Inspection on 18/07/06 for Barrington House

This inspection was carried out on 18th July 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Barrington House 23/09/08

Barrington House 31/07/07

Barrington House 08/11/05

Barrington House 28/04/05

Barrington House 21/10/04

Barrington House 26/05/04

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

CARE HOME ADULTS 18-65 Barrington House Rye Road Ore Hastings East Sussex TN35 5DG Lead Inspector Jeanette Denereaz Key Unannounced Inspection 18th July 2006 09:00 Barrington House DS0000021040.V300101.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 Barrington House DS0000021040.V300101.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. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barrington House Address Rye Road Ore Hastings East Sussex TN35 5DG 01424 422228 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) Barrington House Limited Mrs Delize Pardii Care Home 26 Category(ies) of Learning disability (26) registration, with number of places Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is twentysix (26) 8th November 2005 Date of last inspection Brief Description of the Service: Barrington House is a large Georgian house situated on a prominent junction in the village of Ore on the outskirts of Hastings. It is convenient for main bus routes and is within walking distance of all local amenities. There is no lift in the home and wheelchair access is only available on the ground floor. The home is registered for 26 adults with a learning disability. Only people with a mild to moderate learning disability can be accommodated. The home has two people carriers for trips and transport to clubs. There is a lawned area to the front and side of the building of the house and a wheelchair ramp at the rear of the house allows wheelchair access. Limited parking is available on site. The current scales of fee are £350 per week. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection including a site visit, for the year running from April 1st 2006 to March 31st 2007. Time was spent with the registered manager, residents, staff and an evaluation of gathered information. Support staff on duty the cook and cleaner were interviewed during the visit. Selections of ‘Have you say’ surveys about Barrington House were sent to the home, service users supported by the staff completed 6. From information gathered most service users were happy with the care they received. The surveys invite service users to speak to the inspector, but only two service user requested an interview. However, during the visit all service users at home chatted to the inspector and one service user who had recently taken up residence spoke at length about his new home, and how happy he was. As part the inspection process six family members were also contacted and they all gave positive feedback, especially about how friendly and helpful staff were. The home also has a visitors comment book, which was seen by the inspector and comments they were also positive with comments made: • • • • The atmosphere is always good. The staff work hard, but with kindness and friendliness. The staff are ambassadors for your business The residents are always friendly, happy and look well; the staff are friendly and helpful. The inspector escorted by the registered manager undertook a full tour of the home, which included all the communal areas, bathrooms and some bedrooms. The management must now make the decision about the category of the home to ensure they are not in breach of the regulations, which has recently happened with the admission of the new resident aged 75 years old, without applying for a variation to the age limit of the home, which at present is service users only to be considered if they are under 65 years old on admission. Due to the nature of some of the service, it is difficult to reliably incorporate accurate reflections of the service in the report. Some judgements about quality of life and choices were taken from direct conversation with service users and their family, information received and observation followed by discussions with the management, service users, staff members and evidencing records held in the home. Also the Inspector contacted the care manager of the new resident, and she confirmed that her client was very happy and settled, and in felt this had been a good placement. Within the body of this report service users will be referred to as residents. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The management must now make the decision about the category of the home to ensure they are not in breach of the regulations, which has recently happened with the admission of the new resident aged 75 years old, without applying for a variation. The new resident was concerned that his did not have a room, which could be locked, which is used to and feel secure with his room locked when he is out. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 7 The registered manager informed the inspector that no bedrooms have locks and this has been in the past seen has a risk to Health & Safety. This must be reviewed and individual residents should be assessed and personal preference and personal security must be taken into consideration. Area of home are in need of redecorating and the carpet in the main hallway is in need of replacing due to a water leak. The registered manager informed the inspector that these areas are part of the maintenance and repair schedule. The registered manager must review the medication procedures, and to ensure both staff administrating medication are in view of the resident receiving the medication. 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. Barrington House DS0000021040.V300101.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 Barrington House DS0000021040.V300101.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3 & 4 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Prospective service users are given the information they need to make an informed choice about living at Barrington House. However, the registration of the home does not reflect the service, as this has become over the years a home for Older People with learning disabilities. Younger adults under the age of 50 years old would not be suitable candidates, and would not considered by the home. EVIDENCE: Since the last inspection two new residents have moved into the home. One of the residents was out for the day at her day service, but through her care plan, and her reply to the survey it was evident that she has settled well. She is 55 year old and her family live locally, and she continues to stay in contact with them. The inspector contacted the resident’s family as part of the inspection process and they confirmed their relative is very happy with her new home. The second new resident is also very happy and the home meets all his assessed needs and aspirations, but because of the home’s registration category of being a home for Younger Adults, and he being an elderly gentleman of 75 years Old, the home at the time of the inspection visit the home was in breech of the regulations. The home is in the process of applying for a variation, but for a permanent solution the home must review the category and conditions of registration. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. The registered manager and staff demonstrate their knowledge of the individual residents, and being a stable staff team the residents feel safe and cared living in the home, but staff should support residents to take calculated risks and be consulted on all aspects of life in the home. EVIDENCE: Since the last inspection the registered manager has reviewed all the care plans, and staff are encouraged to participate in the reviewing and writing of these documents. Since the home has adopted a no smoking staff room, this area is now conducive for reading and writing up care plans. All care plans have a recent photo of the residents and relevant information for staff to work from. There is a need for the registered manager and key workers to assess the issue of locks on bedrooms doors, as the new resident spoke to the inspector that he has always had a key to his own bedroom, and enjoys the security of knowing his room is locked when he is out. The registered manager was unaware of this request, and stated that the home has never had locks on bedrooms, this needs to be revised and all residents given the opportunity to have this independence in a risk assessed environment. Barrington House DS0000021040.V300101.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s links the local community are good and enrich residents’ social and educational opportunities. The home takes advantage of being near the town centre of Hastings and use a variety of day services that interest the residents. EVIDENCE: During interviews with the residents it was confirmed that they go out into the community on a regularly bases. The residents access local day services, and on the day of the inspection visit, a group of residents were getting ready to go out for lunch. Some were out to a day centre, and other were spending a quiet day at home. At the last inspection one resident expressed her disappointment at not being able to go to the local library, she now goes regularly and also other residents will collect books for her at other times. She is an avid reading and has a catholic choice of authors and subject matter. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 12 The new resident informed the inspector that he really enjoys living at Barrington House, and he often go out into the town and continues to meet up with his friend. He also loves to work around the home, and he enjoys helping to keep the grounds tidy. The inspector spoke to all the residents who were at home on the day of the inspection visit and most said they enjoyed living at Barrington House, and said they often went out. The home does have people carriers’ vehicles and a saloon car for the use of the residents. From information gathered from relatives it is evident that they are always made to feel welcome, and for one mother, who herself is very elderly, is often invited to Sunday lunch. All relatives spoken to by the inspector spoke very positively about the staff and manager. One care manager interviewed felt her client was very happy and settled at Barrington House, and she had found the home to always friendly and helpful, and felt the manager was very committed and hard working. The inspector spent time discussing the menus with the cook, the store cupboards were well stocked and the cook has a system to ensure the rotation of foods. The refrigerator and freezer temperatures are checked daily and recorded. The home has had a recent Environmental Health inspection, which was positive and the certificate is displayed in the kitchen. The residents interviewed all said they enjoyed their meals and the inspector was invited to lunch and the menu was sausage casserole or omelette and salad, and fresh fruit for dessert. Barrington House DS0000021040.V300101.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Personal and healthcare needs are well documented and supported, however, the management of medication and the procedures of giving out medication needs to be reviewed to ensure the safety of all residents. EVIDENCE: All residents interviewed spoke highly of the care and support they reviewed from the staff team. Also a relative spoke of the care of her relative within the home when the resident is going through psychotic and physical illnesses and the support she received when in hospital and her return to the home. The registered manager is in the process of reviewing all the policies and proededure of the home, and gave the inspector a copy of ‘Administration of Medication document’. The document states: ‘ The member of staff who is responsible for the administration of medication to clients must check that medication is taken by the client for whom ist is prescribed’. This was not the procedure observed by the inspector during this inspection visit. Two staff that were responsible for the administration of medication, but one staff member potted medication out in the kitchen. Given to another staff member who walked from the kitchen down the hallway to the dining room. The staff member who had responsibility for signing did not see the resident. The kitchen area was very busy, and not in view of the dining room. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 14 Due to the heat wave conditions the staff are adhering to an intake of fluids chart for each resident, which is kept in the kitchen area and be monitored by the manager. Ice creams and lollies are also being frequently offered as well as more drinks throughout the day. Barrington House DS0000021040.V300101.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 at least once during a 12 month period. 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. Residents and their relatives’ complaints would be taken seriously and investigated. Staff have the knowledge and understanding to take the correct action to safeguard residents from abuse. EVIDENCE: The inspector saw the complaints book, but there were recorded incidents since the last inspection. During the interviews with the staff and residents the inspector asked about the homes complaints ands concerns procedures. The residents that understood this concept all said they would speak to ‘Dee’ the manager and felt confident she would sort things out. The staff interviewed, which included the cook and the cleaner working on the day of the inspection visit, all had a good understanding about the protection of vulnerable adults and what they would do if they saw or were told of any form of abuse within the home. Family members spoken to also felt that if they had concerns they could always told to the staff. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,2627,28 & 30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The overall standard of the environment including the décor and furnishing are good and provide a homely and attractive place for residents to live. Improvement to the hallway would provide a pleasant environment for residents and visitor when entering the home. EVIDENCE: First impression of the home, now the outside has been painted and the gardens landscape are very grand, and on the day of the inspection visit all windows and doors were open because of the very hot weather. There was garden furniture and garden umbrellas set up for anyone wanting to sit in the gardens. Since the last inspection the home now employs a cleaner, and she is responsible for and all the communal areas, bathroom and bedrooms. The home was very clean and odour free during this inspection visit. There are areas of the home that are in need of redecorating and repair, and the hallway is in need of new carpet. The manager is aware of the areas in need or redecorating and informed the inspector that there is a maintenance schedule in place, and the hallway carpet will shortly be replaced. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 17 As discussed in standard YA9 the manager must ensure that the bedrooms within the home promote the independence of the individual residents and assess the issue of locks on the bedrooms doors. There are plans to build a conservatory off the lounge to improve communal living areas and give more space for residents, also it would provide more views of the village of Ore which some residents enjoys. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 &36 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s recruitment procedure. Staff have the skills to meet their needs and supports them. EVIDENCE: The inspector observed the staff working with the residents and was impressed with the respect and empathy shown by all the staff on duty. When questioned the staff had a good knowledge of the residents, and gave the residents a personal touch to their care, this is achieved by the established staff team working well together. The recruitment procedures for staff is robust and the inspector saw the staffing records for the newest of staff including the cleaner, and all information was in order and the necessary checks and references had been undertaken. The manager undertakes regular formal supervision with the staff, and she also monitors staff working practices throughout the working day, and records this information which she will use in supervision. She is always present during the day, and she and the responsible individual will often pop into the home at different times of the day and night. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 19 Training is very important to the management and the staff and all are encourage by the manager to undertake training. The care staff interviewed during this inspection visit were all on NVQ training or awaiting to start their courses. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,41 & 42 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, well-managed home that is run in their best interests and safeguards their rights. The manager has a good understanding on the area in which the home needs to improve, she has a clear plans and vision for the home. However, The management must now make the decision about the category of the home to ensure they are not in breach of the regulations, which has recently happened with the admission of the new resident aged 75 years old, without applying for a variation. EVIDENCE: There continues to be discussions between the registered manager and the CSCI as to the most appropriate registration category for the home. The majority of the resident are over sixty years old with many much older, and the manager fully understands that it would be inappropriate to admit any new service users who were much younger. It has been suggested that the home should consider changing the registration category to the Older People’s National Minimum Standards. However, this inspection was carried out under Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 21 the National Minimum Standards for Younger Adults. It came to the attention of the inspector when writing the report that because of the registration category being for younger adults, the newest service users was admitted out of category because of his age, when if fact his assessed needs are being met, and he is very settled. The registered manager and the Responsible Individual must made application for a variation to continue to accommodate the new service user who is over 65 years old on admission, and no other service users to be admitted who are over 65 years old until this is situation is rectified. All the health and safety documentation was seen to be in order from inspecting documents held in the home, an from information supplied by the manager in the Pre-Inspection Questionnaire sent to the CSCI on the 13th June 2006. Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 22 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 2 2 3 3 2 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 X 26 2 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 2 2 3 X Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA3 YA1 Regulation 4 ,5,6,12,16, See Schedule 1,See Schedule 4 (2) Requirement It is required the Registered manager and Responsible Individual must ensure that the information given to prospective service users reflect the home. This is in connection with the situation at the present time of the home’s category of registration, and thus not truly reflecting the aims, objectives and service offered of an elderly group of people with learning disabilities and not younger adults It is required the Registered manager must ensure that service users bedrooms are lockable if requested. The manager should reassess all residents in the home to establish that their privacy and choices are adhered to, as no bedrooms at the time of the inspection are lockable. It is required the Registered manager must review the procedure of given out medication, and the procedure should adhere to the home’s policy of guidelines of the DS0000021040.V300101.R01.S.doc Timescale for action 01/01/07 2 YA9 YA26 13(4)(b) 14(2) 01/10/06 3 YA20 18(1)(c) 18/07/06 Barrington House Version 5.2 Page 24 4 YA40 YA41 17(3) administration of medication, which clearly states the person giving out medication must check that the medication is taken by the client for whom it is prescribed. It is required the Registered manager and Responsible Individual must ensure that the information and records required by regulation and maintained, up to date and accurate. This is in connection to the category registration of the home, and the recent admittance of a resident who was over the age of 65 years old and no variation was applied for through the CSCI. 31/08/06 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 Barrington House DS0000021040.V300101.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 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 Barrington House DS0000021040.V300101.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. 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!