Inspection on 20/09/07 for Bonehill Lodge

This inspection was carried out on 20th September 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Bonehill Lodge 09/12/08

Bonehill Lodge 30/06/08

Bonehill Lodge 17/10/06

Bonehill Lodge 25/05/06

Bonehill Lodge 21/02/06

Bonehill Lodge 05/07/04

Bonehill Lodge 29/04/04

Bonehill Lodge 23/10/03

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Bonehill Lodge 62 Park Lane Fazeley Tamworth Staffordshire B78 3HZ Lead Inspector Mrs Mandy Brassington Unannounced Inspection 20th September 2007 09:30 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 Bonehill Lodge DS0000004919.V346587.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. Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bonehill Lodge Address 62 Park Lane Fazeley Tamworth Staffordshire B78 3HZ 01827 280275 F/P 01827 280275 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) Bonehill Limited vacant Care Home 26 Category(ies) of Dementia (6), Old age, not falling within any registration, with number other category (26), Sensory Impairment over of places 65 years of age (1) Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th October 2006 Brief Description of the Service: Bonehill Lodge is a residential home situated in the suburbs of Tamworth, Staffordshire, having access to local amenities and public transport. The home looks out onto open countryside and has a paved area to the rear and a small area of landscaped garden to the front of the home. The home provides a service for 26 older people and is also registered to care for 6 individuals who suffer with dementia. The three-storey property provides residential accommodation on both the ground and first floor, having 22 single occupancy and 2 shared bedrooms, ensuite facility is provided within a number of bedrooms. The first floor is accessible via a passenger lift. Bathrooms and toilets are located throughout the home and in close proximity to bedrooms and communal areas. The property has a large lounge, divided into two separate areas, which leads to a dining area equipped with essential furnishings to meet the needs of the service users. There is a conservatory, which leads to a small paved garden. The registered provider is Bonehill Ltd who has overall responsibility for the home. The manager of Bonehill Lodge informed the Commission for Social Care Inspection on 20 September 2007, during the visit, that the fee level for Bonehill Lodge is between £370 and £441 per week. Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over 6 hours by one inspector who used the National Minimum Standards for Older people as the basis for the inspection. Prior to the inspection the manager completed an Annual Quality Assurance Audit (AQAA) for the Commission for Social Care Inspection. Three completed questionnaires were returned from people who used the service and from one relative. A tour of the home was undertaken. On the day of the inspection, the home was accommodating nineteen people. The inspection included an examination of records, indirect observation, discussion and observation of nine people who use the service, and four staff on duty. Three care plans and three staff records were examined, and observation of daily events took place. Inspection of the storage system and medication procedures were inspected. A meal was eaten with people who use the service. What the service does well: There is a stable group of staff, with the staff team have the skills, knowledge and experience to meet the individual needs of people. Staff support people to take control and make decisions about their life. The people who use the service and relatives spoke highly of the staff team, the care and support. Comments from people included: ‘They’ve got a lot of patience’ ‘They can never do enough for you’ ‘They’re all great, nothing is too much trouble for them’ ‘They’re always there when you need them’. Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 6 Individuals are able to keep in touch with family and friends, who are able to visit the home at any time. The staff team have developed good relationships with family members and welcome their support and involvement. An assessment of need is carried out before moving to the home, and the manager assesses whether the home is able to meet people’s needs. A plan of care is developed with detailed information on how to support people. Working with family and friends, the plan includes a life history, which staff find very useful when talking to people, and helping people to remember. The life history includes important events and people. The home provides a range of good quality food and people have a choice of what they eat. A variety of hot and cold drinks are served with the meals. What has improved since the last inspection? What they could do better: The home has been without a registered manager for fifteen months. The manager has completed a Criminal Records Bureau Check and upon satisfactory clearance needs to submit an application to begin the Fit person process. Bonehill Lodge DS0000004919.V346587.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. Bonehill Lodge DS0000004919.V346587.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 Bonehill Lodge DS0000004919.V346587.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): 1, 2, 3, 4, 5, 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has reviewed the Statement of Purpose, which sets out the aims and objectives of the home, and includes a Service User Guide. Prospective people who use the service have an assessment carried out before they are admitted to the home, and individuals are provided with a Contract. EVIDENCE: The Statement of Purpose and Service user Guide have been reviewed to reflect the current staffing, management arrangements and terms and conditions of occupancy. Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 10 Inspection of plans of care demonstrated that a care management assessment was completed prior to admission. The manager or senior staff have carried out the home’s own assessment to ensure the home is able to meet the person’s needs. The manager recorded within the Annual Quality Assurance Audit, that following any assessment, written confirmation is given, with regard to whether the home is able to meet the needs of the person. People confirmed they are able to look around the home prior to moving in. The home maintains a record of the visit, the staff involved and the room preference of the person. People who use the service are provided with a contract, which details terms and conditions of occupancy and the fee payable. The home does not provide intermediate care. Bonehill Lodge DS0000004919.V346587.