CARE HOME ADULTS 18-65
1 Church Road Wembdon Bridgwater Somerset TA6 7RQ Lead Inspector
Pippa Greed Unannounced Inspection 23rd November 2006 10:00 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 1 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 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service 1 Church Road Address Wembdon Bridgwater Somerset TA6 7RQ 01278 453635 01278 456656 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Paragon Health Care Group Mr James Reginald Marchant Care Home 13 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: No 1 Church Road is a large extended house providing a high standard of accommodation. The home is situated in a quiet residential area on the outskirts of Bridgwater. The property is surrounded by landscaped gardens. The home can accommodate up to thirteen people with learning disability and/or additional physical impairments. All service users have their own bedroom with en-suite facilities. The home is sufficiently spacious to allow the people who live here to be alone or mix with others according to their needs. The manager, James Marchant, and a small staff team provide support. The people living here are supported to access a wide range of recreational activities within the home and the wider community. Contact with friends and families is promoted and supported according to individual needs and wishes. The current scale of charges is £1,025 to £2,097 per week. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The previous inspection was unannounced and took place on 15th February 2006. At that inspection two requirements and five recommendations were made. Those requirements have been met. This unannounced Key inspection was conducted over one day (7hrs), on 23rd November 2006 by CSCI Regulation Inspector Pippa Greed. On the morning of the inspection four support workers, one senior support worker and the manager were on duty. During the afternoon there were six support workers including the deputy. The registered manager James Marchant assisted the inspector during the unannounced visit. On the day of the inspection thirteen service users were at home. The atmosphere was relaxed and informal. Staff were seen to work professionally and demonstrated good rapport with the service users. The inspector spoke with two service users, engaged with two service users and observed service user’s care. The inspector also spoke with three staff. The inspection also involved examination of records, general observation and a tour of the premises. Five service users surveys and three care staff comment cards were received. Four surveys were on completed on service user’s behalf and confirmed that their families were provided with enough information prior to moving into the home. Staff comment cards confirmed that they are clear in their role. Two of which has attained National Vocation Qualification (NVQ). One service user wrote ‘I enjoy living in this home’. One GP, one social worker and two relatives comment cards were received. The GP wrote ‘Always seems very caring’. The social worker commented positively about the home and advocated for the family of service user. The social worker stated ‘I found the home to be welcoming and helpful. I would be happy to recommend this home’. Two relatives comment cards were generally positive and both stated that they have access to an inspection report on the home. A relative wrote ‘Very caring staff, always helpful’. The inspector would like to thank service users, staff and manager for their time and hospitality shown to the inspector during her visit. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better:
One requirement and six recommendations were raised at this inspection. It is required that all staff are provided with mandatory training updates. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 7 The recommendations are as follows: The Behaviour Management Guidelines should be dated and reviewed at an appropriate frequency in relation to the service user’s needs. Service user’s finance records would benefit from two staff signatures in order to provide a clearer audit trail. Liquid medications should be labelled to demonstrate dates when opened and when to dispose by. Returned medication should include reasons for disposal within the returns log. Staff should be provided with formal one to one supervision at least six times a year as outlined in the National Minimum Standards for Care Homes for Adults (18-65). Service users risk assessment should be reviewed and updated to reflect the service users changing needs. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users and their families are provided with relevant information regarding the home. Social and health assessments are completed to ensure that the home is able to meet service users’ needs. EVIDENCE: The home has a Statement of Purpose that provides details of the services and facilities provided at 1 Church Road. The service users contract is stored at head office. It is good practice to include a copy in the service user’s care plan. The Service Users Guide is provided in a simple easy to understand format. It is written using Picture Bank images for ease of understanding. The Service User’s Guide covers the following: What Church Road can offer you, Your rights, How much it costs?, What to do if you don’t like something?, What other service users want to happen at Church Road and Where to find copy of CSCI report and contract. The Service User’s Guide is presently stored in their care plan. There is no vacancy at present.
