Inspection on 25/07/06 for 32 Ringstead Road

This inspection was carried out on 25th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

32 Ringstead Road 20/08/09

32 Ringstead Road 23/09/07

32 Ringstead Road 12/01/06

32 Ringstead Road 10/10/05

32 Ringstead Road 03/02/05

32 Ringstead Road 20/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Ringstead Road (32) 32 Ringstead Road Sutton Surrey SM1 4SJ Lead Inspector Deborah Yapicioz Key Unannounced Inspection 25th July 2006 09:30 Ringstead Road (32) DS0000007209.V303885.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 Ringstead Road (32) DS0000007209.V303885.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. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ringstead Road (32) Address 32 Ringstead Road Sutton Surrey SM1 4SJ 020 8642 7725 020 8642 7725 manager.ringsteadroad@careuk.com 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) Care Solutions Limited Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (1) of places Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include the category of LD (E) for one service user. Date of last inspection 12th January 2006 Brief Description of the Service: 32 Ringstead Road is a residential home for people with learning disabilities. The home is owned, managed and staffed by Care U.K. The home is registered to provide residential care for up to six adults with learning disabilities with medium to high dependency needs. The home currently has six male residents with no vacancies. The service users all have a private bedroom. The home does not provide any emergency or respite provision. The home is a large property, with accommodation provided over three floors, situated in a quite residential road within walking distance of Sutton town centre. The home has a large open plan lounge and dining room. There are French windows, which open onto a large garden. The home also has a drive to the front of the house for parking. 32, Ringstead Road also has transport for the residents use. The current fees charged by the home range from £1,250 to £1,350 per week Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first inspection for the year 2006/2007 and was an unannounced visit, which took place on the morning of 25th July 2006. The home was inspected under the National Minimum Standards Care Homes for Younger Adults. Charlotte Payne is the manager of Ringstead Road and she facilatated the inspection process. Methods of inspection included meeting with the service users, a tour of the premises, observation of contact between staff and service users, meeting with members of staff and discussions with the manager. Records examined included service user plans, care manager assessments, risk assessments, medication records, complaints, staffing records, health and safety and fire records. The home manager had completed a Pre Inspection Questionnaire. Over the last twelve months the management team have kept the Commission for Social Care Inspection informed of any significant incidents involving the service users and the Croydon Office has received reports of the monthly visits carried out by the registered provider. The home was given a variation to their registration certificate earlier this year to accommodate an older service user who wished to remain at the home. The inspector would like to thank the service users, the staff team and Ms Payne for their help in facilitating the inspection. What the service does well: The atmosphere in the home is friendly. The staff members spoken to felt they worked well as a team and would have no difficulties approaching the manager and senior members of the staff tram if they needed to. The service users spoken to during the inspection said that they liked the staff team and the staff team were observed to treat people in a kind courteous manner. The organisation has service users meetings for the group of homes in the local area. The manager explained that the meeting is also a social occasion with service users picking a place of interest such as a fire station and having a meal out as well as the consultation element of the session. Service users choose the venue for the meetings. The service users at the home said that they enjoyed the meetings. The home has self-monitoring systems in place such as Quality Assurance audits, which are completed by Care U. K. The service users all have individual plans that are a record of their aims and goals as well as their achievements. The home is in the process of implementing Person Centred Planning approaches to the care-planning format. Ringstead Road (32) DS0000007209.V303885.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. Ringstead Road (32) DS0000007209.V303885.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 Ringstead Road (32) DS0000007209.V303885.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home provides good information and introduction opportunities for prospective service users and their families to make an informed choice about moving to the home. EVIDENCE: The home has a statement of purpose and service user guide, which are regularly reviewed to ensure information about the home is up to date. The service users guide has also been put into a format suitable for the service users living at the home. The home has a procedure for introducing service users to a new residential placement, which includes the homes, own assessment process and introductory visits. The home manager confirmed that cultural and religious issues were discussed at the time of referral to the home and ways of meeting these needs would be included in the service users care plans. New Service users must also have a full assessment of their needs; compiled by their care manager or other relevant person. The current fees charged by the home range from £1,250 to £1,350 per week The home manager explained that any prospective service user would have a gradual introduction to the home with a series of short visits and overnight stays. The time frame would be flexible depending on the service user. The newest service user was admitted earlier this year, because of their circumstances the placement was agreed after a short time frame than usual, although the manager was able to show the service users did have an Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 9 introduction to the home. The service users family also had an opportunity to visit the home and meet then staff team. All of the present service users have assessments on file including the newest service user. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have comprehensive individual care plans with detailed information on their needs and personal goals. Individual care plans include consultation with service users and are regularly updated by the key-worker to reflect current needs and service users wishes. EVIDENCE: The service users all have individual plans that are a record of their aims and goals as well as their achievements. The plans follow on from the initial assessments completed at the time of their referral to the home. The home manager stated that the home is in the process of implementing Person Centred Planning approaches to the care planning format. Information is available in respect of service users’ preferred likes and dislikes, and includes guidelines on dealing with any challenging behaviours. The home has a key work system. Main reviews occur every year. Care plans are internally reviewed every six months and updated by key workers regularly using monthly reports, which form a useful tool in monitoring changing needs, and ensuring goal/targets can be met. The monthly reports were seen on the service users files during the inspection Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 11 The organisation has service users meetings for the group of homes in the local area. The manager explained that the meeting is also a social occasion with service users picking a place of interest such as a fire station and having a meal out as well as the consultation element of the session. Service users choose the venue for the meetings and have been to places such as Brockett’s Farm, London Aquarium and Sutton Fire Station. The service users at the home said that they enjoyed the meetings. The home operates a risk management system and individual assessments are on service users files. Copies of individual risk assessments are kept under review and new risk assessments are completed when a new activity or area of risk is identified. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users at the home are offered the opportunity to engage in age appropriate activities with an emphasis on using community based facilities. The service users have a varied programme of social activities organised by the staff team to reflect service users individual interests. The home has an open visitors policy to ensure friendships and family links are maintained. EVIDENCE: The home manager informed the inspector that the service users are encouraged to pursue their own interests and hobbies, and have a choice about the entertainment brought into the home. A record of all social activities is kept. Some service users have their own televisions and music systems in their bedrooms as they wish. The manager stated that the service users often attend social events in other homes and have friendships with people other that the residents of the home. The service users attend various day centres including The Cheam Centre and The Orchard Hill further education centre for a variety of activities depending on their interests and goals. The newest service users is in the process of Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 13 trying out various activities and building up his timetable. Each of the service users has a record of their activities, which was seen, on their file. The home continues to arrange for “Us and a Bus” to run activities in the home. The home manager informed the inspector that some of the service users also enjoy massage sessions run by an aroma therapist at the home. The service users have the opportunity to attend local churches if they wish. The staff team at the home are in the process of arranging annual holidays with the service users. At the last inspection it was recommended that service users who would become upset if they spent time away from familiar surrounding should have at least five individual days outing to places that are of interest to them. This recommendation will be carried over to the next inspection when the service users have had their holiday. There is an open visitors policy and the home just ask that visitors phone to ensure their family member is going to be in before they visit. The home manager informed the inspector service users meetings take place, usually on a monthly basis. The company also holds service users forums The home menus are based on the likes and dislikes of the homes service users. They also take into account the service users health issues. They include cultural/ religious choices. The company has a nutritional policy and the staff team attend basic food hygiene training. A record of the training was seen on staff files and the policy was accessible to the staff team. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is carried out in a way that residents prefer so that dignity and choice are maintained. Residents’ physical and emotional health needs are detailed in personal plans to offer consist care in this area. Residents’ medication is well managed to ensure good health. EVIDENCE: The service users need varying degrees of assistance with their personal care. The level of support a service user needs would be detailed in their initial assessment and updated at review meetings and their preferred routines are set out in their individual Plan. The staff team at the home monitor the health of each of the service users and would ensure they receive any treatment needed. For example one of the service users has an ongoing health issue, which the General Practitioner and the local hospital are investigating. A record of any General Practitioner and hospital appointments are kept on his file. The home provides consistency and continuity through designated key workers Incident forms are completed following any accidents. The home has a policy and procedure in place for the receipt, recording, storage, handling, administration and disposal of medication. The medication records were complete at the time of the inspection. Ringstead Road (32) DS0000007209.V303885.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is complaints policy and procedure, which facilitates good access to the complaints system for the residents, their family or their representatives. The home has the appropriate policies in place to ensure the protection of vulnerable service users. EVIDENCE: The home has a clear complaints policy, which includes the timescales and the process of the investigation. The home has not received any complaints in the last twelve months, nor has the Commission. Service users during discussions said that they did not have any complaints about the care that they were receiving. The home has a copy of Sutton’s Vulnerable Adults Policy and Procedures. The staff team have access to training on adult protection and all staff have either attended a course or have been booked on a course. Evidence of this was seen on staff files. Staff team spoken to during the inspection were aware of the complaints procedure and the adult protection policy and were aware of the need to report any incidents. Ringstead Road (32) DS0000007209.V303885.