Inspection on 04/10/07 for Abbeyfield House

This inspection was carried out on 4th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Abbeyfield House 14/12/06

Abbeyfield House 02/02/06

Abbeyfield House 07/06/05

Abbeyfield House 02/03/05

Abbeyfield House 15/07/04

Abbeyfield House 10/02/04

Abbeyfield House 19/11/03

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

CARE HOMES FOR OLDER PEOPLE Abbeyfield House Abbeyfield House Union Street Low Moor Clitheroe Lancashire BB7 2NH Lead Inspector Mr Ajam Auckburally Unannounced Inspection 4th October 2007 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 Abbeyfield House DS0000009529.V347254.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. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield House Address Abbeyfield House Union Street Low Moor Clitheroe Lancashire BB7 2NH 01200 442550 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) The Abbeyfield Lancashire Extra Care Society Limited Mrs Georgina Sandra Marsden Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2006 Brief Description of the Service: Abbeyfield House is a home for older people and is situated in a residential area in Clitheroe close to a bus route with easy access to the town. Abbeyfield House is part of The Abbeyfield Lancashire Extra Care Society Limited, which is a voluntary organisation. The home can accommodate a maximum of 29 older people of both sexes aged 65 years and over. It is a purpose built, detached property set in its own grounds and offers 27 single and 1 shared bedroom, all of which have en-suite facilities. There are 2 lounges and a dining room on the ground floor and a quiet lounge on the first floor. There is a paved patio area and garden to the rear of the home with a small car park to the side. At the time of the inspection there were 27 residents living at the home and they all appeared to be well cared for. Current weekly fee is £390 and additional extras like hairdressing, private chiropody and newspapers are paid for by the residents. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Under IBL (Inspecting for Better Lives) Abbeyfield House was assessed as requiring a statutory key visit (inspection) between April 2007 and March 2008. An unannounced inspection was carried out on 4th October 2007. The inspection lasted a total of 5.5 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a friendly atmosphere and with the full cooperation of the manager, the staff and the residents. During the inspection, some records were looked at and several residents and staff were spoken to. The residents were very positive about the care they receive and the way the staff treat them. Every year we asked the registered person to supply us with written information about the quality of the service they provide and to make an assessment of the quality of their service. A questionnaire called the AQAA (Annual Quality Assurance Assessment) is sent for the manager of the home to complete and return. We use this information, in part, to focus our inspection activity. The completed questionnaire gave information about several areas such as staffing, checks that the home has made about the safety and maintenance of the building, information about residents and other useful information. The AQAA also requests information about good practices and developments. Survey forms were also sent to residents, relatives and other professionals like GP’s. By the time the inspection took place, 4 relatives and 2 GP’s had returned their surveys and had made no adverse comments to make. One relative made some suggestions for improvements and her comments were passed on to the manager. There were 27 residents living at the home at the time of the inspection and there was a good compliment of care staff on duty. The staff were observed to be polite and attentive when talking and dealing with the residents. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The home is well maintained and decorated. The residents said that they like their rooms which are bright and cheerful. A programme of replacing the old beds with new ones has started. Fourteen beds have already been replaced. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 8 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 Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedures and practices to admit new residents are good. Prospective residents are given adequate written and verbal information to make an informed choice about the home. EVIDENCE: The records of admission of the last resident admitted to the home were examined and they showed that a pre admission assessment had been carried out. The manager said that in information is obtained from the residents where possible and also from the relatives. The brochure and the Statement Of Purpose contain information about the home, the care provided, the charges, the staffing, the complaint procedure and other useful information. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 10 A copy of the last inspection report is displayed on the notice board and available to residents or their families. The manager said that prospective residents and their families are encouraged to visit the home and spend some time with the other residents. They can have a meal and participate in daily activities. A member of the management team always visit prospective residents who are unable to visit the home, either in their own home or in hospital. A written pre admission assessment is done at this stage to ensure that the staff of the home can meet the assessed needs. A form is used to record information under the heading of: personal care, physical needs, medical history and several more areas relevant to the care of the resident. A full assessment is carried once the new resident is admitted and continues all the time. Regular reviews are carried to ensure that the level of care provided is appropriate. Every resident has a written contract, which gives details of the services to be provided, and how much they need to pay. The staff said that they are given as much information about the new residents as possible so that they can provide tailor-made care. The manager said that referrals from residents of an ethnic background would be welcomed. She said that the management would find information about the ethnicity of the person, for example about their cultural, religious and dietary needs. The residents said that they were very pleased with the home and that they were very well cared for. They said that the staff are very good and that nothing is too much trouble for them. Intermediate care is not provided at this home. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good practices to meet the health and personal care needs of the residents. Residents’ needs are assessed and met by a team of well motivated staff. EVIDENCE: Two residents, one of whom being the last one admitted to the home were case tracked. This means that two residents were selected by the inspector and the care they receive examined closely. Their assessments and care plans were examined and they were spoken to. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 12 The records show that detailed written information about the residents has been recorded. These include an assessment to identify the needs of the residents and also a care plan which shows how the needs were being met. The physical assessment covers; personal hygiene, mobility, hearing, vision and other areas. The care plans give details of how the assessed needs are met. For example, if someone needed help with personal hygiene, the record will show that this person needs staff to wash and dress her. The care plans are reviewed monthly to meet the changing needs of the residents. The residents can be involved in this exercise. One of the residents being case tracked said that she is very well looked after by a team of very good staff. Other residents spoken were very positive about the staff and the management of the home. They said that Abbeyfield House is a very good home and that they are well looked after. Four relatives and two GP’s completed the survey cards and they were all positive about the staff and the quality of care provided. To meet the needs of residents who need support when walking along the corridors, handrails have been fitted on the walls. The toilets have been fitted with grab rails to help those residents with poor balance and mobility. Bath hoists are available to help with lifting residents in and out of the bath. A passenger lift is available for accessing the first floor. Residents are able to use it independently if they wish. All the residents are white British, but the manager said that if a resident who is not white and British was to be admitted to the home, she will make sure to have as much information as possible by doing some research in order to meet their care and dietary needs. Resident’s health care needs are met by involving health care professionals. GP’s, District nurses and chiropodist visit when required. Medications are only dispensed by fully trained staff. All medications are kept securely in a locked metal cabinet. Residents who are able and willing can keep and administer their own medications. They are supplied with a lockable drawer in their rooms for this purpose. The staff at the home are sensitive to the needs of all the residents and do everything to help them remain as independent as possible. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 13 Each bedroom door has a lock, and the resident’s were given the option of retaining the key to promote additional privacy. The staff said that their job is to work with the residents and meet all their needs. They said that they have very good relationships with all the residents. They were observed talking and helping the residents with dignity and respect. We observed a very relaxed and friendly atmosphere in the home. There were good interactions between the staff and the residents. Most of the staff have worked at the home for a long time and have developed good relationships with the residents. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements to meet the social and recreational needs of the residents. The staff provide a variety of activities to encourage the residents to remain active and stimulated. EVIDENCE: The manager said that the staff try and arrange as many activities as possible. Activities in the home include Bingo, board games, craft, aromatherapy, etc. An entertainer comes to the home regularly to entertain the residents. The appointment of an activity organiser whose sole job would be to organise and encourage residents to participate in stimulating activities was discussed with the manager. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 15 Some of the residents said that they prefer to spend part of the day in their rooms. Some of them were seen in their rooms when the inspector looked around the home. They said that they like the privacy of their rooms and that all the staff respect their wishes. They added that the staff will bring them a cup of tea to their rooms if they want. The residents spoken to said that they are free to do what they want. They said that they can follow their religions and that priests and vicars visit the home on a regular basis. The residents said that the staff are good and that they would take them shopping and for walks if they wanted to. The staff said they will try and accommodate any reasonable activity the residents may wish to do. The residents said that they enjoy the food served at the home. They said that they get plenty to eat and drink. The main meal of the day which is a set meal is served at lunchtime. A substantial alternative is provided for residents who do not like the set meal. Residents who are diabetics are offered the same sweets as sweeteners are used instead of sugar for them. The home caters for any other preferred diets that are requested or required, for example vegetarian, gastric or diabetic food. Catering is done by an external company, which is responsible for providing all the meals and the catering staff. Apart from regular consultations with the chef, the manager of the home has no responsibly for the catering. Meals are served in the dining room, which is pleasantly decorated and furnished. Residents may eat in their own rooms if they prefer. Records of meals served examined show that a good variety of meals are offered to the residents. The chef said that within reasons, he would cater for every taste. He said that he is able to cook food to suit ethnic needs and other dietary needs, and if he did not know how, he will try and find out. The chef said that he has regular contacts with the residents and incorporate their choices in the menu planning. Residents are offered hot drinks at regular intervals during the day. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good policies and procedures to safeguard and keep residents safe. Residents are able to speak their minds without the fear of reprisals. EVIDENCE: The home has a robust procedure for dealing with complaints. All complaints and incidents are recorded in a book as part of the quality monitoring system. Written information about how and who to complain to is given to residents or their families. The residents said that if they had any complaints, they would speak to the manager and had every confidence that their concerns would be dealt with. The management team is always available to speak to the residents or their families. The home has received no complaints since the last inspection. The manager said that she talks to the residents everyday and sorts out any problems they may have. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 17 A policy and procedure on abuse is available. The policy has details of what the manager and staff should do in the event of an abuse taking place and also how to prevent it. There are systems in place for staff to report any incident of abuse either by staff themselves or by families. All the residents appeared to be safe and free from harm, neglect and abuse. Staff were observed treating the residents with respect and dignity. Staff records show that abuse awareness training had been given and staff confirmed this. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is kept to a high standard of hygiene. Maintenance is on going and decorating is of very good standard and quality. Residents live in a well kept and maintained home EVIDENCE: Abbeyfield House is situated in Clitheroe and the home can accommodate a maximum of 29 residents of both sexes who are 65 years old and over. Accommodation is provided in 1 double and 27 single bedrooms, all with an ensuite facility. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 19 The home is very well maintained and there is a programme of maintenance and decorating. Some of the beds have been replaced recently and the plan is to replace all of them. The front door is kept locked and all visitors are let in by a member of staff. This is to ensure the safety of the residents and the staff. The residents said that they feel safe living at the home and that all the staff are very good. A tour of the building was carried out. The home was found to be clean and in good order. The residents said that the staff clean their rooms daily. They said that they can do a bit of their own cleaning if they want. There are two good size lounges and a dining room on the ground floor with another lounge on the first floor. Residents can use these facilities freely. Most of them said that they prefer to stay in the same lounge and sit in the same chair. The home was found to be free from hazards, and all equipments such as bath hoist and lift are maintained by qualified people. There is good access to all areas of the home for residents and visitors with mobility problems, in that there were wheelchair ramps and a passenger lift in place. There are aids and adaptations to help with the residents’ toilet and bathing needs. The residents spoken to said that they were happy with their rooms. All the bedrooms that were visited were clean, very personalised and very comfortable. The laundry area was very clean and hygienic. Policies were in place for the prevention of any cross infection and domestic staff said that they have attended a training course on the subject. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are very good procedures in place when recruiting new staff thus ensuring that they are fit to care for the residents. A team of well-motivated staff ensures good care practices for the residents EVIDENCE: The number of staff on duty has been maintained to a good level to meet the needs of the residents. At the time of the inspection, there were 2 senior care staff, 3 care staff, 4 ancillary staff and the manager on duty. The catering staff who are employed by an external company were also on duty. Staff rotas examined showed that the staffing level is maintained to a good level to care for the residents. The staff files examined show that appropriate checks have been carried out before offers of employment were made. Such checks included CRB (Criminal Records Bureau) and a POVA (Protection Of Vulnerable Adults). Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 21 Training records show that the staff at Abbeyfield House have attended several courses. These include: Abuse, Moving and Handling, First Aid, Medications, etc. Staff were observed treating all the residents with respect and acknowledging their individuality. CSCI (Commission for Social Care Inspection) recommends that at least 50 of care staff achieved NVQ (National Vocational Qualification) level 2 and above. The percentage of care staff at Abbeyfiled House with this qualification is 63 . The staff who had completed their NVQ training had also done a unit covering Equality and Diversity issues. This means that they would be aware of how to make sure that the residents were treated equally, and given care according to individual choice and preferences. The staff spoken to said that they enjoy working at the home very much. They said that the management is very supportive and listens to what they have to say. Most of the staff working at the home have been there for many years and said that they have good working relationships with the residents and their colleagues. The residents said that the staff are marvellous and will do any thing for them. There were good interactions between the residents and the staff. They all appeared to be happy and content Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management team provide a good service to the residents and good support for the staff. The residents and staff benefit from living and working in a well managed home EVIDENCE: Abbeyfield House is owned by The Abbeyfield Lancashire Extra Care Society Limited. Mrs Georgina Marsden is the registered manager of the home. She has many years experience and has worked at the home since it opened 15 years ago. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 23 She said that she is very well supported by a committee who are members of the society. A member of the committee visits the home regularly and once a month completes a Regulation 26 form. This form is completed to ensure that owners who do not work at the home on a daily basis either himself or herself or a representative looks at all areas of the home and leaves a written report. A copy of the report is also sent to CSCI. We found that the home is well managed and that the residents are well looked after. The staff on duty were competent and were looking after the residents well. Residents and or their families are encouraged to deal with their own finances. Most of the fees due to the home are paid for by direct debit arrangements. Where the home, keeps money on behalf of residents, appropriate records are kept. The Home was awarded the Quality Assurance IIP (Investors In People). The home is assessed and its services monitored by an external body regularly. The manager has completed her NVQ level 4 and is nearing completion of the Registered Manager’s Award Staff said that they are encouraged to be proactive in improving the quality of care provided at the home. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 24 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 N/A 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 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP31 OP12 Good Practice Recommendations The registered manager should complete the Registered Manager’s Award Considerations should be given to employing an activity organiser whose main responsibilities would be to encourage and help residents remain active. Abbeyfield House DS0000009529.V347254.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Abbeyfield House DS0000009529.V347254.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. 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. 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