Inspection on 18/07/07 for Chatsworth

This inspection was carried out on 18th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Chatsworth 21/07/09

Chatsworth 21/09/06

Chatsworth 20/09/05

Chatsworth 19/04/05

Chatsworth 31/08/04

Chatsworth 20/04/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Chatsworth Seymour Road Mannamead Plymouth Devon PL1 5BE Lead Inspector Kim Fowler Key Unannounced Inspection 10:00 18th July 2007 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 Chatsworth DS0000003474.V334289.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. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chatsworth Address Seymour Road Mannamead Plymouth Devon PL1 5BE 01752 660048 01752 671201 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) Mr Geoffrey Rhodes Mrs Heather Rhodes, Mr Stephen R Davey, Mrs Janet V Davey Mr Geoffrey Rhodes Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26), of places Physical disability over 65 years of age (26) Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Chatsworth is a large detached property situated in the Mannamead area of Plymouth. The home is registered to provide residential accommodation and personal care for a maximum of 26 people over the age of 65 years who may also have dementia or a physical disability. Accommodation is provided over three floors, and offers 22 single bedrooms, 7 of which have en suite toilet facilities, and two double rooms, one of which has an en suite toilet facility. Stair lifts provide access to all floors. On the ground floor there is a large lounge that has patio doors opening on to the garden, and a large dining room. There is a call bell system in operation in the home. The home has a chair lift to all floors. Various activities and trips are regularly offered at the home. The garden is attractive and accessible to the service users. The fees presently are £359 to £390. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 1 day and started at 10.00am and finished at 5.50pm. The manager Sally Colwill was available throughout the inspection. The registered owners and registered manager were not available during the inspection. The inspector made a tour of the building and spoke to most of the people living at the home. Documentation relating to the care planning process and the management of the home were examined. The inspector spoke to the manager, five staff members and four relatives during the inspection. Prior to the inspection, comment cards had been sent to the care home to allow the people who live there to comment upon their experiences. Three cards were returned and no issues of concern were raised. One staff comment card was also received as well as three relative and one professional. Any comments are in the relevant section of the report. What the service does well: What has improved since the last inspection? The home has decorated many bedrooms, including painting and wallpapering and replacing carpets where needed. The home has applied for and been graded funding to fit two new bath hoists, two outside wheelchairs and a new adapted bath. As well as work starting next week on a new porch for the comfort of people who live at the home. The homes AQAA states that they have, “decorated several rooms throughout the home and replaced furnishings like lounge chairs, dinning room chairs and wardrobes”. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 6 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. Chatsworth DS0000003474.V334289.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 Chatsworth DS0000003474.V334289.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): 1/2/3/6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering admission to the home can be confident that a full assessment with be completed before admission to ensure the home can meet their individual needs. EVIDENCE: One family member spoken with confirmed that they had received information about the home before admission as well as providing assistance with the completion of information the home required to meeting the needs of the person being admitted. This relative went onto to state that they had recently received updated information on the home. The files of people living at the home were examined and provided evidence that each person had received a contract with either the home or the paying authority. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 9 The files of the last two admissions to the home were examined and showed that both contained completed pre-admission questionnaires. These documents are supported by the placing authority care plans and additional information gathered by the manger of the home. The manager confirmed that she visits prospective admissions to complete these forms and each person is invited to the home for several visits before moving in. The home’s AQAA states that all people admitted to the home have a full assessment completed and involves other agencies to ensure the home has as much information as possible to met the needs of the person being admitted to the home. These completed pre-admission questionnaires provided evidence that a requirement from the previous inspection, that pre-admission questionnaire are not routinely undertaken, has been completed. These document are important for prospective admissions to assured people that not only can their health care needs be met but also their emotional, social, cultural or religious needs. The last full inspection held a requirement that the home must not admit people under the Intermediate care provision. A discussion was held with the manager who stated that this was not the case. However they do provided respite care for people who had been admitted to hospital under this scheme and require 2 weeks maximum respite stay before going home. Physiotherapist when needed supports these people admitted for respite care. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7/8/9/10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff and manager provide good personal and health care support to people who live at the home. Ensuring the promotion of privacy and dignity at all times. EVIDENCE: Of the six files examined for people living at the home all had individual care plans in place and each contained information on care needs and how the home would meet these needs. Evidence was recorded that care plans are updated regularly. These care plans are held in an easy accessible office for staff to access regularly. Some care plans are supported by the placing authority’s completed plans of care. These care plans give detailed instructions to all staff to ensure intimate personal care is being provided in a manner that meets with peoples approval. This is particularly important if the people living at the home have limited communication skills. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 11 All people’s assessment and daily care plans are easy assessable for staff on duty and risk assessments are held on individual files for the protection of all people living at the home. The manager stated that the risk assessments are reviewed regularly and updated as and when needed. All people living at the home have access to all health care services and this information was recorded into designated District Nurse files held in individual bedrooms. Information was recorded onto a medical visit record sheet in each persons file that there was input from other professionals including GP’s, chiropodist and consultants based at the local hospital. Many people living at the home were spoken with confirmed that their health care needs were met and one person who had recently sustained an injury to their leg confirmed that they had seen the District Nurse that week and their leg had been dressed. The people living at the home also stated that they had a General Practitioner and optician of their choice. One person confirmed that the optician had visited the home yesterday and other people confirmed that they could attend GP surgery appointments if requested. The homes AQAA states that all people who live at the home have access to other agencies and where possible they try to keep them registered with their own GP. The manager of the home talked through the medication procedure for the home. The home uses the dossett pack system for administration. The manager confirmed that the staff had recently attended a medication training update. It was evident from these discussions that manager understood the medication procedure that included administration, storage and disposal of medication. Any changes in medication were recorded, signed and dated onto the medication recording sheets. One staff file examined held a medication training course certificate. One staff member confirmed they had attended a medication-training course with the local pharmacist. Most people living at the home were spoken with during this inspection and all that were able to confirm that the staff respects their privacy and dignity at all times. Observed during the inspection were staff knocking on peoples doors to promote privacy and shutting the bedroom door when a person had a visitor. Staff were also observed assisting someone sat in the main lounge that required emergency assistance and treating them with dignity and respect. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 12 One service user said, “the staff always shut my bedroom door” and another stated, “The bathroom door is shut when staff help me with my bath”. Chatsworth DS0000003474.V334289.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. People living at Chatsworth House can be confident that the home offers good wholesome meals. The home welcomes and encourages families and friends to visit. EVIDENCE: The home organises activities within the home and staff are responsible for organising such activities as bingo and quizzes. However outside activities are brought into the home and several people living at the home and one visitor confirmed music and sing a long session recently. This visitor also confirmed they had attended in house sessions and that their relative had recently been out to the local Barbican. The person living at the home said, “I went out and we stopped for a cup of tea, it was lovely”. The home has a notice displayed on the notice board to inform people what activities are taking place and when. This information is then transfer to the home activities book to record who has attended the activities. The home’s AQAA states that the home has a varied choice of activities and they also arrange trips out. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 14 During the inspection four visitors were spoken with and all were able to confirm that they are able to visit at any reasonable time. One visitor said they are able to see their relative in the privacy of their bedroom if they wish. All bedrooms visited contained personal possessions and items and one person living at the home and their relative said that the home encouraged them to bring in items from home. All people who were able to made positive comments about the food provided and recorded into the homes quality assurance forms were suggestions and additions for the menus. One of the cooks was spoken with during the inspection about the menus and food on offer. It was evident from the food seen served at tea time of prawn salad and other choices that the food was home cooked using fresh products. The meal was well presented and freshly prepared. The home’s AQAA says, “The menu is varied and adaptable to all residents” and goes onto say, “alternatives are always offered”. The comments received from people living at the home about the food provided included, “good and also an alternative is offered”, “it has got better and they have taken up the new suggestions”. One person said of the tea observed being served, “The prawn salad and home made cake was lovely”. Chatsworth DS0000003474.V334289.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): 16/17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident that any complaints or concerns raised will be listened to, acted upon and well managed by the home, which protects the welfare of all. EVIDENCE: The home’s complaints procedure was displayed for all to access. Visiting family members and friends interview during the inspection all stated that they were aware of the complaints procedure and would approach the manager or owners if they had any concerns. All felt that any complaints would be acted upon. Most of the people living at the home were spoken with and some were aware of the homes complaints procedure and a few stated that they had never had any need to use it. All surveys received by the Commission ticked, Always, when asked if they knew how to make a complaint. And one survey returned stated, “The manager always sorts concerns out very quickly”. The homes AQAA states, “We ensure when new residents come into Chatsworth on their first day they receive a copy of our complaints procedure”. The home complaints folder was seen and this contained a record of any complaints received and included the actions and outcomes. All people spoken Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 16 with including relative and friends felt that any complaints made would be dealt with. The previous inspection made a requirement that all complaints must be investigated and the complaints file examined showed the home has completed this requirement. The home has not had any Adult Protection issues raised since the last inspection. One file examined showed an old referral and any actions and outcomes and in this recorded case no further action was required. The manager confirmed that many staff had completed the local authority’s Adult Protection training and many staff has also completed a recent in house training on Abuse. Case tracking on staff files showed the certificates held for this Abuse training in January 2007 and the homes AQAA says, “We ensure all staff are POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) checked to help protect the residents against abuse”. All staff members on duty were interviewed during this inspection. The discussion with these staff members confirmed that most had completed the Adult Protection training. It was clear from the information given to the inspector from some staff they had a clear knowledge and understanding of the Adult Protection process. Any issues raised on completed staffs CRB (Criminal Record Bureau) were discussed and recorded appropriately to ensure the protection of people living at the home. Chatsworth DS0000003474.V334289.