Inspection on 09/02/07 for Ashville House

This inspection was carried out on 9th February 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ashville House 04/02/06

Ashville House 11/08/05

Ashville House 07/02/05

Ashville House 09/11/04

Ashville House 16/02/04

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

CARE HOME ADULTS 18-65 Ashville House 1 Ashville Road Birkenhead Wirral CH41 8AU Lead Inspector Debbie Corcoran Unannounced Inspection 9th February 2007 10:00 Ashville House DS0000018862.V319183.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 Ashville House DS0000018862.V319183.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. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ashville House Address 1 Ashville Road Birkenhead Wirral CH41 8AU 0151 653 8786 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) Making Space Mrs Elsie Fisher Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 named elderly person with a mental disorder (other than learning disability) may be accommodated. 4th February 2006 Date of last inspection Brief Description of the Service: Ashville House is registered to provide personal care to 10 adults who need support with their mental health. Ashville House is a large, three-storey, detached building set in its own grounds on the edge of Birkenhead Park and is close to local shops, public transport and other amenities. It is within a short bus ride to the centre of Birkenhead. All service users bedrooms are single rooms and are situated on the first and second floors. On the ground floor is a lounge, dining area, laundry and kitchen. Access is not currently available to the front of the home for service users or others who are wheelchair users. There is a large car park to the side of the home. The gardens consist of lawns, shrubs, trees and flowerbeds. There is a patio area with seating provided. Ashville House DS0000018862.V319183.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 home was not announced beforehand. During the visit the majority of the residents were met and spoken with and a number were spoken with on a one to one basis. Members of the staff team were also spoken with. A sample of resident’s records were looked at. Other records looked at include staff files, staff training records and health and safety records. A tour of the home was carried out which included all areas. The manager returned a questionnaire on the service to the Commission and a number of residents returned questionnaires. Some of the information contained in these has been used to inform the findings of this inspection. What the service does well: The residents were very positive about all aspects of the home. Resident’s comments included “It’s very good here” and “staff are lovely”. The home feels welcoming, homely and relaxed. Each resident has a detailed care plan. The care plans include information on the service user’s likes, dislikes, strengths and needs and include goals for supporting the person to develop their skills and aim for a more independent lifestyle. Residents are well supported to remain healthy and staff support the residents to attend health appointments on a regular basis. Staff also support the residents with their emotional and psychological well being. Residents are contributing to decision making in the home and are making choices with regard to their daily routines. Residents meetings take place on a regular basis and residents are also given further opportunities to comment on the home through questionnaires. A good percentage (88 ) of staff are qualified to a National Vocational Qualification (N.V.Q) level 2 in care. Staff appear to have a good understanding of the needs of the residents and there were some good examples noted of how staff support the residents with developing their personal and independent living skills and using the local community. Staff were observed to be pleasant and respectful to residents and welcoming to visitors. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 6 The home environment is well presented, clean, well maintained and the décor and furnishings and fittings in all areas are of a good standard. Health and safety procedures are in place so as to ensure the home environment is safe to residents, staff and visitors. 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. Ashville House DS0000018862.V319183.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 Ashville House DS0000018862.V319183.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. Residents needs are assessed before moving to the home in order to ensure their needs can be met at the home. EVIDENCE: There has been one new resident admitted to the home since the last inspection. It was evident that an assessment of needs had been attained from the referring agency before the person moved to the home. There is also an in house assessment tool which can be used when appropriate. When a new resident moves into the home a member of staff completes ‘admissions information’. This is carried out with the resident and covers issues such as what their daily routine is, whether or not they want to administer their own medication, what they think of the menu and what food they like to eat, and what sort of support they would like with their laundry, cleaning their room, budgeting etc… and residents are provided with information on key policies and procedures which are relevant to them. This information is updated periodically. Ashville House DS0000018862.V319183.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): 6, 7, 8, 9, 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each resident has a plan of care which clearly reflects their needs and choices and residents are making decision about their life and the running of the home. Where a resident is thought to be at risk of harm information on this, and how to manage it, is recorded in their care plan. Resident’s confidentiality is protected by the arrangements for storing information. EVIDENCE: A sample of residents records were examined in order to assess the care planning in place for residents. The resident’s care / support plans are comprehensive, clear, informative and easy to follow. The plans include information on the person’s mental health, medication, physical health, personal care, accommodation, domestic skills, activities, cultural and faith needs, social skills, relationships, strengths, and Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 10 significant events in their life. The plans are signed and dated by the resident. There were many examples of good practice recorded in the resident’s care plans for example the importance of complimenting the person. There were a couple of examples whereby residents have an additional support plan which focuses upon skills development and which identifies areas in which the resident would like to develop their independent living skills. When appropriate the plans include guidelines as to how to support the person with aspects of their physical and emotional health and wellbeing. Plans are reviewed on a regular basis. In addition to comprehensive care planning each resident completes a questionnaire which covers issues such as what their daily routine is, whether or not they want