garden is provided to the rear. There is level access to the front door and good car parking facilities. Care Homes for Older People Page 4 of 27 Over 65 0 39 39 0 Brief description of the care home The home makes the following charges over and above the weekly care and accommodation fees that are listed after this section: Chiropody # 8.00 Hairdressing As charged Newspapers As charged Aromatherapy # 8.00 Fees charged by the home provided in August 2007 are as follows: # 334.98p Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The last key Inspection was undertaken on the 16th August 2007. In July 2008 we undertook an Annual Service Review. This is a report that we write for good or excellent services that have not had a key inspection in the last year. It does not routinely include a visit to the service. The review is an analysis of all the information that we have gathered about the service since the last main inspection. We (the Care Quality Commission) undertook a key inspection, which included an unannounced visit to the home. The staff at the home did not know the visit was going to take place. The manager was asked to fill in a questionnaire, called an Annual Quality Assurance Assessment (AQAA), telling us what they thought they did well, what they need to do better and what they have improved upon. Where appropriate, these comments have been included in the report. We spent four and a half hours at the home over one Care Homes for Older People Page 6 of 27 day.During this time, we looked at care and medicine records to ensure that health and care needs were met and also studied how information was given to people before they decided to move into the home. A tour of the building was undertaken and time was spent looking at records regarding safety in the home. We also examined files that contained information about how the staff were recruited for their jobs, as well as records about staff training. We spent time speaking to five residents, as well as speaking to four staff, the manager and the Owner. We have have not received any complaints about the service since our last Inspection. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: Moe care needs to be taken to ensure that the amount of medicines kept in the home are accurately counted and recorded The manager should continue to implement the planned maintenance and decoration programme to ensure all areas of the home are upgraded. There are no requirements made following this inspection. Care Homes for Older People Page 8 of 27 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Admissions are not made to the home until a full needs assessment has been undertaken. The home is then able to confirm that it can meet the needs of the individual. Evidence: Admissions are not made to the home until a full needs assessment has been undertaken. Care files contain relevant paperwork, including social work assessments and reports from health care professionals prior to a person choosing to stay at the home. The manager also carries out an assessment, which includes a visit to see the person in his or her own home or while in hospital. These measures ensure that admissions to the home only take place if the service is confident staff have the skills and ability and qualifications to meet the assessed needs of the prospective resident. This results in successful placements. One resident told us it is a very friendly home and I enjoy living here. The staff are very caring. Care Homes for Older People Page 11 of 27 Evidence: Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal care needs are being met and are addressed in detailed care plans. Evidence: Three care plans were inspected, two of which related to residents who had lived at the home for a relatively short time. Each resident in the home had a detailed, up to date and individual plan of care, covering all personal, health and social care needs. Any areas of risk for the resident were highlighted, along with the planned action to reduce that risk. Care plans demonstrated that residents personal choices and preferences had been taken into account by staff. This was particularly evident on the Hamer Unit, newly opened dementia care unit, where a personalised characteristic profile had been developed to assist staff in recognising individual traits and ways of assisting the resident as they progressed during the day and night times. We spent time talking with care staff who were working in the home, they were able Care Homes for Older People Page 13 of 27 Evidence: to demonstrate knowledge, skill and a caring manner in carrying out their specific tasks. They were also supported by the Community Psychiatric Nurse (CPN) from the local hospital who support and advice for the residents on the dementia care unit. All care plans had been regularly reviewed by staff on a monthly basis. Evidence of resident or relative involvement was seen on two of the care plans, one of which had recently been reviewed with relatives. The care plans of the two residents who had moved in recently had been signed or agreed with them or their representative. Care plans clearly recorded GP, Psychiatrist, District Nurse, CPN and care management involvement. Residents spoken with said these health professionals were contacted when necessary. One resident described the care as extremely goodand other residents spoken with were satisfied with the overall care provided at the home. Residents said they could have a laugh with staff, which they enjoyed. Observation supported this view and relationships appeared to be relaxed with residents enjoying the interchange with staff. Healthcare arrangements were also good. Residents had good access to their local doctors, dentist and optician and some were also under