Care Home: Tanglewood Sandpiper

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What the care home does well People in this home told us that they were well cared for by a committed and friendly care team. Staff treat people with dignity and respect. They are well trained and have a good understanding of peoples needs and wishes. They encourage people to make their own choices and decisions and to be as independent as possible. There are good systems in place to make sure people are protected, including staff training, risk assessments and policies; people who use this service told us that they feel safe living in the home. There is a range of activities and relatives and friends are made welcome when they visit the home. The acting manager said that training for all staff is undertaken and there is a dedicated training officer in the home. What has improved since the last inspection? During this inspection we found that people are actively involved in their care plans, with staff working closely with people by explaining what is in their care plans and what changes they would like to make in them. What the care home could do better: There were no requirements or recommendations as a result of this visit. We made two suggestions to help make things better. Care plans seen of three residents did not reflect person centered care planning. This would ensure that they had a say in the care that they wanted and this would be documented. We also said that due to new laws introduced in 2007 care plans must identify the capacity of people in what decisions they were unable to make. Care plans also need to identify those decisions that residents can make relating to their daily living and risks that this may present. The compliance manager has contacted cqc and informed us that the above issues have been addressed for all people in the home. Key inspection report Care homes for older people Name: Address: Tanglewood Sandpiper South Street Alford Lincs LN13 9AQ     The quality rating for this care home is:   three star excellent 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: Douglas Tunmore     Date: 0 1 0 1 2 0 1 0 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 26 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Tanglewood Sandpiper South Street Alford Lincs LN13 9AQ 01507462112 01507462480 sonia.little@twhealthcare.co.uk www.tanglewoodcarehomes.co.uk Tanglewood (Lincolnshire) Ltd Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jacqueline Burrows Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 30 The registered person may provide the following category/ies of service only: Care home only - Code PC to service users 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 Date of last inspection Brief description of the care home Tanglewood Sandpiper is owned by Tanglewood Lincolnshire Ltd, and is a two-storey purpose built home situated in the market town of Alford. The home has gardens to the side and rear of the building, a limited number of car parking spaces to the front and is conveniently placed for access to local facilities and shops. The home offers care for service users who require personal care; a total of 30 beds. The home has a Care Homes for Older People Page 4 of 26 Over 65 0 30 30 0 Brief description of the care home Statement of Purpose that outlines its aims and objectives for the home and gives full details of the services provided; the document has been revised. Accommodation is provided in single rooms. We were told that the current fees for a weeks stay at the service range from three hundred and sixty seven pounds to four hundred and fifty five pounds depending on the level of care required. Extras charged for include chiropody, hairdressing toiletries and newspapers. The providers Survice Users guide and the last inspection report is available from the acting manager. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards which have the potential to affect the health, safety and welfare of people who use the service.Throughout this report the terms we and us refer to the Care Quality Commission (CQC). The visit took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we have been notified of since our last visit. Before we made our visit the acting manager had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. Care Homes for Older People Page 6 of 26 The Commission are trying to improve the way that we engage with people who use services so that we gain a real understanding of their views and experiences of social care services. To do this we use a method to carry out the inspection, which is called case tracking, this includes following the care of a sample of people through their care records and assessing their care. We spoke with three people who use the service. We spoke with the provider of this service, the compliance manager, the activities organiser and two members of staff. No visitors were seen during this visit. The acting manager was present throughout this visit and was informed of the general outcomes. We also received one survey from a resident, one from a relative and two surveys from carers at this home. Comments made in these surveys will be used throughout this report. Care Homes for Older People Page 7 of 26 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 26 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 26 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 was information available to enable residents to make a choice as to whether or not to enter the home. People received an assessment, which resulted in their needs being met. Evidence: We were told that, prospective and new residents are given as much information as possible to enable them to make an informed choice as to whether Sandpiper is suitable for their needs. We ensure that we are able to meet the personal social and physical needs of each client prior to admission. We make every possible arrangement for a prospective client and their family or representative to experience all or as many aspects of our service. We offer prospective residents the chance to spend a day or overnight stay to fully review the services we provide. We looked at the files of three people who were being case tracked, which showed us that pre-admission assessments had taken place and their care needs were clearly Care Homes for Older People Page 10 of 26 Evidence: identified. One resident had been an admission from hospital and she made the arrangements to come into this home. Files of those people who were being case tracked also showed that risk assessments had been undertaken and were revised during their stay as required. Residents are also written to by the acting manager confirming whether the home can meet their needs or not. A resident that we spoke with said that; I am perfectly alright, I made the arrangements to come in when I was in hospital. Staff are very good and I am looked after very well until I leave. Another resident stated that, I came straight in, the staff were very friendly and welcoming. One survey received from a resident told us he had enough information to help him decide if this home was the right place for him before he moved in. He also indicated that he had been given written information about the homes terms and conditions prior to admission. Two staff surveys showed that they always get up to date