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Inspection on 18/09/07 for 1 Longmore Road

Also see our care home review for 1 Longmore Road for more information

This inspection was carried out on 18th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

As quoted by a resident "I didn`t know the staff when I first came here, I now know the staff, I like it here". The registered manager and staff support residents to live a valued and fulfilled lifestyle. Residents` choice and independence is promoted, and they are treated with dignity and respect within a homely caring environment. The home has developed picture format activity plans that enable residents to choose activities within the home or within the local community. Residents are encouraged to be involved in menu planning and preparation of nutritionally balanced meals. Staff receive the training they require to protect and meet the needs of the residents, and returned CSCI surveys say that management and staff are approachable and residents` needs are met. Health and Social care professionals are fully informed and involved in meeting residents` health and social care needs.

What has improved since the last inspection?

Redecoration within some areas of the home, and improvements made to the garden have contributed to the comfort of the home for the residents`. Care plans and picture menus have been further developed to promote and respect residents` choice and independence. The home has a full compliment of permanent staff, and a deputy manager has been appointed.

What the care home could do better:

The manager should attend training that would promote the manager`s confidence and management skills. Staff training records must reflect actual training attended with dates. Within the home`s quality assurance monitoring the manager must ensure records are up to date to reflect residents` choice, to ensure their wishes are respected and their needs are met.

