Inspection on 11/09/07 for Cowley Cottage

This inspection was carried out on 11th September 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cowley Cottage 19/05/06

Cowley Cottage 15/11/05

Cowley Cottage 05/07/05

Cowley Cottage 15/10/04

Cowley Cottage 11/07/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Cowley Cottage Ray Park Road Maidenhead Berkshire SL6 8PZ Lead Inspector Jo Griffiths Unannounced Inspection 11 September 2007 09:30 th DS0000011287.V345437.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 DS0000011287.V345437.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. DS0000011287.V345437.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cowley Cottage Address Ray Park Road Maidenhead Berkshire SL6 8PZ 01628 776542 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) www.caremanagementgroup.com Care Management Group Ltd Ms Geraldine Dummer Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (9) of places DS0000011287.V345437.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2006 Brief Description of the Service: Cowley cottage is situated in a residential area of an attractive town on the River Thames. There are shops in the town though it is a distance to walk. The home has its own transport. The service at Cowley cottage is provided within two buildings, the main cottage and the lodge. The main cottage provides accommodation for seven residents and the lodge provides accommodation for two people. Everyone has single rooms. The cottage supports people with moderate to mild learning disabilities and the current tenants are a group of older men. The lodge is designed to support two people to live independently, with some staff support. The garden is shared with another care home, owned by the same company, on the same site. The people in Cowley cottage have regular opportunities to mix with people in the other home. The fees for this service currently range from £514.20 - £1292.11. The fees are agreed following an assessment of the persons needs and may or may not include day care activities. There is currently one vacancy in the lodge and one in the cottage. DS0000011287.V345437.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of Cowley cottage. The Manager was at the home and helped with the inspection. Two people were at home and other residents came home later in the day. Everyone was asked their views of the care home. The inspector had a look around the home and spent some time looking at records and documents that show the care and support that people are given. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000011287.V345437.R01.S.doc Version 5.2 Page 6 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 DS0000011287.V345437.R01.S.doc Version 5.2 Page 7 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): Standards 1, 2, 3 and 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are provided with the information they need to make a decision about the home. They have an assessment of their needs before they move in and are assured these needs can be met before they are offered a place in the home. People’s needs are being well met and they are happy with the service. Everyone has a contract but these do not contain information about the fees charged for the service. EVIDENCE: The Statement of Purpose and Service User Guide give people the information they need about the home. Both documents are in the process of being updated to reflect recent changes to the facilities and décor of the home. Each person has a contract for their accommodation and care. The contracts need to state the fees that are charged for the service and need to be signed by each person or their representative. Each person has had an assessment of their needs and this is kept under review. The assessment links clearly to the care plan to ensure the assessed needs can be met. The needs of everyone currently living in the home are DS0000011287.V345437.R01.S.doc Version 5.2 Page 8 being met and all spoken with said they are happy with the support they receive. One person said “ I am so pleased I moved here, I am getting the help I need to become more independent.” The home is able to meet the diverse needs of the people in the home including their mobility, social, cultural and emotional needs. Staff spoken with demonstrated a good understanding of equality and diversity issues. There is now a policy for admitting new people to the home in an emergency. This is to ensure that their needs can be identified and they can be properly supported if they need to enter the home quickly and without trial visits. DS0000011287.V345437.R01.S.doc Version 5.2 Page 9 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): Standards 6, 7, 8 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Each person has a care plan that ensures their needs are met. People are supported to make their own decisions and to have a say in the running of the home. They would benefit further from Person centred planning being introduced to the home to help them make wider decisions about their lives. People are supported to take reasonable risks as part of an independent lifestyle and all assessed risks are minimised. EVIDENCE: Each person has a care plan. This addresses how their assessed needs will be met. The care plans are reviewed monthly by the keyworker and any changes noted. The Manager is planning to introduce Person centred planning to help people in the home make decisions about their wider futures and things they may be important in their lives. Through observing the staff on duty and reviewing records it was clear that staff provide a service that is person DS0000011287.V345437.R01.S.doc Version 5.2 Page 10 focussed. However, it would be beneficial if staff were to attend training in Person centred planning to help them to support people with making decisions about their lives. The training would provide staff with some of the skills and tools needed to do this. The Manager has recently become aware of the new Mental Capacity Act and intends to research this to share information with staff. People have the right to see their care plan and during the inspection one person was supported to do so. The care plans contain lots of information and records. The plans could be further improved by making them easier for people in the home to understand. Again training for staff in Person centred planning may assist. There are regular meetings for the people living in the home. These are an opportunity to make suggestions about how the service is run, raise concerns and plan activities. People spoken with said they go to the meetings and that they find them useful. Better records could be kept of the meetings so that people can see how the issues have been responded to. Everyone gets involved in the running of the home. There is a rota for people to help prepare meals and staff support is given where needed. People are supported to clean their own bedrooms and to help with their laundry. Everyone has a say in how the home is decorated. Risk assessments are in place for environmental and personal risks to people. People are supported to manage their own money and risks have been minimised to ensure their financial interests are protected. The keyworker reviews all risk assessments each month to ensure they are still relevant. Where