Inspection on 11/09/06 for Coniscliffe Rest Home

This inspection was carried out on 11th September 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Coniscliffe Rest Home 14/01/08

Coniscliffe Rest Home 16/01/06

Coniscliffe Rest Home 15/09/05

Coniscliffe Rest Home 13/10/04

Coniscliffe Rest Home 29/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Coniscliffe Rest Home 37 - 43 Grosvenor Place Jesmond Newcastle Upon Tyne Tyne & Wear NE2 2RD Lead Inspector Deborah Haugh Key Unannounced Inspection 11th September 2006 09:30 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 Coniscliffe Rest Home DS0000000437.V299758.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. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coniscliffe Rest Home Address 37 - 43 Grosvenor Place Jesmond Newcastle Upon Tyne Tyne & Wear NE2 2RD 0191 281 2553 0191 281 8690 coniscliffe@highfield-care.com defoecourt@shealthcare.co.uk Southern Cross Home Properties Limited 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 Terence Lillico Care Home 43 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (31) of places Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One identified service user with Mental Disorder aged over 65 years. Date of last inspection 16th January 2006 Brief Description of the Service: Coniscliffe is a care home that provides personal care to 43 older people and older people with dementia. The Home is located in Jesmond, a residential area of Newcastle upon Tyne and is a conversion of five large terraced houses. There is a range of local shops and amenities within walking distance and the area is well served by public transport. The current weekly fees are £ 355 £499. Coniscliffe Rest Home DS0000000437.V299758.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 on 11/09/06, between 9.30am and 4.00pm. The Registered Manager Terry Lillico was on duty. There were 36 people living in the home. Time was spent looking around the home to check the cleanliness, maintenance and decoration. The views of service users and visitors were sought during the inspection. Time was also spent observing the contact between the service users and staff. Questionnaires were sent to service users, relatives and professional visitors and 15 were returned. Care plans for 3 service users were examined. Staff described their approaches to caring for the service users. Arrangements for the administration and management of medication were checked. Recruitment, training, complaints and protection of vulnerable adults (POVA) were checked. What the service does well: Comments from service users included ‘ Staff are always excellent and my health has improved.’ ‘Meals are always enjoyable.’ ‘I have been well looked after.’ ‘I like it here, they keep an eye on me.’ ‘I enjoy the art.’ ‘Its lovely here they look after us well. Terry’s very good.’ ‘I like to read and be by myself.’ ‘I’m still here and settled.’ Comments from professional visitors and relatives included - ‘She’s doing really well, they’re great here they know when she’s not well and they get help.’ - ‘Staff are very welcoming and appear to be very professional in their treatment of patients.’ - ‘I have always been impressed by the care and kindness the homes staff show to my mother.’ - ‘The home appears to be run very efficiently with good monitoring procedures.’ - ‘There’s a very good newsletter focusing on the residents.’ - ‘Resident’s seem very happy and settled. Good rapport between residents and carers.’ Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 6 The range of structured activities provided by the home such as the art and gardening club. The homes newsletter where service users and staff share their lives. The Manager provides a clear sense of direction and leadership. 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. Coniscliffe Rest Home DS0000000437.V299758.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 Coniscliffe Rest Home DS0000000437.V299758.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users who move into the home have their needs assessed by a care Manager and the home. EVIDENCE: Three service users records were inspected and 2 people have been recently admitted. There was evidence of assessments of the person’s needs by care Managers and the home. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 9 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 the following standard(s): 7 -10 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Care plans are in place and staff have the information to meet service users needs. But two areas must be addressed. The health needs of service users are met and multi disciplinary working is taking place. The arrangements for the administration of medication are satisfactory. Resident’s dignity is respected. EVIDENCE: A sample of service user’s care records was examined. Care plans look at a range of needs based on ‘Activities of Daily Living’. These are evaluated each month. Some people require support with their finances and a care plan must be put in place. Risk assessments and risk management plans are in place. One person is at risk of falling and the arrangements for the nighttime must be risk assessed again and the chair removed from the bed as this puts the Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 10 person at more risk of injury. Alternative solutions must be sought. Accountability records are maintained for people who require close monitoring. There is a system of initial and six monthly reviews of service users care. Service users have access to a range of health professionals. Assessments are in place for pressure sore management, nutrition, falls, moving and handling and continence. Service users questionnaires indicated that people felt that they were provided with the care and support required and medical support is provided. Professional visitor questionnaires are satisfied with the overall care provided to service users in the home. An audit of the medication arrangements was undertaken in the presence of the senior carer on duty and was satisfactory. The Manager intends to update the September 2005 British National Formula (BNF). Service users questionnaires and comments said that they felt their privacy was respected and that staff treated them well. Visitors confirmed this. Staff receive training in Customer Care. Care plans document service users preferred name and this is used. Physical care and medical examinations are conducted in private. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 12-15 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users are able to join in a variety of structured activities but meaningful occupation must be provided for people with a range of ability. Service users have control over their lives and where this is not possible support is provided. Dietary needs of residents are well catered for with a balanced and varied selection of food but two areas must improve. EVIDENCE: Service users are able to participate in a regular programme of arts and crafts, newsletter discussion groups, karaoke sing-a-longs, board games, bus outings, library service and chairobics. There are visits to a local bingo hall, pubs, theatres, shops, museums and church services. Other activities are entertainers and singers. However a large proportion of service users sat and slept through the day with no meaningful occupation at hand to stimulate them. A short sing song was encouraged by two staff after lunch, which some Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 12 people appeared to enjoy. Meaningful occupation can be introduced to people with mixed abilities, which engage the five senses. People who join in the Art and Gardening Groups spoke highly of the activities co-ordinator who provides practical support and enthusiasm. The Gardening Club has grown tomatoes and flowers. New garden furniture and decking for people to enjoy. A painted mural project for the garden wall involved a number of service users. The Art group pieces, which include oil, water paintings and clay sculptures, will be entered into the Southern Cross Calendar Competition. People are encouraged and supported to maintain their interests prior to coming into the care home such as model trains, reading and spiritual contacts. The Manager is committed to providing and reviewing the activities and occupation for service users. Relatives feel welcome when they visit and they can have privacy. Within the context of risk assessments service users are able to maximise their control over their lives. People are able to bring their own possessions with them and handle their own affairs. Service users questionnaires indicated that they felt that staff listened and acted on their wishes. Service users spoke positively about the food. The inspector observed lunch with two service users in the lounge/diner. Lunch was unhurried and service users are able to have a choice and alternatives to the menu. The lunch choice was corned beef pie or tomato omelette with mashed potatoes and mixed vegetables. The sweet was fruit and ice cream or orange sponge and custard. Up to date information is no longer available in the kitchen regarding service users nutritional needs, weights (loss of weight which was highlighted and addressed) and preferences. Menus are not in sufficient detail to judge the nutritional content regarding sandwich fillings, various drinks available and flavour of the soup. The handwritten menus are not always legible. The dry wipe board does not record all the detail of the menu for the day. Staff ask service users what they would like to eat for each meal and there is evidence of a variety of diets and preferences catered for. Some people were being assisted or encouraged to eat at lunchtime. This was done sensitively and discreetly. Staff sat with people and helped them. The atmosphere in the dining room was relaxed. Service users are able to have their meals in another lounge/diner or their room, which some people prefer. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 16 & 18 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home has a satisfactory complaints system in place. Systems are in place to protect service users from harm. EVIDENCE: Service users said they would tell the Manager if they were unhappy about anything. The Manager is proactive in obtaining the views of service users, visitors and staff. Staff spoken with are clear about reporting any concerns to the Manager. Six staff are awaiting training in Protection of Vulnerable Adults. The Manager will provide awareness training to one domestic and the cooks. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 19,20,21,24 & 26 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Service users live in a home suitable for their needs. Services users have access to safe and comfortable indoor and outdoor communal facilities. Service users have suitable W.C & washing facilities but would benefit from the addition of a walk in shower. The home is clean pleasant and hygienic. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 15 EVIDENCE: The lighting in one en-suite bathroom was flickering and required attention, which the Manager assured would be seen to immediately. Bath thermometers in communal bathrooms on the first floor and the ground floor were missing however the Manager gave assurances that thermometers are used and temperatures logged in daily records. Thermometers should be located or replaced and used by staff to maintain safe bathing water temperatures. Maintenance checks on bathing equipment are up to date having been checked in March 2006 and due again this month. Work has been done at Coniscliffe to personalise individual’s bedroom doors. People have chosen door colours and clear nameplates, doorknockers and in some cases letterboxes have been fitted to enable people with dementia to recognise the location of their room. A great deal of work has been done to develop the rear yard sitting area with decking, a water feature, table and chairs and a bench. A mural has been designed on the back wall with input from service users and raised beds developed with tomato plants to encourage those with a gardening interest to take part. Handrails are located throughout the building and flooring in the dining room has been replaced to aid mobility. The Manager plans to make better use of the first floor combined sitting and dining room and intends to provide independent facilities for service users to make drinks and engage in activities. Adequate numbers of bathrooms and toilets are provided for the number of people living in the home. A walk-in shower would improve choices and access to personal hygiene for service users. Lavatory doors are all colour coded and have symbol signage to enable people with dementia care needs to recognise their location and function. A number of rooms were checked during this inspection all had window restrictors fitted. In one room where the fire escape is located the exit door is alarmed and the layout of the room is such that a fridge and kettle may be provided if the occupant wishes, subject to risk assessment. One service user has a static train set and models which he is building located on a waist height plinth which enables him to access his hobby comfortably. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 16 Domestic staff were on duty during the inspection and communal areas were clean and free from odour. Infection control measures are in place and clearly displayed. The laundry was clean and well organised. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27-30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Staffing numbers are appropriate to the assessed needs of the residents, size and layout and purpose of the home at all times. Service users are protected from potential harm as robust recruitment systems are in place. Service users are cared for by staff that are trained and competent. EVIDENCE: The home maintains the level of staffing in accordance with previous agreements with the local authority and this reflects the size and layout of the building and the needs of the residents currently living in the home. The current staffing levels are 5 care staff on duty during the waking day and 3 waking nights. Questionnaires indicated that there are sufficient numbers of staff on duty. The home has met the National Minimum Standards for NVQ Level 2 training for care staff at 50 . Five staff are completing NVQ level 3 and 2 newly recruited staff will commence NVQ Level 2. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 18 Staff have also received training and is planned in the following - Protection of Vulnerable Adults (POVA) & Whistle Blowing - Fire safety - Moving and handling - Control of Substances Hazardous to Health (COSHH) - Oral Hygiene, Pressure Areas, Infection, Continence, Diabetes, Death & Dying. - Healthy Eating for the Elderly, Basic Food Hygiene, - Preventing Accidents, Health & Safety, First Aid. - Dealing with confusion - Challenging Behaviour, Bullying, Restraint - Customer Care - Alcohol and Drugs - Health and Safety - Medication One staff member has commenced employment since the last inspection. And the recruitment records were sampled. Two references, Police and Protection of Vulnerable Adults checks and staff identity are in place. There is one 21hour kitchen assistant post vacancy. The turnover of staff is very low with 2 care staff leaving employment since the last inspection. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,37 & 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The Manager is experienced and is supported by the senior staff in providing clear leadership throughout the home, with all staff demonstrating an awareness of their roles and responsibilities. Quality Assurance systems ensure that the service users receive appropriate care. Arrangements for the management of service users own personal money protects service users. Records are maintained appropriately to protect service users. Service users are protected from robust health and safety arrangements. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 20 EVIDENCE: The Registered Manager has completed the Registered Managers Qualification. And the D32 and D33 NVQ Assessors Award. The Manager continues to undertake further training to update his knowledge, skills and competence. The Manager and his senior team are familiar with the associated conditions and needs of the service users at Coniscliffe. There are clear lines of accountability within the home and externally. The Manager ensures that ethos of the home is to include the views of the service users, advocates and staff. Service user/Relative meetings and staff meetings are held regularly and items followed through and actioned. Two policy and procedures are discussed each month at staff meetings. There is a clear sense of leadership. Staff have confidence in Mr Lillico and feel they can speak to him about anything. Service users clearly know Mr Lillico and a good rapport exists. Southern Cross Care Homes Ltd has a number of quality assurance systems in place. Monthly audits of the catering, medication and management systems are completed. Regulation 26 visits and reports about the conduct of the care home are undertaken by the Company’s representative. Service users money, which is looked after by the home, is securely stored. Only the Registered Manager, Deputy and Administrator have access. Care plans must be put in place where service users require assistance with finances. Southern Cross is looking to open separate individual bank accounts for service users. Service users are able to manage their own affairs. The Staff Handover Book is now confidential and where appropriate refers to the service users individual care record for staff to read. There were no hazards identified at this inspection. A recent window restrictor audit was completed and deficits addressed to ensure the safety of service users. Records of servicing and maintenance of equipment are available. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 X 3 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 3 3 X 2 X 3 3 Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 13(4) Requirement Timescale for action 11/09/06 2. OP7 15 The Registered Person must ensure that the nighttime risk assessment for the identified service user who is at risk of falls is reviewed and the chair removed from the bedside. The Registered Person must 31/12/06 ensure that the arrangements for supporting service users with their finances are put in a plan of care. (Also NMS 35) The Registered Person must ensure that meaningful occupation is provided to all service users to reflect their abilities as discussed at the inspection. The Registered Person must ensure that menus are in sufficient detail and legible to determine whether the diet is satisfactory. (ie sandwich filling, soup flavour, drink choices) 30/11/06 .3. OP12 15 4. OP15 17 schedule 4 30/11/06 Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP15 OP21 OP38 Good Practice Recommendations Up to date details of special diets should continue to be shared with the cooks as discussed at the inspection. Consider providing a walk in shower as a replacement for the damaged bath on the ground floor. Thermometers should be located or replaced and used by staff to maintain safe bathing water temperatures. Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Coniscliffe Rest Home DS0000000437.V299758.R01.S.doc Version 5.2 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. 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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