Inspection on 15/05/07 for Ashfield House

This inspection was carried out on 15th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashfield House 28/11/06

Ashfield House 13/06/06

Ashfield House 10/01/06

Ashfield House 21/06/05

Ashfield House 09/12/04

Ashfield House 28/09/04

Ashfield House 29/06/04

Ashfield House 26/05/04

Ashfield House 16/12/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Bell House 105 Ashley Road Ashley New Milton Hampshire BH25 5BL Lead Inspector John Vaughan Unannounced Inspection 15th May 2007 10:20 Bell House DS0000012384.V336168.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 Bell House DS0000012384.V336168.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. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bell House Address 105 Ashley Road Ashley New Milton Hampshire BH25 5BL 01425 619256 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) Bell House Homes Ltd Mrs Jillian Ann Haughey Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th November 2006 Brief Description of the Service: Bell House is a care home providing personal care and accommodation for service users with a learning disability who may also present challenging behaviours. It is owned by Bell House Homes Ltd, a subsidiary of Allied Care Ltd, which has a number of other registered properties in the area. The home is located on the outskirts of the town of New Milton. The home comprises a detached, double fronted property with care parking for 4 vehicles to the front of the building and a well-maintained and accessible garden to the rear. All bedrooms are occupied on a single basis, and seven of these have an en-suite facility. There is a lounge with a television easily accessible to service users, and a separate quiet lounge and dining room. The home also has another room that is available for use by service users for recreational activities. The fees range from £954 to £2260 per week. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit to the service took place over one day and involved discussions with the manager and staff of the home. The inspector met with most of the people who use the service, talked to them about their experiences of living in the home. Surveys were provided for people to complete and the inspector received five completed surveys from people who use the service and two responses from parents of individuals. The inspector toured the home with staff members and people who live in the home, looked at records including care plans, training records, complaints information and medication administration documentation. An Annual Quality Assurance Assessment was sent to the service to be completed by the manager however this was not returned within the timescale set by the commission. What the service does well: What has improved since the last inspection? The service has updated the risk assessments for people who live in the home to make sure the risk of coming to harm during an activity are reduced. New methods of communicating are being explored and developed with people who use the service with the help of the community speech and language therapist. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 6 The supervision of staff members in their work continues to improve. This makes sure staff understand their roles and support people in the way that has been agreed. 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. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Improvements to the practice of the home means that people who use this service will only be admitted following a full assessment of their needs in consultation with the community team and other professionals. EVIDENCE: The inspector discussed the current admission procedures with the manager and he was told that no new admissions are planned for the home. Some interest has been expressed however the service has not pursued the admissions, as the needs of the individuals could not be met. Recent concerns about the admission of people with very complex needs has been resolved with an undertaking from the provider to ensure that all new referrals are fully explored with the community team to make sure the needs of these individuals can be met by the service. The inspector discussed this agreement with the manager who said that they are fully aware of what is required and will discuss any new referrals with the Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 9 specialist healthcare team to make sure support mechanisms are in place before any admission is agreed. The manager has put together an admission folder to help coordinate and provide information to any person who is thinking of moving into the home. The statement of purpose states that the individual’s needs must be fully assessed and the home will only admit a person whose needs they can be met by the service. The manager was advised to add in the plans to consult with other professionals and the community team as part of the admission process. Bell House DS0000012384.V336168.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Continuing improvement to the practices in the home mean that support plans and risk assessment strategies are reviewed and up to date however more focus on the involvement of people in planning for their support needs will enhance this service. EVIDENCE: The inspector looked at three care plans and assessments for people who use the service. Each of the plans had information on the needs of the individual and how the home has responded to these needs. Plans seen have been signed in places by the individual and in parts were specific agreements have been put in place these have been signed by the care manager or general practitioner. There are still significant gaps in the recording sheets for the goals and activity monitoring sheets examined by the inspector. This has the potential to give inaccurate results in any review of the Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 11 individual’s plans and does not demonstrate that the individual is fully supported to take part in these activities at the frequency agreed in the plan. At the last inspection the need for development of a more person centred approach to meeting people’s needs was highlighted. The manager stated that they have implemented a new assessment checklist, which she obtained from the British Institute of Learning Disability (BILD). The inspector spoke to a person who lives in the home about filling in this document and they said that they had filled it in with their key worker. Photographs were used to help the individual to communicate the needs and wishes during the process and the inspector saw photographs taken of the meetings to help them to recall the experience. The manager stated that all people living in the home have an outcome checklists underway at present and the staff who spoke to the inspector confirmed that they were taking part in this process as key workers for people who use the service. The inspector found that although this process is well underway the staff team has not had specific training in using this document or the person centred planning approach, this could undermine the positive work being done and that enough preparation has been made to ensure the information obtained reflects