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768.28 Tm (Information about the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 20.58 w 31.2 746.8 m 274.61 746.8 l S 0.001 w 1 1 1 RG 20.58 w 276.86 746.8 m 580.25 746.8 l S 0.001 w 0.95294 0.95294 0.95294 RG 73.32 w 31.2 697.6 m 274.61 697.6 l S 0.001 w 1 1 1 RG 73.32 w 276.86 697.6 m 580.25 697.6 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 648.4 m 274.61 648.4 l S 0.001 w 1 1 1 RG 20.58 w 276.86 648.4 m 580.25 648.4 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 625.57 m 274.61 625.57 l S 0.001 w 1 1 1 RG 20.58 w 276.86 625.57 m 580.25 625.57 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 602.74 m 274.61 602.74 l S 0.001 w 1 1 1 RG 20.58 w 276.86 602.74 m 580.25 602.74 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 579.91 m 274.61 579.91 l S 0.001 w 1 1 1 RG 20.58 w 276.86 579.91 m 580.25 579.91 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 758.22 m 582.46 758.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 735.39 m 582.46 735.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 659.82 m 582.46 659.82 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 636.98 m 582.46 636.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 614.16 m 582.46 614.16 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.33 m 582.46 591.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 568.49 m 582.46 568.49 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 759.29 m 30.07 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 275.73 759.29 m 275.73 567.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 759.29 m 581.38 567.42 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 742.03 Tm (Name of care home:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 742.03 Tm (Gillibrand Hall Nursing Home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 719.2 Tm (Address:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 719.2 Tm (Folly Wood Drive )Tj ET /F1 12 Tf BT 1 0 0 1 279.71 701.62 Tm (Chorley)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 684.04 Tm (Lancashire)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 666.46 Tm (PR7 2FW)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 643.63 Tm (Telephone number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 643.63 Tm (01257270586)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 620.8 Tm (Fax number:)Tj ET /F1 12 Tf BT 1 0 0 1 279.71 620.8 Tm (01257232989)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 597.97 Tm (Email address:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 575.14 Tm (Provider web address:)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 539.2 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 519.71 m 353.25 519.71 l S 0.001 w 1 1 1 RG 20.58 w 355.5 519.71 m 565.9 519.71 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 451.21 m 353.25 451.21 l S 0.001 w 1 1 1 RG 20.58 w 355.5 451.21 m 565.9 451.21 l S 0.001 w 0.95294 0.95294 0.95294 RG 20.58 w 31.2 428.39 m 353.25 428.39 l S 0.001 w 1 1 1 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provider\(s\):)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 514.93 Tm (Century Healthcare Limited)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 492.11 Tm (Name of registered manager \(if applicable\))Tj ET /F1 12 Tf BT 1 0 0 1 34.05 469.27 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 446.45 Tm (Type of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 446.45 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 423.61 Tm (Number of places registered:)Tj ET /F1 12 Tf BT 1 0 0 1 358.35 423.61 Tm (50)Tj ET /F1 10 Tf BT 1 0 0 1 28.35 404.67 Tm ()Tj ET 0.95294 0.95294 0.95294 RG 66.24 w 32.32 361.23 m 564.47 361.23 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 373.77 m 567.8 373.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 350.93 m 567.8 350.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 396.6 m 567.8 396.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 373.77 m 567.8 373.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 297.24 350.93 m 567.8 350.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 328.11 m 567.8 328.11 l S 0.001 w [] 0 d [] 0 d 2.25 w 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(50)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 248.3 Tm (physical disability)Tj ET /F1 12 Tf BT 1 0 0 1 302.35 248.3 Tm (50)Tj ET /F1 12 Tf BT 1 0 0 1 434.35 248.3 Tm (0)Tj ET 0.95294 0.95294 0.95294 RG 101.73 w 32.32 168.17 m 564.77 168.17 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 198.46 m 567.8 198.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 221.29 m 567.8 221.29 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 198.46 m 568.1 198.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 117.31 m 568.1 117.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 222.36 m 30.07 116.23 l S 0.001 w [] 0 d [] 0 d 2.25 w 566.72 222.36 m 566.72 116.23 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 205.1 Tm (Conditions of registration:)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 182.27 Tm (The registered person may provide the following category of service only: Care home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 167.69 Tm (with nursing - Code N. To service users of the following gender: Either. Whose primary )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 153.11 Tm (care needs on admission to the home are within the following categories: Old age, not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 138.53 Tm (falling within any other category - Code OP. Dementia - Code DE. Physical disability - )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 123.95 Tm (Code PD. The maximum number of service users who can be accommodated is: 50.)Tj ET 0.95294 0.95294 0.95294 RG 20.58 w 31.2 102.51 m 315.25 102.51 l S 0.001 w 1 1 1 RG 20.58 w 317.5 102.51 m 346.55 102.51 l S 0.001 w 20.58 w 348.8 102.51 m 377.9 102.51 l S 0.001 w 20.58 w 380.15 102.51 m 409.2 102.51 l S 0.001 w 20.58 w 411.45 102.51 m 440.55 102.51 l S 0.001 w 20.58 w 442.8 102.51 m 471.9 102.51 l S 0.001 w 20.58 w 474.15 102.51 m 503.2 102.51 l S 0.001 w 20.58 w 505.45 102.51 m 534.55 102.51 l S 0.001 w 20.58 w 536.8 102.51 m 565.9 102.51 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 113.93 m 568.1 113.93 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 91.1 m 568.1 91.