Inspection on 16/12/05 for 2 Ling Crescent

This inspection was carried out on 16th December 2005.

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 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

2 Ling Crescent 13/02/09

2 Ling Crescent 07/03/07

2 Ling Crescent 05/07/05

2 Ling Crescent 18/10/04

2 Ling Crescent 10/05/04

2 Ling Crescent 06/01/04

2 Ling Crescent 08/09/03

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Dalewood Respite Care

Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 2 Ling Crescent Headley Down Bordon Hampshire GU35 8AY Lead Inspector Marilyn Lewis Unannounced Inspection 16th December 2005 10:00 2 Ling Crescent DS0000012096.V269606.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 2 Ling Crescent DS0000012096.V269606.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. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 2 Ling Crescent Address Headley Down Bordon Hampshire GU35 8AY 01428 713014 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) Robinia Care Limited Miss Sally Budd Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: 2-4 Ling Crescent is a care home for 6 younger adults with learning disabilities. The home is similar in appearance to neighbouring properties and is situated on a small housing estate in Headley Down, Hampshire. All residents are accommodated in single rooms and have the use of two communal lounges and a separate dining room. The home has a large enclosed rear garden that is accessible to the residents. The home is owned and operated by Robinia Care Limited, an organisation that has been a care provider since 1995. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 16th December 2005. The inspector met with three of the five residents currently living at the home, two support workers and the acting manager. A tour of the home was conducted and records were seen for staff recruitment, staff training, medicines, resident’s personal finances, maintenance checks and fire drills. This was the second unannounced inspection for the year 2005/2006. Information on the first inspection can be found in the inspection report dated the 5th July 2005. What the service does well: On the day of the inspection the home looked clean, homely and festive, as it had been decorated for the Christmas season. The three residents who were at home appeared to be relaxed and good interaction was seen between staff and the residents. A full needs assessment is undertaken for all prospective residents to ensure the home can meet their needs and prospective residents and their relatives are able to visit the home before making a decision about taking a place there. Resident’s individual care plans provide clear information for staff to follow to meet the assessed care needs. Residents are encouraged and supported to make their own decisions and to take responsible risks, allowing them to participate in an independent a lifestyle as possible. Residents are able to attend education sessions at a local resource centre, have the opportunity to participate in a wide range of leisure activities and can receive visitors as they wish. Personal support is offered in a way preferred by the residents and their physical and emotional needs are met. Resident’s health is protected by the home’s clear procedures for dealing with medicines. The home’s complaints policy indicates that all complaints would be taken seriously and residents are protected by staff awareness of abuse issues. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 6 Residents benefit from the employment of staff who receive supervision and have clarity of their roles and responsibilities. The residents are protected by the home’s robust recruitment procedures. Residents are provided with opportunities to give their views on all aspects of life at the home and their health, safety and welfare is protected by the safe working practices operated there. What has improved since the last inspection? 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. 2 Ling Crescent DS0000012096.V269606.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 2 Ling Crescent DS0000012096.V269606.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, 3, 4 and 5 No one is admitted to the home without a full care needs assessment ensuring that the home can meet their needs and prospective residents and their relatives are able to visit the home before making a decision about living there. However the written contracts provided for residents require updating to give current information on some financial aspects. EVIDENCE: At the time of the last inspection the home’s Service User Guide required additional information including the qualifications of staff. The Service User Guide has been updated and now contains details of staff qualifications. The acting manager said that arrangements were in place for the document to be provided in a more suitable format for residents. At present it is offered in symbol format. A full care needs assessment is undertaken for all prospective residents, to ensure the home can meet their needs, before a place is offered at the home. The assessment covers all aspects of care needs including personal, social and emotional needs. The medical history and current medication are documented and also the prospective resident’s leisure and social interests. Information from the resident’s GP and other health professionals plus care managers and current care workers is included in the inspection report. The acting manager said that an application had been received for the vacancy at the home but the assessment indicated that it was not the right placement for the person or for the permanent residents of the home and the application was not accepted. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 9 When the assessment has been completed, the prospective resident has the opportunity to visit the home on a number of occasions before they move in. The acting manager said that the person usually starts with short visits to meet the permanent residents and staff and to join them for meals. This is followed by full day visits and overnight stays. The number and length of visits is dependant on the needs of the person and for some it may be assessed as in their best interests to visit only once. The person’s current carers visit with them and this provides an opportunity for staff at the home to learn the prospective resident’s routine and how they would like their care to be provided. The acting manager said that relatives were welcome to visit with the prospective resident or on their own. Each resident is provided with a written contract giving the terms and conditions for living at the home. Contracts seen for two residents required updating to include the organisation’s methods for charging for the use of transport, reimbursement for part of the cost of meals taken when out, such as in pubs and restaurants and expenses offered towards holidays. The contract is provided in symbol format. The acting manager said that the contracts were being reviewed and would be provided in a more suitable format for the residents. The contracts will be assessed at the next inspection. 2 Ling Crescent DS0000012096.V269606.