Care Home: Uplands Nursing Home

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What the care home does well Care services, which focus on meeting individual resident`s particular needs are provided in a comfortable homely environment. The maintenance of of records related to the planning of care and daily reporting are of good standard. The home is actively, and effectively lead, by a manager who is constantly seeking to the quality of life for those resident at the home. People told us: `The matron and her staff are very aware of their residents different needs. They make them feel wanted, cared for.` `The matron and her staff are very aware of the resident`s different needs.` `I am included in the decision making process. My concerns are taken seriously and my questions are answered patiently.` `The home is outstanding in its care of patients, which is sensitive. Each person is treated as an individual and their needs considered when they are spoken to.` `I can only speak in regard to the ways in which my wife`s needs are met, with which I am perfectly satisfied.` What has improved since the last inspection? The home has worked well in effectively addressing all six requirements made at that time. These related to care planning documentation, training for staff in respect of protection of vulnerable adult procedures, staff recruitment processes and ensuring staff attend twice yearly fire prevention training. Progress has also been made in respect of refurbishing the environment so as to make the home physically a nicer place to be. What the care home could do better: Whilst it is noted progress has been made in improving the resident`s environment there remain areas which need attention, particularly in respect of: - improving the range and quality of social and leisure activities - establishing written programme to ensure continuing improvements to the environment Inspecting for better lives Key inspection report Care homes for older people Name: Address: Uplands Nursing Home 43 Upland Road Selly Park Birmingham B29 7JS     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: Keith Salmon     Date: 0 9 1 2 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 26 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 26 Information about the care home Name of care home: Address: Uplands Nursing Home 43 Upland Road Selly Park Birmingham B29 7JS 01214713816 01214155519 uplands43@tiscali.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Jayantilal James Bhikhabhai Patel Name of registered manager (if applicable) Mrs Norrian Jane Pritchard 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: The maximum number of service users to be accommodated is 27. The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admission to the home are within the following categories: - Old age not falling within any other category (OP 27). - Dementia, over the age of 65 (DE (E) 27) Date of last inspection Brief description of the care home Uplands Nursing home is a three storey traditional detached residence that offers care and accommodation for up to 27 people some of whom may have dementia. The home is situated approximately three miles from Birmingham City Centre with easy access to shops and public transport. Accommodation is provided on the first and second floor, and the third floor is used for administration purposes. The home offers mainly single Care Homes for Older People Page 4 of 26 care home 27 Over 65 27 27 0 0 Brief description of the care home bedrooms, six of which have en-suite facilities, and six double rooms. Communal rooms comprise two lounges and a dining room; corridors are spacious and have handrails to enable people to move freely around the home. Mobility aids they may require are available. Upper floors are accessible via a passenger lift. Ancillary services are situated in the basement area of the home. There is adequate parking to the front and side of the building and the home has a well-maintained garden to the rear of the property. The current scale of charges for the home are not included in the service user guide but can be obtained directly from the home. Additional charges include hairdressing, chiropody, and dry cleaning. 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: 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 inspection visit to the home was undertaken by one inspector, commenced at 9.30 pm and was completed at 4.45 pm. The home did not know that we were visiting on that day. The Registered Manager assisted us throughout. Unannounced Key Inspections address all essential aspects of operating a care home and seek to establish evidence, which shows continued safety and positive outcomes for residents. This process considers the care homes capacity to meet regulatory requirements, minimum standards of practice, seeks the views of residents and visitors to the home, and focuses on aspects of service provisions that need further development. Relevant information is gathered from a number of sources. These include: Care Homes for Older People Page 6 of 26 * Observations made during a tour of the Home * Case tracking a small number of residents - this involves discovering their experiences i.e. the outcomes, of people living at the home, by meeting or observing them, looking at medication and care files, and reviewing areas of the home relevant to them *We talked with five people who live at the home, three relatives and two staff. * Review of staff files and duty rotas, plus a range of other documents/records reflecting the general operation of the home * Review of the homes own Annual Quality Assurance Assessment (AQAA). This was completed by the manager and submitted to us prior to the inspection. The content includes information about the people who live there, staff, information relating to the Homes policies, procedures, achievements, and plans for improvement * Regulation 37 reports about accidents and incidents in the home were reviewed in the planning of this visit. *Questionnaires were sent out by CSCI to residents at the home, relatives and health care professionals who visit the home, in order to gain peoples views about the service - all these people were randomly selected. Four relatives returned questionnaires. These contained positive comments, about the service provided, and which are included within this report. It was not possible to gain direct feedback from a number of people living at the home due to their dementia. No immediate requirements were made at the time of this visit. 