Inspection on 19/07/06 for Abbotsford

This inspection was carried out on 19th July 2006.

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

Abbotsford 14/10/08

Abbotsford 09/07/07

Abbotsford 05/04/05

Abbotsford 16/08/04

Abbotsford 20/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Abbotsford 443 Wellingborough Road Abington Northampton Northants NN1 4EZ Lead Inspector Irene Miller Unannounced Inspection 19th July 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 Abbotsford DS0000040840.V304385.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. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbotsford Address 443 Wellingborough Road Abington Northampton Northants NN1 4EZ 01604 636729 01604 636729 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) Msaada Ltd Post Vacant Care Home 18 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (18) of places Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users, whose rooms are on the second floor, should be able to mobilize independently. 28th September 2005 Date of last inspection Brief Description of the Service: Abbotsford is a care home for 16 people over the age of 65 years who have dementia related conditions. Accommodation is set over three floors, rooms on the second floor and annex the are single with en-suite facilities, rooms on the first floor are all shared and do not have en-suites. There are two lounges and a separate dining room. The home is located on a main road and is opposite a park. The town centre is two miles away and is on the local bus routes. The range of fees are Abbotsford DS0000040840.V304385.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 (CSCI) is upon outcomes for Service Users and their views of the service provided. This inspection was a ‘Key Inspection’ that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for older people. The inspector spent two and a half hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes service history, the last two inspection reports and other information in relation to the home. The primary method of inspection used was ‘case tracking’ that involved selecting two residents and tracking the care they received through a review of their individual care plans (that sets out how the home aims to meet their personal, healthcare, social and spiritual needs). A selection of policies and procedures and records in relation to staff recruitment, complaints, medication and general maintenance and upkeep of the home were viewed. Discussion took place with residents and staff, and general observations of care practices were made. The acting manager Julie Pozzetti was available at the home throughout the inspection and the inspection took place over a period of approximately six hours What the service does well: Information is provided to prospective residents and their representatives, to enable them to make an informed decision as to whether the home will meet their needs, support is made available from the visiting health care professionals in meeting the healthcare needs of residents. Where residents have the capacity they are encouraged to be actively involved within the local community, families are encouraged to provide information on their relatives preferred hobbies, interests, previous occupations and lifestyles Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 6 to enable the home to provide activities that are meaningful to individual residents What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abbotsford DS0000040840.V304385.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 Abbotsford DS0000040840.V304385.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 Quality in this outcome area is good. Prospective residents can be assured that the home can meet their needs and expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Prospective residents are invited to meet the residents and staff, and view the home prior to moving in, the homes statement of purpose and service users guides are provided, to enable them to make an informed choice about moving into the home. Following an initial trial visit of one month, formal review meetings are held with residents and /or their representatives, to ensure that the home is meeting and can continue to meet the resident’s needs. However this arrangement is largely carried out with residents that enter the home via Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 9 support from the local authority. The same arrangement is not in place for residents who enter the home through private arrangements This is an area that could be improved upon to ensure equality in the admission processes. The resident’s care plans looked at included pre assessment documentation that had identified the prospective residents needs prior to them moving into the home and the care plans were regularly reviewed. All the residents spoken with expressed their satisfaction on choosing to live at Abbotsford. Abbotsford DS0000040840.V304385.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): 7,8,9 & 10 Quality in this outcome area is good. Residents can be assured that home can meet their health and personal care needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents care plans identified the personal, healthcare and social support required and instructions were available for staff on how the home aimed to meet the needs identified. For residents at risk of developing pressure ulcers, their treatment and on going healthcare support was available from the district nurse and pressurerelieving equipment was seen to be in use. Within the care plans there was documentation to evidence that support was available from other healthcare professionals, such as visits from the chiropodist, optician and dentist and there was records of residents being referred to their general practitioner as and when required. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 11 The staff were knowledgeable of each residents individual health, personal and social needs, and observations of interactions between the staff and residents demonstrated that the staff were experienced in communicating with residents with limited verbal communication On the day of inspection it was particularly hot with temperatures in excess of 34 degrees, staff were observed to be providing the residents with a ready supply of fluids such as water and fruit juices, the acting manager had made arrangements for the home to be supplied with several electric fans, that arrived during the inspection and were placed around the home. Staff had made every effort possible to ensure that the temperature within the building was comfortable for the residents by closing curtains and keeping windows closed. Where possible the residents were encouraged to stay indoors. Residents spoke very highly of the care they received, and for residents who were unable to verbally express their feelings, observations made of facial expressions (smiling) and non verbal body language, indicated that they were relaxed and at ease with the staff. The senior staff has the responsibility of administering medication, to residents and training is made available. The storage and administration records looked at where in general good, however there was a missing staff signature, for one medication that had been administered and uncertainty as to whether a medicated ointment prescribed for one resident had been in use. The administration record had been signed to indicate that a prescribed ointment had been applied, however there was two unopened tubes of the prescribed ointment contained within the fridge, and there was no evidence of a used tube in use, as it had been disposed of within the household waste, this cast suspicion as to whether the ointment had been applied. The missing signature and the suspicion over the unopened tubes of medicated ointment and the records indicating that it had been applied was discussed between the inspector and the acting manager, as an area for further development in the recording and administration of medication within the home. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 12 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): 12,13,14 & 15 Quality in this outcome area is good. The home in general matches the social, cultural, recreational and occupational expectations of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home endeavours to ensure that residents have the access to local community groups, one of the residents case tracked attends a local Afro Caribbean Club twice a week. The staff spoke highly of small drama group that visited the home that entertained residents by putting on small theatrical plays and undertook various activities with residents such as cookery and pottery Following on from this the acting manager had made a request to families for some information on their relatives preferred hobbies and interests and previous occupations and lifestyles. On talking with residents and staff there was evidence that some information had been supplied from families that had enabled staff to provide meaningful activities for residents on a more individualised level. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 13 One resident talked of their previous occupation working in the restaurant at the Co-op in Northampton and how happy she had been working there, when asked how she liked to spend her time she said that she enjoyed knitting, and there was some knitting beside her, that demonstrated that this had been accommodated for by the home. One resident was bed bound, there was documentation within their care plan that identified the risks of being socially isolated, staff said that they had endeavoured to bring the resident into the lounge, but due to their poor physical health found that this was detrimental to the residents well-being Staff said that they make every effort to visit the resident frequently to ensure that the risks of social isolation are to the minimum, staff said that the resident liked to listen to classical piano music and that the home had a selection of CDs available Discussion between the inspector and the acting manager explored the possibility of the home providing portable sensory equipment or specialist seating that could be of some benefit for residents who find that they may be at risk of being socially isolated, due to their physical ill-heath constraints. The home conducts annual Service Users Satisfaction Surveys to seek the views of residents and relatives, to identify areas for improvements, feedback from a survey conducted with residents were available to view, all the comments were very positive. Residents said that they felt safe and happy living at the home, and that the staff were very kind and helpful. The dining area was pleasantly furnished having pine dining tables and chairs that seated four to six people. The home has a vacancy for a cook and the acting manager said that in the interim a relief cook that had been standing in. The kitchen was clean and tidy, however food safety records of fridge and freezer temperatures and cleaning tasks undertaken were not available to view, as the last entries were made on the 18th June 2006. An inspection of the fridge, freezer and cupboard interiors indicated that cleaning had been undertaken as they were all clean and tidy and well stocked. The fridge within the kitchen had a small leak and the seal at the bottom of the door was torn. The staff were aware of this and had attempted to make the floor area safe by placing a rolled up towel under the front of the fridge, the staff said that it was being attended to by the owner of the home. The acting manager said that a property audit was soon to take place and that the need to purchase a new fridge would be a matter of priority. It was noted that the window within the kitchen was open and no fly screens were in place, there was no measures within the kitchen environment to eradicate flying insects, and the food waste bin did not have a lid available. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 14 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): 16 & 18 Quality in this outcome area is good. Residents can be assured that any complaints they may have will be taken seriously, and that they will be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaints procedure is available within the homes statement of purpose that is given to residents and their representatives upon admission. One complaint/allegation had been made since the last inspection taking place and the Commission for Social Care Inspection considers that it was appropriately and fully investigated. Staff training includes abuse awareness and the protocol for reporting any suspected or actual abuse. Should there be any incidents of an abusive nature, The home has a copy of the Northamptonshire Multi Agency Protection of Vulnerable Adult reporting procedures for guidance. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 15 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): 19,20,22,24,25 & 26 Quality in this outcome area is adequate. Residents live in a home that is generally, comfortable and clean and meets their needs and expectations. However there were shortfalls in maintaining written documentation on food safety standards, pest control measures and maintenance of wheelchairs that could place the resident’s health safety and welfare at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the building was conducted and in general the home provides a pleasant and comfortable environment. The bedrooms and communal areas were furnished and decorated to an adequate standard. The resident’s bedrooms viewed contained some personalised items of furniture and were clean and tidy. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 16 The registered provider had endeavoured to provide written and pictorial signage on doors to aid in orientating people living at the home with dementia. It was noted that many of the doors had wedges in use, and the speed at which the doors closures activated was unsafe to residents and staff, as many of the doors slammed shut and presented a high risk especially to frail residents of trapping their fingers, or being knocked over this was brought to the attention of the acting manager Much work had been undertaken on improving the features of the rear garden to include the laying of block paving to create a safe pleasant seating area for residents use, however the gate at the end of the garden was not secured. It was explained by the acting manager that work was taking place on introducing a keypad lock to the gate to provide added security to the premises, there was some evidence to indicate that work had began in this area. At the top of the garden near to the gate there was several household waste refuse bags complete with their contents that had been placed on the floor, within the garden, however there was a household waste bin that was located on the outside of the garden perimeter. There was a clinical waste collection bin available, within the garden however a clinical bag with its waste contents had been placed in a disused shopping trolley outside of the bin. The shortfalls in disposing of the household and clinical waste were stressed to the acting manager who immediately made arrangement for the waste to be disposed of appropriately. There were two wheelchairs within the home, however one wheelchair did not have footrests fitted, the acting manager said that there was no footrests available therefore the chair was unsafe for use. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 17 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): 27,28,29 & 30 Quality in this outcome area is good. Resident’s needs are met by a staff team who are trained and competent to do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing levels in general were sufficient to meet the current needs of the residents living within the home, however on the day of inspection a member of the care staff was standing in for the relief cook who was on holiday. Priority needs to be given to the recruitment of a permanent cook to ensure that all care staff are able to discharge their responsibilities fully. Staff recruitment records viewed indicated that the recruitment process is good; there was evidence of criminal records bureau clearances and references being obtained prior to employment commencing. All staff had received statutory training, such as moving and handling, fire safety, food hygiene, medication and protection of vulnerable adults training. Since the last inspection taking place one safeguarding adults referral had been reported to the Commission for Social Care Inspection, and it was considered that the allegation was fully investigated by the registered provider, Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 18 following the Northamptonshire Protection of Vulnerable Adults Policies and Procedures. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 19 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): 31,33,35 & 38 Quality in this outcome area is good. In general the home is managed well, however their are environmental and procedural shortfalls that could place the health, safety and welfare needs of residents at risk. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered provider has addressed the requirements made following the last inspection visit, and the acting manager demonstrated that there is a commitment to improve on the quality of care provided at the home. Residents and their representatives are consulted on how the home can continually improve on the service provided for residents, through consultation and feedback questionnaires. Copies of letters sent out to relatives to seek Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 20 their involvement in providing some information on their resident’s lifestyles were available to view. For residents who enter the home through private arrangements a formal care review meeting does not take place following the initial 4-week trial period. To ensure that all residents and their representatives have the opportunity to express their satisfaction or dissatisfaction of the home and the services available a formal care review meeting needs to take place. The storage and administration records looked at where in general good, however there was a missing staff signature, for one medication that had been administered and uncertainty as to whether a medicated ointment prescribed for one resident had been in use. Minutes were seen of resident and staff meetings take place, and records were seen of, individual staff supervision taking place to include annual staff appraisals. Staff turnover is low which ensures that residents have stability of care. The financial and accounting procedures within the home safeguard the resident’s interests, and cash held on behalf is stored securely. There is a formal system of monitoring by the registered provider in place records were available of monthly visits that had taken place. The extensive use of door wedges, and the dangerous speed at which the door closures activate needs to be addressed by the registered provider. It was explained by the acting manager that work was taking place on introducing a keypad lock to the gate at the end of the garden to provide added security to the premises, there was some evidence to indicate that work had began in this area. The household waste and clinical waste that was not disposed of correctly presented a high risk of attracting pests into the property. Once this shortfall was addressed to the acting manager, the waste was disposed of appropriately during the inspection visit. Priority needs to be given to the recruitment of a cook to ensure that catering and food safety standards are followed and that all care staff are able to discharge their care responsibilities fully. The registered provider needs to ensure that all equipment within the home is suitable for use the fridge within the kitchen needs to be repaired or replaced and the wheelchair that did not have footrests fitted, needs compatible footrests made available or the chair replaced. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 21 Control measures to prevent and eliminate flying insects within the kitchen environment needs to be in place, and the food waste bin needs to have a lid in place. On the day of inspection it was particularly hot with temperatures in excess of 34 degrees, It was noted that staff were very mindful of ensuring that all residents had a ready supply of fluids such as water and fruit juices, and that the acting manager had made every effort to ensure that the temperature within the building was comfortable for the residents by placing electric fans around the home and closing curtains and windows. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP19 Regulation 23 Requirement The fitting of the security key pad access to the garden gate at the rear of the property must be completed Staff must sign for all medications that have been administered to residents Where doors are required to be held open within the building, the fire authority must be fully consulted. Wheelchairs for residents use must be maintained in good working order. Temperature readings of the fridge and freezer and the probe temperature readings of cooked foods must be kept. In line with Environmental Health Authority Food Safety guidance. Timescale for action 31/08/06 2 3 OP9 OP19 13 23 (4) (5) 31/08/06 31/08/06 4 5 OP22 OP26 23 (2) (c) 16 (2) (j) 31/08/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 24 No. Refer to Standard Good Practice Recommendations Abbotsford DS0000040840.V304385.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Abbotsford DS0000040840.V304385.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!