Inspection on 19/02/07 for 11 Beechpark Avenue

This inspection was carried out on 19th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

11 Beechpark Avenue 13/03/06

11 Beechpark Avenue 15/12/05

11 Beechpark Avenue 07/03/05

11 Beechpark Avenue 02/08/04

11 Beechpark Avenue 16/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 11 Beechpark Avenue Northenden Manchester M22 4BL Lead Inspector Michelle Moss Key Unannounced Inspection 19th February 2007 11:00 11 Beechpark Avenue DS0000029483.V313986.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 11 Beechpark Avenue DS0000029483.V313986.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. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 11 Beechpark Avenue Address Northenden Manchester M22 4BL 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) 0161 945.6265 St Bonaventures Trust Arcon Housing Association Ltd Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th March 2006 Brief Description of the Service: 11 BeechPark Avenue is a care home registered to provide personal care and accommodation for 3 adults with learning disabilities aged between 18 to 65 years of age. The registered provider is St Bonaventures Trust. The house it owner / managed by a housing association. All residents have tenancy agreements in place. The house consists of 3 single bedrooms, a staff sleep-in room, lounge, dining area, kitchen, bathroom and a toilet. There is a utility room attached to the house for laundry. The home is wheelchair accessible with external ramps. The house is a detached building with a paved frontage and a landscaped garden to rear and side. It is set in a quiet residential street with houses of a similar type. It is well located for transport links by road and bus. The home is close to local shopping facilities. The fees of residents are set in accordance with their individually assessed needs. The home has a Statement of Purpose and Service User Guide that provides details about the service and the functions and purpose of the organisation. These are available upon request. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector went to the home without telling anyone she was going to visit on the morning Monday 19th February 2007. The inspector spent 3 hours visiting the home. During the visit to the home the inspector: • Spoke with all residents • Spoke with the staff on duty • Looked at some residents care plan records. • Looked around the home. There were some important things the inspector wanted to find out about the care given by the home. These were: • • • • How the health needs of residents were met. How the personal care needs of residents were met. How the staff helped to keep residents safe and promoted community involvement. How the home respected the residents rights, diversity and identity. This report has also taken into account other information, which the Commission knew about the home. What the service does well: The residents spoken with said. • They were happy living at the home. • They felt the staff listened to them and acted on any concerns. • They said they received the support to help them stay healthy. • They felt they could make decisions independent of the staff. All the information received through talking with the residents showed that the residents felt cared for, they were supported to stay healthy and staff valued the residents’ contribution in decision-making. The staff had been trained in meeting the care needs of residents and were sufficiently skilled to meet the everyday needs of residents, which in turn meant their health and welfare was safeguarded. All residents were supported to go on holiday at least once a year, although often this was several times. The holidays reflected the personal preferences of the individual resident. The residents had access to a range of communitybased activities including opportunities to learn, meet people with similar interests and keep healthy. All these things meant residents were being supported to be included in their community and that activities took account of their diverse needs. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 6 The residents were seen to be treated as individuals and the staff team provided care that reflected the residents’ rights and preserved their dignity and privacy. This meant that the staff team understood the importance of respecting and seeing the house as the residents’ home. The staff rotas showed that the staffing was set to meet the needs of the residents. This showed that there were enough staff to make sure residents were kept safe and adequately supported. Information seen about the support of staff showed they were themselves well supported by their manager and encouraged to develop their skills to better meet residents’ social and health needs. Families stated in returned questionnaires that:“Beechpark delivers the highest standard of Care”. “St Bonaventures (owners) delivers a standard of care that in my opinion would be very difficult to match” These comments showed the families satisfaction of the quality of care provided. What has improved since the last inspection? What they could do better: Overall the home was managed in the best interest of the residents. However, there were some things which could be improved on. These included:The home needed to bring together the findings of their annual surveys completed by residents and stakeholders and put them into the annual published report. The home needed to make sure that the residents accessing the hot water in the kitchen were kept safe. This included carrying out a risk assessment. By undertaking the assessment the home would identify if any further steps were needed to ensure the residents’ safety was not compromised. The home needed to show that they were checking the water temperatures accessed independently by the residents, to make sure they did not exceed 44 Celsius and compromise their safety. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 7 The home needed to provide an audit trail that confirmed the care plan was kept under review and updated where changes emerged. The home’s good practices on using pictorial aids to support written text in various records needed to be extended to house meeting minutes. By making this improvement the home would be ensuring that residents diverse needs were considered. 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. 11 Beechpark Avenue DS0000029483.V313986.