Inspection on 11/09/07 for Ancona

This inspection was carried out on 11th September 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

Ancona 06/12/06

Ancona 24/01/06

Ancona 04/08/05

Ancona 28/10/04

Ancona 14/04/04

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Ancona The Square Freshwater Bay Isle Of Wight PO40 9QG Lead Inspector Ian Craig Unannounced Inspection 11th September 2007 10:30 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 Ancona DS0000034735.V344625.R02.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. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ancona Address The Square Freshwater Bay Isle Of Wight PO40 9QG 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) 01983 753284 F/P 01983 753284 Mrs C M Brooke Mrs C M Brooke Care Home 18 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (18), of places Physical disability over 65 years of age (6) Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th March 2007 Brief Description of the Service: Ancona is a registered care home, which provides care/support and accommodation for people who may have dementia over the age of sixty-five years. Six residents may be accommodated by reason of age related physical disability over 65 years. The home is situated in a quiet residential area of Freshwater close to the centre of the village. Accommodation is organised over 2 floors across 2 houses that are linked on the ground floor, with access to all floors via the two shaft lifts. There are large gardens to the rear of the home, which are enclosed and fully accessible to residents. The ground floor has some bedrooms, but also provides communal space, including a large lounge split into two areas, a dining area, communal bath/toilet facilities, the kitchen, a utility room and staff WC. All bedrooms are single and 13 have been provided with en suite facilities. Each floor has access to communal bathing/shower and WC facilities. The home also has staff accommodation in the attic area. The weekly fees range from £369.00 to £485.00 per week. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the premises, examination of records and documents including residents’ care records. A number of residents were spoken to during the inspection. Two residents were interviewed in private and two other residents were spoken to together. Comment forms were sent to a number of residents, relatives and professionals connected to the home. These were completed and returned by 8 residents, 7 relatives and by 3 general practitioners. Information contained in these survey forms has been used as part of the inspection process. Two of the home’s care staff were interviewed together and discussions took place with the manager. The home completed and submitted a Commission Annual Quality and Assurance Assessment (AQAA) form, which has also been used as evidence for the inspection. What the service does well: The home’s interior is decorated to a very good standard and it is clear that the owners are investing in improvements to the environment. Residents described how much they like their bedrooms. This included the wallpaper, being able to have their belongings in their rooms, and the fact that the rooms are bright and spacious. Several residents also described the garden as tranquil and well maintained. Two residents were observed sitting in the sunshine in the garden. There are patio areas with furniture for the residents to use. The home’s management and staff are described by the residents and their relatives in favourable terms. Comments include the following: • “Creates a homely environment without any patronisation but ensuring the residents’ needs are met.” • “The home generally attends to the best interests of the residents both physically and mentally.” • “Nothing is too much trouble for the owners and staff. The home is always welcoming and with a nice atmosphere.” Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 6 • • • The communication and feedback are excellent. High degree of skill base among the staff. It provides individual and collective care to a high standard.” “The staff are excellent. The premises, care and food are excellent.” “The staff are the nicest girls you could meet. They always do more than is needed. The treatment is excellent.” The home has introduced a monthly newsletter giving details of forthcoming events, changes to the staff group, plans for redecoration and contributions from the residents themselves such as short stories. Procedures for the recruitment of staff ensure that residents are protected as thorough checks are carried out. What has improved since the last inspection? What they could do better: The home needs to be more proactive in obtaining care manager’s assessments of those referred for possible admission to the home. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 7 Residents care records need to be improved so that where any resident has medication ‘as required,’ there are clear guidelines for staff to follow so that medication is given in a consistent manner and that staff can recognise identified symptoms. The programme of activities needs to be developed, which is the intention of the manager. Additional staff need to be trained in first aid particularly the night staff. Assessments of risk need to be carried out and any action taken where there is a risk of a resident falling from a first floor window. 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. Ancona DS0000034735.V344625.R02.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 Ancona DS0000034735.V344625.R02.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): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information is provided to those considering a move into the home to help them make an informed decision. Each person referred for possible admission to the home has his or her needs assessed, although this needs to be improved so that copies of referring care managers’ assessment are obtained to ensure that the home only admits those people whose needs it can meet. EVIDENCE: Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 10 There is ample evidence that residents and their relatives receive information about the service. Copies of the home’s Newsletter were available throughout the home. A copy of the last inspection report was available in the hall. Relatives confirmed that they are given a copy of the Service Users’ Guide before a decision was made about moving in or not. Copies of the Service Users’ Guide and the Statement of Purpose were also available in the home. The process of assessing the needs of those referred to the home for possible admission to the home was looked at. Records show that the home carries out and records its own assessment. The assessment consists of the completion of a pro forma which covers medical details, continence, skin care, mobility, nutrition, appetite, communication, breathing, personal care, sleeping and activities for daily living. The home also obtains copies of hospital discharge summaries outlining current and past health concerns. Copies of assessments completed by social services care managers have not been obtained. The inspector highlighted that this information should be obtained before the person is admitted, in order that the home has all the information to make a decision about meeting the person’s needs. Ancona DS0000034735.V344625.R02.