Care Home: Seaview Residential Care Home

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What the care home does well Care plans and assessments have been developed to demonstrated how the service users` needs would be met. The service users told us that the meals were good and they were offered choices that met their needs. There is a varied activity programme for the service users that they say they enjoyed. What has improved since the last inspection? This is the first inspection since the home was re registered. What the care home could do better: Further development in the management of medicines is needed to ensure that these meet the needs of the service users and managed safely and effectively. Some parts of the home would benefit from refurbishment and part of the ongoing programme of updating the service. The designated smoking area should be reviewed to ensure that this does not impinge on the welfare of people living at the home. Records of safeguarding outcomes/action plans should be further developed in order to ensure that these inform practice and are up to date. There is inadequate evidence that the responsible individual undertakes regular audit of the service to ensure that the home is run in the best interests of the service users. Key inspection report Care homes for older people Name: Address: Seaview Residential Care Home 67-69 Festing Grove Southsea Hants PO4 9QE     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: Anita Tengnah     Date: 0 2 1 0 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 29 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 29 Information about the care home Name of care home: Address: Seaview Residential Care Home 67-69 Festing Grove Southsea Hants PO4 9QE 02392825097 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Seaview Residential Home Ltd Name of registered manager (if applicable) Mrs Karen Samantha Batten Type of registration: Number of places registered: care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Seaview Residential Care Home is registered with the Care Quality Commission to provide care and accommodation for up to 18 older people of both sexes. The building comprises two large houses joined to provide single and shared accommodation arranged over three floors, with access via a passenger and stair lifts. The service has an enclosed rear garden with seating available and accessible via a conservatory. Care Homes for Older People Page 4 of 29 Over 65 0 0 18 18 18 0 Brief description of the care home Communal areas consist a dining room, two lounges, and a conservatory, which is used as a smoking lounge. Fourteen of the service users bedrooms are single and two are double. Not all rooms have en suite facilities. Mrs Karen Batten is the registered manager. Information about the fees charged is available from the service. Care Homes for Older People Page 5 of 29 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: An unannounced inspection visit was undertaken over one day on 2 October 2009 as part of our inspection process. This is the first inspection visit since the change of their registration. We sent out the Annual Quality Assurance Assessment (AQAA) to the registered person at the service. This is one of the means of collecting data from the service. We looked at the environment,service users records and care plans and some staff records as maintained at the service and we observed care practices. We have used information as supplied by the home in their AQAA and other information that we have received since the last inspection. We spoke to a number of service users and their relatives as part of our visit. The service users had positive comments about the care that they are receiving. Their Care Homes for Older People Page 6 of 29 comments will be reflected in the body of the report as appropriate. Care Homes for Older People Page 7 of 29 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 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 8 of 29 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 9 of 29 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. There is a good process in place to ensure that people needs are assessed prior to moving into the home. There is no intermediate care provided at the service. Evidence: We looked at the records for two of the service service users to assess the pre admission process that the home has in place. The records showed that a detailed pre admission assessment was completed prior to the service admission to the home. Information gathered included involvement of a family member and the service user. Assessment recorded the persons ability of their daily living and identified the support that was needed. A list of their medication was recorded on admission and an inventory of their personal belongings was available. We found that an interim care plan was developed on admission to inform the staffs Care Homes for Older People Page 10 of 29 Evidence: practice and this included risk assessments as appropriate. Care managers assessments are sought as part of the pre admission process, records of these were available in the care records we looked at. Staff stated that the service users are offered the opportunity to visit the home and that due to their frailty this was not always possible, however their relatives visited. Information such as the statement of purpose and service users guide are made available to prospective people as required. The manager has confirmed that the home does not provide intermediate care, only short term respite care. Care Homes for Older People Page 11 of 29 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. There is a process in place and staff have developed appropriate care plans and assessments to demonstrate how the care needs are met. The access to health care is well managed. There is a