Inspection on 27/02/07 for Baytree House

This inspection was carried out on 27th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Baytree House 31/01/06

Baytree House 14/06/05

Baytree House 17/01/05

Baytree House 14/12/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Baytree House 423 Unthank Road Norwich Norfolk NR4 7QB Lead Inspector Jenny Rose Unannounced Inspection 26th February 2007 10:30 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 Baytree House DS0000027308.V331692.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. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Baytree House Address 423 Unthank Road Norwich Norfolk NR4 7QB 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) 01603 458503 01603 503528 Baytrhs@aol.com Mr Thomas Paul Hanley Mrs Sandra Elizabeth Hanley Not applicable Care Home 16 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (16) of places Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: Baytree House is a care home providing personal care and accommodation for up to 16 older people with one terminally ill bed/service user. Baytree House is a detached Edwardian property situated in its own grounds in the city of Norwich. Bedrooms are on the ground and first floors and consist of sixteen single bedrooms, seven of which have en suite facilities. The home has three communal areas for the use of service users and a passenger lift to assist service users from ground to first floor. There is car parking to the front and well maintained gardens to the rear of the premises. Baytree House DS0000027308.V331692.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 key inspection lasting 7 hours. A pre-inspection questionnaire had been completed by the proprietor/manager and returned to the Commission with all relevant details. Seven comment cards had been received from residents and five from relatives. All comment cards were positive and stated that they were satisfied, two at least were very complimentary, with the overall care in the home. The proprietor/manager was available throughout the inspection and was helpful in facilitating the process. During the inspection a tour of the building was carried out and records relating to staff and residents were inspected. Three members of staff were spoken to in private as well as two visitors. Several residents were spoken to in passing, three in private. The information from the comment cards and from the people spoken to has been incorporated in the report. Overall the information received prior to the inspection and the information and evidence observed and inspected on the day of inspection suggested that Baytree House is an excellent service; offering good quality care and examples of best practice for those who live there. What the service does well: • • • • • • The building and surrounding gardens offer a well-maintained, comfortable, and homely environment for the residents. The home does not accept a resident unless assessments are made and identify that the resident’s needs can be met in the home. There is an enthusiastic and stable staff team, happy in their role, with excellent training opportunities. Creative activities are available based on individual and group requests. All residents spoken to expressed satisfaction with the meals in the home and there is good choice both of food and where it is eaten. Relatives and friends are welcomed into the home at any time and are involved with decisions regarding care, if appropriate. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 6 • There are excellent management systems and commitment by the management to quality monitoring and continuous improvement guided by the residents’ best interests. One comment from a relative’s comment card noted that, “Baytree House is a ‘home from home’ and exactly what I would wish for any person having to depend on residential care. A very personalised approach is given and having been the main carer prior to my relative entering Baytree my opinions and comments have been sought”. • What has improved since the last inspection? There were no requirements nor recommendations made at the last inspection, however, continuous improvement as result of the home’s quality assurance system has resulted in: • • • • • An extended menu being developed as a direct result of residents’ requests. More attention being given to the laying of tables for meals. More attention to how residents wish to be addressed. The development of “Do Not Disturb” notices to be used on residents’ doors, if so wished. There has been extensive and pleasant redecoration, particularly in corridors, lounge, and kitchen; also new tiling in laundry and toilet areas, as well as new curtains in the lounge and conservatory. The home has produced a new Service User Guide in line with new developments. More detailed nutritional assessments have been introduced in individual care plans. The communal phone has been upgraded to a cordless phone to enable residents who do not have a phone in their room to talk in private. • • • What they could do better: • There was nothing apparent on this occasion. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 7 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. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 8 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 Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 9 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are made prior to admission and the residents living in the home are having their assessed needs met. The home does not offer intermediate care. EVIDENCE: All the comment cards from residents confirmed that they had received enough information about the home before they moved in. “I think it is essential to visit the home before one moves in, in order to get the smell and atmosphere of the place”, commented one. One resident spoken to said that her relatives had visited the home and told her about it and she thought they had made a very good choice. She now lived near her family who visited often and took her out. “I am very happy here”. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 10 Three care plans were examined and all had evidence of assessments by the manager before admission. The most recent resident had moved from another home and there was detailed information from this home, together with healthcare professional assessment and evidence from the preassessment of the resident’s and relatives’ involvement. The most recent resident had recently completed a questionnaire following her first month’s stay. The new, revised, Service User Guide was seen and those issued to existing residents contained a contract and statement of terms and conditions, as well as other required information, including advocacy services and information on fees. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 11 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. Residents’ health and personal care needs were set out individual care plans. Residents felt they were treated with respect and that their privacy was upheld. The home has good medication management systems in place. EVIDENCE: Three care plans were inspected and each file contained a comprehensive resident’s plan detailing the overall needs of each individual. All care plans had a photograph and relevant details in case of emergency. One resident had recorded her consent for her photograph to be included in her care plan and another included wishes for her funeral. Continence needs, nutritional needs, as well as assessments for daily living, charts for diabetes, and the involvement of District Nurses, Psychiatric Nurses, Occupational Therapists and other healthcare professionals, where necessary were recorded. GP and Consultant visits were recorded separately within the plans. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 12 Activities and social needs were recorded and residents and visitors spoken to and the completed comment cards confirmed that residents’ healthcare needs were being met and changing needs monitored with regular reviews. All care plans were consistently reviewed and regular audits undertaken. Medication practice was observed at lunchtime with the help of the senior carer responsible for the medication on the day of the inspection. Practice observed was good and records seen were correct. All staff who administer medication have had the appropriate training. The home uses the Nomad system and the Pharmacy Assistant was present in the home during the afternoon collecting and checking returned medication. Monthly audits are undertaken as part of quality monitoring process. Controlled drugs are stored in a metal cabinet in the locked medication cupboard and the record completed by two people. There were no residents who were entirely self medicating, but risk assessments were in place for those who were partially administering their own medication and there were lockable facilities for safe storage in residents’ rooms. All residents spoken to and evidence from observation confirmed that residents were treated with respect and that their privacy was protected. All interaction between residents and staff was positive and visitors spoken to and comment cards confirmed that relatives could see residents in private if they wished. Following a quality audit, ‘Do not Disturb’ notices had been produced, for residents to use on the outside of their doors, if they wished. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 13 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 excellent. This judgement has been made using available evidence including a visit to this service. Activities take place on a regular basis and there are creative ideas employed in individual and group programmes. Relatives are made welcome in the home. The food provided is wholesome and nutritious. A choice of menu is available and food is served in a variety of comfortable areas. EVIDENCE: Five comment cards stated that there were always activities taking place in the home, which they enjoyed. One comment was “I thoroughly enjoy them. I take part in everything.” One person stated that there were sometimes activities taking place and another that there sometimes were. The home has a commitment to produce a programme of activities based on requests and residents’ previous social experiences. There have been talks on Medieval Norwich, Nelson and Norfolk, Weaving in Norfolk, Gardening and Wildlife in Norfolk. The Mothers’ Union visit; there are Extend classes once a week, hairdressing, Communion, Reminiscence. One resident spoken to said she particularly looked forward to the latter. There are also musical afternoons with various artists and one resident’s family have put her favourite music on an IPOD, which staff help her to use. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 14 Residents had been playing Scrabble on the afternoon of the inspection. The home has many residents who can express their views and preferences very well and there is a regular newsletter, which the residents spoken to said they appreciated. Two visitors were spoken to on the day and others were seen coming into the home. One relative said she came as often as she could and often helped with her mother’s care out of choice. Residents decide when they get up and go to bed, when they bath, what they have at meal times, where they choose to sit in the communal areas, including where they choose to eat their meals and whether or not they choose to stay in their own rooms. One resident said she goes out regularly with her family and the manager confirmed that this was the case for several residents. As a result of a quality assurance survey, the menu was widened to include mild curries and Chinese and Italian dishes. There is always a choice of at least two dishes at lunch time and also a cooked High Tea. On the day, there were three dishes served and attention given to individual likes and dislikes. One resident spoken to said that “the food is very good, we have choice and we have been asked today”. The visitors spoken to also confirmed that the food was good. Five comment cards recorded that the meals were always enjoyed and two said they usually were. As well as a catering qualification, the cook has an NVQ in care. Residents’ nutritional needs are assessed on admission and the information arising from these is available to her, as well as residents’ needs for special and/or soft diets. The home has recently been awarded 5 stars by the Environmental Health Officer for the catering arrangements. Residents choose where to eat; three residents were in the lounge, some in a dining area near the kitchen and others in a pleasant conservatory dining area. Some residents may choose to eat in their rooms. One comment card contained a comment about a wait to be served in the dining room sometimes, but this had been addressed in a recent questionnaire and included in the Quality Audit Report. Baytree House DS0000027308.V331692.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. All residents and visitors spoken to on the day of the inspection were aware of what to do if they wished to make a complaint. The home has a policy and procedures to ensure that residents are protected from abuse. EVIDENCE: The service users’ guide has a clear and accessible complaints procedure. All the residents and visitors spoken to were aware of how to make a complaint, should the need arise. Three comment cards recorded they would always know how to make a complaint, three that they usually would and one resident would ask her advocate, should there be a reason to make a complaint. Five comment cards from relatives revealed that they were aware of the home’s complaints procedure, four had never had to make a complaint and one had had occasion to make a minor complaint about laundry, but this was dealt with satisfactorily by the home. The home had received no complaints and none had been received by the Commission and the manager reported that there had been some discussion at staff meetings about what constituted a formal complaint and everyday concerns which needed attention, such as problems with laundry. She reported that the home’s policy was to deal with these concerns as they arose Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 16 and action was documented. This was corroborated by one relative’s comment card. The home has a policy and procedure with regard to the safeguarding of vulnerable adults and all staff spoken to were aware of the whistle blowing policy. The manager is the representative for the National Association of Care Homes on the Vulnerable Adult Protection Committee and is well informed about the issues of protection. Training Profiles confirmed that all staff have received training in the Protection of Vulnerable Adults. Baytree House DS0000027308.V331692.