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person’s needs are set out in a care plan. Residents’ health needs are met, although some improvements are needed in recording guidelines for staff to follow in administering medication ‘as required.’ Residents are treated with dignity and respect. EVIDENCE: Assessments of need and care plans were examined for 4 residents. Comprehensive documents have been completed for assessing a variety of needs as well as personal details and care plans. These include the following: • Personal details including a photograph of the person Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 12 • • • • • • • • • • • • • Information for the resident on how the personal plan process works Pressure sore assessment report Dependency assessment Care assessment Likes/dislikes Bath procedure Record of baths Record of district nurse visits Information on catheter care Risk assessment form Handling assessment Moving and handling risk assessment outcome Falls assessment These showed that specific needs were being assessed and guidance recorded for staff to follow. This included the prevention of pressure sores, checks in skin condition and use of specialist equipment. Daily running records are maintained for each person and these show that the home monitors the daily personal and health care needs of the residents and that there is liaison with the district nursing service and residents’ general practitioners when required. Records also show that appointments with opticians and dentists are arranged for residents. Care plans also need to have more detail where residents have an identified mental health and neurological condition even if these are currently stable. Feedback from residents and their relatives about the standard of care is very positive with none exception, where the relative feels that the resident in question is isolated and has problems calling for someone to take him/her to the toilet. This was raised with the manager. Other residents reported that the care staff are very quick to respond to the call points being pressed so it may be the case that this person needs additional help. The home’s medication procedures were examined. A record is signed each time a staff member administers medication. The storage of medication is satisfactory. Records are maintained of any incoming and of any discontinued medication. Controlled medication is appropriately stored and records show that it is administered according to pharmaceutical guidelines. A resident’s controlled medication prescription had been changed by a general practitioner and staff recorded this in the daily running records and on the medication recording sheets. The inspector stated that the home must ensure that the responsible medical practitioner confirms these changes in writing. The manager immediately addressed this and contacted the surgery. Controlled medication is prescribed to be taken ‘as required.’ The home does not have record of the guidelines for staff to follow in administering this medication for Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 13 this person. This is required so that staff know how to recognise the symptoms requiring the use of the drug and so that staff are consistent. Records show that staff receive training in medication procedures, which was also confirmed by staff themselves. Resident’s likes, dislikes, preferences for activities and choices are assessed and recorded. It was confirmed from residents that they are able to go to bed and get up when they wish. Staff are described as kind and polite. There is a choice of food at each meal. Residents are encouraged to involve themselves in the home’s monthly Newsletter with one resident compiling a short story for the August edition. The Newsletter also refers to the Resident’s Meetings where matters about the home are discussed. Not all bedroom doors have a lock but a key and door lock are provided if the resident wishes to have one. A record of this is maintained. Several residents have a lock to their bedroom door. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The provision of activities for resident is improving and needs to be developed to meet the needs of the residents. A varied and nutritious diet is provided. EVIDENCE: Residents were observed in various parts of the home either reading, watching television or sitting in the garden. It was clear that residents have freedom of movement around the home. Some of the residents stated that they prefer to spend time in their room. Records show that residents are assessed regarding preferred activities and for how they like to organise their time. The manager states that organised Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 15 activities have been in place since July and August 2007. Two residents described how they enjoyed their visit to Ventnor Botanical Garden. The home’s Newsletter gives details of other activities for the forthcoming months, including, coffee mornings, music and singing and proposed trips out. One resident stated that he/she would like to go out more. This was discussed with the manager who agreed to look into the possible provision of specialist transport. A relative also stated that the home should arrange more outings and another resident stated that there are not enough activities. The manager plans to improve the provision of outings and activities for the residents. Relatives confirmed that they are always made to feel at home when visiting and that the home keeps in touch. . The home has a 6-week menu plan. Residents stated that they enjoy the home’s food and that there is a choice. One person felt that there could be more variety, but also stated that the home always organise another meal if you don’t like the one served. The midday meal looked appetising and consisted of fish pie with vegetables. Residents sat at the dining tables, which were set with tablecloths and napkins. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents and their relatives with a complaints procedure. Residents are protected from abuse. EVIDENCE: The home’s complaints procedure is contained in the Service Users’ Guide, which is provided to residents and their relatives. The procedure is also displayed on a notice board in the hall. The home has not received any complaints in the past 12 months. Relatives state that they know what to do if the need to make a complaint. The manager expressed her commitment to investigating any matters raised by residents or their relatives. The home has its own Abuse Policy and Guidance. Staff complete either a training course provided by an external trainer or complete the home’s own in house course in adult protection. Ancona DS0000034735.V344625.R02.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, 20, 21, 22, 23, 24, 25 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean and well-maintained environment that promotes their dignity. Bedrooms are decorated to a very good standard. The home’s management are committed to enhancing the quality of the environment for the benefit of the residents. EVIDENCE: All communal areas and most of the residents’ bedrooms were seen during the visit. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 18 A number of improvements have been made to the home and these are currently ongoing. At the time of the visit a bedroom was being completely refurbished with the creation of an en suite facility. A toilet was being increased in size to accommodate a walk in shower facility for those with mobility needs, which a resident stated he/she was looking forward to using. A new garden terrace was nearing completion. All of the windows in the home have been replaced by double-glazing. There are plans for further improvements and refurbishment. Since the last inspection a new conservatory has been built which leads to a terrace with tables and seating for the residents. The terrace has ramped access to the garden which residents were observed using. Two residents described how much they like the garden including its flowers, shrubs and the abundance of butterflies. Communal areas and bedrooms have been recently redecorated. Two residents stated that the home is always clean and that they like the wallpaper in their rooms. Bedrooms also contained numerous items of personal possessions such as furniture and items related to hobbies. The home has a passenger lift and a specialist bathing facilities for those with mobility needs. Movement around the home for those with mobility needs was raised by one resident. Reference was made to the access to the lift, which is limited due the need to move around a protruding wall. This was discussed with the manager and the resident and it was clear that the home is taking steps to meet the needs and wishes of those with mobility needs. The home was found to be clean and there was an absence of any unpleasant odours. Residents and their relatives commented that the home is always clean and fresh. The home has a laundry and staff receive training in infection control. Ancona DS0000034735.V344625.R02.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides sufficient numbers of well-trained staff to meet the needs of the residents. Residents are protected by the home’s recruitment procedures. EVIDENCE: The home aims to provide at least 3 care staff from 8am to 10 pm each day, with the deputy manager and the manager’s hours in addition to this. These staffing levels are being maintained as evidenced by the staff rota, observations of staff, discussions with residents, feedback from relatives and interviews with the staff. One relative stated that there are not enough staff on duty, but this was the only comment of this nature. In addition to the care staff, the home provides catering, cleaning and laundry staff. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 20 Residents and relatives describe the staff as kind and well trained. Two relatives state that the staff have a good or high level of skills to meet the residents needs. Another relative stated, “The staff are excellent.” A resident stated that the standard of care is excellent. Staff confirmed that they have access to a variety of training courses including NVQ level 2 and 3 in care. Six of the eleven care staff employed by the home are qualified at NVQ level 2 or above. Two further staff are studying NVQ level 2 and another NVQ level 3. Staff also attend other training courses including moving and handling, medication, Parkinson’s disease, dementia, palliative care and adult protection. The manager has developed in house training packs for staff to complete for dementia and adult protection. Recruitment procedures were examined for 3 recently recruited staff. The home carries out the required checks on staff including, 2 written references, criminal record bureau (CRB) and protection of vulnerable adults(POVA) checks. Records also show that the home carries out interviews and assessments to check the suitability of staff to work with the residents. Newly appointed staff complete an induction, which is recorded. Staff confirm that they attend staff meetings and have regular supervision. This is also supported by records of supervision. Ancona DS0000034735.V344625.R02.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Whilst the home is still in the process of implementing its quality assurance system, the home’s management are committed to improving the service for the benefit of the residents. The home ensures the health and safety of the residents and staff although additional staff need to be trained in first aid. EVIDENCE: Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 22 The home’s management consists of the manager and a deputy. The inspector advised that the hours worked by the management team are recorded on the duty roster even though they are supernumerary to the care staff hours. The manager has attained the Registered Manager’s Award and will be starting the NVQ 4 in care in September 2007. The home is developing its quality assurance system. This will be based on a quality assurance manual. So far the home has obtained the views of residents and relatives about the home’s performance. The home has not yet devised an annual development plan but the manager described plans to develop a training programme for staff as well further improvements to the environment. The home does not handle any residents’ finances or valuables, which are dealt with by relatives. The home’s appliances and equipment are tested and serviced by suitably qualified persons. Residents are protected from the risk of burns from radiators by the installation of radiator covers and from hot water by the use of temperature control devices. The home has not assessed the risk to residents regarding the possibility of falls from first floor windows. Window restrictors are not in place to counter the risk. Staff receive training in moving and handling, first aid and infection control. It was noted that additional first aid training is needed for the nighttime care staff, as there are a number of occasions when there are no staff on duty trained in first aid. Ancona DS0000034735.V344625.R02.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 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Ancona DS0000034735.V344625.R02.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 OP9 Regulation 13 Requirement Where a resident has medication administered ‘as required’ a record must be made for staff to follow showing the circumstances when the medication is to be given and how often. Staff must be trained so there is at least one staff member on duty, at any given time, who is trained in first aid. This applies to the nighttime. The risk to residents of possible falls from first floor windows must be assessed and any action taken to minimise those risks. Timescale for action 30/10/07 2 OP38 13 10/12/07 3 OP38 13 10/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 25 No. Refer to Standard Good Practice Recommendations Ancona DS0000034735.V344625.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Ancona DS0000034735.V344625.R02.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. 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!