Inspection on 13/05/05 for Cornerstone Trust

This inspection was carried out on 13th May 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 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

Cornerstone Trust 03/03/08

Cornerstone Trust 12/09/06

Cornerstone Trust 07/02/06

Cornerstone Trust 27/08/04

Cornerstone Trust 04/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Cornerstone Trust Thicketford Place 132 Thicketford Road Bolton, Lancashire BL2 2LU Lead Inspector Sarah Tomlinson Unannounced 13 May 2005 11.00am 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cornerstone Trust Address Thicketford Place 132 Thicketford Road Bolton Lancashire BL2 2LU 01204 392043 01204 389940 thicketfordplace1@ntlworld.com Cornerstone Trust 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) Clive Olive CRH Care Home 6 Category(ies) of LD Learning Disability : 6 Places registration, with number of places Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home is registered for a maximum of 6 service users to include: Up to 6 service users in the category of LD. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 27 August 2004 Brief Description of the Service: Thicketford Place is a small care home, providing long-term support to six people with learning disabilities. A local, voluntary, Christian organisation, the Cornerstone Trust, set up the home in 1993. A group of trustees oversee its running, with the day to day management carried out by the registered manager. The home is on a main road, in a residential area in Bolton. There is good access to local buses and there are nearby shops, pubs and other local amenities within walking distance. Thicketford Place consists of a large, converted, end-terraced house. There are six, single bedrooms, one on the ground floor, four on the first floor and one on the second (attic) floor. There is a very small garden at the front of the house and an enclosed, patio garden to the rear. There is on-street parking adjacent to the home. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over five and a half hours. One resident was at home for the whole inspection, the other five returned later in the afternoon. Due to most of the residents having communication difficulties, time was spent observing how staff spoke to and supported residents. A brief chat took place with one resident on her return to the house. Three support workers, a senior support worker, and the deputy and registered managers were spoken with. Time was also spent looking at paperwork and some of the rooms in the house. What the service does well: What has improved since the last inspection? Cornerstone Trust had reached a decision about the home’s future. A plan was now in place for two residents to move out into another house and for the other four residents to stay in the home. A new way of writing information about residents was being introduced. It should be quicker for staff to use, giving them more time to spend with residents. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home provided a consistent and stable home environment, where residents’ care and support needs were being met. Implementing the reconfiguration plans (whereby two residents are to move out into new accommodation), should hopefully address the underlying tension brought about by the group living situation and also promote residents’ personal development. EVIDENCE: There had been no changes to the resident group. Four of the residents have lived at Thicketford Place since it opened in 1993, whilst the other two residents have lived there for a number of years. From observing staff and residents together and from speaking with staff about their work and the training and assessments they had received, residents’ needs were being met. However, due to residents’ differing abilities and support needs, a long-term issue regarding the compatibility of all the residents living together as one group still remained (as at times, the current situation caused tension). The home and the trust have been considering over the past several years how this can be resolved to best meet the needs and aspirations of each individual resident. Reviews had taken place between residents, family members, staff, social workers and trust members, and various re-configuration plans had been Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 9 put forward. A final decision had now been reached. Within the current financial year, two of the residents are to move out and live together with a third person in another house. These residents will be tenants and receive a domiciliary care service, hopefully from the existing Thicketford Place staff team. The remaining four residents will continue to live at Thicketford Place, subject to a possible rearrangement of rooms. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9 A knowledgeable staff team, who followed detailed and thorough written guidance, met the personal care and support needs of residents. Consequently, residents were kept safe (with the risk of accidents or harm reduced); treated as individuals; and supported according to their preferred routines. To ensure the ‘hoped for’ benefits are fully realised, the introduction of the new care and risk recording system needs to be completed. EVIDENCE: Good practice was noted, as there was an extensive amount of personalised and very detailed information about residents’ health and social care needs. This included individual and environmental risk issues, and each resident’s daily routines and how they liked their care to be provided. Staff spoken to were knowledgeable about each resident’s support needs and aware of associated risk issues (and how to manage or reduce these risks). The three senior support workers acted as residents’ key-workers. The manager and deputy were in the middle of introducing a completely new way of recording care and risk information. This required care plans, risk assessments and daily notes to be re-written. The intention was for Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 11 information to be easier for staff to access and use; for staff to spend less time writing; and for factual reporting to increase (enabling easier and better monitoring). The changes included separating residents’ routines from their accompanying risk assessments; the replacement of daily ‘write-ups’ with monitoring sheets; and the introduction of appointment and ‘concerns’ forms. The changes had been piloted with one resident and were now being introduced for the remaining five residents. Good practice was noted as the manager and deputy were making the changes gradually to allow for training and discussion within the staff team. The home was advised to monitor the length of this changeover, to ensure that information continued to remain up to date and properly recorded. The home was also aware that it needed to consider how long term support needs (e.g. regarding continence and personal hygiene) were to be recorded and monitored in the new system. Staff said the new system seemed to be working well. They found it helpful and it had cut down on the amount of writing they had to do. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 Residents took part in activities both outside and within the home that reflected their choices and capabilities. EVIDENCE: One resident who had previously chosen to stop attending a day centre, led an unstructured lifestyle, choosing to spend their day at home. Additional funding was received to provide a staff member to support this person each weekday. A second resident had recently stopped attending a day centre and was currently also at home. A second staff member was funded to provide 1 to 1 support for this resident. The remaining four residents attended day centres and colleges each weekday. One of these residents also had a part-time job for one morning a week. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 20 Staff provided personal care and support in ways that reflected individual preferences, promoted residents’ health and encouraged residents to retain control and independence whenever possible. EVIDENCE: Relationships between staff and residents seemed warm, friendly, caring and supportive. Staff were seen to actively listen to residents, to treat residents with courtesy and to support them to make choices. There were detailed records about how each resident liked their care to be delivered. Staff had a good understanding of this information, giving examples of residents’ preferred routines (including how one resident liked to be woken up in the morning, and when and where other residents liked to eat their meals). Staff spoken with had a good understanding of medication procedures. Medicines were stored safely and clear records were kept regarding their administration (plus any unwanted medicines returned to the pharmacy). One resident’s medicines were placed within their food. This had been discussed and agreed with the resident’s doctor and family, with written confirmation and guidelines in place. Staff were able to explain why this was being done and how they explained their actions to the resident each time they administered their medication. The home was advised to also inform their pharmacist of this practice (and record that this had been done). Staff had received externally accredited medication training from Boots (last delivered Feb ‘05). Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Policies, procedures and training were in place to safeguard residents from abuse or harm. The new system of storing and recording residents’ money had made staff access and subsequent recording simpler. However, the system needs to be kept under review with regard to how it will continue to best meet the needs of each individual resident (particularly in view of the forthcoming reconfiguration plans). EVIDENCE: New staff attended Bolton Social Services’ ‘abuse prevention/adult protection’ training as part of their induction. No allegations of abuse had been made to the home or to CSCI. The deputy manager confirmed that all staff had now received CRB disclosures. The home was advised that once seen by CSCI, these should be destroyed. However, before doing so, details of the disclosures’ serial numbers and the dates requested and received should be recorded on staff members’ files. Although two residents were supported to look after small amounts of money, the home retained responsibility for all six residents’ day-to-day spending. The system for looking after residents’ personal allowances had changed. Previously, six individual cash tins and six individual ‘pencil cases’ had been kept. These had been replaced by just one central cash tin, with a float of £200.00. Both staff’ petty cash and residents’ personal spending money was taken from this one float. Staff replaced any money taken with a receipt. There were no further paper records. The manager entered every detail of each resident’s personal expenditure onto the home’s computer. This was Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 15 monitored, with any overspend being identified and paid back (two residents had overspent by £40.00 over the past year). The home confirmed that residents’ computer records were independently audited. Although a simpler and consequently safer system for staff, the home was advised that to residents, the new system could seem like a ‘never-ending supply’ and consequently may hinder the development of money management skills (particularly for one resident who was due to move out of the home). The data entry required for each resident’s receipts was also a very time consuming activity for a registered manager. The home also needed to check through the ‘old’ cash tins and pencil cases and deposit any remaining money. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 26, 28 and 30 Thicketford Place provided residents with an attractive, comfortable, safe and homely place to live. EVIDENCE: Thicketford Place was comfortable, bright and welcoming. There was a high standard of décor and furnishings, which were domestic in style. Residents had the use of a large through lounge, a kitchen and a conservatory dining room. There was also a pleasant enclosed patio garden, with a bbq, a small water feature and planted tubs. There were two staff offices and a staff sleepin room on the first floor. Two residents helped staff show the inspector their bedrooms. These were extensively personalised, had wash hand basins and a suitable range of furniture and fittings. The home had already identified that one of these rooms was not decorated to the same high standard as the others, as the wallpaper was starting to seem tired and worn. As this resident was due to move out in the forthcoming re-configuration, it was agreed that the redecoration should wait until this has taken place. Another resident (who was to continue living at the home) had requested and chosen a new colour for their bedroom. The home planned to re-paint this room shortly. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 17 In accordance with each resident’s abilities and associated risk issues, one bedroom door had a lock fitted. The resident concerned used this on daily basis. The front door was fitted with an intercom/magnetic door release system. Staff operated this. Due to safety reasons, access to the kitchen was limited - a ‘half/stable-type’ door was fitted in one doorway and a raised handle fitted to another door. One resident liked to lie down on a seat within a lounge alcove. As a result, small amounts of wallpaper had come away. This home was aware this needed to be addressed and were also considering the re-positioning of a double electric socket within the same alcove. The home was clean and tidy. Support staff were responsible for most of the housework and laundry, although residents were encouraged to help with some jobs, such as washing up (with a photo task book providing pictorial prompts). The home employed a cleaner for 4 hours a week. Liquid soap and paper towels were provided in the kitchen, toilet and bathroom. Laundry facilities remained in an external brick built outbuilding in the back garden. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34, 35 and 36 Residents’ safety and well-being were promoted through generally rigorous staff recruitment and selection procedures. Comprehensive induction plus ongoing training ensured that residents’ individual and joint needs were properly and fully met. Residents also benefited from a well-supported and supervised staff team. EVIDENCE: Files of three new staff were examined. Application forms, references and confirmation of identity were generally in place, although photographs, and references for one staff member were missing. The deputy manager confirmed that references had been received, although they could not be found. Good practice was noted, as formal notes were kept of applicants’ interviews. Although the POVAFirst check facility was being used (with email confirmation kept), staff did not start work in the home until the full CRB disclosure was received. CRB disclosures were seen for the three new starters. Good practice was noted, as new staff received a comprehensive induction package (both outside and within the home). Before starting work in the home, a 7-day Bolton Social Services induction course was attended. Staff then shadowed a senior worker, observing how residents were supported (e.g. bathing, getting up routines, accompanying residents out in the community). The senior then observed the new starter performing these support tasks. This Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 19 process was formally documented and took place over time, with new staff not working alone until they felt confident to do so. New staff said they felt very supported by this period of shadowing and had found it very useful. The home had provided a range of mandatory and additional, service specific training to existing staff. This had included 3 internal ‘focus days’, which looked at the values and principles of care with regard to two residents (with further focus days planned for the remaining residents). Good practice was noted, as night staff had been included, with the deputy manager covering the topics in supervision for those who had been unable to attend. To fully recognise all training attended and to enable each staff member’s individual training needs to be monitored, the home was advised all staff need individual training records (to also include, for new staff, induction training details). Staff said they received regular, formal supervision. Good practice was noted, as bank staff were also included. Frequent team meetings were also held (including weekly meetings whilst the new care recording system was being introduced). Staff said they found these very helpful. The home was aware of the need for and planned to introduce annual appraisals. Staffing levels were good. Three staff were on duty between 7am and 10am, and 3pm and 10pm weekdays, and between 7am and 10pm at weekends. As two residents were currently at home during the week, two staff were also on duty between 10am and 3pm each weekday. Two staff were on duty at night, one awake and one asleep. Senior support staff provided an out of hours on call service. There were no vacancies. One senior support worker was undertaking social worker training. Good practice was noted, as the home had arranged for just one agency worker to cover these hours (Feb – Apr 05) (and for them to also complete the shadowing training). Three further agency staff had since been used. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Fire safety was well managed, promoting the health and safety of both residents and staff. EVIDENCE: Records showed that fire safety equipment and fire alarm checks were up to date. A fire drill was carried out monthly, with the names of both staff and residents who took part being recorded. Good practice was noted, as to promote understanding and confidence with the fire alarm system, all staff took part in operating it. Fire safety training had been provided to staff in the past four months. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 x x x x x Standard No 31 32 33 34 35 36 Score x x 3 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cornerstone Trust Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 22 no 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. Standard 24 Regulation 13, 23 Requirement The planned redecoration of the lounge alcove and a risk assessment regarding the position of an electric double socket within the same alcove must be carried out (with any required action taken). Two repeat references must be obtained for the identified member of staff. Staff files must contain a recent photograph. Individual training files must be kept for each staff member Timescale for action 31 August 2005 2. 3. 4. 34 34 35 19 19 18 30 June 2005 31 August 2005 31 August 2005 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. Refer to Standard 23 23 Good Practice Recommendations The dates CRB disclosures are requested and received, and their serial numbers should be included in staff files. The current arrangements for looking after residents money on their behalf should be reviewed when the reconfiguration plans take place (with a view to putting in place systems that best support and encourage each residents individual capabilities). The practice of the F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 23 Cornerstone Trust 3. 36 manager carrying out data entry with regard to residents spending should be reviewed. As planned, annual appraisals should be introduced for all staff. Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Cornerstone Trust F56 F06 S9314 Cornerstone Trust V219441 130505 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. 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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