Inspection on 07/06/06 for Waterloo House

This inspection was carried out on 7th June 2006.

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

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

Other inspections for this house

Waterloo House 20/09/07

Waterloo House 12/09/05

Waterloo House 25/04/05

Waterloo House 06/09/04

Waterloo House 04/05/04

Similar services:

Trevayler Residential Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

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

CARE HOMES FOR OLDER PEOPLE Waterloo House Walesby Road Market Rasen Lincs LN8 3EX Lead Inspector Mr Doug Tunmore Key Unannounced Inspection 7th June 2006 10:00 X10015.doc Version 1.40 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 Waterloo House DS0000002470.V297066.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 Older People. 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. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Waterloo House Address Walesby Road Market Rasen Lincs LN8 3EX 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) 01673 842343 Platinum Care (Lincoln) Limited Mrs Isobel Elizabeth Sugden Care Home 35 Category(ies) of Dementia - over 65 years of age (5), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (5), Old age, not falling within any other category (30) Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of service users in categories DE(E) & MD(E) together will not exceed 5. 12th September 2005 Date of last inspection Brief Description of the Service: The home is in a residential area of Market Rasen, within five minutes walking distance of the local shops and amenities. The home provides personal care for up to thirty five residents in the category of mental disorder/dementia (older people) and old age, over sixty five years of age. Bedrooms are located on the ground and first floors, with lounge areas being available on both floors and the dining room is located on the ground floor. The rooms on the first floor are accessed by a shaft lift. The homes statement of purpose makes reference to maintaining the privacy, dignity, freedom of choice, citizens rights and the fulfilment of each resident. The service users guide provides information of the services made available to residents at this home. The current scale of charges at this home starts at £396.00 to £451.00 per week. Website Address: www.waterloohousecarehome.co.uk Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took into account any previous information held by CSCI including the homes previous inspection reports, their service history, the homes pre-inspection questionnaire and residents questionnaires sent to the home by the Commission prior to this inspection. The site inspection consisted of case tracking a sample of two resident’s records and assessing their care. The inspector spoke with the residents who was being case tracked and joined five other residents for lunch. The inspector also spent time with one relative, a visiting community nurse, one member of staff and the registered manager. A partial tour of the home and a review of a sample of the records was also included. What the service does well: What has improved since the last inspection? The home has addressed those requirements made at the last inspection. The manager now carries out annual appraisals on all staff as per their policies and procedures. The home has also introduced a formalised supervision form addressing all those aspects required for the supervision and recording of care workers development and training needs. General improvements and maintenance of the home continues with a walk in shower room being installed and two new rooms added which have en-suite facilities. The reception area and the stairway has recently been re-carpeted. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 6 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. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Residents are admitted into the home only after a full needs assessment has been carried out either by the home and or health care or social care agencies. Written confirmation that the home can meet a prospective residents needs is also undertaken prior to admission. This home does not provide intermediate care. EVIDENCE: A review of all information available prior to this inspection and evidence seen at this inspection in residents files and care plans showed that the home does not admit residents without a care assessment being undertaken. Prospective residents are also written to by the home confirming that they can meet the residents care needs or not. One residents questionnaire was returned to The Commission and this confirmed that the resident had information about the home prior to admission Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 9 and received a contract. The homes manager evidenced in the residents finance files that one of the residents who was being case tracked had a current contract. The second resident had been admitted two weeks previously and the manager was meeting with the family on the day of the inspection to discuss this residents long term future. This must include issuing a contract stating the terms and conditions of this residents stay. The home undertakes their own quality assurance questionnaires for residents relatives and friends. These questionnaires showed overwhelmingly that residents and relatives are happy with the attitude of staff and that they are friendly and helpful. A contract monitoring visit was undertaken by Lincolnshire County Council on the 26/07/05 and evidenced that ‘a specific pre-admission form is completed and used as a baseline for further assessments upon admission further assessments are completed’. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Residents or their representatives are involved in the care plans. The home administers medication appropriately to all residents. There is adequate care planning in this home, which helps ensure that the general health and welfare of residents is addressed. EVIDENCE: A review of all information available prior to this inspection and a previous key inspections carried out in April and September 2005 at this home has evidenced that either residents or their relatives are involved in the care plans. All residents have adequate care plans, which describe their health and welfare needs. Care plans outlined risk assessments, nutritional and dependency assessments. Care plans also evidenced that they have been reviewed on a monthly basis or sooner depending on changing needs. The reviews and care plans of residents had been signed and dated by the carer and the resident. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 11 Three care plans were seen and it was found that limited information is available regarding residents likes and dislikes. This area of care planning is centred around food preferences and not those aspects of residents daily living requirements. Care plans were also seen not to have established the intimate care needs of residents and what help they require when bathing or toileting how their privacy and dignity can be maintained. A senior carer confirmed that she had undertaken National Vocational Training at level 2 in which issues relating to the personal care of residents was addressed. Both residents being case tracked confirmed that they are treated with dignity and one said that ‘I am encouraged to wash myself so I retain my independence’. Both residents had walking aids and both expressed the view that staff are wonderful. One resident stated that the home got her a walking aid and she can now ‘just go off into the garden and other areas and I have control over my life’. The results of the homes residents and relatives questionnaire carried out in March 2006, stated that the care of their relations had been discussed with them and they considered that the home had a good reputation in the community. Individual care plans evidenced that accidents are recorded in the home’s accident book and in the resident daily notes. The home also uses body maps for the mapping of any cuts or abrasions to residents. The homes notifiable incidents record was seen and corresponded with the Commissions service history of the home relating to accidents to residents. The contact compliance visit evidenced that ‘residents care planning files were examined and provided evidence of risk assessments which were found to be adequate’. Files seen confirmed that health care professionals visit the home when required by the residents. A visiting community nurses stated that ‘ she is a regular visitor and that ‘very good care is available at this home, the food is good (having sampled it) residents are happy and they have a very good rapport with care staff’. The residents questionnaire returned to The Commission stated that she usually receives the medical support that she needs. The pharmacist inspected the home on the 22/03/06 and recorded that storage and administration records of medication is carried out appropriately. Due to this no inspection by the regulator of medication was undertaken. Five residents with whom the regulator spent lunch confirmed that they received their medication when required. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 12 The homes training file evidenced that care leaders receive training in the administration of medication. A senior carer confirmed that she had undertaken the Boots medication training course. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. A range of activities are made available to residents. Relatives/friends of service users are made welcome in this home The food is home cooked and caters for individual residents dietary needs. EVIDENCE: Two residents stated that they occasionally take part in activities, with one saying that she sat in the garden yesterday and games came around and she joined in. The other resident commented that that ‘staff took us out yesterday all day in our wheelchairs around town’. The general view of those five residents with whom the regulator had lunch was that they preferred to stay in their own rooms or the garden to read or watch television. However, they confirmed that entertainers visited the home and they receive visitors, who are made most welcome. On the day of the inspection the hairdresser was available to attend to residents hair dressing requirements. The residents notice board listed weekly activities and when the hairdresser and chiropodist would attend the home. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 14 Monthly trips out from May 06 to November 06 in a mini-bus were also posted. The activities sheet also mentioned that if residents wish to go out for a walk or into town please ask a member of staff to accompany them if required. The key inspection carried out in April 05 found that relatives visit residents during the day and evening. Two visitors seen one being the community nurse stated that they are made welcome at this home and that ‘ the home seems very nice and the girls are very nice and lovely. The community nurse commented that staff are very helpful and pleasant when I visit. The homes residents and relatives questionnaire showed that nineteen were returned and confirmed that relatives were happy with the friendly staff and would recommend the home to others. The inspector joined five residents for lunch who said that the food at this home is very good indeed. A number were observed to have a sherry before lunch, which was available to all residents. The regulator found that on the day of the inspection that the food was well prepared, hot and tasty. Observations made by the inspector were that staff are at hand in adequate numbers to help and encourage service users to eat their food. The cook was seen and said that information on individual residents dietary needs is made available for her information. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. Complaints are handled objectively and residents are confident in approaching the manager who they feel will listen to them and act upon their concerns. Care workers have undertake safeguarding vulnerable adults training. EVIDENCE: Previous inspections of this home has shown that a detailed complaints procedure is in place. The homes pre-inspection questionnaire recorded that no complaints had been made since the last inspection. One residents questionnaire showed that she was aware of how to make a complaint and knew who to speak to if she was unhappy. The residents who were being case tracked and those who the regulator had lunch with made positive comments about the staff and the home; ‘its superb here, staff are wonderful so caring, I have no worries with staff feel very safe’. Residents spoken to in September 05 confirmed that the registered manager is approachable as are care staff. A senior care worker was aware of the homes ‘Whistle Blowing’ policy and spoke knowledgeably about abusive practices and what action they would take if this came to their attention. All staff received adult protection training as part of their induction process with training undertaken in 2005 and further training planned for July 2006. The homes Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 16 induction training ‘Skillsforcare’ which all new staff undertake addresses responding to abuse and neglect and actions to be taken. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well maintained, the standard of the environment and its facilities are appropriate to the needs of residents. The home is clean and free of unpleasant odours. EVIDENCE: A partial tour of the home by the inspector found it to be clean and it smelt fresh. A previous inspections undertaken on the 25/04/05 and 12/09/05 found that residents and visitors alike said that the home is always clean and there are no unpleasant smells. A contract monitoring visit was undertaken by Lincolnshire County Council on the 26/07/05 and found that ‘the accommodation was clean and tidy and furnishings appeared to be of a high standard’. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 18 Previous inspections have found that; the home has a maintenance record which records work that has been undertaken and projected work for the coming year. A partial inspection of the home found that it was in a good stated of repair both externally and internally. The homes pre-inspection questionnaire evidenced that various parts of the home have been redecorated. A visitor commented that ‘ there are no unpleasant odours that’s what I like about this home’. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Appropriate recruitment practices are in place. Staffing level meets the needs of residents. The home provides adequate training for care staff. Staff were seen to be competent in carrying out their care tasks. EVIDENCE: A review of all information available prior to this inspection carried out in September 2005, showed that; personnel files contained CRB checks (Criminal Record Bureau), references, application forms and interview notes. A cursory look at personnel files showed that they continued to be in order. A contract monitoring visit by Lincolnshire County Council found that those ‘three personnel files examined had appropriate documentation including CRB, references etc.’ All care workers have been given and signed for The General Social Care Council Codes of Practice, which sets out their responsibilities as care workers looking after vulnerable adults. The homes training record seen in September 05 was seen which showed that, nine care workers had NVQ (National Vocational Qualifications) level 2, three of these having NVQ 3 and five carers are currently undertaking NVQ level 3. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 20 Statutory training such as fire training, moving and handling and first aid are undertaken at this home. Other training undertaken included; food hygiene, first aid and adult protection. A contract monitoring visit by Lincolnshire County Council found that ‘there is a comprehensive training and induction programme and tracking record in place’. One senior care worker demonstrated a clear understanding of her role and responsibilities. She confirmed that she has undertaken NVQ training levels 2 and nearly completed level 3. The home more than meets the standard for 50 of staff to be trained to NVQ level 2 by 2005. One residents questionnaire returned to the Commission showed that she always receives the care and support that she needs. The duty rota received by the Commission prior to this inspection showed that adequate staff numbers are on duty to meet the needs of residents in this home. There are two waking night staff with a senior who can be contacted if required. A visitor commented that there seems to be enough staff on duty when I visit. The questionnaire completed by one resident showed that she receives the care that she needs and that staff listen to what I say and act on it. The homes pre-inspection questionnaire evidenced that there are sixteen care staff and nine ancillary workers and a registered manager. One senior carer stated that there are appropriate numbers of staff on duty and we have ‘a good team of girls who work well together’. Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Records seen show that residents’ health and general welfare and safety are promoted. The home ensures that that the residents have the opportunity to voice their views and opinions. Accurate records are kept of residents’ monies. All care workers have not had annual appraisals undertaken. EVIDENCE: The registered manager was trained as an enrolled nurse. She has not undertaken nursing duties but followed a different career path. This has included management positions in the following; Independent Living Organisation and Research Manager at Rampton Hospital. She has also worked for The Cancer Research Campaign and the Imperial Cancer Research Fund. The manager has worked at Waterloo house since February 2003 Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 22 becoming the registered manager on the 16/09/03. She has management experienced in a wide range of posts relating to the care of diverse groups of clients, which has prepared her for the task of managing a care home for the elderly. The registered manager confirmed that she has completed the Registered Managers Award in December 2005 and is awaiting the certificate of qualification. The contract monitoring report stated that ‘during the course of the visit I witnessed a good rapport between management, staff and residents’. The home conducts a quality assurance report. The 2006 report is available to residents and relatives/visitors and has been used in this report to evidence the opinions of those people who live in this home. The minutes of the last residents meeting held in May 2006 showed that residents are encouraged to voice their views and are actively involved in issues relating to the running of the home. During previous inspections of this home residents have stated that the manager is very approachable and they see her in the home every day. The home only deals with personal allowances of residents, which are kept at the home. All other monies relating to funding are paid into the homes bank account on a standing order by relatives. Residents’ personal allowances were seen at the last key inspection of this home and it was found that an accurate record is kept and receipts are available for any monies spent, with signatures also obtained from the hairdresser or the visiting chiropodist. The contract compliance monitoring visit found that ‘there was evidence of itemised invoicing, which was examined and found to be in good order’ this also included residents small sums of monies which were also found to be in good order. This inspection found that the manager and other senior staff undertake the supervision of care staff on a two monthly basis. Care workers files showed that supervision has been undertaken. All workers have had their annual appraisals in September 2005. These will be reviewed in September 2006. A senior carer confirmed that supervision is undertaken with the care manager and she carries out this procedure with care workers. There are a range of policies and procedures available in the home relating to fire safety and fire risk assessments. There was also evidence that fire alarm, fire drills and emergency lighting checks have been undertaken. Care staff also receive fire training as part of the homes initial training and as a regular training event. The manager confirmed that the shaft lift, bath hoists and wheelchairs had been serviced. All wheelchairs seen on the day of the inspection had footplates, which were in use. Waterloo House DS0000002470.V297066.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 4 x 3 4 x 3 Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Waterloo House DS0000002470.V297066.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Waterloo House DS0000002470.V297066.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!