Inspection on 11/01/07 for Andelain

This inspection was carried out on 11th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Andelain 19/01/10

Andelain 03/03/09

Andelain 10/03/08

Andelain 01/02/06

Andelain 02/11/05

Andelain 10/03/05

Andelain 31/08/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Andelain 12 Eugene Road Preston Paignton Devon TQ3 2PQ Lead Inspector Andrea East Unannounced Inspection 11th January 2007 11:50 Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Andelain Address 12 Eugene Road Preston Paignton Devon TQ3 2PQ 01803 556504 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) Miss Carole Louisa Byrne Miss Carole Louisa Byrne Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7) of places Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for a maximum of 7 LD Registered for a maximum of 5 LD(E) Date of last inspection Brief Description of the Service: Andelain currently provides accommodation for up to six adults who have a learning disability; this can include adults who are over the age of retirement. The home is planning an extension that will bring the number of available registered places back up to seven. In the meantime, the homes certificate remains unaltered at seven registered places. The home is sited on the level near to all local facilities and consists of three storeys (the third floor being for the owners personal use only). The home benefits from a level garden to which there is easy access from the home. The owners intention is to ensure service users are supported to integrate with the local community and provide a small, family type home where service users are supported to live as independent lives as possible and to make good use of all the nearby facilities including local shops, Churches, seafront etc. The range of weekly fees and additional fees for the home was not available. The homes service users guide and a copy of the last inspection report is kept in the homes office. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over lunchtime with the owners present throughout the day and with some of the residents who were spoken too in the homes lounge. A number of documents were examined including two residents files, policies and procedures and resident assessment and care plans. On this occasion relatives had chosen not to respond to a request to feedback their opinions of the home. No survey/questionnaires were returned to the Commission. The owners did not submit to the Commission a preinspection questionnaire. This document asks the owner to provide a range of information to the Commission to inform the inspection visit. What the service does well: What has improved since the last inspection? The proprietors had continued to make progress with the records maintained in the home, extending care plans and some assessments of residents needs. This included the further development of a quality assurance system to continue to look at improvements. The owner had also developed a key worker system that names individual care staff to link with a resident too make sure that all their needs were met and records were kept up to date. The owner and her partner had developed a system for the recruitment of staff. This included an application form, an interview form and a form that recorded all relevant checks including references and police checks. The new recruitment process would ensure that the care staff, employed in the home, Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 6 was suitable to work with vulnerable adults. This would protect residents from harm. The owners had continued to redecorate and refurbish the home in fitting new doors and windows and continually improving the overall appearance of the home. Providing a good standard of accommodation for residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2; Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Suitable arrangements are in place which indicates that resident’s individual aspirations and needs would be adequately assessed. EVIDENCE: There had been no new residents admitted to the home since the last inspection. The residents had lived together for a long time and were known to the owner when she purchased the home. The owner had developed a range of documents that could be used when a vacancy becomes available, including resident’s profiles, assessments and care plans. As yet the owner/manager had not used these documents, as there had been no new admissions to the home. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The owner had developed detailed individual plans for residents, which includes how residents make choices, take risks and were supported in making decisions EVIDENCE: Two residents files and a communication book were examined at this visit to the home. Since the owner purchased the home she and her partner had completely up dated the paperwork in the home extending and changing documents to make sure that residents care needs, personal preferences and interests were clearly identified. Each resident had individualised files, with care plans that were regularly reviewed and updated showing the changes in care needs of that individual. Since the last inspection the owner had extended care plans and had a communications book/diary that acted as a prompt to ensure that health care appointments and any social events were remembered and kept. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 10 One of the residents who had been unwell had a much more detailed care plan that also gave more information about physical care needs including charts for monitoring weight and epileptic fits. The owner had also newly developed a key worker system that names individual care staff to link with a resident too make sure that all their needs were met and records were kept up to date. The owner said that this new way of working was in preparation for the planned employment of new staff in the home. The owner confirmed that the residents continued to be encouraged to make decisions on what they wear, what they choose to eat and were supported in every day life in the home. The owner said Risk assessments had also been completed for each resident and had remained unchanged since the last inspection. Risk assessments were outdated and did not show how the changes to residents care needs had potentially increased risks to the health of the service user. For example one resident had become physically frail and needed more assistance with moving with assistance around the home, these changes were not reflected in the homes risk assessments. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16,17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents took part in appropriate activities as part of the local community, building good personal and family relationships and with their rights respected in their daily lives. Residents were offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: The owner listed a range of activities residents had continued to participate in, such as shopping trips, social events and local trips out too beauty spots. The day opportunities that the majority of residents attended, had introduced a regular pattern of activities and employment into residents’ lives, which included crafts, and music, these activities were clearly recorded. The owner confirmed that service users were encouraged and supported to try a range of activities, suitable to their abilities inside and outside of the home. This had meant for some residents doing less than they had previously, as they were unwell or just preferred to be at home. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 12 The residents lunch time routines continued to vary according to what the residents were doing on that day. For some residents this meant a sandwich lunch served on trays in the lounge, or in the dining room. One resident was enjoying lunch while the inspector was in the homes dining room and when asked he said he had enjoyed his meal and that he had had his favourite food that day. The home had a menu plan, and any changes to the plan were record in the new system of daily recording so that it would be easy to see what residents had eaten. This would be helpful in identifying any food that might be a potential factor in the event of any out- break of diarrhoea and vomiting and also showed the level of choice residents had in the type of food they eat. Since the last inspection the owner has completed Food Hygiene training. This training included basic health and safety information, which would enable the owner to monitor and maintain the high standards of cleanliness needed to prevent contamination of food and food poisoning. The kitchen was clean and tidy. The owners had moved furniture around in the home so that the small room next to the kitchen and a doorway could be used to get to the homes laundry and medication area. This would limit the amount of times the owners and residents walked through the kitchen. This was important, as it had reduced the chances of infection and dirt being brought into the kitchen, reducing the risk of food contamination. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents received personal, physical and emotional care in a way they preferred and required. Residents did not retain and administer their own medication. Residents were protected by the homes policies and procedures for dealing with medicines. EVIDENCE: The resident’s needs were changing as they become older and the owner had put in place additional measures to ensure that the additional physical needs of residents were being fully met. This included increased supervision at night, assisting a resident to eat and drink and help them move around the home as independently as possible. The resident’s individual files with care plans and risk assessments also detailed the personal, emotional and physical care residents received. Two residents were at home when the inspector first called at the home and then later the other residents returned to the home after attending outside activities. All the residents appeared relaxed and were happy to say that they continued to enjoy living at the home. Although some residents’ Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 14 communication skills were limited they indicated that they remained safe and well. Medication was stored in a secure cabinet and the home operated a blister packed monitored dosage system that is supplied by the pharmacy. Residents did not control or administer their own medication. The owner and the residents (or their next of kin/advocate) had agreed that it would not be safe for them to do so. The owners supported and supervised residents to use medication appropriately for example using inhalers. Medication administration was recorded on computerised carbonised sheets that were dated and signed after administration. The owner said that she continued to use a returns book for the disposal of medicines and they were using this to record all medicines returned to the pharmacy. Medication records included a photograph of the resident, a list of homely remedies that might be used, a list of allergies and details of any changes in medication. The owners had also written policies and procedures for medication administration. The owner’s detailed knowledge of the resident’s care, and the procedures they had put in place, including any visits to the doctor or changes in medication, ensured that residents were protected from harm. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents and their representatives felt there views were listened to and that residents were protected from abuse, neglect and self- harm. EVIDENCE: At the last inspection feedback cards and discussion with relatives said that they felt able to bring any concerns to the attention of the owner and her partner and said that they felt the owner listened to them and kept them well informed. Relative feedback cards consistently said that they had been made aware of the homes complaints procedures. On this occasion relatives had chosen not to respond to questionnaires asking them about complaints. The Commission has received no complaints about the home. The inspector had previously looked at the homes complaints procedure, which gave details of the Commission and had been included in the homes service users guide. The owner confirmed that there had been no changes to the complaints procedure, since the last visit to the home The residents’ individual files included risk assessments and care plans that included harm from aggression or self neglect. No evidence was available that the owner had undergone adult protection training. This training would provide up to date information on how to deal with alleged or actual abuse situation. The owner has in the past had this kind of training and in her previous work life had some experience in this area. It is Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 16 important to continue to update in this area to continue to prevent abuse and to know how to report abuse. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents lived in a homely comfortable and safe environment, which was clean and hygienic. EVIDENCE: On touring the premises and viewing Service users’ bedrooms they were comfortably furnished and had been personalised by the individuals concerned with personal items of their own choosing. All areas of the home were clean and tidy and there were no offensive odours. The owners had continued to refurbish and redecorate rooms and had recently fitted new sink units in residents’ rooms. The home had also had a new front door, new windows and a new flat roof. Residents’ rooms and the shared spaces are furnished in a clean, homely and personalised fashion with service users photographs and mementoes. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 18 One resident’s room required redecorating and a new carpet. This was also highlighted at the last inspection and the owner said that this had been postponed due to the additional expenses of new doors and windows. The owner agreed that the redecoration would be finished in the near future. Not all the homes radiators were guarded. The radiators need to be guarded as residents may be at risk of burning themselves or injury due to falling onto the radiators. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34,35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The owner, her partner and on occasion one part time member of staff met resident’s individual and joint needs, having kept themselves up to date with relevant training. EVIDENCE: The member of staff employed at the home, had been well known to the residents and the owners through past association in other settings such as working in day opportunities or other homes. The owner said that this staff member now worked very few hours for the home and that they were advertising for a support worker to join them. The owner acted as the main carer in the home supported by her partner. Previous inspections at the home had included ensuring application forms and police checks had been completed. The owner confirmed that these remain unchanged with no new staff being employed in the home. The changing needs of the residents had meant employing more staff and to facilitate this the owner and her partner had developed a system for the Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 20 recruitment of staff. This included an application form, an interview form and a form that recorded all relevant checks including references and police checks. The forms did not include asking about any past disciplinary issues that staff may have had. The recruitment process the owner had devised, when fully implemented would ensure that the staff recruited for the home are suitable to work with vulnerable adults. This would protect residents from harm. The owner showed the inspector certificates for training in Food Hygiene and the Advanced Care Management Award. The owner said that she had completed up dated training in Health and Safety, first aid and fire prevention. In the past she had also attended training on epilepsy, diabetes and a range of topics related to the work she was doing at that time. The owner had enrolled to do a National Vocational Qualification at level 4 in Care Management. The owner said that she did not intend to continue or complete this course. Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39,42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Resident’s views underpin the development of the home and the resident’s safety, welfare and best interests are protected and promoted. EVIDENCE: The home was run on a friendly informal basis with residents living in the home as part of an extended family. Residents were encouraged and supported to make informed choices and to enjoy life in and outside of the home. The owners had developed a range of systems to protect residents from harm and promote well- being. For example the development of a comprehensive recruitment and medication administration systems, extending care plans and the introduction of a named person linked to one resident. ( A Key-worker system). Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 22 The owners had developed further a quality assurance system that is clearly linked to the standards in the Care Standards Act 2000 and based on positive outcomes for the residents, based on residents’ views and how residents want to spend their time. The system included residents and their relatives or advocates views about the home. This system had not been fully completed or implemented. The development of a quality assurance system demonstrated the owner’s commitment to ongoing improvement. A range of health and safety documentation including risk assessments, care plans, fire logs, and policies and procedures were examined and overall they were found to be well- maintained. There were some areas of health and safety that required attention for example, radiators had not been guarded and risk assessments had not been reviewed and updated. In addition a recent accident in the home, resulting in a resident going to hospital had not been fully recorded. Accidents need to be recorded so that all staff can familiarise themselves with important events and so that they can be monitored. This would help to minimise accidents. Andelain DS0000042639.V330480.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 2 x x 2 x Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA7 Regulation 14(1) Requirement The registered person shall not provide accommodation to a service user at the care home unless, so far as it shall be practicable to do so (a) needs of the service user have been assessed by a suitably qualified person or suitably trained person The registered person shall ensure that the assessment of the service users needs is (a) kept under review and (b) revised at any time when it is necessary to do so having regard to any change in circumstances. Complete review and update risk assessments. The registered person shall 12/04/07 having regard to the number and needs of the service users ensure that (b) the premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally. (d) all parts of the care home are kept clean and reasonably decorated. DS0000042639.V330480.R01.S.doc Version 5.2 Page 25 Timescale for action 12/04/07 14 (2) 2 YA24 23(1) Andelain 16 (2) The registered person shall having regard to the number and needs of the service users ensure that ( c ) provide in rooms occupied by service users adequate furniture, bedding and other furnishings, including curtains and floor coverings and equipment suitable to the needs of service users. Complete as planned the decoration and re-carpeting of one residents room 3 YA24 13 (1) The registered person shall ensure that – (a) all parts of the home to which service users have access are so far as practicable free from hazards to their safety. ( c ) unnecessary risks to the health or safety of service users are identified and so far as practicable eliminated. Radiators must be guarded. 12/04/07 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 2 3 4 Refer to Standard YA23 YA32 YA32 YA39 Good Practice Recommendations The owners to attend adult protection training to up date themselves in this area. Reconsider the completion of a National Vocational Qualification at level 4 in Care Management. Continue to complete training relevant to the care provided. Continue as planned to further extend and develop the homes quality assurance system Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 26 Andelain DS0000042639.V330480.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Andelain DS0000042639.V330480.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. 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