CARE HOME ADULTS 18-65 1 Longmore Road Shinfield Park Reading Berkshire RG2 8QD Lead Inspector Yvonne Souden Unannounced Inspection 18th September 2007 14:45 1 Longmore Road DS0000011354.V348386.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 Longmore Road DS0000011354.V348386.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 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 Longmore Road Address Shinfield Park Reading Berkshire RG2 8QD 0118 986 7457 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) www.milburycare.com Milbury Care Services Ltd Miss Helen Elizabeth Bliss Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st June 2006 Brief Description of the Service: 1 Longmore Road is a detached property in a secluded residential area within the town of Reading. The home is close to the M4 motorway and is subject to the associated noise levels. Service users have a single bedroom with wash hand basin, and rooms are located on the ground and first floor. There is a lounge, kitchen and a conservatory that is used as a dining room. The home has a secluded rear garden with a garden swing, large fishpond and patio area where seating is provided. There are local community facilities nearby, and the home has its own transport. The home is located on a public transport route to Reading town centre. 1 Longmore Road has a Statement of Purpose and Service Users Guide that are available on application to the home. Information CSCI received from the registered manager 18/09/07 confirms that weekly fees range from £1,100 to £1,370. Additional charges are made for example horse riding, toiletries and transport. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The information gathered to support this report includes inspection records, documentation received from the home, 2 surveys from residents’ relatives and a 5.0-hour visit made by the inspector to the home. The site visit enabled the inspector to observe care practice within the home and hear the views of the service from residents, staff and management. The site visit also gave the inspector an opportunity to view further documentation, and the care plans of 3 residents. From the evidence seen by the Inspector and comments received, the Inspector considers that the home would be able to provide a service to meet the needs of individuals of various religion, race, or culture. The home follows the organisation’s policy and guidelines to manage issues relating to equality and diversity. What the service does well: What has improved since the last inspection? Redecoration within some areas of the home, and improvements made to the garden have contributed to the comfort of the home for the residents’. Care plans and picture menus have been further developed to promote and respect residents’ choice and independence. The home has a full compliment of permanent staff, and a deputy manager has been appointed. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 6 What they could do better: 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 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 7 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 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 8 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): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home enables prospective service users and their representatives to make an informed choice. Service users health and social care needs are assessed prior to a placement offer. EVIDENCE: The home has updated their Statement of Purpose and Service Users Guide to reflect the service provided. The Service Users Guide was seen in word and pictorial format. At the time of the inspection the home had no vacancies, the last service user admitted was March 2004. Records of three service users identify that their needs had been assessed prior to admission. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 9 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): 6, 7 And 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users’ Personal Plan of Care has been developed to promote service user choice and independence, whilst minimising risk, but monthly reviews of their care needs are incomplete. EVIDENCE: Of the three-service users’ care plans viewed all detailed the service users’ diverse needs, describing for example their routine, communication needs, hobbies, likes and dislikes. All care plans were seen to be in word/picture format and two service users showed the inspector their care plan. It was evident from the three care plans viewed that service users’ choice and independence are promoted. Care plans describe the service users’ capabilities in managing their daily tasks and detail assistance required by staff to enable them to meet their daily aims and objectives. Service users said they have access to their care plans and are involved in the review process. Records identify that annual multi-agency reviews take place and that some are overdue. The registered manager explained that it is 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 10 normal practice for service users’ care managers to confirm a review date and that the home has been informed that reviews are running behind schedule, but the registered manager had not detailed this information in the service users’ file. Monthly evaluation reports are carried out within the home that address individual support required by the service user and their social diary, but the section that addresses achieved goals and future planning had not been completed. One service user spoke of their review and said that a relative had attended. Risk assessments have an action plan to minimise risk for example: one service user’s risk assessment stated that staff must attend Non-Violent Crisis Intervention training, and that a ratio of 1-1 staff must be in place to meet the service user’s needs safely. Records identify that 1-1 staff is in place and that staff have attended Non-Violent Crisis Intervention training. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 11 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): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users’ independence is encouraged as they are supported to access events within the local community, and maintain links with family and friends. Service users are involved in menu planning that promotes a healthy diet. EVIDENCE: Person centred care and activity plans indicate that service users take part in various activities within the home and within the community for example day care centres, shopping and holidays, and are involved in activities around the home for example menu planning and cooking. On arrival to the home the inspector was informed that a staff member was escorting a service user to an external activity and that three service users were attending day care services. Three service users and three staff were in the home and had just finished baking a cake. A service user and staff said 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 12 that they are developing a favourite recipe book, adding a new recipe each week with pictures of the service users participating. On return from their day out service users were eager to tell staff about their day; it was evident that verbal, body and sign language are used to ensure effective communication between staff and service users. One service user who had been to town spoke of a purchase she had made, whilst another spoke of a trip to the New Forest. Another service user showed the inspector pictures within a photograph album, of their 2007 holiday to Blackpool with two service users and staff. The service user said she had a wonderful time and went on to say, as quoted “its alright here”. CSCI returned relative/representative surveys indicate that the home helps the service users to keep in touch with family and friends and service users spoke of visiting relatives and keeping in touch by telephone. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 13 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): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ preferences are respected in the delivery of their care, and are enabled to access health care services. Staff are trained in the administration of service users’ medication. EVIDENCE: It was evident that the service users’ care plans support choices they have made and enable them to make decisions in their lives for example their bathing and bedtime preference. Equipment to support staff to meet the needs of the service users was observed. The manager completed a CSCI Annual Quality Assurance Assessment and stated ‘The staffing at the home reflects preferred gender for support of service users’. The home’s rota confirms that staff are predominately female with two male staff. All service users within the home are female. The manager confirmed that the home does not have a gender care policy, but confirmed that the home has a gender risk assessment form. The gender risk assessment form refers to controls in place should male staff be required in personal care and instructs staff ‘to read and sign the cross gender form’. A 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 14 cross gender form could not be located on the service users file and the manager stated that it would be unlikely that male carers would be on shift without female carers present, and confirmed that male staff do not take female clients out on their own. A service user’s response when asked, who assists you with personal care? “Female staff sometimes help me” when asked if a male staff member offered to help would that be acceptable? The service user stated “no because he is a boy”. Two CSCI relative surveys indicate that the home meets the needs of their relative. One comment said, “my daughter is very happy and extremely well cared for”. Service users’ health care needs are detailed in their personal plan of care and daily monitoring records record if a service user has had an appointment with a health care professional. The arrangements for medication were seen. This is stored securely, and a monitored dosage system is used. Staff are trained before they are able to administer medication, and stock in place matched records kept. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 15 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): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are protected from abuse by the home’s safeguarding adult protection policy and procedures. The home has a complaints procedure that is made available to service users and their representatives, but the home’s complaints logbook was not available to evidence any complaints that may have been received. EVIDENCE: No complainant has contacted the commission with information concerning a complaint made to the service since the last inspection. As quoted by a service user, “I would tell my keyworker or other staff if I am not happy and she would sort it out as she did today” Discussions with staff identified that they are fully aware of safeguarding adult protection policies and procedures that includes the home’s whistle blowing procedure. Training records and discussions with staff identify that some staff have attended safeguarding adults training, non-violent crisis intervention and behaviour awareness training, but records were not fully available to evidence training attended. The manager reports that the home has received no complaints, but could not demonstrate this from the home’s complaints logbook, as the logbook could not be located. CSCI relative surveys indicate that relatives know how to complain, have complained and that their complaints had been dealt with satisfactorily by the home. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 16 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): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean comfortable and hygienic with infection control measures in place to protect service users. EVIDENCE: The home has made some improvements to their garden by landscaping areas and making safe their garden pond by erecting a fence around it. The home has a conservatory used as a dinning room. The room is in need of redecorating as plaster has come away from the wall exposing wires. The manager informed the inspector that maintenance are aware and have scheduled the repair of the room. The inspector observed hand-washing facilities within the bathrooms and laundry and protective clothing for staff to use. The home has policies on infection control and state within their CSCI Annual Quality Assurance Assessment that staff have received infection control training; some staff certificates/record to evidence infection control training were not available. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 17 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): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by the home’s recruitment policy, and have their needs met by trained and competent staff. EVIDENCE: The home has a diverse ethnic group of staff. Observation and discussions with staff identified patience, understanding and a caring staff team who were knowledgeable of the service users’ needs. Recruitment of staff has taken place since the last inspection and staff appeared sufficient in numbers on the day of the site visit to meet the needs of the service users. The home has policies on Equal Opportunities, Diversity, Anti-oppressive practice, and policies on Recruitment and Employment. Staff records viewed identify that recruitment procedures are followed; references and security checks are obtained on prospective staff prior to an employment offer. Staff spoke of their induction and training received. Training records confirm that staff have attended mandatory and specialist training, but some training 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 18 records were incomplete and certificates were not in place to evidence training content/training attended. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 19 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): 37, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is supportive of the staff team to ensure the needs of the service users are met, but the quality of the service could be jeopardised, as records are incomplete or missing, and quality assurance systems in place do not appear to monitor tasks that have been delegated by the manager to the staff team. EVIDENCE: The home has quality assurance systems in place that monitor health and safety and care practice. Surveys sent to service users state that 98.73 were satisfied by the overall service provided in the home. Senior management within Milbury Care Service undertake a monthly Regulation 26audit inspection of the home reporting their findings to the registered manager and on request to CSCI. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 20 Staff are confident in the management team and feel supported in the work they do. Discussions of the service provided with the registered manager identified that the manager was unsure of the detail submitted to CSCI within their Annual Quality Assurance Assessment (AQAA). The manager confirmed that her line manager had completed most of the AQAA. The AQAA states that all staff have attended Safeguarding Adults Training, but staff training records and lack of certificates could not evidence training attended within this course and other mandatory courses; staff discussions confirmed training attended. The manager confirmed that training dates of staff could not be traced and therefore could not confirm that all staff have attended mandatory and specialist training. There has been no increase in the percentage of staff with a National Vocational Qualification in care (NVQ) since the home’s last inspection June 2006. 45 of staff have an NVQ in care; no staff were undertaking NVQ at the time of this inspection. The completed AQAA states that the manager is responsible for ensuring the review of service users’ needs, but service users’ monthly review evaluations were not complete and records were not made to explain lateness of annual multi-agency reviews. Cross gender forms were not in place and could not be located should a staff member be required to follow guidance given within the service’s gender care risk assessment. The manager could not locate the home’s complaints logbook for auditing at this inspection. The registered manager has completed a Registered Managers Award and has attended training to update her knowledge and skill, but the manager was inexperienced in decision making referring most answers to head office or dismissing responsibility due to having delegated the task to the staff team, therefore recordings not made have not been picked up within the home’s quality assurance monitoring. The AQAA states plans for improvement in the next 12 months include ‘for the manager to attend a Management Development Programme and staff to work towards NVQ 2 to meet 50 of qualified staff’. The manager identified barriers that contribute to poor administration/quality assurance as lack of on the spot I.T facilities, and the vacant deputy manager position. The manager confirmed that I T tasks could only be completed at the organisation’s office, which is time consuming. The manager confirmed the appointment of a deputy manager to commence post 12/10/07. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 21 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 X 4 X 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 2 X 2 X X 3 X 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 YA6 YA18 Regulation 17, Schedule 3 and 4 Requirement The registered persons must develop and update service users care plans to ensure that they are reflective of their current assessed needs and include their identified future goals. This requirement from 1/06/06 has been part met. Timescale 31/10/06 • The registered manager must ensure records made within the service users’ monthly evaluation records are complete by detailing future goals and agreed action plan that would reflect in the service users’ plan of care. The registered manager must document agreed review dates made with social care professionals on behalf of the service user, to ensure an audit trail and ensure service users’ review dates are monitored and undertaken close to the due date. The registered manager Version 5.2 Page 23 Timescale for action 31/10/07 • • 1 Longmore Road DS0000011354.V348386.R01.S.doc 2 YA39 24 must ensure the service’s cross gender forms are available should staff require them to follow guidance given within the service’s gender care risk assessment • Service users’ gender care preferences, must be recorded within their plan of care. • The registered manager must ensure the home’s complaints logbook is held within the home and available for inspection. • The registered manager must be able to evidence staff training by ensuring accurate records are kept. Within the home’s quality assurance monitoring the registered manager must ensure staff complete tasks that have been delegated to ensure service delivery and accurate records kept. 31/10/07 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. Refer to Standard YA37 Good Practice Recommendations It is recommended that the provider implement their improvement plan as stated within the completed AQAA for the registered manager to attend a Management Development Programme to promote the manager’s confidence and management skills. 1 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Longmore Road DS0000011354.V348386.R01.S.doc Version 5.2 Page 25 - 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!