Inspection on 24/09/07 for 16 Hawthorn Crescent

This inspection was carried out on 24th 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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

16 Hawthorn Crescent 28/08/08

16 Hawthorn Crescent 05/09/06

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 16 Hawthorn Crescent 16 Hawthorn Crescent Worthing West Sussex BN14 9LU Lead Inspector Annie Taggart Key Unannounced Inspection 24 September 2007 3:00 th 16 Hawthorn Crescent DS0000067147.V343212.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 16 Hawthorn Crescent DS0000067147.V343212.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. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 16 Hawthorn Crescent Address 16 Hawthorn Crescent Worthing West Sussex BN14 9LU 020 8544 8900 01903 821868 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.caremanagementgroup.com Care Management Group Limited ** Post Vacant *** Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th September 2006 Brief Description of the Service: 16 Hawthorn Crescent is a care home that is registered to provide care for four adults with learning disabilities between the ages of 18 and 65. The Registered Provider is Care Management Group Ltd. The Registered Manager’s post is currently vacant. The home is a semi-detached property, situated in a quiet residential street, just outside Worthing’s town centre. There is easy access to all community facilities, including local rail and bus stations. The current scale of charges is between £1,346 and £1,550 per week. There are additional charges for hairdressing, toiletries, trips out, holidays and clothes. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In preparation for the visit an Annual Quality Assurance Assessment (AQAA) was sent to the manager and was completed and returned in the allocated timescales. Surveys were sent to service user, families and professionals involved with the home. Four service user and one professional returned the surveys and comments from these documents have been used in the report. The last two inspection reports were read along with any other relevant documentation and correspondence relating to the home and a planning document was completed. The unannounced visit was carried out at 3pm, when people were returning from day care and lasted for 3.5 hours. We spent time talking with service users both in their private bedrooms and in communal areas and also spoke with one visitor to the home. Four care plans with all supporting documentation were tracked with any issues needing further clarification being discussed with the relevant service user or the staff team. Three staff files were seen and these were in good order but the records of one new staff member were not able to be found. We also spoke to four of the staff on duty during the day. We saw the main meal of the day being prepared and also looked at food records. Records for the running of the business were seen including fire check and staff fire training, complaints, accidents and incidents and health and health and safety records. Requirements were made with regards to fire safety issues. The manager of the home was on leave and a senior carer assisted with information when needed. What the service does well: 16 Hawthorn Crescent provides a comfortable, homely and well equipped environment for the people who live there. People have access to their local community, colleges and day care centres and are supported to keep in contact with their families and friends. Private bedrooms have all been decorated and personalised to service user’s individual wishes and specialist equipment provided. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 6 Healthcare support is good and people have access to medical specialists. The people living in the home say that they are happy living there, that they enjoy the meals provided and that the manager and staff team are kind, friendly and caring. What has improved since the last inspection? What they could do better: In order to ensure that the rights of service user’s are addressed, risk assessments and agreements must be recorded for the use of bed sides. All staff must be provided with supervision six times a year in order to monitor their practice and offer support and this should be recorded. To ensure the safety of both service users and the staff team, until the fire system is fully functional, a risk assessment must be completed and regular visual safety checks undertaken and recorded. All staff must receive up to date fire training. All records required to be kept for inspection including staff records must be available on the service. It is recommended that to improve the quality of life and enhance independence for service users, consideration be given to supplying the home 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 7 with it’s own vehicle and providing an office space for the staff team to work from that is fit for purpose. 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. 16 Hawthorn Crescent DS0000067147.V343212.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 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 4 and 5 Outcomes for service users in this area are good This judgement has been made using available evidence including a visit to this service. Prospective service users and their families have the information they need to make an informed choice about the home, People’s needs are assessed prior to them moving in and contracts of terms and conditions of residency agreed. EVIDENCE: The home has recently produced a new Service User Guide, using pictures, photographs and words and each service user has a copy of the document on their personal file. There is a comprehensive assessment and pre-admission procedure in place and service users confirmed that they had been involved in the process. Each person living in the home now has a Service User Agreement in place, these detail the terms and conditions of residency and have been signed by the service user or their representative. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 8 and 9 Outcome for service users in this area are good, This judgement has been made using available evidence including a visit to this service. There are care plans, risk assessments and daily records in place to ensure that the staff team are aware of the needs of the people they support. EVIDENCE: For each person living in the home there is a detailed plan of care in place that has been completed using information taken from their pre-admission assessments. The plans contain personal preferences, likes, dislikes and preferred routines and regular reviews are undertaken and recorded. There are also records kept of annual reviews with sponsoring authorities. Comprehensive risk assessments, which are designed to ensure that people can participate in the community safely, have also been completed and are reviewed every three months. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 11 Service users confirmed that they had been involved in the care planning process and said that they were supported to make decisions about their lives and take part in the running of the home. At the last visit a service user said they were unhappy about the staffing rota split shift system that is in place. As all service users attend day services, two staff work the early shift, then break and come back again when people return home. When spoken to at this visit the person said they were happier now because there are more staff on duty and if two people stay at home there are always two staff about. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 15 16 and 17 Outcomes for service users in this area are Adequate This judgement has been made using available evidence including a visit to this service. Although the home provides a variety of activities and outing and people have access to day services, this could be further improved by the provision of a vehicle for outings and further training in communication for the staff team. EVIDENCE: The home provides a variety of activities and outings for people and service users discussed a holiday to Devon and outings to local pubs and shops. All of the people living in the home attend day services or college and one person spoke about how they enjoyed the many activities available at their local Scope club. Each person has a pictorial calendar of weekly events in place and daily diaries are kept to record outings and activities. One person said they enjoyed using the Internet on their computer and another person was enjoying a visit from their girlfriend and planning a meal at 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 13 the local pub. One person indicated using their unique communication method, that they were very happy with the new sensory equipment in their room. One of the service users is very involved in their church and was being picked up by their mother to attend a special service. The same provider also owns the house next door to the home and at present a vehicle is shared between these two houses. A service user said that as all of the people living in the home are wheelchair users, sometimes they miss out on attending day-care or outings because the specialist vehicle is not available and taxis too expensive. Tracking of daily records and speaking to the staff on duty confirmed this. The senior carer on duty said that a new vehicle was being provided for the house but they did not know when. Records show that a variety and choice of meals are provided and people usually have a packed lunch and a hot meal in the evening. Many of the staff team do not have English as a first language and as the last visit a service user commented that there were sometimes problems with communication. Records show that some staff have attending English speaking courses and in the AQAA the manager says that other courses are planned. Comments from service users included, “It’s very, very good here, the staff are very kind and they are good cooks but sometimes I think that the staff have a problem understanding what I say, which can make life a bit difficult” and “ this is a good place to live and my girlfriend lives next door. We can visit each other whenever we want and we are planning to go out for dinner to the pub tomorrow”. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 Outcomes for service users in this area are good. This judgement has been made using available evidence including a visit to this service. The people living in the home receive good healthcare support and medication is well managed. EVIDENCE: The home works with a variety of healthcare professionals and records showed that people have access to their own doctor, dentist and optician. Referrals are also made to a physiotherapist and learning disability specialists when required. Specialist equipment including electric wheelchairs, track hoist systems and other aids and adaptations are in place to aid service user’s independence and mobility and medical assessments have been undertaken for each person. Specialist beds with movable guard sides are in use for each person but there are no risk assessments or agreements in place for the use of the sides. A requirement has been made for agreements and risk assessments to be completed. Since the last visit, a new medication cupboard has been purchased and medication is well managed. An agreement is in place with a local pharmacy 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 15 and during the visit when a family member was taking a service user out, their medication was given to them and the relative asked to sign to say they had received it. Medication Administration Sheets have been fully completed and a list of staff members that are trained to administer medication is kept on file. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Outcomes for service users in this area are good This judgement has been made using available evidence including a visit to this service. Service users and their families can be confidant that complaints will be recorded and acted upon and that the home’s working procedures are designed to protect people form risk of abuse. EVIDENCE: The home has produced a new accessible complaints procedure using pictures, photographs and words. A copy is placed on the notice board in the home and each service user has a signed copy on their personal file. Each service user has an individual complaints book and all complaints and concerns are recorded and acted upon. There is also a general complaints book and this also has the outcomes of two recent complaints recorded. The family member of a service user commented. “ I think the home does a good job and my relative is happy here. There have been some areas I have sometimes not been happy with and have taken them to the manager and if not satisfied have taken them higher than that. Things do get sorted out”. Training records show that staff attend training in the protection of vulnerable adults from abuse and those on duty at the time of the visit were aware of the procedures to follow should they suspect that any form of abuse had occurred. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 26 28 29 and 30 Outcomes for service users in this area are adequate. This judgement has been made using available evidence including a visit to this service. Although service users live in a clean, comfortable and homely environment, the use of their communal space for storage and staff duties means that they do not always have full access to all areas of their home. EVIDENCE: There have been extensive environmental improvements to the home carried out but there are still some areas needing consideration. The home has a large open plan lounge/dining room/kitchen area that is attractively decorated and has comfortable furniture. However because the office space is so small and unsuitable for purpose, the lounge area has files stored, the medication cabinet in place and staff carry out their meetings and complete records in the dining area. A service user commented, “The lounge is used to write reports and keep files in because the office is too small and too hot for people to work in” and a relative said, “An area of concerns for me is that the office is just a small conservatory, too