information about the needs of the people that they care for. The home does not offer intermediate care. Care Homes for Older People Page 11 of 26 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. The health and welfare needs of people living in the home are fully met. Medication procedures keep people safe. Evidence: We were told that, care is personalised for each resident and their health and personal care needs are fully met; their individual rights to privacy and dignity are upheld in life and at the time of their death staff will treat them and their family with care, sensitivity and respect. Two of the three residents confirmed that they knew about their care plans and had signed them. We looked at three files of residents which showed that their likes and dislikes were identified, as was the need to maintain their privacy, dignity and independence. However, there was no evidence that individual residents had been asked as to how they wished their intimate care needs to be managed. Both residents told the inspector that the carers maintained their privacy. Files also identified the health care needs of residents and when the GP or chiropodist visits. Care Homes for Older People Page 12 of 26 Evidence: People told us that they felt that the care given met their needs and that staff listen to what they say and act on their wishes Care plans seen were not person centered in relation to the delivery of a care service. The compliance manager confirmed that care plans are currently being reviewed and will reflect person centered care as well as individual residents wishes regarding their intimate care needs. A residents survey tells us that he always receives the care and support that he needs from his carers. He also states that staff always listen to what he tells them and acts on what he says. He also confirms that staff are usually available when he needs them. One resident confirmed that he is assisted in his personal care by carers who are sensitive to his needs and are mindful of his privacy. He also confirmed that he sees the physiotherapist regularly. He also said that carers are helpful and very friendly. Two carers were aware of maintaining the privacy and dignity of residents and treating them with respect. They also showed that they had a good knowledge of the needs of residents and how these were to be addressed. The pharmacist inspected the home on the 24/11/2009 and an action plan is in place addressing minor issues needing to be resolved from this visit. Due to this an inspection was carried out of medication which showed that on the day of this visit all medication given to people had been signed by the senior carer.The providers training file evidenced that care staff receive training in the administration of medication. A residents surveys tells us that the home make sure that he always gets the medical care that he needs. The acting manager confirmed that no residents are self administering their own medication at this time. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities is available to residents, which suits their needs. Meals provided are well balanced and take into account personal preferences. Evidence: We were told that, our staff training and development programme promotes our residents individual rights to live their lives to their fullest potential promoting and maintaining independence, respecting choice and dignity at all times. We ensure that residents maintain contact with their families, friends, representatives, and the local community as they so wish. We looked at the homes monthly newsletter for January 2010. It evidenced that there are a lot of activities over the Christmas period including, a Christmas Fayre, which raised monies for the residents hospitalities fund. There were also Christmas cakes made by people. There was also a new year party with music and money was raised for the MacMillan nurses. The manager confirmed that have a full time activities organiser. The activities organiser showed us her events folder which showed us what monthly activities were undertaken by people. Activities included,; armchair activities keeping fit, sing a longs, Care Homes for Older People Page 14 of 26 Evidence: reminiscences, cooking, ball games and a knitting club. Coffee mornings are also held for dementia support. People also went to a local primary school where the children presented Jack and the Beanstalk. We were told by the activities organiser that she is going to organise outings once a month to garden centres and picnics at beauty spots. We looked at a list of hobbies and activities which individual residents prefer, which are reviewed on a monthly basis. People told us that, the staff are very good and I am looked after very well. One resident told us that, I dont join in activities, I get a walk in every day around the park and trips out with the home to the coast and garden centres. He also confirmed that he gets visits from his family who are made welcome by the staff. He said that he had spent Christmas with his sister. One relatives survey told us that, on the whole there is an excellent service, they the home try to organise different activities to suit all the residents. He also told us that we are very satisfied, the service is friendly and efficient and the home feels welcoming at the front door. The inspector observed residents during lunch and spoke to three people about the food on offer. Comments were complimentary about the food and they said that choices were available. One resident stated that they know my likes and dislikes. Observations made were that there were enough staff on duty to support people who required help and that staff were mindful of residents dignity. Care Homes for Older People Page 15 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear policies, training and a responsive and caring staff team protect people in this home. Evidence: The provider informed us that, residents and their relatives and representatives are confident that their complaints will be listened to, taken seriously and acted upon. We ensure that our residents legal rights are protected. We ensure that our residents are Safe guarded and protected from potential abuse and inappropriate behaviour or treatment. The Manager is very attentive to all service users and their families and carers. The Manager has an open door policy and is available to discuss concerns and issues raised. Two carers commented that they knew what safeguarding was and what action they would take if abusive practice came to their attention. They were aware of the types of abuse and what forms it could take. They were aware of the policies and procedures, which they have read. They confirmed that they had undertaken training relating to safeguarding people. The provider has the appropriate adult protection policies and procedures regarding the safeguarding of residents. The providers AQAA shows that there has been three complaints and no safeguarding referrals. The complaints file was seen and a record was kept of all complaints and their outcomes Care Homes for Older People Page 16 of 26 Evidence: The director commented that any concerns or complaints should be addressed by the manager as soon as an issue arises as this ensures good practice and a quick resolution of complaints. He also said that we work closely with all