Inspection on 16/04/07 for Cornerways

This inspection was carried out on 16th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Similar services:

Clouds House

Closereach

Westcliffe House

Hilldales

Longreach

Chandos House

Cherry Orchards Camphill Community Ltd

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

CARE HOME ADULTS 18-65 Cornerways 20 Braidley Road Bournemouth Dorset BH2 6JX Lead Inspector Martin Bayne Key Unannounced Inspection 16th April 2007 09:30 DS0000067910.V336162.R01.S.doc Version 5.2 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 DS0000067910.V336162.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 Adults 18-65. 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. DS0000067910.V336162.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornerways Address 20 Braidley Road Bournemouth Dorset BH2 6JX 01202 554851 01202 314306 info@streetscene.org.uk www.streetscene.org.uk Streetscene 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) Miss Sharon Louise Baker Care Home 20 Category(ies) of Past or present alcohol dependence (20), Past or registration, with number present drug dependence (20) of places DS0000067910.V336162.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection First inspection of the home. Brief Description of the Service: Cornerways is a twenty-bedded residential service run by Streetscene, a Registered Charity whose main purpose is to help people suffering from the disease of addiction. The home was registered in November 2006 but prior to this was operating under a different registration in other registered premises. The home is located in a quiet residential area that is close to the centre of Bournemouth and its amenities. It is set in large grounds of ¾ of an acre with some parking available to the side and front of the building. The home has four double bedrooms and twelve single rooms and new residents may be asked to share a room when they first move into the home. Each room has its own sink and requisite furniture. There are three communal bathrooms each with a toilet. There are also two separate toilets and three shower rooms. Other communal rooms available for use to residents include a large lounge conservatory area and dining room, kitchen and laundry room. The home is staffed twenty-four hours a day. Both first stage and second stage treatment of about three months duration for each stage of treatment are offered at the home. The treatment programme uses an eclectic evidence based treatment model with staff trained in addiction counselling. The rules and expectations of residents at the home are detailed within the Service User Guide. Streetscene offers an aftercare service for those residents who complete the programme. The fees for the home are £555 each week with a charity discount of £25 for 2007. DS0000067910.V336162.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection of the home since its registration in November 2006 when the home moved from other premises. Time was spent with the manager tracking required record keeping that has to be kept up to date concerning care of residents. A group of 12 residents were spoken with about their experience of life in the home and comment cards were also left for residents to complete should they choose. Residents returned 13 comment cards. Two members of staff were spoken with and a tour of the premises was made. The results of the above are detailed within this report. What the service does well: What has improved since the last inspection? This was the first inspection of the home. DS0000067910.V336162.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000067910.V336162.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection DS0000067910.V336162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Full assessments of need are carried out prior to a person being offered a place at the home to ensure that these needs can be met. Prospective residents are supplied with good information to assist them in choosing a suitable home to meet their needs. EVIDENCE: At the time of the inspection there were 14 residents staying at the home, all of whom had been referred and funded through care management arrangements from outside of the Bournemouth area. The manager informed that self-funding referrals are accepted. The home has block-funding arrangements with some local authorities. As part of the inspection the personal files for three of the residents were seen to provide evidence of the care provided at the home. It was found that in all three cases a full assessment had been carried out by the home prior to the person being admitted to ensure that their needs could be met. The manager informed that a copy of the Service User Guide is sent out to any person DS0000067910.V336162.R01.S.doc Version 5.2 Page 9 interested in being admitted to the home, which provides comprehensive information about the service as well as detailing the rules and responsibilities expected of residents. All people referred are welcome to visit the home if this is possible. Telephone assessments are an option should a person not be able to visit the home. In all cases the home ensures that they can meet the person’s needs before they are admitted. If a person is accepted for a place at the home they are offered a four-week trial placement. Returned comment cards informed that residents had been involved in choosing the home for their treatment. DS0000067910.V336162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 679 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being fully involved