Inspection on 20/02/07 for Castle View

This inspection was carried out on 20th February 2007.

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

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

Other inspections for this house

Castle View 04/08/06

Castle View 21/03/06

Castle View 12/10/05

Castle View 21/02/05

Castle View 25/08/04

Castle View 19/01/04

Castle View 30/10/03

Castle View 20/01/03

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

CARE HOMES FOR OLDER PEOPLE Castle View Bridport Road Dorchester DT1 2NH Lead Inspector Amanda Porter Key Unannounced Inspection 20th February 2007 10:10 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 DS0000028257.V330543.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. DS0000028257.V330543.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle View Address Bridport Road Dorchester DT1 2NH 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) 01305 756476 01305 756479 castleview@coltencare.co.uk www.coltencare.co.uk Colten Care Limited Mrs Lucy Jane Bradley Care Home 57 Category(ies) of Old age, not falling within any other category registration, with number (57) of places DS0000028257.V330543.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home may accommodate a maximum of 36 service users who require nursing care. A recommendation is made that Mrs Bradley completes an external course in adult protection issues and management within six months and provides evidence of completion to the CSCI. 4th August 2006 Date of last inspection Brief Description of the Service: Castle View is a purpose built care home located on the outskirts of the county town of Dorchester in Dorset. There are several local and national bus, coach and rail links within the town itself and the home also has car parking space for visitors. The home is registered to accommodate a maximum of 57 older people in 53 single and 4 suites (bedroom and sitting room) arranged over 4 floors; all are accessible by the use of passenger lifts. All rooms have en-suite toilet facilities and there are 3 lounges and a separate dining room plus activities rooms. The home may accommodate a maximum of 36 people requiring nursing care. There are also attractive outside patio and garden areas for residents and visitors use. The home employs a full time activities coordinator and offers a wide range of activities and has regular mini bus outings to places that residents have shown an interest in. Colten Care Limited owns the home, a company who have a number of care homes in Dorset and adjoining counties, and is managed on a day to basis by the registered manager, Mrs Lucy Bradley. Colten Care Limited aims to provide its residents with a secure, relaxed and homely environment in which their care, well-being and comfort are of prime importance. Weekly fees range from £658 for residential care and £794 for nursing care. Additional charges are made for hairdressing and chiropody. See the following website for further guidance on fees and contracts: http:/www.csci.org.uk/about_csci/press_releases/better_advice_for_peop le_choos.aspx DS0000028257.V330543.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 20th February 2006 and took approximately five hours. The purpose of the inspection was to assess all of the key standards and review the requirements and recommendation made in the last report. The Registered Manager, Mrs Bradley, and Colten Care Assistant Operations Manager, Mrs Armstrong, were on hand to aid the inspection process and were very helpful throughout. Information gathered for this report came from several sources including: • Reports made to the Commission for Social Care Inspection by the home and Colten Care’s management team. • Tour of the premises. • Review of a variety of documentation including care records, staff records, maintenance records, policies and procedures. • Discussion with residents and staff. Five residents and five members of staff were spoken with and asked their views on the service provided at Castle View. Comments received included: “I’m fine, they look after me well.” “The staff are generally good. Some are better than others.” “Matron is very helpful and if I have any concerns she will sort them out.” All the staff and residents were most welcoming and helpful. What the service does well: Residents at Castle View are cared for by staff who treat them with respect and uphold their right to privacy. The activities arranged within the home meet the expectations of the residents living there. Residents are encouraged to maintain their links with friends and family and all visitors are made welcome. Residents are helped to exercise choice and control over their lives as far as possible. Castle View is well maintained and the standard of the environment is good providing residents with an attractive and comfortable place to live. The home is clean and free from any unpleasant odours. Sufficient numbers of staff are on duty throughout the day and night to be able to meet the needs of the residents. DS0000028257.V330543.R01.S.doc Version 5.2 Page 6 Financial procedures within the home also ensure that residents’ interests are protected. What has improved since the last inspection? The Registered Manager has worked extremely hard to ensure that most of the requirements made in the last report have been met. The home carries out thorough assessments prior to residents moving in and assurances are given that individual needs can be met. A large amount of training has been organised and well attended. This has provided staff with the information and skills to give a good standard of care to the residents at Castle