the wishes of some people who are less able to communicate their needs. The manager said that they have been trying to arrange training but had not been successful. The day after the site visit the manager contacted the inspector to confirm that a visit has been arranged from a member of the person centred planning implementation team. A significant amount of work has taken place in the home in developing the involvement of people who use the service with the introducing of a communication board. Activities are planned at morning meetings and a booklet has been produced with pictures of events, people and places to facilitate the participation of everyone at the meeting. A weekly house meeting takes place to discuss longer-term plans, holidays, activities and planning the menu for the week. Surveys returned to the inspector from people who use the service confirmed that they are supported to make decisions about daily life through these meetings and two of the people the inspector spoke to when he visited the home said that these meetings help them to plan their day and make choices about meals and what to do with their day. One person has a more specific pictorial diary that helps them to plan their day and know what will be happening throughout the day. They have chosen to keep this on the noticed board with the main activity plan. Some staff have received training in MAKATON and this mixture of signing and using spoken words was observed in use with people in the home. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 12 At the last visit the risk assessment process was not fully up to date and this was examined again at this visit. The three files examined had evidence of review for all assessments and all had been reviewed in March 2007. The manager has been prompt in putting risk assessments in place as new areas have arisen. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 13 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, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are supported with a varied and interesting recreational programme meeting their needs and wishes that is enhanced by contact from families and friends. The meals provided in the service are balanced, varied and reflect the likes and dislikes of people who use the service. EVIDENCE: The inspector spent time with most of the people living in the home and discussed their experiences of the service. Positive comments were made about living here and the support from staff. On the day of the visit three people had gone out for a morning activity returning for lunch. The two people remaining were playing board games and Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 14 looking at the morning paper when the inspector arrived. They told the inspector that they had plans to go out in the afternoon for a walk in the forest if the weather improved. The activity boards for the group and individuals matched what the inspector observed throughout the day. Each person’s file examined had a weekly activity plan and individual’s told the inspector that they take part in range of activities that they enjoy such as going for walks, keep fit, gardening, cooking, going to the pub and seeing their families. Tonight a group of people are going to a gateway club where, the inspector was told they would meet with friends and take part in a disco. The inspector received completed surveys from the parents of two of the people who use the service. The responses were positive and confirmed that support is provided to individuals to maintain contact with their families and friends. The home has a cook and they were preparing lunch when the inspector spoke to them. The inspector was told that the menu is put together weekly at the house meeting and all people living in the home take part in choosing meals. The menu seen had a variety of meals and snacks and the manager and cook said that alternatives are provided should anyone change their minds. The inspector sat and had lunch with the people living in the home. This was relaxed and unrushed and staff supported individuals with positive encouragement to eat their meals. Comments from people were very positive, they enjoyed the meals and were able to make choices about what to eat. The inspector was told about a recent Chinese meal evening when people living in the home took part in choosing what would be on the menu and helped to prepare and service the food. People using the service have a key to access the fridge in the kitchenette and were observed by the inspector making drinks for themselves and others throughout the visit. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 15 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home are supported to access healthcare services and the medication practices keep people safe. EVIDENCE: The inspector looked at plans to support people with their personal care which are up to date and include important routines that the individual wishes to follow. Monitoring sheet held in each person’s file record visits to the GP, Consultant, Dentist and Chiropodist. One person told the inspector they were going to the dentist soon. Evidence of contact with other professionals was seen and the manager has set up a medication review with the consultant for one service user. Medication is stored in a secure room within a secure cupboard. The records where accurate and the inspector saw evidence to demonstrate that staff are Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 16 following agreed practices when administering from the monitored dosage system. Homely remedy agreements and as required medication guidelines were on file and signed by the GP. The inspector noted that one ‘as required’ laxative is prescribed to allow for one to two tablets to be given. The blister packs show that on occasions one tablet is given however this is not reflected on the medication administration record. The manager was advised to record the number of tablets administered together with the signature. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 17 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has systems to record and respond to the complaints and concerns of the people who use the service and their representatives. Improving the process of charging for transportation will benefit people who live in the home. EVIDENCE: The home has a complaints procedure that has been developed in a format that helps people to understand their right to raise any concerns that they have. People who live in the home told the inspector that they are able to talk to staff if they are unhappy about anything and named members of staff that they would talk to at these times. The information being sent to the commission continues to demonstrate improvements in the reporting of incidents and allegations through regulation 37 reports. The manager has produced a new complaints log and is busy crossreferencing this record with confidential information related to complaints and allegations held securely in the office. Recent allegations have been fully investigated under the agreed adult protection procedures and one recommendation was for the manager to reiterate the process to their staff team. The inspector saw the minutes of the staff meeting