Inspection on 18/05/05 for Bexton Court

This inspection was carried out on 18th May 2005.

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

Bexton Court 21/09/09

Bexton Court 31/10/08

Bexton Court 25/09/08

Bexton Court 10/09/07

Bexton Court 11/05/06

Bexton Court 28/09/05

Bexton Court 12/10/04

Bexton Court 24/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOMES FOR OLDER PEOPLE BEXTON COURT Bexton Court Knutsford Cheshire WA16 0BZ Lead Inspector Sue Dolley Unannounced 18 May 2005 09.00 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 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. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Bexton Court Address Bexton Road Knutsford Cheshire WA16 0BZ 01565-651725 01565 755750 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Cheshire County Council Mrs Susan Ann Bryan Care Home 23 Category(ies) of DE(E) - Dementia (over 65) (22) registration, with number LD(E) - Learning Disabilities (over 65) (1) of places DE - Dementia (5) BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. 22 older service users with Dementia DE(E) 2. 1 older service user with a learning disability LD(E) 3. 5 service users with Dementia aged between 55 and 65 years DE Date of last inspection 12th October 2004 Brief Description of the Service: Bexton Court is a purpose built community support centre owned and managed by Cheshire County Council. It is near to Knutsford Town Centre, where there are a wide range of shops and other amenities. Bexton Court provides accomodation on a single floor with some office accomodation sited on a second floor. The premises are physically linked to a ward in the adjoining hospital. The home is registered to provide care to a maximum of 23 service users. Bexton Court is a developing provision. It is a well-equipped facility offering a range of short term respite services for people with dementia, which are tailored to an individuals needs. Care can include short breaks, flexible day and overnight care. There is a day care unit which provides 5 places each day from Monday to Friday. In Bexton Court, all rooms are easily accessible to wheelchair users. All bedrooms have wash hand basin facilities, with hot and cold water, door locks and facilities for calling staff should assistance be needed. There are several specially equipped bathrooms with bath and shower facilities. There is a secure garden area for service users and visitors to use. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 18th May 2005 over 8 hours to assess if service users’ needs were being met. A partial tour of the premises included all bedrooms, shared areas such as lounges and dining area, shared bathrooms and toilets. Several members of management staff on duty, and 4 service users were spoken to during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 The assessment process is thorough and well managed to ensure that the people who stay at Bexton Court, and their relatives, know what to expect and that their needs will be met. EVIDENCE: All service users’ needs are assessed before they receive care at the home. Bexton Court gathers information from the potential service users, their relatives, social services and health care representatives to ensure individual assessed needs can be met. 3 service users’ care files were checked and provided full information. The assessments and care plans were positively written, self- care abilities were described, and relevant background information and contacts were provided. Where appropriate, patient transfer information had been provided by Cheshire NHS Trusts. A record of health visits had been completed advising of symptoms and treatment prescribed. Any significant events were adequately recorded. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 8 Bexton Court does not provide intermediate care, therefore National Minimum Standard six does not apply. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 and 11. Service users are looked after very well in respect of their health and personal care needs and family carers are also supported. Service users are closely monitored, with potential health problems promptly addressed by the appropriate health care services. The recording, administration and stock control of medication needs to be improved, to establish whether all service users receive their medication as prescribed. Staff members treat service users with respectfulness and courtesy and service users` dignity and privacy is maintained. Service users’ wishes for terminal care and arrangements after death are discussed and recorded so that they can be carried out accordingly. EVIDENCE: All service users had a plan of care which set out in detail the action needed from care staff to ensure all aspects of their health, personal and social care needs were met. Service users continue to have access to community health support as required during their stay at the home. The home is equipped to meet the care needs of service users with dementia and associated difficulties. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 10 Bexton Court receives suport from the Residential Homes Nurse Triage Team and in addition a Specialist Practitioner Nurse from Eastern Cheshire Primary Care Trust visits on a sessional basis, usually every Friday. Three care plans were checked and contained comprehensive assessments. The community services folders contained information about specific illnesses and conditions. The assessments identified service users’ needs and abilities to ensure that staff members provide any necessary care and encourage service users to maintain their independence as far as possible. Care staff members were seen to encourage service users and to support their capacity for selfcare. Contacts between service users and staff members were kindly, patient and respectful. Staff members had a calm and reassuring approach. There was evidence of effective communication throughout the home and between staff. This helps to ensure all involved are aware of changing needs and provide continuity of care. Despite these areas of good practice and monitoring, the medication administration records showed an unrecognised omission code. Some medication had not been given as prescribed, staff members were using different ways to record medication to be taken as and when required. Some stock balances of medication were unclear or incorrect; there were some unexplained gaps in the recording and one medication administration record did not contain a photograph of the service user to aid identification. See Requirement 1. The care files contained photographs of the service users and showed that appropriate referrals for specialist medical and therapeutic care were made. Service users’ psychological health is monitored, with preventative and restorative care accessed as appropriate. Records showed that the changing needs for personal care and support of service users with deteriorating conditions and dementia, were reviewed and met swiftly to ensure they retain maximum control. Service users and their supporters have access to information held. Information regarding ‘Death Procedures and Funeral Arrangements’ was in place, to guide staff in the event of a death occurring. The service user`s wishes concerning terminal care and arrangements after death are recorded. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14 and 15 Service users are individually spoken to and encouraged to exercise choice and make decisions whether or not to join in activities. A high level of liaison and communication is maintained between service users, their relatives and staff, to ensure daily routines are maintained and residents are enabled to maintain contact with people important to them. Leisure and recreational activities are well planned, providing opportunity for stimulation, social interaction and enjoyment. The food is of a high standard and meals are varied with ample choice to satisfy service users` preferences and dietary needs. EVIDENCE: A record of activities was maintained for each service user, with all significant events in their daily lives well recorded. Opportunities are given for appropriate exercise and activity. The enclosed garden enables service users to walk in and the spacious premises allow freedom of movement. Some service users and staff were seen taking part in various physical activities to improve hand and eye co-ordination and verbal communication. Music and dance was encouraged and enjoyed; individual and group activities were underway. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 12 The notice board showed pictures of recent activities away from the home and of future events planned. A trip to Queens Park in Crewe was being organised for later in the month and residents confirmed they had enjoyed activities they had participated in. A local community group had provided funding to purchase an awning for the garden area and community involvement is encouraged and welcomed. Menus showed a variety of traditional meals. Lunch is the main meal of the day with a lighter meal served at teatime. Individual nutritional needs were recorded and specialist diets and alternative meals are always provided. Service users generally eat in the pleasant dining areas. Mealtimes are a sociable event with several staff members eating with service users and providing discreet help when necessary. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17 and 18 Arrangements are in place to protect service users and to respond to their concerns; to ensure they stay safe and are satisfied with their care. EVIDENCE: Bexton Court uses Cheshire County Council’s complaints procedure. The council’s policy states that all comments, critical or otherwise, are received in a positive manner and are acted upon. There were no complaints since the last inspection. Service users and relatives are encouraged to speak freely to staff if they feel unhappy about the care or surroundings. If a service user or relative is not satisfied after speaking to a senior staff member, they are invited to make a formal complaint. Information about the complaints procedure is included in the service user guide and information pack. Copies of complaints booklets were available in reception providing advice regarding further actions if things go wrong. A complaints procedure was also available which included a checklist for dealing with any complaints to Headquarters. A range of information leaflets in the reception area provide support and advice to service users and carers, with a range of contact addresses to access support. Where service users lack capacity, the registered person should facilitate access to available advocacy services. See Recommendation 1 BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 14 The Department of Health guidance ‘No Secrets’ was available within the home. Information leaflets for the protection of vulnerable adults were also available. Staff members were aware of various forms of possible abuse and had received information on the various ways service users can be safeguarded and protected. Staff members now await adult protection training. See Recommendation 2. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,24,25 and 26 Bexton Court is well maintained and clean with only a few areas requiring attention. Overall, it is decorated and furnished to a good standard which helps to create a comfortable and welcoming environment. EVIDENCE: This purpose built home provides accommodation for service users on the single floor with some office accommodation on the second floor. Service users’ rooms cover two wings; twelve rooms in wing 1 and eleven rooms in wing 2. The premises are generally maintained to a good standard, attractively decorated with good quality furniture and furnishings. Some areas need redecoration including the lower walls of the dining area and the area outside the office. The ceiling of the medication room has been damaged by a water leak. Four bedrooms also need some redecoration. Two rooms had odours and one needs re-carpeting. One bedroom has some damage to the window recess and window board. See Requirement 2. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 16 Ample communal space is provided for various social activities and service users can meet visitors in private. A large secure garden is available for both service users and visitors. All bathroom and toilet areas are easy to access and well equipped. The doors of the toilet area are painted red to be easily recognised. One of two toilets off the dining area remains locked, as this is small and would be unsafe to use if a service user fell whilst using the toilet and needed help. A sluice sink has recently been removed from a communal bathroom and replaced with a wash hand basin. Bexton Court hopes to secure funding to fit a specialist bath in a bathroom to improve facilities. As storage space for large equipment is limited, a vacant bedroom is often used. A call alarm system is in place throughout the home. Some pressure mats are in use and bedroom doors can be alarmed to monitor movement to and from bedrooms, to help keep people safe without restricting their freedom of movement. Heating and lighting are satisfactory, with emergency lighting provided and maintained. The laundry is well organised and protective clothing is given to visitors to the orderly, well - equipped kitchen. Infection control policies and procedures are in place and staff members were seen to have good hand hygiene practice. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30 The generous staffing levels ensure service users` needs are met promptly and staff members have time to spend with individuals. Appropriate staff training is provided to ensure they are trained and competent to do their jobs. EVIDENCE: At the time of inspection ten service users were living there and a day care service was also offered. New staffing levels are agreed as the number of service users increases. At the time of the inspection the staffing levels were generous: • • • • Morning Mid shift Evening Nights 1 senior and 3 care assistants. 2 additional care assistants work either 10.30am - 6.30pm or 9.30am - 5.00pm. 1 senior and 3 care assistants. 1 senior and 2 care assistants. A second senior is usually employed on a shift 3/4 times a week. The staffing levels are designed to provide additional help at the busiest times of the day. The registered manager, group leaders, administration and ancillary staff are extra. The team includes a range of ages, skills and experience. A recent recruitment drive has resulted in the employment of seven new staff members. The recruitment procedures and practices were thorough. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 18 Bexton Court has a team plan 2005/2006 stating that all new staff will be given induction training, NVQ training to level 2 and 3 will continue and six monthly dementia awareness training sessions will be facilitated off site. Two senior care staff had received 3-day dementia care mapping training in February 2005. 6 staff members have completed NVQ training to NVQ level 2. Recent training has included health risk assessment training and outcomes training. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36,37 and 38 Bexton Court has good organisation systems and clear lines of accountability which enables it to run in the best interests of service users and their relatives. EVIDENCE: The registered manager and other management staff communicate a clear sense of direction and leadership, which, staff and service users understand. The processes of managing the home are open and transparent. By speaking with service users it is clear that they feel well cared for. Through looking at records and written comments from relatives, it is clear that they feel supported, both by the service provided and by the staff. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 20 A quality standards monitoring system exists and a plan is in place to encourage feedback about the service from a user satisfaction questionnaire following six weeks of receiving the service. It is hoped that information from the quality standards satisfaction questionnaires will help the service to respond quickly and flexibly to demands, ensure person centred delivery and maximise service user ability. Bexton Court gives family supporters a small written report of each episode of respite care. This gives written feedback of their experience and covers appetite, sleep, activity and provides other important information. The report invites the recipient to contact Bexton Court with any queries or questions and thanks them for using the service. Suitable accounting and financial procedures are in place to ensure effective management of the business. Appropriate insurance cover is in place. Short stay service users and their supporters normally manage their own money. A small amount of personal allowance money is kept within the home for the hairdresser, trips out and to buy things from the trolley shop. Random samples of three individual balances were checked. Two discrepancies were found and staff were going to find out why there were differences, rectify the situation and amend the records accordingly. See Requirement 3. Evidence of regular staff supervision was seen. Supervision sessions address educational needs, provide support to individuals and relate to individual performance and service user and staff matters. Job descriptions were in place and annual reviews are undertaken relating to staff performance. Formal supervision occurs every two months, in addition to daily monitoring, supervision, observation and support to staff when needed. Both service users and their family supporters can access their records, and help to maintain them by giving up to date information. Individual and home records are secure, up to date and in good order. The home’s management team ensure that staff are suitably inducted and trained in moving and handling, fire safety and infection control. A detailed training schedule is kept for each staff member. Senior carers are trained to give medication and all staff members are encouraged to attend basic first aid training. Catering staff members are trained in food hygiene and food safety, and relevant health and safety procedures are displayed throughout the home. The fire fighting equipment had been regularly serviced; a fire precautions record book was maintained and showed all fire safety checks. The last fire evacuation was recorded as 18th May 2004 and torches for emergency use were tested on 14th January 2005. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 21 Cheshire Fire Brigade visited 24.01.05 and a work schedule was itemised. The visiting fire officer strongly recommended that all bedroom doors be fitted with smoke seals with intumescent strips. See Requirement 4. Advice was given during the inspection as a footrest from a wheelchair was found in a bathroom area. A staff member tried to find which wheelchair it was missing from. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 2 3 3 3 x 2 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 2 2 x 3 4 3 2 3 3 2 BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 23 Yes Are there any outstanding requirements from the last inspection? 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 9 Regulation 13 Requirement Arrangements must be made for the accurate recording and administration and stock contol of medication. All areas of the home must be kept clean and reasonably decorated. Keep and maintain an accurate record of all money deposited by service users.(This requirement was also made at the previous inspection on 12.10.04). Take adquate precautions against the risk of fire and for containing fire. Make arrangements for fire training and evacuation and for checking torches. Timescale for action 18.07.05 2. 3. 19 and 24 35 23 17 and Schedule 4 23 18.08.05 18.07.05 4. 38 18.08.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP17 Good Practice Recommendations Where service users lack capacity, Bexton Court should facilitate access to available advocacy services. F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 24 BEXTON COURT 2. OP18 Ensure care staff are provided with adult protection training. BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D, Off Rudheath Way Gadbrook Park Northwich. Cheshire. CW9 7LT. 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 BEXTON COURT F51 F01 S36255 Bexton Court V226482 180505 Stage4.doc Version 1.30 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!