Inspection on 20/04/07 for Bamford Close

This inspection was carried out on 20th April 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bamford Close 30/11/05

Bamford Close 28/06/05

Bamford Close 26/11/04

Bamford Close 04/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Bamford Close Adswood Lane West Cale Green Stockport Cheshire SK3 8HT Lead Inspector Michelle Haller Unannounced Inspection 09:00 20th April 2007 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bamford Close DS0000008538.V336842.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bamford Close Address Adswood Lane West Cale Green Stockport Cheshire SK3 8HT 0161 480 6712 0161 429 6123 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) Borough Care Limited Amanda Crabtree Care Home 40 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (40) of places Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 40 OP and up to 4 DE(E). The registered manager must ensure that she successfully completes a relevant qualification in management by April 2006. 30th November 2005 Date of last inspection Brief Description of the Service: Bamford Close is a purpose built, single storey building offering accommodation for up to 40 older people; four of whom may be diagnosed as having a degree of dementia. The home also provides a day care service for up to ten people. The home is situated within a short drive from the motorway network, Stockport town centre and the local shopping precinct. Public transport is easily accessible and there are local shops within walking distance. The home is one of 12 care homes owned by Borough Care Limited, a ‘not-forprofit’ company. The home is divided into four units, each accommodating up to ten residents, all of who have single rooms. Each unit has a lounge, kitchen, bathing and toileting facilities that are conveniently situated for residents. Bamford Close presents as a lively home with lots going on. Day care and residential residents are able to meet and enjoy each others company in the main areas, with the individual units being restricted to residential care residents only. The home charges £332.00 to £390.00 each week. The previous CSCI inspection report was on display at the entrance to the home. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included an unannounced site visit to the home on 20th April 2007. The home did not know we were coming to inspect. In the course of the inspection six care files and other records concerning the support and care of people in the home were examined in full. Policies, procedures and other documents concerning the running of the home were also examined. Four people using the service and three relatives were spoken to. Two members of staff were interviewed. The interactions between those using the service, their families and staff were also observed and the procedure for medication process was checked. A tour of the private and communal areas of the building was completed. What the service does well: Bamford Close provides a homely and relaxing living environment. The accommodation is spacious, allows for small group living and enables service users to develop relationships and become accustomed to one another. The staff at Bamford Close work hard at developing good relationships with everyone they deal with. The home has a good relationship with health care professionals and service users feel that they are well cared for. Comments included “Staff seem to know what she needs.” The variety and quantity of food provided to service users is satisfying and meets their needs. Remarks included “The food always looks nice - freshly cooked and varied.” People living at Bamford Close expressed a high level of satisfaction. Comments from them and their relatives included: “Staff are approachable and caring”, “Staff are nice”, ‘‘They give you the idea that if you’ve got any problems you can talk to them”, “Always somebody about to talk to” and “I wouldn’t change anything from how it is. She is safe here”. The service ensures that people are listened to and the routines in the home are flexible. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 6 The home is good at promoting the health and safety of people living and working there. 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. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (6 is not applicable) Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service ensures that it can meet the needs of those referred to the home and that people and their representatives are helped to make the right decision about moving into the home. EVIDENCE: A cross-section of service users’ care files were examined and these included the most recent admission and a service user requiring intensive support. An admissions checklist is completed and this includes prompts in respect of sleep-patterns, food preferences and dislikes. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 9 It was possible to assess that, in the majority of cases, health care assessments, including physical wellbeing, risk of falls, moving and handling needs and communication needs, were completed either by the home or the person’s social worker prior to admission. Information about the most recent admission provided a clear idea of the initial needs, although information was spread through a number of documents. Bamford Close runs a day care centre and a significant number of people were already familiar with the home as they had previously used this facility. The home has recently started to ask people about their social histories, interests and hobbies. This area could be improved if the home’s own assessment provided more detailed information about needs, and if all the information provided by health and social care was included in this. A copy of the home’s ‘service user guide’ was seen in a number of bedrooms. Those who commented about the process of moving into the home stated ‘I knew of the place and I had a good idea of the quality of care.’ Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. People receive the health and social care support they require. support is provided safely and with dignity and respect. EVIDENCE: Six care plans were examined. The usefulness of the information that was written varied and did not always state the actions that staff needed to take or expected outcomes of any intervention or support. The care plans that were examined tended to identify the same three needs for everyone. Occasionally, additional needs and instructions about care were added, however for two people, the care plans did not reflect the complexity of their needs. The home should demonstrate that people are treated as individuals and that needs are assessed and prioritised individually. This would assist in demonstrating that the support provided is person centred. Care and Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 11 Assessment information for each service user was not kept in a single file or transferred onto a single care plan and so it could be difficult for staff to keep a track on all the care required and to effectively review the progress of service users. At times, the home was unable to demonstrate that they had made the appropriate referrals, maintained relevant records or responded in full to a change in circumstances. Records, reports and other correspondence, however, did confirm that, in the main, people had access to routine and specialist health care, including general practitioners, dentist, district nurses, mental health nurses, dieticians, optician and specialist consultants through attending out-patients hospital appointments. People kept their own general practitioners whenever possible. Specialist equipment, such as pressure area beds, is provided and charts indicated that staff follow the instructions provided by district nurses and others involved in planning care. Medication is received into the home through a metered dosage system provided by the pharmacist. The medication policy was examined and the guidance promoted safe administration, storage and recording. The independence of service users is promoted, as a number manage their own medication. Service users appeared well groomed, neat and tidy. Many were wearing prescription glasses and had been supported in wearing hearing aids. Staff have completed a course that highlights the importance of good personal grooming called ‘Look good - feel good.’ Daily records, though limited in the information provided, were written in a respectful manner. Comments from service users included ‘The care in itself cannot be faulted’ and ‘They are very good – if there is anything wrong they do what is needed and the doctor comes in regularly’, ‘Everyone is very nice to me - they come in and have a chat and a joke, they’re very good’ and ‘Staff are kind - they treat the confused service users very gently.’ Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Recreational and social provision meets the residents’ expectations. wholesome, well prepared and dietary needs are met. Food is EVIDENCE: Staff have received training to help them develop ways of creating an interesting and stimulating environment for people living in Bamford Close. These courses included ‘Working creatively with older people’ and ‘Yesterday today and tomorrow’ a course about the effects of dementia. Bamford Close runs a day service and activities are planned by a trained activities co-ordinator. Everyone in the home is able to join in with these activities. On the morning of the inspection armchair exercises had been organised and a singer provided entertainment in the afternoon. As the inspection commenced it was interesting to hear people discussing the merits of the different entertainers they had seen over the past months. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 13 People were observed reading newspapers and books, watching television and speaking to each other and staff. In addition, the home provided specialist equipment such as a piano keyboard for someone with an interest in playing music. The activities calendar included bingo, quizzes, arts and crafts, sing-alongs, entertainers, manicures, darts and video afternoons. The home also acknowledged special days, such as saints’ days, birthdays and significant anniversaries, and makes an effort to make sure individuals have the opportunity to do things they enjoy, or of importance to them, for example, gardening, going to church or receiving communion. A display of arts and crafts produced by the home was on display in the hall. Comments relating to activities included: ‘Always something to do’ and ‘We have things to do - in the morning we do exercises and have indoor games,’ ‘they’ve given me my own patch of garden to plant-up and look after.’ And: ‘They mark anniversaries-they make a real effort - we had a big family do.’ This person also confirmed that, when possible, entertainment was culturally relevant. People also commented that they would like to go on more outings. This was discussed with the manager who was aware of this and had already started to organise transport that would take people to where they wanted to go. Records also confirmed that staff took people out shopping on a one to one basis. Visitors were seen throughout the day and every one interviewed felt that they could receive visitors when they wanted. People also commented that they regularly went out with friends and family. The lunchtime meals tend to be a snack and hot pudding. The meal during the inspection was egg and bacon, and soup and sandwiches. According to the menu, other choices included spaghetti or beans on toast, sandwiches, fishcakes and jacket potatoes on the day of inspection. Teatime meals included a variety of casseroles, roasted meats, fish dishes, flans and pies. The manager is considering changing this arrangement, as it seems people eat less in the afternoon. However, this has been discussed at residence meetings and no strong opinions were voiced. The weight records indicated that, in the main, people maintained their weight while living in the home and steps were taken to investigate and deal with weight loss. The dining area of each unit is nicely decorated, bright, clean and meal times were seen to be a pleasant social experience. Staff were observed providing support and assistance with dignity. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 14 Throughout the day it was noted that all private issues were dealt with as discreetly as possible, and with respect and consideration. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Complaints are dealt with fairly and openly. Arrangements and procedures are in place to prevent and deal with abuse, thereby offering protection to people living at the home. EVIDENCE: Entries in the home’s complaints book demonstrated that complaints and concerns were taken seriously and dealt with openly and fairly. People were keen to confirm that if they had any concerns, they could speak to the manager. They were confident that if there were issues, these would be listened to. The general view of those interviewed is summed up by the comment: ‘I’ve never complained but I feel this would be dealt with.’ The home’s adult protection policy was read through and requires updating to make it clear that an incident of abuse between people living in the home would be investigated and recorded. The policy was last reviewed in 2005 and so is due revision. Discussion with staff indicated that they were unclear about dealing with this scenario and a clear policy was not available. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 16 Staff have received adult protection training in the past year. The manager stated that no adult protection investigations had arisen since the last inspection. One relative commented that they felt “she is safe here” when referring to their mother. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The physical design and environment of Bamford Close enables the residents to live in a safe, well maintained and comfortable environment. EVIDENCE: A tour of the communal areas and a number of bedrooms were inspected. The majority of bedrooms had been personalised. All the rooms were warm and free from unpleasant smells. Records confirmed that people were able arrange to have their rooms redecorated to a colour scheme of their choice. The layout of the home promotes independence and people were observed mobilising and using aids such as handrails. There are aids to assist with bathing and the manager stated that there are plans to install a shower room. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 18 The division of the home into ‘units’ appears to encourage friendships and gives a homely atmosphere. As each unit has a kitchen area, people are able to have snacks and drinks when they want. On the day of inspection all areas of the home were clean. Comments about the environment included: ‘The cleaning is very thorough they clean the table and the chair legs!’ and ‘The home is clean and tidy, bedding is changed frequently, clean towels daily.’ Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Bamford Close provides staff who are well trained and in sufficient numbers to meet the needs of those living in the home. EVIDENCE: There were 40 people living at Bamford Close on the day of inspection. There were eleven staff on duty with a variety of skills, including the registered manager, clinical supervisor, six care staff, a cook and kitchen assistant, laundress and three housekeepers. At night there are two “wake and watch”, and one sleep-in care staff available. The care staff are allocated between the four units and people commented that in general there were sufficient staff. Remarks included: ‘Sometimes staff are very, very busy but overall I’m very happy’ and ‘staff are very good - work hard, nobody gets neglected.’ Staff interacted with people in a relaxed and unhurried manner, and in the afternoon it was noted that staff took time to chat with people. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 20 Staff records confirmed that all had been employed using a proper recruitment and selection process. Application forms, two references and Criminal Record Bureau checks were in place. Furthermore, there was additional proof of identity and health declaration forms had been signed. The most recent recruits had been enrolled on an induction into care programme and completed workbooks to support their learning. The training calendar and records of attendance confirmed that staff had received training in the past 12 months which included: pressure area care; basic and advanced first aid; loss, grief and bereavement; food safety; falls prevention, recording accidents, infection control, moving and handling, palliative care; fire safety, managing conflict and protection of vulnerable adult alerter. This training is provided through the Borough Care organisation of which Bamford Close is a part. 20 of the 26 permanent care staff have achieved the National Vocational Qualification (NVQ) in Care level 2, and four others are completing this course. The safety of those living in the home is protected, as 30 members of staff have a recognised first aid qualification. Staff were complimentary about working conditions, the training received and care provided in the home. Comments from staff included: ‘The carers are all good and the office staff are there for you - we all work as a team’ and ‘We work as a team, the managers listen to any issues or complaint.’ Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The management at Bamford Close is based on openness and respect which promotes the rights of people living at the home. EVIDENCE: The registered manager has attained the National Vocational Qualification level 4 in management award. The training she has attended since the last inspection included updating her medication training and moving and handling training. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 22 The running of the home appears efficient and supervision records indicated that staff are well managed. Relatives stated that the manager was approachable. Borough Care conducts a yearly review of Bamford Close and this includes finding out the opinions of service users and their relatives. The outcome of this review is published and made available for all concerned. Unfortunately, only one person returned the questionnaire the last time the review took place. This was discussed with the manager who confirmed that steps had been taken to encourage more people to complete and return the questionnaires. Discussion with people, staff and the manager indicated that residents had the chance to comment and influenced what happened in the home. As a result of these meetings a shower room is to be installed and transport arrangements in the home have been improved. Discussion with the manager and checking records and financial transactions confirmed that service users’ money is fully accounted for and kept secure. The manager ensures that the health and safety in the home is maintained. The fire records were checked and confirmed that all emergency lighting and fire exits are checked weekly and fire drills take place at least once a month. Accident reports are maintained, however, it was noted that the manner in which accidents are recorded should be changed to meet confidentiality legislation. Borough Care audits the accidents and incidents that are reported by Bamford Close. An analysis is developed and additional risk assessment and intervention put in place if required. Records also confirmed that the manager attended health and safety management meetings that aimed to promote the safety and wellbeing of those living, working or visiting the home. Maintenance records confirmed that electrical and gas safety checks were conducted in accordance with the relevant regulations. Record provided by the organisation established that health and safety training including first aid, infection control and food hygiene is provided to staff. Staff also said that they had received health and safety training. Bamford Close DS0000008538.V336842.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 4 Bamford Close DS0000008538.V336842.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. Standard Regulation Requirement Timescale for action 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 OP7 OP18 Good Practice Recommendations The registered person should ensure that the care plan reflects the actual needs of service users and how these needs are to be met. The registered person should take measures to prevent and reduce the risk of abuse by making sure that staff know what to do when abuse takes place between people living at the home. Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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 Bamford Close DS0000008538.V336842.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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