View. Training undertaken includes: • Palliative care. • Protection of vulnerable adults. • Falls awareness. • Sight/hearing awareness. • Effective communication. • Professional accountability. Care documentation has been improved. Assessments are thorough and contribute towards the plan of care to be given. The care plans generally give clearer information on how the residents’ needs are to be met but there continues to be room for improvement. Residents and their representatives are included in the review of care plans. Their individual wishes are reflected in the care given. Some staff have received training in many aspects of palliative care. Colten Care has reviewed it’s policy on palliative care and staff are following the guidance given. The home has introduced the role of “Social Carer”, which means that residents who are unable to attend the group activities have the opportunity of one-to-one time with a member of staff. Residents continue to like the food provided and enjoy the choices offered at each meal. A more thorough nutritional assessment has been completed for each resident to ensure that dietary requirements are met. The complaints procedure can reassure residents that their views are important to the home and that any complaints they raise will be properly investigated. The policy has been reviewed and includes contact details for the local Primary Care Trust and Social Services. DS0000028257.V330543.R01.S.doc Version 5.2 Page 7 The home protects the residents from abuse by ensuring robust policies and procedures are in place, which staff can easily follow. A thorough recruitment process is now followed when employing staff, which ensures that residents are protected from risk. Mrs Bradley has commenced work towards her Registered Managers Award and is due to finish later this summer. This has helped in giving her the necessary skills to manage this large home. Staff and residents confirmed they felt she is a competent manager. The standard of record keeping has much improved since the last inspection and is now of an acceptable standard. The health and safety of the residents and staff are protected by the policies and procedures that the staff follow at Castle View. Staff have received training in health and safety within the home. 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. DS0000028257.V330543.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000028257.V330543.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 4. Standard 6 is not applicable to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents move into the home having had their needs assessed and been assured that these needs will be met. Through recent training and revision of policies, staff are more equipped to meet the needs of residents living at Castle View. EVIDENCE: The care documentation for five residents was reviewed. Each file contained a pre-admission assessment. Since the last inspection the paperwork used for the pre-admission assessment has improved and now documents that a full and informative assessment had taken place. Sufficient information was gained so that a care plan could be drawn up for staff to follow, to ensure that the resident’s care needs could be met appropriately. DS0000028257.V330543.R01.S.doc Version 5.2 Page 10 The Registered Manager wrote to each prospective resident giving assurance that their needs could be met. Since the last inspection shortfalls in training have been addressed and staff are more equipped to meet the needs of the residents at Castle View. For those residents needing specialist equipment, such as a pressure-relieving mattress, it was seen to be provided and used appropriately. DS0000028257.V330543.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 & 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning system in place, which provides staff with most of the information they need to meet residents’ needs. However to ensure that staff are able to give a high standard of care these plans must contain specific rather than general information. The health needs of the residents are well met with evidence of good support from community health professionals. The medication at this home is well managed promoting the good health and well being of residents. Residents are treated respectfully and care is offered in a way that protects their right to privacy and dignity. Policies and procedures are in place and are followed to ensure that, at the time of their death, residents and their families are treated with care and respect. DS0000028257.V330543.R01.S.doc Version 5.2 Page 12 EVIDENCE: The care documentation for five residents was reviewed. Files contained a variety of assessments including: • Moving and handling • Nutrition • Activities of daily living • Risk of falls • Environmental risks • The risk of pressure sores. Information from the assessments was used to formulate plans of care. Most of the care plans clearly set out individual care needs and how they are to be met. However, there were still some that gave general rather than specific instructions as to how needs were to be met. Residents and/or their chosen representatives were invited to be involved in drawing up care plans, which were reviewed regularly. Residents spoken with were happy with the care they received. It was clear from discussions with staff and residents that they have access to the health services they need. There was evidence to show that residents get support from General Practitioners, the local hospital, the district nurse, chiropodists, opticians and dentists. The home has a well-written and informative medicines policy and procedure