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 115.01 m 30.07 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 316.37 115.01 m 316.37 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 347.67 115.01 m 347.67 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 379.02 115.01 m 379.02 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 410.32 115.01 m 410.32 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 441.67 115.01 m 441.67 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 473.02 115.01 m 473.02 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 504.32 115.01 m 504.32 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 535.67 115.01 m 535.67 90.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 115.01 m 567.02 90.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 97.75 Tm (Date of last inspection)Tj ET /F1 12 Tf BT 1 0 0 1 328.2 97.75 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 359.53 97.75 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 390.86 97.75 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 422.18 97.75 Tm (6)Tj ET /F1 12 Tf BT 1 0 0 1 453.53 97.75 Tm (2)Tj ET /F1 12 Tf BT 1 0 0 1 484.86 97.75 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 516.18 97.75 Tm (0)Tj ET /F1 12 Tf BT 1 0 0 1 547.53 97.75 Tm (9)Tj ET endstream endobj 8 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 9 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (3)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 17 w 31.2 776.72 m 565.9 776.72 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 768.18 m 30.07 440.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 768.18 m 567.02 440.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 786.35 m 568.1 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 767.1 m 568.1 767.1 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 441.85 m 568.1 441.85 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 766.02 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.02 787.43 m 567.02 766.02 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 35.5 773.16 Tm (Brief description of the )Tj ET /F1 12 Tf BT 1 0 0 1 177.31 773.16 Tm (care home)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 753.91 Tm (Gillibrand Hall is a listed building, set in its own grounds, within a residential area close )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 736.91 Tm (to Chorley town centre. Public Transport does serve the area nearby and the home is )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 719.91 Tm (now accessible via the new Gillibrand north estate. The home provides care for up to )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 702.91 Tm (fifty residents of either sex that have nursing and/or personal care needs. At the time )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 685.91 Tm (of the site visit, forty-two people were living at the home.)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 668.91 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 35.5 651.91 Tm (Accommodation is set on two floors. Currently, the ground floor offers accommodation )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 634.91 Tm (for residents who require nursing or personal care and the first floor for residents who )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 617.91 Tm (suffer from dementia. The first floor is served by a passenger lift .)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 600.91 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 35.5 583.91 Tm (A number of rooms are equipped with en-suite facilities and both floors have enough )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 566.91 Tm (communal space. Residents have use of an enclosed courtyard, and garden areas to )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 549.91 Tm (the front of the building, both of which are furnished with appropriate garden furniture. )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 532.91 Tm (Information about the facilities and services provided can be found in the home's )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 515.91 Tm (Statement of Purpose and Service User Guide.)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 498.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 35.5 481.92 Tm (The current fees for residential accommodation at Gillibrand Hall range from 435:00 )Tj ET /F1 12 Tf BT 1 0 0 1 35.5 464.92 Tm (per week to 686:50 per week.)Tj ET /F1 12 Tf BT 1 0 0 1 35.5 447.92 Tm ()Tj ET endstream endobj 10 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 11 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (4)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 745.27 Tm (What we found:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 691.53 w 31.2 389.44 m 580.26 389.44 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 736.33 m 582.46 736.33 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 737.41 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 737.41 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 720.15 Tm (This unannounced, random inspection site visit to Gillibrand Hall Nursing Home was )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 705.57 Tm (undertaken by the lead inspector and a pharmacist inspector. The visit in total, lasted for )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 690.98 Tm (a period of just over eight hours. We spoke with the Managing Director of the company, )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 676.41 Tm (the acting manager at the home and several members of the qualified staff team. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 661.83 Tm (Discussion also took place later in the visit, with the Director of Nursing. We also looked )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 647.24 Tm (at a number of records relating to care planning, staff recruitment and medication )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 632.66 Tm (practices. At the last key inspection that took place in June 2009, these three key areas )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 618.09 Tm (were identified as requiring improvement. This random inspection visit was to establish )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 603.51 Tm (how much progress had been made.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 588.92 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 574.34 Tm (At this site visit we looked at the care records of eight people living in at the home. This )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 559.77 Tm (included some people accommodated in the dementia care unit. An individual plan of care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 545.18 Tm (is generally developed for each area of need. However we found some inconsistencies. