Inspection on 30/08/07 for Cottingham Road

This inspection was carried out on 30th August 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cottingham Road 22/08/06

Cottingham Road 23/05/05

Cottingham Road 31/01/05

Cottingham Road 14/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Cottingham Road 399 Cottingham Road Corby Northants NN18 0TW Lead Inspector Helen Abel Unannounced Inspection 30th August 2007 09:50 Cottingham Road DS0000012753.V349567.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 Cottingham Road DS0000012753.V349567.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. Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cottingham Road Address 399 Cottingham Road Corby Northants NN18 0TW 01536 401888 01536 406388 AnneG@mencap.org.uk 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) Royal Mencap Society Mrs Elizabeth Anne Grout Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Cottingham Road Care Home is registered to provide personal care to male and female service users who fall within the following categories: Learning disability (LD) 4 Physical disability (PD) 4 The maximum number of persons to be accommodated at Cottingham Road care Home is 4. 22nd August 2006 2. Date of last inspection Brief Description of the Service: Cottingham Road is a care home providing personal care and accommodation for four younger adults with learning and physical disabilities. The Premises are owned by the health authority and are managed by New Era a housing association. Each resident has a tenancy agreement with New Era. The national charity Royal Mencap Society provides the care service. Cottingham Road is a bungalow, which is located on the outskirts of the town of Corby. There is a large mature garden area to the side and rear of the building, which is accessible to residents’. All of the bedrooms are single, there are no en-suite facilities however there are washbasins in each bedroom. The communal areas, have limited space, and there is insufficient space in the lounge for all of the service users to sit together, given that additional equipment, such as wheelchairs and adapted seating is required. There is one communal bathroom Information about current fees was provided in the pre-inspection questionnaire received on 10 July 2006. The fee per resident per week is currently £352.39. In addition to the fees, local authorities provide a grant to Mencap for provision of the services in the county. Residents pay an additional £62.35 per week from their benefits. The fees include personal care, staff support, accommodation, meals, laundry and a contribution towards a holiday. A list of additional costs and who is responsible for payment is available from Cottingham Road. Items to be paid by the resident include activities, meals and drinks while out, hairdressing and travel for pleasure. Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Since the last key inspection on the 22nd August 2006 a Random visit took place on the 7th November 2006 to monitor progress of requirements and recommendations. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered The service history was reviewed, which details all contact with the home including notifications of events reported by the home, any complaints and telephone calls. An annual quality assurance assessment completed by the Registered Manager was also examined. No completed questionnaires from relatives or health professionals had been received at the time of the inspection. The unannounced visit covered the morning on a weekday. The inspection was carried out by ‘case tracking’ which involves selecting a sample of people and tracking their care and experiences through review of their records, observation of interactions with care staff and care practices. The Inspector was unable to communicate with the residents. It has been necessary to form judgements about their experiences based on all other evidence including observations. Discussions took place with support staff and a manager from another Mencap service with feedback given. The use of the term ‘residents’ has been used in the body of this report, rather than ‘service users’ as this is how they are referred to in the home. What the service does well: The admission process provides assurances that the needs of residents entering the home are met. The statement of purpose includes large easy read text, symbols and colour photographs and is an excellent document that it sets out the services and care, which the home provides to residents. Residents are involved in day to day decisions, are well supported to take reasonable risks and good support plans accurately reflect their needs. Support plans were well written detailed and included photographs and were presented in clear text. Residents receive appropriate personal support and their health needs are well met. Good systems are in place to protect residents with a complaints Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 6 procedure with pictures in contained in the statement of purpose for residents and their families. Good health and safety practices ensure resident’s welfare in those areas is promoted. Good systems are in place to ensure resident’s views inform the way the service is delivered. What has improved since the last inspection? What they could do better: Sufficient staff must be provided to meet residents assessed needs at all times. In particular to enable them to take part in regular leisure activities. This requirement has been outstanding since 2005 with no consistent staffing arrangement being put in place. On the day of inspection senior managers at Mencap confirmed staffing arrangements would be improved immediately. The adequacy of the premises in relation to meeting residents’ needs and lifestyles should be kept under regular review in conjunction with placing authorities. Plans for building are in progress to make the home bigger with another bathroom and larger living accommodation. Cottingham Road DS0000012753.V349567.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. Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 8 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 Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 9 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): 1,2,3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process provides assurances that the needs of residents entering the home are met. EVIDENCE: There are currently no vacancies at Cottingham Road and there have been no new admissions for the last seven years. Staff confirmed that Mencap have an assessment format which would be used to determine prospective residents’ needs and if they could be met within the home. The assessment process includes several opportunities for prospective residents to visit the home prior to moving in. Since the last inspection the statement of purpose has been updated and now contains all of the information required by the Care Homes Regulations 2001. The statement of purpose includes large easy read text, symbols and colour photographs and is an excellent document that it sets out the services and care, which the home provides to residents. Cottingham Road DS0000012753.V349567.