CARE HOMES FOR OLDER PEOPLE
Alexander Court Nursing Home 2 Lydgate Court Crookes Sheffield South Yorkshire S10 5FJ Lead Inspector
Sue Turner Key Unannounced Inspection 13th April 2007 08:40 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 DS0000021763.V331522.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. DS0000021763.V331522.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Alexander Court Nursing Home Address 2 Lydgate Court Crookes Sheffield South Yorkshire S10 5FJ 0114 268 2937 0114 268 2945 alexandercourt@schealthcare.co.uk www.schealthcare.co.uk Southern Cross Healthcare Services Limited 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) Post Vacant Care Home 60 Category(ies) of Old age, not falling within any other category registration, with number (60) of places DS0000021763.V331522.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. One service user named on the Application for Variation of Registration form dated 19/8/03, who is in the category DE/E; Dementia for people 65 and over, may reside at the home. 25th April 2006 Date of last inspection Brief Description of the Service: Alexander Court is a purpose built home for older people, which provide 60 places for people with personal and nursing care needs. All bedrooms have an en-suite facility. It is in a residential area of Sheffield with good access to public services and amenities for example shops, pubs, and public transport. It is built on three levels serviced by a lift. The home has single and double rooms and a suitable number of lounges and dining rooms. The home has a car park and lawned areas. A copy of the previous inspection report was on display and available for anyone visiting or using the home. Information about how to raise any issues of concern or make a complaint was on display in the entrance hall. The manager confirmed that the range of monthly fees from 1st April 2007 were £362 - £623 per week. Additional charges included newspapers, hairdressing and private chiropody. DS0000021763.V331522.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced key inspection carried out by Sue Turner and Mike O’Neil, regulation inspectors. This inspection took place between the hours of 8.40 am and 2:40 pm. Sharon Rogers, project manager, had been deployed at the home to cover the post of manager as the substantive manager had recently resigned. Sharon was present during the inspection. The manager had submitted a pre inspection questionnaire and three service users; four professionals and two staff members had returned care home surveys to the CSCI prior to the actual visit to the home. Their views and some information from the questionnaire are included in the main body of the report. Opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home, check the homes policies and procedures and talk to five staff, one relative and five service users. The inspectors wish to thank the staff, relatives and service users for their time, friendliness and co-operation throughout the inspection process. What the service does well:
Service users said that the care they were receiving was good. Service users made comments such as “staff are lovely” and “staff are very kind and helpful”. Health professionals made comments such as “the staff demonstrate a clear understanding of the service users needs”, “staff communicate clearly and work in partnership with me” and “I am satisfied with the overall care provided to service users within the home”. The inspectors observed that service users were well dressed in clean clothes and had received a good standard of personal care. Some service users said they enjoyed the activities available at the home. The activities coordinator was keen to include as many service users as possible in different types of activities. The inspectors were pleased to hear that the activity coordinator spent some individual time with service users that chose not to join in with the group activities. Service users said that they had a choice of food and that the quality of food served was good.
DS0000021763.V331522.R01.S.doc Version 5.2 Page 6 The home was clean and tidy. No unpleasant odours were noticeable in the home. One relative and service users said that the home was always kept clean. What has improved since the last inspection? What they could do better:
Information within care plans needs to be in sufficient detail, to ensure that service users are receiving a consistent high standard of care. Service users and/or their representatives should be invited to be involved when care plans and reviews take place. All health and personal care needs, for each service user, need to be monitored and recorded in full. Meals should be served at times that are convenient to each service user and individual food preferences should be considered.
