Inspection on 25/01/08 for Chatsworth House

This inspection was carried out on 25th January 2008.

CSCI found this care home to be providing an Good service.

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 House 17/12/09

Chatsworth House 28/01/09

Chatsworth House 14/03/07

Chatsworth House 09/06/06

Chatsworth House 27/02/06

Chatsworth House 13/07/05

Chatsworth House 22/11/04

Chatsworth House 30/07/04

Chatsworth House 31/01/04

Similar services:

Fairfields Country Rest Home

Fairfax House

Claremont Nursing Home

Doveridge Care Home

Dunmore

Chatsworth

Dunraven Lodge

Eastleigh Care Homes, South Molton

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

CARE HOMES FOR OLDER PEOPLE Chatsworth House 9 Belvedere Road Redland Bristol BS6 7JG Lead Inspector Jon Clarke Unannounced Inspection 25th January 2008 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Chatsworth House DS0000026651.V350253.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 House DS0000026651.V350253.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chatsworth House Address 9 Belvedere Road Redland Bristol BS6 7JG 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) 0117 9743253 0117 9743258 chatsworthhouse@tiscali.co.uk B & C Care Limited Mr Peter Kong (Wai Pean) Care Home 15 Category(ies) of Dementia - over 65 years of age (15) registration, with number of places Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Dementia aged 65 years and over on admission- Code DE(E)maximum 15 places The maximum number of service users who can be accommodated is 15. 14th March 2007 2. Date of last inspection Brief Description of the Service: Chatsworth House is a privately owned Care home that is registered by The Commission for Social Care Inspection to provide accommodation and personal care for up to 15 people aged 65 years and over who have dementia. It is situated in a residential area close to Durdham Downs in Westbury Park and is located close to major bus routes. The home is a converted older property providing single room accommodation on three floors, which can be accessed via stairs or a passenger lift. There is one shared room. Five bedrooms have en-suite facilities. The home is situated in its own grounds with a courtyard to the rear. Visitors are welcome at any time and refreshments are readily available. Inhouse activities and entertainments are also provided. The range of fees is currently £376 and £475 / week and extra charges are made for chiropody, hairdressing etc. Currently this information is provided verbally prior to admission and then confirmed in writing within a new residents contract. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. This was an unannounced visit to the home which was part of an inspection. A number of documents were looked at including care plans, medication records, recruitment and training. There was also an opportunity to discuss with individuals who live in the home their experience and views about the quality of the care they receive. I was also able to talk with a number of staff and in addition spent time observing staff. A number of Have Your Say questionnaire were sent to the home before this inspection responses were received from 3 residents however no responses were received from relatives. As part of this inspection the manager completed a Annual Quality Assurance Assessment (AQAA) which set out the areas of practice based around the National Minimum Standards summarising what the home does well, the evidence for this, what they could do better and how they have improved in the last 12 months. The information from the AQAA and questionnaires has been used to help make a judgement about the quality of care provided in the home. What the service does well: There was a real sense from talking with individuals and staff that there is a real commitment to provide care which meets individual needs. Care planning is of a good quality with detailed information about the individual and efforts are made to provide care which is person centred. The environment of the home despite a need for some improvements offers a homely and supportive atmosphere with visual information to assist individuals with orientation around the home. In talking with staff they spoke of working as a team and working well together this is a real strength. The home recognises the importance of having good relationships with relatives particularly important where individuals may not be always able to express their views. This was confirmed by a relative I spoke with on the day of the visit and by comments received by the home in response to their questionnaire. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 6 “I think I would have to go a long way to find a better place. You have created a nice family atmosphere and everyone is very friendly.” “any comments are listened to and discussed, relatives are kept informed.” “staff are sensitive to resident’s needs and are caring and supportive.’ “great care is taken to give residents their right to make own choices where possible.’ What has improved since the last inspection? What they could do better: Whilst it is recognised that the approach of staff is positive and supportive this would be greatly improved along with their skills and knowledge if Dementia and Person Centred care training was provided to all staff. It is a significant gap in achieving the required competence for care staff working in this care setting. The environment specifically individual accommodation remains a concern in that there were a number of rooms where the décor was poor with wallpaper peeling and old electrical fitting in place. In the inspectors view this has not been a priority for the owner of the home and as a consequence it is not of the standard which individuals have a right to expect. Whilst the home is homely and there is no an expectation it should be pristine the state of some rooms is beyond homely and has reached shabby in décor and appearance. In addition the shared room offers no privacy for individual when personal care or personal hygiene such as washing is taking place. The arrangements for mealtimes could be improved to encourage greater independence and choice. Specifically the practice where all are served with plated meals does not promote independence and potentially de-skills individuals. There should be greater choice available on the menu for Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 7 lunchtime and tea (having only one sandwich filling is rather limiting and in the inspector’s view implies a take it or leave it attitude). 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 House DS0000026651.V350253.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 Chatsworth House DS0000026651.V350253.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): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s Statement of Purpose provides the required information about the home, the facilities, staffing arrangements, admission procedure and aims and objectives of the home so that individuals can make an informed choice about the suitability of the home. The home undertakes full and comprehensive assessment of prospective residents so that they are able to make an informed decision about the capacity of the home to meet health and social care needs. EVIDENCE: The home’s Statement of Purpose was looked at it clearly sets out the aims and objectives of the service providing information about the facilities, staffing arrangements, admission procedure, activities, health and safety and the complaints procedure. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 10 A number of pre-admission assessments were looked at they were comprehensive in providing an outline of the health and social care needs of the individual. Included were assessments which had been undertaken by the local authority. Chatsworth House DS0000026651.V350253.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care Planning and arrangements for meeting health care are generally good providing staff with the necessary information so that the health and social care needs of residents are met. Arrangements for managing resident’s medication make sure that resident’s health needs are protected. The practice of staff and policies of the home help to make sure that residents are treated with respect and their dignity is upheld. EVIDENCE: A number of care plans were looked at they provided good information about areas of care: Diet and Nutrition, Personal care. Also included were life events and memory books giving a real personal perspective of the individuals. Risk assessments had been completed for areas such as falls and in one instance guidance was recorded in the event of individual having a fit. Moving and handling assessments had been completed and reviews undertaken regularly. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 12 There was information about personal routines “likes own choice of seating at mealtimes”. In one instance where an individual had established a relationship with another person in the home it was noted the importance of “giving privacy and their choice respected” however importantly it was also noted how because of the mental health of the individual there was risk of the relationship becoming “non-consensual” and risk of abuse occurring. For another individual there was an entry about how “they like to go to bed a little late and does like to get up early.” However a record which stated “throws tantrums when awakens in the morning” is inappropriate and such language is not professional. A further record illustrated the home’s approach to recognising choice this was related to sleep pattern of an individual “allow her to choose her bedtime” (however it should not be about “allowing” but rather it is a right of individuals to have that choice.) Individuals who live in the home have access to community-based services such as chiropodists, dentist and evidence was seen in files of contact with district nursing, psychiatrists and Community Psychiatric nurses. The arrangements for the storage, administering and management of medication were looked at. Storage was secure and records had been completed as required. Currently the home has no individuals who receive controlled drugs in this event a controlled drug register should be in place. It was noted that there was no record of returned medication or receipt of such medication. The home uses homely remedies and these had been recorded as required on the administering record of the individual. Staff were observed throughout the visit interacting with individuals in a respectful manner. This was particularly evident where staff were supporting individuals in personal care i.e. assisting to the toilet this was done in sensitive and dignified way. A relative I spoke with spoke of their relative being “treated with respect and maintain her dignity”. They felt this was one of the things that was good about the home namely the “warmth, sensitivity of staff”. Chatsworth House DS0000026651.V350253.