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): 6,7,8,9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents are involved in day to day decisions, are well supported to take reasonable risks and good support plans accurately reflect their needs. EVIDENCE: All support plans were up to date and had been reviewed. Support plans were well written detailed and included photographs and were presented in clear text. Comprehensive risk assessments form part of each plan and address risks to the resident themselves as well as those around them. Staff are fully aware of and actively contribute to support plans and routinely refer to them to gain information as to how to support and respond to individual residents needs. Detailed daily notes are kept and are referred to at staff handovers. Residents are supported to make decisions about their own lives such as the kind of food to eat and what social activities to pursue. Residents manage their own finances with staff support. This involves records of balances being kept Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 11 and the manager regularly audits these records. The records and balances for two residents were checked and found to be accurate. Cottingham Road DS0000012753.V349567.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): 12,13,14, 15,16,17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. While staff work hard to identify activities that provide residents with a fulfilling life, opportunities are limited by staff shortages. Residents enjoy a healthy and varied diet. EVIDENCE: Residents have all expressed various activities pursuits on a activity lists in their support plans. Whilst some of these activities are met whilst attending day centre services during the week, many other activities have not been provided. Discussion with staff identified and upon checking staffing rota’s confirmed there have been inconsistent staffing arrangements during busier times of the day and this has disadvantaged staff to assist residents’ in accessing community activities/facilities. For example each resident is allocated some Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 13 one to one time from a member of staff each week and the time is used to go shopping, out for lunch or for a walk. Records showed that one resident case tracked went to the Woburn Zoo in July, had 3 trips out in May and one in March. The other three residents had received no other opportunities for chosen activities/ trips. The other resident case tracked had indicated a wish to go swimming in the support plan and a risk assessment had been produced but had not been able to go. The Commission raised this aspect for Social Care Inspection on inspection visits in June 2005, November 2005, August 2006 and November 2006. On these occasions the Provider gave assurances additional staffing requirements would be provided. In the past residents have the opportunity to go away on holiday with staff support and have been to different locations. Staff advised that the destination is arrived at through discussion about individual needs and was confirmed when reading recent residents meeting minutes. All residents are due to have holiday this year and is likely they will stay at the Mencap holiday bungalow while some re-decoration and refurbishment work takes place at Cottingham Road. Discussions with staff confirmed that every effort is made to support residents in maintaining family relationships. Residents support plans reflect this and residents case tracked enjoy regular contact with their families. Nutritional screening assessment is completed for all residents and concerns with regards to eating and weight are monitored. Two residents case tracked enjoy a healthy diet and their health and dietary needs are planned for. One resident has full fat milk and eats very well, the other resident enjoys a low fat diet including skimmed milk. Cottingham Road DS0000012753.V349567.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 receive appropriate personal support and their health needs are well met. EVIDENCE: Residents personal support needs are clearly documented in their support plans and staff are aware of the kind of support each individual requires. One resident prefer to wait in her room prior to going to day centre, as this was more calming and less noisy for her. Good arrangements are in place for accessing additional support from physiotherapists and other professionals to meet the additional physical health needs that some residents have. All residents have access to primary care services such as GP, dentists and opticians and are supported to attend appointments. Systems for storing, recording and administering medication are good with pictures of resident’s photographs for added clarity. Clear guidance is available Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 15 to staff around the side effects of medication and are aware of whom to report any concern. Staff receive medication training and clear guidelines are in place for the administration of medication. Two errors were noted around the recording of medicines administered. However senior staff were quick to follow their policies and procedures and follow through these incidences immediately. It is recommended a review of staff medication training take place to ensure all staff have current knowledge and ensure residents are protected. Cottingham Road DS0000012753.V349567.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 is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to protect residents. EVIDENCE: Two staff confirmed receiving mandatory adult protection training. Adult protection is frequently discussed in supervisions and at staff meetings. The Commission for Social Care Inspection have received no complaints about the service since the last inspection and staff confirmed that no complaints have been received by the home. A complaints procedure with pictures is contained in the statement of purpose for residents and their families. The Registered Manager is looking to present the complaints procedure in a more accessible format along side Mencaps Family Charter The Inspector was unable to communicate with the four residents due to their level of disability and limited communication. However the inspector observed that residents’ responded well to staff. Residents were observed preparing to leave for day centre activities. Staff were observed attending to individual residents dress and grooming and interacted in a warm and friendly manner. Cottingham Road DS0000012753.V349567.