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 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ changing needs were assessed which in turn helped the home to plan and ensure their needs were continually met. EVIDENCE: The home had a static resident group, which had resulted in the home not receiving any new admission for some years. As part of the ongoing care of residents a multi agency review was held a minimum of once each year. This involved the resident’s needs being reassessed and updated where changes were highlighted. This in turn helped to inform the care plan about any changes in needs, including the resident’s health, social and emotional wellbeing. This process ensured that the overall needs of residents were being monitored and staff kept updated about any specific changes. The home had a policy on admissions. As part of the admission process all prospective users of the service were invited for trial visits to meet other residents and provided with information about the home to help them to decide if the home was suitable. 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefited from having a comprehensive care plan that highlighted their needs. This included having their care, health and diverse needs recorded and balancing risks that enabled them to maintain a level of independence over their lives. The only slight weakness was that it missed the formal evidence to show the plan was kept under review. EVIDENCE: Two out of three Care plans were examined. Both plans were detailed and comprehensive. Both plans were extensively supported by pictorial aids to help the resident to be actively involved. From talking with residents they were found to be familiar with their care plan and its contents. If a resident was able to sign, their signature was included on the plan. The care plan covered details about meeting the resident’s diverse needs both in areas of spiritual and social need. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 11 The format of the plan made the whole document easy to read. Where health needs were identified detailed explanation was provided which informed staff about how best to keep the resident healthy and safe. The management of risk was incorporated into the plan in a person centred approach. The care plan was found to be respectful of the wishes of the resident. It highlighted the things that were important to the resident and why. It also explained about the things that the resident disliked and why. The level of detail recorded in the care plan and its overall development was commended. The deputy on duty confirmed that where changes in needs emerged the plan was updated. However, from examining the plan no formal evidence was held that confirmed this took place. The home needed to ensure dates and references to changes were made to demonstrate formally that the plan was kept under review. 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were able to exercise their rights, including having their privacy and their diverse needs valued by the staff. The home also enabled residents to choose their own daily routines, maintain family links and have a varied and nutritious diet. EVIDENCE: From talking with the residents they explained they were supported to develop / maintain their independence. They confirmed that with support they were encouraged to access a range of activities both through the organisation and the wider community. The residents were supported and encouraged to participate in a range of community based social, leisure and educational activities. The staff actively encouraged and supported residents to maintain relationships with their families and friends. The enjoyment of the range of activities was confirmed from talking with residents. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 13 The residents confirmed that every year they went on holiday. They were asked about where they would like to go. One resident spoke about looking forward to their trip to ‘Lourdes’ in April. Another resident spoke about going to York. The trust owned a caravan in Wales which residents were able to access several times a year for breaks. Everyone indicated their enjoyment of going to the caravan. The staff team were found to be actively investigating various educational courses for the residents that reflected their personal likes and needs. From examining a sample of care plans evidence was seen that the diversity of residents was respected by the home. Details about spiritual and culture needs were comprehensive. A sample of menus were examined. Also residents were asked about food. It was found that healthy eating was promoted and that meals served were varied, respected cultural needs and diverse in meeting the dietary needs of individual residents. 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were having their personal and healthcare needs met by the home. This included ensuring that good arrangements were in place for safeguarding residents’ general health and welfare. EVIDENCE: The home supported residents to maintain their personal and healthcare needs. Policies and procedures were in place for the safe handling of medication to keep residents’ safe and well. The care plan was an extensive source of data on how to keep the resident healthy. Daily care logs indicated where health concerns were noted the appropriate referral to a GP was made. From talking with residents they were familiar with the importance of staying healthy. One resident spoke about doing regular exercises. This included walking and taking a bike ride. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 15 Medication records were examined and found to be well maintained with an audit trail that indicated medication was administered in accordance with the GP’s instructions. Within the care plan the home had addressed the subject of planning for life, illness and death. This was seen to be done in a sensitive manner and respected the wishes of the resident and their family. 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ views were listened to and acted on. Policies and procedures and training programmes were in place that the staff team were required to attend and follow. This ensured that residents were safeguarded from all forms of abuse. EVIDENCE: From examining staff training records evidence was found which demonstrated a number of staff had completed courses on POVA (Protection of Vulnerable Adults). Of the Staff spoken with, they were found to be familiar with the importance of safeguarding residents from all forms of abuse. The home had a complaints procedure, which was made available to residents. The home had not had any complaint made about the service since their last inspection. A questionnaire completed with the residents by the home, asked questions about being happy or sad. All residents indicated being happy. One resident spoken with was asked about the home’s complaints procedure. They were aware of who they could go to if they were worried about something. Part of the recruitment of staff involved checking the prospective staff member’s suitability to work with vulnerable adults. 