procedure in place for the management of medication, however this is not currently adequate to ensure people receive all their prescribed medicines safely and effectively. The service users are treated with respect and receive the support as required. Evidence: The care records of three service users were looked at as part of our visit. These show that assessments such as personal care needs, moving and handling,nutritional assessments, and fall assessments had been completed. The record for a service user showed that following admission, a brief care plan was put in place and a more detail care plan was developed within a week with the involvement of the service user. The care plans gave details of personal care needs and assistance required in order to inform the staffs practice. There was evidence that Care Homes for Older People Page 12 of 29 Evidence: the service users were involved in their care plans and staff had an understanding of their needs. Staff maintained details of care given as part of the daily records seen at the home. As part of the assessments staff monitored risks such as pressure areas, nutritional screening, moving and handling and personal risks. Care plans are developed to show how these risks would be monitored. One record showed that following unintentional weight loss was noted, the service users doctor was informed and action taken. The manager reported that some of the staff had recently completed training in the use of Malnutrition Universal Screening Tool (MUST). They are planning to introduce this tool as part of their nutritional needs assessment for all the service users. The manager is aware and ensures that the service users receive care and treatment from the Primary Care Trust ( PCT) as required. The staff reported that they have a good relationship with the local surgeries and they were supportive. The records for a recently admitted service user showed that they had a pressure ulcer. They had been referred to the district nurses team, assessments and care plans were developed and available at the service. The plans contained details of the treatment such as cleaning of the wound and the type of dressing applied in order to inform the staffs practise and ensuring that the needs of this person are met appropriately. We spoke to a number of the service users and two relatives during our visit and they were all complimentary regarding the care that they were receiving. They commented that they always received the care and support when they requested and that the staff were very kind and helpful. We looked at the medication management that the home undertook on behalf of the service users. The home was using the Nomad system of dispensing medicines. We found that the staff maintained records of the medicines on the medication administration record (MAR) charts. All medicines were stored securely at the time of the visit and the manager stated that only the staff who had completed medicines training were responsible for the service users medications. The home has a homely remedy procedure in place and the manager stated that this is reviewed regularly to ensure that it reflects the current needs of the service users. A random check of the MAR records showed that these were completed , however there were gaps in one of the service users record seen and this related to an ointment that had not been recorded as administered. Care Homes for Older People Page 13 of 29 Evidence: There was no care plan in place for medication that are prescribed to be given as required. There is a risk that people may receive medication when they do not require or not receiving it when they need. These included analgesias and inhalers. A service users record showed that they were prescribed an inhaler to be given as required and they had been receiving this twice a day on a regular basis. Staff must ensure that all medicines administered are clearly recorded on the MAR charts to inform practice. Accurate records of all medicines received into the service were not available in particular for people who brought in their own medicines on admission. This meant that an audit of medicines received could not be completed. Records of variable dosages were not available in order to inform the staff practice. Medicines that are transcribed on to the MAR charts by staff should contain two signatures to eliminate any risk of errors. These records must include clear instructions as stated on the prescription. The service users spoken with and interaction observed showed that the staff and the service users had developed and maintained good relationship with each other. The service users were treated with respect when they were supported in the lounge and the dining room. They said that the staff were very good. Comments included staff are brilliant , cheerful and always trustworthy. The shared rooms that we looked at contained screens as needed to maintain the privacy of people as required. Some of the bedrooms doors had glass panels and these should be looked into to ensure that they do not compromise peoples privacy and dignity. Care Homes for Older People Page 14 of 29 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. The activities and meals at the home are well managed and meet with the satisfaction of the service users. There is a good support for the service users to maintain links with their family and friends. Evidence: There is a planned activity programme and this included a weekly list of activities that was displayed in the entrance hall. Some of the activities included music and movement, sing along, games and movies on Sundays. During the afternoon of the visit a group of services users were observed taking part in one of the weekly planned activities. The arm chair exercise session appeared interactive and service users spoken to afterwards said that they always