changes have occurred these have been recorded on the review sheet but the actual risk assessment has not always been updated. This should be done to ensure staff have the latest information they need about minimising risks. DS0000011287.V345437.R01.S.doc Version 5.2 Page 11 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): Standards 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People lead busy and interesting lives that reflect their interests. They are supported to be valued members of the community and to build and maintain relationships. People are aware of their rights and responsibilities within the home. They are supported to plan and prepare their meals and enjoy a balanced and varied diet. EVIDENCE: Most people in the home use a local day service that arranges activities for them based on their interests and needs. Reviews show that people enjoy these activities. The type of activities provided include art, computers, drama, reminiscence, line dancing, leisure centre and gym, music, gardening and current affairs. For those people that do not use a day service activities are DS0000011287.V345437.R01.S.doc Version 5.2 Page 12 arranged with the staff in the home and records show that everyone in the home has something to do every day. In the evenings and at weekends outings are arranged, meals out and pub trips take place and there are opportunities for in house activities such as movie nights and bingo. One person has their own computer in their room and most people have TV/DVD player. Most people attend social groups run in the local area. One person has been refused access to a local group and the Manager is working to resolve the issues. The Manager is aware of the person’s rights to access services under the Disability Discrimination Act. Everyone spoken to was looking forward to their planned holiday. The Manager said that they had been offered a number of options and decided as a group where they wanted to go. People said they were getting ready and packing their things and one person showed the inspector the photographs of the hotel they will be visiting. People can receive visitors when they wish and are supported to see friends outside the home. The Manager and staff have a good understanding of people’s rights to form personal relationships. The Manager is currently working with one person to ensure they have opportunities to meet people and to ensure they are supported to have appropriate personal relationships that meet their needs. People are aware of their rights and responsibilities within the home. Issues relating to abuse of rights are discussed regularly with people in the residents meetings to ensure they understand their rights. Staff and people in the home were seen to respect the personal space of others and everyone has a key to their own bedroom. One person has some restrictions in place through a risk assessment to ensure their safety whilst out alone in the community. The Manager and care Manager are meeting with the person to review this next week to ensure their right to access the community independently is not restricted more than absolutely necessary. The people living at Cowley cottage plan their menu each week. Staff offer support and guidance in relation healthy eating. There are alternatives available if a person does not want what is on the menu for that day. Mealtimes are relaxed and times of meals are flexible to suits people’s activities. A record is kept of the meals that are eaten to help staff monitor that people are eating well. People spoken with said they enjoyed the meals and could always get snacks and drinks when they want to. People were seen to be offered drinks throughout the day and those that can make them independently did so when they wanted. DS0000011287.V345437.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have their health and personal care needs met. They are supported to manage their medication safely. EVIDENCE: Each persons care plan outlines the support they need with any personal care. The home is equipped with bathrooms and shower rooms that meet a variety of needs. There is some equipment available for people with limited mobility. People are supported to manage their own personal care as far as they can. Staff said that people can choose to go to bed when they wish to and people living in the home confirmed this when spoken to. Health action plans have been completed with each person and accurate records are kept of any appointments with health care professionals. Issues around health eating and keeping safe and well are discussed with people in the residents meetings. DS0000011287.V345437.R01.S.doc Version 5.2 Page 14 Medication is stored securely and administered by staff that are assessed as competent to do so. Risk assessments have been completed regarding individual’s medications to ensure they are managed effectively. There is no one in the home who has currently chosen to manage their own medicines but there is policy in place to support this if someone wished to. The medication storage and records were checked. A protocol for when a PRN (as needed) medication should be given needed to be written. The Manager completed this before the end of the inspection. DS0000011287.V345437.R01.S.doc Version 5.2 Page 15 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): Standards 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People know how to make a complaint if they need to and know their concerns will be taken seriously. People are safeguarded from abuse but would benefit from staff undertaking up date training. EVIDENCE: There is a complaints procedure for the home that tells people how to raise any concerns they may have. An easy to read picture format of the procedure is on the wall in places around the home. The residents meeting minutes show that people are asked if they have any complaints or concerns at each meeting. The complaints log showed where people in the home had been supported last year to make a complaint in relation to another person in the home. An independent person supported the people to make the complaint and the issues were dealt with quickly and to everyone’s satisfaction. The complaints log book provides a clear auditable trail of action taken in response to complaints. There have been no recent complaints received by the home and no complaints received by CSCI. Most staff have attended training in safeguarding adults, although some staff require updates. The new member of staff who is on their induction must have training booked in this area. Policies for safeguarding adults and whistle blowing have been discussed with staff in team meetings. The Manager intends DS0000011287.V345437.R01.S.doc Version 5.2 Page 16 to introduce a system for staff to sign when they have read and understood a policy. Staff spoken with during the inspection demonstrated clear understanding of the policies and their responsibilities to report concerns and allegations. The Manager hopes to use the residents meetings to discuss issues of abuse and how people should report concerns. There has been one referral made under the local safeguarding adults procedures. This was reported appropriately and has been fully investigated. The allegation was unfounded. The records relating to this incident are kept in the person’s care plan file. It is recommended that a summary of the allegation and the action taken be logged in the complaints book. DS0000011287.V345437.