Inspection on 11/07/07 for Ashtead House

This inspection was carried out on 11th July 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 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

Ashtead House 05/12/06

Ashtead House 24/10/05

Ashtead House 06/06/05

Ashtead House 14/12/04

Ashtead House 20/09/04

Ashtead House 16/02/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Ashtead House Ashtead House 153 Barnett Wood Lane Ashtead Surrey KT21 2LR Lead Inspector Jo Griffiths Unannounced Inspection 11th July 2007 11:15 DS0000013561.V343081.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 DS0000013561.V343081.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. DS0000013561.V343081.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashtead House Address Ashtead House 153 Barnett Wood Lane Ashtead Surrey KT21 2LR 01372 810330 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) ashteadhouse@ntlbusiness.com Ashtead House Ltd Miss Sheila Cassidy Care Home 10 Category(ies) of Learning disability (6), Physical disability (4) registration, with number of places DS0000013561.V343081.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be 18 - 60 YEARS. 5th December 2006 Date of last inspection Brief Description of the Service: Ashtead house is part of the Allied Care group. The home is registered to accommodate ten people with mild to moderate learning disabilities and physical disabilities, although there is a maximum occupancy of nine people at present due to one bedroom being used for additional communal space. The home is a detached property located a short distance from Ashtead town centre. Accommodation is situated on the ground floor and first floor. All bedrooms are single occupancy. There is no lift to access the upper floor. There is a communal garden at the rear and parking for several cars at the front. The service supports people with daily living skills, activities and occupation of their choice and their emotional needs. People are supported to develop their skills and move from the home into more independent accommodation in the future if they wish. The current fees for this service range from £1,150 to £1,644.32 per person per week, depending on individual’s assessed needs. More information can be obtained from the Manager of the home. DS0000013561.V343081.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of the care home under the ‘Inspecting for Better Lives’ programme. The focus of the inspection was to ensure that there are good outcomes for the people using the service. As part of the inspection the Manager completed an Annual Quality Assurance Assessment (AQAA) for the home and sent this to the Commission. The Inspector visited the home on 11th July between 11.15am and 4.15pm. During the visit some of the people living at the home were spoken with and some staff. The Manager was present throughout the visit and some of the documentation in the home was inspected. What the service does well: What has improved since the last inspection? The medication charts are now being completed properly to ensure that there is a record to show that people have had their medication when they need it. The office has been moved to a new room in the house. This is a safer environment for staff to work in and it is easier for people who use wheelchairs to access. There have been some improvements to the way people in the service are asked their views. Each month a Manager from Allied Care visits the home to do a quality audit. This now includes asking the views of the people in the home and the staff. DS0000013561.V343081.R01.S.doc Version 5.2 Page 6 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. DS0000013561.V343081.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 DS0000013561.V343081.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 and 3 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have a full assessment of their needs to ensure they can be met before they are offered a place at the home. The home is able to meet the diverse needs of the people using the service. EVIDENCE: Each person has an assessment of their needs before they move to the home. The Manager completes all assessments and confirms with the person if their needs can be met. The assessment covers all areas of their lives that they may require support in. The assessment for the latest person to move to the home was inspected as well as one person who had been living at the home for some time. The document informs the person’s care plan when they move to the home and is kept under review. The home is able to meet a range of diverse needs, including people from minority ethnic groups and individual cultural needs. Individuals’ needs are identified in the assessment and have been addressed in the care plan. DS0000013561.V343081.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 8 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at the home have a care plan that meets their needs. They are supported to make their own decisions and to have a say in how the home is run. People are supported to take risks as part of an independent lifestyle. EVIDENCE: Each person has a plan of care that provides staff with the information they need to appropriately support the person whilst encouraging them to be as independent as possible. The plans are written in a person centred way and demonstrate respect for the individual. The plans could be further improved by reviewing them to ensure that information is not unnecessarily repeated through the care plan file. This will make the information easier for staff to access when they need it. DS0000013561.V343081.R01.S.doc Version 5.2 Page 10 Two care plans were inspected in depth. They have been written with the involvement of the person and photos have been added to give them ownership of their plan and to assist understanding. All areas of health, personal care, social and emotional support are addressed by the plan, but the Manager was advised that more information could be added to support people with their personal relationships and the consent issues that surround this. The care plans have been regularly reviewed. Examples of how equality and diversity issues have been identified and addressed within the care plans were noted. This included the support and environmental adaptations available for a person using a wheelchair. The care plans also showed that individuals’ preferences regarding their support for personal care were clearly recorded. There was evidence that people’s wishes in relation to practising their religious beliefs were being upheld. People are supported to make decisions about their lives and their futures through Person centred planning. Each person has a keyworker who talks with them regularly about how things are going and any wishes they have. House meetings are held every two months for all the people living in the home to get together and discuss issues about how the home is run. Some of the key policies for the home have been translated into a format that better supports the communication needs of the people in the home. The Manager is working with the speech and language therapist to develop this further. Advocates are used where needed to support people to make decisions and people are supported to attend a self-advocacy group if they wish to. Where possible people manage their own finances, but the home does hold some money securely on behalf of people if they wish for this. Two new safes have been purchased and safeguarding procedures are in place. Individual risk assessments are in place and are referred to within the care plan. People living at the home are aware of any restrictions placed upon them and the reasons for this. They have consented to this within their plan. The risk assessments are kept under review and regularly discussed with the individual. Where needed specialist healthcare or behavioural therapists have been involved to support people with their needs. DS0000013561.V343081.