Inspection on 12/10/07 for Braunton

This inspection was carried out on 12th October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Braunton 06/01/09

Braunton 24/01/08

Braunton 08/06/06

Braunton 06/02/06

Braunton 10/08/05

Braunton 21/02/05

Braunton 20/08/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Braunton 23 Grove Avenue Yeovil Somerset BA20 2BD Lead Inspector Barbara Ludlow Unannounced Inspection 12th October 2007 09:50 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 Braunton DS0000054718.V347165.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. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Braunton Address 23 Grove Avenue Yeovil Somerset BA20 2BD 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) 01935 422176 01935 422176 Braunton Residential Home Limited MRS ALEXANDRA VICKERY Care Home 9 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (8) of places Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user with learning disabilities under the age of 65 Date of last inspection 8th June 2006 Brief Description of the Service: Braunton is a family run home providing accommodation and support for nine older people in domestic scale accommodation. Mr & Mrs Lambert, the owners, continues to be directly involved in the management of the home. Their daughter Alexandra Vickery is the registered manager. The management team, are supported by a small staff team. Residents are encouraged to maintain links with family and the wider community. The emphasis is on providing care within a homely environment. Fees range from: £373.00 per week Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This inspection visit was carried out over 8.5hours. The inspector met with Mrs A. Vickery the registered manager and the proprietor was seen during the day. Three members of staff were spoken with and all the people in residence. A tour of the premises was made and people who live at the service were seen in the communal room and in private. Daily life and mealtimes were observed. Records were examined these included care plans, medication records, staff recruitment records and maintenance records. Feedback was given to Mrs Vickery at the inspection and in conclusion by telephone on 15th October. The inspection was well received and the management are keen to remedy the requirements made at this inspection. What the service does well: What has improved since the last inspection? The management have made a good response to the regulatory requirements and recommendations made at the last inspection. The hot water at the bath tap outlet has been fitted with a temperature fail-safe device to reduce the risk of scalding from very hot water. Braunton DS0000054718.V347165.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. Braunton DS0000054718.V347165.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 Braunton DS0000054718.V347165.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): 3 Quality in this outcome area is good. Information about the home is available. A pre admission assessment is made for potential permanent residents to ensure that their care needs can be met at the home. Short respite stays are not always seen pre admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager informed us that pre admission assessment is made when someone is coming into the home as a permanent resident. The manager would visit to assess the person’s level of need to ensure that the service can meet this assessed need. Information about the home is available to the prospective resident. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 9 The home has a block contracted respite care bed with social services, which is well used. Admissions for respite care are made for periods of a week or more. Respite care, had been given to thirty six people in the past year, according to the Annual Quality Assurance Assessment (AQAA) sent to the Commission for Social Care Inspection (CSCI). The manager stated that these admissions are often made at short notice making them reliant upon the information coming in from social services, with no time for an assessment visit. The manager described her actions in response to a respite request and her information gathering is well managed. The most recent person admitted to the home was spoken with; family had arranged their place at Braunton. People in residence were complimentary about the home and commented that they all get along well together. The home also offers a day care service for one or two people. Braunton DS0000054718.V347165.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): 7,8,9,10 Quality in this outcome area is good. The manager uses the preadmission information to plan and deliver person centred care. Medications systems were safe; staff must be careful and adhere to good procedure at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were in place for all the people in residence and all were examined. The care plans contained a good range of information. Personal information including close contacts was recorded. The single assessment process documentation was seen where respite care was given this was used with a daily assessment record and risk assessment. There was recorded input by professional services allied to healthcare such as the optician and the chiropodist. One person commented that they had Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 11 received both of these services since admission and were very pleased with their new spectacles. A dependency rating tool is used to assess the level of help required and monitor changing levels of need. The key to this assessment was not apparent and the member of staff consulted did not understand the rating score. The addition of the key with the plan would be helpful for staff to using the records. There was input by the people in residence into their care plans. Where people are self caring this was recorded, care plans had been reviewed and were signed. Staff confirmed that all people in residence that bathe all use the assisted bath. No manual handling risk assessments were seen in the care plans for bathing with the aid of the hoist, this should be done and recorded. An inventory of personal belongings is made and was seen to be recorded in the care plans. Medications are stored safely in a locked and secured medications cabinet. The management of medications was detailed in the individuals care plan and was person centred, explaining how each person preferred to take their medicine. There was a comprehensive information sheet for each person detailing the reason each medication was prescribed and the route of administration. This was prepared with other information should the person need to go to hospital in an emergency or transfer elsewhere. With one exception where an obvious error had been made this was useful in supporting a transfer and the continuation of care. The management of medication was observed, staff were aware of the good practice of not signing the administration record until the medication had been administered. One member of staff was reminded about this and also about the recorded directions for the administration of an antibiotic, where it needed to be given before food. The Medication Administration Records (MAR) were seen; they contained photographic identification and other useful details. There was a list of homely remedies. One hand transcribed entry had only one signature. A second signature is recommended to ensure the entry is checked for accuracy by a second person. Medication managed by the district nurse was recorded on to the MAR charts and was recorded in the care plan. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 12 Praise was heard for the staff who were described as ‘all very kind’ and one person said they ‘like the staff, all very kind’. One other person said that a member of staff had raised their voice to them; this was reported to the manager to be investigated by the home. Braunton DS0000054718.V347165.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. People living at Braunton can spend their time as they wish. Independence is promoted and family contacts are welcomed. The food looked appetising. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live at the home were seen in the communal area and as they moved about the home to their rooms as they wanted to. The people said they all get along well together and have ‘lots of laughs’ and ‘fun’. Staff were heard to be respectful and patient in their approaches to the people in residence. One person confirmed they have their breakfast in bed and get up when they like. People said they had their televisions and radios and there was the company of the other residents. One person has regular visitors whom they said are made welcome when they visit. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 14 The home has a pleasant garden and there is access around the home and from the conservatory. There were no formal activities organised for this inspection day and people asked said they were happy to watch the television together in the lounge. The hairdresser visits the home each week and newspapers can be delivered at cost. The kitchen is domestic in size and is fitted out to a good standard with the exception of damage to the tiling on the small window sill, the kitchen was well managed and kept very clean and tidy. Daily catering records were in place. Two staff were cooking and preparing lunch. Lunch was seen in progress in the dining room at 1210pm. The dining table can seat eight comfortably. Five people were seated together at the nicely laid dining table and one person had chosen to stay in their armchair with a lap table. Fish and chips with vegetables had been served. Dessert was syrup cake and custard. Squash was available to drink. The comments heard were that lunch had been ‘very nice’,’very good’ and ‘enjoyed’‘. During the day the comments about the food were positive and indicated that the usual standard of food offered is always ‘good’. Tea was served at 5pm, no menu was available but a carer had earlier gone to each person in turn to take their request from a selection list of salad, sandwich and dessert options. Braunton DS0000054718.V347165.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 poor. There was good management of feedback from people in residence. However the outcome of this section is marred by poor recruitment practice, which was judged to have placed people who live at the service at potential risk. Management and staff need to undertake adult protection training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Recruitment files were sampled for three new starters. All had CRB checks in place. At the commencement of their employment one had a Protection of Vulnerable Adults (POVA) check but only one reference, a second had a POVA First check dated six days later than their start date and one reference on file. A third had a POVA check dated seven days after their start date and two references both dated later than the person’s starting work date. This is unacceptable. A minimum of a POVA First check and two references must be received before the person starts work at the home. The county and national protocol for safeguarding vulnerable adults is by alerting social services who have the lead role in all adult protection matters. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 16 The manager was not clear about this and training is required to bring her knowledge up to date. The proprietor may also wish to refresh his awareness of the procedure with training. This training can then be cascaded through the organisation to benefit all staff. People at the home asked said they would be able to raise any concerns with the homes staff. One person said they had raised a concern with a member of staff but said no action had been taken; this was reported to the manager for investigation and will be followed at the next key inspection. Braunton DS0000054718.V347165.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): 19,26 Quality in this outcome area is good The home is well maintained but is in need of some refurbishment such as carpets in some communal areas. The home was generally clean and was fresh smelling. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was made. The home was generally clean, tidy and odour free on the day of the inspection. Some high / deep cleaning was identified such as a bathroom lampshade and hall skirting boards which were very dusty. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 18 The home is decorated and comfortably furnished. People who live at the service are able to personalise their bedrooms to help make them feel homely. The service users have access to the rear garden with benches, patio table and chairs. The home also has a conservatory, which provides additional communal space for people in residence to relax in, this area were not being used at this inspection. The bedrooms were seen, all have en-suite facilities. All rooms were modified to ensure service user’s safety such as radiator covers and pull cords for the staff alert system. Beds were made up with soft sheets and were very nicely presented and looked comfortable. We were informed that hot water taps throughout the home have been fitted with fail safe devices to reduce the risk of accidental scalding from the previously very hot water. One hot tap was tested and this was at a safe temperature. Foot operated flip top bins have been introduced to help to reduce the risk of cross infection from hand wash waste. Locks are fitted to bedroom doors and residents can have a key to their lock. Three of these locks were found to be Yale deadlocking types. This poses a hazard, as it is not possible to make an emergency entry to the room with the spare key. These locks must be adapted or changed. First floor windows were seen that were widely opening, this must be risk assessed for the individuals who have access to the room. The requirement at this inspection is for an audit of the rooms to identify risks and make adjustments and amendments as per the individual room and resident. One bathroom only used by staff had a box of hazard marked chemicals. The manager dealt with the removal and safe storage of these chemicals during the inspection. Braunton DS0000054718.V347165.