Care Home: Thurlestone Court

Similar services:

• The Vicarage
• Fairfields Country Rest Home
• 7 Hyde Road
• 5 Seafield Road
• Poldhu
• Queensmount
• Trevaylor Manor
• Didsbury Court Rest Home

What the care home does well Thurlestone Court is well managed and provides a safe, comfortable and homely place in which individuals can live their lives. Everyone looked clean and well cared for. There is a good assessment process that assures people thinking of moving into the home that their needs will be met. Everyone living at the home has a care plan that sets out their needs. Staffing levels are sufficient to meet the needs of people currently living at the home and staff are well trained. People living at the home said that staff were helpful and friendly. Staff said that they felt well supported by management and each other. Staff said via survey forms, that the home `helps to keep the service user as independent as possible`. Another said when asked what the home does well `Keeping the home clean and fresh and keeping residents safe`. Another staff commented `If any of my family need a home I would be very happy for them to go to Thurlestone Court`. There was evidence of good multi-disciplinary working with other professionals and all records, including those relating to medication administration were well maintained. People felt that meals were very good and there was a good variety of food available, they also said that there was always an alternative if they didn`t want what was on the menu. What has improved since the last inspection? The boiler has been replaced to provide extra heating in 3 bedrooms which are prone to the cold due to their position in the building. The carpets in three bedrooms have been replaced and fire doors are held open only with approved devices. The laundry has been redecorated and reorganised and the kitchen has been refitted. All staff have received training in POVA (Protection Of Vulnerable Adults) issues. What the care home could do better: Care plans could be improved if more detailed instructions were given to staff on how the identified needs of individuals were to be met. Complaints should be recorded separately so that anyone wishing to see information relating to themselves could not see information relating to other individuals. Proof of identity for all staff must be retained at the home. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Thurlestone Court Thurlestone Court Thurlestone Kingsbridge Devon TQ7 3LY     The quality rating for this care home is:   three star excellent 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: Sue Dewis     Date: 0 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2010) 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Thurlestone Court Thurlestone Court Thurlestone Kingsbridge Devon TQ7 3LY 01548560737 01548560737 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Thurlestone Court Limited care home 25 Number of places (if applicable): Under 65 Over 65 25 25 25 25 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category physical disability Additional conditions: Age 50 Date of last inspection Brief description of the care home 0 0 0 0 Thurlestone Court is a detached two-storey property standing in its own grounds in the coastal village of Thurlestone, in the South Hams area of South Devon. It is part of the Court Group of care homes, and is registered to provide care for up to 25 older persons who may also have a physical disability and/or dementia. Accommodation is provided in en suite rooms on the ground and first floor with a passenger lift providing access to the upper floor. Most rooms have very pleasant views. Aids and adaptations are provided to meet peoples needs. Communal rooms are spacious and are situated on the ground floor. A large conservatory adjoins the lounge. Outside there is a level Care Homes for Older People Page 4 of 27 Brief description of the care home garden area. Fees currently range from 400- 500 pounds per week. Written information regarding the home and the services provided is on display in the reception area. A copy of the most recent CQC Inspection report is available on request. 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: 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: This unannounced visit took place over 7 hours, one day at the beginning of March 2009. The home had been notified that a review of the home was due and had been asked to complete and return an AQAA (Annual Quality Assurance Assessment). This shows us how the home has managed the quality of the service provided over the previous year. It also confirms the dates of maintenance of equipment and what policies and procedures are in place. Information from this document was used to write this report. Although only one inspector undertook this inspection, throughout the report there will be reference to what we found and what we were told. This is because the report is Care Homes for Older People Page 6 of 27 written on behalf of the Care Quality Commission. During the inspection 3 people were case tracked. This involves looking at peoples individual plans of care, and, where possible speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process CQC likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to some people living at the home, and some staff. At the time of writing the report, responses had been received from 10 people living at the home and 9 staff. Their comments and views have been included in this report and helped us to make a judgement about the service provided. During the inspection 2 people living at the home were spoken with individually and 4 others in a group setting, as well as observing staff and people living at the home throughout the day. We also spoke with 3 staff and the manager. Brigitte Harvey, the Responsible Individuals representative, was present for part of the day. A full tour of the communal areas of the building was made and a sample of records was looked at, including medications, care plans and staff files. All key standards were inspected. 