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 530.6 Tm (Although the majority of individual care plans were detailed and clearly informed staff of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 516.03 Tm (the specific needs of that particular person and how those needs were to be met, other )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 501.45 Tm (care plans were less well developed and did not really advise staff of how to address an )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 486.86 Tm (identified need. For example, one care plan evidenced said, "All staff to be aware of the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 472.29 Tm (symptoms ***** may experience", but did not go on to say what these symptoms were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 457.7 Tm (or what staff should do if these symptoms were noted. Another individual care plan for )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 443.13 Tm (the same person said, "Everybody to be supportive and sympathetic towards ****" but )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 428.55 Tm (again gave no details of how the support and sympathy could be best offered.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 413.96 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 399.39 Tm (In respect of somebody else the social needs care plan said, "Needs encouragement to )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 384.8 Tm (join activities". There was no instruction about what activities the resident may actually )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 370.23 Tm (enjoy, what activities the resident was to be encouraged to join in with or how staff were )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 355.64 Tm (to encourage this person. This sort of detail promotes, good person centred practice and )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 341.07 Tm (gives specific guidance to staff. Without this sort of detailed information, care planning )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 326.48 Tm (remains generic and lacks a person centred focus. This can lead to an inconsistent service )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 311.9 Tm (with the social care needs and requirements of the individual being unmet.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 297.33 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 282.74 Tm (In another instance, although there appeared to be a evidence in the daily diary notes of )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 268.17 Tm (a recent, possibly recurrent health condition that could be linked to some previously )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 253.59 Tm (recorded episodes of a similar condition, there was no specific care plan in place. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 239.01 Tm (Similarly there was clear evidence from documentation completed by staff at the home )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 224.43 Tm (that at least one person suffered from auditory hallucinations. Again there was no care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 209.85 Tm (plan in place to advise staff how to respond to these episodes or how best to support this )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 195.26 Tm (particular resident during these periods.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 180.68 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 166.1 Tm (For another person, there was clear documented evidence that this person may )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 151.52 Tm (experience depressive episodes or try to harm themselves but again there was no care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 136.95 Tm (plan in place advise staff what to do if they were concerned, or what triggers may )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 122.36 Tm (suggest medical intervention was required. These are important issues that has potential )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 107.79 Tm (to seriously impact on the well being of the individual resident.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 93.21 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 78.63 Tm (Care must also be taken in the words used when writing, reviewing or amending care )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 64.04 Tm (plans. One care plan in respect of mood and emotion gave specific information about a )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 49.47 Tm (particular resident. This 'mood and emotion' care plan had been reviewed some months )Tj ET endstream endobj 12 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 13 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (5)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (later and the written review information suggested that there had been a deterioration in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (mood and emotion. However through discussion with the acting manager, it appeared )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (that any changes had been minimal. If this was the case, the review record should have )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (reflected this.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (The individual person centred approach that was been provided in the home was not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (always supported by a specific care plan. For example, for one person the family had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (written a pen picture that included information that this resident enjoyed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (mass/communion and would welcome visits from the priest from her old church. Through )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (discussion with the acting manager at the home, it was clear that the religious care needs )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (of this lady were being met as requested, but there was no actual care plan in place to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (support this good practice. Several of the care records evidenced, incorporated a social )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (care needs assessment format, however in the majority of cases this had not been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (completed. Consequently no care plan had been developed. When a social care needs )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (plan had been developed these were generally good and advised staff how the specific )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (social care needs of that person could be met. It appeared that although staff had been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (provided with documentation to ensure that assessed needs could be addressed through )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (an appropriate care plan, staff were not necessarily using the documents provided in a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (consistent way. The social, religious and cultural care needs of each individual resident do )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (matter and if not addressed, can seriously effect the quality of life for that person.