Inspection on 21/05/08 for Aniska Lodge

This inspection was carried out on 21st May 2008.

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

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

Aniska Lodge 02/06/09

Similar services:

The Shelley

Thorndene

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Extracts from inspection reports are licensed from CQC, this page was updated on 27/09/2008.

CARE HOMES FOR OLDER PEOPLE Aniska Lodge Brighton Road Warninglid Haywards Heath West Sussex RH17 5SU Lead Inspector Annie Taggart Unannounced Inspection 21st May 2008 10:00 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 Aniska Lodge DS0000071049.V363152.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. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Aniska Lodge Address Brighton Road Warninglid Haywards Heath West Sussex RH17 5SU 01444 464 130 01444 461 602 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) Excel Care Homes Ltd Sara-Jane Barrington Care Home 49 Category(ies) of Old age, not falling within any other category registration, with number (0), Physical disability (0) of places Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (OP) 2. Physical disability (PD). The maximum number of service users to be accommodated is 49. Date of last inspection This is the home’s first inspection. Brief Description of the Service: Aniska Lodge is a care home with nursing registered to provide personal and nursing care to 49 people in the categories older people (OP) and people with physical disabilities (PD) The home offers accommodation over three floors with all ensuite bedrooms and a range of specialist equipment. The home is close to the main A23 near the rural village of Warninglid, three miles from the town of Haywoods Heath and five miles from Crawley. Current fees are between £636 to £764 per week Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. In order to prepare for the visit, surveys sent to service users, families and professionals involved with the home and an Annual Quality Assurance Assessment (AQAA) had been sent to the manager for completion. This was returned within the given timescales and contained detailed information about the home. One service user and one professional’s surveys were returned and both were very positive about the care being provided in the home The unannounced visit was carried out by Annie Taggart and Diane Peel at 10.00am on Wednesday 21st May 2008 and the visit lasted for four hours. During the visit we spent time with the people living in the home in communal areas and in their private bedrooms and we spoke to the staff on duty and observed staff practice. Five care plans and all supporting documentation such as daily records were tracked and we also looked at four staff records and the system for the recording and administration of medication. We looked at menus and food records, saw the main meal of the day being prepared and served and we asked people how they are given a choice in the meals that are provided. Records for the running of the business including the quality assurance process, health and safety, fire records and incident and accident recording were seen and we also saw the home’s registration certificate, which was current and correct. The registered manager Mrs. Barrington was present and received feedback following the visit. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: In order to ensure that service users have the correct level of healthcare support that they require, care plans and daily records must be improved to include clearer nutritional information and a system must be put in place for identifying and monitoring pressure relieving equipment. In order to ensure that all staff working with service users have undergone the necessary employment checks records such as application forms, references and CRB checks should be kept in the home and available for inspection. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 7 In order to ensure that the health and safety of both service users and the staff team are protected, fire doors in the home must not be wedged open and records of staff fire training must be kept in the home. 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. Aniska Lodge DS0000071049.V363152.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 Aniska Lodge DS0000071049.V363152.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): 1 2 3 5 and 6 The outcome for service users in this area is good. This judgement has been made using available evidence including a visit to this service. There is good information available about the services on offer in the home and prospective service users and their families can be confident that their needs and wishes will be assessed and recorded. EVIDENCE: Aniska Lodge provides good information for prospective service users and the home has produced a brochure that contains photographs showing the services on offer and details of the environment. In order to ensure that the home can meet people’s diverse and individual needs we saw evidence that pre admission assessments are carried out and recorded. We also saw the admission process carried out for two service users who had been admitted on an emergency basis over the weekend and this showed us that assessments and care plans had been completed within 48 hours of the admissions. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 10 The registered manager, Mrs Barrington showed us copies of welcome letters detailing the services on offer, given both to service user and their families when people are admitted to the home and we saw a copy of the Service User Guide in people’s bedrooms. A person who had moved into the home recently told us that they had visited the home themselves to have a look around, meet the people already living at the home and to have a meal. They told us that they needed see what the home was like before deciding to move there. The home agrees contracts detailing the terms and conditions of residency and Mrs Barrington told us that these are agreed and signed by service users or their representatives. Aniska Lodge does not provide intermediate care. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 The outcome for service users in this area is adequate. This judgement has been made using available evidence including a visit to this service. Although the people living in the home tell us that they are well cared for, the information in care plans and daily recording need to be improved to ensure that people’s healthcare needs are fully met. EVIDENCE: For each service user living in the home there is a plan of care in place to guide the staff team to the needs and wishes of each person. We looked at the care plans for five service users and all contained basic care information that had been recorded from information gained during the assessment process. For four people there were moving and handling, pressure area and nutritional risk assessments but for one person the moving and handling section had not been completed. We saw four people who were being cared for in bed and were being nursed on pressure relieving mattresses. Two of the people were of very differing weights but had the same pressure set on their mattresses and one person said that Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 12 they found the bed to be very hard and uncomfortable on their back. Although pressure area risk assessments had been completed there was no record in the care plans or in people’s rooms to guide