Inspection on 27/07/07 for Baronsmede

This inspection was carried out on 27th 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 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

Baronsmede 24/07/06

Baronsmede 06/03/06

Baronsmede 27/06/05

Baronsmede 15/03/05

Baronsmede 22/09/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Baronsmede Queens Road Crowborough East Sussex TN6 1EJ Lead Inspector Nigel Thompson Key Unannounced Inspection 27th July 2007 10:00 Baronsmede DS0000021039.V345703.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 Baronsmede DS0000021039.V345703.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. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Baronsmede Address Queens Road Crowborough East Sussex TN6 1EJ 01892 654057 01892 667457 baronsmedehomes@btinternet.com 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) Baronsmede Family Homes Ltd Mrs Norma Martin Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of residents to be accommodated is nine (9). Only service users with a learning disability may be accommodated. Service users should be aged between eighteen (18) and fifty-five (55) years on admission. Service users with additional physical disabilities requiring the use of a wheelchair should not be accommodated. Date of last inspection Brief Description of the Service: Baronsmede is a large detached house in a residential part of Crowborough near to the shops and other amenities. The house provides care for up to 9 adults with a learning disability. Seven of the nine rooms have en-suite facilities. Communal facilities include a lounge, dining room lounge and a conservatory. There is a large garden with a patio to the rear of the house. Baronsmede is one of three homes owned by Baronsmede Family Homes Limited. Day care services are provided at the organisations day centre that is situated nearby. The proprietor has not notified the Commission for Social Care Inspection of the fees charged to service users of the Old Hay Barn. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five and a half hours in July 2007. It found that the majority of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was good. Service users observed and spoken with during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were seven service users living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the home’s records and discussion with three service users, three members of staff, the Registered Manager and the Registered Provider. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: After a difficult year for Baronsmede, on many levels, it is acknowledged that a lot of time and effort has been put in and a lot of commitment shown by many people to address previously identified shortfalls. Residents at the home clearly benefit from having an experienced manager and dedicated staff team who are evidently committed to providing consistent and high quality care. Staff work closely with service users and have developed a sound understanding of their individual care and support needs. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 6 The relaxed, homely and welcoming environment has evolved over many years and reflects the commitment within the staff team and the open and inclusive management style. Residents are encouraged and supported to make decisions about their lives. They are involved and regularly consulted on many aspects of life in the home, including menu planning and activities. Staff receive effective induction and foundation training, regular supervision and are clearly valued and supported by the manager and owner. 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. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 7 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. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 8 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 Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3 & 4 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective service users know that the home is able to meet their individual care and support needs. EVIDENCE: Although there have been no service users admitted to Baronsmede for more than two years, comprehensive information relating to the home is made available to all prospective residents, their relatives and associated care managers. Relevant documentation including an updated Statement of Purpose ‘ and ‘Service User Guide’ was examined and found to be satisfactory. Clear admission criteria and a thorough pre-admission assessment of each prospective service user, which incorporates a comprehensive breakdown of all personal, emotional and social care needs, ensures that all identified needs can be met. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 10 The manger confirmed that Baronsmede continues to maintain a good working relationship with the local Community Learning Disability Team (CLDT), who consequently have a sound understanding and awareness of the suitability of the home and the range and quality of the services provided. A referral to the home from the CLDT consists of a thorough Social Care Assessment and any additional relevant reports. The manager will also visit the prospective service user and carry out a full pre-admission assessment, including any personal and emotional care and support needs, mobility issues, social and cultural needs and family involvement. In addition to establishing whether the individual’s care and support needs can be met within the home, the manager also stressed the importance of ensuring compatibility with existing service users. As well as being invited to visit the home to look around and meet with existing residents and staff, prospective service users have the opportunity to stop overnight before moving in. The manager confirmed that all new residents undergo a flexible trial period at the home, during which time their suitability and compatibility are fully assessed and it is established whether their identified care and support needs are able to be met. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 11 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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. High quality service users’ care plans enable staff to meet assessed needs in a structured and consistent manner. Individual plans, including risk assessments are regularly reviewed to reflect changing support needs. Systems for consultation and participation remain effective and service users are treated with respect and encouraged and enabled to make decisions about their dayto-day living. EVIDENCE: High quality, ‘person centred’ care plans have been developed for each service user, clearly linked to the individual’s assessed needs. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 12 The plan is formulated by the key-worker, manager and evidently with the direct involvement of the resident themselves or family member, as appropriate. Staff spoken to during the inspection confirmed that, despite the variable and limited verbal communication of many residents, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting service users in a professional, sensitive and respectful manner. The proprietor emphasised the importance of staff developing close working relationships with individual service users and being aware of often subtle changes in their mood or condition. The manager confirmed that service users and, where appropriate, a relative or representative have the opportunity to be involved in care plan reviews. In plans that were examined, it was evident that recent reviews had taken place. Independence and individuality is evidently encouraged and promoted within the home and is reflected in the personalising of service users’ rooms, the choice of bedclothes and colour schemes and individual preferences for occupational and leisure activities. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 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. Service users are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Service users benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The recreational and leisure interests of residents are identified and recorded in their individual care plan and they continue to be supported to access activities and facilities, reflecting their individual needs, preferences and abilities. An individual activities programme has been developed for each service user Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 14 Community participation remains a focus in the home and service users are evidently encouraged and supported to visit the cinema, theatre, local shops and other amenities. The manager confirmed that, where appropriate, service users’ family links are encouraged and supported, however not all residents have regular family contact. Visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. Menus are varied and balanced and are based on service users’ identified likes and preferences. An alternative to the main meal is always available. It is evident that the format for menus has been improved and is now more accessible. Daily menus have been imaginatively developed and make effective use of coloured photographs of individual meals. A member of staff confirmed that, where appropriate, residents have the opportunity to be involved in meal preparation. This was supported by one resident, spoken with during the inspection: ‘I sometimes like helping in the kitchen’. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with service users and demonstrate an awareness and sound understanding of their individual care and support needs. Service users are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. EVIDENCE: In accordance with their care plan, service users are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, staff were observed interacting with residents in a professional and respectful manner. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 16 Documentary evidence was in place to demonstrate that the health and emotional care needs of residents are continuing to be met within the home. All service users are registered with local GPs and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. It was noted, in care plans that were examined, that all appointments with, or visits by, health care professionals are recorded. Staff spoken to during the inspection confirmed that service users are supported to access a range of health care professionals in the community. The home continues to work closely and effectively with the Community Learning Disabilities Team, which provides support and guidance in addressing service users’ psychological healthcare needs. Up to date, detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. The home uses a monitored dosage system (MDS) for the administration of prescribed medicines and a local pharmacist continues to carry out quarterly monitoring visit. In house staff training is provided in the control and safe handling of medicines. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that service users, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Service users are protected, through policies and procedures relating to abuse and adult protection. EVIDENCE: A clear, simple and accessible complaints procedure has been developed for the benefit of residents, their relatives and other visitors to the home. All complaints are recorded and include actions taken and outcomes achieved. Close working relationships, effective and ongoing communication and consultation and residents’ meetings provide adequate opportunities for any concerns to be raised and discussed, before they become complaints. Residents and members of staff, spoken with during the inspection, confirmed that they would have no hesitation in speaking to the manager or making a complaint if necessary and each person was confident that they would be listened to. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 18 It was noted that there have been no concerns or complaints recorded by the home since the last inspection. The home has produced detailed policies and procedures, recently reviewed, relating to adult protection and abuse, including a whistle blowing policy. These documents have evidently been drawn up in accordance with the multi agency guidelines for the protection of vulnerable adults (Safeguarding adults). The manager and all care staff have undertaken appropriate training regarding abuse awareness and adult protection procedures. This was supported through discussions with members of staff during the inspection and evidenced through individual training records. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for it’s stated purpose. Service users benefit from all necessary specialist equipment and pleasant accommodation that is comfortable, well maintained and decorated to a satisfactory standard. EVIDENCE: During my ‘guided tour’ of the premises it was evident that the generally well maintained décor and adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for service users. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 20 In addition to the routine refurbishment and redecoration other changes in the physical environment at Baronsmede were noted: New woodblock floors have been fitted to the conservatory, office and small lounge areas, which have then been redecorated and new furniture provided as necessary. Several of the residents’ bedrooms have been repainted according to the preferences of the individuals concerned, with new furniture and carpets provided where needed. Furniture in the lounge area has been replaced, and a new carpet fitted. It was also noted that several en-suite rooms have also been recently upgraded, including one with specialist aids. The manager confirmed that independence and individuality continue to be promoted within the home and this is evident from the personalising of service users’ individual rooms, reflecting individual preference and interests. It was noted that infection control policies and procedures are in place and clearly adhered to. On the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 &36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There is always sufficient trained and competent staff on duty to meet the assessed needs of the service users. Service users are protected by satisfactory staff recruitment policies, procedures and documentation. EVIDENCE: From the staff rotas examined and through discussion with the assistant manager and care staff, it is evident that sufficient staff are employed to meet the current assessed needs of residents and to ensure consistency and continuity of care. The manager confirmed that staffing levels are closely monitored and are directly linked to service users’ levels of dependency. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 22 There are currently seven members of staff who hold the National Vocational Qualification (NVQ) level 2, or above. This represents 50 of all care staff in the home. More staff are currently working towards this award. The manager also confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. This was confirmed through discussions with staff and supported by effective training records examined: ‘There are always plenty of opportunities for training here’. Formal supervision is provided for all care staff on a regular basis. This was evidenced by effective supervision records examined and through discussions with staff, spoken with during the inspection, who acknowledged the benefits of effective supervision and confirmed feeling valued and supported by the manager and owner: ‘Supervision is good. I find it very useful and the manager is always very supportive’. The manager is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of residents. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users benefit from a competent and experienced manager and are protected by satisfactory health and safety procedures. Their best interests are safeguarded by effective quality monitoring systems. EVIDENCE: The registered manager is competent in her role and experienced in the running of the home. She has been in her current post for eighteen years, is working towards her Registered Manager’s Award (RMA) and expects to complete later this year. Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 24 The manager has undertaken the necessary relevant training in order to ensure that her knowledge, skills and practice are up to date. She has a relevant job description that details all areas of responsibility and accountability. The organisation has achieved the ‘Investors In People’ and following a reassessment of their standards last year the award has been renewed. Quality assurance questionnaires have been sent out to parents and other professionals and the results of these have been incorporated into a report. Through discussions with residents and members of staff, it is evident that the manager continues to demonstrate a clear sense of leadership and direction. She is clearly motivated, positive and approachable and continues to create an open and inclusive atmosphere within the home. The manager confirmed that the health, safety and welfare of service users and staff remain of paramount importance within the home. As previously documented, staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is satisfactorily recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Temperature regulators are fitted to all hot water outlets, accessible to service users. All accidents, incidents and injuries are recorded and reported, as required Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 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 3 X 3 X X 3 X Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 26 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. Refer to Standard Good Practice Recommendations Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Baronsmede DS0000021039.V345703.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!