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (It is important that these inconsistencies in care planning arrangements are addressed. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (The well developed care plans seen were good and provided detailed information and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (instruction for staff to follow. All care plans pertaining to each area of assessed needs or )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (requirements, should be developed to the same high standard. Where a strength or need )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (has been identified through the assessment process, whether this be associated with a )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (medical, mental health, personal care, social, religious, cultural or any other identified )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (need associated with that specific individual, a care plan should be in place so that all )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (staff have clear guidance, as to how best to meet that need.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (Generally there was evidence that care plans are reviewed on a monthly basis, so that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (the information remains current and up to date. It is important that each individual )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (element of the care plan and risk assessments are reviewed individually on a monthly )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (basis and can be evidenced as such. However of late there has been some slippage with )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (regard to the timing of reviews. This in part was a direct result of the registered )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm (manager's post becoming vacant. For the present, a temporary manager has been )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (appointed who is keen to make sure that the automatic monthly review of care plans )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (takes place as recommended. It was noted that a number of records completed by staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (had not been signed or dated or alternatively signed but not dated or dated but not )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (signed. It is important that who ever write or amends a record or care plan or risk )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (assessment takes ownership of the recording so that a clear audit trail can be made.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (It was also noted that in the early afternoon period in the dementia care unit, there were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (only two people on duty. We were told by the senior person working in that unit, that the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm (other two member of staff assigned to work in the unit were taking their break together. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (Consideration should be given to staggering staff breaks so that more than 50% of staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (assigned to the unit are actually working in that unit at any one time. This would help to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (keep people living in the unit safe, and help to make sure that assessed needs were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (being met.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (As part of the visit a pharmacist inspector looked at how medicines were being handled. )Tj ET endstream endobj 14 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 15 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (6)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 741.55 w 31.2 414.45 m 580.26 414.45 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 42.55 m 582.46 42.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 41.47 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 41.47 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (We check a sample of medicines records and stock and spoke with several members of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (staff. Overall we found medicines were not always being handled safely because staff )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (were not following the policies and procedures of the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (We found records of medicines received into home were not always complete. Two people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (that were currently on respite care had no records of the quantities of medicines that had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (been brought into the home so it was not possible to fully account for them. Medicines )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (that needed to be carried forward to a new monthly cycle were not clearly recorded and )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (one person went without two of their medicines because staff had thrown their supply )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (away. We found some medicines to be out of stock because the re ordering system was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (inefficient, this meant some people went without important medicines for several days. )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (Although we saw some improvements in the records of medicines given we continued to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (see unexplained gaps and on the day of the visit several medicines had been given that )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (morning but the records had not been properly completed. We also saw some records )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (incorrectly dated because staff had not checked them properly. Poor record keeping of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (medicines can lead to serious mistakes that can affect the health and wellbeing of people )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (who live in the home.