Inspection on 07/09/07 for Beechwood House

This inspection was carried out on 7th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

Beechwood House 15/07/08

Beechwood House 29/01/08

Beechwood House 29/06/06

Beechwood House 29/11/05

Beechwood House 15/06/05

Beechwood House 19/11/04

Beechwood House 23/06/04

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

1 Marten Road

St Joseph`s

Ridgemount

Wingham Court

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

CARE HOMES FOR OLDER PEOPLE Beechwood House Woodberry Lane Rowlands Castle Havant Hampshire PO9 6DP Lead Inspector Anita Tengnah Key Unannounced Inspection 7th September 2007 10:00 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 Beechwood House DS0000049982.V344990.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. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beechwood House Address Woodberry Lane Rowlands Castle Havant Hampshire PO9 6DP 023 9241 3153 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) Rowland Court Healthcare Ltd Position vacant Care Home 37 Category(ies) of Dementia (10), Dementia - over 65 years of age registration, with number (37), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (9), Old age, not falling within any other category (37) Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A maximum of ten service users may be admitted in the category Dementia (DE), all of whom must be aged over 45 years. 29th June 2006 Date of last inspection Brief Description of the Service: Beechwood House is registered to accommodate and provide personal care to thirty-seven older people, including nine with either dementia (DE (E) or a mental health problem (MD) (E). It has also recently registered to provide care for up to ten service users who are younger adults with dementia. Rowland Healthcare owns the service and has a number of care and nursing homes in Hampshire. The home is located in a quiet residential area, close to the centre of Rowlands Castle and within easy reach of local shops, amenities and public transport. Services not included in the fee are hairdressing, chiropody, newspapers and magazines, personal telephone lines and personal toiletries. The current fee charged is £415-£480 per week. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit to the service was undertaken as part of the inspection on the 7th of September 2007. The process included a tour of the service where a number of the bedrooms, communal areas, kitchen, and bathrooms were viewed. As part of case tracking 5 staff and 6 service users views were sought and care records were looked at. Information gained from the Annual Quality Assurance Assessment (AQAA) was also used and included in this report, as was information gathered by the commission since the last inspection to contribute in assessing judgements in this report. Positive comments were received from the service users regarding the care that they were receiving at the home. The commission received 10 comment cards from the service users and some contained input from their relatives. Care practices observed at the time of the visit showed that the staff and the service users had developed good relationships. What the service does well: What has improved since the last inspection? Twenty- three of the bedrooms has been refurbished and provides the people using the service with a homely environment. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 3,6 The pre admission assessment process is good and ensures that the people using the service needs are assessed and the home can meet them. The home does not provide intermediate care. EVIDENCE: The care records of two recently admitted persons were looked at as part of case tracking. Pre admission assessments of needs were carried out and staff reported that this information is used to formulate their initial care plans on admission. Assessments of needs included dietary needs, likes and dislikes, mobility and mental status. There was no evidence that the service users/ family were involved in the assessments, this should be developed in order to Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 9 ensure that all care needs are identified prior to admission. Discussed with the staff that care manager’s assessment must be sought and form part of the pre admission assessment process as appropriate Comment cards received indicated that the family visited the service and staff reported that the people using the service did not usually visit due to their frailty. Information received indicated that the people using the service did not always receive adequate information prior to moving in. The statement of purpose was not available on the day of the visit, this was discussed with the provider who reported that the home was producing a new brochure and the statement of purpose would be made available as required. The home does not provide intermediate care. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 7,8,9,10 The care plans and records of care given need further development to ensure that staff have clear information about how the assessed needs of people using the service would be met. The health care needs and access to external agencies are satisfactory, however some aspects of medication management do not meet people needs and puts them at risk. The home’s staff treated the people using the service with respect. However their right to privacy was not always upheld when receiving treatment. EVIDENCE: The care plans of 3 people were seen as part of this visit to look at how the home plans to meet the needs of the service users. The care plans contained information about the assessed needs of the service users. These included Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 11 assessments such as mobility, diets, continence, and mental status. Night care plans were also in place. The care records seen showed that assessments had identified people with indwelling catheters, risk of falls and wandering during the day and night times. However there was no guidance or action plan in place to demonstrate how these assessed needs would be met. The care plans must contain action plan for the staff in order that care could be delivered in a consistent manner. There was no evidence that the service users/ advocates, family were involved in these assessments and care planning. This is an area that requires further development as most of the people using the service have varying degree of dementia and would not be able to participate in their care planning. One of the people using the service raised issues about the way staff attended to his personal care on the day of the visit. The care plan seen did not contain details of how his personal care needs would be met in particular when he has a bath. This was brought to the attention of the provider and must be addressed. All the service users are registered with three surgeries. The manager reported that the home had good relationship with the local primary care trust and the people using the service were supported to access health care services as required. The staff reported that the district nurses were available for advice and one of the people was receiving treatment for leg ulcers. The GP did not undertake regular visits to the home but was available on request. A random sample of the Medication Administration Record as maintained by the home was