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11, 12, 13,1 4, 15, 16 and 17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People are supported to develop their skills and to participate in the activities of their choice within and outside the home. They are supported to maintain contact with their family and friends and to have personal relationships if they choose to. People feel they are valued members of their community. People living at the home are aware of their rights and their responsibilities and are supported to be as independent as possible. A balanced diet is provided and people enjoy the meals. EVIDENCE: Each person has a timetable of their planned or preferred activities in their care plan. They review this with their keyworker each month and are supported to find out about new activities. Some people regularly attend a day DS0000013561.V343081.R01.S.doc Version 5.2 Page 12 centre and others are doing various courses at college including computer courses. There is no one at the home who has paid employment at the moment, but the Manager gave examples of previous tenants who had successfully gained employment. The Manager said she would regularly review employment opportunities with people to ensure they are supported in this area if they wish. At home there are opportunities to develop skills through preparing meals, managing money and use of the computer at the home. Some people have their own computers in their rooms or they can use the house computer in the quiet room. There is a TV and DVD player in the main lounge and the quiet room. An activities person comes to the home to do pottery and arts and crafts once per week and people can choose whether they wish to join in. There is also a visiting masseuse. Every person is supported to go on a holiday each year if they wish to. Outside of the home people are supported to do their own shopping, go to the pub, go out for meals, go ten pin bowling and to the cinema amongst other activities. One person enjoys riding his pushbike and therefore this is being safety checked and a proficiency test arranged so that he can do this independently. People living at the home said that they are supported to go to a church of their choice if they wish. People are supported to maintain contact with their family and friends and can receive visitors when they wish to. There are regular opportunities to meet new people and support and advice is provided regarding intimate relationships. The Manager described how support is provided to individuals to help them express their sexuality and own identity. As reported above, it would be useful for staff to have more information, in a discreet way, in the care plan about peoples’ needs in this area. Within the home people are expected to do their own laundry and keep their own rooms clean. Support is provided with these two tasks. The staff will cook meals but people can be involved or choose to cook their own meals if they wish to. Some people have their own fridges in their rooms for storing snacks and others are provided with money from the food budget to purchase ingredients for their meals if they wish to. People that have chosen to have a key to their room and the front door. The menu is planned for four weeks and has been written following the advice of a dietician to ensure it is nutritious and balanced. There are two choices on the menu for each meal or people can choose another option if they wish. Meals and mealtimes are flexible to meet peoples’ needs. Generally people enjoy their evening meal together but eat separately at lunchtime as they are all doing different daytime activities. People that live at the home said they enjoy the meals and can help themselves to snacks and drinks whenever they like. DS0000013561.V343081.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have their health and personal care needs met fully and in a sensitive way. They are supported to manage their medication safely. EVIDENCE: Individuals are registered with a GP of their choice, a dentist and an optician. There is a chiropodist that visits the home. Other healthcare needs are met through the GP or the local community learning disability team. Some people have the involvement of physiotherapy, speech and language therapy and dietician. Each person has a health action plan within their care plan and their needs are identified and addressed quickly. Records show that healthcare needs are well met and people living at the home confirmed this. Personal care is provided as according to the person’s individual care plan. The senior carer showed the inspector the rotas and described how measures are DS0000013561.V343081.R01.S.doc Version 5.2 Page 14 taken to ensure that personal care is provided by a staff member of the same gender as the person or by a preferred person if requested. Equipment and facilities are available in the home to meet peoples’ needs for personal care. Staff undertake training in manual handling, infection control, safeguarding adults and equality and dignity. People living at the home said that the staff respect their privacy and do not go into their rooms uninvited. Medication is only administered by trained staff, unless an individual has been assessed as able to manage their own medication safely. The Manager carries out informal observations of staff administering medication to check their practice. Competency checks for medication, as well as other areas of training, are being introduced into supervision sessions. The signing of medication records has improved and an audit of medication is being included in the monthly audit of the home. Records show that reviews of medication have been carried out with the GP. DS0000013561.V343081.