in their treatment through assisting in development of their care plans. Within the confines of the house rules, residents are able to make decisions and choices affecting their lives. As treatment progresses, residents take on more responsibility for themselves and are supported to take risks. EVIDENCE: Should a person be referred through care management arrangements a copy of the assessment and care plan carried out by the social worker are obtained and this forms the basis for developing a care plan within the home to meet DS0000067910.V336162.R01.S.doc Version 5.2 Page 11 the goals set out in the care management care plan. For people who are selffunding, the home carries out their own in-depth assessment to ensure that the person’s needs can be met. It was found that for the three residents tracked through the inspection, a care plan had been developed that detailed how the staff were to support that individual resident. The care plans were signed by residents and also included an assessment of risk and how the possibility of harm was to be reduced. The plans had been reviewed at least monthly and in some areas weekly, depending upon the timescale set for each goal. The residents spoken with all informed that they were kept informed and were involved in their treatment plan. In line with providing a safe environment for people’s treatment, the home has a set of rules and expectations that residents sign up to on admission. They are informed of these before they are admitted through the Service User Guide. When a person is admitted they are again reminded of the rules that govern the treatment programme. As residents progress through treatment they are given greater responsibility and given more opportunities to make decisions about their lives. During stage one treatment, residents are supported to settle into the home, learn about the disease concept of addiction and treatment is offered in groups and by way of individual counselling. During this stage they are not allowed out of the home on their own. During stage two of treatment residents are given more responsibility to test out things they have learnt in stage one. Residents spoken with informed that they were comfortable with the expectations underpinning the ethos of the home and said that within the confines of the house rules they were supported to make decisions on how they wished to conduct their lives. Although a resident’s stay at the home is for a period averaging six months, there is a weekly community group where residents have a voice about the running of the home and planning for the week ahead. There is an expectation that residents carry out household chores on a weekly-rota basis as part of their rehabilitation. As mentioned earlier in the report, care plans are incorporated into a risk assessment framework that ensures that people are safe, but are also able to make choices about their lives. Should a person breach house rules and the decision be made that they cannot continue treatment within the home, a discharge plan is made to ensure the person is engaged with services. DS0000067910.V336162.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 15 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides people with opportunities for personal development with appropriate activities arranged with residents. As treatment progresses, residents are encouraged to make links with the local community. Residents are supported to maintain links with their families and develop a network of support within and outside the home. Residents benefit from a good standard of food and through being encouraged to maintain a healthy diet. EVIDENCE: DS0000067910.V336162.R01.S.doc Version 5.2 Page 13 The whole ethos of the treatment programme is to provide residents with opportunities for personal development in terms of physical, emotional, spiritual needs. From the three personal files of residents, there was evidence that residents were able to set goals for achieving their own objectives, such as re-establishing relationships with family members. The home has links with one of the local colleges and residents attend an outreach course designed for people in the early stages of recovery. The course develops IT skills and people set assignments to build self-esteem. It also aims to assist in budgeting and identify areas such as numeracy, literary and other life skills. Residents are also encouraged to take part in volunteer work as part of the treatment with examples given of people helping at the Brownsea Island Nature Reserve, Dorset Reclaim and some local charity shops. Residents also can attend groups in the community such as Narcotics or Alcoholics Anonymous. Some outings and excursions are arranged, mainly in the summer months to meet recreational needs. There is an expectation on residents to contribute to group work and be respectful of other people in treatment. Forming special or sexual relationships with other people in treatment is against the rules as this detracts from treatment progress and residents sign up to this rule on admission to the home. Residents said that they felt well supported and those getting to the end of their stay were very positive about the ongoing network of support offered. Residents informed that the food was of a good standard with one person informing of how they had increased in weight of one stone, being under weight when they were admitted a month before. Three residents were working in the dining room and kitchen; they said that the lunch had been good and offered a choice of items. There were two large bowls of fresh fruit in the dining room and it was confirmed that the bowls were restocked two or three times a week. Drinks were available at all times. The residents said they were able to discuss and suggest items for the menu; however there were checks in place to ensure that nutritional quality was maintained. The manager informed that residents are encouraged to maintain a healthy regular diet. The menu for the week ahead was seen and this reflected a varied and balanced diet. DS0000067910.V336162.