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents lived in a homely and comfortable environment. Their health and well-being was protected by the design of the premises and by having a good state of cleanliness. EVIDENCE: The home was found at the site visit to be furnished to a good standard and reflected a domestic character. The home completed weekly / monthly health and safety audits of fire and electrical safety. Staff training in health and safety was covered as part of their induction. Fire training awareness was covered annually. Testing of water safety was completed at set internals. Information provided in questionnaires sent in by families all indicated that the home was always clean and tidy. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 18 Residents were offered a key to their bedroom where they were able to use it independently. Where this was not possible a risk assessment was in place. From talking with staff on duty it was noted that the residents were not offered lockable storage space in their bedroom. It was recommended that the home review this and offer this facility in line with good practice. 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good practices in staff training and staffing levels which reflected the needs of the residents. This meant that there were adequate staff to make sure residents are well cared for and their welfare protected. EVIDENCE: The staff that were on duty confirmed that there were two staff from 7:00am until 10:00pm. At night one staff would be on duty from 10:00pm on sleep in duty. There was no dedicated domestic or cook. These jobs were carried out by the staff team, and residents confirmed they were encouraged to participate where appropriate, which they stated they enjoyed. Staff on duty were able to confirm that most staff have either completed or were in the process of completing NVQ training. This meant that out of 6 staff 5 held an NVQ. Staff on duty said that they had access to ongoing training and development opportunities and said that they felt well supported by the management. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 20 From examining two staff files evidence on going training and development was confirmed. From examining a sample of staff files evidence was found that showed staff were receiving regular supervision from their line manager. Staff files were examined and it was noted that all appropriate documentation was on file including two written references and Criminal Record Bureau Checks (CRB). There were also copies of supervision notes. Where staff had worked for the trust over 3 years a second CRB was being undertaken. 11 Beechpark Avenue DS0000029483.V313986.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall, areas of management and health and safety were good, although the failure to check the water temperatures did pose a risk to the residents’ health. A quality assurance systems and internal monitoring of care were in place. However, information was not brought together to provide sufficient evidence of the organisation self-assessing their quality of care. EVIDENCE: The residents had access to information in a variety of formats and were able to select the one most appropriate for them. However, this good practice did not extend to the house meeting minutes. Policies and procedures were in place for health and safety, and appropriate insurance with public liability cover was in place. However, it was noted that water temperatures were not routinely checked to ensure that they did not exceed the 44 Celsius. During the visit the temperatures were checked. The wash basin independently accessed by the residents were found to be within 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 22 the safe zone of 44 Celsius. To ensure that the safety of residents is maintained it was recommended that the home routinely check the temperatures and record the findings and where necessary take action to ensure residents safety is not compromised. The home was routinely seeking the views of residents through house meetings, questionnaires and through their care plans. This was all good practice. Stakeholders’ views were also sought including sending out questionnaires. Some of the comments made by families included: “Beechpark delivers the highest standard of Care”. “St Bonaventures (owners) delivers a standard of care that in my opinion would be very difficult to match” The home had in place a Quality Assurance Statement / Report for 2006/07 which was examined. This provided evidence of the aims and objectives for the service. However, it had not linked the findings of the questionnaires received by residents and stakeholders into the report. No link had been made with the aims and objectives of the service. Also no evidence shown in the report how the organisation had self-assessed the care provided to residents. The manager was not on duty at the time of the site visit. 11 Beechpark Avenue DS0000029483.V313986.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 X 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 3 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 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X 3 3 x 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 24 no Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 YA39 Good Practice Recommendations The home should bring together the findings of the annual surveys completed with residents and other stakeholders and put them into the annual Quality Assurance published report. The home should make sure the residents accessing the hot water in the kitchen are kept safe. This included carrying out a risk assessment. It is recommended that the home offers each resident a lockable storage space in their bedroom. The home should check the water temperatures accessed independently by the residents, to make sure they do not exceed 44 Celsius. The home needed to provide an audit trail that confirmed the care plan is kept under review. DS0000029483.V313986.R01.S.doc Version 5.2 Page 25 2 3 4 YA9 YA26 YA42 5 YA6 11 Beechpark Avenue 6 YA41 The home’s good practices on using pictorial aids to support written text in various records should be extended to include house meeting minutes. 11 Beechpark Avenue DS0000029483.V313986.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection CSCI, Local office 11th Floor West Point 501 Chester Road Old Trafford, Manchester M16 9HU National Enquiry Line: 0845 015 0120 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 11 Beechpark Avenue DS0000029483.V313986.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!