Inspection on 27/04/06 for 20 Longton Road

This inspection was carried out on 27th April 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

20 Longton Road 06/02/08

20 Longton Road 24/10/05

20 Longton Road 30/11/04

20 Longton Road 17/05/04

Similar services:

Polesworth Group 68 Long Street

10 Whitfield Avenue

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 20 Longton Road Stone Staffordshire ST15 8DQ Lead Inspector Mr Berwyn Babb Key Unannounced Inspection 27 April 2006 13:30 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 20 Longton Road Address Stone Staffordshire ST15 8DQ 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) 01785 615477 RMP Care Mr Paul Stevenson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Home will be run as two units, the former No 19 as a fully staffed unit and the former no 20 as a semi staffed unit. 24th October 2005 Date of last inspection Brief Description of the Service: The home is a terraced house that adjoins another home owned by the Proprietors. The appearance of the home is in keeping with the surrounding properties and as such does not present itself as a care setting. The location of the home provides for good access to public transport systems and is within walking distance of the town centre. The home is managed by one of the proprietors. The Home provides for three younger adults with a learning disability. The accommodation is provided on two floors and consists of a lounge/dining area, kitchen and ground floor bathroom. There are three single bedrooms on the first floor. There is an enclosed courtyard to the rear of the property that leads to a grassed garden. The home is staffed to the assessed needs of the service users and it has been agreed that a member of staff should do sleep in duty in the adjoining home, and the alarm call in No 20 be diverted to arouse that member of staff in No. 21 at night. The aims and objectives of the home are to provide a small comfortable home which is staffed to meet individual service users needs and enable development and integration into the local community. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced key inspection and only planned inspection of the year 2006/2007. Initially one residents one member of staff and the general manager of the group of homes managed by RMP Care were present and these were later joined by three more of the current residents and one of the proprietors. A phone call was received during the inspection to inform the home that the fifth residents, who had been undergoing a period of reassessment at health service provision, would not be returning to the home as his needs had now developed such that they were outside of the scope of the care being offered here. The care of these two differing groups of residents matched the documented assessed needs and personal choices, and demonstrated commitment to maximising the differing potential of each individual. Attention to assessed risks was demonstrated to have prompted the home to vary its provision so that they could maximise through the mediums of education, training, staff assistance and medical care, the ability of residents to achieve or maintain their ability, choice or lifestyle, rather than to pose any limit to it. Three of the four residents present engaged fully with the inspection process, the fourth engrossed in a favourite television programme as soon as he returned to the home. The inspector is grateful to all residents and members of the management and staff of the home for enabling the time spent in the home to be so client focused. In free discussion with the inspector, the residents emphasised their part in picking the new furniture and fittings, and the styles and colours of the renewed decoration. The only adverse comments received were that one resident couldn’t get a picture on his television through the lack of an aerial connection, and another didn’t see why she should have to negotiate the stairs at night in order to go to the toilet, when the bedrooms in the extension had been fitted with en-suite facilities. What the service does well: This home provides the best service possible of an independent model of living for two separate groups of people, one having higher staff input than the other, but both firmly located in the local community. It has a history of providing a stepping-stone towards supported accommodation, and two current residents continue to consider their long-term future along these lines. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 6 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. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 The outcome for this group of service users was good because pre-admission assessments and available information allowed for proper choices to be made in relation to the appropriateness of the home for an individual. EVIDENCE: Before inspecting the home, the inspector had been furnished with a copy of the Statement of Purpose and was able to verify that it accurately recorded the new situation presented by the extension of this home. The ability to provide accommodation for two residents, who had a greater degree of need for the input of care from permanent staffing, featured with the description of the new facilities provided for those residents. The inspector spoke at length with one resident from each of the two units, one of who told him that she was in possession of a contract, which she was able to comprehend, and that she had been able to make several visits to the home before taking the decision that this was the place where she wanted to be. The other resident who had just moved into the more robustly staffed unit was able, through his conversation, to indicate the various processes by which an assessment of his changed needs had been formulated, and his understanding and agreement with the move to the new unit, in order to be able to meet these needs more fully. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 9 RMP’s general manager provided further information as to how the extra funding for this gentleman had been negotiated and also details of the CPA single care plan. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The outcome of this group of residents is good as their care plans are easily accessed and accurately record their needs and choices, and how these are met. Outcomes show they have been assisted to reach enabling decisions, within which they have been supported through the minimisation of hazards to take acceptable risks. EVIDENCE: Care plans examined prior to the inspection of the home had shown extensive investment of time in exploring most suitable and appropriate channels for caring for the individual in line with their assessed needs and declared choices. This entailed involving a large number of partner agencies and professionals, always with a view to development of a potential, rather than to limitation of a lifestyle. They demonstrated the shared nature of record keeping in this home, with residents recording their own daily activities, in line with their differing abilities. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 11 In discussion with the residents on the day, it was established that they were aware of the concept of advocacy and that some had experience of using it. Whilst in the home they had a high degree of input into the planning and preparation of the activities of daily living, and their vibrant social life. Limitations on choice were seen to be not only in consultation with the resident and in their best interest to prevent abuse or harm to themselves or others, but also to be the least restrictive alternative available. Much staff input and training was seen to be aimed at expanding the independence of individuals through programmes designed to reduce the perceived risks inherent in some of their chosen activities. Examples seen included increasing the distances travelled by public transport and the complexities involved in these journeys, and the new more intensively staffed unit was allowing one man to continue as a resident of a facility in the community, where the escalation of his challenging behaviour might otherwise have resulted in him being incarcerated in more institutional care. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The outcome for this group of service users is good because nobody is expected to engage in activities that are not suitable for their age or expectation, nobody is excluded from the local community, nobody is excluded from having relationships of their choice, nobody is excluded from a fall part of the life of the home and everybody is involved in planning, producing and serving a balanced diet. EVIDENCE: The resident who was in the home when the inspector arrived and who hopes eventually to move to supported accommodation, is engaged in part time employment in a local care home for the elderly. Another resident travels to the nearby county town, where she has found work in a prestigious local coffee house. Another resident assists with an advocacy group as well as attending day service provision and the fourth current resident attends day services and a local rural project. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 13 All service users have extremely active social lives and were able to recount enjoying activities at various clubs and centres of entertainment including cinemas and restaurants, trips to night spots, shopping trips, and one resident who exercise her religious choice. Residents were able to speak positively about other people living in their neighbourhood, and who were very supportive to the community of this home. Towards the end of the inspection the second member of staff came on duty to enable some of the residents to participate in a special evening that had been planned in order to celebrate the birthday of one of them. It was seen in records that flexible staff provision was also made to enable participation in sporting activities such as keep fit clubs and swimming. There was evidence from the care plans, and also from the informal conversation with the residents, that they were able to engage in a wide range of relationships and maintain close family and friendship ties. The inspector has been consulted by the home during the period between this and the previous inspection, about the nature of some of the sexual awareness training that they were facilitating for residents. All residents have keys to their bedroom doors, and each toilet and bathroom was fitted with a privacy lock. Residents undertook various housekeeping tasks and from talking to them it transpired that as in any “family” some were more enthusiastic about this than others. One resident was celebrating his birthday, and a group discussion had previously decided to make this a curry night, so towards the end of the inspection the level of excitement was visibly mounting, as take away menus were acquired and lively discussion entered into about whose choice of what food was going to be eaten. Discussion and reference to written records showed that residents quite often enjoyed “themed” evening with an appropriate meal, and they assured the inspector that they thoroughly enjoyed this. The providers demonstrated their consciousness of the need for healthy eating and a balanced diet, by ensuring daily supplies of fresh fruit and the involvement of healthcare professionals in monitoring and service provision for the diet of one resident. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The outcome for this group of residents was good because they were seen through discussion and examination of the records to be receiving support in the way they preferred, being consulted about how their physical and emotional needs were met, and where they require medication, appropriate training had been received by those responsible for its administration. EVIDENCE: The inspector spoke at some length to one female resident who assured him that she received appropriate assistance from staff that was sensitive to both her choices and her gender. She confirmed that staff were supportive of residents with emotional care needs and accommodating to their personal choice of rising and retiring times and such things as when they would have a bath. The inspector had been made aware previously through consultation, of the educational guidance being offered to one resident, in respect of the interpretations that other people may put on some of her choices in styles of dress. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 15 During the variation to register the extension there had been extensive discussion with the providers that briefed the inspector concerning the extent to which the health care needs of service users were being assessed, and the amount of time being put into planning input both within the home, and through regular and “as required” appointments with such healthcare professionals as consultants, nurses and GP’s. In addition to the enablement of residents who obtain the tertiary healthcare provisions of chiropody, dentists, opticians and specialist nurses for such things as diabetes, extensive links had been fostered with the various clinical teams providing assistance to those people who have learning disabilities. These encompassed physic try, psychology, speech therapy, community behavioural team and LD specialist community nurses. Where residents used medication, this was seen to be stored and recorded appropriately, either by themselves or where risk assessments indicated this to be more appropriate, or where it was their choice, by members of staff who had been suitably trained. Information was available in the medicine book and on the individual care plans of residents, concerning the effects of the medicines being administered, and the possible and less desirable side effects of these medications. There were also appropriate protocols for the use of “homely remedy” medicines. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The outcome for this group of service users is excellent because of the consistency that has been demonstrated by the management in providing training about abuse for residents and staff, together with a rugged complaints procedure. EVIDENCE: The inspector chatted at length with one resident who not only demonstrated a precise knowledge of the complaints procedure of the home, but also verified that she had a copy of it in her possession. The member of staff on duty had good knowledge of the procedures to be followed in case abuse was suspected, and this confirmed the historic records of this home in dealing effectively and appropriately with any suggestions of abuse, whether potential or actual. Leaflets on how to make a complaint were freely available in the home as they have been on every occasion with this inspector as visited any RMP Care home whether this be by arrangement, or unannounced. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 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 The outcome for this group of service users is good because the providers strive continuously to improve the property and to maintain the standard of provision and decoration to enhance the lives of the residents. EVIDENCE: Alterations have recently taken place to link this building with the adjacent building at number 19 and remedial work following this has included the laying of new carpets in the dining and lounge areas, the redecoration of these areas and the refitting of the furnishings and electric light shades and lamp standards, and the provision of new pictures for walls, all of which have been chosen with the guiding and major input of residents. The validity of this was confirmed to the inspector by one of the residents with whom he had a long conversation. One point that was made however was that the new provision next door has toilet facilities located near to the bedrooms upstairs, and the residents of the original house have to negotiate the stairs at night, if they wish to go to the toilet. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 18 The resident could not see why it if had been possible to make conversion in the house next door which was of a mirror image to the original number 20, that the original number 20 could not be treated in the same way. This point was drawn to the attention of the group’s general manager during the inspection, and she agreed to bring this to the attention of the director responsible for maintenance and renewals. The premises are in keeping with the local community in part of a terrace of houses and being in no way stigmatised as being a registered home. The home presented as being extremely clean and tidy, with systems in place whereby residents contributed towards the maintenance and upkeep of the daily standard of the home, including the use of domestic washing machine, and ensuring that soiled clothing was never in contact with food during the process of preparation, cooking or eating. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,35 The outcome is good for this group of service users because the providers are committed to a programme of training that covers not only the mandatory subjects, but also specific areas related to the individual needs of the residents of their homes. EVIDENCE: The schedules training provided by the group general manager to the inspector shows a weekly commitment to learning disability, award framework training each Tuesday, a session of training for speech and language and communication and understanding on 17th May, a session on non aversive intervention during the month of June, accreditation training in medication during July, and NVQ training during August. In addition to this there were regular update training for people whose certificates were due to expire in First Aid, Food and Hygiene, Moving and Handling, Fire Protection Awareness, and Hygiene and Infection Control. The staff rota shows that there is a member of staff on duty 24 hours of the day in the fully staffed unit, in addition to which an extra member of staff is on duty in the semi staffed unit between 17.00 and 22.00 hrs each day. This is judged to be sufficient for the assessed needs of the residents whilst they are in occupation of the home, remembering that the majority of them spend their daytime hours either at work, education or activity locations away from the home. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 20 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): 39,42 The outcome for this group of service users is god because their opinions are sought on all aspects of the running of the home, both formally and on an ad hoc basis and the providers take active steps to ensure the best health, safety and welfare of their residents as is practically possible. EVIDENCE: The inspector was able to confirm with service users that they had been fully consulted, and had in fact driven the redecoration of the home, both the communal areas and their own private rooms, and that the providers and staff consulted them at all times, about any issues that were relevant to their life in this homes. The inspector was able to view a sample of questionnaires that had been filled in by residents and other stakeholders in the home, making clear their feelings about the manner in which the home was run. All those seen by him were complementary and positive. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 21 The home undertakes regular safety audits and does training to promote safe working practices. A member of staff who was interviewed confirmed that first aid, fire safety and food hygiene and health and safety training were all kept up to date, and the company made time available for them to receive training either in the home on a cascade basis from the general manager, or by going on course that had been put on by training organisations, or by the Staffordshire Association of Registered Care Providers. The group general manager assured the inspector that their fire evacuation risk assessment process was based on the assessed needs of each individual and that where an individual through there condition was thought to be at risk of not responding to the need to evacuate the premises, then a plan for dealing with this and identifying that person would be was with their consent, secured to the fire control board. Evacuation procedures were seen posted in the hall and in the service area, and an emergency information sheet has also been added to the fire control board to be read by anybody calling the brigade. This contained clear information about the best vehicular access to the property. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 22 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 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 X 3 X X 3 X 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA24 YA27 Good Practice Recommendations The resident identified to the Group General Manager at the time of the inspection, should have suitable arrangements made for his T. V. to receive a good signal. The resident identified to the Group General Manager at the time of the inspection, should have en-suite facilities provided, so she does not have to negotiate the stairs at night, in order to reach the toilet. 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 20 Longton Road DS0000005091.V291997.R01.S.doc Version 5.1 Page 25 - 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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