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from being fully involved in their treatment programme and being supported in an appropriate manner. Residents’ health needs are assessed with appropriate action taken to meet these. Some small additions to the recording system for medication administered will ensure that medication is administered in line with best practice. EVIDENCE: There were very positive comments made about the treatment programme when speaking with the group of residents. Returned comment cards were all very positive about the way the home was run and the opportunity the programme had given them to recover. They informed that they were treated respectfully as adults. DS0000067910.V336162.R01.S.doc Version 5.2 Page 15 There was evidence in the personal files of those residents tracked through the inspection that health needs were being met. Dental and optician appointments had been arranged as required. Every resident is registered with the GP surgery with whom the home contracts. The GP has a special interest in addictions and therefore health needs of residents are well met. Should a person at the home have mental health needs, arrangements are determined before admission on how these are to be met and by whom. Residents are educated, informed and supported concerning blood born viruses. As a general rule the staff at the home manage residents’ medication. Exemptions to this rule are such things as prescribed inhalers and risk assessments were seen for residents to handle such medication safely. All medications are logged into the home and stored in the home’s medication cabinet in the staff office. Only staff trained through the local pharmacy and deemed competent are allowed to administer medication in line with the home’s policies and procedures. The medication administration records for the residents tracked through the inspection were seen. These records were being completed correctly in the main, however a recommendation was made that where staff have to enter by hand medications to the record, this should be checked and signed by a second member of staff. It was also recommended that allergies should be recorded on the medication records or ‘none known’. The medication cabinet was seen and medications were stored correctly. On occasion residents may be admitted at the end stages of detoxification whilst still being prescribed controlled drugs. One resident spoken with informed that this had been managed successfully. The home had developed a register for entering controlled drugs and their administration but it was agreed that a controlled drugs register would be purchased through the pharmacist. The medication cabinet has an inner lockable facility for storing controlled medications. DS0000067910.V336162.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having access to a well-publicised complaints procedure and the staff being trained and aware of adult protection issues. EVIDENCE: Since the home has been registered in November 2006 there have been no complaints made about the home. A register was available for recording any complaints made. The complaints procedure is detailed within the Service User Guide, a copy of which is given to each resident and conforms with the Regulations and National Minimum Standards. It was found that all of the staff have been trained in Adult Protection and the home has policies and procedures that link to local ‘No Secrets’ arrangements. During the discussion with the staff both were aware of the procedures for responding to signs or allegations of abuse. They added that all procedures were posted electronically on the organisations “intranet” allowing easy access to up to date information. DS0000067910.V336162.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well-maintained, clean home that is suitable for a treatment setting. EVIDENCE: Both staff, residents and the manager said that they were pleased with the new premises and that they afforded a good environment for a treatment setting. A tour of the premises was made that included viewing two residents’ bedrooms. The home was well decorated throughout with furnishings and fittings in good repair. There was evidence in a resident’s bedroom that they could personalise their own space. A discussion took place with the manager about the type of screening that would be made available in one of the double rooms. This will be followed-up at the next inspection. The home was found to be clean throughout. DS0000067910.V336162.R01.S.doc Version 5.2 Page 18 It was noted that locks on some of the bathroom doors did not have ‘panic locks’ fitted that allow staff to enter in an emergency. The inspectors were informed that the building is listed and the original doors could not be fitted with these locks for this reason. It was agreed that ‘panic locks’ fitted would be fitted to those doors not subject to the listing restrictions. This will be followed up at the next inspection. DS0000067910.V336162.R01.S.doc Version 5.2 Page 19 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 