Inspection on 18/07/07 for Cairndhu Rest Home Ltd

This inspection was carried out on 18th July 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

Cairndhu Rest Home Ltd 18/06/09

Cairndhu Rest Home Ltd 18/07/08

Cairndhu Rest Home Ltd 06/07/06

Cairndhu Rest Home Ltd 13/03/06

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Cairndhu Rest Home Ltd 6 Warren Road Blundellsands Liverpool Merseyside L23 6UB Lead Inspector Ms Lorraine Farrar Key Unannounced Inspection 10:45 18th July 2007 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 Cairndhu Rest Home Ltd DS0000065360.V333036.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. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cairndhu Rest Home Ltd Address 6 Warren Road Blundellsands Liverpool Merseyside L23 6UB 0151 924 8427 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) Cairndhu Rest Home Ltd Ms Veronica Parker Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The Service is registered to accommodate up to a maximum of 17 service users in the category of OP. The Service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 6th July 2006 Date of last inspection Brief Description of the Service: Cairndhu is registered to provide personal care and support for seventeen older people. Staff are available in the home twenty-four hours a day to assist the people living there and meals and laundry facilities are provided. The house is semi-detached in a residential area of Blundellsands. It fits in well with local houses and is not immediately distinguishable as a care home. It is well located for accessing local facilities including shops, cafes, pubs, Crosby Beach and public transport. Cairndhu is operated and managed by Veronica Parker who has worked in the home for many years. She is assisted by a deputy manager and a staff team who are experienced carers and well known to the people living there. Accommodation within Cairndhu is provided over three floors. Private accommodation is available in either single or double bedrooms, with a lift providing access to the upper floors. Shared accommodation is all downstairs and consists of a sitting room to the front of the house and a large dining room with lounge to the back of the house. The home also has a large front garden with parking and rear gardens with seating areas. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. An unannounced visit took place for six and a half hours on the 18th July 2007. This included reading records and looking at the building. Time was spent looking in depth at the support three of the people living at Cairndhu receive. This included looking at the support they get with their care plans, medication, money, activities and environment. The inspector talked with seven of the people who live at Cairndhu. She also had discussions with four visitors and three members of staff including the manager. Any information the Commission for Social Care Inspection (CSCI) has received since the last key inspection of Cairndhu is also taken into account in writing this report. This includes information provided by the manager on a pre-inspection questionnaire and any random inspection visits that have taken place at Cairndhu. Comment cards were sent to the people living at Cairndhu and their relatives. Two of the people living there and four of their relatives returned these. Their views were taken into account in writing this report. It costs between £332.50 and £360 each week to live at Cairndhu. Social Services may contribute towards this fee. What the service does well: The people living at Cairndhu say that they are very happy living there. One person commented, “On crossing the threshold, I knew instinctively that this was my future ‘HOME’, and this is where I wanted to live. The atmosphere simply oozed friendship and care, it was quite uncanny. I had been used to a happy home environment and this matches perfectly”. Another person said “To sum up, this is a lovely home. Lovely well kept gardens and very kind and loving carers. I’d recommend it to anyone”. There are sufficient staff available to meet the needs of the people living there and to spend time talking with them and responding quickly to their requests. Staff and the manager always take time to listen. One person explained, “there’s always someone to listen” and everyone spoken with said that they know how to raise concerns or complaints and were confident these would be dealt with. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 6 Meals and drinks are provided throughout the day with people offered the opportunity to have these facilities within their room if they wish. The people living at Cairndhu said that they are offered plenty of choice and “want for nothing”. There is sufficient space within the house for people to spend their time alone or in company, as they prefer. Aids and adaptations are provided to help people with their mobility and remaining as independent as possible. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cairndhu Rest Home Ltd DS0000065360.V333036.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 Cairndhu Rest Home Ltd DS0000065360.V333036.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&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient information is provided to and obtained about, potential residents to ensure that Cairndhu can meet their needs and choices. EVIDENCE: The people living at Cairndhu and their relatives said that before they moved in they were provided with sufficient information to help them decide if Cairndhu was the right place for them to live. One person explained, “On crossing the threshold, I knew instinctively that this was my future ‘HOME’, and this is where I wanted to live. The atmosphere simply oozed friendship and care, it was quite uncanny. I had been used to a happy home environment and this matches perfectly”. Records showed that before offering anyone a place to live the manager and deputy manager meet with the person and if appropriate their family and any health and social care professionals who support them. An assessment of the Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 9 persons support needs and their choices is carried out. The person and their family are invited to visit Cairndhu and meet with those working and living there. This information helps everyone to decide if Cairndhu can meet the persons needs and their choices and is the right place for them to live. Cairndhu does not provide an intermediate care service. Cairndhu Rest Home Ltd DS0000065360.V333036.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 adequate. This judgement has been made using available evidence including a visit to this service. The people living at Cairndhu receive support with their personal care in a way that ensures their independence and privacy is respected. However systems for recording support with health care do not always ensure that any issues are quickly noted and therefore acted upon. EVIDENCE: The people living at Cairndhu said that they always receive the care and support they expect and need with one person explaining, “Greatest care is taken”. Another person said, “You go to bed when you want. Staff help with whatever you want. It doesn’t matter what you ask them to do they do it. I want for nothing”. Individual care plans and records are in place for everyone living at Cairndhu. These had been signed by the person and a resident spoken with confirmed that staff discuss her care plan with her so she is aware of the contents. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 11 Care plans contain information about the persons history, the things they do and don’t like and the support they need with their personal care. One plan recorded that after assisting a lady into the bath staff should leave her alone until she rang for support to get out. The lady confirmed that staff followed this and ensured she had privacy and enough time when in the bath. This also helps to ensure that people are supported to remain as independent as possible. Other plans recorded that people get up when they want and the people living there confirmed that they make their own choices about this, with staff respecting their wishes. They also explained that staff respond quickly to requests for help or if they ring their call button and that they are offered a cup of tea if they wake during the night and first thing in the morning. Throughout the site visit staff were seen to talk respectfully to the people living there and to respond politely and quickly to requests for support. Records showed that people are offered support to access health care with appointments for regular health checks such as the optician and GP as well as support when they are unwell. Although care plans had been reviewed each month not all of the health information in them was up to date. For example some plans contain an assessment to look at the risk to the person of developing pressure sores. One of these had not been completed since 2005. Although this had not resulted in adverse effects for the person these assessments are supposed to be completed regularly so that any changes can be quickly noted and acted upon before an issue arises. Daily records for one person recorded that they had, “been really good today” and “complaining about silly things”. In discussion the person explained that she gets the support she needs and that staff always respond to her requests politely. However this method of recording is not respectful or factual and could have a negative impact on the long term view of the persons needs and choices. Medication is stored correctly in a locked cabinet and all staff who deal with residents medication have had training in this area. Good practice was noted in that one lady is supported to manage her own medication with a risk assessment in place and locked storage provided for her. Medication is received from the chemist in a blister pack and staff sign to confirm the amount received. There is also a system in place for regularly auditing the medication to ensure it is correct. However this audit had not been carried out recently. One blister pack had the seal intact but a tablet missing. Another contained one more tablet than had been signed for. This means that people may not always have their medication as prescribed or have it available to take. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 12 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 people living at Cairndhu are supported to live a lifestyle of their choice and remain as independent as possible. EVIDENCE: During the site visit some of the people living there were out and about in the local community. Others were engaged in chatting with visitors, looking through old photographs with staff and spending time in their room engaged in activities of their choice. Several of the people living there said that they did not want entertainment or activities provided daily. However they explained that they enjoy the times an entertainer visits, a yearly barge trip, theatre trip and monthly ‘arm chair exercise class’. A hairdresser visits weekly and there is a Church of England service held monthly with communion provided fortnightly by a Catholic Eucharistic Minister. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 13 During the day visitors were seen to arrive frequently and those spoken with said that they are able to visit whenever they wish and that they are “made very welcome at any time”. Another visitor explained that, “we are very happy with it. Its homely not an institution”. Although the menus shows a variety of meals are offered, there is no set alternative to main meals. However the people living were positive about the meals offered. One person explained, “If you don’t like them they do something else. We are very well treated, get anything we want”. Another that, “You get as much as you want, you are never hungry. If you want anything you only have to ask and you get it. I have a nice life”. Throughout the day staff were seen to make drinks regularly and a resident explained that in addition to set times, “you can have a drink whenever you want”. Good practice was noted in that some residents are supported to have facilities in their room to make hot drinks and snacks as they choose. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 14 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 people living at Cairndhu are confident that their views are listened to and any concerns they have will be acted upon. EVIDENCE: The people living at Cairndhu said that they know who to talk with if they are unhappy and how to make a complaint. One person added “I have never really heard anyone say they are unhappy here” and another that “There is always somebody who will listen”. No complaints or concerns about the service at Cairndhu have been raised since the last inspection. There are polices and procedures in place for dealing with these and staff have had training in recognising and reporting any concerns or potential adult protection issues. One of the people living there explained that she would talk with the manager or deputy manager who, she was confident would, “definitely listen”. Another said that she knows who to talk to about concerns but explained, “I’m happy”. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Cairndhu provides a warm, welcoming and clean home for people to live in with suitable adaptations to meet their needs and support their independence. EVIDENCE: Located in a residential area of Blundellsands Cairndhu is set back from the roads and provides a peaceful environment with well maintained gardens that people can sit and relax in. However due to its location it has easy access to public transport and a local, busy shopping area. Downstairs there is a front lounge with TV and to the rear of the house is a linked dining room and second lounge with music and TV provided and doors out into the garden. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 16 The majority of bedrooms are single rooms, where these are shared screens are provided for privacy. Bedrooms are located over the three floors of the house with a passenger lift to access the upper floors. There are bathrooms and toilets provided throughout, although none of the bedrooms have en-suite facilities they have washbasins and commodes can be provided. The day prior to the site visit a flash flood had affected the basement laundry room. However the manager acted quickly and due to the design of the room it was able to be used again the following day. Gloves, aprons and disposable bags are all available to help staff deal with any potential outbreak of infection. The people living at Cairndhu said that the home is always fresh and clean with one person explaining, “You could eat your dinner off the floor!!! No bad smells either”. Rooms visited during the inspection were all clean and nicely decorated with a homely atmosphere throughout. Aids and adaptations are provided to support the people living there. These include, call buzzers, ramps, storage for motability scooters, handrails and bath chairs. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 adequate. This judgement has been made using available evidence including a visit to this service. The people living at Cairndhu are confident in the support provided by the staff team. Training planned for staff will further enhance their skills in ensuring people are safely and effectively supported. EVIDENCE: The people living at Cairndhu were positive about the staff team. Their comments included, “Staff are ‘marvellous, always cheerful” and staff are “good, hard working, we have a laugh”. A record of the staff rota showed that there are two carers working during day time hours with an additional carer at busier times. There is also a cook and domestic on duty and the manager and deputy are both available throughout the day. At night there is one carer ad a carer sleeping on the premises to help with any emergencies. The people living there said that staff are always available to talk with and to support them when needed, responding quickly ad positively to requests for support. Of the fourteen care staff two hold a qualification in care and six are about to start working towards this (NVQ). This qualification is nationally recognised and will help to ensure carers are up to date with their practice and in the support they offer to people. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 18 Records showed that the manager carries out checks on new staff, these includes obtaining copies of references, Criminal Records Bureau (CRB) checks and a check on the protection of vulnerable adults list. These checks help to ensure staff are suitable to work within a care setting and protect the people living there. Staff have received training in basic areas of care including dealing with medication, food hygiene and fire. A newer member of staff had received an in-house induction and a plan of the future training she would need had been compiled. Future training is planned in understanding visual impairment. This is good practice, as it will help staff to understand the needs of individual residents and ensure they receive sufficient training to be able to support people correctly. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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. This judgement has been made using available evidence including a visit to this service. Cairndhu is a safe place for people to live in, further development of quality assurance systems would enable the people living there to help plan future developments. EVIDENCE: Miss Veronica Parker is the registered owner and manager of Cairndhu. She has many years experience within the field of care for older people and has worked at the home for some time, she also holds a management qualification. Lines of accountability within the home are clear and this information is passed to residents and their relatives via the homes statement of purpose. She undertakes regular training to ensure she remains up to date in care issues. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 20 There are some systems in place to check the quality of the service provided at Cairndhu. This includes a monthly check of the environment and equipment used. Where issues are identified these are noted and addressed. In addition a system is in place for regularly reviewing care plans and for planning future improvements to the environment. The people living at Cairndhu said that there is always someone to listen to and one explained the manager is, “very kind, always ready to help and listen”. However there is no formal system in place for obtaining the views of the people living there, their relatives and friends and other professionals involved in the service. A formal system would provide people living there with a way to express their views and influence planning for future improvements. The service does not act as appointee for anybody’s benefit money. This is either managed by the person themselves or their family. At the time of the site visit they were not holding any monies belonging to the people living there. However some people do have a safe place to store their money in their bedroom if they wish. Records and certificates showed that checks are carried out on equipment and the premises to ensure they are safe. This includes annual checks on the gas supply and small electrical appliances as well as regular fire checks and servicing of the lift. Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 21 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 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 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 3 X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 Score N/a X X 3 3 X 2 X N/a X X 3 Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 22 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 OP8 Regulation 14(2) Requirement Health assessments for the people living at Cairndhu most be reviewed and updated regularly. This will help to ensure that any issues are quickly identified and acted upon. 2. OP9 13(2) Regular auditing of medications must take place. This must be recorded. This will help to ensure that people’s medication is managed safely. 30/08/07 Timescale for action 30/08/07 Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 23 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 OP9 Good Practice Recommendations The Registered Person should consider replacing the glass doors on the medication cupboard with something more secure and appropriate for the safe storage of medication. This is a recommendation of the previous two inspections. 2. OP7 Staff should receive training in accurate and factual report writing. This will help to ensure that records are factual and not an expression of the member of staff’s opinion. A survey of the views of people closely linked with the service should be carried out. This will help offer them the opportunity to influence future plans for the service. 3. OP33 Cairndhu Rest Home Ltd DS0000065360.V333036.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 - 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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