Inspection on 06/11/06 for Arliemoor

This inspection was carried out on 6th November 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Arliemoor 15/12/05

Arliemoor 09/05/05

Arliemoor 09/12/04

Arliemoor 19/04/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Arliemoor Halsdon Cross Holsworthy Devon EX22 6NX Lead Inspector Jo Walsh Unannounced Inspection 6th November 2006 10:00 Arliemoor DS0000003641.V312994.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 Arliemoor DS0000003641.V312994.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. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Arliemoor Address Halsdon Cross Holsworthy Devon EX22 6NX 01409 254232 01409 259321 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) Mrs Jacqueline Rowe Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: Arliemoor is a large farmhouse providing residential care for younger men and women suffering from poor mental health. They do not provide facilities for blind people or those with a history of arson. It provides accommodation for 8 service users and has a new recreation room and office facility. It is set in ten acres of countryside and has no close neighbours. The owners have a number of dogs and horses and are happy for service users to become involved in their care. The grounds currently include a spacious garden, poly tunnel with tropical plants, a basic gym and a workshop area. Transport is provided by the home so that service users have access to education, social and leisure events, individual interests, families and friends and links with health services. There is also a bus service in the vicinity, although some service users prefer to use their bikes or walk to Holsworthy, which is two miles away. The range of fee are £425 to £450 per week and do not include holidays, toiletries and hairdressing. A copy of the inspection report is held in the office and available for anyone to read. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on a week day in November lasting 6.5 hours. The main focus of this inspection was to seek the views of the residents and find out about their experiences of living at the home. All but one resident was spoken to during the inspection and 2 individuals were case tracked, meaning these individuals were spoken to at length about their experiences of living at the home, and their records of care and medications were also looked at. All residents were sent a survey prior to the inspection and 6 were returned. All expressed high level of satisfaction of the care and support they receive. 8 staff were also sent surveys and 7 returned. During the inspection four staff were also spoken to. This information together with comment cards received from health care professions and care managers has helped to inform the inspection process. A tour was made of the building including some of the residents’ bedrooms. Some key documents were also looked at, these included, residents’ care plans staff records, medication records, finance records in relation to residents’ monies, and the fire log book and accident incident reports. The home was asked to complete a pre inspection questionnaire, which provides details about details of safety and maintenance as well as information about staff training. What the service does well: Good systems are in place to ensure that potential new residents have a comprehensive assessment completed and that where possible introductory visits to give them a chance to get to know residents and staff before moving in. The home offers a family like atmosphere where residents are encouraged to take part in all aspects of daily living including working with the animals and helping within the home. One resident commented ‘I have received brilliant care at Arliemoor’ another said ‘this is the best place I have ever lived, I cannot think of anything that they could change to make it better!’ The home is clean safe and well maintained and residents are encouraged to personalise their own rooms. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 6 Each resident has a plan of care that is detailed and explains how the home will meet his or her needs in terms of personal, health care, emotional and social needs. Plans are reviewed weekly with residents to ensure their views and aspirations are considered. Residents’ needs are well met. One resident commented that ‘I have never been better since living here, the staff make sure you are well and look after us all very well.’ The home offers a balanced diet and residents are encouraged to get involved in the planning and cooking of meals. All residents said the food was good, and one said that if you had special requests the provider would try to accommodate these. The home provides a good level of staffing who use their experience and local knowledge to ensure residents have a full and varied activities programme that suits each individual. The home is to be commended for their level of commitment in ensuring that residents’ individual social and leisure needs are well met. The staff team have a good understanding of current residents needs and are well supported by the management to do their job. Comments from staff included, ‘The home offers me everything I could want from a job and enables me to work to my full potential, I wouldn’t change anything’ ‘I have felt the attitude and support provided by the management is excellent. This is relevant to both staff and clients.’ ‘They support you 100 if ever I am unsure of anything I can go to the owner/manager and they are willing to help.’ What has improved since the last inspection? What they could do better: The home needs to ensure that all staff follows the medication procedures, the last four entries for controlled medications given had not been double signed. Also the home should ensure that records for controlled drugs are kept in a book that cannot be tampered with, i.e. Numbered pages. These measures will ensure that the medication system is robust and protect residents. It is also recommended that the home look at how it can ensure a good audit trail is available for all medications, as they do not use a monitored dosage system. The registered providers must ensure that the recruitment process is followed for all new staff, including any that leave for a few months then return to employment at the home. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 7 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. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 8 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 Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential new residents can be assured that their needs will be fully assessed prior to moving into the home. EVIDENCE: The home is currently looking at a potential new resident moving in and on the day of the inspection this person was visiting. They were able to confirm that they had visited on a number of occasions in order to get to know the staff and residents. Staff confirmed that good assessment information is available prior to new people moving in, and the manager said that they always ensure that they have a copy of the care management assessment and care plan. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 10 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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are well documented plans of care for each individual that enables staff to understand their assessed and changing needs. Residents are supported to make decisions about their everyday lives within a risk management framework. EVIDENCE: As part of the case tracking, two care plans were looked at in some detail. Plans of care include individuals’ personal, health care and social needs and how these are met. Potential risks have been assessed with what needs to happen to minimise identified risks. Where possible the home has a weekly meeting with the individual to look at the plan of care and discuss any changes needed. They also document what involvement there has been from outside agencies including formal reviews of the placement and any changes to plans of care. Residents are encouraged to keep daily diaries with support from staff. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 11 Staff also have a separate communication diary to record any significant events or changes in individuals care or support needs. Residents spoken to said that they were involved in reviewing their plans, although one said that they prefer not to have weekly meetings as it makes them anxious. This individual had raised this with staff and the weekly meetings have stopped but they can talk to staff about any issues or things they would like to do for the future at any time. Staff spoken to had a good understanding of what individuals’ care and support needs were and said that the plans of care were useful to refer to. Where individuals are at risk of self harming a detailed action plan is contained within the care plan, and is usually at the front of the file for quick reference. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 12 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): 12,13,15,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and encouraged to take part in a wide range of activities including accessing resources within the local community Residents can be assured their rights will be respected. The home offers a well balanced diet with choices. EVIDENCE: Residents spoken to said that they have good opportunities to attend local college courses. Two individuals said they were working towards maths and English qualifications, something they did not believe they would have previously done. One individual said that they had a good range of activities including helping out in the stables with the providers horses, going to college and doing some leisure activities such as shopping, going out for drinks and visiting friends and Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 13 family. One resident said that they really enjoyed living out in the countryside, helping out with the animals and building work as this helped them ‘stay busy and out of trouble’. Another resident said that they enjoyed swimming and Pilates and was currently doing an Open University course. Staff spoken to and those who returned surveys all believed that there were good opportunities available for residents to participate in a range of activities and that the home one commented that ‘the home always went out of their way to ensure that individuals had opportunities to access educational and leisure activities’. One staff member said ‘it would be good if residents fees were increased so we could look at increasing activities and opportunities.’ Residents spoken to said the staff treated them with respect and felt their opinion was listened to. Comments included ‘ Staff here are very good, they always listen to you’ and ‘its very like a family living here, we all help each other and staff are very supportive and treat us equally.’ Residents are encouraged to help with getting their own breakfast and lunchtime meals and staff help prepare the evening meal. Residents said that there was always a choice and if they wanted anything particular such as a type of breakfast cereal they could ask for this to go on the shopping list. The kitchen is available to residents at all times and they are able to make drinks and snacks at any time. The home ensures that a balanced diet is offered and takes into consideration individuals’ likes and dislikes. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 14 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): 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’ personal and health care needs are well met. Some medication procedures need to be improved to fully protect residents. EVIDENCE: The routines of the home are flexible to suit individual needs and preferences. Most residents are able to attend to their own personal hygiene and where support of guidance is needed this is clearly identified in their care plan. Residents spoken to said that they can choose what time they get up and go to bed and how they spend their days. One resident commented that their health and emotional well being had improved since being at Arliemoor and that staff were very supportive and encouraged them to do as much for themselves as possible. One resident commented ‘I have received brilliant care at Arliemoor’ another said ‘this is the best place I have ever lived, I cannot think of anything that they could change to make it better!’ Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 15 Throughout the inspection staff were seen to support residents to get prepared for activities or outings and transport them into the local town for shopping at to attend college and leisure activities, and health care appointments. Staff spoken to had a good understanding of individuals health care needs and said that they work well as a team ensuring that where there is a deterioration in someone’s mental health, they monitor carefully and keep the relevant health care professions informed. Four comment cards were returned from the local doctors, none expressed any concerns, but all said that they were new to the practice. The home has a good link with one of the doctors who have a special interest in mental health, but that unfortunately they were off sick at present. Medication records and storage was checked with the manager. The home does not currently have anyone who self medicates, but said they would risk assess an individual where they wished to self medicate. It was suggested that they should start from the premise that all residents may wish to self medicate and that everyone should be risk assessed, even if they then choose for the home to administer their medications. The home do not currently use a controlled drugs book for recording controlled medications i.e. a book that has numbered pages. They currently use a notebook and although these records were generally well maintained, the last four entries had not been double signed as recommended. The manager agreed to ask the pharmacist about a numbered pages book for safer recording of their controlled medications, and would raise medication procedures at the forthcoming staff meeting to remind staff that when controlled medications are given these need to be witnessed and signed by two members of staff. This will ensure a more robust system is in place to protect residents. The home do not use a monitored dosage system for medications and it was suggested that they date when a new pack of medications are started to ensure that a good audit trail is available for all medications. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views are listened to and acted upon. Policies and procedures are in place to protect residents. EVIDENCE: The home has a written complaints procedure and residents spoken to and those who returned surveys all said they knew who to talk to if they had any concerns. One resident said that they could discuss any issues at residents meetings or with staff if they did not ant to talk to a big group. All residents were confident their views were listened to. There have been no complaints raised either with the home or the Commission since the last inspection. The home have policies in place to help staff understand what to do if they suspect abuse, and future training for staff will include the Protection of Vulnerable Adults. The home has a well documented and accountable system for the handling of residents’ monies, which was checked during this inspection. Arliemoor DS0000003641.V312994.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): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides residents with a clean comfortable and safe environment. EVIDENCE: The home is very much a family home, with resident and staff choosing to sit and socialise in the dining area, which has a large dinning table to accommodate everyone. There are two lounges; one is a designated smoking lounge, which ensures the rest of the home is kept smoke free. Some residents’ bedrooms were seen during this inspection. Residents had chosen their own colour scheme and had personalised their rooms. Bedrooms are well furnished, some have en suites and all but one room has a lock fitted to ensure privacy. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 18 The providers employ a cleaner to ensure that the home is kept clean and hygienic, although residents are encouraged to take some responsibility for keeping their own rooms and communal areas clean and tidy. Arliemoor DS0000003641.V312994.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): 32,34,35 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 staff team that are trained, competent and well supported to do their job. Some improvements are needed to ensure the recruitment process fully protects residents. EVIDENCE: Staff spoken to have a good understanding of the current residents needs and most have completed NVQ training. Since the last inspection staff have had the opportunity to attend some mental health seminars at North Devon District Hospital. This was recommended at the last inspection. Some staff said they found this useful, and would welcome more specialist training. The registered providers are keen to promote training and ensure that all areas of health and safety are covered and that staff that wish can complete NVQ training. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 20 Staffing levels are usually high to ensure that all needs can be met and to facilitate activities and outings. On the day of the inspection there were three care workers, the manager and the registered provider and her husband who live on site. All were involved in aspects of residents’ care and welfare. Staff spoken to and those who returned surveys said they were well supported to do their jobs and that supervision sessions took place. Comments included ‘The home offers me everything I could want from a job and enables me to work to my full potential, I wouldn’t change anything’ ‘I have felt the attitude and support provided by the management is excellent. This is relevant to both staff and clients.’ ‘They support you 100 If ever I am unsure of anything I can go to the owner/manager and they are willing to help.’ Three staff files were looked at to ensure that the home follows a robust recruitment procedure. Two files had all relevant checks completed, but one staff member had left employment at the home, then returned several months later. The providers should have ensured that a POVA and CRB were completed on this person, even though they had done one previously. Arliemoor DS0000003641.V312994.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): 37,38,42 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 well run home, where their views are taken into consideration and health and safety issues are taken seriously. EVIDENCE: The registered provider, who lives on site, has many years experience of running the home. The Manager has now completed her NVQ 4 training, but is yet to apply to register with the Commission as the registered manager. Staff and residents said that the management approach was open and that their views are considered. Systems are in place to ensure that residents have an opportunity to comment on the quality of care via resident meetings and their weekly review meetings. Staff said that they are able to contribute to the running of the home via team meetings and talking individually to the provider. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 22 The pre inspection questionnaire completed by the provider prior to this inspection details that safety and maintenance checks are completed to ensure that the home is safe. It also details staff training to ensure that all aspects of health and safety are covered, which means the staff are able to do their job safely and effectively. During this inspection the fire log book and accident and incident reports were checked. Records of residents’ monies were also checked. These records were well maintained and help to ensure residents are kept safe. Arliemoor DS0000003641.V312994.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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 2 X 3 X 3 X X 3 X Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 24 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 YA34 Regulation 19.1 (b) Requirement The registered person shall not employ a person to work at the care home unless: (b) he has obtained in respect of that person the information and documents specified in (i) paragraphs 1-7 of Schedule 2 (This refers to the ensuring all checks are completed again if staff leaves employment at the home and then return.) Timescale for action 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The home should ensure that all controlled medications are double signed and that an appropriate controlled drugs book be used, for recording. The home should ensure that a system is in place to ensure an audit trail is available to account for all DS0000003641.V312994.R01.S.doc Version 5.2 Page 25 2. YA20 Arliemoor medications. Arliemoor DS0000003641.V312994.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Arliemoor DS0000003641.V312994.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. 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!