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, 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person has a plan of care that is clearly written and easy to understand. The plan looks at all areas of the individual’s life including valuable information regarding the life history of the person, and is reviewed regularly. Robust medication procedures are in place and staff understand the principles for safe administration of medication. EVIDENCE: Three plans of care were sampled and contained information relating to the individual, including family history and a life story. Detailed information relating to the persons past history, places visited, holidays, work activities, significant life events, schools attended and hobbies and interests were recorded. Staff reported this information is obtained from the person, relatives Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 12 and friends. Discussion with staff demonstrated a good knowledge of the person and their life experiences, and it was evident that this information was used to support people in the home. The plan of care contained information regarding support needs, social support and included an assessment of risk for falls, pressure care, complex behaviour and moving and handling. Specific health needs were recorded and how and who would meet these needs, including support from professionals. Staff reported that each person is registered with a local General Practitioner, and has access to chiropodist services, opticians and where appropriate a community Psychiatric nurse and District nursing services. The plans included an assessment of risk for having a key to bedrooms, voting and personal mail. The plans have been reviewed monthly. Discussion took place with staff regarding exploring all options for evidencing involvement with the formation of plans, and the review process. All people spoken with, talked highly of the service and the care provided. People who used the service stated they were treated with dignity and respect, and encouraged to be as independent as possible. This was confirmed from information from relatives and other comment cards. Comments from service users and relatives regarding the staff included: ‘They’ve got a lot of patience’ ‘They can never do enough for you’ ‘They’re all great, nothing is too much trouble for them’ ‘They’re always there when you need them’. All people were well presented and dressed in a style of their choosing, and individuals took pride in their appearance. A number of people were supported to wear make-up, and the home included manicures and nail care in the weekly activity programme. It was evident, that staff have ensured that individuals are able to receive support to address personal care issues and personal hygiene. Medication is stored within a locked trolley and following the previous inspection, the manager had reviewed the medication practices and procedures within the home to ensure a robust record of all medicines was maintained, that can be easily audited, and two staff sign any entries on the Medication Administration Record (MAR). Bonehill Lodge DS0000004919.V346587.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, 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home enables people to maintain links with family and friends. Staff have sought the views of the people who use the service, and considered their varied interests when planning and arranging activities both in the home and the community. EVIDENCE: The home has an Activity Plan, which is displayed in the Hallway. During the week of the inspection, the activities arranged included, board games, hair and manicures, ‘Tell me a story’, sing-a-long, and gentle exercise. Discussion with individuals revealed there were more activities provided in the home during recent months. One person spoke enthusiastically about being supported to continue knitting. Three people commented that they enjoyed just having the company of others in the home, one person commented, ‘I like it here, I’ve got Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 14 the company, and we all look out for each other, sometimes I join in, but I love the company more than anything’. Staff reported that during the summer, individuals were given opportunities to go shopping, and have a meal or drink at local venues. One person reported that they had been able to go on holiday to visit family members. From discussion with people who use the service, and from observation of practices, individuals are able to retain control of their lives and were given opportunities to make informed decisions. One person reported, ‘I manage on my own, I like to be able to look after myself, though it’s nice to know the staff are there if I need them’. At lunchtime, people ate in the main dining room. A menu board is on display and prior to the meal, people were aware of the choices available. The main meal is served at lunchtime, and on the day of the inspection, the meal prepared was a choice of shepherds pie with vegetables or ham salad, and dessert of bananas or sponge and custard. People were offered a choice of hot and cold drinks. The meal was relaxed with jovial banter between people who used the service and staff. Where support was required, this was sensitively given. The meal was unhurried and people were able to eat at their own pace. Regarding the meals, individuals reported, ‘the meals are good here; there’s nothing they do that I don’t like’, ‘you always get a good meal here’. Discussion with people who use the service confirmed there were no restrictions on visiting from family and friends, individuals are also able to stay away from the home with family members. The design of the home provides seating within the communal areas of the home, where individuals can entertain their visitors, in addition to the privacy of their own room. Bonehill Lodge DS0000004919.V346587.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, 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an open culture that allows people who use the service to express their views, and concerns in a safe and understanding environment. The service has a complaints procedure that is clearly written and displayed in the home. EVIDENCE: The home has an open culture in relation to receiving complaints, and from information obtained within surveys, and from discussion with people who use the service, individuals stated they would feel confident raising a concern or complaint. The home has produced a Complaints Procedure, which is clearly displayed throughout the home and has been amended to display the new office details of the Commission for Social Care Inspection. Staff have received training in Safeguarding Adults and know how to respond in the event of an alert or disclosure. The policies and procedures for Safeguarding Adults are available, and give clear specific guidance to those using them. Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 16 The people who use the service and family members are responsible for personal finances. Three records for personal monies were inspected and an accurate record of all transaction was maintained. Bonehill Lodge DS0000004919.V346587.