Inspection on 13/02/09 for Albert House

This inspection was carried out on 13th February 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Albert House 07/04/08

Albert House 15/05/07

Albert House 09/05/06

Albert House 03/11/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

CARE HOME ADULTS 18-65 Albert House 167 High Street Clapham Bedfordshire MK41 6AH Lead Inspector Angela Dalton Unannounced Inspection 13th February 2009 10:55 Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albert House Address 167 High Street Clapham Bedfordshire MK41 6AH 01707 652053 01707 662719 karen.cox@caretech-uk.com 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) CareTech Community Services (No.2) Ltd Post vacant Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 8 7th April 2008 Date of last inspection Brief Description of the Service: Albert House is located in the village of Clapham, a short car or bus ride away from Bedford, which has shops, leisure facilities and links with national bus and rail services. The home has been converted from its original purpose as a domestic dwelling. The building is an extended bungalow which provides single room accommodation for 8 younger people with learning disabilities and who may also have physical disabilities. A communal lounge/diner and a room that is used for activities are located to the rear of the property. A shared drive at the front of the property leads to a parking area for several vehicles. To the rear of the property is a large garden that leads directly to the river Ouse. The fees for this home are in the region of £1500.00 per week, depending on the assessed need of the person. Additional charges are made for hairdressing, aromatherapy, chiropody, toiletries, community based activities, holidays and transport other than for attendance at health appointments. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. One inspector conducted this unannounced site visit on 15th February 2009 between 11.55am and 6.55pm. The deputy manager is currently acting manager and this was their first experience of an inspection. Two people were case tracked: the inspector followed the care of people who use the service to ensure the care they receive is reflected in the care plan and meets their individual requirements. The case tracking process cross-references all the information gathered to confirm that what we are being told is actually happening and reflects the Statement of Purpose, which contains the aims and objectives for the service. We met with service users, staff and the acting manager to discover what it was like to live and work in the home. This was the service’s second key inspection to determine the progress made with the requirements issued at the previous inspection in April 2008. People who use the service are well cared for and staff focus upon individual needs and ensure that people develop their skills and independence. What the service does well: What has improved since the last inspection? Care plans reflect that the information they contain has been explained to people who use the service. A record is kept, as most service users are unable to sign their care plan or verbally communicate. Agency staff receive training and supervision to ensure that they are able to meet the needs of people who use the service. Complaints are responded to and a record of the response is kept. All service users have an individual action plan. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 6 The statement of purpose and service users’ guide are made available in a format suitable to all people in the home and prospective people so that they know what services the home can and will provide. 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. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective and current service users have the information needed to make an informed choice about the home. EVIDENCE: There have been no new admissions since the previous inspection in April 2008. The acting manager would ensure that the needs of the current people were a priority before any future admissions were made and that they were compatible. The service users guide has both words in large print text and pictures to ensure it is user friendly. The acting manager plans to review the statement of purpose to ensure it is in a similar easy read format. Contracts had been removed from individual files to enable keyworker to check that the information was correct and review any fees or changes to terms and conditions. We reviewed contracts at the previous inspection and as there have not been any new admissions we are satisfied that this standard has been met. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are the focus of the service and individual choices are actively encouraged and implemented. EVIDENCE: We looked at care plans for two people who live at the home. Each person has a care plan held in two folders. An overview of how care is delivered and the daily routine is explained and accompanied by pictures. Where a person does not use verbal communication this is recorded and a record has been made when staff explained the content of a care plan. Family involvement is reflected, specifically where family have liaised with staff regarding end of life wishes. Some directions were unable to be carried out, as staff had not yet had training: one care plan requested that Makaton signs were used with a resident but we did not observe this taking place. The acting manager told us that training was to be arranged. Staff appeared to understand each person’s needs Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 10 and they were able to make their needs known. The Acting Manager plans to expand care plans to ensure that there is more information about how people use their emotions and behaviour to convey their wishes e.g. if someone is tired and wants to go to their bedroom. Risk assessments were in place to determine how identified risks were managed. Again, the Acting manager plans to add some additional detail that will enhance information such as sling sizes in the moving and handling assessments. Two staff have received training on person centred planning, which reflects individuals’ hopes dreams and aspirations. There are plans to review person centred plans in the near future. The Acting Manager reported that the company plans to introduce a new care plan format in the near future, which may address some of the issues identified during the inspection. Most people who use the service have contact with their families and one receives regular visits from their advocate. Other service users have received support from an advocacy service in the past but have since been discharged. The Acting Manager was satisfied that if needed all service users could be supported by an advocacy service to ensure that individuals’ views were sought. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Daily living activities are tailored to the individual requirements of people who use the service. EVIDENCE: On the day of the inspection all of the people who use the service were at home. A review was taking place in the home, which the person was attending. Staffing levels had been allocated to ensure that staff could attend. The service achieves a homely atmosphere: there is no regimented approach and the staff team and acting manager have successfully achieved a sense of belonging for people who use the service. People were asked what they wanted for lunch and staff stated that they had pictures to support most menu choices but not the ones available when we visited. Some of the crockery is chipped and does not lend itself to ‘ordinary living’ because of its specialist appearance. The acting manager will investigate Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 12 if more appropriate specialist crockery is available. We observed staff support and assist people appropriately. The acting manager plans to introduce staff eating their meal with service users to ensure a more homely experience and to enable staff to know that they are assisting people at the correct pace and to monitor the temperature of food. Meals are served on an open trolley and the acting manager will explore whether a heated trolley would be useful. People have a weekly plan outlining their activities. There are no records kept if people do something different from their plan or remain at home so it is difficult to determine if an outing has taken place or is repeated. Some people had been out the day before and bought some spring flower displays. These were scented so that those with sensory impairments could appreciate them. There is an annexe at the rear of the building that is used for arts and crafts. There are photographs of people on holiday - the most recent being in Oxford last summer, and also a small sensory room. The sensory equipment is mobile and can be used in other parts of the home. The acting manager reported how beneficial this was if people wanted to lie down and enjoy different lighting effects. A range of activities is available incorporating attendance at a day centre and college. One person attends horse riding and everyone gets the opportunity to develop daily living skills with staff. All of the people who use the service have one to one time with staff and are able to pursue activities that they enjoy. Staff support five people to attend church on a regular basis and the local vicar has good links with the home. The television in the lounge was on as one service user enjoys watching DVDs. It was noted that the picture was slightly ‘fuzzy’ which the acting manager plans to investigate. The home does not yet have a satellite signal. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Health records could better record the high standard of care delivered. EVIDENCE: Some expansion is needed to reflect how individual health needs are met. One person was having a pressure sore treated by the district nurse but the care plan did not identify the site of the pressure sore or the management details. It was unclear how pressure-relieving equipment was used and cared for to assist in the management of the pressure wound. There was a reference to a bruise in an accident report but this did not correspond to care of a pressure sore. The acting manager recognised that staff would benefit from pressure care training as many residents have poor mobility and may be at an increased risk of pressure sores. A proportion of staff are new to the service and had not received training in this area. The same person was also receiving treatment for an infected toe but no care plan was in place to reflect the treatment so it was not possible for staff to monitor any improvement or deterioration. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 14 One care plan stated that ‘weight is to be monitored’ but no reason as to why this was happening was recorded. There was a contradiction as the care plan stated ‘use sweetener in my tea or coffee as I am watching my weight.’ A few sentences later the care plan stated ‘please encourage me to eat as I am reluctant and have lost quite a lot of weight.’ The daily record sheets are tick sheets and do not reflect how individual needs are monitored and managed. Epilepsy guidelines were in place but not dated so it was unclear if there had been any changes to the care needed, as there was no review in place. A protocol was in place for the administration of emergency epilepsy medication but hand written changes had been made and were then crossed out and rewritten making the instructions difficult to follow. The acting manager confirmed that there was always someone on duty who had this training. This is especially important at night when there are two waking night staff. One person has their blood sugars taken regularly: there is no record of staff having received training to do this safely. The Acting Manager stated she would contact the nurse to request certificates to show which staff were competent to perform blood sugar tests. Despite the records requiring some additions the people who use the service clearly receive a high level of care. One person was seriously ill a few months ago and they have recovered well from their illness, as staff were able to meet their needs. One care plan identified that a resident may have Hepatitis B but there was no accompanying care plan or risk assessment to explain how this was managed. An aromatherapist visits the home each week but there was no risk assessment in place to reflect that any potential reactions to treatment had been considered. The acting manager plans to obtain a copy of the CRB for the aromatherapist as it is currently held at head office. We checked medication records and storage for two service users and found everything to be in good order. This ensures that a safe system for medication administration and recording is in place for the protection of people who use the service. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Measures are in place to ensure people who use the service are protected from abuse. EVIDENCE: The home’s complaints procedures need has been updated to reflect the current address of the CSCI office for correspondence. The complaints procedure was produced in a format appropriate for people who use the service to understand and access. The home had a safeguarding vulnerable adults policy in place, which included whistle blowing. Most staff had also attended abuse awareness training, which included Safeguarding of vulnerable adults (SOVA); SOVA training was also included and formed part of the homes induction process for staff. Three monthly SOVA questionnaires are completed by staff to ensure that they remain familiar with up to date guidance on how to protect vulnerable people. The homes policies and practices regarding people who use the service, their money, and financial affairs were generally satisfactory and protected people who use this service from abuse. We checked finances of two people who use the service and found them to be in good order. There had been no complaints made since the previous inspection. The acting manager also keeps a copy of compliments that the home has received. They also plan to devise a system to reflect how concerns have been dealt with to ensure that they do not escalate into complaints. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service provides a homely environment, which meets the needs of people who use the service. EVIDENCE: The home was clean, tidy and odour free. Since the last inspection the lounge has been recarpeted and decorated. Work has been completed on the walk in shower and new flooring has been fitted in the dining area. There are plans to recarpet the hallway and 3 bedrooms. The annexe is also going to be redecorated and have a hand sink fitted to aid with arts and crafts. Good infection control measures were in place – protective clothing is available for staff. New hand towel dispensers are on order and dissolvable alginate bags are used for soiled laundry. The home reflects the personality of the people who live there and their pictures and belongings are present throughout and not confined to bedrooms. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are equipped to meet the needs of people who use the service. EVIDENCE: Some staff changes have occurred since the previous inspection but we observed a good rapport between staff and people who use the service. The service is currently recruiting to fill 2 part time day staff vacancies and 1 full and 1 part time night staff vacancies. A requirement made at the previous inspection to ensure agency staff were adequately trained and supervised has been met. The home has access to the company’s agency staff who work regularly and know service users’ needs. Should they wish to transfer to working permanently in the home there are fewer problems as recruitment checks have already been completed. We looked at the records of six staff who had commenced work since the previous inspection. The originals of records are kept at head office and copies and a ‘pro forma’ checklist are kept in the home. All were satisfactory. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 18 Several staff are working towards their NVQ and some have neared completion 1 is working towards Level 4, 3 are working towards level 3, 2 are working towards Level 2. 4 staff will enrol to work towards Level 3 in September. All staff complete a 5 day induction and are allocated 12 weeks to achieve a further induction and foundation in line with Learning Disability Qualifications skill sets (formerly Learning Disability Award Framework). There are plans to offer medication training, which is recognised by the British Institute of Learning Disabilities (BILD). Staff had completed a comprehensive training programme over the past twelve months including Autism, dementia, and Peg Feeding. A training matrix clearly displays when staff are due to attend mandatory courses to ensure that they remain up to date with training such as moving and handling, first aid and food hygiene. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is running smoothly in the absence of a registered manager but the post must be filled to satisfy the Care Home Regulations. EVIDENCE: The previous registered manager has transferred within the company creating a vacant post and the Commission for Social Care Inspection have been kept up to date with developments. The deputy manager is acting as manager and the senior support worker is acting as deputy. The acting manager has recently returned form 9 weeks absence which the acting deputy covered. Staff stated that they felt supported by the acting manager and they could raise any concerns that they had. The home appears to be running smoothly in the absence of a manager and the company are advertising the vacancy. Quality Assurance audits occur annually and questionnaires are issued to people who use the services’ families and any professionals involved in their Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 20 care. The results are issued in a report; the acting manager is reviewing the report and aims to incorporate results in the annual review of the statement of purpose. Regular health and safety checks are conducted. We saw records of hot water checks and fire drills and checks. The acting manager plans to obtain the local fire services’ risk assessment and fire plan to ensure comprehensive details are made available to staff. Staff do not currently have access to a computer or the Internet, which impedes any changes to documentation. All documents are faxed or posted to the Hertfordshire Head Office. The Area Manager aims to provide a computer for staff to use by the end of March, which will greatly assist staff to keep up to date with professional websites and assist in completion of NVQ and additional qualifications. Albert House DS0000065423.V373853.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 2 X 3 X X 3 X Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA19 Regulation Requirement Timescale for action 30/04/09 2. YA37 12(1)(a)(b) More information is required to illustrate how health needs are met e.g. management of pressure sores, epilepsy, weight and nutrition. Records must be available to reflect that staff are competent to take blood sugars and training has been delivered. Risk assessments must be expanded and developed e.g. to identify how potential hepatitis B is managed and what potential risks aromatherapy may have upon individuals’ health. 8 A registered manager must be employed to oversee the running of the home. 30/06/09 Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 23 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 YA17 Good Practice Recommendations Staff should eat with service users. Specialist crockery should fit in with the rest of the crockery in the home. Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Albert House DS0000065423.V373853.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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