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, 7, 8, 9 and 10 Residents care plans provide clear information on their assessed needs and the actions required to meet those needs. Staff encourage and support residents to make decisions about their lives and good risk assessments allow them to take responsible risks as part of an independent lifestyle. EVIDENCE: The acting manager said that she was currently auditing the care plans and risk assessments for all the residents. Care plans seen for two residents were detailed and contained clear information for staff to follow, to support the residents. Plans were in place for all aspects of care needs including personal care, nutrition, mobility, communication methods and leisure interests. The resident’s likes and dislikes were documented and the records indicated that the residents were able to change their minds as they wished. During the inspection visit staff were observed encouraging the three residents at home, to make decisions about their lives. Staff were seen to give residents a choice of activities they could participate in and to ask if they would like a drink and if so, what type, coffee, tea or juice. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 11 The acting manager said that one to one discussions were held with the residents to obtain their views on the quality of care provided and to ensure they were kept up to date with any changes in the home, for example, redecoration of rooms and the recruitment of new staff members. Risk assessments for daily living and leisure activities were included in the care plans. The risk assessments were good and gave details of the assessed risk and the actions required to minimise the risks. Risk assessments are completed for all leisure activities such as horse riding before the activity can begin. A risk assessment was undertaken for one resident with regard to using a trampoline before his wish to purchase a trampoline for the garden was agreed. The home has a system in place where staff are required to read the care plans and risk assessments and to confirm that they understood the documents. The home has a confidentiality policy in place that is given to all staff members when starting work at the home. A staff member spoken to was aware that information regarding the residents was confidential. 2 Ling Crescent DS0000012096.V269606.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): 11, 12, 13, 14, 15, and 16 Residents are treated with respect, have the opportunity to attend educational sessions and are supported to participate in a wide range of leisure activities both at the home and the community. EVIDENCE: The five residents attend educational sessions at the organisation’s resource centre located in a nearby town. Sessions attended vary according to the needs and wishes of the residents. Records seen indicated that residents participated in swimming, rambling, artwork and cookery while at the resource centre. Each resident has an activities programme in place for activities at home and in the community. The activities that the resident has been involved with are recorded and a reason is given for a change in the programmed activity, such as the resident wished to go for a walk instead of artwork. Activities programmes seen were for Monday to Friday and did not include the weekends, although the resident’s daily records indicated that residents were involved in activities on Saturdays and Sundays. The acting manager said that she would arrange for the programmes to cover seven days a week. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 13 The acting manager said that arrangements were being made for four of the residents to go on holiday in the spring of 2006. One resident who does not wish to stay away from the home will be spending the holiday going on day trips. The acting manager said that visitors were welcome at the home at any time but it was requested that they telephone prior to visiting to ensure the resident will be at home. Visits from relatives and friends were documented in the resident’s care plans. Each resident is provided with a document that outlines their rights while living at the home. These include the right to be treated as an adult, to be treated with respect and to receive care in the way they wish. During the inspection staff were seen to interact with residents in a friendly, respectful manner. 2 Ling Crescent DS0000012096.V269606.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 and 21 Residents receive personal support in the way they prefer, their physical and emotional needs are met and they are protected by the home’s clear procedures for dealing with medicines. EVIDENCE: The residents preferences for the way they receive personal care was documented in their care plans including the time of day they preferred to take their bath or shower and when they wished to go to bed. The records indicated that timings for daily living activities were flexible with one resident going to bed at any time from 10pm to 11.30pm. Visits by the GP and other health professionals were recorded in the resident’s care plans. On the day of the inspection one resident was visiting the GP with a staff member. The behaviour pattern of the resident had changed and a review was taking place of their medication. The care plans indicated that advice and support was sought as required. The home has clear procedures in place for dealing with medicines. Only staff who have received training in the administration of medicines are allowed to give out the medication. Medication records seen had been completed appropriately and records for medicines kept in the controlled medicines 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 15 cupboard matched the stock held. There is a recording system in place for all medicines received into the home and the disposal of unwanted medicines. Information on medicines in use at the home is available for staff. The acting manager said that it was difficult to determine the resident’s levels of awareness to ageing and death. The wishes of relatives were documented in the resident’s care plans and care managers were to be informed if a resident was seriously ill if there were no known relatives. 2 Ling Crescent DS0000012096.V269606.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): 22 and 23 The home’s complaints procedures indicate that all complaints would be taken seriously and residents are protected by staff awareness of abuse issues and the procedures to be followed should abuse be suspected. EVIDENCE: The home has a complaints procedure in place that indicates who will investigate the complaint and timescales for the process. The acting manager said that no complaints had been received in the last twelve months. Due to communication issues it was not possible to discuss the complaints procedure with the residents. However the good interaction between the staff and the residents indicated that residents were able to make their wishes known to staff. Staff were seen to take their time communicating, allowing the residents the opportunity to make their views known. Staff receive training in abuse awareness during induction. The home has procedures in place to be followed should abuse be suspected. Two staff members spoken to during the inspection knew about the procedures and indicated that they would have no hesitation in reporting any concerns. Small amounts of resident’s money are kept in the home. The monies are kept securely and records are kept of all transactions. Records seen for two residents matched the amount of money held. Residents are reimbursed £1.50 of the cost of a meal taken when away from the home such as when visiting the pub for lunch. A system for transport costs has been implemented that will be charged on a mileage basis. However, the home has not yet been notified of the actual rate per mile that will be charged. The acting manager said that residents do not contribute to gifts for staff. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 17 The organisation has recently arranged for residents to receive £500 towards the cost of their first holiday of the year. 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 18 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): EVIDENCE: These standards were assessed during the last inspection and information can be found in the inspection report dated the 5th July 2005. On this occasion the home looked clean and cheerful, with decorations in place for the Christmas season. 2 Ling Crescent DS0000012096.V269606.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, 32, 33, 34, 35 and 36 Residents benefit from the home’s robust recruitment procedures and staff who have clarity of their roles and responsibilities and receive regular supervision. Improvements have been made in staff training particularly in autism awareness but staff must continue to be offered training opportunities in communication methods. EVIDENCE: The home employs a registered manager who is currently on leave, an acting manager, a shift leader, a senior support worker and nine support workers. The use of agency staff has reduced to an occasional shift for a driver for the home’s transport. Staff receive a clear job description when starting work at the home and the role of the senior support worker has been discussed during staff meetings. Two staff members commented on the feeling of stability in the work force and one said ‘ we are building into a team’. Recruitment records were seen for two staff members who had recently commenced employment at the home. The records contained all the information required including two written references, confirmation of qualifications, proof of identity and work permits. Police checks from their home countries had been obtained and also checks had been made with the Criminal Records Bureau and Protection of Vulnerable Adults. One staff 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 20 member had not yet received a completed CRB check but had a POVA check and was working under supervision until the CRB check was through. At the time of the last inspection training records indicated that staff had not received training in areas relevant to the residents living at the home. Training had improved. All staff had received training in epilepsy and all bar one had received training in autism awareness. Records indicated that only four staff members have received training in communication. The acting manager said that arrangements were in place for staff to attended training in communication methods and learning disability awareness. This will be assessed at the next inspection. The organisation has introduced a training programme to follow on from the induction programme that gives a more in depth understanding of the provision of care for people with learning disabilities. Staff are required to complete this six month training programme before they are able to apply for National Vocational Qualifications. The acting manager is currently undertaking training in NVQ level 3 and the organisation’s management training programme that is formed of three parts, disciplinary procedures, recruitment and a project involving the home. When the management training programme has been successfully completed the acting manager will be able to commence NVQ level 4 and the Registered Managers Award. Two staff members are in the process of completing NVQ level 2 and two more staff members are due to commence the training programme in January. One staff member is a trained nurse in their home country and an application has been made for accreditation of an NVQ. Staff receive supervision from the acting manager who has received training in providing supervision for staff. Supervision meetings are arranged for at least six times a year and at a time suitable for both parties. The supervision covers aspects of the staff members working routine including their strengths and weaknesses and also training needs and opportunities. Records of the meetings are kept in the staff member’s personal file. The acting manager receives supervision from the area manager. 2 Ling Crescent DS0000012096.V269606.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): 39 and 42 The residents are provided with opportunities to give their views on all aspects of life at the home and their health, safety and welfare is protected by the safe working practices operated there. EVIDENCE: The registered manager is currently on leave from the home and an acting manager has the responsibility for running the home. The acting manager has been receiving support from the area manager. Residents meet together to discuss the quality of care provided at the home. Staff also hold one to one meetings with residents to provide opportunities to obtain feedback on the opinions of the residents. Pictures, photographs and symbols and signs are used to assist the residents to participate in the discussions. The acting manager said that residents are involved in all aspects of the running of the home including changes to the environment such as redecorating of rooms and staff recruitment. The home has one vacancy for a 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 22 resident and the acting manager said that the views of the residents would be obtained with regard to anyone who is assessed as suitable for the home. At the time of the last inspection records for fire drills indicated that some staff members had not attended a fire drill. On this occasion records showed that all staff had attended fire drills, including evacuation of the residents. Records seen indicated that staff received training in moving and handling, food hygiene, first aid, infection control and health and safety. The kitchen looked clean and in good order with foods stored appropriately. Hazardous substances such as cleaning fluids were stored securely. Health and safety posters were displayed around the home. Records seen indicated that regular maintenance checks were being carried out on electrical appliances. 2 Ling Crescent DS0000012096.V269606.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 x x 3 3 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2 Ling Crescent Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x DS0000012096.V269606.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 YA35 Regulation 18(1)(c) Requirement The registered person must ensure that staff receive training in communication. Timescale for action 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 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 2 Ling Crescent DS0000012096.V269606.R01.S.doc Version 5.0 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. 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