that followed this adult protection, which covered abuse, the adult protection protocol and whistle-blowing policy. The inspector spoke to Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 18 staff during the visit and they demonstrated a good understanding of how to protect people and how to raise concerns. The charging for transportation remains an area that needs to be resolved. The last inspection of the service recognised that the charges were now recorded and at this visit the inspector saw information on individual files. The manager stated that they are still trying to obtain agreements from care managers on the charging of transportation costs through the placement fees. Part of the work the service is undertaking is focussing on communication with people living in the home. The inspector noted that the manager has included a communication checklist within the assessment. This will be helpful in recognising when people are unhappy and how to respond to this observation. The inspector reiterated the need to ensure staff members are fully trained in completing these documents to ensure an objective view is obtained. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 19 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, 25 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a safe, comfortable and homely environment. EVIDENCE: The inspector toured the home with the assistance of the manager and people who use the service. The home was clean and free from any unpleasant smells. Both lounges were being used by people throughout the day for watching TV, playing board games or sitting quietly and reading the paper. Each room is decorated to a good standard with comfortable furniture that gave these spaces a homely feel. The bedroom of one person was seen and this had been laid out in a way that suited the individual. Personal belongings, pictures and ornaments were in place and the individual said that they were very happy and comfortable in Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 20 their room. This individual also keeps fish and has space within their room to keep their fish tank and equipment. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 21 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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using this service are supported by staff that are recruited, trained and supervised to meet their needs. EVIDENCE: The inspector spoke to staff during the visit to the service and explore the current training and supervision programmes in the home. Staff confirmed that the have regular supervision with their manager and this was supported with records of these sessions held on staff files. The manager said that they have a programme in place that ensures staff have regular supervision and staff meetings that has significantly improved communication in the home. Staff members reported that they are encouraged to improve their skills and one staff member told the inspector that they have recently completed their National Vocational Qualification (NVQ) level 2. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 22 A training record was seen to demonstrate that a programme of mandatory training is ongoing in first aid, moving and handling, food hygiene, medication safe handling, fire safety, health and safety and infection control. Additional training specific to the needs of people using the service is in place. Subjects covered included MAKATON, Autism, Asperger’s syndrome and Epilepsy. The manager stated that none of the people who live in the service require physical intervention and this was confirmed by the staff team who spoke with confidence on resolving issues through de-escalation and distraction techniques. The manager confirmed that no new staff have been recruited to the service since before the previous inspection of the service and the recruitment practices have not changed. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 23 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, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The practices of the home continue to demonstrate improvement demonstrating more effective and sustained management of the service that has benefited the people who live in the home. EVIDENCE: The manager continues to make improvements to how the service supports people living in the home. The agreement to work closely with other professionals in the assessment of new people wishing to move into the service is a positive move to ensure only people the service has the ability to support will move into the home. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 24 Risk assessment reviewing has improved and the manager has completed new assessments where new risks have been identified. The inspector confirmed that there are systems to involve people in the day-to-day events in the home, planning for activities and communication with people who use the service. Reporting mechanisms are consistently followed to keep the commission informed of any incidents in the service and where improvements in the homes practices have been recommended under the adult protection process the manager has responded promptly. A system is in place to review the quality of the service involving the people who use the service and the representatives. This process is due to start again soon with the issuing of surveys to all stakeholders. The last inspection of the service confirmed that an internal audit takes place and the results of this were in keeping with the commission’s findings. The commission has introduced an Annual Quality Assurance Assessment (AQAA) as part of the review of registered services and when requested the service must return this document within the timescale set. The manager failed to return this document in time and a copy of the document was obtained at the visit. The level and quality of information within the assessment was not satisfactory, as it did not fully support any of the statements made with enough evidence. This was discussed with the manager at the site visit who will need to consider how they will respond to the request for information in future. One area still needs to be addressed and this is the development of the person centred plans within the home, which requires training for staff to ensure this process is implemented effectively and consistently. The manager was able to demonstrate that they are planning for this shortfall. The inspector was provided with evidence to confirm that equipment, heating, hot water and fire safety systems are serviced regularly to maintain the safety of people using the service. Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 25 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 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 26 Yes 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 YA6 Regulation 15 Requirement People using this service must have a care plan that has been constructed from a person centred approach to assessing and responding to their needs. This is a repeated requirement previous timescale 01/03/07 partly met. Timescale for action 10/07/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bell House DS0000012384.V336168.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!