Inspection on 02/05/07 for Alde House

This inspection was carried out on 2nd May 2007.

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

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

Other inspections for this house

Alde House 30/04/09

Alde House 03/10/06

Alde House 08/02/06

Alde House 22/06/05

Alde House 17/12/04

Alde House 06/07/04

Alde House 16/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Alde House Alde House Church Road Penn High Wycombe Buckinghamshire HP10 8NX Lead Inspector Chris Schwarz Unannounced Inspection 09:45 2nd May 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 Alde House DS0000022950.V330857.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. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alde House Address Alde House Church Road Penn High Wycombe Buckinghamshire HP10 8NX 01494 813365 01494 814154 None available 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) Stumpwell Housing Association Limited Mrs Violet Bassam Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd October 2006 Brief Description of the Service: Alde House is a care home for older people situated in Penn, Buckinghamshire. It has fifteen places. The home was opened in 1972 and is managed by Stumpwell Housing Association Limited. The home has been adapted for its present use and comprises the original house and an extension. There is a large and pleasant garden to the rear with views over the surrounding countryside. The home is on two floors and there is a passenger lift to the first floor for service users with impairment of mobility. The home is mindful of its origins in Penn and priority is given to people who either live in the village, have lived there in the past, or still have family or friends in the area. The home endeavours to meet a range of needs and draws on the resources of health and social care professionals and other services in the local community as required. The fees range from £415 to £475 per week. Services such as hairdressing and chiropody are at additional cost to the service user as are personal items such as toiletries. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was conducted over the course of a day and covered all of the key National Minimum Standards for older people. Prior to the visit, a questionnaire was sent to the manager for completion alongside comment cards for distribution to service users, relatives and visiting professionals. Any replies that were received have helped to form judgements about the service. The inspection consisted of discussion with the manager and other staff, opportunities to meet with service users, examination of some of the home’s required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the manager at the end of the inspection. The manager, staff and service users are thanked for their co-operation and hospitality during this unannounced visit. What the service does well: Prospective service users are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. Service users have varied activities available to them, they are provided with nourishing meals and enabled to keep in contact with family, friends and the community to maintain important social links. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training, to ensure staff have the right skills and competencies to support the people who live there. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 6 The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. What has improved since the last inspection? What they could do better: Clarification is needed with one person’s Criminal Records Bureau check, to ensure that all previous names were entered on the application form. Pre-admission/care plan documents could be supplemented with details of service users’ background history and other significant matters such as family composition, to provide a more rounded picture of the person. The medication administration record should indicate why medicines have been removed from the final blister in the pack, ahead of time, to provide a clear audit trail. Details of complaints and actions taken need to be promptly recorded in the log book, to make sure that an up-to-date record is kept. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 7 A copy of the local authority interagency adult protection procedures should be available at the home, to ensure staff are familiar with local reporting and investigative procedures 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. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6 Quality in this outcome area is good. Prospective service users are thoroughly assessed prior to admission and are given opportunity to visit the home beforehand to ensure it meets their needs. Intermediate care is not provided at this service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Pre-admission documents relating to the three most recently admitted service users were looked at. Each file contained information about the person and their care needs in sufficient detail to provide care. It was suggested to the manager that these documents could be supplemented with more background and history about the person such as previous occupation and family composition, which relatives may wish to provide around the time of admission. People who completed inspection comment cards said that they had received sufficient information before moving into the home and that contracts/terms Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 10 and conditions were in place. The home’s service users guide was seen and found to be satisfactory with all relevant details included. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were in place for each person and included a photograph of the person, an outline of their care needs, evidence of weight being checked regularly, risk assessments on moving and handling, falls and fractures and pressure area assessments. Records of medical visits were noted and feedback from service users on the day was positive in terms of access to medical treatment and care provided at the home. One of the doctors who attends the home was satisfied with overall care provision and indicated being able to see service users in private, that staff incorporate specialist advice into care plans and that staff demonstrate understanding of needs although skills and knowledge around health needed to be supplemented. This could be incorporated into staff training programmes. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 12 A relative felt that one of the things the home does well was “Oversees medical treatment as required”. Another relative said that one of the things the home does well is “give care in a friendly environment.” One person commented “We are glad our mother is at Alde House. In her words ‘I don’t think I’ll ever be really happy to be here, but I am quite content.’” Service users had been enabled to look well presented and take pride in their appearance and to wear make up, nail varnish and jewellery if they wished. Staff had assisted service users with their hair so that it looked neat. Medication was being kept secure and the cabinets locked when not in use. The home uses a monitored dose system and medication administration records were mostly in good order although the manager was reminded that where tablets are removed from the final blisters in the pack, such as when tablets are dropped, this should be recorded on the reverse of the record sheet to provide a clear audit trail for medicines. A recommendation is made to this effect. Training had taken place on medication administration since the last inspection and the manager was awaiting certificates to be supplied. Some staff had followed on from this by undertaking a distance learning course on infection control, which is a good practice course to undertake. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. Service users have varied activities available to them, they are provided with nourishing meals and enabled to keep in contact with family, friends and the community to maintain important social links. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users and staff confirmed that visitors are welcome at any reasonable time. During a tour of the premises, it was evident that some people have had private telephone lines installed to keep in contact. For those who have not made such arrangements, staff were seen helping a service user to the telephone in the hallway. A relative said “I visit each week but if there was a problem I have no doubt the staff would be very helpful and make sure my mother would be able to keep in touch.” Another wrote on a comment card “As family members visiting, we are always welcomed with courtesy and friendliness.” On the day of the inspection, a local artist was visiting the home as part of a regular arrangement, to facilitate an arts and crafts session with service users. This was clearly enjoyed by the people taking part and examples of their artwork were displayed in the sun lounge. Some visitors also arrived to hold a Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 14 game of Scrabble. Games of dominoes were also popular, according to service users. Service users had enjoyed a trip out the previous day to Henley; weekly trips out are organised to local places of interest using tail lift transport. The home books an entertainer for a Saturday evening every two months. A service user who was selecting a new book to read confirmed that the library visits each month and a selection of large print books is available to everyone. Daily newspapers are also delivered to the home. A relative said that provision of some quality newspapers at weekends would be beneficial in meeting needs of some of the service users, in addition to the papers that are already provided. A religious service is held on a Friday with Holy Communion every other Tuesday. The home arranges a hymn sing on the weeks when Holy Communion is not available. A hairdresser visits each week and staff carry out manicures for service users. Service users made use of the patio furniture during the day to go out and enjoy the fine weather and admire the well kept garden. A service user was enabled to enjoy a cigarette outside and staff brought her out a drink and a biscuit. Comments from relatives and service users completing comment cards were that the home “tries to encourage stimulating activities” although added that staff input needs to be encouraged here. One person felt there were “very few activities,” whilst another said that “entertainment is provided on a regular basis and also trips out which I know my mother enjoys.” Meal provision is good. Service users said they enjoy the food and that there is plenty of it. The lunchtime tables had been attractively arranged with linen napkins and a flower on each table. The meal of home made lamb and vegetable pie with fresh vegetables was well presented and service users said it was good. A dessert using fresh fruit followed. Cold and hot drinks had been made available to service users during the day. People completing comment cards said that there are “regular enjoyable meals”, “the food is excellent,” although one felt that the breakfast choices could be improved and another said “the cooking could sometimes be improved” without adding any examples of where improvement was needed. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. Complaints and adult protection are effectively managed to listen to views of people who live at the home and reducing the risk of harm to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure in place which includes the contact details of the Commission. No complaints had been received at the home since the last inspection although a matter raised with the inspector on the last occasion, which the manager investigated, had not been noted in the complaints log. It is recommended that any complaint is promptly added to the record book. The Commission has not been contacted by any service users or their representatives with concerns about quality of care at the home. Service users and relatives who completed comment cards were aware of how to make complaints although none of them had needed to use the procedures. An adult protection procedure is in place and this had been revised since the last inspection. The home needs to make sure it has a copy of the local authority inter-agency adult protection procedures, and that staff are familiar with these, to make sure that all necessary action is taken to protect service users. Training for staff on adult protection had taken place since the last inspection with certificates of course attendance on staff files. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 16 The Commission is not aware of any adult protection referrals or concerns regarding this service. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Alde House is a detached property on the Penn to Beaconsfield Road. It consists of single room accommodation on two floors, some rooms have ensuite facilities and those without are close to shared toilets and bathrooms. Rooms have been well decorated and service users have personalised them to different tastes. Adaptations are in place to enable service users to use toilets and baths and there is a shower suitable for people with disabilities to use. The kitchen and laundry were clean and well organised and all parts of the building were odour free and kept to a good standard of cleanliness. There was plenty of seating in the lounge with an additional sun lounge overlooking the garden, where most service users chose to sit. The garden has been very well maintained and provides a restful outlook from the lounge, dining room and Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 18 bedrooms. There was seating and tables on the patio and an awning that can be opened to shade both the patio and the sun lounge. There is parking at the side and rear of the property. Improvements had been made where doors need to be held open to allow safe access through the building, with approval obtained from the fire department. People completing comment cards said “Provides a safe, secure, clean environment.” “The home is clean and well maintained.” “There is a ‘homely’ atmosphere” adding that one of the things the home does well is maintaining standards of cleanliness. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training, to ensure staff have the right skills and competencies to support the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users who completed comment cards said that staff listen and act on what they say and are always or usually available when they need them. On the day of the visit, one person said “I’m very well looked after” and another said “I like the routine here”. A relative wrote on a comment card “The staff generally are very supportive and do their best to help the residents. They also support relatives and friends very well.” Another said “Alde House does well in making residents feel “at home” and the staff are appreciated.” One person commented “I feel the care home provides a caring environment and the staff are always available to help the residents whatever their needs.” A further relative was satisfied overall with the home but added that increased staff presence such as talking with service users and watering their plants would be beneficial. The manager was on duty, plus carers, a domestic worker, the cook and a maintenance person who is present three days a week. A new deputy manager had been recruited a short while ago and she was on duty during the afternoon. Through speaking with staff, a good sense of team work was Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 20 described and the atmosphere throughout the day was unrushed. Staff were gentle in their interaction with service users and respectful. A sample of staff files showed that mandatory training has been brought up-todate. There was evidence of good local links being made for staff training to make sure that courses meet the needs of staff and the service. Five of the staff had achieved National Vocational Qualification level 2. Recruitment records of some of the new staff showed that all required checks had been undertaken. A possible error on the part of the Criminal Records Bureau with one person’s clearance was brought to the manager’s attention for her to take up with them. A requirement is made for this to be addressed. Some agency staff were being used to fill gaps on the rota. Information supplied by the agency was of a very good standard and provided satisfactory evidence of recruitment practice and training. Staff files showed that induction is undertaken with new staff to introduce them to the practices and procedures necessary for working effectively at the home. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a registered manager who has worked at the service for many years. The successful recruitment of a new deputy was seen by her as key in ensuring that practice at the home develops and that tasks can be delegated appropriately. The deputy is also a very experienced person and has management experience. The chairman of the committee has been making regular monitoring visits to the home since the last inspection, when there was a lack of reports to Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 22 substantiate that monitoring had been happening. Reports were available up to February this year although the manager was certain that more visits had taken place. Service users also mentioned that the chairman and other committee members visit the home. The manager said that the chairman had recently sent out questionnaires to relatives as part of a quality assurance exercise. He was in the process of compiling a report of the findings. Service users’ money was being well managed with records and receipts kept to verify expenditure. A check of a few balances showed that they tallied with the records. Health and safety checks were being undertaken in a number of areas. The fire log showed that routine testing takes place and servicing of fire detection and fire fighting equipment was up-to-date. The cook maintains regular checks of fridge and freezer temperatures and tests core food temperatures of cooked foods. At the last environmental health inspection in 2005, the home was again given the silver award for food safety. The passenger lift had recently been serviced and a contract was seen to be in place for disposal of clinical waste. Accident records were being completed by staff. Staff training on health and safety related topics, such as moving and handling and food handling, was in good order. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP29 Regulation 19 Timescale for action The discrepancy with a Criminal 01/06/07 Records Bureau check is to be taken up with the Bureau or a new check undertaken which takes into all account all required details of previous names. Requirement 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 OP3 Good Practice Recommendations Pre-admission/care plan documents are to be supplemented with details of service users’ background history and other significant matters such as family composition, to provide a more rounded picture of the person. The medication administration record is to indicate why medicines have been removed from the final blister in the pack, ahead of time, to provide a clear audit trail. Details of complaints and actions taken are to be promptly recorded in the log book, to make sure that an up-to-date record is kept. A copy of the local authority interagency adult protection DS0000022950.V330857.R01.S.doc Version 5.2 Page 25 2 3 4 OP9 OP16 OP18 Alde House procedures is to be available at the home, to ensure staff are familiar with local reporting and investigative procedures. Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Alde House DS0000022950.V330857.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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