including reference to self-administration and associated risk assessment and arrangements for ordering, administration and disposal. Medicines were stored securely. However, there was no clear audit trail to identify how much medication was held by the home. Examination of records indicated that medicines are properly administered in accordance with the prescriber’s instructions. Comments received from residents confirmed that staff treated them with respect and were supportive and kind. Staff have received training in various aspects of palliative care. The home’s policy for palliative care has been reviewed and updated and staff are following the guidance provided. Further documentation was reviewed with regard to palliative care given at Castle View and it was clear the staff had a better understanding of the needs of residents and their families towards the end of life than at the previous inspection. DS0000028257.V330543.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an adequate range of social opportunities available in the home, which reflects residents’ interests and preferences. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Residents are helped to exercise choice and control in their daily lives within their capabilities and desire to do so. The dietary needs of residents are generally well catered for with a balanced and varied selection of food available that meets their tastes and choices. EVIDENCE: The home continues to provide a variety of activities, which residents enjoy. These include: • Minibus outings • PAT dog visits to the home DS0000028257.V330543.R01.S.doc Version 5.2 Page 14 • • Musical entertainment Quizzes and games. It was clear through discussion with residents that some of them preferred to arrange their own social activities, which they were free to do and they could spend their days as they wished. The home has introduced the role of “Social Carer”, which means that residents who are unable to attend the group activities have the opportunity of one-to-one time with a member of staff. Residents and staff confirmed this was working well and was much enjoyed by residents. Residents confirmed that they could receive their visitors in private and that they were always made very welcome. The menu provided choice and the chef was aware of residents’ likes and dislikes. Residents confirmed they could take their meals where they wished and some preferred to eat in their rooms and some preferred to go to the dining room. They said they liked the food offered. Each care file seen contained a nutritional assessment, which had been completed. This alerted staff to the dietary needs of each resident and where supplements were needed they were provided. DS0000028257.V330543.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A written complaints procedure leaves residents in no doubt that steps will be taken to deal with any complaint or concern they may have. Staff’s knowledge and understanding of Adult Protection issues provides a safe environment to protect service users from abuse. EVIDENCE: The home has a clear complaints procedure available to everyone. Since the last inspection the registered manager has investigated nine complaints, five were substantiated and two were partially substantiated and appropriate action was taken where necessary. Residents spoken with during the inspection said that if they had any concerns they would feel confident about talking to the manager, knowing that she would listen to them. Castle View has a robust policy and procedure to respond to suspicion or evidence of abuse or neglect. Staff had received training on abuse. Through discussion staff demonstrated knowledge of the Department of Health guidance “No Secrets” and local protection of vulnerable adults procedures. DS0000028257.V330543.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): 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within Castle View is good providing residents with an attractive, homely and safe place to live. The home is kept clean and smells pleasant thereby making daily life for all in the home more pleasurable. EVIDENCE: The home has a programme of routine maintenance and the home provides an extremely comfortable environment in which to live. Records show that a variety of outside agencies have attended the home to undertake the routine maintenance of: • Fire safety equipment. • Gas installation. DS0000028257.V330543.R01.S.doc Version 5.2 Page 17 • • Lift. Hoists. A call bell system is available in every room. All areas of the home were clean and there were no unpleasant odours. The laundry was well managed and adequate supplies of clean linen were seen to be available. DS0000028257.V330543.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): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient staff are employed and deployed to meet the care needs of residents. Robust recruitment procedures are in place to protect residents from the risk of unsuitable staff working at the home. Staff are generally well trained and experienced and residents could be confident they would be well looked after. However residents would benefit from more staff having NVQ level 2 in care award. EVIDENCE: At the time of inspection staff rosters demonstrated that there are sufficient staff on duty at all times. During the inspection call bells were answered promptly and residents commented that staff were on hand when they needed them. The home has an ongoing training programme, which includes NVQ level 2 in care. The registered manager confirmed that at the time of inspection less than 50 of care staff held this award but since