enjoyed the fun and games. A visitor said that they did not partake in the activities but there is plenty to keep them occupied. Another comment was they are well looked after. I come at least two to three times to see my friends. The staff reported that the relatives also took the service users out regularly. One of Care Homes for Older People Page 15 of 29 Evidence: the service users had gone out for a short while with their relative. Another person was going out to lunch with their daughter. Arrangement was in place for the service users such as a monthly service from the local Methodist church. The Roman Catholic priest attended the home on a weekly basis and provided support to another service user. The home has an open visiting policy and the records of visitors, as maintained at the service showed that there was no restriction on visiting. People we spoke to confirmed that they visited at different times and they were always made welcome. A relative took one of the service users out to the local shop, and another person was going out to lunch with their family. There was a number of visitors to the service and all those spoken to were complimentary about the welcome that they received. There is a planned menu in place that is rotated on a four weekly basis. The service users are supported winter choice of meals and they said that choice was available. Comment was you can always get something else, but there is no need. Other comments included that they look after you well and the food is always good here. The six service users we spoke to, all said that the food was very good We observed the lunchtime meal during our visit and found that the service users had three choices of meals served. Meals looked well presented, wholesome and balanced. The staff were available to offer support in a sensitive manner. The chef stated that they used meat and vegetables sourced locally. Fresh fruits and vegetables were bought weekly from the local shops. Care Homes for Older People Page 16 of 29 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. There is a satisfactory process in place to respond to peoples concerns and records are maintained . Training in the protection of abuse was available for the staff. Records of outcome of safeguarding need further development. Evidence: There is a complaint procedure in place and three people we spoke to said that they would not worry and would speak to the manager or the staff if they had any concerns. people told us that the staff were supportive and a comment was the staff are brilliant and trustworthy. The complaint procedure was available in the entrance hall as part of information provided to people. The manager said that the current details of the commission has been updated as required to ensure that information provided to people is up to date. The manager maintained a complaint log that showed that actions taken on receipt of concerns and their outcomes. Record showed that a safeguarding referral was made on receipt of an allegation. The manager took appropriate steps until the investigation was concluded by the safeguarding team and this included retraining for the staff member involved. Care Homes for Older People Page 17 of 29 Evidence: Records of all safeguarding referral and their outcomes need to be further developed to ensure that these are available to inform practice. Training in safeguarding was available for the staff and further training was planned for November 2009. Care Homes for Older People Page 18 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users are provided with a comfortable home, however some parts would benefit from refurbishment. There is a satisfactory infection control process in place. Evidence: We looked around some parts of the home during our visit and this included the communal lounge, dining rooms, kitchen, food storage facility. We also looked at some of the service users bedrooms with their consents and assistance of the manager. The home was clean and there was no mal odour when we walked around the home. It was evident that the service users are supported to bring in items of personal belongings when they move into the service. Some of the bedrooms seen were personalised and homely. The shared bedrooms that we visited had screens available as required, to ensure that the service users privacy is protected. People we spoke to said that they spent time in their rooms as preferred and came to the dining room for lunch. Some parts of the home looked tired and dated and would benefit from planned refurbishment/ upgrade to meet the needs of people accommodated. This should Care Homes for Older People Page 19 of 29 Evidence: include risk assessments for the building, identification of and risk/ trip hazard and an action plan put in place to ensure that this is managed appropriately and safely. The service has a designated area that the service users who smoked were using at the time of this visit. This area is next to the dining room and smelt strongly of stale smoke. One person said that they did not smoke but you can always smell it in here. This should be reviewed to ensure that it does not impinge on other people living g at the home. Infection control procedures were in place and equipment for the prevention of infection such as gloves and aprons were available to the staff. The home has a laundry and the service users laundry is undertaken internally. Care Homes for Older People Page 20 of 29 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 adequate staff to meet the current needs of people. However the provider should ensure that care hours are not eroded by non care duties. There is a recruitment process in place to safeguard people and staff checks are completed as required. There is a satisfactory training and induction programme to support the staff. Evidence: We looked at the