Inspection on 22/06/07 for Cornerways

This inspection was carried out on 22nd June 2007.

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

Cornerways 19/12/09

Cornerways 19/06/09

Cornerways 10/08/06

Cornerways 16/01/06

Cornerways 25/07/05

Cornerways 22/02/05

Cornerways 17/08/04

Similar services:

St Vincents

The Cotswold Home

Winton House

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Cornerways Church Lane Kings Worthy Winchester Hampshire SO23 7QS Lead Inspector Ian Craig Unannounced Inspection 22nd June 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Cornerways DS0000040361.V338791.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. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cornerways Address Church Lane Kings Worthy Winchester Hampshire SO23 7QS 01962 882060 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) Hampshire County Council Mrs Hazel F Hiskett Care Home 40 Category(ies) of Dementia - over 65 years of age (40), Old age, registration, with number not falling within any other category (40) of places Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st October 2006 Brief Description of the Service: Cornerways is a registered care home providing personal support and accommodation for up to forty older people. Hampshire County Council owns the home and the manager is Mrs Hazel Hiskett. The home is divided into four units, with ten single bedrooms, a communal lounge, dining room and kitchenette in each unit. Both units on the ground floor accommodate residents who require dementia care. The two remaining units on the first floor accommodate older people. The home is surrounded by landscaped gardens. The home is situated in the quiet village of Kingsworthy, three miles away from Winchester. A small local shop is within walking distance from the home. Current weekly fees are £403 to £446.00 with additional costs being made for hairdressing, newspapers, chiropody and sundries. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection consisted of a tour of the premises, examination of records, documents, and policies and procedures. Survey forms were sent to residents as part of the inspection process; six of these were returned. A member of the district nursing team and a social worker also returned survey forms. The home’s manager also completed a CSCI Annual Quality Assurance Assessment, which was also used as part of the inspection evidence. Several residents were spoken to during the inspection and two were interviewed in private. Discussions took place with the manager and the deputy manager. Two staff were interviewed about their work at the home. What the service does well: The building is clean, light and airy. There are plans to refurbish and redecorate communal and private areas as part of an ongoing maintenance programme. Each resident has his or her own bedroom. Residents are able to contribute to the choices for redecoration and refurbishment, including their own rooms. Each resident has a care plan and other records detailing how personal and healthcare needs are to be met. Comments from the residents included reference to the kindness of the staff and their willingness to help, such as: • “I think the care staff here are brilliant.” • “I’m very happy here. I have everything I want.” • “Top marks for Cornerways.” Generally, feedback from residents showed a satisfaction with the service provided with the exception of the quality of the food and the activities. Staff have access to a training programme, which staff described as very good. The home has a quality assurance system, which includes ‘satisfaction survey forms’ for residents, staff and visitors to complete. Each staff member has completed an equality and Diversity questionnaire. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: There was considerable feedback from residents regarding the quality of the food, which they felt has deteriorated. The home’s management are aware of this and are trying to improve the situation. The provision of activities should be developed. One resident stated that he/she would like more activities and another person stated that their disability prevented him/her from joining in, indicating that closer attention is needed so that all residents have access to the activities programme. The home has access to a mini bus in the evenings and at weekends, but outings have not been provided for over 2 years. Residents moving and handling needs are not always recorded in care plans. Resident’s records did not always include a photograph of the service user. Recruitment procedures were not of a satisfactory standard for one person. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 7 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. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents only move into the home after their needs have been assessed so that the home knows that it can meet the person’s needs. EVIDENCE: The home has a Statement of Purpose displayed on a board in each of the 4 units and a copy of the document is held with each person’s records. The document gives details about the service provided including details of the facilities, staff and management. A resident stated that he/she has not had a copy of the document. This person also said that he/she did no know that CSCI inspection reports are available for residents to read. A copy of the latest Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 10 inspection report is available in the front doorway. This is an area that the home’s management should review to ensure that each resident has received a copy of the Statement of Purpose and a copy of the latest inspection report where they wish to have one. Residents’ records show that the home obtains information from referring social services departments and other agencies, such as hospitals, so that an assessment of the person’s needs can be carried out to determine if the person is suitable for the home. Records also show that the home obtains information from multi agency planning meetings for those with dementia. Residents’ records also show that each person has a terms and conditions of residence and that the resident has signed the document to acknowledge theiragreement. Two residents stated that they had not been given a contract, indicating that this may need to be reviewed especially for those that have lived at the home for some time. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are of a good standard, showing how health and personal care needs are to be met, with the exception of some improvements regarding those recently admitted. Residents are treated with dignity and respect. EVIDENCE: Care records were examined for 4 residents: 2 who have been recently admitted and two longer stay residents. These showed that each person’s needs have been assessed and that care plans are devised to meet those needs. Care plans have been signed by residents to acknowledge their Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 12 agreement to the contents. It was clear that the assessments and care plans for those recently admitted were incomplete. The home has had sufficient time to complete them as one of the residents was admitted to the home some 2 months prior to the inspection visit. In particular, there was no moving and handling plan or photograph for either of the residents and one set of records had not been signed or dated by the staff member completing it. Care plans included details of residents’ needs and preferences for daily living. Details of the symptoms and guidance for staff to follow regarding mental health needs such dementia are recorded. One resident’s records included a copy of a life history by their son/daughter. Each resident has a nighttime care plan. Written risk assessments are completed where appropriate. Residents’ commented that their care and health needs are met. One resident stated that the home contacts medical teams when necessary. Records and care plans show how personal and health care needs are provided and include attention to details such as a monitoring form for weight, height, nail care, oral care, eyesight and foot care. Feedback from a member of the district nursing team confirmed that health and personal care needs are usually met, but that a high turnover of staff has been a barrier to continuity of care and that there has been concerns regarding the flow of information to carers from senior supervisors/mangers on a day-to-day basis. This is an area that the home’s management should explore with a view to improvement. A social worker and a member of the district nursing team reported that the home is good at liaising for advice regarding appropriate care. Procedures for the handling and administration of medication were examined and showed that medication is stored and administered according to pharmaceutical guidelines. The administration of the midday medication was observed. Staff complete a signature each time medication is administered. Controlled medication procedures also meet guidelines of the Royal Pharmaceutical Society. Staff receive training in the handling and administration of medication; records of this training are available in the home. Residents described how they are treated with dignity and kindness. One resident stated that there is always attention to detail in the provision of personal care. Residents are able to have their own telephone line, which was observed in several bedrooms. Each bedroom has a lock, which residents can use for privacy and security. Staff were observed to treat residents with respect and patience. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Whilst the home provides activities for the residents, this needs to be improved so that there are opportunities for residents to access the community. EVIDENCE: Each unit has an activities folder, which gives details of the programme of planned activities for the residents with an entry to show which resident attended which activity. These include cooking, gentle exercise, sing-a-long and reminiscence. It was noted that the frequency of activities could be developed further. One resident also stated that the provision of activities could be improved, and another person stated that he/she couldn’t access the activities due to a disability. Another resident stated that the activities have improved with pottery, painting, arts and crafts and exercises now available. Entertainment is also provided for the residents in the home. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 14 Residents’ religious and cultural needs are recorded as well as relationship details and social contacts. A volunteer coordinates a shop trolley for residents to purchase items. Details of forthcoming events are displayed on notice boards in the home, including residents’ meetings. Residents confirmed that meetings take place and this was also evidenced by the minutes of the meetings. Residents were observed using the lounge facilities to watch television or to read newspapers and books. A resident commented on the benefits of being able to use the mobile library, which regularly visits the home. Opportunities for accessing community facilities were discussed with the manager. Previously, the residents were able to make use of the adjoining day centre facilities, but this has now ceased. The home has access to the day centre mini bus but has not arranged any outings for any residents for over 2 years. Some of the residents are taken out by their families. It was acknowledged that taking out those residents who have dementia can mean special arrangements have to be made, but that such a lack of access to outings for such a long period, indicates it as an area in need of attention as a matter of priority. A staff member also commented that there are not enough outings for the residents. A number of residents made assertive remarks about the quality of the meals, stating that this has become a problem. In particular, vegetables were said to be ‘under cooked.’ The home’s management are aware of this and state that it relates to staff recruitment difficulties and the arrangements for organising the food provision. The inspector observed the midday meal, which looked appetising. Residents made positive comments about this meal. There was a choice of fish and chips, or boiled fish in a sauce with chips or mashed potato, or cheese and onion quiche. Vegetables of fresh carrots and cabbage were served in dishes for residents to help themselves to. One resident praised the method of serving the vegetables in this way. Dessert was strawberry cheesecake, or fruit salad, or ice cream. Residents also stated that there is always a choice of food. A requirement has not been made for the home to improve the meals as this is already being addressed by the home’s management. Each resident has a nutrition assessment demonstrating that any needs regarding special foods are addressed. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views are listened to and the home takes steps to protect residents. EVIDENCE: The home’s complaints procedure is displayed in each of the 4 units and residents confirmed that they know what to do if they wish to make a complaint. Residents are able to air their views at the residents meetings. Feedback from residents confirmed the view that each person’s views are listened to and acted upon. Staff receive training in adult protection. This was confirmed from staff records and from discussions with staff and management. Feedback from a district nurse commented that the home is good at “keeping frail elderly people safe.” Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 24 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean, well-maintained and comfortable home. EVIDENCE: Each of the 4 units has a dining room and lounge area with an attached kitchenette. These are comfortable and homely. Residents were involved in choosing the colour schemes for communal areas, and their bedrooms. There are plans to refurbish the kitchenette areas, which are showing signs of wear and tear. New furniture has been ordered for the lounges. The home also has Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 17 an activities room and a visitors’ lounge. There are several offices and staff rooms. Each resident has his or her own bedroom. Several of these were seen and contain numerous items of personal possessions, such as televisions and audio equipment. A number of residents have had their own telephone line installed. It was noted that one resident did not have a television aerial point in his room with the consequence that TV reception was poor. This should be looked into. The home is clean and tidy with no unpleasant odours. Residents commented that staff keep the home clean. Staff receive infection control training and the home has a sluice room for dealing with clinical waste. The home is surrounded by landscaped gardens with flowers, shrubs and courtyard seating areas. Access can be gained to the garden via ramped paths. The home has plans to create a sensory garden. Each of the 4 units has a bathroom with a variety of bathing facilities including specialist baths. Flooring in one bathroom is stained and is due to be replaced. It was noted that there is a small area of exposed piping in one bathroom which the manager will be referring to the county council estates department. Mixer valves have been installed to regulate hot water to prevent possible hot water scalding. Covers have been installed on radiators and pipes to prevent possible burns to residents. It was observed that each of the 4 bathrooms is locked so that residents can’t access the areas for safety reasons. It was unclear of this is included in a written risk assessment and this should be checked, and completed if not. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels have improved and the staff are trained to a good standard. Recruitment procedures do not always protect residents. EVIDENCE: Due to concerns at the previous key inspection the staffing levels in the home were assessed in detail at this inspection. The home reviews each resident’s needs on a weekly basis to give a staffing level that will allow the residents’ needs to be met. On the week of the inspection, for instance, this resulted in an assessment that 5.5 care staff are needed. The rota showed that his was being achieved with levels never falling below 5 staff and often 6. The home’s management also use the CSCI Residential Forum Guidance for determining staffing levels in homes. This is no longer used by CSCI. The home calculated that 796.2 hours are needed using this calculation and examination of the staff rota for the week commencing 17/06/07 showed that this was Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 19 being achieved. In addition to the care and management hours the home deploys the following: • 3 domestic staff totalling 117 hours per week • 40 laundry hours per week • 63 cook hours and 51 kitchen assistant hours per week. Comment was made from several sources that there is a high turnover of staff and the management stated that it has been difficult to recruit to staff. The rota for the week commencing 17/06/07 included 122 agency care staff hours. The home’s management are aware of this and are trying to address the issue. Records conformed that staff have access to training on a regular basis. One staff member stated, “the training is brilliant.” Training records for 2 staff were looked at and included attendance at the following courses: • Moving and handling • Infection control • Food hygiene • Medication • 4 day dementia foundation • Exercise for residents • Adult protection Over 50 of the staff are trained in NVQ level 2 in care, or above. Records also showed that regular formal supervision sessions take place for carers by a member of the management team and this was also confirmed by two of the staff team. Newly appointed staff have an induction programme. This was evidenced from records and discussions with the staff and management. Recruitment procedures were examined for 3 staff. These showed that appropriate checks had taken place with the exception of one person where there was no employment history and only one reference had been obtained. The inspector was informed that the second reference was verbal, but there was no record of this on the person’s file. Confirmation was received from the manager that the staff member provided an employment history immediately following the inspection, and that the organisation were pursuing the second reference. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and is run in the best interests of the residents. EVIDENCE: The home’s manager is qualified at NVQ 4 and has the Registered Manager’s Award. She also attends other training courses. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 21 The home uses a county council quality assurance tool entitled, Quality Management System for Nursing and Residential Homes. This involves satisfaction survey forms being given to staff, residents, visitors and others linked with the home. An annual service plan is then completed. Procedures for the handling and safekeeping of residents’ valuables were examined and found to be satisfactory. Records are maintained of any amounts deposited with the home for safekeeping, any amounts withdrawn, including a running balance. On most occasions two staff record a signature to acknowledge the transaction. The Commission Annual Quality Assurance Assessment confirmed that the home’s appliances and fire alarm system are tested and serviced on a regular basis. At the time of the inspection the inspector witnessed the home’s emergency generator working immediately following a power cut. Staff receive training in first aid, moving and handling, infection control and food hygiene. Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP7 OP7 Regulation 17 Schedule 3 13 Requirement Resident’s records must include a photograph of the person. Each resident must have an assessment of their moving and handling needs and a care plan for staff to follow. The provision of community activities and access to the community must be reviewed for each resident and arrangements made to provide this activity where appropriate. The home must ensure that they obtain an employment history and two written references before a member of staff commences work in the home. Timescale for action 30/08/07 22/09/07 3 OP13 16 22/09/07 4 OP29 19 Schedule 2 01/08/08 Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cornerways DS0000040361.V338791.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!