Inspection on 07/08/07 for Carham Hall

This inspection was carried out on 7th August 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 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

Carham Hall 17/07/06

Carham Hall 15/12/05

Carham Hall 10/05/05

Carham Hall 11/11/04

Carham Hall 22/07/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Carham Hall Cornhill On Tweed Northumberland TD12 4RW Lead Inspector Anne Urwin Brown Unannounced Inspection 7th August 2007 09:00 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 Carham Hall DS0000000511.V343685.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. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Carham Hall Address Cornhill On Tweed Northumberland TD12 4RW 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) 01890 830338 01890 830338 admin@carhamhall.wanadoo.co.uk Mrs J Baxter Mr J Baxter Mrs J Baxter Care Home 22 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (12) of places Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate one identified resident - category MD for periods of respite care. 17th July 2006 Date of last inspection Brief Description of the Service: Carham Hall is a large detached stone built house standing in its own grounds overlooking the River Tweed. The nearest villages are about a mile away and Coldstream, where there is access to public transport is about five miles. The Home is registered to accommodate up to twenty-one elderly people, ten of whom have been diagnosed with dementia. Carham Hall is well furnished and appointed with a large number of en-suite rooms, while others have exclusive use of a bathroom or toilet. A shaft lift is fitted for access to the first floor and a wheelchair lift is available for a short flight of stairs on the ground floor. Fees are from £407.00 to £600.00 per week. There may be an additional charge over and above the council approved rate for some rooms and this will be agreed at the time of admission. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 17th July 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 7th August 2007. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the providers what we found. What the service does well: The needs and wishes of each person living at Carham Hall had been properly assessed before they moved into the Home. This meant that staff knew about the needs of each person and what care and support they required. Appropriate plans of care and risk assessments had been completed for each person. This meant staff had the information they needed to support each person. The arrangements for monitoring and meeting the health care needs of people living at Carham Hall were good. This meant that people received the care and support they needed. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 6 The arrangements for supporting people to make decisions about their daily lives and individuals preferences are clearly recorded. Satisfactory arrangements were in place for people to take part in activities in line with their needs and preferences. The arrangements for supporting people living at Carham Hall to maintain contact with their friends and family were good. The relationships between staff and people living at the home were good and personal support was provided in such a way as to promote and protect privacy and dignity. The meals at the Home provided a varied, nutritious diet. Staffing levels were adequate and appropriate training is provided. This means that staff has the skills to meet the needs of the people living at Carham Hall. 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. Carham Hall DS0000000511.V343685.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 Carham Hall DS0000000511.V343685.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): Standards 1, 3 and 6 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information is provided for people thinking about living at Carham Hall so that they are able to decide whether or not to move into the home. Comprehensive assessments are carried out before and after admission to ensure that peoples’ needs are well planned and met at Carham Hall. Intermediate care is not provided at Carham Hall. EVIDENCE: The Statement of Purpose/Service User Guide is comprehensive and contains all of the information identified in Schedule 1 of the Care Standards Regulations. It includes information about the services offered by the home including staffing, who the home can care for, social activities, and arrangements for religious observance as appropriate, complaints, care Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 9 planning, and the homes environment. Changes are being made to the Statement of Purpose/Guide. Residents and their representatives are encouraged to visit the home and spend time there, this results in them having good information on which to base their decision to move into the home. Individual records contain comprehensive pre-admission assessments, which are completed by the Manager or the senior staff. The assessments cover the areas identified within Standard 3 of the National Minimum Standards for Care Homes for Older People. Staff draw up individual plans of care using the information in the assessment. In addition care management assessments were available in the records sampled. Four people spoken with during the inspection said that they were satisfied that staff were aware of their needs when they came to live at the home. They said they felt well supported when they came to live at Carham Hall. The home is not registered for, and therefore does not provide, intermediate care. Carham Hall DS0000000511.V343685.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): Standards 7, 8, 9 and 10 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good individual plans provide sufficient information for staff to support meeting peoples’ needs. Care is planned sensitively with people living at the home in a way they prefer. Peoples’ health care needs are well met using a multi-agency approach. This helps to keep people healthy. Good procedures and practice for dealing with medicines protects those living at Carham Hall. EVIDENCE: Each resident has an individual plan of care, which is based on the admission assessment and is then added to during the placement. The care plans contain an assessment for nutrition, skin care, moving and assisting, and continence Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 11 promotion as well as a dependency rating. The individual plans showed that account is taken of peoples’ diverse needs. These are up to date and are regularly reviewed. Good recording systems are in place. Comprehensive risk assessments are in place for specific interventions, and these are updated when necessary. Each person has regular reviews and they are involved in this process together with relatives/representatives if appropriate. Three people said that they are well looked after at Carham Hall and they are very happy with the support they receive. They also said staff are caring and kind. Staff are well