the last inspection several health care assistants had started work on this award. DS0000028257.V330543.R01.S.doc Version 5.2 Page 19 Five • • • • • • staff recruitment files were reviewed and they contained: Completed application forms Two written references Enhanced CRB and POVA first checks Terms and conditions of employments Documentary evidence of any relevant qualifications Proof of identity, including a photograph. Training files demonstrated that healthcare assistants were receiving induction training and this was confirmed with staff spoken with during the inspection. The Registered Manager had encouraged staff to take up a number of training opportunities provided since the last inspection. Recent training included: • Common induction training • Moving and handling • Fire safety • Health and safety • Basic food hygiene • Palliative care • Elder abuse awareness • Pain control • Falls awareness • Effective communication and professional accountability • Care planning • Sight and hearing awareness. Further information on available training can be accessed through the following websites: www.picbdp.co.uk www.skillsforcare.org.uk DS0000028257.V330543.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): 31, 33, 35, 36, 37 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and staff understand their work and receive training appropriate to their needs. The home reviews some aspects of its performance through a programme of self-review. The information gained has not yet been used to formulate an annual development plan. Residents are assured of sound management of their financial interests. An appropriate supervision system is in place but not all staff receive regular sessions. Therefore individual’s training needs and practice may not be thoroughly assessed. The standard of record keeping safeguards the interests of the residents. DS0000028257.V330543.R01.S.doc Version 5.2 Page 21 The health and safety of the service users and staff are protected by the policies and procedures followed at Castle View. EVIDENCE: Since the last inspection Mrs Bradley has commenced the Registered Managers Award and is due to complete later in the summer. She has worked hard with her staff to meet the requirements made at the last inspection of Castle View. Through discussion with staff it was evident that Mrs Bradley gives clear direction and staff know what is expected of them. They confirmed that she was approachable and if they had any concerns they would discuss them with her. They also said that they felt free to comment at staff meetings and their views were listened to and considered. The quality assurance monitoring system has improved. Internal audits undertaken since the last inspection include: • Care plans • Call bells • Cleaning • Food satisfaction • Complaints • Accidents. The registered manager confirmed that action is taken as a result of their findings. However, the quality assurance and quality monitoring system does not include seeking feedback from residents, relatives, friends or stakeholders in the community such as GPs, district nurses on a regular basis. There was also no annual development plan available to those using the service. Residents confirmed that they either deal with their own finances or have appointed a responsible representative to do so. This is frequently another family member. The home does hold ‘pocket money’ for some residents at their request. All monetary transactions were recorded and were seen to be up to date and accurate. The Registered Manager confirmed that formal staff supervision is improving but not all care staff were receiving it six times a year. The documentation reviewed demonstrated that the record keeping had much improved since the last inspection and was now of an appropriate standard. Records showed that all staff had received recent training in fire safety and manual handling. Substances hazardous to health were seen to be stored DS0000028257.V330543.R01.S.doc Version 5.2 Page 22 securely. Records showed that equipment had been serviced regularly. Accidents were recorded and appropriate action was taken as necessary. DS0000028257.V330543.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 3 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 3 3 DS0000028257.V330543.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP31 Regulation 9 Requirement The registered manager must obtain a suitable management qualification. The responsible individual must ensure that the home regularly seeks the views of people living in the home and visiting the home. From feedback and the results of audits an annual development plan must be produced, which supports continuous improvement, ensuring that the service is run in the best interests of residents. 3. OP36 18(2) The home must ensure that all staff receive effective formal supervision at least 6 times a year, which details how each member of staff is performing and where shortfalls are noted action is taken. 20/05/07 Timescale for action 01/08/07 2. OP33 33 20/05/07 DS0000028257.V330543.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP9 OP28 Good Practice Recommendations All care plans should provide staff with specific information about how the needs of each resident are to be met. There should be a clear audit trail for all medications coming into and leaving the home. The home should continue to work towards at least 50 of staff achieving a minimum of an NVQ 2 award. DS0000028257.V330543.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 DS0000028257.V330543.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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