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (We looked at the times medicines were given and found some medicines were not being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm (given at the right and best time. Medicines that should have been given before food were )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (often given after food because the medicines round had not been properly organised. One )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (current course of strong antibiotics that should have been given before food was being )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (given wrongly after food. Giving medicines at the wrong time can stop them work )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (properly and so affect people's health and wellbeing.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 410.92 Tm (We looked at how liquid medicines were handled and found some mistakes that showed )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 396.33 Tm (they were not always being given correctly. One medicine used to help a person's )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 381.76 Tm (agitation had no information about how and when it was to be used and our checks )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 367.17 Tm (showed it had been given at five times the prescribed dose on one occasion. We also )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 352.6 Tm (found the stock did not add up for the last month showing it had probably been given at )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 338.02 Tm (the wrong dose on numerous other occasions. The acting manager told us all liquid )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 323.43 Tm (medicines were thrown down the sink when they were no longer required, this is not legal )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 308.86 Tm (because all medicines should be properly disposed of by a special waste management )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 294.27 Tm (company. We checked some other liquid medicines and found they did not add up )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 279.7 Tm (showing they might have also been given at the wrong dose.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 265.11 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 250.54 Tm (We checked a further sample of boxed medicines and found some did not add up showing )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 235.96 Tm (they had sometimes been missed. One controlled drug \(a strong medicine that can be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 221.38 Tm (misused\) used for pain was given to a person two days late, which could have resulted in )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 206.79 Tm (them suffering unnecessary pain. A laxative powder used for several different people did )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 192.21 Tm (not add up showing staff had signed the records but not given it. Records of external )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 177.63 Tm (medicines such as creams and nutritional supplements were not always complete so we )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 163.05 Tm (could not be sure they were being used properly. The acting manager agreed that these )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 148.48 Tm (records were not always accurate so we discussed how improvements could be made.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 133.9 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 119.32 Tm (We checked the care plans of several people that refused their medicines on a regular )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 104.74 Tm (basis and found their mental capacity had not been properly considered. Paperwork to )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 90.15 Tm (support this was not always completed and some of the information was out of date )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 75.57 Tm (because it had not been properly reviewed. We gave some advice to the managers about )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 60.99 Tm (how to improve this because failing to consider people's mental capacity correctly can )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 46.42 Tm (result in their rights not being fully protected.)Tj ET endstream endobj 16 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 17 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (7)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 367.5 w 31.2 601.47 m 580.26 601.47 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 416.6 m 582.46 416.6 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 415.52 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 415.52 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm (We looked at how the managers made sure staff were competent and made sure )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (medicines were being handled safely. The last medicines audit \(check\) we saw was )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (carried out over six months ago even though it was expected to be done every other )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm (month. Managers told us that staff had been formally assessed as competent but the )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (paperwork to support this was not available on the day. Staff had all received some )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (medicines handling training about a year ago. Given the number of mistakes found at this )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm (visit it was evident that competency checks and medicines training need to be repeated )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (as soon as possible.