Inspection on 06/11/07 for Watcombe Circus Care Home

This inspection was carried out on 6th November 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Watcombe Circus Care Home 23/02/09

Watcombe Circus Care Home 14/02/07

Watcombe Circus Care Home 13/07/06

Watcombe Circus Care Home 10/01/06

Watcombe Circus Care Home 14/07/05

Watcombe Circus Care Home 11/01/05

Watcombe Circus Care Home 07/09/04

Watcombe Circus Care Home 23/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Watcombe Circus Care Home 2-4 Watcombe Circus Carrington Nottingham NG5 2DT Lead Inspector Rehana Rashid Unannounced Inspection 6th November 2007 10:30 Watcombe Circus Care Home DS0000002258.V354302.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 Watcombe Circus Care Home DS0000002258.V354302.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. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Watcombe Circus Care Home Address 2-4 Watcombe Circus Carrington Nottingham NG5 2DT 0115 844 3745 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) marion.jennison@ncha.org.uk Nottingham Community Housing Association Ms Nicola Louise Turner Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users shall be within category LD Date of last inspection 14th February 2007 Brief Description of the Service: Watcombe Circus is a large property that has been adapted from two semidetached buildings. The home is sited in a residential area and has access to bus routes to the city centre. There are local shops, a post office, churches and other community facilities within walking distance in Sherwood and Carrington. The home offers accommodation for up to fourteen adults with a learning difficulty. Accommodation is on two floors. There is not a lift so bedrooms on the first floor would not be suitable for individuals with mobility problems. Information about the home is provided in the statement of purpose and service user guide. The acting manager stated that the current weekly fees range start from £730 to £974. Additional charges are for chiropody home visits, transport (social) and hairdressing. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. This inspection was unannounced and took place on 6 November 2007 over approximately five and half hours by one Inspector. On the day of the inspection there were fourteen residents in residence. The main method of inspection was “case tracking,” which involved selecting two service users and looking at the quality of care they receive by review of their records, discussion with residents where possible, discussions with the care staff and observation of care practices. Two service users were also spoken with as part of the inspection process. Prior to the inspection the Annual Quality Assurance Assessment (AQAA) was sent out to Watcombe Circus Care Home, which asked questions around the service including staffing levels and number of service users. The AQQA, which was returned to the Commission for Social by the acting manager, was used within this inspection report. Surveys were sent out to service users and their relative’s representatives and advocates to gain their views about the service received. Four completed surveys from service users were received; five surveys were received back from service users relatives, representatives and advocates. Three staff surveys were returned from staff at the home about the care and support given and the way the home is run. The acting Manager assisted in the inspection process. One member of staff was spoken with and two staff files were examined. A sample of health and safety records maintained by the service were also looked at. What the service does well: Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 6 Resident’s have care plans in place, which provided information on how their needs can be met. Residents spoken with stated that they are happy living at Watcombe Circus. Observations of staff working practices showed that residents were treated with respect and staff were friendly and approachable. Residents are supported to access community facilities. During discussions with residents they said “there is lots to do and keep me busy,” and another resident stated, “I go shopping with the staff.” Comments in completed surveys for relatives, carers and advocates included “staff are friendly and helpful,” “the service user group are valued by the staff team and very open to working within a multidisciplinary team.” What has improved since the last inspection? What they could do better: Two requirements have been made following this inspection and one remains outstanding from the previous inspection. This relates to service users being supported in their right to have and maintain relationships. Any restrictions on this right must be clearly documented in a care plan and accompanying risk assessment, along with evidence of consultation with the service user and other relevant professionals. Although medicine management has improved there was one error found at this inspection, one medication audited did not tally with what was signed as given on the medication administration record (MAR). The registered person should ensure that consultation takes place with the Fire Authority regarding the current fire evacuation procedures, which includes the issue regarding some service users not leaving the premises during fire drills. When asked how the care home can improve comments written in surveys for relatives, carers and advocates included “having a consistent approach to service users particularly in behaviour management strategies,” “a little more Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 7 help for our relative with selecting clothes to wear i.e. sizes,” and another comment was “communicate with us about our relative,” 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. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 8 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 Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents individual needs are assessed prior to moving to the home, so that their needs are identified and planned for. EVIDENCE: Case tracking confirmed that a structured admission process was completed for prospective residents. Documentation supported that prospective residents needs were assessed prior to them moving into the home. In the last twelve month there have been two new admissions. Assessments were detailed providing information about the individual’s personal, social and health care needs. Copies of the placing authority’s community care assessments were seen for the two residents case tracked. Watcombe Circus Care Home DS0000002258.V354302.