Inspection on 19/05/08 for Ascot House

This inspection was carried out on 19th May 2008.

CSCI found this care home to be providing an Good 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

Ascot House 28/06/10

Ascot House 12/11/07

Ascot House 20/12/06

Ascot House 09/05/06

Ascot House 12/07/05

Ascot House 18/05/05

Ascot House 27/09/04

Ascot House 01/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

CARE HOMES FOR OLDER PEOPLE Ascot House 28 - 36 Wingrove Road Fenham Newcastle Upon Tyne Tyne & Wear NE4 9BQ Lead Inspector Aileen Beatty Key Unannounced Inspection 19th May 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ascot House DS0000000391.V366056.R07.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. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ascot House Address 28 - 36 Wingrove Road Fenham Newcastle Upon Tyne Tyne & Wear NE4 9BQ 0191 272 1020 0191 2725171 sheilahead@caringhomes.org.uk 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) Ascot House Care Home Limited Margaret Ann Barr Care Home 35 Category(ies) of Dementia - over 65 years of age (35) registration, with number of places Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One resident is under pensionable age, within the DE category. Date of last inspection 12th November 2007 Brief Description of the Service: Ascot House is a 35 place care home with nursing providing care for older people with dementia. Care in the home is provided by Registered Mental Nurses supported by care staff. The home is owned and managed by Caring Homes Ltd a national provider of care to vulnerable client groups. The home is situated in Wingrove Road in the west of the city of Newcastle upon Tyne close to local shops and good public transport links. The building is on four floors, the basement being staff and office accommodation and the upper three floors being residents’ accommodation. Some bedrooms have en-suite facilities. There are a number of lounges and dining rooms on the ground floor. The current fees are between £365 and £400. A service user guide and statement of purpose for the home is available. A brochure and inspection reports are also available. Ascot House DS0000000391.V366056.R07.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 2 stars. This means the people who use this service experience good quality outcomes. Before the visit: We looked at: • Information we have received since the last visit on 4th December 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 12th November 2007 During the visit we: • Talked with people who use the service, relatives, staff, the manager & visitors. • Looked at information about the people who use the service & how well their needs are met, • Looked at other records which must be kept, • Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, • Looked around the building/parts of the building to make sure it was clean, safe & comfortable. We told the proprietor what we found. What the service does well: A detailed service user guide and statement of purpose are available. These provide useful information to service users and their representatives. The manager regularly audits the home and residents are consulted about their preferences. This enables the manager to monitor closely the standard of the service being provided. Residents say they are happy with the care provided, stating, “the nurses are lovely” and “you get nice food here”. One relative said, “The staff are all nice without exception”. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 6 The home is clean and tidy and most areas are well maintained, making it a pleasant place for people to live. Recruitment practices are sound and protect people who use the service. What has improved since the last inspection? 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. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 7 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 Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information is available to enable prospective service users decide whether the home can meet their needs. Comprehensive assessment information is gathered before admission. EVIDENCE: The home has a new statement of purpose and service user guide, both are detailed and contain all of the required information. Residents are given a copy of the service user guide, which welcomes them to the home and describes the services available. This includes information about accommodation, care planning, medical services, personal possessions, laundry and meal times. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 9 The statement of purpose for the home describes the philosophy of care of the home. This gives details of the proprietors, and company details in addition to a summary of who may live in the home and staff working there. Care files were checked during the inspection and all contained evidence that pre admission assessments and relevant information had been collected before people were admitted to the home. This forms the basis of the home’s decision about whether they can provide the level of care required to the person before they are admitted. The assessments read were detailed, and comprehensive assessments from care managers (social workers) are also held on file. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and personal needs are well met, and medication safely administered. EVIDENCE: Care plans examined during the inspection show a general improvement in the standard of care planning and record keeping. Plans are more detailed, and information contained in files is up to date and regularly reviewed. Additional sections have been added to care records including residents’ preferences and lifestyle and interests. Health needs are assessed such as nutritional needs, moving and handling requirements, pressure ulcer (bed sore) risk assessment, and mouth care. Residents’ weights are monitored carefully. Health assessments are reviewed on a regular basis and a full care review involving residents and family are held six monthly. Residents have access to a range of health professionals including GP, chiropodist and optician. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 11 During the inspection, nurses, the deputy manager and manager were holding a planning meeting where they discuss various clinical issues and practical issues affecting the running of the home. This meeting happens monthly and helps to ensure consistency and good communication. The inspector was invited to attend the meeting and observed staff discussing the organisation of work in the mornings. Two nurses are now on duty in the mornings and this means that one can concentrate on administering medicines and the other is available to deal with appointments and the telephone. Staff agreed that this system is working well. Tasks in the diary are allocated to a named person during eh handover period which ensures jobs get done and there is a record of who was responsible. Residents spoken to say they feel well cared for. A relative commented that all staff are very nice without exception. Staff were observed caring for residents sensitively and respectfully. Medication procedures have been tightened up since the last inspection. The treatment room was found to be clean and tidy and room and medicine fridge temperatures are taken and recorded daily. Medication