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): Standards 24, 25, 26, 28, 29 and 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is clean and comfortable and provides a safe environment that meets the needs of the people that live there. EVIDENCE: The home is clean, well maintained and comfortable for the people that live there. Some areas have been recently redecorated. There is a large lounge in both the cottage and the lodge and sufficient dining space for the people that live there. Both the cottage and lodge have single bedrooms and adequate bath and shower facilities to meet people’s needs. Some equipment to help people with mobility difficulties has been provided in the cottage. The lodge is not suitable for people that use wheelchairs as the bedrooms are on the first floor. The cottage provides accommodation on both the ground and first floors. DS0000011287.V345437.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, and 35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People are protected by the homes procedures for recruiting new staff. They are supported by trained and qualified staff but would benefit from staff undertaking further training and updates. EVIDENCE: The recruitment files for two members of staff were inspected. These contained evidence that all the necessary checks had been made to ensure that the people in the home are protected. New staff undertake an induction to the home which includes familiarising themselves with the policies and procedures for the running of the service. New staff do not yet undertake the ‘skills for care’ induction which is the induction required by the National Training Organisation for social care. The Manager has all the information and documents for this and plans to implement this within the next month. DS0000011287.V345437.R01.S.doc Version 5.2 Page 19 Most staff have completed the key training courses they need to do in order to support people safely and effectively. Some staff require updates and the new staff need to be booked for the courses. The Manager has had some difficulties in the past in accessing training provided by the company due to the location of courses. This has been resolved by an agreement that some courses can be arranged locally. The Manager needs to produce a training plan to evidence that courses have been scheduled for staff. The training matrix that is used by the Manager to monitor staff training needs has not been kept up to date. Of the three permanent care staff in the team two staff are currently working toward their NVQ award. The new member of staff will be starting this award once the induction is complete. In addition to the permanent team of carers there is one regular ‘bank’ worker used. Training for staff in working with older people has taken place since the last inspection. People in the home would benefit from staff undertaking training in Person centred planning. This would help staff to provide support to people to plan for their futures and make decisions about their lives. DS0000011287.V345437.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39, 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People that live in the home benefit from a competent and experienced Manager that runs the home in an open way. The home is run in the best interests of the people that live there and their health and welfare are safeguarded. EVIDENCE: The Registered Manager has been running the home for 9 years. She is working toward the Registered Manager Award (RMA) and plans to undertake the NVQ4 in Care once the RMA is completed. The Manager was observed interacting with staff and people that live in the home. There is an open atmosphere and people were comfortable in approaching the Manager for support. DS0000011287.V345437.R01.S.doc Version 5.2 Page 21 People that live in the home were asked their views on the Manager. All the comments were positive and comments included “ Geraldine is very supportive” and “ I like Geraldine very much”. Staff said they felt supported by the Manager and that it worked well in the home because everyone has worked together as a team for many years. People that live in the home are asked to complete a questionnaire about the service every year. They also have regular residents meetings where they can share their views. A representative from ‘The Care management Group’ visits every month to carry out a quality audit of the home. Part of the visit includes seeking the views of people in the home. The Manager also described how she takes time each week to talk to each person informally to monitor the service they have been receiving. People in the home are kept safe and any risks to their well being are assessed and minimised. Regular health and safety checks are made and any required repairs are reported to the maintenance department. Records show that fire alarm tests and drills take place and staff have undertaken training in fire and health and safety. The Manager is advised to refer to the Department of Health document ‘Essential steps to infection control’ to ensure the home is free from infection risks. DS0000011287.V345437.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 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 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 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 x DS0000011287.V345437.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA23 Regulation 13(6) Requirement The registered person must ensure that people in the home are safeguarded from abuse through staff training or other appropriate method. The registered person must ensure that all staff receive the training that they need to support people safely. Timescale for action 31/10/07 2 YA35 18(1)(c) (i) 31/10/07 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 YA5 YA6 Good Practice Recommendations It is recommended that the current fees be added to each persons contract to enable them to sign the contract. It is recommended that it be made easier for people to read their own care plans by producing them in a format that best suits each individual. It is recommended that staff undertake training in Person centred planning to help them support people in making DS0000011287.V345437.R01.S.doc Version 5.2 Page 24 2 YA7 3 YA8 decisions about their lives. It is recommended that minutes be kept of the residents meetings to show what action has been taken in response to the issues raised. It is recommended that the actual risk assessment document be updated with any changes as well as the review sheet to ensure staff have accurate information. It is recommended that any safeguarding adults referrals be logged in the complaints book with the action taken and outcome. It is recommended that the ‘skills for care’ induction be started for new staff. It is also recommended that the training matrix be kept up to date. 4 YA9 5 YA23 6 YA35 7 YA42 It is recommended that the Manager obtain a copy of the ‘Essential steps to infection control’ document to use in the home. DS0000011287.V345437.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 DS0000011287.V345437.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!