Care Home: Templemore

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What the care home does well The home provides staff to look after the residents who are recruited thoroughly and receive comprehensive training. The home provides a comfortable and homely environment for the residents to live in. The residents` views are taken into consideration and put into place to make sure that their choices are met. Visitors to the home are made very welcome and families are communicated with about changes to the resident. What has improved since the last inspection? The requirements made at the last inspection were reviewed at a Random Inspection and had been completed. There were no further requirements made at that inspection. What the care home could do better: The home could provide improved transport to allow higher numbers of the residents to enjoy trips out of the home. They could make sure that the staff are aware of how to assist the residents with eating in a dignified way. The complaints policy could be reviewed to include the details for social services and to provide a comprehensive form to record the complaint details. The residents should be provided with a home that is free from unpleasant odours. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Templemore 121 Harlestone Road Northampton NN5 6AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anthea Richards     Date: 1 9 0 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Templemore 121 Harlestone Road Northampton NN5 6AA 01604751863 01604588638 templemore@bmcarehomes.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): B & M Care Limited Name of registered manager (if applicable) Monika Relton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Cedars 1 - Dementia Care Unit No more than 22 residents can be accommodated under the DE(E) category in this part of Templemore Care Home Cedars 2 - Dementia Care Unit No more than 18 persons can be accommodated under the DE(E) category in this part of Templemore Care Home No more than 32 persons can be accommodated in the main house of Templemore Care Home Templemore Care Home is registered to provide care for male and female service users who fall within the following categories:- Old age, not falling within any other category (OP) 32 Dementia over 65 years of age DE(E) 72 The main house :- No person under the DE(E) category or OP category can be accommodated in the main house of Templemore Care Home once 32 persons under the categories/combined categories are residing in the home The maximum number of persons to be accommodated at Templemore Care Home is 72 Care Homes for Older People Page 4 of 27 care home 72 Over 65 72 32 0 0 Two service users under the MD(E) category can be accommodated in the main part of Templemore Care Home Date of last inspection Brief description of the care home Templemore is a care home providing personal care for seventy three older people the majority of whom have care needs from varying degrees of dementia. The home is owned by B&M Care who have one other home in Northamptonshire and other homes in different parts of the country. Close to parkland, Templemore is an old listed building full of character and with easy access via local transport to the town centre. There are three units within the home on two floors, the main house accommodates residents in the categories of older people (OP) and dementia (DE)(E). There are also two dementia care units accommodating residents with varying levels of dementia. There are sixty two single bedrooms of which forty five have en-suite facilities. The home has five double rooms with four of these having en-suite facilities. A passenger lift provides access to those bedrooms on the first floor. The home has attractive enclosed gardens, which include a courtyard sensory garden. The current fees range from £470.00 to £520.00 per week. 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: This was a key inspection of a care home for older people, which ended with an unannounced visit to the service. Before the visit we [throughout the report the use of we indicates the Commission for Social Care Inspection], spent five hours reviewing information received by the Commission for Social Care Inspection [CSCI] since the last annual service review on the 29th October 2007. The visit took place on the 19th January 2009 and lasted seven and a half hours. During the visit we checked all the key standards as identified in the National Minimum Standards. Care Homes for Older People Page 6 of 27 This was achieved through a method called case tracking. Case tracking means that we looked at the care provided to four of the residents. To achieve this we spoke with the staff supporting their care and looked at the records relating to their health and welfare. We spoke with the residents and their families. With their permission the residents bedrooms were looked at. We also checked how the home was run and organised. This included looking at staff records, training and how the staff are organised. We looked at health and safety records, menus, minutes of meetings and the quality audit. The policy for handling complaints and how the home dealt with them was looked at. We looked at how prospective residents and their families are given information about the services the home can offer and whether they are suitable for them. During the visit we spoke with the manager, an assistant manager, the residents, the staff and families and visitors to the home. We also spoke with a district nurse visiting the home. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 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 9 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents needs are always assessed before moving into the home and they have good information to help them make the right choice about the home. Evidence: The residents and their families who were case tracked told us that they had seen the Statement of Purpose and the homes information pack. They had also been given the terms and conditions. The Statement of Purpose and Service Users Guide gives people the information that they need to know about to help them make a decision about the home. Providing a comprehensive Statement of Purpose & Service Users Guide gives the Care Homes for Older People Page 10 of 27 Evidence: residents good information, making sure that they they can get the most suitable care. The manager or a senior member always visits prospective residents before they are admitted to the home and there is a thorough pre admission assessment form in place. This was seen in the care plans looked at and confirmed by the residents and the families spoken with. This makes sure that that the manager and the staff in the home have the the right information before the resident is admitted, so that they can get the best care. It makes sure that the home can meet the residents needs and that the resident meets someone from the home who they can recognise. The families and the residents spoken with confirmed that they were given the opportunity to visit the home before their relative came in. Members of the staff spoken with said that they always knew what the residents needs were before they moved in. A resident told us My daughter couldnt have chosen better The current registration certificate from the Commission for Social Care Inspection [CSCI] was displayed in the entrance of the home with an up to date insurance certificate. The latest report from the CSCI was available in the managers office. Care Homes for Older People Page 11 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. The staff meet all the care needs of the residents, with privacy, dignity and respect. Evidence: The case tracked records were found to contain good individual evidence of the care being given to the residents and reflected the care that the residents needed. There was evidence that the residents and/or their relatives had been involved in planning the care. The residents and the families spoken with told us about the care that they needed and that they were happy that they received it. A comment recieved: It cannot be faulted There are records of the involvement of G.P.s, district nurses, chiropodist, optician, where needed in the care plans, showing that thorough health care is being provided for the residents. The residents and their families spoken with said that they could see the doctor and other health professionals when they needed to. There was evidence that the care plans are regularly reviewed and the residents and the families spoken with confirmed that they had been involved Care Homes for Older People Page 12 of 27 Evidence: and were aware of the care to be given and that they were happy with it. The daily record of care was up to date but some were found to have limited information about the residents day or night. Fully completed daily records make sure that the residents receive the right care and the staff know what has happened to them during the day or night. We saw residents being treated with dignity and respect when staff spoke with them and undertook their care, particularly when moving them. They were seen to be knocking on the residents bedroom doors before they went into them. There are records of the residents nutritional needs and weight, which makes sure that they are eating well and are not losing or gaining large amounts of weight. The staff spoken with were aware of the care needs of the residents and the residents and the families spoken with were happy that all care needs were being met. A district nurse told us that the staff cared well for the residents, were aware of their limitations and always referred people to them when they should. There were risk assessments in place to cover all the identified risks for the residents and how the staff should manage those risks. This makes sure that the residents and the staff are protected from any risks that have been identified, without restricting their activities. Comments from the residents included I am very happy with the care that I get They look after me well Medication records for the case tracked residents were in order. Medicines are given by the senior staff who have regular updating and training in medicines. We saw that the medicines were administered individually and the residents were seen to be taking them. Medicines are supplied in a monitored dosage system where each tablet is in a separate pop out card, which is a safe method of administration, helping to make sure that the resident is always given the right medicines. The staff spoken with were knowledgeable about the medicines and where to obtain information. They were also aware of the requirements for the receipt, storage and disposal of medicines. The manager or an assistant manager carries out a monthly written audit of the medicines and the medicine sheets to make sure that they are correct. Care Homes for Older People Page 13 of 27 Evidence: The controlled [dangerous] drugs and records were checked and found to be in order. There was a self-medicating policy in place but there were no residents looking after their own medicines at that time. 