1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are supported to make decisions about their life through clear communication systems. The home has developed an appropriate care plan for each service user. Service users are encouraged to exercise choice and participate in all aspects of life within the home. Service users are supported in taking risks. Records relating to service users are stored securely and appropriately maintained. EVIDENCE: Care plans are maintained for each service user. Four care plans were examined in detail. Care plans seen included a photograph of the service user,
1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 11 and provided information regarding service users needs. This included general health (dental, optical, chiropody), medication, diet, self-help skills, daily living skills, activities, communication, social and behaviour. The care plan also included specific risk assessments. However some of these will need updating. The care plan also included manual handling assessments, which were up to date. The manager informed the inspector how two service users health care needs were catered for by the home. Documentations relating to these were seen. One service user wore arm splints since childhood to prevent picking her eczema. The home has gradually introduced gloves and removed the splint in order to retrain service user’s habit. The progress made appears to be positive. Another service user who has severe epilepsy had an operation in June to have a nerve stimulator implanted into the brain in order to help regulate brain activity and reduce seizures. The home is optimistic that this will help reduce seizures and medication intake thus increasing his quality of life. This demonstrates that the home strives to enhance service users wellbeing. This is positive outcome. Service users were observed participating in tasks within the home, and they were consulted and enabled to make choices. Staff have a good understanding of service users’ needs and respond to choices that are expressed through verbal and non-verbal communication. The home operates a Key worker system to ensure that the home continues to meet the needs of each service user. Staff will support service users in managing their finances where required. Financial records were examined for three service users. The money was checked and the final balance was correct. However, it is recommended that two staff signature support all entries in order to provide a clearer audit trail. Records are stored in a confidential manner. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The home supports the service user with personal development. The home offers service users opportunities to engage with peers, access appropriate leisure activities, and exercise choice. Service users are supported with friendship and family contact. Service users rights and responsibilities are respected. Service users are offered a choice of menu, and the options are developed around their preferences and dietary needs. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 13 EVIDENCE: The high level of staffing at the home provides service users with the opportunity to participate in a range of activities. These include: music, trampoline, massage, ‘atmospherics’, hydrotherapy, physiotherapy, horse riding, horse & cart, bread making, arts and crafts, bowling and college. On the day of the inspection, service users attended hydrotherapy session during the morning. Service users participated in a cookery session during the afternoon. There is a small sensory room provided in the home. A music therapist visits the home each week. The home has use of minibus in order to access local facilities. Service users enjoy social events jointly arranged by Voyage homes such as the ‘Funky Social’. One service user has been supported in purchasing their own exercise machine, which promotes healthy living and exercise. The manager informed the inspector that a service user was supported with one to one staffing on a holiday trip to Scotland during the autumn. A group of service users enjoyed a holiday break to Cornwall during the summer. Staffs support service users in maintaining contact with friends and family members, be it home visits or regular phone calls. The menus appear to provide a variety of foods that are nutritious and appetising. The meal on the day was beef stew and dumplings followed by jam roly-poly and custard. The staff team offer service user choices in all aspects of food and drink and are very aware of the likes and dislikes of the service users. The Inspector noted the meal was freshly prepared and appeared appetising. The home has a very pleasant dining room that appears very comfortable to eat in. The fridge and freezer were in good working order and daily temperature recorded. Food probe records were also regularly maintained. Cleaning schedules were seen. All of which were completed appropriately. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. The home also provides appropriate aids and equipments. The home has a medication policy. Medication Administration Records are managed safely. EVIDENCE: Service users are provided with support to undertake personal care tasks as required. Many service users have complex health care needs. Staff supports service users in accessing healthcare services and ensure that specialist advice is sought as necessary. Care and support plans demonstrated regular support from hospital consultants as well as GP or community nursing support. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 15 A record is maintained in care and support plans of healthcare appointments and outcomes. Staff are provided with medication training. Currently medication is stored securely. No current service users are able to self-medicate. The inspector sampled the Medication Administration Record and found this to be generally well maintained. Two staff signatures supported all hand transcribed entries. No gaps were found on the Medication Administration Record. Two recommendations are made as a result of this inspection. To further enhance systems in place, it is recommended that the returns book include reasons for return. Also, liquid medications should be labelled as good practice to show when it was opened and when to dispose by. The home has policies in place regarding death and dying. At present the home does not contain details in the care plans relating to standard 21. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a clear Adult Protection flow chart, which is accessible. Staff are clear on correct reporting procedure. The home has systems in place to protect the service users from abuse. EVIDENCE: The home has not received any complaint since the last inspection or in recent years. The complaint procedure states that complainants are able to contact the Commission for Social Care Inspection at any stage of a complaint. Service users who live at the home are protected by a clear complaints procedure and by the organisation’s corporate policies for whistle blowing and for the protection of vulnerable adults. The home has a clear, easy to understand flow chart for whistle blowing procedure placed in the office. Staff spoken with confirmed their understanding of Adult Protection procedure and Complaints procedure. Essential checks such as Protection of Vulnerable Adult (POVA1st), Criminal Records Bureau (CRB) and identification are done centrally and evidence is included in the file of a new staff member. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has been decorated and furnished to a high standard. The home has sufficient communal areas and bathrooms to meet service users’ needs. The home was found to have a good standard of cleanliness. EVIDENCE: No 1 Church Road is a large extended house providing a high standard of accommodation. The home is situated in a quiet residential area on the outskirts of Bridgwater. The property is surrounded by landscaped gardens, which provides wheelchair access. The home has thirteen single rooms, five of which are on the ground floor and seven on the first floor. The home is decorated to a high standard. All rooms have en-suite facilities. Bedrooms are adapted and personalised according to individual needs and tastes. Communal areas include two lounges, a dining room, and a kitchen, which is available for service users to use with
