Inspection on 27/01/06 for 15 Hulse Road

This inspection was carried out on 27th January 2006.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

15 Hulse Road 27/09/06

15 Hulse Road 19/08/05

15 Hulse Road 11/03/05

15 Hulse Road 10/09/04

15 Hulse Road 01/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hulse Road (15) 15 Hulse Road Salisbury Wiltshire SP1 3LU Lead Inspector Tim Goadby Unannounced Inspection 27th January 2006 15:25 – 17:45 Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hulse Road (15) Address 15 Hulse Road Salisbury Wiltshire SP1 3LU 01722 326490 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) H5M049Piper@mencap.org.uk www.mencap.org.uk Royal Mencap Society Tracy Piper Care Home 6 Category(ies) of Learning disability (6), Physical disability (2) registration, with number of places Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users in the age range 18 to 64 years who may be accommodated in the home at any one time is 6 No more than 2 service users in the age range 18 to 64 years may have both a learning disability AND a physical disability The Commission must be advised of any circumstances when named service users are unable to access first floor communal space. The Commission must be consulted if it is decided to use the communal space area for staff sleeping in and give prior approval for such a change. 19th August 2005 Date of last inspection Brief Description of the Service: 15 Hulse Road provides care and accommodation for up to six adults with a learning disability. Up to two service users may also have a physical disability. The service is operated by Mencap. This is a national voluntary organisation working in the learning disability field. They have a number of care home and supported living facilities throughout Wiltshire. The home is located within level walking distance of the cathedral city of Salisbury. It is close to a range of amenities. These include shops, a cinema, a theatre, and a leisure centre. The building is an older property, located in a residential area. It has been extended on the ground floor. Service user accommodation is arranged over three floors. There are four single bedrooms, and one that is shared. Three of the bedrooms have en-suite facilities. Ground floor accommodation is available for any service users with some degree of physical impairment. There is no lift in the home. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in January 2006. A total of 2.5 hours was spent in the home. The following inspection methods have been used in the production of this report: indirect observation; pre-inspection questionnaire, completed by the provider; sampling of records; discussions with service users and staff; survey of service users and relatives. What the service does well: What has improved since the last inspection? A requirement of the previous inspection is met. The home is now ensuring that any significant incidents which may adversely affect the safety or wellbeing of service users are notified to the CSCI without delay. This means that people benefit from reporting systems which are open. A recommendation of the previous inspection has also been addressed. Guidance about supporting a service user who is at assessed risk of falling whilst using the stairs has been reviewed and clarified. It now sets out what advice and assistance that staff should give; explains the reasons for these instructions; and also specifies what steps staff should not take. This helps to Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 6 promote the safety and welfare of the individual service user and of the staff supporting them. 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. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users have their needs and aspirations met by the home. EVIDENCE: Following some recent admissions, the mix of abilities and needs amongst Hulse Road’s user group has changed. The service has coped well in absorbing the impact of these changes. The needs of all users are being met. Staff have received training in relevant topics. In addition to the support provided by the home’s own team, the input of other relevant agencies is accessed as needed. Comment cards completed by service users, with support from staff where necessary, indicate that people are satisfied with the service provided by Hulse Road. All responses show that people like living in the home, and feel well cared for and safe. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7&8 Service users can make choices and decisions in their daily lives, and about the conduct of the home. EVIDENCE: Service users have input to their own care plans. Individuals have signed these documents, if they are able to. The home works with its users to promote their independence and autonomy. Any limitations are clearly linked to assessments and care plans. Service users have regular opportunities to make their views known. They can discuss issues relating to their own care in meetings with their allocated staff keyworker. There are also house meetings every two weeks, which allow topics affecting the whole household to be talked about. Service users are also surveyed periodically as part of the service’s quality assurance system, and their feedback is incorporated into the resulting development plan. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 10 Various communication methods are used to promote the involvement of all service users as much as possible. These include the use of forms of signing, and symbols and pictures. Staff receive training in these techniques. Records of any complaints raised by service users show that these are taken seriously and responded to appropriately. Again, these can help to identify areas in which the service can make improvements, in line with the wishes of the people living there. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15 & 16 Service users have the opportunity to maintain and develop skills. Service users are provided with a range of activities and opportunities, offering them full engagement with their local community. Service users are able to maintain and develop appropriate relationships with family and friends. Service users’ rights and responsibilities are upheld, balanced with appropriate steps to safeguard their welfare. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 12 EVIDENCE: Communication styles and abilities vary amongst the service user group. Some are able to use speech. Others rely more on signs, symbols and pictures. Various information is presented in ways that are accessible to the different individuals. Staff receive training to enable them to communicate as effectively as possible with each person. Skills assessments are documented. These show service users’ abilities and needs in key areas of daily living, such as personal care, cooking, cleaning, and money management. People are regularly involved in these tasks, which are allocated on a rota basis. Residents participate fully in cleaning, cooking, washing up, and ironing. They also answer the door, and phone calls. The maximum degree of independence is promoted, with some monitoring and support from staff if this is assessed as necessary. Most service users have a full daily programme during the week. This includes attendance at local day centres and clubs. Some are also studying at the city’s college. When people do not have programmed activities outside the home, they are supported by Hulse Road’s own staff. The weekly timetable for each individual is on display in the kitchen. People can fill their leisure time in a variety of ways at home. They also have active social lives. Individual interests and preferences are recorded within care plans. Regular outings include the cinema or theatre, shopping, or going out for a meal. These are supported by staff, as necessary. Service users either walk, use public transport or take a taxi. Service users all receive the opportunity to have an annual holiday. They are involved in choosing the destinations for these. Various photographs are displayed in the home, showing the places people have visited. Service users spoke about their holidays from summer 2005, and how much they had enjoyed these. Wherever possible, the home actively supports service users to maintain contact with family and friends. Visitors are welcome to Hulse Road at any reasonable time. Some people regularly go to see their families. Staff support service users to send presents and cards for family birthdays. A number of residents have close friendships with people they have lived with in the past. Care plans include information about key relationships for each individual, and how they are helped to maintain these. The home is also working to try and widen the circle of friends and acquaintances for its user group. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 13 Comment cards from the relatives of service users indicate that families are satisfied with the service provided. People feel that the arrangements for visiting, and for being kept informed of important matters, are satisfactory. People are provided with keys to the front door, their own bedroom, and a lockable space, if they wish to have these. The home has an agreed no smoking policy. Anyone wishing to smoke may only do so in the garden. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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): 20 Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: All the service users at Hulse Road need support in the management of their medication. Staff receive relevant training, and are observed until they are assessed as competent to carry out this task. There are suitable arrangements for the secure storage of medication. Records are also maintained appropriately. Some medication is prescribed to be given ‘as required’. Where this is the case, there are suitable guidelines which set out how a decision would be reached. If two staff are on duty, they need to agree the necessity. When only one staff member is present, they can contact an on-call manager for advice. Records show that the use of such medication is very infrequent. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Service users are safeguarded by the home’s policies and procedures for complaints and protection. EVIDENCE: Mencap’s organisational complaints arrangements are appropriate. Information is clearly displayed within the service. It includes symbols and photographs, to help make it more accessible to service users. Complaints received by the service since the previous inspection have been notified to the CSCI. There is a full awareness of local procedures for the protection of vulnerable adults. When necessary, issues have been referred to this. The CSCI has again been notified of relevant matters. All Mencap staff attend training on abuse awareness and protection, as part of their core induction and foundation learning. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29 & 30 Service users live in a comfortable, clean and safe environment, suitable to their needs. EVIDENCE: 15 Hulse Road is located at the end of a quiet residential street, close to the centre of Salisbury. The accommodation is spread over three floors. The premises are domestic in scale. They are attractively decorated, and appear well maintained. Responsibility for the majority of maintenance issues rests with the housing association that owns the property. Bedrooms are provided on all three floors of the home. There are two ground floor rooms. Both of these have en-suite showers and toilets. The shared bedroom is on the second floor. This has an en-suite toilet. The remaining two bedrooms are on the first floor. In addition to the en-suite facilities, there is a bathroom on the first floor. There are also toilets on both ground and first floors. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 17 The home’s main lounge and dining area are at the rear of the ground floor. The kitchen also has space for a table with seating. The home has recently created extra communal space, by de-registering a first floor bedroom. This has become a second lounge, which can also serve as a private meeting area. The intention is for this to be more of a quiet space, where people can relax. A condition has been set that all service users should be able to access this room, to ensure that it can reasonably count as part of overall communal space calculations. The office, which doubles as a sleep-in room, is on the first floor. Space in this area is limited. It is likely that the additional lounge may also become the sleep-in room, through the use of a sofa bed. Care would need to be taken to ensure that this did not unduly restrict its use by service users. The home is required to consult again with the CSCI, and obtain prior approval, before implementing such a change. There is a large garden to the rear of the property. This has a patio and an area of lawn. One of the service users is particularly involved in helping to maintain the garden. The home is registered to care for two people who may have physical impairments, in addition to a learning disability. The possibility of offering ground floor accommodation for such service users enables this aspect of care to be provided. Various adaptations and equipment have been provided within the home. Examples include fitting grab rails by the bath; and having lever handles on taps, for easier operation. Staff at the home are responsible for the cleaning. Service users also participate, in keeping with their abilities and wishes. The home was found to be clean and hygienic in the areas seen at this unannounced inspection. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 18 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, 33, 34 & 35 Service users are supported by suitable numbers of appropriately trained staff. The home is unable to evidence that appropriate recruitment processes are in place, to ensure the protection of service users. EVIDENCE: Rotas are drawn up in line with the weekly routines of service users. There are always at least two staff present during daytime hours, when all service users are at home. This enables one or two people to go out at a time. Numbers can vary. For instance, only one staff member may be needed if there are fewer service users, such as at weekends, when some people may visit their families. Or more staff may be provided, to enable service users to undertake activities. Cover is maintained by the use of relief or agency workers, when necessary. On the day of this unannounced inspection, two staff were on duty. One was due to finish at 21.00, which would then leave the other person to cover the overnight sleep-in. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 19 The newest service user currently has noticeably higher support needs than the rest of the group, meaning that this individual is more likely to require one to one support from staff. For this reason, there are usually three staff on duty to cover the busy morning period, when everyone is getting up and going out to their various daytime activities. Hulse Road has experienced a period of staff turnover. The majority of the team now in post have been working at the home for less than two years. Recruitment continues to take place, with two full-time and one part-time post still due to be filled at the time of this inspection. Mencap has a range of procedures, guidance and standard documentation relating to the recruitment and selection of staff. These address all the statutorily required elements, such as the various checks which must be completed on all prospective employees. Staff on duty on the day confirmed that they had had to undergo these checks. Unfortunately, staff records were not accessible at this visit, in the absence of the home’s manager and deputy. So practice could not be verified on this occasion. The home may make use of staff from an agency to maintain cover. Information is available on file from the agency which is used, confirming the checks they carry out on any staff supplied. Service users participate in the recruitment process. One person spoke about their previous involvement in interviews of candidates, and was looking forward to undertaking some more in the near future. A staff member appointed during 2005 confirmed the range of training already undertaken. They had worked through an induction and foundation package, and attended a range of courses. These covered topics such as fire safety, food hygiene and medication practice. Training records detail the courses which each staff member has undertaken. There is also a training and development plan for the year ahead. This shows what sessions are required for which staff, and how these will be provided. All staff undertake all mandatory training, and a range of courses that are run by Mencap for all its employees. Learning also takes place on some topics which are of specific relevance to the needs of the service at Hulse Road and its users. For instance, information about supporting people with autism; and training in specific communication techniques that some individuals use. The service is above the minimum 50 target for care staff with National Vocational Qualifications (NVQs) in care. One person has achieved this award at Level 3, and three others have done so at Level 2. In addition, the deputy manager is now working towards Level 3, and two other staff are to commence studying for Level 2. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 20 Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 The registered manager is suitably qualified, competent and experienced, so that service users benefit from a well run home. Quality assurance measures underpin service developments, and include actions based on the views of service users. EVIDENCE: The home’s registered manager is Mrs Tracy Piper. She works as part of the care team, in addition to her administrative and managerial responsibilities. Within the home, she is supported by a deputy manager. Mrs Piper has completed the Registered Manager’s Award qualification. Organisationally, there are clear structures within the regional Mencap team. Senior managers have set responsibilities in relation to the service. There are good communication channels and support systems in place. As required under care standards legislation, a senior Mencap manager carries out monthly Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 22 visits and reports on the conduct of the home. Copies of these are supplied to the CSCI. Mencap has an organisational approach to quality assurance. There are regional and area development plans, as well as service specific ones. Plans are set out under a number of topic headings, which ensure that all areas of service delivery are considered. There are topics which are particularly focused on service users. Areas for development are identified in various ways. These include internal audits; comments received from service users and others; and the findings of other agencies, such as the CSCI. Hulse Road carried out survey exercises in 2005 with its service users; and with other stakeholders, such as families and friends of residents, and other agencies who have contact with the service. Results from these show that the comments received have influenced the actions planned by the home. Once an improvement task has been defined, it is made clear who is responsible for addressing this, and in what timescale. The service’s development plan also shows the way in which information about targets and progress is shared. Health and safety was not checked in detail at this inspection. But a recommendation of the previous visit, relating to the support of one individual when using the stairs, has been addressed. Guidance is now clearer in explaining what advice and assistance staff give, the reasons why they do so, and what steps they must not take. An occupational therapist has given appropriate professional advice on this and other related issues for the person concerned. Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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 X 3 3 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 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 3 X 3 X X X X Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 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. 1 Standard YA34 Regulation Requirement Timescale for action 31/03/06 1 YA34 7;9;19;Sch2 Staff records must contain evidence that all required recruitment checks are carried out. Statutorily required records must be available for inspection in the home at all times. 17This part of Regulations also 2,3b;Sch4-6 applies to the above Requirement. 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Hulse Road (15) DS0000028695.V281147.R01.S.doc Version 5.1 Page 26 - 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!