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.cqc.org.uk. You can get Care Homes for Older People Page 8 of 27 printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedure ensures that there is a proper assessment prior to people moving into the home, and that they can be assured that their care needs can be met. Evidence: There is a Statement of Purpose, Service User Guide and Brochure available to people thinking of moving into the home. The manager explained the admission process from when she first receives a referral. She said that she will go to see the individual in their own home or hospital and complete an assessment form, she also collects as much other information from as many people as possible. A life history form is completed over the first few weeks they are in the home. People are always invited to look around the home, but many people rely on their Care Homes for Older People Page 11 of 27 Evidence: relatives to do this on their behalf. We spoke with one person who had been recently admitted, they felt they had received enough information from the home to enable them to make the decision about moving into the home. They praised the staff in helping them to settle in and felt they were receiving the level of care that they needed. Admission records that were looked at showed evidence of good assessments and risk assessments undertaken prior to the person moving in. The home writes to people to confirm that their assessed needs can be met before they move in. The home does not provide intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Everyone who lives at the home has a care plan. The management of medication is good and helps ensure people are protected from the risk of not receiving their prescribed medication. Evidence: The care plans of three people living at the home were looked at. The care plans are written in the 1st person and contain evidence of detailed assessments including, what I would like you to know about me, activities/interests and emotional well being. However, while the plans contain good detail of the individuals assessed needs there was little detailed information for staff on how these needs should be met. Although It was clear through discussions with staff that they knew the people they care for very well and knew how best to meet to meet their needs, consistency of care would be further maintained if more detail was recorded. There was evidence that detailed risk assessments have been completed where necessary and in particular there were risk assessments relating to pressure area care Care Homes for Older People Page 13 of 27 Evidence: and moving and handling needs. There was also evidence that care plans had been reviewed and that the individual or their representative had been included in the care planning process. However, although care plans were reviewed regularly, relevant changes were not always made. For example one individuals care plan said that they were insulin dependent, but in fact their diabetes was now controlled by tablets. Care plans are kept in the main office and senior care staff write on them on a daily basis using information passed to them by care staff. There is a key worker system in operation at the home which means that each individual has a named member of staff who is specifically responsible for their care. The keyworkers write a monthly report on each of their nominated individuals. There was evidence on file that peoples health care needs were being met, and that a range of health care professionals visited the home, including GPs and District Nurses. It was possible to see where one person had been visited by the SALT (Speech and Language Therapists) team following a stroke. Peoples nutrition and hydration is promoted and monitored on a daily basis. The manager said that since an initiative had started about 2 years ago there have been positive outcomes for peoples health and there has been a vast reduction in urinary tract infections. There is a policy and procedure for the administration of medicines and evidence was seen to show that people are supported to look after their own medicines if they wish to. All medicines were seen to be stored correctly and staff were seen administering them appropriately and signing the MAR (Medication Administration Record) as needed. We were told that all staff who administer medication have received appropriate training and that no-one administers medication until they feel confident to do so. All people we saw during this visit looked well cared for, were treated with respect by the staff and their right to privacy was upheld. Personal care was seen to be offered in a discreet manner. Staff told us how they respect peoples privacy when helping them with personal care and we heard staff speaking with people in a kindly, friendly way. There was an obvious affection between staff and the people they care for. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Social interaction and activities are available, and there is good daily variation for people living in the home. Evidence: People told us that they can choose how and where they spend their time and routines within the home are flexible. Care plans contain information about peoples past life and we were told these are used to help plan activities and entertainments. A weekly programme of activities is displayed on the noticeboard. A record of activities is kept and these include music therapy and weekly outings in the mini bus. There are good links with the local church and school and 2 people go into town for lunch every week. We were told, and records confirmed that regular meetings are held every 3 months so that people living at the home can express their views about the home. On the day of the visit 10 people were enjoying a music therapy session and were singing and playing musical instruments. They told us that they always look forward to Care Homes for Older People Page 15 of 27 Evidence: the sessions. Some other people that we saw in their rooms said that they preferred not to join in with communal activities and liked to spend their time in their own rooms watching the TV or reading. Staff told us that they have time to spend with people individually in their rooms. People living at the home told us that their family and friends can visit them at any time and that they are always made welcome. Staff were able to tell us how they offered choices to people thoughout the day, including what time they get up, what they wear and where they sit. We were told that people were encouraged to remain independent and that as few restrictions as possible were put on their daily lives. Staff felt that this was one of the things that the home did very well. People told us that the food was very good and there was always plenty. The menu is displayed on the noticeboard so that if people do not like what is on offer they can ask for something else. We ate lunch with people in the dining room. The meal was tasty, well presented and nutritious and people said that they enjoyed it. We were told by the manager that the cook prepares the menus based on healthy eating ideas and the likes and dislikes of the individuals. We were told that vegetarian and diabetic meals are also supplied if needed. 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 is a good complaints procedure and people can be confident that their concerns will be listened to. Adequate procedures are in place to ensure that people are protected from abuse. Evidence: There is a clear and simple complaints procedure in place to help people who may wish to raise concerns. A copy is displayed in the entrance hall and individuals have their own copy in their room. A complaints book is kept that shows a record of written complaints received by the home, it does not list moans and groans that are dealt with immediately. Any complaints received by the home should be recorded separately and not in a book. This is so that anyone wishing to see information about themselves cannot see recorded information about anyone else. Some people living at the home who were spoken with during this visit were unsure about the homes formal complaints procedure. However, those who were spoken with were able to tell us who they would speak with if they were unhappy about anything. This was generally the manager or their key worker. Records show, and staff told us that they had now received training in Protection Of Care Homes for Older People Page 17 of 27 Evidence: Vulnerable Adults (POVA) issues. All three staff that we spoke with were able to discuss different forms of abuse and said that they would report any suspicions they had to the manager. They were also able to tell us who they would report any concerns to, outside of the home. 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 home provides a pleasant, comfortable and safe environment for those living in, working at and visiting the home. Evidence: A full tour of the communal areas of the home was made and some individual bedrooms were looked at. Peoples bedrooms contained many individual items and reflected the personality of the occupant. People told us that they had been able to bring things from their home when they had first moved in. Communal areas consist of a comfortable lounge and conservatory and separate dining room. All areas a nicely decorated and have a comfortable and homely feel. There is level access to the outside of the premises, where there is a patio area and pleasant garden, which has recently been landscaped. A new security lock has been fitted to the front door and people who are able to use it are provided with the code to the door. The home has a range of equipment including grab rails, handrails, a mobile hoist and Care Homes for Older People Page 19 of 27 Evidence: moving and handling equipment. We were told by the manager that since the last visit, the boiler has been replaced to provide extra heating in 3 bedrooms which are prone to the cold due to their position in the building. We were also told that temperature valves have been fitted to taps in order to minimise the risk of scalding from very hot water. We were also told that 3 bedrooms have been fitted with new carpets to prevent trip hazards and that all fire doors remain closed unless approved hold open devices are fitted. All areas of the home were clean, well ventilated and there were no unpleasant odours. The laundry area is small but adequate and has commercial equipment installed. An impervious floor covering is fitted to minimise the risk of cross contamination and the area has been redecorated. The kitchen has been reorganised and refitted and we were told by the responsible individual that the kitchen has had all new equipment purchased. Staff confirmed that disposable gloves and aprons were available to them in order to minimise the risk of cross infection. They also confirmed and records show that they have received training in this area. 