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 home provides a comfortable, well maintained, safe and homely environment which meets the needs of the residents. EVIDENCE: Overall the quality of the environment is good. Private and communal accommodation is comfortable and homely. Residents and relatives expressed their satisfaction about the homeliness of the environment and also their individual rooms, which were seen to be personalised. A number of areas have been pleasantly redecorated, recarpeted and curtains renewed recently in the lounge and the large conservatory. Flooring had been replaced in one bathroom, toilet and the laundry. The home has a pleasant rear garden, which is well maintained and accessible to people who use wheelchairs and to those with restricted mobility. There is a great deal of seating and colourful planting outside residents’ windows with views over the garden. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 18 The communal telephone has recently been upgraded to a mobile handset, so that residents may receive phone calls in private, should they not have their own private line. There is a good standard of cleanliness in all areas of the home seen and one resident’s comment card said of the hygiene… “very good standard”, and six others reported that the home is always fresh and clean. The manager reported that the home has recently reorganised the cleaning schedule, giving domestic staff responsibility for certain areas of the home and also in July 07 employed a second cleaner in the kitchen. Baytree House DS0000027308.V331692.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. The management ensure that good staffing levels are maintained. The safety and welfare of residents is ensured by an excellent training programme for the manager and the staff team. The recruitment practice further ensures the safety of residents, although there is a stable staff team with no recent recruitment. EVIDENCE: One resident spoken to said, there is a “nice atmosphere…staff are very kind.” A copy of rota for the inspection week showed three care staff on in the mornings, two in afternoon, one member of staff waking at night, with a sleepin carer as backup if needed. Many of the staff have many years care experience. All the comment cards reported favourably on the availability of staff. There is a keyworking system in operation, the keyworkers, who are senior staff, are responsible for the reviews and liaising with relatives. Tasks are rotated between all the care staff, who work as a team, and they all spoke of good handover times being allowed between shifts. The Pre-Inspection Questionnaire showed the number of staff hours provided are above the average and 69 of staff hold an NVQII qualification. There is an excellent training programme and the management are committed to training for all members of staff. Future training is to include a study day on evaluating care Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 20 plans and Vision in the Elderly. All staff administering medication have received appropriate training. Three members of staff, were spoken to in private and four staff files examined as well as training folders. They all described the staff team as very friendly. Staff meetings were held every month, these were minuted and circulated to those who could not attend. Each one spoke of the many opportunities for training provided by the home and the support given individually by the manager for staff to complete qualifications, whatever their role within the home. There have been no new members of staff since the last inspection, as the manager values the stable staff team. However, the staff files examined showed that all the documents required were in place. All new staff are required to complete an induction programme leading to foundation training and then to NVQ. Baytree House DS0000027308.V331692.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 excellent. This judgement has been made using available evidence including a visit to this service. The home is run and managed by a person who is fit to fulfil her responsibilities fully. The home is run in the best interests of the residents with good examples of best practice. The home encourages residents for whom it is appropriate to manage their own finances. The home actively promotes the health, safety and welfare of residents and staff. Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 22 EVIDENCE: “This is a quite outstanding private home with truly superb owners and staff” is one of the comments on a relative’s comment card. The owner/manager is a qualified nurse with much experience and has completed a registered manager’s award. Staff and relatives spoken to spoke of the open and inclusive management style in the home. The manager is committed to keeping abreast of new developments and updating policies and procedures at the home in line with these. Evidence of this was the detailed nutritional charts now included in individual care plans. She is also an NVQ Assessor. All the staff spoken to confirmed that they were regularly supervised on a one-to-one basis by the manager and that the annual appraisal was linked to a training needs analysis and this was evidenced in the files seen. There is an excellent quality assurance system, which takes into account particularly the views of residents, as well as their relatives and staff. There are many examples of these views being taken into account. Residents had given their views that the laying of tables for meals was important and all members of staff were instructed in this, another example was how residents’ wished to be addressed and this is now included in care plans. The last quality audit report published in July 2006 instituted improvements in Management Reviews as well as improvements in Care Plan Reviews, the activities programme, kitchen cleaning, as well as producing an extended menu. The Pre-Inspection Questionnaire and the manager confirmed that the home does not handle residents’ finances. These are either managed by the residents themselves, their families or advocates. Residents are billed monthly for personal expenditure such as hairdressing and newspapers and records kept, which were seen. There is a comprehensive, professionally produced, Health and Safety Risk Assessment for the house, including records for central heating, lift and hoist maintenance and evidence of PAT testing, Fire Officer visit and Maintenance of Equipment and the visit of the Environmental Health Officer visit recently gave the home a five star rating. Baytree House DS0000027308.V331692.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 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 4 X X 4 X 4 Baytree House DS0000027308.V331692.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. Refer to Standard Good Practice Recommendations Baytree House DS0000027308.V331692.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Baytree House DS0000027308.V331692.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!