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, 20, 23, 25, 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is comfortable, clean and warm, and the property is being upgraded in relation to décor and furnishings. There are different communal areas for individuals to choose from. Individuals are able to personalise their rooms according to their interests. EVIDENCE: The three-storey property provides residential accommodation on both the ground and first floor, having 22 single occupancy and 2 shared bedrooms, ensuite facility is provided within a number of bedrooms. The first floor is Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 18 accessible via a passenger lift. Bathrooms and toilets are located throughout the home and in close proximity to bedrooms and communal areas. The property has a large lounge, divided into two separate areas, which leads to a dining area equipped with essential furnishings to meet the needs of the service users. There is a conservatory, which leads to a small paved garden. Since the last visit the registered person has upgraded the lounge and dining room furniture and parts of the home has been redecorated. Previously the home was painted in one colour throughout, this has been reviewed, and each separate bedroom area has been painted in a different colour, and the unit has been named. Discussion took place with staff regarding exploring different options to support people with dementia to recognise their room, and parts of the home. Two bedrooms have been refurbished and co-ordinated furnishings provided. Individuals are able to bring personal possessions into the home. Discussion with four people revealed that they have never been concerned about people entering or wandering in to their room and do not wish to have a key; this decision is recorded within the plan of care. On the day of the inspection work was being carried out in the laundry room as the registered person has upgraded the heating facilities. The home was clean, warm and comfortable and people reported they were happy with the standards in the home. Bonehill Lodge DS0000004919.V346587.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, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use service have confidence in the staff that care for them and there are sufficient numbers of staff available to work in the home. There are robust recruitment procedures in place to ensure people are protected from harm. EVIDENCE: On the day of the inspection, the manager and assistant manager were working from 8.00am – 3.00pm and were supernumerary. Three care staff were working from 8.00am - 5.00pm and three staff worked from 5.00pm – 10.00pm. There were two waking night staff working from 10.00pm - 8.00am. The home also has a cook who works from 8.00 - 2.00pm and domestic support from 9.00 - 1.00pm. The registered person has recruited a number of staff to the home and records demonstrated there are good recruitment procedures. Inspection of two personal records revealed that an application form was completed, details of Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 20 the interview were recorded, references were obtained and a PoVA First (Protection of Vulnerable Adults Check) and Criminal Records Bureau Check had been obtained. Discussion with one member of staff revealed that there had been a six week induction to the home, where they had worked alongside a senior member of staff and received basic training in moving and handling, health and safety, food hygiene and record keeping. Further external training these areas and for Safeguarding adults had been arranged. Staff have completed a level 2 certificate in Dementia Care, Level 2 Certificate in Health and Safety covering, Health and Safety at Work, Electricity and Control of Substances Hazardous to Health (COSHH), fire safety, risk assessments and hazards. Staff have also received training for safe administration of medication, infection control, continence care and optical training. There are four members of staff that have achieved a National Vocational Qualification (NVQ). Twelve staff have enrolled to start NVQ training through a local college. Staff members spoken to talked about people in a sensitive and respectful way and understood the need to promote their dignity and maintain confidentiality. People who use the service spoke very positively about the staff, the care and support received. Bonehill Lodge DS0000004919.V346587.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, 32, 33, 35, 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager has worked alongside the team of staff to review practices and raise standards in all areas of the home. The manager communicates a clear sense of direction and supports the team members to achieve the required standards. The manager needs to compete the Fit person process to seek registration for the home. EVIDENCE: Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 22 The home has been without a registered manger since July 2006; the new manager has completed a Criminal Records Bureau Check with the Commission, and upon satisfactory clearance is to submit an application to begin the Fit person process. The manager has enrolled through a local college to start NVQ 4. The manager has worked with the team of staff and has reviewed the daily records, care planning system and all standards within the home. It is evident from observation and discussion with staff, that all staff are extremely enthusiastic and committed to providing a quality service, and as a team have raised the standards within the home to a good level. Staff commented they feel valued and part of a supportive team. Staff stated they would have no hesitation approaching the manager or assistant manager who are supportive and recognise personal achievement. A monthly monitoring visit by the responsible individual has been conducted. The home has begun to carry out quality audit questionnaires with people who use the service. The manager reported that this is to be extended to relatives, carers and professionals; information obtained will be reviewed. Fire records were examined. There was evidence that regular tests and drills take place and a Fire Risk Assessment was in place and is linked to the dependency levels of service users. The Fire Officer visited the home in April 2007 and work identified by the Officer has been completed by the registered person. The manager reported within the Annual Quality Assurance Audit, that required checks and annual servicing had all been completed this year. Bonehill Lodge DS0000004919.V346587.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 3 3 3 x 4 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 X 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 2 3 3 X 3 X X 3 Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 24 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 OP31 Regulation 8 (1)(2) Requirement The manager is to begin the Fit person process. Timescale for action 30/10/07 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 OP7 Good Practice Recommendations Explore methods of including and evidencing service user involvement in the plans of care Bonehill Lodge DS0000004919.V346587.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Bonehill Lodge DS0000004919.V346587.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!