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. The arrangements for meeting the social and recreational needs of residents are good and there are opportunities for residents to maintain links with family, friends and the local community. The home’s practice and routines are flexible and enable residents to exercise choice and have control over their lives. The home provides meals, which are balanced and meet the dietary needs of individuals in the home. EVIDENCE: A range of activities are available to individuals who live in the home including reminiscence, skittles, passive exercise, sing-a-long. Staff spoke of being able to spend time with individuals and were observed on this visit sitting and talking and generally engaging with individuals in the communal lounge. One individual I spoke with said how much they enjoyed the outside entertainers that come into the home. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 14 The home has open visiting arrangements and a relative I spoke with who visits weekly spoke of how they are “made to feel welcome” and how they “can come anytime”. On the day of my visit lunch was observed being served on this day there was no choice and again at teatime there was no choice available. The menu was seen and did not indicate daily choices though was varied. A relative comment stated “meals appear to be well planned varied and well cooked” and another “meals varied and interesting, the menu always looked good. There was an unhurried and relaxed atmosphere with staff available. It was noted that a number of individuals required assistance with feeding in one instance this was not done in a sensitive manner namely sitting with the individual. There were no condiments or sauces available for individuals to use. At teatime individuals were served a plate of sandwiches (no choice) rather then giving individuals where able the opportunity to help themselves and if assistance needed provide such assistance. Staff also used aprons on individuals and I question for what purpose? An individual I spoke with said how they “enjoyed the food” and another “the food is always good here”. Chatsworth House DS0000026651.V350253.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. The home has clear procedures in place and this enables individuals to make a complaint and voice their views about the service they receive and to know that they will be listened to and actions taken where necessary. The home makes sure that as far as possible residents are protected from harm by having policy and procedure about the Protection of Vulnerable Adults and providing training to all staff in this area. EVIDENCE: No complaints have been made since the last inspection. One individual I spoke with said how they found staff “attentive” and “listen to what we say”. Relatives I spoke with said they found the manager “approachable and always responsive to our concerns”. Relative stated, “any comments are listened to and discussed, relatives are kept informed and listened to”. There is a Safeguarding Adults policy in the home and staff have attended Adult Protection training. The manager has also completed this training since the last inspection. When speaking to staff they illustrated a good understanding of what may constitute abuse and were clear about the actions they would take in response to any allegation of abuse. Chatsworth House DS0000026651.V350253.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): 19,24,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Whilst homely in some respects the environment of the home is one of “make do” and fails to provide the standard individuals have a right to expect. EVIDENCE: In walking around the home it was very evident that there had been little if any effort to address the poor quality and decorative order of the home since the last inspection. Whilst there has been some effort to make the environment of the home suitable for individuals with dementia such as visual prompts this could be improved during the decorating and re-furbishment of the home. The communal areas as were other areas were seen to be clean and the home was free from offensive odours. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 17 Individual accommodation was all of a poor standard with peeling wallpaper in some rooms, window restrictor broken, old electrical fittings still in place and lack of basic decorative features and facilities such as bedside lamp. The shared room had no screening available to provide privacy. Toilet and bathing facilities were generally worn and basic there had been little if any effort to make these areas warm, homely and inviting. In the toilets there was no equipment such as rails to assist in mobility and maintaining independence. A comment received by a relative was about lack of “quiet space” and “another area for relatives to sit” other then individual accommodation which generally lacked warmth and provided poor environment for the individual and any visitors they may have. Whilst there was a seating area on a landing of the home this was unattractive and cold. As noted at the last inspection “the whole house is beginning to look worn and neglected and in need of urgent decoration and refurbishment”. In the inspector’s view at this visit the house was no longer “beginning to look” but had got to the stage where it was “worn and neglected”. Chatsworth House DS0000026651.V350253.