Inspection on 15/09/05 for 185 Passage Road

This inspection was carried out on 15th September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

185 Passage Road 17/02/09

185 Passage Road 31/12/07

185 Passage Road 03/04/07

185 Passage Road 10/04/06

185 Passage Road 21/04/05

185 Passage Road 13/09/04

185 Passage Road 27/04/04

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 08/07/2008.

CARE HOME ADULTS 18-65 185 Passage Road Brentry Bristol BS10 7DJ Lead Inspector Karen Walker Unannounced Inspection 15th September 2005 09:30 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 185 Passage Road Address Brentry Bristol BS10 7DJ 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) 0117 9509586 0117 9699000 The Brandon Trust Mr Andrew Kevin Williams Care Home 7 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (2), Mental disorder, excluding of places learning disability or dementia (3) 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate male persons only May accommodate persons aged 40 years and over May accommodate persons with a Learning Disability and additional Mental Disorder 21/04/05 Date of last inspection Brief Description of the Service: This home is registered to accommodate 7 male residents with a learning disability. The current resident group have a variety of complex needs whose ages range from 43-88 years. The Registered Providers for this home are the Brandon Trust. This single level home is situated on Passage Road and is close to local amenities. There are local bus stops providing easy access to the city center and to Cribbs Causway and its shopping facilities. The home blends easily into the local community and is in keeping with the neighbouring properties. The home is fully accessible to the current resident group providing ground floor accomodation. There is a large well kept garden mainly laid to lawn with fruit trees. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this inspection was to review the requirements set at the last inspection and review care practice in the home. The inspector spoke at length to 3 residents and 4 staff members all of whom provided information for the compilation of this report. Documentation was examined relating to residents and to the general running of the home and health and safety issues. The inspector spoke with 3 residents who said they were happy living at the home. One said, “yes its nice I like it”. Another said, “I like it here my rooms nice”. “I went out the other day to a café and my niece came to visit me”. What the service does well: What has improved since the last inspection? One person has a comprehensive epilepsy care plan, which has been compiled with professional input. This document ensures staff are aware of certain actions to take when the resident has a seizure, when to call for emergency services and how best to support him. A number of environmental improvements have taken place that residents approve of. One said “its brighter in here” when asked about the newly painted living area. Another asked “do you like our nice new flooring in the dining area?” Some residents confirmed they were now getting out more and were enjoying trips to cafes and pubs. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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): 1-5 Adequate information is not recorded on admission to demonstrate that residents are given the information needed to make an informed choice about where to live. Contracts are not updated from one home to another and the statement of terms and conditions are outdated. EVIDENCE: The resident’s register that must be completed on admission to the home was dated 2001even though the resident in question moved in a couple of months ago. The address was recorded as his last placement and his board and lodging charges and contract referred to his old home. All of his personal information including the people in his life relate to his last placement. This is not acceptable and a requirement is made to ensure all personal information relating to residents is updated on admission and reviewed as necessary. The statement of purpose or the service user guide was not examined at this inspection although was seen to include all necessary information as required by legislation at the last inspection. The manager was reminded of the need to update each document to reflect the staffing changes. Residents have the opportunity to test drive the home and one resident confirmed he “came for tea before moving in”. He was also accompanied by a staff member from his previous home who carried out some duties at the home to aid with orientation. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 9 The inspector examined in depth two care planning folders and noted that both contained assessment information completed by social services prior to moving into 185 Passage Road. Through examining records and correspondence it was evidenced that specialist services are sought through the community learning disabilities team (CLDT). The consultant psychiatrist has regular input and carries out medication reviews. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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): 6,9 Staff and residents do not have the necessary written documentation to ensure changing needs are assessed, reviewed and met. Risk assessments do not reflect current care needs and do not identify current risks. EVIDENCE: Care plans were examined and one contained inadequate information essential in offering the correct support and meeting changing needs. A referral had been made for one person regarding a ‘breakdown of skin’ the referral was not signed or dated so it was difficult to track progress. There was no information available in the plan of care to inform staff how to meet this particular need; there was no associated risk assessment to reduce the risk of further skin breakdown. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 11 The care plan was examined and it did not contain information relating to skin care, diet, mobility and aggression both physical and verbal. Care plans and risk assessments must be put in place to adequately support residents and a written immediate requirement was left with the deputy manager on the day of this inspection. The need for satisfactory risk assessments was highlighted at the last inspection and although some progress has been made in the way of generic assessments more emphasis must be put on individualised risk assessments or enforcement action may follow. Staff members confirmed that one resident in particular was becoming more challenging both physically and verbally. Although behaviours seen as challenging are recorded it is recommended that this be more structured. An ‘ABC’ chart will prompt staff to record the triggers, (Antecedent) what the behaviour was (Behaviour) and the outcome of the behaviour (Consequence). Records seen were respectfully written although sometimes lacked detail. It is essential that a strategy plan and associated risk assessment be put in place to ensure resident and staff safety and reduce the risk of such incidents occurring. An immediate requirement was left on the day of inspection in respect of this. Staff confirmed regular staff and resident meetings take place although records were not examined. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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): 12,14,17 Residents are offered a healthy diet based on choice. Residents are not supported to maintain interests and attend church services of their choice or day care/activities of choice. EVIDENCE: The inspector spoke with one staff member who had menu planning and recording as her area of responsibility. She explained how she offered choice to the residents and how she planned a rolling 3-week menu. One of the residents said “the food is good, I always get a nice Sunday lunch with the meat that I like”. The staff said 2 joints were offered to ensure everyone had their preferred choice of meat. Deviations to the planned menu are recorded as per residents’ choice. Another resident said, “I like the food it is nice”. The deputy manager and staff members said that more activities were now offered to residents. One confirmed he enjoyed lunch out at a café and was really pleased to be visited by a family member. He said, “I get out and about a bit more now if I want to but I don’t always want to”. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 13 Staff members confirmed that another resident is encouraged to accompany staff when shopping or visiting cafes. However it was noted that this resident does not receive any of his originally planned day care or social activities as highlighted in his plan of care transferred from his last placement. Staff confirmed that this resident is often “at a loose end” and “gets no stimulation”. It is highlighted that it is ‘essential’ that his day care package be continued and that his Tuesday night ‘gateway club’ continues. He also used to attend a church where he is well known and feels a part of the church community. He was also a member of a luncheon club in Clifton. All of this has been discontinued since he moved to Passage Road. This is unacceptable and measures must be taken to ensure this resident continues to have his assessed needs met with regards appropriate activities. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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 Residents receive personal care in private in a way in which they prefer. Residents are confident that specialist support and advice will be sought where needed. EVIDENCE: Two of the care plans examined by the inspector contained detailed records setting out the preferred routines and likes and dislikes of the individual. There were also details regarding methods of communication and other preferences. The deputy manager was able to evidence to the inspector that specialist support and advice had been sought where needed. An example of this was found in two care plans that recorded involvement and referral from the occupational therapist and the continence advisor. A resident confirmed, “I was seen by a very nice Doctor who said I must drink more”. Records show that fluids are encouraged and this was confirmed by a staff member who said “I always offer cranberry and other juices”. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 15 One resident confirmed he had been visited by the occupational therapist and was able to tell the inspector of the recommendations made to support his mobility. He was also pleased to be getting a wheelchair for longer distances. Medication administration sheets were examined and found to be in order. The inspector did not take the opportunity to take a stock check of the as and when medication (PRN). There have been no incidents regarding medication administration or recording reported to the CSCI since the last inspection. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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): Residents are confident that their views will be listened to and acted upon. There are procedures in place to ensure residents are protected from abuse. EVIDENCE: Two residents told the inspector that they have made complaints, staff confirmed this. The complaints book was examined and it was noted that both of these complaints were recorded along with the action taken to resolve the complaint. One resident said, “I have no problem making a complaint, I tell my key-worker or the other staff”. It was noted that since the last inspection the ‘No Secrets in Bristol’ document has been placed on the notice board for ease of access. Staff confirmed they were aware of the Protection policy and new staff said they had attended protection training provided by the Brandon Trust. It is recommended that protection training be added to the rolling training programme and be attended on an annual basis. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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): 24-30 Residents live in a homely environment that has benefited from environmental improvements. Bedrooms and other areas in the home meet the needs of the current resident group. EVIDENCE: Although the home is accessible to the current resident group the inspector was told that a ramp is to be considered for ease of access to the rear garden. This is strongly recommended to meet the changing mobility needs of residents. All of the environmental requirements made at the last inspection have been met. There are adequate bathing facilities and toilets available that meet the assessed needs of residents. A new assisted bath is being installed and one toilet has the added benefit of a toilet raiser. One resident now has a footstool and a commode in his bedroom and said “this has helped”. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 18 Residents’ bedrooms are homely in appearance and individualised. One resident was happy watching TV in his room and was surrounded by photographs and personal items. He said he enjoyed staying in his room and agreed it was comfortable. The living area has greatly improved since the last inspection and looked brighter and cleaner. Newly decorated walls and floor coverings gave the area a fresher look. There were no unpleasant odours found in the home on the day of this inspection. The garden was well kept and the deputy said there were plans to purchase a summerhouse. There was garden furniture provided however it was noted that this was in need of wood staining to retain the quality and appearance of the wood. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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): 31-35 A robust recruitment process protects residents however the home does not meet current legislation, as records are not stored at the home. EVIDENCE: Staff confirmed they attended various training courses both statutory and resident related. Staff confirmed there is a planned ‘challenging behaviour’ workshop. All new staff receive structured induction training within the first 6 weeks of employment and carry out foundation training within the first 6 months where the Learning Disability Award Framework (LADAF) is completed. One new staff member confirmed this. New staff said they were aware of their roles and responsibilities and had been given ‘areas of responsibility’ for which they are responsible. One staff member said her new responsibility was ensuring a balanced menu with support from residents. The deputy manager said that the staffing levels for the establishment had improved and this was confirmed by the duty rota. However it is required that adequate staffing be provided to ensure residents attend their planned activities as stated in their essential lifestyle plans. This links to standard 14. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 20 Staffing records are not held on the premises but are held at Brandon Trust HQ. At the last inspection the manager confirmed he had access to potential staff CRB’s and recruitment records. It remains however a requirement to ensure all staffing records relating to recruitment is held on the premises. This requirement has been the subject of much discussion between the CSCI and the Brandon Trust and remains unresolved. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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): 37,38,40,41,43 Residents’ benefit from the knowledge that there is a staff team in post that are aware of their roles and responsibilities within the home. The manager is yet to go through the registration process. Residents’ rights and best interests are safeguarded by the homes policies and procedures. EVIDENCE: Unfortunately this home has seen many staff changes and is in need of an effective manager who will offer continuity of care to an unsettled resident group and workforce. The home has been lucky to have the support of the deputy manager throughout all the changes that have taken place. This has helped to alleviate the anxiety felt by some of the residents. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 22 It is recommended that a full team day be planned where the team can explore issues surrounding change and networking opportunities to gain support, discuss their feelings and offer a way forward. Staff members spoke positively of the new manager in post. Comments included “she has got some good ideas” and “she is motivated and a bit of a go-getter”. Staff said and the rota confirmed that the manager carried out a waking night shift to experience first hand any difficulties arising at night. This is commended. The manager has not yet completed the registration process and the inspector awaits the return of references. Once this process has been completed the manager will be invited to attend a ‘fit person interview’ at the CSCI office. The home’s certificate of insurance was displayed, as was the registration certificate, which will be updated when the new manager has successfully gone through the registration process. The inspector noted that all fire doors have automatic closures activated by the fire alarm. Staff confirmed they had attended fire training but the fire logbook was not examined. The home has many policies and procedures put in place by the Brandon Trust to safeguard residents and staff. Policies are adopted and adapted to suit the home. Unless identified throughout this report records were generally up to date, daily records were kept and records of a confidential nature were kept in a lockable facility. The Service Development Manager carries out monthly ‘regulation 26’ visits to ensure the service is running smoothly and offer support. Copies of these reports are sent to the CSCI. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 3 3 3 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 X X 1 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 2 13 X 14 1 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 3 2 2 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 185 Passage Road Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 X 3 DS0000026543.V249184.R01.S.doc Version 5.0 Page 24 Yes 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 YA11 Regulation 17(3)(a) 3(3)(a-q) Requirement Timescale for action 01/10/05 2 YA5 3 YA6 4 YA6 All personal information relating to residents must be updated on admission and reviewed as necessary. The residents’ register must be completed. 5(1)(c) All residents must have a 01/10/05 written and costed contract referring to the place in which they live. 15(1)(2)(b) Care plans and associated risk 15/09/05 13(4)(c) assessments must be put in place to adequately support residents, these must reflect changing needs and be adequately reviewed. An action plan must be forwarded to the CSCI. As per immediate requirement. 13(6) With regards physical and 15/09/05 verbal aggression It is essential that a strategy plan and associated risk assessment be put in place to ensure resident and staff safety and reduce the risk of such incidents occurring. As per immediate requirement. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 25 5 YA14 6 YA33 7 YA34 16(2)(n)(3) Action must be taken to restore some of the essential day care/activities that were attended by one resident before his move to Passage Road. This includes being a member of his chosen church. The home must send an activity plan to the CSCI. 18(1)(a) It is required that adequate 16(2)(n) staffing be provided to ensure residents attend their planned activities as stated in their essential lifestyle plans. Requirement linked to standard 14 above. Schedule Ensure all staffing records 4(6)(a-f) relating to recruitment are held on the premises. 01/10/05 01/10/05 01/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard YA6 YA23 YA24 YA24 YA37 Good Practice Recommendations Put in place an ABC chart with regards behaviours that are seen as challenging. It is recommended that protection training be added to the rolling training programme and be attended on an annual basis. Consider installing a ramp for ease of access to the rear garden. The garden furniture is in need of wood staining to retain the quality and appearance of the wood. Plan a full team day where the team can explore issues surrounding change and networking, discuss their feelings and offer a way forward. 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 185 Passage Road DS0000026543.V249184.R01.S.doc Version 5.0 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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