duty rosters as maintained at the service. This showed that there are two carers on the day shifts and the manager is available to provide support and supervision of the staff. Night duty has one awake and a sleeping in staff, who worked until 23:30 and started back at six am. The manager stated that care hours are based on the needs of people. However this should be managed and ensuring that care hours are not eroded by non care duties. The carers were also responsible for all the service users laundry. The home has a chef and domestic staff to support the carers. Comments were usually there is someone around when you need help. It was evident from the interaction observed that the staff and the service users had developed good relationship with each other. Care Homes for Older People Page 21 of 29 Evidence: We looked at the recruitment process that the home has in place to ensure that this was appropriate and did not put people at risk. The records of two staff were looked at, these were people who had been recently employed at the service. The records they completed an application form which contained past employment history and names of referees. The manager interviewed the candidates, references all necessary checks such as Criminal Record Bureau (CRB) and POVA first checks were completed and records of these were available at the service. Staff were provided with the terms and conditions of employment. The manager confirmed that staff complete the skills for care common induction programme, as part of their employment. The service has an ongoing training programme in place to support the staff and to ensure that training and updates are available to them. A random sample of training records showed that this was put in practice. Recent training for the staff included first aid, infection control, medication, dementia, food and health, sensory deprivation, nutritional assessments. Moving and handling and mental capacity updates are planned for November 2009. Mental health and depression awareness is planned for October 2009. Care Homes for Older People Page 22 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a registered manager who has clear lines of responsibility for the service. There is an internal audit system in place. However there is inadequate evidence to demonstrate internal audits are completed by the responsible individual as required. There is a good process of managing the personal allowance of the service users. The home has in place a satisfactory system to manage the health and safety of the service users. Evidence: The home has a registered manager who has day to day management responsibility for the service. The manager has completed the NVQ training at level 4 and the registered manager award (RMA). The staff and the service users we spoke to were complimentary about the manager. Interaction observed with the relatives and service Care Homes for Older People Page 23 of 29 Evidence: users showed they had developed and maintained good relationship with each other. There is an internal audit system in place that included regular staff meetings. The service has completed an audit of the service users views in July 2009. Positive comments were received regarding the care and facilities at the service. Comments included : Residents are always happy and the staff are friendly. The biggest asset is the caring staff. Outing for wheelchair users would be beneficial. Comments from external health and social care professionals included: Calm feel of the service. Service users privacy considered and much like a home. We looked at the monthly unannounced visits that the responsible individual is required to undertake as part of their internal audit process. The last record available at the home showed that this was completed in May 2009 and no further records were available. The responsible individual is required to ensure these monthly visits are completed and their outcomes are shared with the registered manager. Records of these must be available at the service as required. A random sample of the service users personal allowance was looked at as part of our visit. The manager stated that there are designated staff who have access to the moneys held on behalf of the service users. Records of all transactions were maintained and two staff signed the records. Invoices are raised for items such as hairdressing and chiropody and these are sent to the person responsible for payments as appropriate. The manager is aware that reports of incidents that are detrimental to the health and welfare of people using the service are sent to the Commission. A record of these must be developed and available at the service. The AQAA states that there is an ongoing programme for the servicing of equipment Care Homes for Older People Page 24 of 29 Evidence: to ensure that they remain in good working order and safe. The environmental health officer attended the home in October 2008 and this was satisfactory with no outstanding recommendation. Care Homes for Older People Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 29 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 9 13 The registered person must ensure that arrangements are in place for the safe recording, handling, safe administration of all medicines received in the care home. So that people receive their prescribed medication as required and are not put at risk of harm. 30/11/2009 2 33 26 The registered person must ensure that unannounced visits are completed and records of these are maintained at the service. So that this informs your care delivery and forms part of your internal audit. 30/11/2009 Care Homes for Older People Page 27 of 29 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 28 of 29 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 29 of 29 - 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!