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm (At the last key inspection it was noted that one recently appointed member of staff had )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (been allowed to take up their employment at the home without the required number of )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (suitable references being received. This appeared to be an over site in an otherwise )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 585.88 Tm (robust system of staff recruitment. On this occasion we looked at the staff files of the five )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 571.29 Tm (people that had been recruited to work at the home since the last key inspection in June )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 556.72 Tm (2009. All the required references and clearances had been obtained and deemed to be )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 542.14 Tm (satisfactory before the member of staff had taken up their employment at the home. This )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 527.55 Tm (helps to keep people living at the home safe and to ensure that only suitable people are )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 512.97 Tm (appointed.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 498.39 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 483.82 Tm (We also looked at staff training to establish if staff had been provided with recent health )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 469.23 Tm (and safety training. There was clear evidence that all staff are to receive planned )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 454.65 Tm (infection control training and manual handling training in February 2010 and planned food )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 440.08 Tm (hygiene training in March 2010. This important training helps to protect both residents )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 425.49 Tm (and staff.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 398.53 Tm (What the care home)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 175.95 398.53 Tm (does well:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 35.16 w 31.2 369.76 m 580.26 369.76 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 388.46 m 582.46 388.46 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 351.05 m 582.46 351.05 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 389.54 m 30.07 349.98 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 389.54 m 581.38 349.98 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 372.28 Tm (This inspection was carried out to look at specific areas of service provision and did not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 357.7 Tm (look at other areas.)Tj ET /F1 14 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 330.73 Tm (What they could do better:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 278.12 w 31.2 181.61 m 580.26 181.61 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 321.8 m 582.46 321.8 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 582.46 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 322.87 m 30.07 40.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 322.87 m 581.38 40.35 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 34.05 305.61 Tm (A care plan should be developed for each area of identified need. This would make sure )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 291.03 Tm (that staff had clear written guidance on how to meet that specific need.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 276.45 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 261.87 Tm (All care plans should be of the same high quality so that a consistent service is provided.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 247.29 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 232.71 Tm (Staff should take care to ensure that written records actually reflect the current situation )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 218.13 Tm (for that particular individual.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 203.55 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 188.97 Tm (All individual care plans and risk assessments should be reviewed on at least a monthly )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 174.39 Tm (basis to make sure that the information remains current.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 159.81 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 145.23 Tm (All records should be signed and dated by the person making the entry in order to take )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 130.65 Tm (ownership of the recording.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 116.07 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 101.49 Tm (Medicines must be given to people as prescribed because receiving medicines at the )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 86.91 Tm (wrong time, wrong dose or not at all can seriously affect a persons health and wellbeing.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 72.33 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 34.05 57.75 Tm (Records of medicines received into the home, given to people and disposed of must be )Tj ET endstream endobj 18 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 19 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (8)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 1 1 1 RG 192.54 w 31.2 688.96 m 580.26 688.96 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 28.99 786.35 m 582.46 786.35 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 591.56 m 582.46 591.56 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 787.43 m 30.07 590.48 l S 0.001 w [] 0 d [] 0 d 2.25 w 581.38 787.43 m 581.38 590.48 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 31.8 775.41 Tm (clear, accurate and complete so that all medicines can be fully accounted for.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 760.84 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 746.26 Tm (Staff competency in giving and recording medicines should be regularly assessed to help )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 731.67 Tm (make sure they have the necessary skills.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 717.09 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 702.52 Tm (Care plans and supporting paperwork should have detailed information about how when )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 687.93 Tm (required medicines should be given to people to help make sure they are used properly.