Inspection on 07/03/07 for Aberford Hall

This inspection was carried out on 7th March 2007.

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

Aberford Hall 29/10/08

Aberford Hall 27/02/06

Aberford Hall 31/10/05

Aberford Hall 28/01/05

Aberford Hall 10/06/04

Aberford Hall 21/04/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Aberford Hall Oakwood Green Leeds Yorkshire LS8 2QU Lead Inspector Kate Shackleton Key Unannounced Inspection 09:30 7th March 2007 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 Aberford Hall DS0000001316.V319396.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. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aberford Hall Address Oakwood Green Leeds Yorkshire LS8 2QU 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) 0113 2323225 0113 2736550 www.schealthcare.co.uk Southern Cross Healthcare Services Limited Mrs Jacqueline Wisdom Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42), Terminally ill over 65 years of age (1) of places Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. TI (E) is for the named person in the application dated 5.5.06 Date of last inspection 27th February 2006 Brief Description of the Service: Aberford Hall is a privately owned care home providing nursing, personal and social care for up to forty-two people over the age of sixty. The home is purpose built and accommodation is provided over two floors in forty single and one double room with en suite facilities. The first floor is accessed by a passenger lift. There are well-maintained gardens that can be accessed by the residents and people enjoy sitting out in the good weather. Local amenities are available within a reasonable distance including shops and a pub. At the time of this visit fees ranged from £367-67p to £633 per week. The Commission for Social Care Inspection report is available in reception area of the home. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • A review of the information held on the homes file since its last inspection. • Information submitted by the registered provider in the Pre Inspection Questionnaire. • Surveys received from five service users survey and one relatives comment card. • This was an unannounced visit to the home, which lasted about seven hours. The visit included a tour of the premises; talking to service users, care staff, visitors and the manager. Examining some records and observing staff working with service users. What the service does well: Service users or their representatives are given enough information about the home before they move in. Someone from the home visits them prior to admission and they are offered the opportunity to visit the home for a look around and to ask questions about how the service is delivered. This enables them to make an informed decision as to whether the home is the right place for them to live. Comprehensive assessments are done from which a clear easy to understand care plan is developed. The user of the service is seen as a “whole person” and the service works well with other services to ensure that health needs are met. Service users and or their representative are asked what they need and are actively encouraged to be involved in their care plans and reviews. This promotes the service users right to have a say in the care delivered and makes sure that all of their needs are considered. The home is clean and comfortable. It is decorated and furnished to a high standard. Staff are kind and helpful and make an effort to provide the service in the manner that service users want. Comments made by service users about staff included they “are very nice” and “very good to me” Other comments received were “A friendly caring home for my mother” and “ I’ve found the standard of care for mum is high” One visitor spoken to described the care as Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 6 “absolutely brilliant” Emphasis is placed on maintaining the independence of people using the service and enabling them to exercise choice in key areas of their lives. Examples given included rising and retiring times, clothes, food and activities. This ensures that service users maintain some control. The safety of service users is an important aspect of the service delivered. It is demonstrated through good recruitment practices, risk assessments, staff training and the servicing of equipment and maintenance of the premises. A good choice of food and drinks are available. This ensures that service users receive a varied and nutritious diet. One service user spoken to said “The food is excellent.” There are various in house activities, which provide stimulation and interest. Visitors are encouraged and made welcome. There is a clear and user-friendly complaints procedure and the manager shows a positive approach to complaints and ideas for improvement. There are clear ways in which quality can be measured which include feedback from service users. This ensures that the service continues to deliver care in the best interests of people who use the service. The staff are provided with comprehensive training to improve their knowledge and skills. This means that service users receive care from a well-informed staff team whose practice is up to date. The home is managed in a manner that is service user focussed. It concentrates on the needs, wishes and views of the people who use the service. 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. The summary of this inspection report can be made available in other formats on request. Aberford Hall DS0000001316.V319396.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 Aberford Hall DS0000001316.V319396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply to this service. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manger completes a comprehensive assessment and gives careful consideration to the needs of each person requesting admission to the home. This ensures that people are only offered a place when the manger is confident that the service delivered can meet the person’s needs. EVIDENCE: Case files examined confirmed good practice. The manger visits prospective service users at home or in hospital and undertakes a comprehensive assessment of their care needs. Relatives are involved where possible to find out more information that the service user may not be able to provide. At this visit the manager explains how she feels the service can meet the needs of the person needing care and assesses if any specialist equipment needs to be provided in the home. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 9 Everyone is offered the opportunity to visit the home prior to moving in and to stay for a meal if they want to. On admission a named nurse and a key-worker is allocated to each service user. Everyone is admitted for a four trial period to make sure that they settle and want to stay followed by a six-week review of the situation. The manager discusses the level of the persons needs with her senior staff before a decision is made to admit anyone. This enables a considered discussion to take place to ascertain if staff feel confident that the service can meet the persons needs. Before admission senior staff discuss with the rest of the staff team the needs of the person about to be admitted. Service user feedback confirms that they or their representatives are involved with their admission to the home. In discussions with staff some felt they didn’t get all of the information they needed soon enough. They said that this tended to happen when bank staff were in charge. Aberford Hall DS0000001316.V319396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users receive a high quality service that meets their needs. EVIDENCE: All service users have a robust care plan. The plan is a working document. It contains sufficient detail to ensure that care staff know the support they have to provide to meet the diverse needs of service users in a manner that promotes independence and respects privacy and dignity. Service users and their families are involved in drawing up the care plans where possible and evidence was seen that the plans are reviewed monthly and updated on a regular basis. The manager completes a three monthly quality audit of the care plans. Each plan contains a range of comprehensive risk assessments. As part of the management of risk the views of service users are taken into account in order for them to maintain their independence and lead fulfilling lives. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 11 Some staff spoken to said that they found it difficult to find time to read care plans. They were able to give examples of best practice relating to the promotion of the privacy and dignity of service users and were observed providing support in a kind and helpful manner. Service users looked clean and well cared for. Staff promote the rights of service users to access the health care professionals that they need. If it is possible they retain the GP they had prior to admission, if not the home assists in registering them with a local practice. Service users spoken to say they can see the doctor when they need to. Any GP visits plus the outcomes and any required actions are clearly recorded in the service users files. Staff are able to access any specialist services that residents may need including Tissue Viability and Diabetic Nurses. Evidence was seen that a Chiropodist visits the home to treat residents every six weeks and Opticians and Dentists visits are arranged as required. Discussions with service users found that they were happy with the standard of service provided. Comments like staff “are very nice” and “very good to me” were heard. Feedback from surveys confirmed that service users receive the care and support they need. Comments included “A friendly caring home for my mother” and “ I’ve found the standard of care for mum is high” One visitors spoken to described the care as “absolutely brilliant” Satisfactory arrangements are in place for the safe storage and administration of medications. Service users are supported to self medicate if they want to and provided with lockable facilities in their bedroom to store their tablets. A risk assessment is completed to manage any risk associated with this activity. The ground floor room where medications are stored felt very warm and is probably above the optimum temperature for storing drugs. The manager is aware of this and plans are in place to provide better ventilation/air conditioning. Aberford Hall DS0000001316.V319396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff provide opportunities for stimulation and interest for people living in the home. Meals are nutritious and offer a varied diet. EVIDENCE: An activities organiser is employed and is in the home Monday to Friday. She has individual discussions with people to find out the types of activities that they are interested in. The programme details the outcomes expected from each activity. Although there is a weekly programme of activities, which includes one to one sessions as well as group work and entertainers, the organiser is sensitive to how people are feeling on a daily basis and will tailor the programme accordingly. Feedback from talking with service users and surveys shows that in general people are satisfied with the activities offered. One service user would like more trips out. Arrangements are made for clergy to visit the home in response to requests from service users. Routines are flexible and staff were able to give examples about how service users are able to make choices and maintain some control in their lives. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 13 Service users confirmed that they could make their own decisions about how they spend their time. Staff training and the ethos of the home promote the rights of service users being in control of their life. Visitors are encouraged and visitors spoken to said that staff are very friendly. They said they are offered refreshments and can stay for a meal. Regular service user meetings are held but no one attended the last one. The manager holds a weekly surgery for family and friends but no one usually attends. Family and friends tend to speak with the manager and staff as and when they are in the home. Menus are varied and nutritious. There is a choice of food at each mealtime and special diets are catered for. Service users can choose where to eat, either in the dining room, their bedroom or lounge. Dining room tables were set properly with tablecloths, appropriate cutlery and condiments. Staff served meals with support being provided for people who needed help to eat. Mealtimes were relaxed and unhurried allowing service users as much time as they needed to complete their meal. Service users said that the food was very good. Discussions with the cook showed that she gets involved with discussions with service users and their family in order to get it right for service users who have particular difficulties with eating. The feedback from surveys revealed that three people always liked the meals, two usually and one sometimes. Comments included “My mother eats well even though she unable to feed herself” and “starter and sweet quite good, main course mostly uneatable” The manger said that “special birthdays” are celebrated. Key-workers liaise with family and special arrangements will be made to mark the occasion. Last month to mark Valentines Day, an invitation was extended to spouses to join their husband/wife for lunch in the home. Aberford Hall DS0000001316.V319396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Complaints and concerns raised are properly followed up and appropriate action is taken to resolve the situation in the best interest of service users. Robust procedures and staff training protect service users from abuse. EVIDENCE: The home has a clear complaints procedure. The procedure is given to every service user and is on display in the home. Feedback from discussions with service users and surveys show that people know who to speak to if they are not happy with the service. The complaints record showed that concerns are dealt with speedily and thoroughly, seeking an early resolution in the best interests of all concerned. There has been two safeguarding adults investigations completed since the home was last inspected, one of which resulted in a member of staff being dismissed. The home has safeguarding adult’s policies and procedures in place to guide staffs practice. Staff are provided with training and are aware of the need to report any allegations or suspicions of abuse to their manager. Management know the measures to take in relation to protecting and safeguarding the rights of service users. Aberford Hall DS0000001316.V319396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, clean and comfortable home. EVIDENCE: The home provides a very well maintained, safe, comfortable and attractive home, which has all the specialist equipment and adaptations needed to meet individual service user needs. Service users bedrooms contain a lot of their own personal possessions, which promotes feelings of ownership. A picture of the key worker is displayed in each bedroom. This helps service users and relatives to keep track of the member of staff that has a special interest in them. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 16 A team of domestic staff are in the home every day working in an organised manner. Protective clothing is available for staff where required and the home has a control of infection policy in place. The laundry is well organised and a specific person takes care of this area. Aids and adaptations are regularly serviced. The home employs a handyman who is responsible for routine maintenance and the monitoring of some health and safety aspects of the premises. Fire equipment, gas and electrical appliances are routinely checked. Feedback from service users and others shows that the home is usually always fresh and clean. Comments received included “when I first viewed this home prior to moving my mother in, it was the “ no smell” factor that impressed me” and “no odours when I visit” Aberford Hall DS0000001316.V319396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of competent staff that have been properly recruited and trained to meet the needs of service users. EVIDENCE: Staff were observed responding quickly and appropriately to requests from service users and spent time talking to them. Service users spoken to say that staff were always available to provide appropriate support and that they felt safe living in the home. Feedback from service users and others included the following comments, “ In my mothers situation where she needs 24 hour care for all her needs I am happy with Aberford Hall” “ Care at the home is very high, all the carers give a little extra” and “very pleased about the staff and the home. Everyone is very kind” One relative commented, “Sometimes it seems understaffed in the evening although I can always find a member of staff if needed” Discussions with staff provided mixed responses. Some felt that the home was understaffed and they would like more time to spend with service users. One comment heard was “Don’t have time to give residents the attention they need”. Other staff either didn’t feel this way or were non-committal. The staff rota confirmed the numbers and grades of staff on duty. The manager is able Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 18 to access extra staff if they are required. The home has its own bank staff. Agency staff are rarely used. Discussions with the manager about the care staffs views re short staffing showed that there is a system used to match the dependency level of service users to the numbers of staff needed. The manager would refuse admissions if she felt she didn’t have the resources available to provide a good service. Staff files examined showed a robust recruitment process, which endeavours to make sure that only suitable people are employed. Two written references, Criminal Records Bureau (CRB), Protection of Vulnerable Adults (POVA), Visa and work permits checks are all obtained before anyone is allowed to work at the home. All staff are subject to a probationary period. Training of staff is given a high priority There is an induction programme that ensures new staff members are given the right information to be able to do their jobs well. Staff spoken to said that the on going training programme is good, providing them with the skills and knowledge to meet service users needs. The training programme includes all the mandatory training needed to meet service users basic needs such as lifting and handling, food hygiene, and health and safety. Specialist training provided includes dementia care, catheter management, continence management, pressure ulcer prevention, palliative care and safeguarding adults. Staff say that they are able to identify their training needs at their annual appraisal. 39 of staff have achieved National Vocational Qualifications level 2 or above. Aberford Hall DS0000001316.V319396.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes high standards of service delivery in the best interests of service users. EVIDENCE: The manager is registered with the Commission for Social Care Inspection. She is a Registered General Nurse and has many years experience of delivering care services to older people. She demonstrates a commitment to leading and supporting the staff team in providing high quality services. People who use the service and their representatives say that they receive a service from staff that are courteous and respectful. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 20 The home has sound policies and procedures in line with current thinking and practice. They were all reviewed in 2006 Regular service user/representatives meetings, staff meetings and staff supervision promotes an open and transparent management style that is service user focused. There is a wide range of quality monitoring systems to ensure that high standards are consistently achieved. Service users are surveyed about different aspects of the service in order to get their point of view. The results of surveys are displayed on the notice board. Findings from quality audits are analysed and improvements made where necessary. A senior manager of the organisation visits monthly to audit the service. These visits include discussions with service users and visitors. Service users are encouraged to manage their own financial affairs and spend their money as they wish. Staff provide support for service users who require help in managing their finances and there is a robust procedure in place to direct staff in their practice and protect service users from financial abuse. Proper appointee arrangements are in place for people who are unable manage their own finances. The home works to a clear health and safety policy and regular safety checks are carried out. The health, safety and well being of service users and staff is promoted. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 21 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 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 4 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 22 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. 1 Refer to Standard OP28 Good Practice Recommendations A minimum ratio of 50 trained members of care staff (NVQ level 2 or equivalent) should be achieved. Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Aberford Hall DS0000001316.V319396.R01.S.doc Version 5.2 Page 24 - 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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