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. A wide range of training is provided and the numbers and skill mix of staff on duty are sufficient to meet the needs of people currently living at the home. People are generally protected by recruitment procedures that ensure people who may be unsuitable to work with vulnerable people are not employed at the home. Evidence: On the morning of the visit there were 23 people living at the home. There were 3 care staff on duty plus the manager and 2 ancillary staff. People that were spoken with felt that there were enough staff at the home to meet their needs. Three staff files were looked at. One file contained all the required information including satisfactory CRB (Criminal Records Bureau) checks, two written references and proof of identity. The files of the other 2 staff did not contain proof of identity. However, the manager assured us that no-one is allowed to work in the home until all the required checks are complete. Training has a high priority at the home. Records show and staff confirmed that they receive a wide variety of training, including Fire procedures, Moving and Handling, Food Hygiene, First Aid and Infection Control. Staff are also encouraged to work for NVQs (National Vocational Qualifications) and 5 staff currently have NVQ level 2 or Care Homes for Older People Page 21 of 27 Evidence: above. All staff have now received training in POVA (Protection Of Vulnerable Adults) issues and training for staff working with people with Dementia has also been provided. All new staff receive a full induction in line with Skills for Care recommendations. Staff meetings are held every two months and the manager has devised a questionnaire for staff to complete prior to the meetings so that there are always topics for discussion. Staff are paid for any training or meetings they attend when off duty. Staff were praised by people living at the home when we spoke with them and one person told us that manager and staff were always very good. 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 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 resulting in practices that promote and safeguard the health, safety and welfare of people who live and work in the home. Evidence: Yvonne Hooper, the registered manager, holds the Registered Managers Award and the National Vocational Qualification certificate in Care at level 4. She has many years experience of working in the care of older people, including several as a manager. She has also gained the National Vocational Training Assessors Award. The home is managed efficiently and she and the staff team work together well to create a homely environment for the people who live at the home. Staff that we spoke with during the visit told us that they felt supported by the manager to do a good job. One staff said via a survey form we work well as a team. Individuals or their representatives manage their own financial affairs. However, the manager holds a small amount of money for 4 people. Good records were seen for any Care Homes for Older People Page 23 of 27 Evidence: incoming money and outgoing payments. However, it would be good practice to number receipts and ensure there are 2 signatures for all transactions. The home has an annual quality assurance survey that seeks to gain the views of people living at the home, their representatives and staff. The results are made available to all interested parties and are included in the Service Users Guide. In line with Regulation 26 of The Care Standards Act 2000, the Responsible Individual (the representative of Thurlestone Court Ltd) carries out monthly quality audits covering all aspects of the provision of the service, to ensure that standards are maintained. The home has achieved the Investors In People award for the second time against the new standards. Regular meetings are held with people who live at the home and staff, and minutes were displayed. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that Thurlestone Court complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. Policies and procedures are not always inspected during the visit but the information provided on the AQAA helps us form a judgement as to whether the home has the correct policies to keep people living and working at the home safe. Information provided by the home, evidenced that policies and procedures are in place and along with risk assessments are reviewed regularly and updated where necessary, to ensure they remain appropriate and reduce risks to people living and working at the home. So that the risk of burning from hot surfaces is minimised, radiators within the home have been covered. Restrictors are fitted to windows above ground floor level to minimise the risk of anyone falling from these windows. These restrictors are about to be changed to further minimise any risk. An Alligator water system was put in place in 2004/5 and allows water to be stored at 43 degrees centrigrade (or higher). The system has an ongoing cleaning system that ensures legionella is not present. The Responsible Individual for the home told us that they have arranged to have thermostatic control valves fitted to all taps so that the overall temperature of the water can be increased. This is so that the 2 bedrooms which were not getting water at the correct temperature now do so. 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 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 16 You are recommended to record any complaints separately, so that individuals cannot see information recorded about others, if looking at information about themselves. You are recommended to ensure all receipts are numbered and all transactions are double signed, in relation to individuals monies. 2 35 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or 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 © (2010) 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!