Inspection on 29/08/08 for Dallimore House

This inspection was carried out on 29th August 2008.

CSCI found this care home to be providing an Poor service.

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

Other inspections for this house

Dallimore House 01/08/07

Dallimore House 25/05/06

Dallimore House 15/11/05

Dallimore House 17/05/05

Dallimore House 21/01/05

Dallimore House 12/08/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2009.

CARE HOME ADULTS 18-65 2a Guildford Road Chertsey Surrey KT16 0QA Lead Inspector Kenneth Dunn Unannounced Inspection 29th August 2008 09:30 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2a Guildford Road Address Chertsey Surrey KT16 0QA 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) 01932 568553 Welmede Housing Association Ltd Susan Narriman Davies Care Home 6 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Physical disability (LD) The maximum number of service users to be accommodated is 6. 2. Date of last inspection 1st August 2007 Brief Description of the Service: 2a Guildford Road is a detached property situated off of the main road and within walking distance of Chertsey town centre. The home is owned and managed by Welmede Housing Association, with the staff team employed by North East Surrey Primary Care Trust. The home provides accommodation and care for up to six people who have a learning disability, four of whom may also have a physical disability. There are currently six service users living at the service. The service is wheelchair accessible throughout. The accommodation is a lounge-dining room, kitchen, laundry, toilet and one bathroom. All bedrooms are single occupancy and none are en-suite. The home has the use of its own vehicles to access activities and local amenities and has limited parking to the side of the building. The fees for the home are £1,375.00. Items not covered by the fee, include hairdressing, personal items, clothing, toiletries and some holidays. Activities are paid out of the amenity fund. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 0 star. This means the people who use this service experience poor quality outcomes. This unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection (CSCI). The inspection was carried out on behalf of the CSCI by Mr. Kenneth Dunn regulation Inspector on the 29th August 2008. The CSCI Inspecting for Better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) to be completed by the service, which includes information from a variety of sources. This initially helps CSCI (us) us to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document was received by CSCI and is referred to throughout the report. The registered manager for the service has been absent from the service for 10 months due to ill health. The organisation has implemented temporary arrangements for the day-to-day management of the home. They have coopted a registered manager from a second establishment to oversee 2a Guildford Road two days a week. The information contained in this report was gathered mainly from observation by the inspector, speaking with residents, and care staff and from information contained within the AQAA. Further information was gathered from records kept at the home. All records sampled were up to date with care plans being signed by the residents and or by their representatives. What the service does well: The people who use this service are fully assessed prior to moving into 2a Guildford Road. The service has a robust policy to deal with complaints and potential abuse. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 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 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 was assessed during this visit. People who use the service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The policies and procedures in place ensure that any prospective residents will have a full assessment of their needs completed prior to them being offered a place in the home. EVIDENCE: There had been no further admissions since the last inspection by the CSCI on the 1st August 2007. Records examined confirmed good practice admission assessment procedures were followed for all residents. A random sample of the individual files of the people who use the service was conducted. The files sampled all contained a full set assessment of needs completed prior to the person moving into the home. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9 were assessed during this visit. People who use the service experience a poor quality outcome in these areas. This judgement has been made using available evidence including a visit to this service. The people who use this service are not assured that their needs and goals are reflected in the care plans. Individuals are assisted to make appropriate decisions by staff. Service users are supported to take reasonable risks further risk assessments are required. EVIDENCE: The care plans of four people who live at the service were sampled and there was evidence that the health, personal and social care needs had been identified and assessed. However in three files the information sampled had not been reviewed recently and was in a format that was not user friendly. One member of the care team had difficulties in finding the appropriate section in the files and then could not find plans that were up to date. The lack of user-friendly care plans was recorded in the previous CSCI inspection report (1st August 2008), at that 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 10 point the manager of the service stated that the plans were in the process of changing. A member of staff stated that the people who use the service are fully supported to make decisions about their lives and that the staff only become involved if they need assistance. Samples of risk assessments were viewed during the visit. A small percentage showed evidence of being recently reviewed by staff. There is however a need to expand the process of risk assessment to ensure that all risks are assessed and minimised as far as possible. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17 were assessed during this visit. People who use the service experience a poor quality outcome in these areas. This judgement has been made using available evidence including a visit to this service. The people who live at this service have intermittent access to appropriate activities. Generally the lifestyles of the individuals living at the service have been limited. There has been a failure by some members of staff to recognise and support individual’s dignity and respect. The service has failed to make suitable provisions for the production of meals, hygienic drink and washing. EVIDENCE: As part of the site visit the activity files of four people who live at the service were sampled. One file had been reviewed recently and contained relevant information regarding the likes and dislikes of the individual concerned. The key worker involved in the review was knowledgeable and explained the process that had been used to review and redevelop the activity plan for this person. The three 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 12 remaining files contained out of date plans or had no information about the person and the activities they undertake or enjoy. These files also contained nicknames, which were not appropriate and could be considered derogatory. The files also contained other examples of the lack of understanding of the basic premise of equality, diversity, dignity and respect by focussing upon individual’s idiosyncrasies and not relevant facts. It was stated by a member of staff that the service users are all supported to make choices in their everyday lives as far as they are able. In the event of service users having family members in contact they are consulted and encouraged to be involved in the decision making process. At the time of the visit one person living at the service was away on a family holiday and a further 3 individuals were preparing to leave for a 5 day holiday in Bournemouth. The service has been unable since the 4th August 2008 to produce adequate healthy meals for the people who live there. The kitchen was removed on the 4th of August 2008 to be replaced by a new one. However on the day of the site visit the kitchen was on site but not fitted, the inspector was given an approximate completion date by a member of staff as mid September. The staff have been preparing snack meals in the microwave that had been relocated to the dining room along with the fridge and two freezers. The majority of meals were stated to be either takeaway food or meals out. The staff also had to use the laundry room to wash crockery and cutlery and this was also the main source of water for the homes drinks. The service had not undertaken any risk assessment or impact studies on how the people who use the service would cope with such an upheaval. In addition to this the system of safe food storage and handling was not being adhered to. In the fridge we found raw bacon left lying on top of open containers of cooked food. The inspector made two immediate requirements because of these issues and two others, which are detailed in the statutory requirements section of this report. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 20 were assessed during this visit. People who use the service experience an adequate quality outcome in these areas. This judgement has been made using available evidence including a visit to this service. The people who use the service health care, wellbeing and welfare are supported. The homes medication procedures ensure the safety and wellbeing of the people living in the home. EVIDENCE: The care plans demonstrated that the personal support needs of the people who use the service were documented and had been agreed with the individuals their, families and care professionals. The plans sampled however have not been reviewed for some time and still refer to the service when it operated from a two-story building with 12 residents. There is evidence in the minutes of staff meetings that staff have been repeatedly requested to review and update all care plans. There are regular visits to the local G.P and service users have an annual health check. The medical team as well as other professional health care people, including the dentist and optician when required, regularly review the health needs of all service users. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 14 The service has a robust policy in place for medication administration and storage. The Medication Administration Record (MAR) sheets were seen for three of the people who live in the service and it was noted that there were no gaps on the recording records. A member of staff stated that in line with a requirement from two previous inspection reports all staff have now had training in the administration of rectal diazepam. The training certificates however were not available to corroborate this. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience a good quality outcome in these areas. This judgement has been made using available evidence including a visit to this service. The people who use this service should benefit from the knowledge that any complaints or concerns will be listened to and they are protected from abuse. EVIDENCE: The complaint procedure had been produced in a pictorial format. There is sufficient information available to keep people aware of what is abuse and where and how it may occur. The Annual Quality Assurance Assessment provides information that there have been no complaints reported at the service. Records sampled during the site visit indicated that there have been no complaints made since the last inspection. The Commission for Social Care Inspection have not been informed of any issue or complaint since the previous inspection visit (01/08/2007). There is a clearly written safeguarding adults procedure and a copy of the local authority safeguarding adults from abuse policy was available. The contact details for the local authority Social Care Team was also displayed. All staff have attended in the Safe guarding adults training. The training records were not available to confirm the staff had undertaken this training. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 27, 28 & 30 were assessed during this visit. People who use the service experience a poor quality outcome in these areas. This judgement has been made using available evidence including a visit to this service. Poor planning and the lack of risk assessments have potentially placed the people who live in the service at risk. EVIDENCE: Since the previous CSCI inspection visit (01/08/2007) the building has been sub divided into two separate and independent care facilities. The configuration of the building is now supported living on the upper floor and the registered care home 2a Guildford Road occupies the ground floor. As was previously stated in the lifestyle section of this report the kitchen was removed on the 04/08/2008 and work started to fit new units and appliances. At the commencement of this site visit the service had been without a kitchen for 25 days and had been given a mid September date for completion. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 17 In order to provide some meals the microwave and the kettle had been moved into the dining room along with the fridge and two freezers. There was no hygienic area to prepare food and drinks in the dining room. The only water available to make drinks and to wash up was situated in the laundry. The service had not completed any risk assessments to ensure the safety of the people and staff who use the service during this temporary arrangement. The appointed manager contacted the CSCI after the visit and stated that the kitchen would be fully operational by the 4th of September 2008. It was also stated that appropriate risk assessments had been undertaken and a health and safety audit had been requested to ensure that the residents are safeguarded during the final stages of the kitchen refurbishment. As a result of the reconfiguration of the building the service has only one bathroom. The was not in a good state of repair a replacement bath had been fitted, which had come from a bathroom on the upper floor and did not match the colour of the existing suite. The décor of the bathroom was poor with broken tiles, discoloured paint and there was also a strong mal odour in the room. The person appointed by the organisation to temporarily manage the service stated that there are plans for the bathroom to be replaced and a wet room fitted and this was planned for later in the year. The carpets throughout the service were heavily stained and discoloured and need to be deep cleaned or replaced. Two immediate requirements were made in respect of the kitchen the initial process of completing both requirements these was started on the day of the visit. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, & 35 were assessed during this visit. People who use the service experience an adequate quality outcome in these areas. This judgement has been made using available evidence including a visit to this service. The people who use the service benefit from sufficient numbers of staff on duty to meet their needs. Staff training and development planning requires further development. EVIDENCE: The staff on duty were knowledgeable about the needs of the people who live at the service and they were seen to be enthusiastic about offering the correct support for each person. The organisation has a robust set of policies and procedures. The policies should if appropriately implemented ensure that the staff employed at the service do not represent a risk to the people who live there. A random selection of four staff files was sampled during the visit. In the entire file sampled there were significant gaps in the education and employment histories of the staff members. The manager stated that the gaps should have been highlighted and discussed during the persons interview process. A sample of the interview notes indicated that the gaps had not been 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 19 raised during the staff members interview and therefore have remained unexplained. The Annual Quality Assurance Assessment indicated that all staff have received all of their mandatory training and several additional events have also been undertaken. However this was not substantiated during the site visit, as the training file could not be located. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39, & 42 were assessed during this visit. People who use the service experience a poor quality outcome in these areas. This judgement has been made using available evidence including a visit to this service. The service has not been directly managed for over 10 months. The health and welfare of the people who use the service has been compromised. EVIDENCE: The registered manager of the service has been on long term absence from the home due to ill health. The organisation had co-opted a registered manager from another service to provide management cover two days a week, the remaining five days the home in effect self manages. The net result of the lack of a full time manager is the running of the home has become poor and ad hoc. Essential reviews and care plan updates have not always happened and documents have been mislaid or lost. There is evidence in the minutes of the 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 21 staff meeting of a request being made for the action and completion of reviews and risk assessments but these have not been followed up. The organisation undertakes regular regulation 26 visits to the service and these were sampled during the visit. However there was no evidence of any formal quality audit from the point of view of the people who live at the service, their families or anyone with relevant links to the home. This was discussed with a member of staff who was unaware of any procedure to ask for feed back from the residents or any one else. The health and safety of the people who use the service has been compromised by the lack of an impact study and risk assessment being undertaken for the period the kitchen would be out of operation. The failure of the service to identify potential risks and to ensure that appropriate provisions were in place has impacted upon the lifestyles of individuals living in the home. 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 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 X 2 3 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 3 23 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 2 28 2 29 X 30 1 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 X 2 X LIFESTYLES Standard No Score 11 X 12 1 13 2 14 X 15 3 16 2 17 1 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 1 X 2 X X 1 X 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15 Schedule 3.21(b) 13(4) Requirement To undertake full reviews of all care and individual plans. The reviewed documents must be agreed and in a user-friendly format. All risk assessments must be reviewed. Potential risk must be assessed and appropriate measures put in place to minimise the risk. The people who use the service must have the ability to take part in appropriate activities. The meals offered must be of a quality and quantity to meet the needs of the people who use the service. The service must be fit for purpose. A review of the hygiene arrangements must be completed to ensure that the people who use the service are safe from cross contamination. The registered provider must ensure that all staff files contain the relevant information, in order to safeguard the people who use the service. The registered provider must DS0000013481.V368920.R01.S.doc Timescale for action 29/09/08 2. YA9 29/09/08 3. 4. YA12 YA17 16(2,m) 16(2,h,I) Schedule 4.13 16(1), 23(1 & 2) 13(3), 16(j, k), 23(2) 19 Schedule 4.6 9(2,b,I) 29/09/08 29/09/08 5. 6. YA24 YA30 29/09/08 29/09/08 7. YA34 29/09/08 8. YA37 29/09/08 Page 24 2a Guildford Road Version 5.2 9. YA39 10. YA42 11 YA37 ensure that the service is run and operated for the best interests of the people who live there. 24 The registered provider must 29/10/08 ensure that effective quality control and auditing is undertaken regularly. 13, The registered provider must 29/09/08 23(2b,c,d) ensure that the health and safety Schedule of the people who use the 3.3j service is not restricted and impeded by any future renovation work to be carried out within the building. 9(2,b I) The registered provider must 29/09/08 ensure that the home is effectively managed at all times. 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 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 2a Guildford Road DS0000013481.V368920.R01.S.doc Version 5.2 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. 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