DS0000021763.V331522.R01.S.doc Version 5.2 Page 7 The number of staff on duty must be sufficient to ensure that service users needs can be met. Staff trained to NVQ Level 2 or equivalent should be increased to at least 50 . At recruitment, two references, one from the previous employer, must be obtained. There must be a permanent manager, who has registered with CSCI, employed at the home. Following a quality audit review, action should be taken to put right any identified issues. Following the Regulation 26 visit to the home, the provider should forward their written report to CSCI. All records should be stored securely. A copy of the gas safety certificate should be forwarded to CSCI. 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. DS0000021763.V331522.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 DS0000021763.V331522.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): Standards 1 and 3. Standard 6 is not applicable to this home. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided sufficient updated information to inform service users about their rights and choices. Service user assessments prior to admission took place. These enabled staff to be aware of service user needs and to ensure that they could be met. This home does not provide intermediate care services. DS0000021763.V331522.R01.S.doc Version 5.2 Page 10 EVIDENCE: The home provided sufficient updated information to inform service users about their rights and choices. Service user assessments prior to admission took place. These enabled staff to be aware of service user needs and to ensure that they could be met. This home does not provide intermediate care services. DS0000021763.V331522.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): Standards 7, 8, 9 and 10. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information in one care plan was inadequate to ensure that the service users health, personal and social needs could be fully met. Service user or/and their family and friends were not invited to be involved in the care planning and evaluation process, which would have contributed to ensuring that service users specific needs were met. Service users themselves said that the care they were receiving was good and that the staff were helpful, friendly and nice. In one instance the nursing staff were failing to adequately monitor a service users hydration healthcare needs, which could affect the service users general health and well being. DS0000021763.V331522.R01.S.doc Version 5.2 Page 12 Medication procedures provided protection to service users. Service users privacy and dignity was upheld at the home. EVIDENCE: Three service user care plans were checked. The standard of the care plans had improved significantly since the last inspection and the staff had clearly made an effort to meet the requirement made at the last inspection. One care plan however did not provide enough detail of the service users specialist needs. The service users personal and social care needs were not recorded in sufficient detail to ensure that his/her complex wishes could be met. The plans contained detail of all health care contacts, appointments and treatments, and the home supported access to these to ensure health was maintained. Access to dentists, chiropodists and opticians was available. A visiting chiropodist completed a professional comment card and said that they were able to treat the service user in private and that any specialist advice they gave was incorporated into the care plan. The inspectors observed that service users were well dressed in clean clothes and had received a good standard of personal care. One relative said that the staff were helpful, friendly and nice and provided a good of standard of care. For one service user a fluid balance sheet was not fully completed and staff had not monitored the input and output so that further action could be taken if necessary. The staff had regularly reviewed the care plans seen. There had been no involvement from the service users themselves or their relatives in either the care planning or reviewing process. Trained staff administered medications in the home. Medicines were securely stored around the home in locked cupboards within treatment rooms. Medicine Administration Records (MAR) checked were completed with staffs’ signatures. Service users and relatives spoken with said that the staff were respectful and friendly. They commented on the hardworking and kind nature of the staff team. The inspectors saw staff consistently treating service users in respectful and friendly way. DS0000021763.V331522.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): Standards 12, 13, 14 and 15. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A range of activities was offered which suited the preferences of the service users. Service users had a choice of lifestyle within the home and were able to maintain contact with family and friends. The home had an open visiting policy, which assisted in maintaining good relationships with service users family and friends. Meals served at the home were of a good quality and in the main offered choice to ensure service users receive a healthy balanced diet. Choices and preferences diminished at mealtimes because of inadequate staffing levels and the increasing needs of the service users. For one service user individual preferences for meals and food had not been considered.