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 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. People have sufficient information about the home to enable them to make an informed decision about whether they would like to live there. Evidence: The home has a comprehensive statement of purpose and service user guide, which have both been updated in July 2007 to ensure they provide current information about the home and the services provided. The service user guide does not include details of fee rates and it is recommended that this information is included so that people have all the information about the home. In addition to this the home has a brochure, and each room has a Welcome booklet, which provides basic information about the home. These documents are not currently available in alternative formats, but the manager has identified this as an area to improve during the coming months. Only one page of the certificate of registration is displayed,and this was brought to the attention of the manager, as both pages should be displayed so that people can see conditions of Care Homes for Older People Page 10 of 26 Evidence: registration. A copy of the previous inspection report is displayed so that people have access to this information. Comprehensive pre admission assessments are undertaken prior to people coming to live at the home. Evidence for this was seen in documentation of five residents who we case tracked. All had fully completed preadmission assessment sheets, the information from which was used as the basis for development of the care plan. People or their relatives are able to visit the home before admission so that they can sample what it would be like to live there. Prospective residents all receive a letter advising them and/or their relatives that their care needs can be met by the home. 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. Residents can be confident their assessed care needs will be effectively met with their privacy and dignity being respected. Residents can also be confident the process of administering medicines will be completed in a safe manner. Evidence: Since the previous key inspection the care plan used by the home has undergone review and revision. The documentation, which shows evidence of direct input by residents or their relatives, now presents a comprehensive approach incorporating detailed reference to residents assessed care needs, and individual lifestyle preferences. Specifically the documentation presents a comprehensive approach incorporating; recent photograph of the resident; preadmission information; full post admission assessment; a care plan which includes risk assessment and evaluation documents e.g. mobility, bed rails use, skin integrity,continence, nutritional state and weight; monthly observations of weight, blood pressure, pulse and urine and a record of attendance by visiting clinical professionals e.g. chiropodist, optician. The 24-hour information records viewed showed relevant and informative entries. Evidence was Care Homes for Older People Page 12 of 26 Evidence: seen of input to care plan development by the resident and/or relative and of review by the manager on at least a monthly basis and agreement with relative(s) regarding urgent contact should it be necessary. Two recommendations made at the previous inspection i.e. the need to improve the level of detail in care plans, and particularly to include reference to each residents preference in respect of bathing, are considered met. We saw that staff knocked bedroom and bathroom doors before entry; privacy screens in wet room showers, and in shared bedrooms were used appropriately. These observations, backed by discussions with residents and relatives, suggested residents privacy and dignity is respected at all times. We undertook a full review of the homes practices in respect of the management of medicines. We found these practices to be in accordance with accepted good practice. Examples illustrating this were meticulous record keeping in respect of administration of medicines, review of each residents prescribed medicines, by the General Practitioner, every 10 weeks, audit of medicines administration by manager at least three monthly, - Full review of the homes practices in respect of the ordering, reception, disposal and record keeping relating to medicines administration The above findings led us to conclude recommendations relating to medicines administration are met. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Those residents who are able, choose their lifestyle, social activity, and pursue religious preferences, as they wish. Those who are not able to do so are supported by programmed care which helps them reach their potential. Opportunities for contact with family, friends, and the wider community, are established and encouraged. Evidence: As the home does not currently have a dedicated activities coordinator, leadership in this area of care activity is provided directly by the manager with care staff assisting in the organisation of activities. However the manager told us of plans to establish a dedicated post to lead and plan social and leisure activities. It is recommended that plans for a dedicated activities coordinator be achieved as soon as possible. Residents have personal social and leisure activities preferences noted on admission, so the home can provide activities which are meaningful to them as individuals. Examples of activities, some of which residents confirmed they had requested through the residents meeting are; fortnightly film shows, singalongs, craft activities e.g. card making, and painting, bingo, card games, and gardening. Activities away from the home include shopping, visits to local pubs, Cadbury World,and to Birmingham Botanical Gardens. One resident told us, There are now more activities of the kind I Care Homes for Older People Page 14 of 26 Evidence: like. A visitor reads the daily paper for a group of residents interested in taking part, and includes discussion of current issues. External entertainers provide activities and these include progressive mobility. Since the previous inspection there have been improvements to the garden area so that it is more accessible for all residents. This work has included the making of raised beds so as to enable wheelchair bound residents to pursue gardening activities. The hairdresser visits the home on a regular basis. Ministers of various religions, also visit regularly, so meeting residents spiritual needs. Visiting times are flexible enabling residents to maintain contact with friends and relatives at times that suit them and the residents. Also, visitors may stay for meals with residents. Residents said they were able to make choices and spend their time as they wished e.g. they could get up and go to bed when they wished, and could spend time in their own rooms or in communal areas. Residents bring personal items of furnishings and possessions into the home to reflect their personal taste and interest. The home has a four weekly rolling menu and can cater for dietary, religious needs, and individual preferences. Although the lunch menu does not provide a choice, one resident told us If I dont like what is on the menu I can have something different. The dining area is spacious with nicely presented tables. The lunchtime meal observed seemed satisfactory, with residents telling us they liked the food, including comments such as; Lunch was excellent, as it always is; I eat in my room and the food is always nicely presented and hot. Staff were observed to assist people who required help, whilst promoting their dignity. There is an open visiting policy so that people can see their visitors as they choose. All relatives interviewed confirmed they were made welcome at the home, with one person saying, I am always made welcome, cup of tea, feel like part of the place.; another visitor commented My frequent visits are met with genuine friendliness. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their relatives can be confident their views are listened to and acted upon, and that residents are safe and protected from abuse. Evidence: The complaints procedure is contained within the service user guide, and there is a copy in each residents bedroom. However, we noted no information regarding the procedure was available in the public areas. It was suggested to the manager, that visitors to the home, should have access to the policy and procedure should they wish to make a complaint. It was agreed to place this information on some of the homes notice boards. overall though we felt the home has a well-organised, well documented system for receiving and responding to complaints including a niggles book. In this book relatives and residents are able to make comments or suggestions which are not, in their view, a complaint. Residents and visitors told us they knew who to raise any concerns or complaints with (i.e. the manager or nurse in charge) and that they were confident issues raised would receive thorough and effective attention. Review of the accidents/incidents book showed them to be up to date, and containing nothing to cause us concern. Policies and procedures relating to the safeguarding adults are in place, and up to date. The content of these policies was familiar to staff who were able to confirm they had received necessary training, and were able to describe action they should take if they received a complaint, or observed abuse of a resident. Care Homes for Older People Page 16 of 26 Evidence: Comments from four returned relatives questionnaires which support the view that the home manages this area of care well included; ...never had any need for concern... (about the safety of my relative).; ...clear information is provided... (about how to complain).; The matron and her staff have always listened to my concerns as circumstances have arisen, with positive cooperation. A requirement made at the previous inspection in respect of the homes policy, and staff training as regards adult protection is considered met. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although some parts of the home are in need of redecoration/refurbishment the environment in which residents live is generally pleasant, safe, and clean, with satisfactory standards of hygiene. The home provides equipment consistent with providing necessary care. Evidence: A tour of the home, which included all communal rooms and corridors, laundry, kitchen, all toilets and bathrooms, and a random selection of bedrooms, showed the home provides residents with a comfortable and safe environment. Since the previous inspection improvements to the environment have been made which reflect positive action being taken by the new owner and new manager. Although many areas are yet to be addressed and remain rather tired, a redecoration programme to revamp the whole building is planned. The commencement of this is seen in the recent redecoration of the dining room, and new curtains and carpets throughout the first floor. The beginning of overall improvement to the environment is reflected in comment to us, by a relative who has visited the home for some years, who said The appearance