administration records were checked and there were no gaps in the ones viewed as part of case tracking. This is an improvement since the last inspection. Medicine trolleys have been reorganised so that they are not so full, two trolleys are now used, one for daytime medication and one to be used at night. The manager plans to replace the existing trolleys, which are old fashioned and difficult to keep organised because of their design. Procedures for the ordering and disposal of medicines are good. At the last inspection, there were a number of occasions where the dignity of residents was compromised by the tendency of some staff to treat residents in a childish fashion. There was also evidence of staff being indiscreet during an episode of incontinence. The manager was given detailed feedback about these examples and has provided training and advice to staff to demonstrate how their actions, albeit not deliberate, could embarrass or damage the self esteem of some residents. This is monitored by the manager and there is an expectation that trained staff model best practice and train new staff in person centred practices as part of their induction. This appears to be working well and the manager and staff have made a great improvement in this area. Over the two days of the inspection, there was only one very small example of a staff member saying that a resident “can’t come in here” without explaining why. This was then followed by some very caring communication and again, it is clear that staff in this home are able to take on board new ideas when they can see it is for the benefit of residents in the home. Staff also knock on doors and were observed rearranging clothing to ensure dignity is maintained at all times. Standard 11 was not fully inspected during this inspection but it was noted that nurses have received training about end of life care from the Co-op funeral Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 12 parlour. More residents have also noted their funeral arrangements in their care files. Ascot House DS0000000391.V366056.R07.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): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Social cultural recreational and religious needs are not always full met. EVIDENCE: There are some activities available at Ascot House but the standard of activity planning is something which needs to be more clearly linked to the care planning and evaluation process. Some good information is now available, by way of biography information for many residents and this information should be then used to plan activities that might be of interest to the individual, and also demonstrate that these are tailored to be appropriate to their ability level. One relative commented that they were sure activities happen, but there is no way to tell what has been going on, and act as a conversation point with their relative. It was suggested that activities planned could be displayed on a notice board, and perhaps a monthly newsletter could be introduced to keep relatives up to date with what is going on in the home. The manager explained that activities would be more of a focus in the next few months now that some of the more pressing issues relating the health and personal care have been Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 14 resolved. There were no planned activities taking place during the inspection but staff were observed chatting to residents. The dolls used for doll therapy are now available again and placed around the home. Studies have shown that some people with dementia react very favourably to dolls and they can encourage communication and a sense of purpose and relaxation in some people. Staff in the home have had training to facilitate doll therapy and relatives should ask for details if they are interested or concerned about the purpose of the dolls. On the second day of the inspection, a member of staff was with a resident in the lounge and two other staff members were sitting there and chatting too, while other residents were sitting alone. Staff should be encouraged to use any spare time to chat with residents. This is equally as valuable as structured activities and what was discussed, the mood level of the person and general observations can be recorded in social care plan evaluation providing valuable information. At the last inspection, the standard of the meal was very poor and the kitchen was disorganised, the kitchen assistant inadequately trained to do the work, and parts of the kitchen were dirty and disorganised. There has been a big improvement and the standard of meals and the kitchen are now very good. The kitchen assistant has now been trained and is supervised by a very experienced chef who has been employed since the last inspection. The kitchen is clean tidy and well organised with good supplies of fresh ingredients. Residents were joined for lunch prepared by the kitchen assistant on the first day of the inspection, and it was tasty, served at the correct temperature, and well presented. The meal cooked by the chef was sampled on the second day which was also very good. The mealtime was relaxed and unhurried, and the system of having two sittings for lunch appears to be working well. Caring Homes Hospitality Projects officer was visiting the home during the inspection and carried out a kitchen audit and found the general cleanliness to be excellent, and only minimal deficiencies in labelling food found. He described the rest of the audit as excellent, and a big improvement since the last one carried out. More choices are offered in the home, and at meal times the choice of drinks has improved. The chef bakes his own cakes and éclairs and personally serves fresh cakes to residents each Sunday, which is a nice touch. The manager described how the overall standard of cooking is much more professional, such as adding beer to batter for fish and chips for example as they would do in a restaurant. The chef would benefit from training in nutrition for the elderly and fortified diets. The kitchen assistant is also learning how to make new foods for example she was going to be shown how to make mushy peas as she had never made these before but is keen to learn new things, and has grown in confidence since the last inspection. Paperwork was up to date on the days of the inspection. Ascot House DS0000000391.V366056.R07.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good complaints and Safeguarding procedures in place. EVIDENCE: There have been no complaints or safeguarding issues in the home since the last inspection. There were safeguarding issues in the home in the previous 12 months and these were dealt with very well by the home. An alert was quickly made and all of the correct procedures followed. 100 of staff have received training in Safeguarding Adults. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 16 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, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally clean and well maintained. EVIDENCE: There have been a lot of improvements in the environment since the last inspection, considering how recently it took place. An improvement plan was requested following the last inspection and in relation to the environment, cleanliness and infection control standards have improved. A number of rooms in the home have been redecorated and the overall standard of most rooms is good. This is ongoing and there are still some items of bedroom furniture that are old and either unsightly or damaged. Bedrooms are, however, clean and tidy and any creams and lotions found in bedrooms are named and in the correct room. They are nicely personalised and homely Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 17 and residents are encouraged to bring in their own furniture and personal effects. Signage has improved in the home and there is now closer attention the orientation of residents so signs point out the way to the toilet, and clocks now tell the right time. Staff are now more aware that people with dementia require these visual clues as they spend a lot of their time problem solving, and this is an area that will be further developed. Pictures have been moved lower down on walls to enable people to see them as they were very high. This was a good practice recommendation at the last inspection. A new full door has also been placed at the top of the stairs at the rear of the dining room, as there was a half door which was less safe. A new carpet cleaner has been purchased and there was no odour problem in the home during the inspection, carpets are cleaned on a regular basis. The bedroom corridors have been repainted and they are much brighter and less institutional in appearance. Some toilets remain clinical and bare but bathrooms have improved. New furniture has been provided in a number of areas in the home, including the dining rooms and the office has been redecorated and is more organised. The manager has suggested using a disused toilet for storage. A letter should be provided to CSCI explaining work that has been carried out and confirming that there are sufficient toilets available. The standard of bed making in some bedrooms was very poor, (confirmed beds made by staff) and the manager will monitor this. She has a weekly walk around the home to monitor the environment specifically so is aware of areas that need to be addressed. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Services users are protected by the homes recruitment procedures and there are sufficient staff on duty at all times. EVIDENCE: There are sufficient staff working in the home, and there remains a stable staff team who have worked in the home for many years. More bank staff have been recruited meaning that familiar staff can be called upon when the home is short staffed meaning minimal disruption to residents. There has been an emphasis on bringing staff training up to date since the last inspection as a matter of priority. A new training matrix is in place, and statutory training is up to date and recorded so that there is a record of training due. Care staff are offered training to NVQ level 2 and above and over 50 of staff are working towards this. A new staff induction has been introduced by caring homes and this is carried out partially on line by staff and also in the home. This includes information about the expectations of staff in terms of their manner with residents and being respectful at all times. The manager has also worked closely with nurses Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 19 to ensure clinical practices are satisfactory and this has been successful in areas such as medication administration which was previously poor. Staff recruitment practices are followed and ensure residents are in safe hands. The files of two new staff were read. Both contained all of the required information such as references, identification and police checks. An application form, interview record and job description are also available. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 20 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): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and is run in the best interests of service users. EVIDENCE: A new manager is in post and has been cleared through the fit person interview and clearance process with The Commission for Social Care Inspection. There is also a new deputy manager in post which has strengthened the management of the home and has added greater support to the nursing and care staff. The home did not have a permanent manager for a long period of time, and this contributed to a deterioration in standards in some areas. At the last Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 21 inspection, this resulted in a high number of statutory requirements being made, and these have all been met or are in the process of being met through forward plans. As a result, standards in the home have improved noticeably, and the home is being managed in a methodical and structured way, meaning shortfalls are quickly identified and rectified. The home is run in the best interests of residents. There is more of a focus on consulting residents through meetings, and resident individual preferences questionnaires. These detail the preferences of residents in a number of areas such as what time they would like to get up, do you have any preferences regarding your named nurse, what people call you, and whether you want to participate in the running of the home. Residents and families spoken to during the inspection said they are very happy with the care provided. Residents’ money of properly accounted for. All transactions are recorded and a random check on the balance of one account found the total to be correct. The home has recently passed a company safety audit with a high mark achieved. This is an improvement since the last inspection. There are good systems in place in the company and locally to quality monitor a number of areas including safety. There were no safety concerns identified during the inspection. There are regular checks in place of fire safety equipment, and regular drills take place. The manager has been working closely with the maintenance staff member responsible for ensuring checks are up to date and these are now carried out on a regular basis and audited regularly by the manager. External fire safety checks on lighting and exits were carried out in May 2008, and electrical tests were carried out in January 08. The gas safety check carried out annually is due in July. Window restrictors and water temperatures are also checked on a regular basis. Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 23 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 OP12 Regulation 16 (2) (n) Requirement The range of activities must be improved and advertised, recorded and monitored through the care planning process. This will ensure residents are social needs are met in a way that reflects their individual interests and wishes. The chef and kitchen assistant must receive training in basic nutrition for the elderly and special diets such as fortified foods. Damaged bedroom furniture must be replaced, as it is unsightly. Care should be taken when bed making to ensure beds are tidy but also comfortable to sleep on. Bare and clinical toilet areas must be updated. Timescale for action 19/08/08 2. OP15 16 (2) (i) 19/09/08 3. OP19 23 (2b) 19/08/08 Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 24 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 Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Ascot House DS0000000391.V366056.R07.S.doc Version 5.2 Page 26 - 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!