34 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff have the skills and training to ensure that the residents receive appropriate care and support. The organisation’s recruitment process helps to maintain the skill of the team and avoids the appointment of unsuitable applicants. Systems in place for supervision and staff development helps to equip the staff to meet the needs of the residents. EVIDENCE: The home is staffed by two counsellors / project workers during the day time with the manager on the premises during the week; at night there is one worker supported by an on call counsellor and a duty manager. DS0000067910.V336162.R01.S.doc Version 5.2 Page 20 Four staff files were examined, each contained information on the roles and responsibilities of the individual. The information held was of a good standard however, on one file there were gaps in the employment history, which should have been explored during the interview and the reasons recorded. On another file there was only one reference. All files seen had evidence that the required clearances had been obtained before the member of staff started working in the home. Each person had a record of two monthly supervision meetings with their line manager. The training records showed that staff had access to a good range of training for care workers and specialist training relating to addiction. Two members of staff on duty were working on or starting their NVQ level 3 in care. New staff complete an induction programme during the first weeks of employment. It was agreed that the manager would review the system against the Skills for Care induction standards to ensure the required topics were met. The members of staff on duty were seen privately. Both were clear about their roles and responsibilities and said the organisation was very supportive and encouraged personal development. There was a system of group supervision where particular issues were discussed in a staff forum to develop strategies. Both members of staff said that their ideas were heard and considered by management. DS0000067910.V336162.R01.S.doc Version 5.2 Page 21 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The organisation’s management structure supports the local manager and helps to ensure that the home is focused on providing good outcomes for those using the service. Residents and staff views are welcomed and used to develop the service. The organisation has health and safety procedures for the protection of residents and staff. EVIDENCE: DS0000067910.V336162.R01.S.doc Version 5.2 Page 22 The manager has gained experience managing other services for the organisation. She has also completed National Vocational Qualification at level 4 in care home management. The home has weekly “community” meetings where the residents are able to raise issues and ideas these meeting are recorded and actioned. Residents commented that the meetings were helpful and made them feel involved and valued. In addition to the community meetings the home also uses client satisfaction questionnaires to gain additional information about how the home is operated. A representative from the organisation also carries out monthly visits to the home and completes a report on the findings. The report is given to the manager and available for inspection by the Commission. As a new service the home had been visited recently by officers from Dorset Fire and Rescue Services and Environmental Health. The home has an accident book, which showed good levels of recording; however the completed reports were not removed from the record pad and could compromise the privacy of affected individuals. The counterfoil on the record pad also needs to be numbered to allow an audit trail. There was no evidence that accident analysis took place. The fire record book showed that the fire safety systems were regularly tested and maintained. There was also evidence of staff training and fire drills taking place. The home had completed a Fire Risk Assessment as required by the Fire Safety Order. The inspectors were concerned about the level of detail recorded and suggested that the manager seeks further guidance on the recording of the risk assessment. DS0000067910.V336162.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 Standard No Score 1 x 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 2 X DS0000067910.V336162.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations It is recommended that where staff have to hand write entries on medication administration records, these are checked for accuracy by a second member of staff who then sign the record. It is recommended that any allergies or ‘none known’ be recorded on the medication administration record for each resident. It is recommended that the registered person ensure that new staff are not appointed until two references had been obtained and any gaps in employment history explained. It is recommended that the organisation ensures that the induction programme for new staff considers the topics identified by Skill for Care guidance. It is recommended that the registered manager ensures that:• completed accident reports are removed from the DS0000067910.V336162.R01.S.doc Version 5.2 Page 25 2. 3. YA20 YA34 4. 5. YA35 YA42 • record pad. The counterfoil is numbered to provide an audit trail for the completed forms. DS0000067910.V336162.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000067910.V336162.R01.S.doc Version 5.2 Page 27 - 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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