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Generally the home provides a comfortable, clean and safe environment for service users to live in, however some of the communal areas are in need of redecoration. EVIDENCE: 32 Ringstead Road is situated on a residential street within walking distance of Sutton. The home’s premises are in keeping with the local community and were suitable for their purpose. The home was comfortable, bright, well ventilated and free from offensive odours at the time of the inspection. The home has appropriate laundry facilities separate from the kitchen and the preparation of food. The washing machine is capable of washing clothes at high temperatures, which helps with the control of infections. The laundry has suitable flooring. There is a locked cupboard for the Control of Substances Hazardous to Health products. The home has policies and procedures on the disposal of clinical waste. The home has undergone some improvements over the last twelve months, which has created a more comfortable environment, however the communal lounge dining area of the home is looking quite worn and shabby and is in need of redecoration. The carpet in this area is also stained and worn in places and should be replaced. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 17 Each of the service users in the home has a single room. All of the rooms have been personalised and decorated to reflect their individual taste. Bedrooms viewed provided sufficient and suitable furniture. Service users spoken to during the inspection said they liked their bedrooms. Ringstead Road (32) DS0000007209.V303885.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team at the home have a range of skills and abilities, which enable them to meet the needs of the service users living at the home The staff team have all had Criminal Records Check, as a safeguard to offer protection to the homes service users EVIDENCE: The home manager arranges for at least three members of the staff team to be on duty during the morning when there are more activities and two members of staff in the afternoon. There are two members of staff at night; one waking and one sleep in person who is on call. On the morning of the inspection there were three members of staff as well as the home manager on duty. All new members of staff receive an induction as part of their probationary period of employment. The record of this is signed and dated on completion and placed on the staff members file. These were seen during the inspection. The induction covers service users care needs, emergency procedures, safe working practices, adult protection, moving and handling etc. The home has a rolling programme of staff training in place including LADAF, fire safety and adult protection. Training records are kept on the staff members file. The home has regular staff meetings; records of the issues discussed are on file at the home. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 19 There has been an improvement in the level of staff supervision at the home since the last inspection and the staff team should all receive at least six supervisions this year. The staff team have all had an appraisal. The atmosphere in the home is friendly. The staff members spoken to felt they worked well as a team and would have no difficulties approaching the manager and senior members of the staff tram if they needed to. The staff team were observed to treat service users with dignity and respect during the inspection. Ringstead Road (32) DS0000007209.V303885.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The management style appears to be transparent with clear lines of accountability, however the home manager must register with the Commission for Social Care Inspection. In the main health and safety arrangements are in place to ensure potential risks to service users health and safety are so far as reasonably possible identified and minimised. EVIDENCE: Charlotte Payne is the manager of Ringstead Road. She was aapointed to the post of manager in September 2005, although she had been acting manager before that. Ms Payne has worked in different care and management positions with in the “Care UK” organisation. Ms Payne now needs to register as home manager with the Commission for Social Care Inspection. There was a clear line of accountability within the home and the manager demonstrated a good knowledge of the service users and the staff team. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 21 The home has self-monitoring systems in place such as Quality Assurance audits, which are completed by Care U. K. The home manager informed the inspector that she is in the process of completing a quality survey for the home which included seeking the views of service users care manager and the General Practitioner used by the home as well as the families of the service users. Records required for the safety and well being of service users are in place including accidents, water temperatures, complaints, incidents, food records, fire records, staff and service users case files, medication records and so forth. A first aid box and a fire blanket are situated in the kitchen. There are fire extinguishers throughout the house. All staff must attend training relating to health and safety issues including fire safety and medication training. A record of training attended is kept on staff files. There are thermostatic control values on water outlets. Water temperatures are taken and recorded. Fridge and freezer temperatures are also taken A representative of the registered provider visits the home regularly and copies of the visit reports are sent to the Commission for Social Care Inspection Croydon Office. Ringstead Road (32) DS0000007209.V303885.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 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 X Ringstead Road (32) DS0000007209.V303885.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. 2. Standard YA24 YA24 Regulation 23(2)(d) 23(2)(d) Requirement The registered provider must replace the stained carpet in the communal lounge The registered provider must replace the shabby/worn wallpaper in the communal lounge diner The home manager must apply for registration by the Commission for Social Care Inspection, Timescale for action 30/11/06 30/11/06 3. YA37 8. -(1)(a) 30/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA14 Good Practice Recommendations The home manger must ensure that all service users who do not go away on an annual holiday have at least five days out to places that are of particular interest to them. A record of the activities should be kept on their file. Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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 Ringstead Road (32) DS0000007209.V303885.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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