hot to use in the summer and too cold in the winter. This 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 18 means that the staff write their reports and have meetings in the lounge/dining room, which encroaches on the comfort and privacy of residents”. The staff on duty said that they thought that further improvements to the home had been considered but did not know when this would be. Service users have large, well equipped bedrooms that have been personalised to each person’s taste and have large wet room type ensuite facilities. Adaptations and hoist tracks are in place to suit individual needs and as previously stated one person has been supplied with sensory equipment. The garden area has also recently been improved and is now attractive, easily accessible from the house and well maintained. There have been some complaints from a neighbour and from a service user about the noise of the laundry being used late at night, the staff on duty said that the laundry was now not being used after 8pm. Water temperatures were at a safe level and the home was clean and comfortable throughout. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 and 36 Outcomes for service users in this area are adequate . This judgement has been made using available evidence including a visit to this service. To ensure that the staff receive the support they need , supervisions should be carried out on a regular basis. Staffing records should be available for inspection at all times. EVIDENCE: Staffing rotas show that staffing levels have been improved in order to meet the needs of service users. Three staff work on the early shift and when service users leave for day services, two people break and then come back for the late shift. There is one person awake at night and one person on call. Service users confirmed that there were enough staff to meet their needs and that if people need to stay at home for any reason the rota is adjusted to ensure that sufficient staff are in place. Relationships between the staff on duty and service users was friendly, respectful and supportive and when people came back from day services they were greeted with a cup of tea and asked how their day had gone. Service users were complimentary about the staff team and comments included, “ The staff here are very nice, very kind and I can choose what I want to do”. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 20 As previously stated, many of the staff team do not have English as a first language, which was observed to sometimes makes communication with service users difficult. The AQAA states that this is being addressed by further training. The home has organisational policies and procedures in place regarding the employment of staff. Three staff files were seen and all contained the required documentation including a current Criminal Bureau Check and two references. However, there was a new member of staff on duty shadowing an experienced person but no records could be found for this person on the file. The staff on duty said that the manager would probably have these. A Requirment has been made regarding the availability of staff records. Speaking to the staff on duty and looking at records confirmed that all new staff receive a structured induction and attend training relevant to their roles and responsibilities. The AQAA states that in the staff team of nine people, six have NVQ2 or above and three are working towards the award. Regular staff meeting are held and supervision agreements are kept on each person’s file but records showed that staff supervisions are still not up to date. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 and 43 Outcomes for service users in this area is adequate. This judgement has been made using available evidence including a visit to this service. There are potential risks to both service users and the staff team regarding fire safety checks being recorded and by all staff fire training not being up to date. EVIDENCE: The acting manager of the home has been in post since June 07 and has not yet made application for registration or started a management course. In the AQAA the acting manager states that both of these areas will be addressed in the near future. Both the staff on duty and service users were complimentary about the commitment and attitude of the manager and a service user said “ what I like best about her is her kindness”. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 22 Service users have opportunities to discuss their views at regular service user meetings and also an annual quality assurance process is carried out by the organisation. Surveys had been sent out, replies had been collated and published and a copy of the outcomes was held in the home. The home has for the past month had intermittent problems with the fire system and although there are records of regular repairs having been carried out , the system is still is not working correctly. The staff on duty said that as the system kept breaking down regular visual checks are undertaken especially at night but these have not been recorded or a risk assessment completed. Fire checks and staff fire training records were not all up to date and this was brought to the attention of the senior carer on duty. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 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 2 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 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 2 3 3 x 2 X 3 X X 1 2 16 Hawthorn Crescent DS0000067147.V343212.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. 1. YA18 23 (4) (a) In order to respect the rights of service users, risk assessments and agreements for the use of bed sides should be obtained and recorded. To ensure that the staff team have the support and guidance they need, supervision for each person should be carried out and recorded six times a year. To address any potential fire risks to service users and the staff team a risk assessment should be carried out and extra visual checks recorded until the fire system is replaced or repaired. To ensure the safety of service users and the staff team, regular fire training should be carried out and recorded for all staff. To ensure that correct checks are being carried out prior to employment, all staff recruitment records should be held in the home and available for inspection. 30/10/07 2. YA36 18 (2) 30/10/07 3. YA42 23 (4) (e) 15/10/07 4. YA42 23 (4) (d) 15/10/07 5. YA34 19 (1) (b) 15/10/07 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA13 YA16 Good Practice Recommendations In order to improve the quality of life and enhance independence for service users, consideration should be given to providing the home with it’s own vehicle. In order to ensure that service user’s use of their own home is not affected, consideration should be given to building or providing an office that is fit for purpose. 16 Hawthorn Crescent DS0000067147.V343212.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 16 Hawthorn Crescent DS0000067147.V343212.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. 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