DS0000021763.V331522.R01.S.doc Version 5.2 Page 14 EVIDENCE: Some service users said they enjoyed the activities available at the home, whilst others said that they chose not to join in with the activities arranged. Activities were advertised around the home. Some activities that service users had participated in were recorded in their care plans. Service users said that they were able to get up and go to bed when they chose to. Inspectors observed care plans that indicated the service users preferences on personal care and general lifestyle. Choices around meal times were severely reduced due to staffing numbers. One service user said they preferred their breakfast at around 9am but it was nearer to 10.30am when they got it. During the inspection, inspectors observed breakfast being served up to 10.30am, as lunch was served at 12.30pm; the time span between meals was not fitting. Staff said that due to the high number of service users that needed assistance to eat, mealtimes were taking up a lot of time. Staff said that the activities coordinator had recently been deployed to help at meal times and on the day of the inspection ancillary staff were also assisting carers at meal times. Service users said that they had a choice of food and that the quality of food served was good. Breakfast, in the dining room, was served in a pleasant relaxed manner and service users were sat at tables, which had been nicely set. Staff asked service users their preferences. A substantial number of service users were served their breakfast in their room, which was by choice but did mean that they were waiting for quite some time. In one service users bedroom, family had provided foods that met the preferences of their relative. Staff said that they hadn’t given a lot of thought to the service users dietary preferences and had not asked either him/her or their family about how they could best meet their dietary likings. Service users and relatives said that that they were able to see their visitors in private and that they were made welcome at any time, which helped them, maintain contact. DS0000021763.V331522.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): Standards 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints procedures were in place to enable service users and relatives to feel confident that any concerns they voice would be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure service users were protected from abuse. EVIDENCE: The homes complaints policy was on display in the entrance area of the home. It contained relevant information and informed the reader who to contact external to the home, should the complainant wish to do so. The homes record of complaints was well organised, as a consequence information was easily obtained. The acting manager said that there were no outstanding complaints and since the last inspection CSCI have not received any complaints about the service. DS0000021763.V331522.R01.S.doc Version 5.2 Page 16 The homes adult protection policy included information on local procedures. Staff spoken to were aware of their responsibilities in reporting any complaints or allegations. Staff said they had received training in adult protection procedures were able and to describe types of abuse that service users could be susceptible to. DS0000021763.V331522.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): Standards 19 and 26. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment within the home was well maintained and clean providing a comfortable, safe environment for service users. EVIDENCE: The home was clean and tidy. Lounge and dining areas were domestically furnished to a good standard. Since the last inspection a refurbishment of the home had continued. Carpets and furniture had been replaced and large areas of the home had been redecorated. This refurbishment had markedly improved the aesthetics of Alexander Court and provided a more “homely” feel to the building.
DS0000021763.V331522.R01.S.doc Version 5.2 Page 18 Bedrooms checked were comfortable and homely. Service users said their beds were “comfy” and “cosy”. Bed linen checked was clean and in a good condition. No unpleasant odours were noticeable in the home. Relatives and service users said that the home was always kept clean. DS0000021763.V331522.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): Standards 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff were not employed in sufficient numbers to meet the service users needs. The checks made on staff were insufficient to adequately protect the welfare of service users who lived at the home. Staff were receiving adequate training on their induction. Recommended levels of NVQ trained staff had not been achieved, however a proportion of staff had completed training that assisted in ensuring these staff had the competences to meet the service users needs. EVIDENCE: The staff rota identified agreed staffing levels had not been met on several shifts. On the day of the inspection there were two qualified staff and seven carers on duty. One more carer arrived at 10am to cover sickness. DS0000021763.V331522.R01.S.doc Version 5.2 Page 20 The shortfall of staff was clear to see during the inspection. The staff on duty, to their credit, were working hard, and as mentioned earlier were patient and showing empathy to the service users. However physically they could not provide care to the service users when needed, hence the reason why some service users were eating breakfast at 10.30am.Additional staff were needed but also a review of the working patterns may be needed. Staff said that they were concerned that the staffing numbers were insufficient to meet the service users needs. Of the 25 care staff, 3 staff had achieved NVQ level 2 or above in care. A further 1 was in the process of completing. This falls extremely short of the requirement that a minimum ratio of 50 staff is trained to NVQ Level 2 or above. Four staff recruitment files were checked. Protection Of Vulnerable Adults (POVA) checks had been made. Enhanced Criminal Record Bureau (CRB) checks had been obtained for the staff members and all staff had completed an application form. In two files seen only one reference had been obtained and in one case the reference was not from the persons previous employer. There was a training and development plan for the staff. Staff said they were encouraged to attend training on various care topics and the frequency of training had increased in recent months. Two staff files checked identified that the staff had received induction training when they commenced work at Alexander Court. DS0000021763.V331522.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): Standards 31, 33, 35, 37 and 38. People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. As there had not been a permanent manager for a long period of time, service users and staff were not able to benefit from a clear sense of management and leadership. The lack of quality assurance systems and service user/relative meetings means that the home cannot be run in the best interests of the service users. Service users monies were safely handled, which ensured that finances were accurate and safeguarded. In the main, records were kept securely and safely.