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. 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 care of residents is planned and given in a way that respected individuality. EVIDENCE: The two residents were case tracked their care plans identified the needs of the individuals and their preferences. They also covered aspects of social, emotional, health and personal care needs. There was evidence that these care plans are evaluated on a regular basis in order to identify if any changes are necessary. Staff member spoken with demonstrated an understanding of the purpose of care plans and a good awareness of the individual needs of residents, as reflected in the written plans. Following discussions with residents it was clear that they are supported to make decisions around everyday tasks. For instance one resident spoken with stated that they are able to decide what activities they would like to do. Individual risk assessments are in place in a number of areas, which include going out, social activities and challenging behaviours. These enable residents Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 11 to be able to pursue independent lifestyles within a risk management framework. Watcombe Circus Care Home DS0000002258.V354302.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. 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. Suitable activities are provided, which met the leisure and recreational interests of residents. Meals offered give both choice and variety, catering for individual likes and dislikes. EVIDENCE: Discussions with two residents about activities showed that residents participated in social activities of interest to them. For instance one resident commented “there is lots for me to do and keep me busy.” Both residents talked about the Bonfire night party, which took place recently, and they enjoyed. Some of the residents attend local day centres, and others are using local community facilities. One of the residents spoken with stated that they have been to Great Yarmouth on holiday. On the day of the inspection some residents were returning from Spain. Both residents were spoken with about community activities, and both said that they were busy, and went to the local shops and to the local pub. Observations of staff and resident interactions were seen to be positive, with residents being treated with respect. Staff were observed knocking on resident’s bedroom doors, and were heard to speak to residents in a friendly, Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 13 and sensitive manner. Residents spoken with confirmed that staff treat them with respect. Relatives and friends are encouraged to visit the home and are invited to organised parties. Comments in a completed survey for relatives, carers and advocates stated, “Our relative telephones homes regularly.” A requirement made at the previous inspection remained outstanding at this inspection. This refers to the issue around service users being supported in their right to have and maintain relationships. Any restrictions on this right must be clearly documented in a care plan and accompanying risk assessment, along with evidence of consultation with the service user and other relevant professionals. Residents are involved in planning the menu on a weekly basis, and this showed a balanced diet was on offer. Discussions with two residents about the food were positive, with them saying: “It’s lovely,” “very nice” and “the food selection is good.” Watcombe Circus Care Home DS0000002258.V354302.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. 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. Staff practices ensure resident’s health and personal care needs are well managed. Medicine management does not fully protect residents. EVIDENCE: The two care files that were seen identified individual preferences and how to provide personal support taking into account resident’s individual needs. The case tracking of the resident’s files showed that residents receive regular healthcare input. Visits to the GP and hospital appointments were recorded. Discussions with two residents evidenced that they felt their health was supported well by the staff, with the necessary appointments being made when required. Since the last inspection there have been some improvements in medication management. However at this inspection issues were yet again identified with medicine management. One boxed medication that was audited did not tally with the quantities of medication remaining in the box and the Medication Administration Records (MAR). Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 15 There are medication policies in place including the procedure to follow should there be a drug error. Medication Administration Records (MAR) were completed with no gaps in the entries. Medication was stored securely. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 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. 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. Residents are safeguarded by the homes complaints and adult protection procedures. EVIDENCE: There is a satisfactory complaints procedure, which is included in the service user guide. It is recommend that this be made available in a suitable format for residents. Complaints records looked at are well maintained and showed that there have been three complaints since the last inspection. Two have been resolved suitably and one complaint remains open. The Commission For Social Care Inspection has received no complaints since the last inspection. Discussions with residents stated that if they were not happy about something they would talk to the manager. When asked in the surveys for service users and relatives, carers and advocates about how to make a complaint all said they were aware how to do this. The homes policies and procedures for responding to suspicion or evidence of abuse, or neglect, are satisfactory. Since the last inspection there have been three adult protection investigations. The registered manager followed the correct protocol in reporting these allegations. She also said that as far as she is aware they have been resolved, however still awaiting outcome forms from social services. A staff member spoken with demonstrated an understanding of their responsibility to alert the manager of any disclosure or suspicion of abuse. The staff member confirmed that she had undertaken training in adult abuse. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 17 Records for two resident’s finances were viewed, both were found to be accurate. Resident’s monies are held individually and records are kept of transactions made. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean, comfortable and homely which meets their particular needs. EVIDENCE: A partial tour of Watcombe Circus Care Home showed that the home is generally decorated to a good standard and well maintained. There was a homely atmosphere around the home. Bedrooms viewed were personalised. Residents spoken with commented that the home was clean. Radiators are thermostatically controlled, however on the day of the inspection the surface temperature was hot. A basic risk assessment is in place about the risk of the radiators. The laundry facilities were suitable and appropriate for the needs of the current residents. The communal areas of the premises viewed were kept clean and hygienic. Comments in a survey for relatives included that “the home was generally clean and tidy.” Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment practices at Watcombe Circus protect residents. Staff have the necessary skills and knowledge to ensure that residents needs are met. EVIDENCE: The staff rota viewed for the week of the inspection showed that shifts are covered and that adequate staffing levels are in place to meet the needs of the current residents. There is an arrangement between the Commission for Social Care Inspection (CSCI) and Nottingham Community Housing Association (NCHA) that all staff personnel files including written references and application forms are held at the central office for NCHA. As part of this agreement both parties agreed that details of staff records to be set out in an pro-forma capturing information such as pre employment checks including Criminal Bureau Records (CRB) and references and for this to be kept at the home for inspection purposes. Since the last inspection this system has now been implemented at Watcombe Circus Care Home. Information on the pro-forma evidenced that necessary pre employments are taking place before staff commence employment. All three staff members in the survey stated that pre employment checks such as CRB and references took place before they started work. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 20 Training certificates and matrix showed that staff access training courses, which included medication administration, fire safety, food hygiene, first aid, moving and handling, health and safety in the work place. Staff member spoken with confirmed that they had attended numerous training courses, which are relevant to their roles. When asked in the staff survey about the training provided comments from staff included “the training is always relevant to my role,” and “at the end of the induction training I was ready to take on my job. Comments in completed surveys for relatives, carers and advocates included “staff are friendly and helpful,” “the service user group are valued by the staff team and very open to working within a multidisciplinary team.” Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well managed home, with formal quality assurance and quality monitoring systems, and this ensures that their health, safety and wellbeing is met. EVIDENCE: The acting manager was present throughout the inspection and demonstrated good management knowledge. At the time of this inspection the acting manager had submitted a registration application to the Commission for Social Care Inspection. Staff member spoken with stated that the management team are supportive and approachable. Files were kept in good order and easily accessible for inspection. Records relating to residents and staff were kept securely in lockable cabinets. A quality assurance monitoring system is in place to obtain the views and opinions of the residents, relatives and external providers about the service. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 22 This includes residents meetings, three audits that take place over the year by a manager of another NCHA service. Resident’s surveys are carried out yearly. Results summary from the most recent residents surveys were positive about the service. A sample of records relating to health and safety were examined. Records relating to fire testing were observed and found to be carried out at the required intervals. Gas servicing certificate was viewed which confirmed this was carried out annually. Training records showed that they have undertaken training in mandatory health and safety subjects including food hygiene and first aid. The fire drill record viewed showed that during two occasions not all of the residents left the building. The registered person should ensure that consultation takes place with the Fire Authority regarding the current fire evacuation procedures, which includes the issue regarding some residents not leaving the premises during fire drills. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 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 X 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 X 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 2 X Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA16 Regulation 12(3), 15 Requirement The registered person must ensure service users are supported in their right to have and maintain relationships. Any restrictions on this right must be clearly documented in a care plan and accompanying risk assessment, along with evidence of consultation with the service user and other relevant professionals. Initial timescale 01/05/07 not met. The registered person must ensure that there are adequate arrangements for the recording, handling, safekeeping and safe administration and disposal of medicines received into the care home. This refers to: ensuring all tablets in the home are accounted for, by carrying over any remaining medication for the previous cycle onto the next Medication Administration Record. The registered person should ensure that consultation takes place with the Fire Authority DS0000002258.V354302.R01.S.doc Timescale for action 30/12/07 2. YA20 30 30/11/07 3. YA42 23(4) 10/12/07 Watcombe Circus Care Home Version 5.2 Page 25 regarding the current fire evacuation procedures which including the issue about some service users not leaving the premises during fire drills. This will ensure the safety of all staff, service users and visitors. 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 YA22 Good Practice Recommendations The registered person should ensure that the complaints procedure is available in a format appropriate for the residents. Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Watcombe Circus Care Home DS0000002258.V354302.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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