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. Chatsworth House continues to maintain a clean and suitable environment for it’s stated purpose and the people who live at the home can be assured that they will live in an attractive and comfortable home that is regularly maintained. EVIDENCE: The home is safe and well maintained and suitable for its stated purpose. It is very comfortable, warm and light home. Several people living at the home confirmed this is usual. The gardens are well maintained and the four owners carry out everyday repairs and general upkeep of the home. One person who has lived at the home for many years confirmed that they’d had their bedroom painted and decorated recently including new curtains. This person said, “I am very pleased with my room”. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 18 The laundry facilities are sited separately and a sluice is available. The home was very clean, hygienic and free from offensive odours and the laundry facilities were suitable for its stated purpose and the washing machine has a sluice facility. The process for the removal of clinical waste was discussed and was satisfactory dealt with. Several of the staff confirmed they had completed an infection control course and that the home provided disposable aprons and gloves for their protection. Comments received on the survey forms returned to the Commission were, “The home is kept very clean” and another wrote, “Provides a safe and comfortable accommodation with good food in pleasant dinning area”. A third said, “It is very clean and odour free”. Chatsworth DS0000003474.V334289.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 good. This judgement has been made using available evidence including a visit to this service. Ongoing staff training is encouraged enabling people who live at the home to receive the best possible service. EVIDENCE: The home’s rotas and the staff confirmed that there is sufficient staff employed to care for the number of people currently living at the home. However some staff felt that at times due to holidays or sickness they could be short of staff. During the evening of the inspection only 2 care staff were on duty with 26 people currently living at the home. These care staff were supported by on domestic. The manager of the home informed the inspector that one staff member was sick that afternoon and she would be staying on duty. All the staff on duty during the inspection were spoken with and each provided evidence that they either held an NVQ qualification or are working towards it. The manager confirmed that currently 10 care staff hold an NVQ. Those staff files examined contained the required pre-employment checks, including Criminal Record Bureau Disclosures, ensuring as far as possible unsuitable staff are not employed. However the inspector recommended to the Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 20 manager that the employment history for some staff be expanded to include the dates of months and years of previous employment. One new staff member stated that their recruitment and selection process was fair and they had recently completed a CRB check and were continuing to shadow other staff members and had started the completion of an Induction programme. The home AQAA confirms by stating that, “When a new staff members is employed there is a Induction process”. The staff-training files provided further evidence that regular training was carried out. All staff interview confirmed that they receive regular and updated training. This included First Aid, Manual Handling and Food Hygiene. Comments received from staff on the training offered by the home was, “Plenty of training provided” and “loads of training offered”. The visitors spoken with during the inspection spoke very highly of all the staff and comments received included, “Staff always helpful and when I visit are always welcoming”. The people living at the home said of the staff, “Excellent”, “can be very caring” and another said, “ Staff come to check on me if I stay in my room and always bring me a cup of tea” and one said, “Will do anything for you” One staff survey received wrote, “The staff are BRILLIANT”!! One relative survey wrote, “All the care that is given is excellent”. Chatsworth DS0000003474.V334289.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. The management of this home is very good and ensures that records are effectively maintained. EVIDENCE: The manager was available throughout the inspection process. The registered owners and registered manager were not available. The manager confirmed she has an excellent relationship with the registered owners and registered manager and lines of communication are good with them being available when needed. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 22 The manager has a NVQ 4 in care and the Registered Manager award and writes in the homes AQAA, “I continue to update my training”. The office showed that all records are secure. The manger has recently completed quality assurance forms and all comments recorded on these forms were positive. One person living at the home confirmed they had completed the form and agreed that issues recorded were acted upon including additions to the homes menus. The manager also produced a newsletter that was distributed to all involved in the home to show the results of the surveys. One family member visiting also confirmed that had read the newsletter with the results of the survey and said, “It was good to see what people think”. Staff supervision records showed that this is carried out regularly and on a one to one bases and the manager confirmed that they hold regular staff meetings. All staff interview confirmed that they receive supervision and this includes discussion on courses available. Several service users’ money and accounts were checked and were accurate and well recorded. The records are secure, updated and the home monitors receipts and expenditure for the protection of the service users. Sampling of records indicated equipment is serviced regularly and maintained in good order. Health and Safety is a priority in the home and records examined showed fire safety training and fire protection is in place and up to date. The accident records were accurate and files examined showed that information is recorded onto accident forms and also written into service users daily records with appropriate action taken when needed. The home’s AQAA records “We will also continue to listen to everyone involved with Chatsworth i.e. owners, staff, residents, relatives and any visitors to help us maintain the high standard of care that we like to provide for our residents”. One relative comment card received said, “ Overall Chatsworth does its best to ensure that everything is done to a high standard, and I think that they have got it right”. Chatsworth DS0000003474.V334289.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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 X 4 X X X X X X 4 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 3 X 3 Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Refer to Standard OP29 Good Practice Recommendations All staff files should have recorded months and years of previous employment. Chatsworth DS0000003474.V334289.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Chatsworth DS0000003474.V334289.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. 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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