1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 18 supervision and support. The kitchen was considered clean and hygienic. Near the kitchen is a good-sized laundry room, which houses an industrial washing machine and a tumble drier. It was found to be clean and well organised. The home also offers a sensory room and an art room. The home offers many smaller quiet communal space should a service user wish to spend time alone or with families. The inspector viewed two bedrooms with service users’ permission. Two service users showed the inspector their favourite belongings and it was evident how well personalised the bedrooms were. Each service users bedroom was specifically decorated to their taste and interest. The bedrooms were filled with a range of décor such as rope lights, large framed photograph, comfortable armchair, television, DVD player, CD collection, cross stitch, artwork and personal memorabilia. The bedrooms are complemented by full en-suite facilities, which were also personalised in a bright and cheerful manner. Church Road also provides service users with specialist equipment to meet the assessed needs of the individual. There are adapted beds, communication aids, specialist cutlery and tableware. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are experienced and provide a good standard of care. Staffing levels are appropriate to meet service users’ needs. The home has a robust recruitment procedure. Staff have been provided with regular opportunities to attend training. However, some staff will require mandatory training updates. Staff are supervised and well supported by the manager. EVIDENCE: Duty rotas are well maintained. On the day of the inspection; four support workers; one senior support worker and the manager were on duty. During the afternoon there were six support workers including the deputy. Three waking night staff were rostered for that night. Since the last inspection, four staff have joined the team at 1 Church Road. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 20 The Manager has completed an analysis of staff training needs, to ensure that all staff are provided with appropriate training to undertake their role. Newly employed staff have completed a thorough Induction programme, mandatory training, Non Violent Crisis Intervention (NVCI), and Learning Disability Awards Framework (LDAF) training. Staff are provided with regular opportunities to receive training, and have attended courses on Health and Safety, Food Hygiene, First Aid, Rectal Administration, Manual Handling, and Protection of Vulnerable Adults. However, there are gaps where staff will require mandatory training updates. Twenty of the twenty-five staff employed (excluding the manager) have obtained the NVQ level 2 or above qualification in care. Three staff recruitment files were examined. These were maintained appropriately. Each was found to contain the documentation required within Schedule 2 of the Care Home Regulations 2001. The inspector viewed the records in relation to staff supervisions. The manager has an overview of all staff supervisions that have been conducted. However, it is recommended that staff are provided with formal one to one supervision at least six times a year. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is very well run and benefits from a competent manager. There is a relaxed and open atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and service users. EVIDENCE: James Marchant is the Registered Manager for the home. He has many years experience of providing care to a service users who have a learning disability. James has attained National Vocational Qualification (NVQ) level 4 in Management and the Registered Managers Award. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 22 Staff at the home seek service users’ views on an individual basis, taking account of behaviours, verbal and non-verbal communication. There is a strong person centred focus and this was evident throughout the inspection process. Staff spoken with confirmed that the manager was approachable and that they would be able to raise any concerns. The staff spoken with commented that they felt well supported and stated that they felt the manager manages the home very well. One staff commented ‘It’s lovely working here and James is a very good manager.’ Relative and GP comments cards also commented positively on the home. A social worker stated that ‘I found the home to be welcoming and helpful. I would be happy to recommend this home’. The home operates a comprehensive system of health and safety audits. Fire safety records were examined. Fire equipment had been serviced and tested as required. The electrical hardwiring certificate, portable appliances and landlord gas safety certificates have been appropriately maintained. Accidents have been recorded and an analysis completed on a monthly basis. The monthly analysis are complied by the manager and sent to Head Office for further audit. This is considered as good practice. Records are kept of daily fridge/ freezer temperatures and food probes. These were maintained regularly. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 3 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 4 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 3 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 3 3 3 3 3 3 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA35 Regulation 18 (1) (c) (i) Requirement It is required that all staff are provided with mandatory training updates. Timescale for action 28/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA9 YA40 YA20 YA20 YA36 Good Practice Recommendations It is recommended that Behaviour Management Guidelines are dated and reviewed at an appropriate frequency in relation to the service user’s needs. It is recommended that service user’s finance records is signed by two staff members in order to provide a clearer audit trail. It is recommended as good practice that liquid medications are labelled to demonstrate dates when opened and when to dispose by. It is recommended as good practice to include reasons for returned medication in the returns log. It is recommended that staff are provided with formal one to one supervision at least six times a year. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 25 6. YA9 It is recommended that risk assessments are reviewed and updated in order to reflect the service user’s changing needs. 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 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
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 1 Church Road DS0000039968.V317117.R01.S.doc Version 5.2 Page 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!