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. The home provides activities that the residents enjoy and take part in and meets their spiritual and nutritional needs. Evidence: The home employs a full-time activities organiser who with the staff provides activities in all parts of the home. She regularly documents the activities that the residents have taken part in into the care plans. The care plans describe the residents past life and their interests so that the home can let them continue those interests if they wish to. The activities include craft work, cooking, newspapers, nails hairdressing, crosswords, card games, board games, skittles, movement classes, outside entertainment such as singers and a piano player. The home has provide a sensory room with lights and music, which is well used by all the residents. The staff and the activities organiser make sure that anyone who is in bed is included in any activity that they can, particularly with reading, crosswords, puzzles. On the day of the visit there was a reminiscence group being held in the morning and a group of people were making fruit kebabs in the afternoon. Staff, including the activities organiser, were seen sitting and talking to the residents and looking at Care Homes for Older People Page 15 of 27 Evidence: newspapers. Residents and the families told us that they were happy with the amount of activities and joined in those that they wished to. The staff were seen to be asking them if they wanted to join in, giving them a choice. The staff and the records seen confirmed the level and variety of activities. Trips out of the home such as pub lunches or garden centre visits take place but are limited because of the lack of appropriate transport, there is only a normal saloon car available to the home. The menus seen only gave one choice of meal, however on speaking with the chef, the staff and the residents, they all told us that they could have a choice and had what they liked at meal times. This was seen when we spent time with the residents at both lunch and tea time, the residents on one of the tables had three different meals. The chef saw the residents every day to check what they would like for their meals. The residents and their families told us about this. The chef told us that she received regular good quality deliveries of food, but did have the flexibility to buy individual items locally if she needed to. Comments include; I really like the food and we get a choice The home holds church services every month that includes a morning service, a songs of praise service and a communion service. Hairdressers regularly visit the home and were there on the day of the visit with several of the ladies telling us that they had their hair done and how much they enjoyed it. 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. There are systems in place to support and protect residents and staff are aware of the processes. Evidence: There is a complaints policy in place which gives the details of how to complain and who to complain to in the home if they needed to. The details for Social Services are not in the complaints policy and the manager told us that she would have them included. Complaints about care in the home should be made first to the Social services department. The policy could be made available in a large print and other languages if it was needed, which makes that as many people as possible could read it. The complaints form could be updated to include an audit trail of when the complaint was received, resolved and the names of who had dealt with it. The home has received one complaint since the last annual service review on 26th November 2007. This has now been resolved, which was confirmed by the manager and the correspondence seen. The residents and the families spoken with and who responded to the surveys that we sent out, were aware of the policy, of how to complain and who to complain to. They Care Homes for Older People Page 17 of 27 Evidence: were happy that their concerns would be listened to and acted on. The staff spoken with were aware of how to handle any complaints. The staff spoken with were able to describe how they would deal with an allegation of abuse, knew the areas where abuse could happen and could describe the process that they would go through if they suspected any abuse. They confirmed that they had had training in safeguarding adults and whistle blowing and the manager and the records seen supported this. Most of the staff have either got an NVQ at least at level 2 or have started the award, during which they receive training in safeguarding as well as the training given in the home. They were confident that the management would handle any issues correctly. We looked at the accident book, which had been completed correctly. These practices make sure that the residents are safe from any abuse and that any concerns are handled properly. 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. The residents and staff are protected by the policies and procedures in the home to provide a safe environment. Evidence: Templemore is a converted and extended house in a suburban area with easy access to the centre of Northamton. The home had an unpleasant odour on our arrival, but appeared to be clean, homely and welcoming. The home is divided into three units, one in the main, old part of the home and two purpose built units where those residents with dementia were cared for. In the main home there were bedrooms on the first and second floors that could be reached by the stairs or the lift. There were bathrooms and toilets on all floors that were found to be clean and free from hazards. There were lounges and a dining room on the ground floor that were bright, well decorated and comfortable for the residents. The bedrooms seen had been personalised and were mainly found to be clean and well decorated. One of the Care Homes for Older People Page 19 of 27 Evidence: bedrooms had a strong odour that the manager told us they were trying to remove. The residents spoken with were happy with their rooms and said that they were able to bring their own belongings in with them. The Cedar units were clean, bright and well decorated. The bathrooms were clean and well equipped. The bedrooms seen were clean and well decorated, but some did not have much personalisation. The assistant