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, 25, 26, 27, 28,30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The premises do not fully meet the needs of the current residents, but are clean and homely, but is clean and homely. EVIDENCE: The lack of adequate space to meet the needs of residents has been the subject of various requirements and recommendations since the establishment of the National Care Standards Commission the predecessor to The Commission for Social Care Inspection in April 2002. Previous requirements have also been made regarding the number of bathing facilities; the bathroom is required for all four residents and is also used by staff that carry out a sleep in shift. A new bathroom has been installed since the last inspection and plans have been identified for a second bathroom to be built. Mencap have confirmed in an action plan that they are satisfied that the premises meet the needs of people living there and that this is validated by needs led assessments carried out by care managers working for the placing authority. Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 18 Due to observations and discussions with staff about the practicalities of caring for residents’ on a day to day basis the inspector would advise that the adequacy of the premises in meeting residents’ needs without limiting their quality of life should be kept under careful review. For example the communal areas, have limited space, and there continues to be insufficient space in the lounge for all of the residents to sit together, given that additional equipment, such as wheelchairs and adapted seating is required. The difficulties with dining space are being addressed and an extension is to be built onto the existing lounge and dining areas. Residents are kept informed of building extension developments in residents meetings. All of the bedrooms are single, there are no en-suite facilities however there are washbasins in each bedroom. The inspector observed items blocking access to a residents wash hand basin and suggested these be properly resited. The hallway carpet looked dirty, staff confirmed this would be steam cleaned. A prominent lounge PVC window was cloudy and prevented clear vision and looked unsightly. Staff agreed and confirmed this would be repaired. The gas fire in the lounge had loose shiny stones as part of the feature. The inspector suggested this item should be risk assessed as this may present a hazard to residents. Good standards of hygiene are maintained with all areas being clean and tidy with no unpleasant odours. The back garden area was spacious and attractive. with flower baskets hung outside the home. Cottingham Road DS0000012753.V349567.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): 32,33,35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Arrangements for the training of staff are met, however staffing levels continue to be insufficient at times to meet residents’ needs. EVIDENCE: Senior staff confirmed Cottingham Road have over has over 50 of the staff team have achieved a National Vocational Qualification. This qualification provides staff with a basic understanding of care practices. A new member of staff confirmed that a training programme is in place and that this included induction training. She confirmed receiving good supervision and guidance from line managers. Ongoing concerns have been raised during inspections about the adequacy of the staffing levels in meeting residents’ needs at particular times of the day. An action plan submitted by Mencap following the inspection carried out in August 2006 stated that additional staff needs had been identified for key times. A sample check of the rota and discussions with staff identified that these staffing levels have rarely been achieved. Insufficient staff to meet Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 20 resident’s needs and action must be taken to address this shortfall. On the day of inspection senior Mencap managers confirmed that additional staff will be made available as soon as possible. Due to the absence of the Registered Manager staff recruitment files were not accessible and will be inspected at the next inspection. Cottingham Road DS0000012753.V349567.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. Good health and safety practices ensure residents welfare in those areas are promoted. Good systems are in place to ensure resident’s views inform the way the service is delivered. EVIDENCE: The homes annual quality assurance assessment confirmed that regular maintenance checks and servicing is carried out on equipment such as fire equipment, electrical appliances and the central heating boiler. Discussion with staff confirmed that relevant health and safety training is being provided such as first aid, fire safety, food hygiene and manual handling. A Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 22 new member of staff welcomed the wide range of training, induction and support she had received in a short period upon taking up post. The homes annual quality assurance assessment confirms -the Registered Manager has built good working relationships with residents, staff and relatives. Has reviewed all policies and procedures within the service and made changes to improve the service to residents. Over the next 12 months would like to develop more policies and procedures in accessible formats. Residents meetings have been introduced to enable residents to have more choice and involvement. Two surveys have been distributed and completed by residents and their families and the results analysed and changes made as part of the homes continuous improvement plan. Cottingham Road DS0000012753.V349567.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 3 2 3 3 3 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 2 25 3 26 3 27 2 28 2 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 2 14 2 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA33 Regulation 18 (1) (a) Requirement Sufficient staff must be provided to meet Residents assessed needs at all times. (Previous requirement with timescales of 30/06/05, 15/11/05 and 13/10/06 07/11/06 have not been met) Timescale for action 30/08/07 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 YA14 YA20 Good Practice Recommendations Residents should receive any necessary staff support to enable them to take part in regular leisure activities. It is recommended a review of staff medication training takes place to ensure all staff have current knowledge of medication management to safe guard residents when dealing with medicines. The adequacy of the premises in relation to meeting residents’ needs and lifestyles should be kept under regular review in conjunction with placing authorities. 3. YA24 Cottingham Road DS0000012753.V349567.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Cottingham Road DS0000012753.V349567.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!