informed about individual needs and demonstrated this during the inspection. Peoples’ health care needs and any specific treatments are clearly recorded. All contact with the doctor, district nurse and other health care professionals is recorded appropriately. Records showed that the home seeks expert advice from external professionals if necessary. Aids and other equipment are in place for those who need it. Residents said that the staff are aware of their health needs. They said they get support to attend appointments. Three people said they were satisfied that they can access the health services that they need. The systems for managing medicines in the home are in line with safe working practice guidelines. The records relating to the administration of medicines are fully completed and staff are clear about the procedures. Storage arrangements are satisfactory. Staff training in handling medicines has been provided so that they understand their responsibilities. Risk assessments are in place for people wanting to manage their own medicines and lockable storage is provided. Carham Hall DS0000000511.V343685.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): Standards 12, 13, 14 and 15 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have good opportunities to take part in a variety of leisure pursuits and activities that helps them to maintain links with the local community. Family contact is well supported and encouraged. People living at Carham Hall are encouraged to exercise control over their lives, which helps them retain their independence. Mealtimes are flexible to suit individual preferences and lifestyles. People are give plenty of choice and are supported sensitively to eat meals where they have specific needs. EVIDENCE: People living at Carham Hall said that they are able to make choices about their daily routines, like when they get up, go to bed and what they do with their time. Individual routines are identified within care plans. There is a programme of activities and information about this is made available to people Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 13 living there. People coming to live in the home receive information that describes regular activities and outings organised. Staff said that they are able to spend time on an individual basis with people living in the home. The atmosphere is homely and during the inspection it was observed that people are encouraged to make choices about where and how they spend their time. There are videos, music tapes, newspapers and books available. One person said she much preferred spending time in her room as she enjoyed her own company and had a wonderful view from her window. People living in the home said that they have regular visitors and this was evident from the Visitors Book and from seeing visitors coming in during the inspection. Two people said that they could see visitors in their own rooms or in the public areas of the home. Information is available for relatives about visiting and this is made available before a resident is admitted. There was evidence that the staff actively support people to maintain contact with relatives and friends. People are encouraged to continue to manage their finances for as long as they are able and this was evident from care plans. They are encouraged to bring in furniture, ornaments and pictures from their previous homes. Rooms are personalised and reflect peoples’ interests and taste. People are encouraged to follow their own religion and local ministers visit the home regularly. Information is available at the home about advocacy services if any resident needs this. The menu shows that a varied diet is provided that offers choice at each mealtime. Peoples’ likes and dislikes are recorded and the staff regularly consults with them about the food. There is choice about where food is served so that people can choose to have their meals in their room or in the dining room. People living in the home said that the food is well cooked and presented. They said that they have plenty of choice as well as being able to make suggestions for the menu. Staff have completed Food Hygiene training. Carham Hall DS0000000511.V343685.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): Standards 16 and 18 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A satisfactory complaints procedure is in place and is made available to people living in the home and their representatives to ensure that complaints are dealt with effectively and to the satisfaction of the complainant. Good arrangements for protecting people using the service are in place. EVIDENCE: Each person is supplied with a copy of the complaints procedure, which is clearly written and easy to understand. People living in the home said they were aware of how to make a complaint and that they felt able to speak to the owners or the staff if they have any concerns. They said that they were satisfied that their concerns would be taken seriously. Records of complaints are good and this includes details of the investigation and any actions taken. Staff were aware of how to help someone living at Carham Hall to make a complaint. Policies and procedures provide clear guidance to staff about protecting people living in the home and the action to be taken in the event of any allegations being made. People using the service are made aware of what abuse is and the safeguards in place for their protection. Access to external agencies is promoted. Staff were clear about the procedures to be followed if an Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 15 allegation is made. Staff training has been provided in Protection of Vulnerable Adults. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 16 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): Standards 19, 20, 21, 22, 24 and 26 were inspected. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Carham Hall provides a safe, well-maintained homely environment that encourages independence. It has very attractive gardens that are easily accessible for people living in the home. Good quality accommodation is available for individuals in single rooms with en-suite toilets or the exclusive use of a toilet. Specialist equipment is available to maximise peoples’ independence. The home is clean, pleasant and hygienic. EVIDENCE: Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 17 The home’s management have upgraded the accommodation to a high standard over the last few years. Carham Hall provides good quality accommodation that is well maintained and suited to the needs of the people living there. The environment is comfortable and accessible to people with physical disabilities. Adaptations and specialist equipment are available to suit the needs of the people living in the home. The gardens are attractive, accessible and well maintained. The sitting and dining rooms are well furnished and the décor is of a high standard. There is a selection of impressive communal areas within the home that have good views out to attractive accessible gardens that are well