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): 27,29,30 Quality in this outcome area is adequate. The home has a regular staff team. All staff had a current CRB check but the recruitment practice examined was flawed and compromised the safety of the people in residence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At this inspection there were three staff and the manager on duty in the morning and two staff on duty during the afternoon. The home has one waking night staff and one sleeping ‘on call’ night staff. The manager and the proprietors are on call in the event of an emergency or a need for management advice at night. Staff were described as being ‘very kind’ ‘nice’ and being ‘liked’ by the people living at the home. One commented that ‘they are great’. The night staff received praise for answering call bells promptly. The home has 75 of staff with a National Vocational Qualification (NVQ) in care and three staff working towards an NVQ, which represents 92 of the staff team, which is excellent. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 20 Recruitment files were sampled for three new starters. All had CRB checks in place. At the commencement of their employment one had a Protection of Vulnerable Adults (POVA) check but only one reference, a second had a POVA First check dated six days later than their start date and one reference on file. A third had a POVA check dated seven days after their start date and two references both dated later than the person’s starting work date. This is unacceptable. A minimum of a POVA First check and two references must be received before the person starts work at the home. The staff spoken with at this inspection confirmed their awareness of abuse and the need to protect vulnerable people in their care. Staff had received induction, which was described as being over a two day period where staff worked alongside an experienced member of the staff. Supervision had been carried out and is becoming a part of the routine management of the home. There are staff meetings and opportunities for staff feedback. The staff skill matrix was sent to CSCI with the AQAA before the inspection. This document had been produced for the homes Quality Rating submission to Social Services. Some of the dates given on this document indicated that training had been undertaken some time ago. This useful matrix should be updated to ensure that where skills have been refreshed the evidence is accurately represented. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. The home has an approachable capable manager. Health and safety environmental risk assessments and action is required. Service users views are important and are acted upon by the manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has an experienced and capable registered manager who has recently resumed her role at the home after taking maternity leave. There were some areas at this inspection such as the recruitment and POVA awareness that whilst being very significant shortfalls must not detract from the very good management work that has been addressed. The manager expressed a willingness to cooperate and work to improve and develop the service. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 22 The home is run in the best interests of the people living there. Feedback from the people in residence is taken very seriously. One comment that had been received as a result of the homes quest for feedback was logged as a complaint. This was investigated to ensure that the care practices were as good as they could be for that person. One person in residence at the home said ‘it’s not home but it is as good as’. All the people spoken with were satisfied with the service. The home does not manage any ones finances. Small amounts of money can be held for safekeeping. One such amount of money was checked, a record was held of the amount, the money was secure and access was restricted. Staff supervision records were sampled. Supervision had been undertaken and was recorded. The manager confirmed that supervision was booked for staff the following week. The homes maintenance records were sampled. Fire safety equipment, the fire alarm, emergency lighting and extinguishers had been serviced in April 2007 and 9.10.07. Weekly in house fire alarm tests are made; the last was recorded for 3.10.07. The last fire officer visit had been in May 2006. The fire risk assessment had been reviewed in March 2006. Accidents are recorded in the correct format that is data protection sensitive. No serious injuries had been reported. There are cleaning schedules for the home, however some areas were seen to require deep cleaning these included the bathroom’s dusty lampshade and the dusty skirting boards in the hall. The stair carpet looked worn and was ill fitting on one tread; this posed a trip hazard and was rectified at the time of the visit. Chemicals with COSHH hazard markings were seen in the staff toilet, which is a bathroom that is not used by residents. This was brought to the manager’s attention and the chemicals were promptly removed to a locked store. The home has some unrestricted first floor windows, three dead locking bedroom door locks and a bathroom radiator that is not covered and is a potentially hot surface in a resident area. We recommend at this inspection that the environmental risk assessments are reviewed and any remedial work is carried out. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 1 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 2 Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP38 Regulation 13(4)(c) Requirement Deadlocking bedroom door locks must be changed to enable the rooms to be accessible in an emergency. Staff recruitment must be safe and meet the requirement of the Care Home Regulations (2003) With regard to new not starting work until all POVA First and two written references have been received. Environmental risk assessments must be undertaken: 1.Where first floor windows can be opened widely. 2. Where a bathroom radiator is not covered and poses a hot surface risk of burning someone should they fall against it. The manager and all staff must have POVA awareness training. Manual handling risk assessments must be undertaken for assisted bathing. The tiles in the kitchen must be repaired to ensure that they form a wipe clean hygienic surface. Timescale for action 30/11/07 2. OP29 19(1)(b) (i) Schedule 2 30/11/07 3. OP38 13(4)(c) 30/11/07 4. 5. 6. OP30 OP8 OP38 10(3) 13(6) 13(5) 16(2)(j) 30/12/07 30/11/07 30/11/07 Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 25 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. 2. Refer to Standard OP26 OP38 Good Practice Recommendations The cleaning rota should be audited to ensure the deep cleaning is kept up to date. Harmful chemicals subject to COSHH legislation should be stored securely when not in use. Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Braunton DS0000054718.V347165.R01.S.doc Version 5.2 Page 27 - 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. 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