to administer their own medication, what they think of the menu and what food they like to eat, and what sort of support they would like with their laundry, cleaning their room, budgeting etc… Where a service user is involved in activities which pose a risk to their safety then this is recorded in the person’s care plan along with information on what steps need to be taken to prevent the risk from occurring. Many of the staff have worked at the home for a significant period of time and therefore they have had the opportunity to build relationships with the residents and to get to know the residents well. Residents were very positive about all aspects of their support and appeared confident that staff were meeting their needs and providing good care and support. Residents who were spoken with said that they are making their own decisions as to their daily support and their routines within the home. Residents are supported to manage their own matters when possible. For example to manage their own money or their own medication. Residents have the opportunity to attend residents meetings whereby they can discuss the running of the home with staff on a more formal basis. All personal and confidential information is stored appropriately and staff are aware of their responsibilities in this area. Ashville House DS0000018862.V319183.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): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to develop their independent living skills, to develop and maintain relationships and to be involved in local community activities. Residents are included in decision making on the running of the home. Residents are provided with a varied diet of home cooked food. EVIDENCE: Residents gave good feedback on their support with pursuing leisure and social activities. Residents are going out and using community resources independently when they are able to and with support from staff when needed. The residents care plans / support plans include a good level of information on how to support the person with using and developing their independent living skills. From discussions with residents it was clear that they are supported to develop their independent living skills as appropriate to their individual needs. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 12 Residents are encouraged to make choices about the running of the home and their care. Residents confirmed that they are making choices and they gave examples such as choosing when to get up, when to go to bed, their meals, their daily routine, how to spend their day and this will include going outside of the home on their own if they have the skills to be able to do this independently. Residents are supported to manage their own affairs when possible, for example managing their own money or their own medication. Residents reported that staff respect these choices. Residents have the opportunity to attend a residents meeting on a regular basis and are given the opportunity to complete surveys to give feedback on the home. An activities co-ordinator has recently been appointed to the home. This person is in the process planning activities with the residents and has recently introduced a number of activities. Records and discussions with residents and staff show that residents are supported in activities such as shopping, walking, games and going to the library. Residents have recently identified a number of additional activities which they would like to be supported in for example going swimming and going to art galleries and the activities co-ordinator stated that she is in the process of arranging these and in developing an interesting range of new activities including supporting residents to attend college where appropriate. Relationships are encouraged and this was confirmed during discussions with residents and in the residents care planning. Visitors are welcome to the home at all reasonable times. In order to assess the meals and food provided the menus were checked, the kitchen was checked including food storage and health safety in the kitchen, and many of the residents were asked to comment on the food. The home has a cook who is responsible for the main meals of the day. In addition to the main kitchen residents have a kitchen area in the dinning room where they can make their own food and drinks. Staff described that there has been a recent emphasis on residents being involved in cooking and this should be encouraged and supported. Food was stored in good supply and stored safely. The menu was varied and appetising and all feedback on the food and meals was positive. Ashville House DS0000018862.V319183.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): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are being well supported with their personal, emotional, physical and health care needs and medication is well managed. EVIDENCE: The resident’s care / support plans include a good level of information on how to support the person with both their emotional and physical health and well being. During discussions with the residents they felt that staff support them well. When asked if staff were respectful of their privacy residents said that they were. Records showed that the residents are well supported to remain healthy and to attend health related appointments on a regular basis. New care plans are being introduced and these include clearer information on the resident’s needs with health care and health appointments and this information will be recorded directly onto the resident’s care plan. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 14 Medication storage was checked and a random sample of administration records were checked. These showed that medication appears to be safely managed. Staff have been provided with medication training. Medication stock is checked on a daily basis. Residents are encouraged to manager their own medication when this is appropriate and a risk assessment is carried out to ensure that residents who do manage their own medication are able to do this safely. Ashville House DS0000018862.V319183.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): 22, 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place for dealing with complaints and residents know how to make a complaint. Systems are in place to protect residents however these need to be clearly communicated to staff. EVIDENCE: The home has a complaints procedure which is time scaled appropriately and includes contact details for the Commission. A copy of the complaints procedure is available to residents and is on display in the main hallway. Residents spoken with about complaints said that if they weren’t happy about something then they would tell the staff. There have been no complaints made to the home since the last inspection. Senior staff reported that there have been no adult protection issues. Staff were unable to locate an adult protection procedure or the Local Authority adult protection procedures but reported that these documents were at the home. These procedure should be readily available to staff. Care staff have been provided with training in adult protection. However staff who were asked about how they would respond to an allegation of abuse were not able to provide appropriate answers. Senior staff should be aware of their responsibilities for dealing with an allegation of abuse and for contacting relevant authorities. Staff therefore require further training on adult protection. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 16 A record of key events is maintained for example incident reports and accident reports. These were checked and found to be maintained appropriately and there were no areas of concern identified. A record is maintained of residents monies and residents sign for receipt of their money. Receipts are retained for items purchased and these are kept for audit purposes. It has been a significant period of time since the last recorded audit of resident’s monies. It is recommended that the manager introduces a regular audit of resident’s monies in addition to an external audit. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with a well presented, well maintained, comfortable, clean and safe home environment. EVIDENCE: A tour of the home was carried out. Accommodation is provided over 3 floors. The ground floor comprises of one large main lounge, a dinning room and office. Resident’s bedrooms and bathrooms are located on the first and second floors. Each resident has there own bedroom and a sample of these were checked and found to be well presented and furnishings and fittings were of a good standard. The home is well maintained and during the visit there were a number of areas of maintenance being attended to. The only area of concern with the home environment is that there is only one lounge and this is used by both people who smoke and non smokers. The responsible person must consult with residents and provide alternative arrangements to this. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 18 The home has health and safety practices and procedures which are aimed at ensuring the home is safe and clean and as free from hazards to the health and safety of service users and staff. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by appropriately qualified and trained staff. Staff are supported through regular supervision and team meetings. Staff numbers are not consistently appropriate to ensure that the resident’s needs are being met effectively. Staff recruitment and selection practices are thorough and aim to protect residents. EVIDENCE: Residents gave positive feedback about the staff including that “staff are very good”. Staff were observed to be warm and friendly with the residents throughout the inspection. Staff turnover is low and therefore many of the staff have been supporting the residents for a significant period of time and have had the opportunity to get to know the residents well. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 20 Discussions with the service user and staff indicated that staff are supporting the aims and objectives of the home in encouraging service users to make choices, develop their independent living skills and use their local community. There are 9 members of care staff and of these 8 have attained a National Vocational Qualification (N.V.Q) level 2 in care. In addition to care staff the home employs a number of domestic staff and cooks. There has been only one new member of staff since the last inspection. The records for the recruitment of this member of staff were checked. These showed that all relevant pre employment checks had been carried out before the person started working at the home. At the time of the visit there was only one member of care staff scheduled to work from 4pm to 10.30pm. The staff rota showed that this was the case for the following week. A senior member of staff was advised to contact the responsible person for an urgent review of staffing levels and for a copy of this to be forwarded to the Commission as a matter of priority. The manager of the home did do this following the inspection and advised that agency staff were rotad to ensure that 2 staff were on duty. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well organised and is run in the best interests of the residents. The health, welfare and safety of residents and staff is promoted and protected. EVIDENCE: The registered manager left the home in January. A new manager has been appointed and has been in post for approximately four weeks. This person will need to apply to the Commission for registration as manager. The manager was not available during the inspection. However, the home is well organised and senior staff were able to locate readily locate relevant information. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 22 Along with residents contributing to daily decision making in the home residents are also invited to comment on the home through residents meetings and through completing surveys on the home on annual basis. The home is visited by a representative from the organisation on a monthly basis and reports of these visits are forwarded to the Commission. The manager should ensure that recorded staff meetings occur more frequently. This is to ensure that staff members have a regular forum to discuss issues that may effect the service provided to service users and the implementation of polices, procedures and practices within the home. Staff records and discussions with staff show that staff are being provided with one to one supervision. The home has numerous policies and procedures in relation to the health and safety of service users and staff and staff are provided with training in core health and safety related skills. Fire safety and health and safety practices are adopted. Records of fire and health and safety checks were checked and found to be up to date. Risk assessments are also in place for safe working practices and these are regularly reviewed. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 3 X X X 3 Ashville House DS0000018862.V319183.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 YA23 Regulation 13 (6) Requirement The registered person must ensure that staff are provided with training in adult protection and must ensure that staff are aware of their roles and responsibilities in safeguarding residents. Adult protection policies and procedures must be readily available at all times. The registered person must review the arrangements for designated smoking areas in the home. The registered person must review staffing levels and ensure that staff are provided in adequate numbers so to safeguard the health and welfare of residents. The registered person must ensure that an application for registration of a suitably skilled, experience and qualified manager is made to the Commission. Timescale for action 09/05/07 2. YA24 13 (4) (a) 09/04/07 3. YA33 18 (1) (a) 09/03/07 4. YA37 9 23/04/07 Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 25 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 YA41 YA33 Good Practice Recommendations The manager should introduce a system for auditing resident’s monies on a regular basis. The manager should ensure that recorded staff meetings take place on a regular basis. Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Ashville House DS0000018862.V319183.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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