Inspection on 16/01/07 for Bungalow, The

This inspection was carried out on 16th January 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bungalow, The 24/11/05

Bungalow, The 12/07/05

Bungalow, The 27/09/04

Bungalow, The 15/04/04

Bungalow, The 08/03/04

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 HOME ADULTS 18-65 Bungalow, The 35 Grosvenor Avenue Crosby Liverpool Merseyside L23 0SB Lead Inspector Mrs Joanne Revie Unannounced Inspection 16th January 2007 10:00 Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 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 Bungalow, The DS0000005434.V304644.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 Adults 18-65. 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. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bungalow, The Address 35 Grosvenor Avenue Crosby Liverpool Merseyside L23 0SB 0151 928 8318 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) North West Community Services (GM) Limited Mr Thomas Robson Ritchie Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 3 LD The service should, at all times, employ a suitably qualified and experienced manager who is registered with the CSCI. Date of last inspection Brief Description of the Service: 35 Grosvenor Avenue is a detached bungalow located in a residential area of Crosby. It is situated close to local amenities and all forms of public transport. The home is registered to provide care and support for three people who have a learning disability. The service provider for the home is North West Community Services. The organisation has other similar homes in the North West region. The house is owned and maintained by LHT a local housing association. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The visit was unannounced and took place over three and a half hours. Discussions were held with the two service users who reside at the home, the manager, the responsible individual for the service and a member of staff. A variety of records were viewed which are referred to in the evidence section of the report. How the service promotes equality and diversity for service users was assessed as part of the visit. The service promotes individuality and respects and promotes service users rights. As this is a small service, details of how the service does this have not been provided to protect the service users anonymity. What the service does well: Service users needs are assessed on a regular basis. Support provided is altered to meet these needs and service users are fully involved in this process. This helps to make service users feel as though they are in charge of their lives. Staff are quick to take action if service users become unwell. One service users commented” I like it here, its my home, staff are good”. Staff support the service users to be as independent as possible. This includes helping with the usual domestic chores of any home such as food preparations, shopping etc. This encourages service users to develop daily living skills and helps to promote a homely relaxed atmosphere. One service user commented ” They help me (staff) and I help them”. Each service user is supported to do activities of their own choice. This includes education as well as recreation. One service user commented that “ I go out when I want, the staff always help me”. Staff support the service users to maintain relationships with other people outside the home who are important to them. Visitors are welcome whenever service users choose. Service users trust the staff and feel comfortable telling them if they are unhappy with something. The home is a clean comfortable safe place to live in. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 6 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. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service The service monitors service users well being and takes appropriate action when changes occur EVIDENCE: Two service users plans were viewed and a discussion was held with two service users and the manager. It was evidenced that both service users have lived at the home for some time. One has moved to the home since the last inspection. Appropriate contact and assessments were undertaken by the service to make sure that the new service users needs would be and could be met. As a consequence the new service user has settled into the home well. Evidence was available which showed that all changes in support are fully explored with the service users. Plans are reviewed as a minimum of six monthly. Records were viewed which showed that the service takes appropriate action should changes in needs occur. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The Quality outcome in this area is good This judgement has been made using available evidence including a visit to this service Each service user has an up to date plan, which clearly details their needs, likes and dislikes. Service users are encouraged to be empowered and make the usual decisions, which affect daily life. Service users are encouraged and supported to take risks according to their individual needs. EVIDENCE: Two service user plans were viewed. Each showed that the service users had been consulted and been involved in any changes to their care and support. A discussion with one service user showed that this was true. The plans are essential lifestyle plans and were found to be very detailed regarding the needs and wishes of each service user. The manager has provided summaries of the most important information within the plans so that new staff to the service are able to quickly gather knowledge about what is most important to the service users. The plans are reviewed six monthly. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 11 One plan was not as up to date as the other however it was explained and evidence was provided to show that this plan was being reviewed at the time of the visit. Staff keep clear daily records in a dairy. This was viewed and the standard of record keeping was found to be very good with clear details. Each plan contained detailed information of how the service user wished to be supported and how they would like staff to deliver this support. Viewing the daily records showed that staff do deliver the support how service users would choose. Both service users were positive about the support that they receive form staff during discussions. Team meetings are held monthly and are attended by staff and service users to discuss forthcoming events within the service or arise concerns etc. Minutes of these meetings were viewed on the office notice board. Both plans viewed showed that service users are encouraged to lead as independent lifestyle as possible. Both undertake individual activities with staff support when required. Both were supported to attain regular employment in the past. Contracts of these jobs were also held on file, which showed that the service was overseeing the service users rights. Each plan viewed contained detailed risk assessments around the individual activities and capabilities of each service user. All were current. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 The Quality outcome in this area is good This judgement has been made using available evidence including a visit to this service. Service users are supported to undertake appropriate leisure and educational activities both inside and outside the home. Staff support service users to maintain relationships, which are important to them. Service users are supported to take ownership of the home as if it were their own. Service users are involved in choosing shopping and preparing healthy food. EVIDENCE: Evidence for this section included discussions with two service users, the manager viewing two plans of care and indirect observation. During the visit both service users were observed undertaking domestic kitchen duties. One service user is supported to attend a local daycentre. Both service users have undertaken regular employment in the past. Both have undertaken courses at college such as numeracy and college. One service user regularly takes part in and has become very adept at the game of Boccia. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 13 Both agreed that the staff support them to find new activities and encourage and support them to visit the local community. One service user is being supported to improve their literacy skills. A short holiday had been planned shortly after the visit to a local retreat and service user had enjoyed holidays to Blackpool last year. Diary records showed that activities are organised on a day to day basis usually individually according to needs and preferences. However both service users enjoy playing bingo every Wednesday and visiting the cinema weekly also. Staff encourage service users to be as independent as possible around managing their finances. Both service users are registered with local G.P.s The home has transport which was viewed and appeared in good condition to enable service users to travel further a field. Both service users have essential lifestyle plans. These were viewed and each clearly specified who was important to them in their lives. The manager explained the regular visits that take place from these visitors. Viewing daily records showed this to be true. One service users visits a family member at her home on a weekly basis. Both service users agreed that they enjoy doing light domestic chores and one took pleasure in having their bedroom viewed which was furnished with numerous personal possessions. This service user explained that they liked to keep the bedroom clean and tidy. One service user offered to make hot drinks during the visit. Each ELP contained a detailed list of each service users different food preferences. A copy of a weekly menu was viewed which was displayed on the wall of the kitchen. One service user confirmed that they help with the weekly shopping. The manager agreed with this. Kitchen cupboards, storeroom, fridge and freezer were seen to be stocked with supplies to make nutritious meals and snacks. Both service users agreed that they are involved in choices and that they help prepare meals. One service user was observed peeling potatoes for the evening meal. Daily records were viewed which showed that staff are recording what meals have been eaten but no specific details were available to show that service users are supported to eat” five a day” portions of fruit and vegetables in line with government guidelines for health eating. This was discussed with the manager who felt that over the course of the day five portions were consumed by service users however record could be developed further to support this. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The quality outcome in this area is good This judgement has been made using available evidence including a visit to this service Service users receive personal support how and when they would like it Staff support service users to meet their physical and emotional needs Staff manage medication safely on behalf of service users but could improve on record keeping in this area. EVIDENCE: Two care plans were viewed. Each provided clear details of how service users prefer to receive personal support including specific days that this support is to be given. Daily records showed that staff delivered support in this way. One service user confirmed that staff provide support in the way that they prefer. Health care needs for each service user were also identified on the plans viewed. This included provide support to attend optician dental and G.P. appointments. Reading records and holding a discussion with one service user and the manager evidenced that the organisation and the home do take action if health needs change. Medication administration records and storage systems were viewed. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 15 The service has polices around administration disposal and receipt of medications. Permission has been sought from G.P.s to administer homely medications. Medications are blister packed so it is easy to identify at a glance whether medication has been given or not. Medication audits are carried out weekly to ensure medications are being administered as prescribed. All of these checks showed that medications are being administered however viewing records showed that blank spaces were evident on some records. Each service user has a locked cupboard attached to the wall for the purpose of medication storage. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The Quality outcome in this area is good This judgement has been made using available evidence including a visit to this service Service users understand how to complain and believe their concerns will be listened to. Staff have the skills to protect service users from abuse and promote their rights EVIDENCE: No complaints have been made to CSCI since the last inspection. The manager confirmed that none had been made to the home either and viewing the complaints file showed this to be true. A copy of the complaints procedure was viewed. This has timescales of response within 24 days and included the contact details for CSCI. Discussions with both service users confirmed that they understood how to complain. Both said they would approach any member of staff but would talk to the manager if it was more serious or if they were unhappy. A copy of the most recent guidelines on how to protect vulnerable adults was available in the office. Copies of the company’s own policy was also available. Through discussions the manager proved that he understood these and knew what to do if he suspected that abuse had occurred. Viewing three staff files showed that staff have had training on this subject and one member of staff confirmed during discussions that this was true. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 17 Both service users commented that they felt the staff could be trusted and agreed that they felt safe at the home Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The quality outcome in this area is good This judgement has been made using available evidence including a visit to this service The outside boundary of the home requires attention to ensure that it is as safe and secure as the inside. The home is a clean, warm comfortable place to live. EVIDENCE: A tour of the environment was undertaken. The manager explained that on going redecoration occurred however communal areas had been redecorated since the last visit. The home has two spacious lounges. One contains a dining table and the other a TV. Each service user has their own bedroom, which is furnished according to their personal tastes. All furnishings viewed appeared good quality and the home presented as a warm and comfortable place to live. The home has a separate laundry room, which is equipped with an industrial style washer and dryer. Although service user are involved in light domestic chores the majority of cleaning is undertaken by staff. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 19 Rotas were viewed which confirmed this. The manager audits these to ensure that tasks are completed. The home has a large garden. Trees on the perimeter had become overgrown and were in danger with interfering with overhead wiring. A small low fence has been placed around the boundary of the property but this was broken in places and appeared in effective. The manager explained that a landlord who was aware of these issues owns the property but as yet no date had been fixed to address these concerns. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality outcome in this area is adequate This judgement has been made using available evidence including a visit to this service Service users receive support from staff that they know well The organisation has robust recruitment procedures which helps ensure staff are “ fit” to do the job Staff have had training on how to promote service user safety. EVIDENCE: Discussion with the two service users showed that they understood who was in charge of the home. Viewing staff rotas confirmed that the service users receive support from a dedicated team of regular staff. The manager explained that although the night shift is covered by a sleeping member of staff waking staff can be provided if service users are unwell. Rotas were viewed which showed that this had happened in the past for a previous service user. The rota also showed that a mixed gender of staff are employed and utilised at key times to meet the service users needs. The rota also showed that start and end time of shifts are flexible according to the activities undertaken by the service users. The manager explained that the staff rota had been reorganised which meant that staff could be more flexible if the need arose. In particular the manager felt that this reduced the need for agency staff. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 21 Monthly team meetings are held for all staff and which are attended by Service user also. These meetings are used to plan forthcoming events etc within the home. Viewing the rota staff files and a discussion with the manager evidenced that only one member of staff out of a team of six does not hold a national vocational qualification or equivalent. Two of the staff files were viewed. These contained all of the documentation required by the care home regulations 2001. The manager explained that all new staff commence on a six month probation period and usually will shadow a senior support worker for 1 to 2 weeks depending on experience and capabilities. Viewing staff files and a discussion with a staff member and the manager evidenced that a programme of training is ongoing within the home. The manager explained that the areas manager sources training for the forthcoming year based on the requests made by the manager of each home. The manager explained that training needs for the home are identified through individual staff needs during supervision. Evidence of supervision sessions were viewed which supported this. As this inspection took place early in the year the manager explained that this years training plan was not yet available. However last years was available and was viewed. This showed that mandatory training such as food hygiene; manual handling etc was on going. Evidence was also viewed which showed that staff had received training in medication management since the last inspection. The manager explained that as mandatory training was now ongoing the intention was to source training for staff which was specific to the service users individual needs. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The quality outcome in this area based on vailbale evidence is good This judgement has been made using available evidence including a visit to this service. The service is managed effectively. Service users are consulted about aspects of the running of the home. The home is a safe place to live EVIDENCE: The manager is registered with CSCI. He has familiarised himself with his role and has developed audits to ensure that staff are undertaking their duties and to ensure that he is managing the service. Evidence of these audits was viewed and discussed with the manager. The manager is undertaking a national vocation qualification in management (level 4). The responsible individual confirmed over the home that he undertakes visits in line with regulation 26 of the care home regulations 2001. No completed format was available to view within the home however viewing the visitors book , a discussion with a service user and the manager confirmed that these visits regularly take place. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 23 The manager undertakes monthly audits in the following areas; finances, medications, communication diary, daily diary, essential lifestyle plans, water temperatures, fridge and freezer temperatures and monitoring of fire alarm. Completed audits on these areas were viewed. The manager explained that service users are not formally asked to complete surveys, as they are involved in all aspects of running of the home through monthly team meetings, which they attend. Minutes of these meetings were viewed which supported this. No health and safety concerns were identified during the tour of the environment or during the visit. A variety of documentation and certificates were viewed which showed that staff and the organisation is monitoring systems to ensure that the safety of the service users is promoted. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X X 3 X Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 25 no 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 YA20 Regulation 13.2 Requirement The manager must ensure that staff complete medication administration records to show that medication has been administered (or not) The responsible individual must ensure that the landlord takes action regarding the broken fence and the overgrown trees on the perimeter of the property. The manager must carry through his intention to source training for staff, which is specific to the service users needs. Timescale for action 28/02/07 2 YA24 23 01/04/07 3 YA35 18 01/04/07 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 YA17 Good Practice Recommendations The manager should ensure that record keeping is developed to show that service users are being offered five portions of fruit and vegetables per day as part of a healthy diet. The responsible individual should provide copies of past DS0000005434.V304644.R01.S.doc Version 5.2 Page 26 2. YA39 Bungalow, The regulation 26 visits within the home for future inspections. Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Bungalow, The DS0000005434.V304644.R01.S.doc Version 5.2 Page 28 - 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!