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): 27,29,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing arrangements in the home are generally satisfactory so that the needs of residents can be met in an efficient way. However the skills and competence of staff would be greatly improved by the providing of specialist training to all staff. The recruitment and selection of staff needs to be more thorough to make sure that as far as possible the health and welfare of resident is protected. EVIDENCE: Staffing rotas were looked at for a period of four weeks. They showed that there are generally 3 care staff on duty during the day (8-9/8-6) with two waking night with deputy manager (8-6). In addition there is domestic support Mon-Fri 9-2. Recruitment records were looked at for two members of staff who were both on student visas (copies seen). Pova list checks had been completed as were police check from country of origin. There were no references. Training records were looked at for 7 members of staff all had completed Moving and Handling, Food Hygiene. Five of the seven had completed Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 19 Safeguarding Adults. Also undertaken was first aid, loss and bereavement, medication by some but not all. None had completed Infection Control training (this included domestic). None had completed Mental Health, Dementia or Dealing with Challenging Behaviour training. Chatsworth House DS0000026651.V350253.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): 33,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good opportunities for individuals who live in the home and others to express their views about the service they receive. The practices of the home help to make sure that the health, safety and welfare of residents and staff are protected. There is a good effort to provide regular supervision to staff to offer opportunity to formally review practice and identify any concerns or areas for improvement. EVIDENCE: We were advised that resident’s meeting are held however there were no minutes of these meeting available to look at and evidence the content of meetings. However relative’s questionnaires had been circulated and the responses were positive (other comments have been incorporated into this Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 21 report). There were a number of positive comments about the staff working in the home: “generally speaking all the staff are very kind and caring” “staff very supportive and caring, a well run home”. Supervision records were looked at and of the 8 records seen 3 individuals had received supervision every 2 to 3 months, 2 last had supervision Nov 07 and two June 07. Health and Safety record in relation to fire safety were looked at and showed that there is a fire risk assessment in place; an inspection of the fire system took place Feb 07. The last fire drill for day staff took place 1/11/05 and night staff 06/06/06. Further records were requested at the time of this visit however these had not been received. Fire alarm weekly tests take place however there was no record of monthly emergency lighting tests. Since the visit documented evidence of fire alarms, lighting tests and staff fire drills has been provided and they confirmed satisfactory tests and drills take place in the home. The AQAA completed by the manager failed to provide full and detailed information about areas of the service and improvements over the past year or what they were hoping to improve in the coming year. The data section of the AQAA was completed although there were gaps in providing information. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X 2 X 3 STAFFING Standard No Score 27 3 28 X 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 2 X X X X 2 Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13 (2) Requirement Timescale for action 30/03/08 2. OP19 23 3. OP19 23 The registered manager to ensure there are safe arrangements for the disposal of medicines received into the home. (This refers to the need to have a returns book) The manager to ensure that the 01/07/08 home is kept in a good state of repair internally and all parts of the home are reasonably decorated. (This refers to the poor decorative state of rooms and other areas of the home) A planned programme of 31/03/08 redecoration must be sent to The Commission for Social Care Inspection as part of the response to this inspection report. The manager to ensure screens are provided in shared accommodation to provide privacy. The manager to ensure suitable adaptations are made as may be required. (This refers to provision of rails in toilets and any other identified areas) DS0000026651.V350253.R01.S.doc 4. OP10 16 (2) © 30/04/08 5. OP22 23 (2) (n) 01/06/08 Chatsworth House Version 5.2 Page 24 6. OP29 19 (1) C Schedule 2 18 (1) (a) © 7. OP30 The manager to ensure that thorough recruitment measures are in place. (This refers to obtaining two references for potential employees) The manager to ensure that staff receive training appropriate to the work they are to perform and are suitably qualified and competent. (This refers to specialist training relating to the needs and welfare of individuals who live in the home) 25/01/08 30/07/08 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 OP15 Good Practice Recommendations To look at arrangements for providing of meals particularly around choice of meals and food available on a daily basis and maximising independence as far as possible. Chatsworth House DS0000026651.V350253.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Regional Office 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 House DS0000026651.V350253.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!