Inspection on 17/04/07 for Cedar House

This inspection was carried out on 17th April 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

Cedar House 05/12/05

Cedar House 20/07/05

Cedar House 08/12/04

Cedar House 22/06/04

Cedar House 18/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Cedar House 249 Station Road Rothley Leicestershire LE7 7LD Lead Inspector Chris Wroe Unannounced Inspection 17th April 2007 10:50 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cedar House DS0000001795.V334822.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. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cedar House Address 249 Station Road Rothley Leicestershire LE7 7LD 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) 0116 2303066 0116 2375520 Mr John Lowe Mrs Dorothy Lowe, Mr John Lowe (jnr), Mrs Lynda Lowe Zena Bentley Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of Registration. Date of last inspection 5th December 2005 Brief Description of the Service: Cedar House is situated in a rural setting, on the border of the village of Rothley, and is a short walk from the Great Central Railway station. The home is registered to provide accommodation and care for up to 20 older persons. All of the bedrooms currently provide single en-suite accommodation. The home has one double bedroom, which can be used for partners or other people who wish to share, when it is available. There are a number of lounges and two dining rooms on the ground floor of the home. There is a large secluded and private rear garden, with appropriate seating and cover for people who live in the home to use. There is a large car park to the front of the home. There are no shops in the immediate vicinity; the nearest shops are in nearby Rothley village-centre. There is a local bus service to Leicester and Loughborough. The fees charged currently range between £422.50 per week and £482.50 per week. Extra charges are made for hairdressing, chiropody and newspapers and magazines. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included a visit to the service. The inspector visited the home on 17th April 2007. The manager, Zena Bentley, and staff helped us during the visit. The visit started at 10.50am and lasted for just over five hours. The inspector spoke with a sample of five residents during the inspection, and their views are given in the report. We also received comments cards from four residents, which gave views about different aspects of care. The main method of inspection used was ‘case tracking’. This means looking at the care given to service users in different ways. The ways this was done are: • talking to the service users • talking to staff and the manager • watching how service users are given support • looking at written records. All the residents who spoke to the inspector were happy about the care given by staff. They felt they got good support. They felt the home was comfortable and they had what they need. All the key standards were checked during this inspection. The information below is based only on those aspects checked in this inspection. Details about individual people has been kept out of the report, to make sure it is kept confidential. What the service does well: The manager carries out assessments for people who might like to come and live in the home, to find out about their care needs and whether the staff will be able to support them. Staff have training to enable them to meet the needs of people living in the home. The manager assesses people during a full-day visit to the home (which prospective residents must pay for), when people have lunch and tea in the home and see how they like it. Staff write care plans about people who live in the home, which give some basic information about their needs. Staff review these weekly to make sure Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 6 they are kept up to date. The members of staff we spoke to showed a good understanding of the different needs of people who live in the home. People who live in the home said that staff pay good attention to their healthcare needs. During the inspection visit, an optician was in the home carrying out eye tests. One resident said that the chiropodist was visiting on the following day. Staff who give out medication have had training. Medication administration is good. Residents who spoke with us on the day of our visit said that they felt well looked after regarding their health and medication. We observed the ways in which staff interact with residents – they were seen to be respectful and polite. One member of staff we spoke to showed good awareness of how to treat people with dignity. Residents told us they are able to make choices in their daily lives – about when they get up and go to bed and how they prefer to spend their day. There are some activities available for people to do. Residents can have visitors to see them when they choose to. During our visit, relatives and friends were visiting residents and were made welcome. Residents are able to take part in religious worship if they want to. A vicar comes to the home to lead services. Relatives or solicitors mainly handle the financial affairs of residents. There are facilities for residents to keep money safely in the home. Residents told us that they like the food, and that they are able to have a choice. Meals are served in two dining rooms, which are attractively laid out. There is a complaints procedure in the home. Residents who we spoke to told us that they felt able to raise any concerns with the manager or with staff. There have been no complaints since the last inspection. Staff were able to tell the inspector about what they would do if they had any concerns about harm to residents. During the visit, we looked around at some parts of the home. We checked a sample of bedrooms, bathrooms and toilets, lounges and dining rooms. We found all areas were clean and tidy and well-maintained. The manager makes sure that safety precautions and checks are carried out in the home. There are very well maintained gardens – there are paths all around the building so that residents are able to walk independently around. During the visit we saw that residents enjoyed the gardens and were able to sit out at tables under umbrellas. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 7 Staff rotas show that minimum staffing requirement levels are met, and the numbers of staff on duty when we visited matched rota levels – although levels of staffing must always depend on the needs of residents. The inspector checked a sample of staff records. These showed that staff are recruited properly, and that the owners mostly make sure checks are carried out so that they can be confident that staff are safe to work with residents – such as Criminal Record Bureau (CRB) checks. There is an ongoing staff training programme in the home. Staff learn a range of different skills to help them to improve their ability to care for residents in the home. There has been no change in management of the home. The manager has completed the Registered Managers Award. The manager makes sure she continues her learning and development. There are different ways in which the manager tries to get people’s views about how the home is run. The manager and staff make sure that the home is run properly, keeping residents safe. Staff have training in safety aspects, such as food hygiene, infection control and first aid. Staff told the inspector about safety precautions for controlling the spread of infection, and there are procedures in the home to make sure that staff work safely. What has improved since the last inspection? What they could do better: Care plans contain basic details about risks to residents, to make sure that staff keep residents safe in the home. However, in some cases, the risk assessments are not detailed enough– for example risks relating to helping someone move around and preventing falls. There are a range of records kept about residents’ welfare. However, records are not all kept separately for each individual person, which does not comply with data protection. For one person, who had returned to work in the home after a period of absence, a Criminal Records Bureau (CRB) check had not been received and a Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 8 POVAfirst check (initial required check) had not been carried out. The manager made sure that this was obtained without delay during our visit, and assured that the person would always work under supervision until the check was received. Staff are shown safe ways of moving people in their induction training, but there is no formalised moving and handling training for staff, to tie in with the moving and handling policy and risk assessments. The manager said she intends to put this in place. 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. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 9 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 Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 10 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 is currently not applicable in this home) Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a very good admissions procedure to the home. EVIDENCE: The manager carries out assessments for people who might like to come and live in the home, to find out about their care needs and whether the staff will be able to support them. Staff have some training to enable them to meet the needs of people living in the home, such as training in dementia and confusional states, to help them support people who may be becoming confused. Three people who responded in comment cards said that they had received enough information about the home before moving in, to enable them to make Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 11 a choice about whether it was the right place for them. During our visit to the home, we saw that people who came to have a look around were made welcome and given a copy of the last inspection report. The manager assesses people during a full-day visit to the home (which prospective residents must pay for), when people have lunch and tea in the home and see how they like it. We discussed with the manager how to make the home welcoming to all prospective residents from all different backgrounds. For example, currently written information describes that one double bedroom is available to married couples – we discussed how this could state that it was available to people in different kinds of partnerships, to be inclusive and open, in line with the home’s values towards people. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home mostly benefit from having their health and personal care needs well looked after. EVIDENCE: Staff write care plans about people who live in the home, which give some basic information about their needs. Staff review these weekly to make sure they are kept up to date. The members of staff we spoke to showed a good understanding of the different needs of people who live in the home. Care plans contain basic details about risks to residents, to make sure that staff keep residents safe in the home. In some cases, the risk assessments are not detailed enough– for example risks relating to helping someone move around and preventing falls. The manager has some new information about care plans and risk assessment that she intends to use to make improvements in this area. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 13 Staff keep other records, like daily records about how residents are, and records of visits by nurses. This is good practice. However, these records are not all kept separately for each individual person, which may not comply with data protection. People who live in the home said that staff pay good attention to their healthcare needs. Staff contact GPs and nurses when health support is needed. During the inspection visit, an optician was in the home carrying out eye tests. One resident said that the chiropodist was visiting on the following day. Four people who commented in comment cards said that they always receive good care and support from staff. Staff who give out medication have had training. We checked a sample of medication records and stocks. The record-keeping and storage of medication is good. We watched a member of staff giving out medication and saw that she did so sensitively, and she was able to answer residents’ questions about what the medication was for. Four people who commented in comment cards said that they always received good medical support. Residents who spoke with us on the day of our visit said that they felt well looked after regarding their health and medication. We observed the ways in which staff interact with residents – they were seen to be respectful and polite. People who live in the home can have their own space but are supported to be with others if they choose. One member of staff we spoke to showed good awareness of how to treat people with dignity. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 14 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. Residents are enabled to have a good lifestyle in the home. EVIDENCE: Residents told us they are able to make choices in their daily lives – about when they get up and go to bed and how they prefer to spend their day. There are some activities available for people to do. On the day we visited, the hairdresser was in the home, styling people’s hair. Some residents get daily newspapers and magazines to read – one resident said they then share magazines with each other. Out of four comment cards received, two people had commented that there are always enough activities, and two people that there usually are enough. Activities in the home include bingo and singalongs, and sometimes staff support resident to go out for walks. Sometimes there are trips organised outside the home, like visits to restaurants or boat trips. Residents can have visitors to see them when they choose to. During our visit, relatives and friends were visiting residents and were made welcome. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 15 Residents can see visitors in their rooms or in one of the lounges. One resident told us that they like to keep in touch with friends using their private phone in their bedroom. Residents are able to take part in religious worship if they want to. A vicar comes to the home to lead services. Relatives or solicitors mainly handle the financial affairs of residents. There are facilities for residents to keep money safely in the home. Residents told us that they like the food, and that they are able to have a choice. Of four comments cards received, two people commented that they always like the meals in the home, one person that they usually like them, and one person that they sometimes like them. Meals are served in two dining rooms, which are attractively laid out. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 16 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. Residents are protected by procedures and good staff awareness regarding complaints and safeguarding from harm. EVIDENCE: There is a complaints procedure in the home – a copy is available on the notice board, and in residents’ files. Residents who we spoke to told us that they felt able to raise any concerns with the manager or with staff. Out of four comment cards received, all residents commented that they always knew how to make a complaint. There have been no complaints since the last inspection. Staff were able to tell the inspector about what they would do if they had any concerns about harm to residents. Staff said that the manager has gone through the procedure with them. One member of staff said she had learnt about abuse and safeguarding vulnerable adults in her National Vocational Qualification (NVQ) training. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents benefit from a very comfortable living environment. EVIDENCE: During the visit, we looked around at some parts of the home. We checked a sample of bedrooms, bathrooms and toilets, lounges and dining rooms. We found all areas were clean and tidy and well maintained. There are very well maintained gardens – there are paths all around the building so that residents are able to walk independently around. During the visit we saw that residents enjoyed the gardens and were able to sit out at tables under umbrellas. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 18 Residents are able to have their own possessions in their bedrooms. Residents told the inspector that they felt comfortable in the home and had what they needed in their own bedrooms. Of four comments cards received, four people commented that the home is always fresh and clean. One person commented “very fresh and clean always and tidy, and the windows and paintwork [are] kept clean”. The manager makes sure that safety precautions and checks are carried out in the home. Records showed that checks of equipment, such as fire safety equipment, are carried out regularly by qualified persons. There are systems in place for making sure laundry is done efficiently. Machines are suitable for purpose and there are sluicing facilities in them. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from a mostly well trained staff team and mainly positive recruitment processes, but there was a serious gap in checking safety of staff, which could put residents at risk. EVIDENCE: Staff rotas show that minimum staffing requirement levels are met, and the numbers of staff on duty when we visited matched rota levels – although levels of staffing must always depend on the needs of residents. Out of four comments cards received, two people said that staff were always available when they needed them, and two people said they were usually available. Staff carry pagers so that they are able to respond quickly to calls. The inspector checked a sample of staff records. These showed that staff are recruited properly, and that the owners mostly make sure checks are carried out so that they can be confident that staff are safe to work with residents – such as Criminal Record Bureau (CRB) checks. For one person, who had returned to work in the home after previously leaving, a CRB check had not been received and a POVAfirst check (initial required check) had not been carried out. The manager made sure that this was obtained without delay Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 20 during our visit, and assured that the person would always work under supervision until the check was received. There is an ongoing staff training programme in the home. Staff learn a range of different skills to help them to improve their ability to care for residents in the home. Recent training courses completed by staff include diabetes care, funeral care, National Vocational Qualifications (NVQ) in care. New staff receive induction training and are supervised in their work, although there was not full written recording of these aspects. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a well managed home. EVIDENCE: There has been no change in management of the home. The manager has completed the Registered Managers Award. The manager makes sure she continues her learning and development – she is currently doing diversity training. There are different ways in which the manager tries to get people’s views about how the home is run. Residents are asked to fill in surveys about their views of the home. Residents’ meetings are held approximately every three to Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 22 four months, where residents can give their ideas and views. The manager talks to residents and relatives on an ongoing basis, to find out whether they are satisfied with care and whether residents need anything. Staff meetings are held regularly to make sure that staff are aware of working practices and procedures, and to get their views. Staff are not paid to attend if they are not on shift, so the manager produces a newsletter after the meeting. Staff have training in safety aspects, such as food hygiene, infection control and first aid. Staff told the inspector about safety precautions for controlling the spread of infection, and there are procedures in the home to make sure that staff work safely. There are gloves and aprons available to staff. Staff are shown safe ways of moving people in their induction training, but there is no formalised moving and handling training for staff, to tie in with the moving and handling policy and risk assessments. The manager said she intends to put this in place. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X x 2 Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13 (4) (a) Requirement The provider must make sure that any risks to people who live in the home are properly identified and assessed and so far as possible eliminated. The provider must make sure that no member of staff commences work in the home until the required checks have been carried out. The provider must make sure that staff are properly trained in moving and handling people who live in the home. Timescale for action 31/05/07 2. OP29 19 (1) (b) 30/04/07 3. OP38 13 (5) 31/05/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations It is recommended that information about each resident is recorded separately so that it can be kept lawfully, in accordance with data protection legislation. Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Cedar House DS0000001795.V334822.R01.S.doc Version 5.2 Page 26 - 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. 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