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at the home know how to make a complaint and feel they are listened to. They are safeguarded against harm and abuse. EVIDENCE: The home has a clear complaints procedure. This is displayed in the entrance hall for people living at the home and their visitors to see. ‘Speaking up’ forms are available for people to complete if they have a concern and there are monthly keyworker meetings and 2-monthly house meetings that provide an opportunity for people to have their say. People living at the home said they felt the Manager and staff listen to what they say and help them with any problems. During the visit to the home the Manager was seen to respond to various issues raised by people in the home and there was a relaxed open door policy. There have been no complaints received by CSCI about Ashtead House since the last inspection of the service. Complaints are recorded and the Manager or a representative from Allied Care investigates all complaints. It is recommended that the Manager ensure that all complaints recorded have a clear record of the action taken to resolve the issue, the outcome and the feedback to the complainant. The Manager is also DS0000013561.V343081.R01.S.doc Version 5.2 Page 16 looking at ways to record informal complaints or concerns that are raised in the home. All staff have received training in safeguarding vulnerable adults and the Manager has obtained a copy of the new Surrey procedures. There is a policy in place for the protection of people living in the home and staff are aware of the whistle blowing policy and its uses. There are no safeguarding adults referrals outstanding for this home. DS0000013561.V343081.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 28 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is clean, safe and comfortable and meets the needs of the people that live there. EVIDENCE: The home has recently employed the services of a maintenance worker to carry out decorating and minor repairs in the home. At the time of the visit the quiet room was being decorated and the hallway had been recently completed. An area around one of the doorways needs some repair and quotes have been obtained for this. The stair carpet requires replacement as it is worn. The office has been relocated and is now safer for staff to work in. It is also easier for the people living at the home to access. DS0000013561.V343081.R01.S.doc Version 5.2 Page 18 The home is clean and hygienic. All staff have completed training in infection control and measures are taken to support people living at the home to keep their rooms clean and hygienic. Everyone has his or her own bedroom and there is a large lounge/diner and separate kitchen. The quiet room has comfortable seating and a computer. This room is used frequently by people in the home and can also be used to receive visitors in private. There is a large rear garden and the people living at the home said they enjoy having BBQs outside. The home meets the needs of the people living there and is comfortable and homely. People’s private space is respected. DS0000013561.V343081.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 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 living at the home are supported by sufficient numbers of qualified and competent staff to meet their needs. They benefit from a team of staff that are trained, supported and supervised. People in the home are safeguarded by the homes procedures for recruiting new staff. EVIDENCE: Recruitment files were sampled and found to contain the required information. The recruitment procedure that is followed by the Manager is robust and includes taking up written references, a CRB check and formal interview. New staff undertake an induction. The senior carer described how staff are required to work alongside an experienced member of staff for two weeks until they are allowed to be included on the rota. Training is planned when they are appointed. All staff have completed the training they require to safely support people. Updates are arranged by the Manager as needed. Records of staff training are available in the home. DS0000013561.V343081.R01.S.doc Version 5.2 Page 20 Over 70 of the staff team have achieved or are working toward their NVQ award. The Manager is aiming for 100 of staff to have the award by next year. This commitment to qualifications for staff is very positive for the people in the home. They can be assured that they are being supported by competent staff at all times. The Manager ensures that all staff receive a formal supervision session at least every two months. Records are kept to evidence that these have taken place. Training needs and practice issues are discussed in supervision and it is planned that competency testing following training courses will be introduced. The rota showed that there are three staff on duty in the morning and afternoon with one person covering a 9-5 shift. There is a waking night and a sleep in staff on during the night. The rotas are written ensuring that people’s personal care needs can be met by a staff member of the same gender. People’s social needs are also taken into account and a driver is always available. The home does not use any agency staff. DS0000013561.V343081.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People living at the home benefit from a competent Manager that runs the home in their best interests. The health and welfare of staff and people living at the home is safeguarded. EVIDENCE: The Manager of the home is qualified and experienced and runs the home competently. She consults with the people that live at the home daily about their needs and more formally through the monthly audit of the home and the 2-monthly house meetings. There is an annual survey that is sent to all people in the home and any relatives or visitors. The results of this have been collated and the Manager is working on producing this in a bar chart format that will be clear for people to see on the notice board. DS0000013561.V343081.R01.S.doc Version 5.2 Page 22 The Manager creates and open environment in the home and people living there feel confident to speak to her whenever they wish about any concerns or views they have. People in the home are kept safe and any risks are assessed and minimised. Equipment and facilities in the home are maintained, serviced and tested and regularly and the Manager ensures that health and safety matters are monitored daily. DS0000013561.V343081.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 3 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 2 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 4 3 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X DS0000013561.V343081.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23(2)(b) Requirement The registered person must ensure that the necessary repairs are made to the doorframe in the hallway and the worn stair carpet is replaced to ensure the environment continues to be a comfortable living area. Timescale for action 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA6 YA15 Good Practice Recommendations It is recommended that the care plans be reviewed and any repeated information removed to ensure they are easy to access for staff. It is recommended that care plans be further developed to include information about the support needs of people in the home with regard to intimate relationships. Consent issues should be clearly reflected in the plan. It is recommended that the record of complaints show the action taken, outcome and response to complainant. It is recommended that the job application form ask people to declare any criminal cautions as well as DS0000013561.V343081.R01.S.doc Version 5.2 Page 25 3 4 YA22 YA34 convictions. DS0000013561.V343081.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 DS0000013561.V343081.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!