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 673.35 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 658.78 Tm (Procedures and paperwork should be improved to help make sure peoples mental )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 644.2 Tm (capacity is properly considered at all times.)Tj ET /F1 12 Tf BT 1 0 0 1 31.8 629.61 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 31.8 615.03 Tm (Medicines must be disposed of safely according to the law to help prevent mishandling )Tj ET /F1 12 Tf BT 1 0 0 1 31.8 600.46 Tm (and misuse.)Tj ET /F1 12 Tf BT 1 0 0 1 28.35 575.5 Tm (If you want to know what action the person responsible for this care home)Tj ET /F1 12 Tf BT 1 0 0 1 483.55 575.5 Tm (is taking )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 559.5 Tm (following this report, you can contact them using the details set out on page 2.)Tj ET endstream endobj 20 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 22 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (9)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 529.07 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 547.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 36.25 w 29.47 752.7 m 564.97 752.7 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 773.08 m 568.3 773.08 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 753.83 m 568.3 753.83 l S 0.001 w [] 0 d [] 0 d 2.25 w 26.14 734.58 m 568.3 734.58 l S 0.001 w [] 0 d [] 0 d 2.25 w 27.22 774.15 m 27.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 423.22 754.9 m 423.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 468.22 754.9 m 468.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 495.22 754.9 m 495.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 540.22 754.9 m 540.22 733.5 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 774.15 m 567.22 733.5 l S 0.001 w [] 0 d /F1 12 Tf BT 1 0 0 1 33.75 759.89 Tm (Are there any outstanding requirements from the last inspection?)Tj ET /F1 12 Tf BT 1 0 0 1 429.75 740.64 Tm (Yes)Tj ET /F2 12 Tf BT 1 0 0 1 476.37 742.58 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 501.75 740.64 Tm (No)Tj ET /F2 12 Tf BT 1 0 0 1 548.37 742.58 Tm (5)Tj ET 0.95294 0.95294 0.95294 RG 124.56 w 32.32 615.67 m 564.97 615.67 l S 0.001 w 1 1 1 RG 20.58 w 31.2 564.8 m 91.05 564.8 l S 0.001 w 20.58 w 93.3 564.8 m 197.4 564.8 l S 0.001 w 20.58 w 199.65 564.8 m 289.45 564.8 l S 0.001 w 20.58 w 291.7 564.8 m 473.8 564.8 l S 0.001 w 20.58 w 476.05 564.8 m 566.1 564.8 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 577.3 m 30.07 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 577.3 m 567.22 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 608.77 m 568.4 608.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 576.22 m 568.3 576.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 577.3 m 92.17 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 577.3 m 198.52 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 577.3 m 290.57 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 577.3 m 474.92 552.31 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 680.2 m 568.4 680.2 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 608.77 m 568.4 608.77 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 576.22 m 568.4 576.22 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 553.39 m 568.3 553.39 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 681.28 m 30.07 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 609.85 m 92.12 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 609.85 m 198.52 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 609.85 m 290.62 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 609.85 m 475.02 575.14 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 681.28 m 567.32 575.14 l S 0.001 w [] 0 d /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 662.99 Tm (Outstanding statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 644.58 Tm (These are requirements that were set at the previous inspection, but have still not )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 629.99 Tm (been met.)Tj ET /F1 12 Tf BT 1 0 0 1 95.57 629.99 Tm ( )Tj ET /F1 12 Tf BT 1 0 0 1 104.02 629.99 Tm (They say what the registered person had to do to meet the Care Standards )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 615.41 Tm (Act 2000, )Tj ET /F1 12 Tf BT 1 0 0 1 96.58 615.41 Tm ( Regulations 2001 and the National Minimum Standards.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 597.59 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 594.59 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 594.59 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 594.59 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 594.59 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 582.45 Tm (action)Tj ET endstream endobj 23 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 24 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm (Page)Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 522.07 16.38 Tm (10)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 536.06 16.38 Tm ( of )Tj ET /F1 11 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 554.36 16.38 Tm (13)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 16 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 770.27 Tm (Requirements and recommendations from this inspection:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 754.85 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 0.95294 0.95294 0.95294 RG 108.12 w 32.32 692.47 m 564.97 692.47 l S 0.001 w 1 1 1 RG 20.58 w 31.2 649.83 m 91.05 649.83 l S 0.001 w 20.58 w 93.3 649.83 m 197.4 649.83 l S 0.001 w 20.58 w 199.65 649.83 m 289.45 649.83 l S 0.001 w 20.58 w 291.7 649.83 m 473.8 649.83 l S 0.001 w 20.58 w 476.05 649.83 m 566.1 649.83 l S 0.001 w [] 0 d 2.25 w 0.75294 0.75294 0.75294 RG 30.07 662.32 m 30.07 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.22 662.32 m 567.22 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.3 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.17 662.32 m 92.17 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 662.32 m 198.52 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.57 662.32 m 290.57 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 474.92 662.32 m 474.92 637.34 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 748.78 m 568.4 748.78 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 693.79 m 568.4 693.79 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 661.24 m 568.4 661.24 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 638.41 m 568.3 638.41 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 749.86 m 30.07 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 694.87 m 92.12 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 694.87 m 198.52 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 694.87 m 290.62 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 694.87 m 475.02 660.