Inspection on 25/07/05 for Clifton Gardens, 59

This inspection was carried out on 25th July 2005.

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

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

Other inspections for this house

Clifton Gardens, 59 09/01/08

Clifton Gardens, 59 28/06/06

Clifton Gardens, 59 25/01/06

Clifton Gardens, 59 03/12/04

Clifton Gardens, 59 30/06/04

Clifton Gardens, 59 15/02/04

Clifton Gardens, 59 09/10/03

Clifton Gardens, 59 09/12/02

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Clifton Gardens, 59 Chiswick London W4 5TZ Lead Inspector Gavin Thomas Unannounced 25 July 2005 at 11.20am 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 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. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 59 Clifton Gardens Address Chiswick, London W4 5TZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 020 8995 1955 020 8742 7322 Nick.Apetroaie@Hounslow.gov.uk London Borough of Hounslow Mr Neculai Apetroaie Care Home 35 Category(ies) of Dementia (9), Old age, not falling within any registration, with number other category (26) of places Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 3 & 6 December 2004 Brief Description of the Service: 59 Clifton Gardens is a purpose built home for older people. It is istuated close to Chiswick High Road where there are shops, cafes, places of worship and a library. Chiswick Park and Turnham Green underground stations, and a number of bus routes are within walking distance. There is a health centre near to the home. The home is owned and managed by the London Borough of Hounslow. Accommodation is situated over two floors and is divided into four units. They are: Elmwood, Belmont, Savoy and Lavender. Belmont unit is a dedicated unit for dementia care. This is a nine - bedded unit. It is staffed separately and two out of the nine beds are used for respite care. Each unit has a lounge, kitchen and dining area. There are thirty - three single bedrooms and one double bedroom. All of the bedrooms have wash hand basins. There are three assisted bethrooms, one shower room and fourteen toilets. Pleasant grounds surround the home, within an enclosed courtyard in the centre of the building, and a roof garden. The home has a designated room for smoking. This room has a 1940s theme and may also be used for visitors and meetings. The offices and laundry are located on the ground floor. The staff team consists of a Registered Manager, Assistant Manager, four senior Support Workers and a team of day and night Support Workers. There is a separate team of domestic and catering staff, a Business Support Manager and a Handy Person. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours. During this time, the Inspector spoke with service users and staff including the Registered Manager, Business Support Manager, Activities Coordinator and care staff. All records required for inspection purposes were accessible and well maintained. A tour of the premises was conducted with the Registered Manager. The home was very well presented. The grounds of the home were well maintained. The paved areas in the garden have maximised service users safety. In particular, for those service users who are dependent on walking aids. All service users spoken to, gave the impression that had settled in the home and had no concerns. Some of the comments made by service users were as follows: • We are looked after splendidly. • This is a nice home. • The food here is good. The atmosphere in each unit was welcoming. Activities were taking place and all service users taking part in activities appeared to be enjoying themselves. Two staff spoken to said they enjoyed working in the home. What the service does well: The service does well in providing an environment, which meets the varying needs of frail elderly people. The service also does well in providing a high performing specialist service for people with dementia. The home has mastered good concepts in applying the National Minimum Standards for Older People and the Care Homes Regulations 2001 to the dayto-day running of the service. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 4 Information provided for service users and significant others about the provision of service were well written. Thorough procedures were in place for the assessment and admission of prospective service users. EVIDENCE: A Statement of Purpose and Service User Guide were in place. The contents of the Statement of Purpose were in keeping with the criteria as set out in Schedule 1 of the Care Homes Regulations 2001. There were no changes to the Service User Guide. The Registered Manager confirmed that all service users had been given a copy of the Service User Guide. The Registered Manager confirmed that assessments are carried out with all prospective service users before their admission to the home. The assessment records seen indicated that this process was thorough and detailed. The Registered Manager conducted an assessment at the time of this inspection. The Registered Manager said that social work assessments are obtained for all prospective service users. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 9 Completed assessment records examined were comprehensive. The assessment methodology used for service users with dementia is based on the “well being observation model”. Service users needs are well met. Staff training reflects service users needs. This includes dementia care and illnesses associated with old age. The home had made very good progress in introducing new methods of communicating with service users with dementia. These were as follows: • • Objects of reference- objects of reference are being used to give service users a definition of when an activity or task starts and when it finishes. Communicating environment – the environment is constantly being changed to give service users a sense of where they are and to help them distinguish certain parts of the building such as doors and door frames and the colour of toilet seats. Equipment used for activities and games are now left within easy reach. These items are no longer put away. Smoking room – this room is fitted with a working gramophone and cues which reflect the 1940’s such as photographs and pictures. • • Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 9 The quality of care plans was very good. Care planning systems were consistent. Overall, the medication at this home is well managed. EVIDENCE: Care plans were in place for all service users. Care plans were randomly examined for the purpose of this inspection. The quality of care plans was very good. Entries on daily records and care plan monitoring records were well written. Associated care planning records in place were: • Daily records • Life history • Social history All service users care plans are reviewed on a monthly basis. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 11 A medication policy was in place. There were no changes to this policy. The Registered Manager said that this policy is due to be reviewed later this year. The MDS (Monitoring Dosage System) was introduced in the home in May 2005. All staff attended training regarding the Monitoring Dosage System in April 2005. Medication is stored in locked cabinets in each unit. All staff are required to undergo a medication competency assessment annually. Records examined confirmed this. Controlled drugs were being stored, recorded and administered correctly. The storage of medication was satisfactory. Medication Administration Records for two units were examined. It was noted that there were occasions when these records were not completed. Routine Pharmaceutical audits are carried out. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 The home does well in providing a range of meaningful and stimulating activities. Links with the community are good. Dietary needs of service users are well catered for, with a balanced and varied selection of food, which meets services users tastes and choices. EVIDENCE: The home has a full time activities coordinator. Activities are continuously being monitored and developed. Service users are encouraged to contribute to the activities program. As stated for standard four of this report, the home has done well in reviewing ways in which items used for various activities are made readily accessible to service users at all times. The environment and environmental cues in Belmont unit are adjusted and tailored to meet the needs of service users with dementia. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 13 Service users have the choice of participating in a wide selection of in and outdoor activities, which include: • Music • Art • Baking • Gardening • Shopping • Bingo • Keep fit Some service users attend Chiswick Day Centre. This enables staff to spend more quality time with service users staying at home. The home is supported by the Hounslow Volunteer Bureau and relatives who assist with activities and entertainment. Members of the Hounslow Volunteer Bureau were teaching some service users basic IT skills and putting together a recipe book. Relatives assist the home with day trips and outings. A photo diary is kept of these events. The Inspector observed staff carrying out activities with service users and spending time talking to them. The home maintains positive links with relatives and significant others. An annual family day is hosted by the home. Carers (relatives) meetings are held bi annually. The Registered Manager said that the home provides relevant training for carers such as care planning and different aspects of well-being. Visiting arrangements are flexible. However, visitors would normally be asked to leave the home by 9pm. The home is well known by various religious denominations in the area. Service users attend places of worship in accordance with their wishes. Church Ministers and Priests also visit the home. The Inspector observed one service user setting the table for the evening meal. All meals are freshly prepared. Meals are based on summer and winter menus. However, service users are offered other foods if they do not want the foods as stated on the menus. Records are kept of all foods served to service users. Two service users said they enjoyed the food. Lunch was being served in an unhurried manner. The atmosphere in the dining areas was clam and relaxed. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18 The home has a satisfactory complaints process in place with some evidence that service users feel that their views are listened to and acted upon. Staff are fully supported and trained to understand adult protection issues and to maximise service users safety at all times. EVIDENCE: A complaints policy and procedure was in place. Robust systems were in place for managing complaints. All complaints received are fully investigated. The home had received three complaints since the last inspection. The record of complaints must include if a complaint was upheld or not. Adult protection policies and procedures were in place. These had been updated since the last inspection. Staff last attended adult protection training in October 2004. Refresher training has been scheduled for staff to attend later this year. The Registered Manager said that he attended adult protection training for Managers in June 2005. The Registered Manager said there were no known concerns regarding the safety or protection of service users. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 25 & 26 The standard of the environment within in this home is good, providing service users with a safe and homely place to live. The overall quality of the furnishings and fittings was good. EVIDENCE: The home was clean and well kept throughout. Research had been undertaken to review the environment and what it communicates for service users with dementia. As a result, a considerable number of changes have been made to the environment since the last inspection. Door frames have been highlighted in a different colour, bold signs have been place on kitchen cupboard doors to maximise service users abilities to locate items independently, and allotments have been created in the garden. These are wheelchair accessible. The flushing mechanisms on toilets have been changed. Service users can now flush the toilet by pushing a button. The kitchen has been fitted with new windows, fly screens and a door. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 16 A programme of routine maintenance was in place. The home has a handy person. CCTV cameras are used for external purposes only. The London Borough of Hounslow has made application to the CSCI to register Elmwood as a unit for dementia care. The application was being processed at the time of this inspection. Future developments for this establishment include an extension to the existing building to provide an additional service for eight service users with dementia. The home was well lit and warm throughout. The home has a central heating system. All central heating radiators are covered to maximise service users safety. A policy on the control of infection was in place. This policy has been revised since the last inspection. The policy included procedural guidance for the handling and managing of sharps, clinical waste and soiled linen. An approved contractor collects clinical waste from the home. The laundry room has been arranged to ensure that soiled linen and clean linen are kept separate at all times. Both washing machines comply with the Water Supply (Water Fittings) Regulations 1999. The Inspector observed staff wearing protective clothing for specific tasks. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30 The home has a good match of experienced and qualified staff offering consistency of care. Staff are familiar with service users needs and how these needs are met. A comprehensive training and development programme was in place. EVIDENCE: There was a good range of skills, experience and expertise within the staff team. There were two staff vacancies at the time of this inspection. Three prospective staff had been offered employment subject to recruitment checks. A middle shift has been created between the hours of 10am and 5pm Monday to Friday. The purpose of this shift is for the additional member of staff to commit their time to service users. The Registered Manager said that service users were consulted on the most appropriate times for this shift. Staffing levels are determined according to the assessed needs of service users. Staff rotas were in place showing which staff were on duty at any one time and in what capacity. Domestic staff are employed in sufficient numbers to maintain a good standard of hygiene and cleanliness throughout the home. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 18 All staff on duty on the day of this inspection were correct in accordance with the rota. One of the senior team is allocated as Duty Manager on a daily basis. The Duty Manager is responsible for co-ordinating daily routines and responding to other duties as required. The Duty Manager is supernumerary to the care staff on each shift. Staff files examined were satisfactory. Recruitment checks are carried out in accordance with the criteria as set out in Schedule 2 of the Care Homes Regulations 2001. A staff training and development programme was in place. The recording of staff training had much improved since the last inspection. Maximum provisions are made for staff training and development for understanding Dementia and working with people with Dementia. Staff are required to attend other core training. Induction and foundation training programmes were in place. Ten staff had achieved an NVQ Level 2 in care. Six staff were working towards this qualification. Four staff were registered to do the NVQ Level 3 in care. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 38 The Registered Manager has a clear development plan and vision for the home. This is effectively communicated to service users, staff, relatives and significant others. The home regularly reviews aspects of its performance through a good programme of self – review and consultations with service users and relatives. Health and safety systems were well maintained. EVIDENCE: Quality assurance and monitoring systems were in place. Some of these systems were under review and being developed. A Residents Watch Dog meeting is a new set up. The Registered Manager explained that this is a way in seeking the views of service users regarding the provisions of service. The Residents Watch Dog meetings are held monthly. The committee for this meeting consists of the Registered Manager and elected service users and staff. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 20 Annual surveys are distributed to service users with a person centred approach. Surveys will be distributed to service users again in September this year. The Activities Coordinator will be responsible for this exercise. The Registered Manager said that surveys for relatives and significant others were under review. The Registered Manager said that the home was looking into the possibility of having an independent audit done for reviewing the quality of the service. In particular, the services provided for Dementia care. The home will be implementing the “Well – Being” care model. This will be integrated in the Person Centred Planning in September 2005. An annual development plan was in place. A business and financial plan was also in place. Monitoring systems include: • Frequency of service users reviews being carried out. • Referrals, assessments and occupancy. • Referrals and admissions for respite care. • Absenteeism. • Night spot checks. The home produces a quarterly newsletter. The newsletter highlights special events, articles contributed by service users and examples of the work carried out at the home. The Inspector can confirm that reports for visits carried out by the London Borough of Hounslow as required under Regulation 26 of the Care Homes Regulations 2001 are submitted to the CSCI. Health and safety policies and procedures were in place. Staff had attended updated training on First Aid, food safety and moving and handling. Contracts were in place with approved contractors to service the gas, electrical and fire appliances. Records examined indicated that these appliances were checked and tested routinely. The Lift was last serviced in February 2005. Records of hot water temperatures were satisfactory. Records examined indicated that hot water is delivered to bathing and showering appliances within a safe range. Fire drills are carried out monthly. The home was advised to include the times on each drill and to indicate that night staff have attended fire drills. Weekly Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 21 checks are carried out on the fire detection system. Records examined confirmed this. An accident record was in place. Robust systems were in place for recording and monitoring falls in the home. Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 x x 3 x x x x 2 Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 23 Yes 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. 1. 2. 3. Standard 9 16 35 Regulation 13(2) 17(2) Schedule 4(11) 16(2)(1) Requirement Timescale for action 31/8/05 4. 38 17(2) Schedule 4(14) Medication Administration Records must be completed at all times. The record of complaints must 31/8/05 include if a complaint was upheld or not. Details must be supplied to the 30/9/05 CSCI with regards to the types of accounts, which will be opened for service users finances and how these accounts will be managed. (Timescale of 31/1/05 Not Met). The record of fire drills must 31/8/05 include the times of each drill and to indicate that night staff have attended fire drills. 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 Good Practice Recommendations Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Ground Floor 58 Uxbridge Road Ealing London W5 2ST National Enquiry Line: 0845 015 0120 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 Clifton Gardens, 59 G61-G10 s32624 Clifton Gardens v214188 250705 Stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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