looked at. Records were maintained of medication administered and there was one person who was administering his own medication at the time of the visit. Lockable storage facility was provided in the person’s room. All other medication was locked safely. The provider reported that only the staff who had completed medication training administered the people using the service medication. A requirement was raised at the last visit for the registered person to ensure that a record of all the people using the service medication to be maintained. Record seen indicated that on a number of occasions medication received had not been recorded appropriately to include dates and quantity received. This requirement has not been met. A further requirement would be made from this report. There were also discrepancies relating to variable dosages that were not recorded. Staff when transcribing onto the MAR sheets did not record the frequency and dosages for some medication. It is also strongly recommended that hand-written charts by carers that are not checked by the GP are checked by a second person and referenced back to the original prescription to reduce the potential for error. Please refer to the Royal Pharmaceutical society guidelines. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 12 The record of medication stored as controlled drug was looked at as part of the visit. This indicated that staff were pre recording the total amount left prior to dispensing the medication. It was noted that medication that was stored as controlled drug for one person using the service was missing/ could not be accounted for. This has been reported to the pharmacy inspector for further investigation. The home must ensure that written confirmation is obtained from an authoritative source for medication brought in by relatives following admission prior to this being administered. The manager must ensure that a review of medication management is undertaken and appropriate action taken to ensure that staff follow the guidelines as set by the Royal Pharmaceutical Society for the management of medication in the care homes. Comment cards received and interaction observed throughout the visit indicated that the people using the service and the staff had developed good relationships with each other. People were supported and spoken to in a respectful manner. Comments included “ my mother is very happy with the care she receives and thinks a great deal of the staff.” On the day of the visit one of the service users was distressed and raised concerns that “ the staff bossed him about” and also he was not allowed to watch television downstairs and was asked to go to his room to watch television. Other issues he raised were about his personal care. The responsible person was aware of these issues and said that she would be looking into this. The manager is aware that the staff must ensure that the people using the service have their autonomy and choice respected at all times. It was noted that some of the people using the service were receiving treatment such as chiropody in the communal lounge. This was brought to the attention of senior staff, as this practice does not promote the privacy and dignity of the people living there. Beechwood House DS0000049982.V344990.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 12,13,14,15 The social and recreational facilities for the service users are satisfactory. The service users are supported to maintain links with their family and friends. The meals are varied and meet with the satisfaction of the service users, however the people involvement in making choices about meals must be further developed to ensure all needs are met. EVIDENCE: The home has a planned programme of activities for the people using the service. The home employs an activity coordinator for sixteen hours a week and activities available included games, bingo, and reminiscence. There are monthly external entertainers and arts and crafts. Comments received indicated that they were satisfied with the activities provided and one comment was “I enjoy the bingo”. Staff reported that recent event included a tea dance in conjunction with help the aged that was successful. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 14 The home has an open visiting policy and it was evident from the record of visitors as kept by the home that there was no restriction on visiting. Comment received confirmed that they have autonomy to receive their visitors in private. Comments included “ I am always made welcomed when I visit”. The home has a planned menu that staff reported is rotated on a four weekly basis. Meals were observed on the day of the visit that was taken in the communal dining room. Lunchtime meal appeared well presented and looked appetising. Staff were available to offer support with meals as required. Comments received were that “the meals are always very good”. A record of meals taken was maintained, however there was no record of meals/ desserts for people who were on diabetic controlled diets. This was brought to the attention of staff and must be addressed. One of the service users was unhappy about the meal at lunchtime as he was expecting battered fish and was offered fish fingers. It was unclear how meals choices are offered to the people living at the service, in particular at lunchtime as all the people were offered the same meal. However the record of food for teatime meals were more varied and offered choices. This was discussed with staff and must be developed further to ensure that needs are fully met. Beechwood House DS0000049982.V344990.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 16,18 The complaint management is good and the service users are confident that their complaints would be listened to. Staff have clear understanding of adult protection and ongoing training is available. EVIDENCE: The manager maintained a complaint log of complaints received. The home had received three complaints since the last visit. Record seen showed that these were investigated and one of these involved safeguarding adult team. The family were also involved throughout the investigation process and all of these have been resolved. The staff spoken with had clear understanding of adult protection issues and what they need to do if any allegation is reported to them. The staff reported that further training in the prevention of abuse was planned for new staff. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 19,26 The home provides the service users with a high standard, clean and wellmaintained accommodation that meets their needs. The infection control procedures at the home are good and ensure that the service users are protected. EVIDENCE: Some parts of the building were looked at as part of the visit and included some bedrooms, communal lounges, bathrooms, kitchen and the laundry. It was evident that the home has an ongoing programme of refurbishment. Recent refurbishment included twenty- three of the bedrooms and the Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 17 communal lounges. A shower facility was near completion on the ground floor that would benefit people with limited mobility and access for hoist. The people using the service are provided with a warm and welcoming environment to live in. The bedrooms seen were personalised with call bells access available. Furnishing was of very good standard and appropriate to the needs of the service users. It was evident that the service users are encouraged to bring in items of personal belongings on admission. The home has a laundry where all the service users laundry is undertaken internally. The laundry room was clean and well equipped. The washing machines were fitted with sluicing facilities. Information on infection control was available. Staff practices observed indicated that they were aware of them and used protective gloves and aprons as needed. It was noted that one the commodes in a bedroom was rusty and pose an infection control risk, as this would not be able to be cleaned adequately. The responsible person agreed that this would be replaced. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 18 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): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. 27,28,29,30. The staffing numbers are adequate to meet the present needs of the service users. The home has system in place to ensure that staff have the skills to deliver care safely. The recruitment process does not ensure that staff are eligible to work in this country. There is a training programme in place to ensure that staff are supported in their work. EVIDENCE: A sample of the duty roster was looked at as part of this visit. This indicated that there is 4 staff on the morning and late duties. Night duty has two staff. The provider reported that as this was adequate as the home has only 26 people living there at present. The staffing is reviewed according to the needs of people using the service. Staff spoken with said that staffing was “all right”. Comments from the questionnaires five of them indicated that “usually” and three said “always” when asked if staff were available to meet their needs. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 19 Comments included “some of the staff are natural carers”. Other comments were “ some do not have the right manners to deal with older people” and “sometimes night staff don’t listen and the “nurse is very good”. This was discussed with senior staff and would be looked into. Information received from the AQAA indicated that three staff have completed National Vocational Qualification (NVQ) at level 3 and three at level 2. There was one staff who was undertaking NVQ 4. There is an induction programme in place and the manager reported meets with Skills for Care guidance. A sample of the staff records was seen and this indicated that staff completed an application form and references are sought prior to employment. The home undertook checks such as CRB and POVA first checks prior to employment. There were no records of their eligibility for them to work in this country for two of the staffs. The registered person must ensure that staff records are maintained as Schedule 2. The home has an ongoing training programme and recent training included epilepsy, managing challenging behaviour, dementia awareness and prevention of abuse and infection control. It was difficult to ascertain whether all the staff had completed the required mandatory training such as moving and handling and fire safety. The staff reported that some of the certificates had not been received with regards to manual handling training. The development of a training matrix would be beneficial in assessing training that staff had completed and would also help management identify any shortfalls in mandatory training. Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 31,33,35,38 The home has a manager who has clear lines of accountability for the service. The financial interests of the service users are safeguarded through appropriate accounting. The process of seeking the service users’ views is good. There is a satisfactory procedure in place to ensure the health and safety of the service users is promoted. EVIDENCE: Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 21 The home has a registered manager who is in day- to- day control of the service. She has completed her NVQ 4 and comments received indicated that staff and relatives would approach her if they have any concerns. The service had recently conducted an audit of the people who use the service and their relatives’ views in July 07. They received eight responses that were positive about the care that the home was providing. Staff reported that the result would be collated and outcome/ action plan would be shared with the relatives and published on the notice board. The last meeting for the people using the service was in February 07 and the responsible individual said that this needed to happen more often and would be addressing this. The director undertook regulation 26 visits to the service and the last report available was dated April 07. The registered person must ensure that regular visits are undertaken and copies of these reports following these visits must be available at the service. The home managed some of the people using the service personal allowances. These are for hairdressing, chiropody and toiletries as needed. Records of all transaction are maintained and including invoices. Information received and staff confirmed that there is an ongoing programme for the servicing of equipment that included bath hoists, passenger lift, fire equipment and emergency lighting. A fire risk assessment for the building was available. Beechwood House DS0000049982.V344990.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 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 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Beechwood House DS0000049982.V344990.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 OP7 Regulation 15(1) Requirement The service users’ plan must set out in details how all the assessed needs of the people using the service would be met. Timescale for action 15/10/07 2 OP9 13(2) Evidence of service users/ family involvement in the formulation of care plans must be maintained. Systems must be put in place 15/10/07 that record all medication received into the home. This is a requirement from 01/09/06 that remains outstanding. 3. OP9 13(2) Records kept for all drugs stored, 15/10/07 as controlled drugs must accurately show the amount received into the home and the balance left after each time the medication has been administered. The current system must be reviewed to ensure it complies with the guidance given in the Royal Pharmaceutical Guidelines. This is a requirement from Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 24 01/09/06 that remains outstanding. 4 OP9 13(2) The registered person must ensure that records relating to medication movement are accurate and complete to enable an audit as necessary. 30/09/07 5 OP9 13(2) 17(1) (a) Schedule 3. 12(4) (a) 6 OP10 7 OP29 19 (1) (a) Staff must ensure that the 15/10/07 medication administration record contains the variable dosages administered to the people using the service as applicable. Staff must ensure that the 15/10/07 service users privacy and dignity are upheld at all times when receiving personal care. The registered person must 15/10/07 ensure that all checks are carried out prior to employment including staff eligibility to work. 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 Beechwood House DS0000049982.V344990.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Beechwood House DS0000049982.V344990.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!