agencies with regard to keeping people safe. Staff surveys showed that they knew what to do if a resident or relative had concerns about the home. One comment was the home provides a high standard of care and staff are given good training and on the whole it is a happy atmosphere to work in. A residents survey told us that there is somebody he could speak to if he was unhappy and that he knew how to make a complaint. During this visit no residents made negative comments about their care to the inspector. Observations made were that people are treated with dignity and respect by carers. One resident told us that he had the complaints policies of this home and I feel safe here. The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. Care Homes for Older People Page 17 of 26 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 benefit from a comfortable and clean environment that meets their individual needs. Evidence: We were informed that, the location and layout of our care home enables our residents to live in a safe, well maintained environment. Residents have access to safe and comfortable indoor and communal facilities and the care home provides sufficient and suitable WCs and excellent bathing facilities. Residents have the specialist equipment they need to maximise their independence. Each resident lives in safe comfortable surroundings, having their own room that is furnished to meet their assessed needs. There are call bells in all rooms, which two people said they have good access to. Rooms seen by the inspector were decorated to a very high standard. There are telephone points so that residents have a choice about using a phone of their own and there are television points in all rooms. During the visit the acting manager told us that there is a programme of maintenance in place and that in 2009 two bathrooms were refurbished one with a wet room. All communal toilets had been refurbish and their are now sluices on both floors. There has been a new hairdressing salon and we were told that all soft furnishings had been Care Homes for Older People Page 18 of 26 Evidence: replaced throughout the home. The garden is landscaped and their is garden furniture so people can sit outside in a pleasant environment. Two residents stated that they liked their rooms and rooms seen on both floors had memorabilia, which people had brought with them when admitted. People said that their rooms are kept clean and are dusted and cleaned and there are no unpleasant smells. We visited seven bedrooms with the consent of residents. They were found to be personalised and clean. We were told by one resident that he liked the decor its done out very well, more like an hotel. He also said its not over crowded. Care Homes for Older People Page 19 of 26 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. The home is adequately staffed with employees who were experienced, competent and trained to care for older people. People are protected by the homes robust employment procedures. Evidence: We were told that, we have a committed and dedicated workforce, supported by the Compliance Manager and working Directors. A significant number of employees have been employed by the company for many years. All employees are subject to a robust recruitment procedures. Two members of staff confirmed that they had undertaken training including; fire training, first aid, moving and handling, infection control, medication training and dementia training. Training is undertaken to ensure that staff can meet peoples needs. The providers AQAA and training programme also showed that staff have undertaken NVQ, National Vocational Qualifications in caring for the elderly level 2 or level 3. The acting manager stated that all staff are encouraged in undertaking NVQ training. Both carers confirmed that they have undertaken employment checks carried out by the provider. This included obtaining two references, a criminal record bureau check (CRB), protection of vulnerable adults check (POVA) and a formal interview. In house Care Homes for Older People Page 20 of 26 Evidence: training relating to safeguarding has been undertaken and was documented in the training programme. We looked at two carers personnel files and found that checks had been undertaken. The acting manager stated that those staff who had POVA checks were supervised whilst their CRB was received. A residents survey showed us that he received the care and support he needed and that staff were usually available when he needed them. He also confirmed that staff always listened to him and acted on what he said to them. A specific comment from a resident was there is always someone there when I need them. We looked at the staff rota, which confirmed that appropriate staffing levels are being maintained and ensures a mix of skills are available to meet the needs of residents. Both members of staff felt that there was enough carers most of the time and that morale was good among staff. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and people have a say in how the home is run. Evidence: We were told that, the acting manager is a very experienced care home manager and been recently employed by the company. She has excellent knowledge and experience to manage the care home. The acting manager is assisted by two Care Team Leaders and has extensive knowledge of the client group, and are well supported and respected. The fit person interview was undertaken with the acting manager on the 4th March 2010 and a recommendation has been made for the approval of the acting manager to be registered. The manager is supported by the provider and the compliance manager. These is also a training officer in post who also advises on training issues and undertakes the training needs of care staff. Care Homes for Older People Page 22 of 26 Evidence: Both members of staff stated that the acting manager is very supportive and that she doesnt panic. They confirmed that she also very capable and moderate in the way she runs the home. Observations made by the inspector during this inspection were that the acting manager spent a lot of time with residents and had an approachable manner. She was also proactive in addressing those issues raised in this visit and undertook changes as required. The providers undertake residents meetings and audits. We looked at the last audit, which evidenced that residents were happy with the care that they receive at this home. The acting manager confirmed that regular monthly audits are undertaken on records of any monies held on behalf of residents is maintained. We looked at financial records of two residents monies, which is kept in a safe place. It was found that there is a clear audit trail in place and that an accurate record was kept with receipts for purchases made being available. The providers AQAA identified that there are a range of policies and procedures available in the home relating to the health and safety of residents. This document also showed dates when equipment was serviced and the fire alarm was checked to ensure the safety of residents and staff. Care Homes for Older People Page 23 of 26 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 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 26 of 26 - 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. 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