manager told us that they did encourage families to bring items into the home but that many chose not to. There was evidence of equipment in the home to help the residents, such as wheelchairs, special mattresses and hoists. A recent environmental health inspection to the kitchen had given the home a satisfactory rating. There was a well maintained garden with sitting areas with tables and chairs for the residents to enjoy in the better weather. A branch had been blown off a tree and the manager told us that the trees were being looked at by a tree surgeon to make sure that the residents were not at risk from falling branches. The residents and the families spoken with were happy with the cleanliness of the home, and told us that the staff worked hard to keep it clean. There are staff employed to complete the cleaning in the home and they have had training in health and safety. The cleaning products are stored in a locked cupboard, which we saw. This was confirmed by the staff spoken with, the records seen and by the manager. The records for hot water testing were up to date and all the temperatures were within the recommended levels. The records for fire alarm testing, drills and instruction were found to be up to date. Staff spoken with told us that they had regular fire drills. 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. The recruitment policy, the training and staff numbers meet the residents needs and protect their safety. Evidence: We looked at three staff files and the required information was complete in all of them. This included evidence of identification, adequately completed application forms, two written references and a Criminal Records Bureau [CRB] check. The manager makes sure that all the required documentation is in place before an employee starts work. This was confirmed by the staff spoken with, who told us that they could not start until they had all the paperwork in place. The staff spoken with confirmed that they had received recent training in moving and handling, dementia, safeguarding of vulnerable adults and first aid. The residents and the families spoken with felt that the staff were well trained to do their job and that there were always enough staff to look after them. We saw the induction programme, the basic one takes three days to complete and includes fire, health and safety, moving and handling and infection control. Care Homes for Older People Page 21 of 27 Evidence: Most of the care staff either hold a National Vocational Qualification [NVQ] at least at level 2 or are in the process of completing it. The National Vocational Qualification is a qualification for care staff to make sure that they receive training in the needs of the resident group whom they are caring for. 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 residents views are taken into account and their safety is protected by the practices in a home that is run in their best interests. Evidence: The manager, who has managed the home for two and a half years is registered with the Commission for Social Care Inspection and has completed the registered managers award. There are regular meetings held for the residents and for their families, to discuss activities and menus in addition as to how the home is meeting their needs. These were confirmed by the residents and their families and by the staff spoken with. There is an annual quality questionnaire sent to the residents and their families and the questionnaires that we saw on the visit confirmed this. The families and the residents told us that they had completed the questionnaires. These were sent to Care Homes for Older People Page 23 of 27 Evidence: professional staff, residents, families and the staff. These were mainly found to be positive apart from two comments about the laundry and four about the odour in the home. We received positive comments from the residents and the families at the visit amongst which were that the staff were very supportive of them and their relative. The residents accounts were seen and all in order, and had two signatures on each entry. This makes sure that the resident and the member of staff handling the money are protected. We saw that receipts were obtained for purchases. There was evidence from the staff spoken with and from the records seen with that they are having regular, formal supervision with their line manager. Formal supervision of the staff gives them and their line manager the opportunity to discuss work and training issues and needs. New staff are seen after three and six months for a review of how they are doing and their training needs. There are regular staff meetings held, confirmed by records held and by the staff spoken with. The manager completes a regular audit of any accidents that have happened in the home to make sure that if at all possible they could be avoided. The areas of health and safety such as hot water temperatures and fire alarm testing were found to be in order. 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 26 16 (2)(k) That the manager 28/02/2009 makes sure that the homa is kept clear of any offensive odours To make sure that the residents live in a pleasant environment. 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 2 3 4 5 7 12 15 16 16 That the staff are updated as to what information should be contained in the daily record. That consideration is made to enable more residents to be taken out at one time. That when assisting a resident to eat, that it is done discreetly and sensitively. That the details for Social Services are included in the complaints policy. That a new audit form is produced to include an audit trail of dates and names to show when and how the complaint was dealt with and resolved. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 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!