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 749.86 m 567.32 660.17 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 34.05 732.6 Tm (Immediate requirements:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 715.02 Tm (These are immediate requirements that were set on the day we visited this care home. )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 700.44 Tm (The registered person had to meet these within 48 hours.)Tj ET /F1 10 Tf BT 1 0 0 1 31.2 682.62 Tm (No.)Tj ET /F1 10 Tf BT 1 0 0 1 96.1 679.62 Tm (Standard)Tj ET /F1 10 Tf BT 1 0 0 1 202.5 679.62 Tm (Regulation)Tj ET /F1 10 Tf BT 1 0 0 1 294.6 679.62 Tm (Requirement)Tj ET /F1 10 Tf BT 1 0 0 1 479 679.62 Tm (Timescale for )Tj ET /F1 10 Tf BT 1 0 0 1 479 667.47 Tm (action)Tj ET 0.95294 0.95294 0.95294 RG 556.24 w 32.32 321.8 m 564.97 321.8 l S 0.001 w 1 1 1 RG 140.22 w 31.2 429.39 m 91.05 429.39 l S 0.001 w 140.22 w 93.3 429.39 m 197.4 429.39 l S 0.001 w 140.22 w 199.65 429.39 m 289.45 429.39 l S 0.001 w 140.22 w 291.7 429.39 m 473.8 429.39 l S 0.001 w 140.22 w 476.05 429.39 m 566.1 429.39 l S 0.001 w 140.22 w 31.2 286.92 m 91.05 286.92 l S 0.001 w 140.22 w 93.3 286.92 m 197.4 286.92 l S 0.001 w 140.22 w 199.65 286.92 m 289.45 286.92 l S 0.001 w 140.22 w 291.7 286.92 m 473.8 286.92 l S 0.001 w 140.22 w 476.05 286.92 m 566.1 286.92 l S 0.001 w 96.48 w 31.2 166.32 m 91.05 166.32 l S 0.001 w 96.48 w 93.3 166.32 m 197.4 166.32 l S 0.001 w 96.48 w 199.65 166.32 m 289.45 166.32 l S 0.001 w 96.48 w 291.7 166.32 m 473.8 166.32 l S 0.001 w 96.48 w 476.05 166.32 m 566.1 166.32 l S 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2.25 w 28.99 533.17 m 568.4 533.17 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 500.63 m 568.4 500.63 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 358.15 m 568.3 358.15 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 215.68 m 568.3 215.68 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 116.96 m 568.3 116.96 l S 0.001 w [] 0 d [] 0 d 2.25 w 28.99 41.42 m 568.3 41.42 l S 0.001 w [] 0 d [] 0 d 2.25 w 30.07 603.24 m 30.07 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 92.12 534.25 m 92.12 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 198.52 534.25 m 198.52 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 290.62 534.25 m 290.62 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 475.02 534.25 m 475.02 499.55 l S 0.001 w [] 0 d [] 0 d 2.25 w 567.32 603.24 m 567.32 499.55 l S 0.001 w [] 0 d /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 588.98 Tm (Statutory requirements)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 34.05 568.98 Tm (These requirements set out what the registered person must do to meet the Care )Tj ET /F1 12 Tf BT 1 0 0 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1 202.5 660.36 Tm (All records should be signed and dated by the person )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 645.78 Tm (making the entry in order to take ownership of the )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 631.21 Tm (recording.)Tj ET /F1 12 Tf BT 1 0 0 1 34.05 608.38 Tm (8)Tj ET /F1 12 Tf BT 1 0 0 1 96.15 608.38 Tm (18)Tj ET /F1 12 Tf BT 1 0 0 1 202.5 608.38 Tm (Consideration should be given to staggering breaks so that )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 593.79 Tm (more than 50% of the staff assigned, are actually working )Tj ET /F1 12 Tf BT 1 0 0 1 202.5 579.22 Tm (in the dementia care unit at any one time. )Tj ET endstream endobj 30 0 obj<>/ProcSet [/PDF /Text /ImageB /ImageC /ImageI]>>/MediaBox[0 0 612 792]>> endobj 31 0 obj <>stream 0 J 0.75294 0.75294 0.75294 RG 19.36 w 28.35 20.75 m 583.65 20.75 l S 0.001 w /F1 11 Tf 0 0 0 rg BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 16.38 Tm (Care Homes for Older People)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 11 Tf BT 1 0 0 1 491.55 16.38 Tm 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Tel: 0870 600 5522. Online ordering from )Tj ET /F1 12 Tf BT 1 0 0 1 34.05 547.53 Tm (the Stationery Office is also available: www.tso.co.uk/bookshop)Tj ET /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 526.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 509.36 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 494.79 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 480.2 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr 34.16 w 25.8 460.61 m 563.3 460.61 l S 0.001 w /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 31.2 455.08 Tm (Helpline:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 420.92 Tm (Telephone:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 147.95 420.92 Tm (03000 616161)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 389.27 Tm (Email:)Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 99.55 389.27 Tm (enquiries@cqc.org.uk)Tj ET /F1 20 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 357.61 Tm (Web: )Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 20 Tf BT 1 0 0 1 88.63 357.61 Tm (www.cqc.org.uk)Tj ET /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 327.95 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 18 Tf BT 0 0 0 RG 0.5 w 2 Tr 1 0 0 1 28.35 299.21 Tm ()Tj ET 0.75294 0.75294 0.75294 RG 0.001 w 0 Tr /F1 12 Tf BT 1 0 0 1 28.35 276.5 Tm (We want people to be able to access this information. If you would like a summary in a )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 259 Tm (different format or language please contact our helpline or go to our website.)Tj ET /F1 18 Tf BT 1 0 0 1 28.35 232.98 Tm ()Tj ET /F1 12 Tf BT 1 0 0 1 28.35 210.26 Tm (Copyright \(2009\) Care Quality Commission \(CQC\). This publication may be reproduced )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 192.76 Tm (in whole or in part, free of charge, in any format or medium provided that it is not used for )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 175.27 Tm (commercial gain. This consent is subject to the material being reproduced accurately and )Tj ET /F1 12 Tf BT 1 0 0 1 28.35 157.77 Tm (on proviso that it is not used in a derogatory manner or misleading context. 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