the staff team to what rate the pressure relieving equipment should be set at. We asked the manager Mrs. Barrington about this and she told us that there was no guidance currently available for the staff team. Three of the nutritional risk assessments highlighted concerns in food and fluid intake for service users but there was no system in place to actually record what the people concerned had to eat and drink on a daily basis. There were some records in place for two people who were ill, the amounts of fluid taken were recorded but for food the records said for e.g. “ate all breakfast” instead of specifying what was actually eaten. Care plans also did not have a background or social history for people and Mrs Barrington said that she was currently working on producing these. There were also no risk assessments or agreements in place for the use of bedsides, which we saw were in use for several people. People told us that they were very well cared for and that they had access to other healthcare professionals such as the community mental health team and doctors and during the visit we saw a doctor visiting the home and a service user told us that he was waiting to go to the dentist. In a returned survey a care manager for a service user told us, “ this facility is appropriately staffed and the staff are extremely caring and friendly. With our previous experience of care homes we consider this place excellent in all manners”. We saw that medication was stored in a locked, walk in drugs storeroom and the administering nurse on duty had signed the medication recording sheets. We saw that controlled medication was being stored in a locked metal cabinet within another metal cabinet. Two people were receiving controlled medication so we checked the medication for one person. The stock of medication was correct as listed in the controlled medication record book. Medication is administered from a metal drugs trolley and at lunchtime we observed the registered nurse on duty administering medication to people. This was carried out in an organised manner with medication being signed for after people had taken it. The trolley was locked each time the nurse left it. We heard people being asked if they wanted particular medication, which the nurse later explained was prescribed as an “as required medication”. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 and 15 The outcome for service users in this area is good. This judgement has been made using available evidence including a visit to this service. There are some activities in place to provide interest and stimulation, people tell us they are treated with dignity and respect and the home offers a variety of fresh, home cooked meals. EVIDENCE: There are no records in care plans or daily records of regular entertainment or activities taking place in the home but the manager, Mrs Barrington told us that an activities co-ordinator comes to the home twice a week and that the records were kept with her. We were also told in the AQAA that occasional outings and parties are arranged. Service users confirmed that activities such as bingo, music and crafts are sometimes provided but in a survey a service user told us that there were no activities of interest being provided for younger people and this was confirmed by a service user during the visit who told us “ there is not much to do here”. During the visit people were either in their bedrooms or watching television in the lounge. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 14 Mrs Barrington told us that as there were so few people currently living in the home, a full programme of activities had not yet been put in place but she told us that this would be addressed as more people are accommodated. A service user told us, “it is very nice here, people are very kind and the food is good but there is no real entertainment”. People told us that their visitors are made welcome at any time and we were told by a staff member that they were going to support a family member in taking a service user to a hospital visit so the person would have someone familiar to support them. From looking at menus and food records we saw that people are offered a variety of fresh, home cooked meals, this includes a cooked breakfast and drinks and snacks are available at any time. Service users told us that they enjoyed the food provided and said that they were always offered an alternative. There was also evidence that cultural issues are addressed and one person was having special food provided to ensure that their religious and ethnic needs were being met. We saw lunch; the main meal of the day being prepared and served and the meal was prepared with fresh ingredients and looked appetising and attractively presented. People told us that they were treated with dignity and respect and that the staff team were kind and caring. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 17 and 18 The outcome for service users in this area is good. This judgement has been made using available evidence including a visit to this service. There are processes in place for complaints to be recorded and acted upon and the staff team are aware of their responsibilities regarding safeguarding adults procedures. EVIDENCE: There is a clear complaints procedure in place that includes timescales for responses from the manager and people told us that they felt confident in saying if they were unhappy about the service being provided in the home. We saw the complaints log and Mrs. Barrington told us that no complaints had been received since the opening of the home. In the AQAA the manager told us that all staff had received adult safeguarding and also mental capacity act training but as the training files were not available we could not see evidence of this. The manager told us that the training files were at the company’s other home. The staff on duty told us that they had received the training and were very clear about their responsibilities and they told us that they would report any suspected abuse straight away. Mrs Barrington told us that the home did not manage any monies on behalf of service users and families or legal representatives are invoiced for any costs incurred. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 16 Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 22 24 and 26 The outcome for service users in this area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home is attractive, clean and well equipped, there are risks to service users and staff in the event of a fire occurring from fire doors being wedged open. EVIDENCE: The home has been decorated and furnished to a very high standard and is attractive and comfortable. There is a large bright lounge and dining room on the ground floor and also smaller lounges and “quiet rooms” on other floors. Service users at the present time are accommodated over the ground and second floor, the first floor not yet having been put into use. There is a small garden area that is mostly paved with a high wall to the side to assist with reducing road traffic noise. All bedrooms are ensuite and there is a range of specialist equipment in place including four assisted baths, hoists, wet rooms with showers, pressure Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 18 relieving equipment and profile beds. People said that they were happy with their private space and some people had personalised their rooms with their own belongings. On the second floor we found that the automatic door closure equipment had broken down and we were told that this was awaiting repair, we saw that several bedroom doors had been wedged open with chairs and in one instance the footplate of a wheelchair, which would have presented a risk to service users in the event of a fire occurring. There is a well equipped, modern laundry in use but we saw that this door was also wedged open also causing a fire risk to both service users and staff. We discussed this with Mrs Barrington who told us that it was not practice in the home to wedge doors open and she said that that she would speak to the staff team about the dangers this presented. Infection control equipment such as gloves, aprons and antiseptic hand gels were in use by the staff on duty and the home was clean and hygienic throughout. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 The outcome for service users in this area is adequate. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff on duty to meet the current needs of service users but in order to ensure that all of the correct recruitment checks have been carried out, staffing records should be kept in the home and be available for inspection. EVIDENCE: From looking at the staffing rotas and talking to service users we saw that on the day of the visit there were sufficient numbers of staff on duty to meet the needs of the twelve service users currently living in the home. There were two trained nurses, (one was being inducted), two carers, a chef and a cleaner. The registered manager’s hours are in addition to the rota. Although the number of staff were sufficient to meet people’s current needs we saw that some people needed a high level of support needing two staff and sometimes people waited a long time for a bell to be answered or on one occasion a person was left, without explanation during being attended to so that the staff member could answer a bell. This was also a difficulty as people were situated on the ground and second floor and not all together. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 20 We asked Mrs. Barrington how these issues would be addressed when the home is full and she told us that other staff would be recruited and there would be staff designated daily to each floor of the home. Service users were very complimentary about the staff team, describing them as “friendly, kind and caring”. We saw the files for four staff currently being employed by the home and their records were complete and included evidence of a interview process, two references and a current Criminal Bureau Check (CRB), however we had asked to see the records of the two most recently recruited people and these were not available. Mrs Barrington told us that she is currently overseeing another of the company’s homes until a manager has been recruited and said that these records and records of nurses PIN numbers were at the other home. During discussion Mrs Barrington acknowledged that these records should be kept at the home. For the files of the four people that we looked at there was evidence of an induction process and mandatory training such as manual handling and first aid but as Mrs. Barrington told us that the training files were also at the other home as training was carried out across both homes. We could not therefore evidence the training received by the whole staff team. We spoke with the two care staff on duty and they confirmed that they had undergone an induction process and had attended training. Both said that they were well supported and had attended training such as manual handling, fire training and safeguarding adults. Mrs Barrington told us that as she has been so busy setting up the home and overseeing the other home that formal supervision has not yet been put into place but as the staff team is so small at the moment she is assisted by senior carers and nurses in supporting care workers. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 37 and 38 The outcome for service users in this area is adequate. This judgement has been made using available evidence including a visit to this service. Although the home is being managed by an experienced and qualified manager improvements are needed to managing records and health and safety issues. EVIDENCE: The registered manager, Mrs Barrington is a registered nurse, has completed the registered manager’s award and has five years experience of managing a care home. Mrs Barrington told us that she attends courses and seminars to update her skills and knowledge; most recently she has become an Independent Prescriber for medication. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 22 Both service user and the staff on duty were complimentary about Mrs Barrington’s management style describing her as “open and friendly” As the home has not yet been open for a year a full annual quality assurance process has not been carried out but Mrs. Barrington told us that she regularly receives feedback from service users, families and other professionals about their satisfaction with the service being provided and she told us that a full process would be carried out later in the year. We saw the fire book and this showed us that regular weekly checks had been carried out and recorded but there was no record of staff fire training or monthly emergency lights checks. Mrs Barrington told us that the staff fire training records were at the other home but the staff on duty confirmed that this training had been carried out. We were also shown a new fire book that the home has been told to use as a requirement made during a recent fire department inspection and this book is designed to record all checks and staff fire training. As detailed in other parts of this report, in order to ensure that the home is managed in the best interests of service users and for the health and safety of people, improvements need to be made in the recording of people’s pressure area and nutritional needs in care plans, fire doors should not be wedged open and records such as recruitments records, staff training records and staff fire training, should be kept in the home and available for inspection. Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X X 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X 3 X 2 2 Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP8 Regulation 15-(2) (b) Timescale for action In order to ensure that service users have the correct level of 01/07/08 healthcare support that they require, the registered manager must ensure that care plans and daily records are improved to include clearer nutritional information and a system must be put in place for identifying and monitoring pressure relieving equipment. In order to ensure that all staff working with service users have 01/07/08 undergone the necessary employment checks the registered manager must ensure that records such as application forms, references and CRB checks are kept in the home and available for inspection. 01/07/08 In order to ensure that the health and safety of both service users and the staff team are protected, the registered manager must ensure that fire safety equipment is in working order, that fire doors are not wedged open and records of staff fire training must be kept in the home. DS0000071049.V363152.R01.S.doc Version 5.2 Page 25 OP29 2. 19-(1) 3. OP38 13- (4) Aniska Lodge 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 Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Aniska Lodge DS0000071049.V363152.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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