used by people living there. People living in the home said that they feel very satisfied with the quality of the accommodation. One person said “ It is very comfortable here and I spend most of my time in my room as I have such wonderful views. I watch the birds feeding in the garden, just beside my window. Another person said “I have been able to bring my own furniture and other bits and pieces that make it just the same as my own home was.” People have access to specialist equipment and aids that are necessary to help them live as independently as possible. There is a shaft lift for access to the first floor and a stair lift accesses bedrooms on the ground floor. Bathrooms are well equipped and are homely. Sufficient baths and toilets are available to meet the needs of the people using the service. Aids and adaptations are fitted to maximise peoples’ independence. Records showed that aids are provided as people need them by the home. Each room has its own en-suite toilet and in some cases bath or the exclusive use of a bathroom/toilet. Bedrooms promote high levels of privacy and keys are available to each room. Some rooms are very impressive and spacious. All rooms are comfortably furnished and show that individuals are encouraged to bring items from their previous home. People are able to make choices about the temperature of the heating in their rooms. Double bedrooms are in use only when people have chosen to share. The laundry is well equipped and good infection control procedures are in place. The home is well lit, clean and tidy and no odours were evident. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 18 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): Standards 27, 28, 29 and 30 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are sufficient to meet the needs of the people living at Carham Hall. Opportunities for training are good and this enables staff to learn new skills to better support the people living at the home. Good recruitment procedures protect people living at the home. EVIDENCE: The rota showed that there are enough staff on each shift to meet peoples’ needs. However there are regular occasions when staff are working up to sixty hours per week, particularly when there are staff holidays. The rota showed a variation of between forty and sixty hours for staff in the week of this inspection. This means that this system of working could place undue pressure on staff that may affect the quality of care provided. People living in the home said during the inspection that there were enough staff on duty at the home. One person said that there “are enough staff on duty and that they are kind and helpful. They know what I need help with.” Staff said that generally there are enough staff to cover the rota and that arrangements for covering holidays and sickness mean that people work extra hours. At night there is one waking Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 19 night staff on duty and the owners live on the premises and are available on call. Eighty four per cent of staff have completed national qualifications in care and two staff are currently working towards their award. Staff are committed to training and recognise the importance of gaining recognised qualifications. They said they feel training is well supported by the management of the home. Staff recruitment policies and procedures are in place to protect people living at the home and records show that these are followed. Diversity and equal opportunities issues are included in guidance. Appropriate reference and Criminal Records Bureau checks are carried out and evidence of these was in individual records. The training records show that appropriate training opportunities were provided during the past year. Records are clearly maintained and offered an efficient and easily examined system. Statutory training is provided and includes moving and handling, food hygiene, first aid, fire, and health and safety. Staff said that new staff receive comprehensive induction training and records confirm this. They also said that there have plenty of opportunities to access training. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 20 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): Standards 31, 33, 35 and 38 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager is qualified and experience in running this service. There are good management systems in place to ensure that the service runs smoothly to provide good quality care for the people living at the home. Quality assurance systems are in place, but these could be improved by introducing regular audits of records. This will help to shape the quality of the service to suit the needs of the people living there. Personal allowance management is good and the systems and records are in place to allow audit to be effective. Peoples’ financial interests are safeguarded by the appropriate systems for handling money held on their behalf. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 21 People living in the home and staff are protected by the good systems and practices for health and safety. EVIDENCE: The Manager has the required qualifications and experience to run the home and meet its aims and objectives. Management systems for strategic and financial planning are in place to ensure that the home is well run. The management of the home have a clear vision of the home’s values and priorities. The owners communicate a clear sense of direction and are in the process of reviewing quality systems in relation to customer satisfaction, continuous improvement and quality assurance. One of the people living at the home said “The owners are always around and they are very approachable and I can talk to them if I have any concerns.” The Manager undertakes regular training and understands and values the importance of her continuing professional development. There are effective systems in place for safeguarding and managing money held on behalf of people living in the home including clear records. People using the service or their relatives have access to the records whenever they wish. Records show that training in moving and handling, first aid, fire safety, food hygiene and infection control is provided at regular intervals. Staff said that they receive this training. Records showed that regular checks are made of electrical equipment and the central heating system. Risk assessments are in place for safe working practices. Staff said that appropriate induction training is provided for new staff and records are in place to confirm this. Records of fire alarm tests, servicing of fire equipment and the alarm, fire training and emergency lighting are kept in a suitable manner. Full details of accidents are kept. Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 4 X 4 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP27 OP33 Good Practice Recommendations Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Carham Hall DS0000000511.V343685.R01.S.doc Version 5.2 Page 25 - 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!