the care of a district nurse. A resident told us that the The girls look after us and really care for us. There is an efficient Medication Policy supported by procedures and practice guidelines. Staff follow robust systems to make sure that medication records are fully completed, contain required entries and are signed by appropriate staff. We found one error of counting in relation to the Controlled Drugs Register but this was corrected during our visit. Personal care was provided privately in bedrooms or bathrooms, and door locks or engaged signs were used. Residents wore their own clothes and were dressed appropriately for the weather and their activity. A relative spoken with during our visit stated The residents are very well cared for. The staff are very pleasant and approachable if I need to ask them anything. My mum is quite content here and all the residents seem to be well cared for personally and individually. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social activities provide daily variation and interest for people living in the home. The dietary needs of the residents were well catered for with a balanced and varied selection of food being served. Evidence: The residents involvement in social activities varies greatly according to their abilities and needs. Some of the residents spoken to preferred to stay in their own bedrooms and enjoyed reading, listening to music and watching the television. The home has a very pleasant friendly atmosphere and staff give a great deal of thought to arranging social activities to suit individual needs and preferences. Social needs are assessed in detail when a resident is admitted and residents and relatives spoken with were pleased with the homes varied programme of social events. Staff work hard to ensure social interests are stimulating and it was evident through discussion with a number of residents that they enjoy a lifestyle that meets their preferences. In the AQAA we were informed that an activity person is responsible for organising a programme of activities. A care worker was also allocated on a daily basis to work Care Homes for Older People Page 15 of 27 Evidence: with the residents in taking part in the activity of their choice. External entertainers are visiting more frequently and there are more organised trips out. A discussion with the residents and care staff confirmed that the residents were able to receive visitors in private and that they were able to choose whom they see and do not see. Visitors can be seen in the privacy of the residents bedroom although many choose to sit in one of the communal areas. Residents are encouraged to bring personal possessions into the home. Many of their bedrooms were highly personalised with small pieces of their own furniture, pictures, photographs and ornaments on display. We did not dine with the residents but observed lunch being served in the dining room. The meals served were of ample portion and looked appetising. The tables were nicely set with napkins, cruets and cold drinks. Staff discreetly assisted some residents to eat. Comments regarding the food included: The meals are served nicely hot and are always tasty You could not have better - very good food Everyones birthday is remembered and celebrated with a party There was always a choice of meal at lunchtime and evening. The menus were examined and they looked varied and nutritious. Mid-morning and mid-afternoon drinks were served and milky drinks were provided at supper time. A discussion with the residents showed that they were very happy with the choice and quality of the food provided. 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 home has a clear complaints procedure and residents and their families know action will be taken to resolve their concerns. Staff have a good knowledge and understanding of Adult Protection issues which safeguards residents from abuse. Evidence: All residents are informed of complaints procedure and would be fully supported by staff in making their complaints. The care home keeps a record of all complaints received and the action which was taken. Residents and their relations can be provided with advocacy service information. The complaints procedure is available in the main entrance of the home for all visitors to see and the procedure is also provided to each resident on admission. Residents spoken with said they knew of the complaints procedure but had not had any occasions to use it. They said that staff were approachable and if they had any concerns, they would speak with staff. Records show that most of the staff have received training in the protection of vulnerable adults. Staff spoken with said they had training in understanding what abuse was and what to do if they suspected abuse. Records were available of staff training. Staff also confirmed they had undertaken NVQ training and this also included information and training in abuse. Care Homes for Older People Page 17 of 27 Evidence: The staff are provide with information in what to look for and how to recognise abuse and what actions to take if they suspect potential or actual abusive situations. In the AQAA the manager informed us that the home has a clear and accessible complaints procedure illustrating timescales and how complaints are dealt with. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in pleasant, safe, comfortable and well-maintained surroundings Evidence: The home is well maintained, decorated to a good standard and was clean and tidy during the site visit. There is car parking space to the front and the home has a central patio area with easy access on all sides of the home. The home is suitable to meet the needs of residents. Specialist equipment is provided including grab rails, a call bell system and assisted bathing and toilet facilities. The home is well laid out and accommodation is clearly signed so that residents can identify their own rooms. Toilets and bathrooms are clearly identified with pictorial prompts as well as doors painted in a colour that is consistent throughput the home. A partial tour of the building was undertaken, two bathrooms, the communal areas and six bedrooms were viewed. The bathrooms were clean and tidy and hot water temperatures are recorded each month to ensure the hot water is delivered to a safe temperature. Bedrooms viewed had individual items and were homely. A resident said, I have everything I need, including some of my own furniture that my son brought from my house. Bedrooms have door locks and storage space for valuable items. Bedrooms have a call system with a hand held buzzer to call for assistance. The home usually has two domestics on duty, who have clear cleaning rotas, which include regular steam cleaning of carpets. This leads to a clean and hygienic home Care Homes for Older People Page 19 of 27 Evidence: where odours are kept to a minimum. An infection control policy was in place and staff spoken with described safe infection control practice. Disposable gloves and colour coded aprons were provided for staff use when assisting with personal care and serving food. Liquid soap and paper towels were provided in communal areas. Satisfactory practice was in place with regard to disposal of clinical waste. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are appropriately trained and experienced care staff employed so that residents feel supported and that their needs are understood and met. The recruitment policy is generally robust to protect the residents. Evidence: The staffing rotas for the month of June were viewed along with the current rotas. Sufficient numbers of staff were on duty at the time of the site visit to care for the residents and the staff team comprised of three care staff, the manager, a maintenance man, domestic and catering staff. The owner of the home was also present during the site visit. The home has a stable workforce and a number of staff have worked at the home for many years. Staff were complimentary regarding the support they receive from the manager. Residents interviewed described the staff as Caring, Helpful and Polite The home has a rolling programme for staff training and a training plan viewed evidenced courses attended in including Dementia Infection Control and the Protection of Vulnerable Adults. The selection procedure includes obtaining an application form, 2 references and a formal interview. All staff had enhanced CRB disclosure checks. Upon Care Homes for Older People Page 21 of 27 Evidence: appointment staff are issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. A sample of staff files were examined and these contained all the relevant documentation and were clearly sectioned and well-organised. These are all good practices and ensure that a carefully selected and vetted staff team supports residents. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager provides guidance and support to staff, ensuring that the residents receive a consistently good standard of care. Evidence: An application by the manager to be registered with the Care Quality Commission has been made but has not been processed by the Commission. The manager needs to re submit the application in order to become registered. The manager has the required qualifications and experience and is competent to run the home. She works to continuously improve services and provide an increased quality of life for residents. There is a strong emphasis of being open and transparent in all areas of running of the home. The manager is supported well by the owner, a competent senior staff team, and the home generally has a low staff turnover rate. Care staff reported that they received good support from senior staff and had regular supervision to discuss their role and personal development. This leads to a stable and Care Homes for Older People Page 23 of 27 Evidence: consistent service for people living in the home. The Home operates a recognised Care Quality Assurance and standards that includes physical aspects of running the Home as well as monitoring the delivery of service. The provider carry out regulation 26 monitoring visits. There are some good quality initiatives that ensure residents views are instrumental in the running of the home. Residents and relatives attend meetings and are provided with survey forms to establish what they think of the home. Residents and relatives interviewed were satisfied with the overall management of the home and were pleased with the support offered by the manager and staff. The manager has effective systems in place to ensure the safety and up keep of the physical environment, such as cleaning rotas and maintenance records. Fire Records, annual gas and electrical checks, and servicing of hoists were all checked and these were all up-to-date. A relative stated I am very happy with the care my Mum receives, it always feels a happy home and is well run 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 1 31 9 An application for registered manager must be submitted to the Care QualityCommission So that the Commission is assured that the home is being managed by someone competent to do so 30/08/2009 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 9 An accurate record of all medicines held by the home is to be maintained so that all residents medicines can be accounted for. Hand transcribed medications should be witnessed by two members of staff so that errors can be avoided 2 9 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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!