DS0000021763.V331522.R01.S.doc Version 5.2 Page 22 The health, safety and welfare of service users were in the main promoted. EVIDENCE: Since November 2004 the home had not registered a permanent manager with CSCI. From 2004 to the present there have been a number of managers and acting managers that have left before they have become registered. On the day of the inspection a project manager, working for the organisation had taken the role of acting manager. Staff spoken to raised concerns about the many changes of managers and how this caused disruption and interference to working practises. The inspectors believe it is imperative that a permanent and stable manager is recruited to the post so that staff have a clear sense of direction and leadership. Recorded quality assurance visits by the registered provider had been carried out each month, as required by the regulations. Reports were seen in the home for visits that were undertaken however these had not been forwarded to the CSCI. On display in the entrance hall was a Quality Audit Summary that had been undertaken in March 2007. Ten out of fifteen questionnaires, sent out to relatives had been returned. Relatives had made positive comments and also highlighted areas for improvements. Following the audit there was no information to suggest that any action had been taken to resolve any identified issues. There were no minutes from relative or service user meetings. The acting manager said that when meetings were arranged no one turned up and therefore staff spoke to relatives on a one to one basis, whilst they were visiting. Minutes from the last staff meeting, which was on the 28th March 07 were seen. Three service users monies were checked. Receipts, records and money all tallied and all were kept securely. In the main records at the home were kept in a secure way, however there were a number of weekly report sheets, which contained service user information kept in an unlocked cupboard in lounge areas. Since the last inspection the acting manager said that all the staff had received annual or updated moving and handling training. DS0000021763.V331522.R01.S.doc Version 5.2 Page 23 Fire drills were being held at different times of the day so that all staff could participate in a drill. Staff spoken to had an understanding of the home’s fire procedures; they had received training on moving and handling, fire and food safety. Two staff records checked confirmed that this training had occurred. Fire records stated that weekly testing of the fire alarm system had occurred. At the time of inspection fire exits were clear and window restraints were in situ at first floor windows checked to prevent falls. This will promote the safety and welfare of the service users. A sample of records showed servicing of the homes utility systems had occurred. The acting manager said that a gas safety check had been carried out as required, but there was no evidence at the home to confirm this. The acting manager was asked to forward this to CSCI. DS0000021763.V331522.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 3 STAFFING Standard No Score 27 2 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X 2 3 DS0000021763.V331522.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP7 Regulation 15 Requirement Care plans must contain sufficient detail to ensure that service users receive a consistent high standard of care. Service users and/or their representative must be involved in the care planning and reviewing process. Service users healthcare and personal care needs must be monitored and recorded in full. Service users individual preferences for food/meals must be met. Mealtimes at the home must be restructured to ensure that all service users receive meals at a time convenient to them. There must be sufficient numbers of competent and experienced staff on duty at all times. There must be 50 of the care staff trained to NVQ Level 2 or
DS0000021763.V331522.R01.S.doc Timescale for action 01/06/07 2. OP7 15 01/06/07 3. OP8 14 01/06/07 4. 5. OP14 14 16 01/06/07 01/06/07 OP15 OP14 6. OP27 18 01/06/07 7. OP28 18 01/06/07 Version 5.2 Page 26 8. OP29 19 9. OP31 30 10. OP33 24 equivalent. (Previous timescale of 31.12.06 not met). Two written references, one from 01/06/07 the previous employer, must be obtained for all prospective members of staff. There must be a permanent 01/08/07 manager employed at the home who must apply to register with the CSCI. There must be evidence that 01/06/07 appropriate action has been taken following a quality audit review. A copy of the review must be forwarded to the CSCI and made available to service users. Following the Regulation 26 visit, 01/06/07 from the provider, the written report must be forwarded to CSCI. All records must be kept securely 01/06/07 stored. 11. OP33 26 12. OP37 17 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000021763.V331522.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 DS0000021763.V331522.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