of the home has very much improved. Prior to the new manager, and new owner, it was very dowdy everywhere, it is now much brighter. It is noted the home is at the beginning stages of an ongoing environment improvement programme, within which initial progress has been made. There is good access throughout the home for Care Homes for Older People Page 18 of 26 Evidence: wheelchair users, with access to the first floor by passenger lift. Also the home has good provision of specialist equipment, consistent with meeting the assessed care needs of service users, and the demands of tasks carried out by Care Staff. Records demonstrated maintenance and servicing of care related equipment, e.g. passenger lift, hoists, wheelchairs, call bells, is regularly undertaken. The laundry is well run by dedicated laundry staff. Clothes are labelled for each resident, thus ensuring laundered items are returned to the rightful owner. This was reflected in residents being dressed in well-fitted, clean clothes. We found the home to be clean and hygienic - a view supported by comments from a visitor who said The home is always clean and smells fresh. Inspection of the records of hot water testing, showed water temperatures at outlets accessible to residents, to be satisfactory, that is of a temperature which is comfortable for residents use, but which will not scald. Recommendations made at the previous inspection in respect of overall provision of bathing facilities, provision of bedroom door locking for residents who required it, and the provision of privacy curtains in shared rooms have been addressed, or are in process of being addressed. 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. Residents can be confident staff numbers on duty, and the mix of trained nurses and care staff, are sufficient to provide good quality care to meet their assessed care needs, and that recruitment and employment practices are consistent with safeguarding them from abuse. The commitment of the home in providing training for care staff is good, and in accordance with individual staff members learning needs. Evidence: Staff numbers, skill-mix and deployment at the time of the Inspection, demonstrated staffing to be sufficient to meet the assessed care needs of current residents. Furthermore, the Manager is usually supernumerary and there is good support from, kitchen staff, domestic staff and the full-time maintenance man. A review of files demonstrated recruitment practices to be satisfactory. Staff described the robust recruitment process they had gone through prior to appointment, and commencing work at the home. All said they enjoyed working at the home and were able to give a detailed account of their initial orientation/induction and subsequent training. At the time of inspection 85 of care staff had attained National Vocational Qualification (NVQ) at least at level 2. Staff benefit from ongoing and regular supervision by the manager. The training programme is very supportive in enabling staff to successfully complete training, thus enabling them to give safe and appropriate Care Homes for Older People Page 20 of 26 Evidence: care to residents. 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 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 effective management, which ensures the focus of care provision is in meeting residents care needs, and realisation of their aspirations wherever possible. Residents and their relatives can be confident their views on the provision of service quality will be sought and, where possible, acted upon. Residents, visitors to the home, and staff, can be confident they are entering a clean and safe environment. Evidence: The manager has many years experience of working as a senior nurse at the home, since May 2007 as manager/matron, and is currently working toward the Registered Managers Award. Almost two years on from initial appointment she is now well established and, well supported by the owner, leads a team providing a good quality of care for residents. There is strong focus on equality and diversity issues, which is reflected in our observations and findings during the inspection. This is particularly so Care Homes for Older People Page 22 of 26 Evidence: in comments made directly to us, by residents, visitors and staff, which, without exception, portrayed a picture of much improved quality of care at the home over the past year or so. Further support for this view is seen in completed questionnaires returned to CSCI. These included comments including; There have been improvements all the time. and Uplands has always had a good reputation but was in need of a make-over and it is happening monthly. My frequent visits are met with genuine friendliness. The home does not handle personal monies. However, should costs be incurred e.g. hairdressing, newspapers, these instances will be dealt with by means of direct billing to relatives or representatives of the resident. Changes, since the previous inspection, in care practices,record keeping, and attention to the environment, all present a picture of thorough, thoughtful, and effective management. Systems are in place to protect the health, safety and welfare of people using the service. Accidents are reported appropriately and there are risk assessments in place to ensure safe working practices. 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 1 12 It is recommended that plans to improve the range and quality of social and leisure activities, by the introduction of an activities coordinator post, be achieved as soon as possible. It is recommended a written refurbishment and redecoration programme, with target dates, is introduced to help ensure priorities for improvement are identified together with timely completion. 2 19 Care Homes for Older People Page 25 of 26 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. 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