Inspection on 11/07/06 for Croft House

This inspection was carried out on 11th July 2006.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Croft House 08/07/08

Croft House 13/09/05

Croft House 10/05/05

Croft House 06/10/04

Croft House 06/04/04

Croft House 02/05/03

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 Croft House Redlands Lane Fareham Hampshire PO14 1EY Lead Inspector Laurie Stride Unannounced Inspection 11th July 2006 09:40 Croft House DS0000033288.V298502.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 Croft House DS0000033288.V298502.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. Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Croft House Address Redlands Lane Fareham Hampshire PO14 1EY 01329 280600 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 To Be Confirmed Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Croft House is a Hampshire County Council Home for adults with learning disabilities aged 18-65. The home is divided into four separate units. There are two main units for five service users and two units for more independent living or more intensive support. These can each accommodate one service user. The home is a short distance from Fareham town centre with nearby access to public transport. The primary reason for care is learning disability but some service users may have additional needs. Emergency admissions may occur, which can lead to the home reducing its respite service at times. The home may also become involved in longer-term care whilst waiting for alternative accommodation to be provided. Care plans are prepared with service users and relatives. The home has a sensory room, computer equipment, and a garden. The current range of fees is £4.81- £108 per night, plus a client contribution depending on the care package. Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit and lasted approximately six hours, during which the inspector met two of the service users and spoke with two members of staff and the deputy manager. A tour of the premises was undertaken and samples of the home’s written records were inspected. 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. Croft House DS0000033288.V298502.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 Croft House DS0000033288.V298502.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective and improved systems are in place to ensure that service users’ aspirations and needs are assessed before they move into the home. EVIDENCE: A sample of two service users’ files was seen in relation to the initial assessment of their needs prior to admission. The home obtains a care management assessment for each individual and also conducts its own detailed assessments. This can include a visit to the service users’ home where the start of a personal profile and care plan is drawn up with assistance from the service user’s relatives/ representatives if appropriate. Service users may also visit the service before using it on a regular basis. This is not always possible as the home does have emergency admissions from time to time. For regular users of the service, the home asks for information about any changes to the person’s needs since the last visit and updates the care plan and risk assessment accordingly. Admission and discharge forms were seen on file and contact sheets were recorded throughout people’s stay in the home. The deputy manager demonstrated how the home has recently improved the assessment process and related service user documents (see next section on Individual Needs and Choices). A standard document is used with ‘bolt on’ Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 8 additional profiles of individuals’ particular needs. Service users now keep their files with them in their rooms during their stay. Croft House DS0000033288.V298502.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear and effective care planning and risk assessment systems in place to promote service users’ independence and provide staff with the information they need to meet service users’ needs. Service users are enabled to make decisions and the staff provide them with support. EVIDENCE: The sample of two service users’ files seen contained comprehensive care plans reflecting service users’ assessed and changing needs and personal goals. A new system of recording these was in place making information easier to access and to read. As mentioned, a new standard document is used with ‘bolt on’ additional profiles of individuals’ particular needs, for example with regard to epilepsy or moving and handling requirements. Information is kept in two main files, a current file for up-to-date information and a second file for older relevant information. Care packages are reviewed every time a service user stays at the home. Evidence was seen that two longer-stay service users’ needs were being kept Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 10 under review, including meetings with other professionals from external agencies. Documents also showed that staff members work with service users who are planning to move on to prepare them for alternative or more independent accommodation, helping to ensure they have the necessary skills. How service users like to make choices is clearly recorded in their care plans, including guidance on money management and any assistance required. Each service user has a key worker from the staff team assigned to them. Discussion with a service user confirmed that staff respect service users’ right to make decisions and give appropriate assistance. Where there were restrictions or limits on particular service users’ rights to make decisions on, or take control over, particular aspects of their lives there was documentary evidence to show how the decision had been made and that other professionals and independent advocates had been involved. Risk assessments were in place for the service users whose care plans were seen. These contained information and guidance to assist staff and enable service users to take risks as part of independent lifestyles. A preliminary risk assessment is recorded and additional information added as necessary. Risk assessments are reviewed and updated as part of the overall care plan. Croft House DS0000033288.V298502.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit through opportunities to take part in appropriate activities, access the community, maintain relationships and participate in the planning of meals. Service users’ rights and responsibilities are recognised in the daily routines of the home. EVIDENCE: Care plans contained information and guidance for staff in relation to service users’ lifestyles, including nutritional needs and preferences. The deputy manager explained how the home is planning activity weekends for young people who use the service. Care plans also contained sections for details of service users’ cultural and religious needs, friends, family and significant relationships. Service users’ interests are recorded in the initial assessments and this is updated each time the person stays in the home. Activities are planned in response to these and service users are also encouraged to engage in new Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 12 activities while they are staying in the home. The deputy manager said that the home had recently designated a member of staff as the activities coordinator and there were plans to create a website containing details of local facilities. The home has an arts, computer and sensory room. A service user confirmed that they enjoyed the activities and using the sensory room. Service users have opportunities to develop skills, both in and outside of the home. For example, attending life skills courses at college or being supported to maintain and develop practical skills for independent living within the home, including preparation for moving on. The home provides service users with transport to and from the day service and college and with opportunities for going out. At the time of the visit a number of service users went out supported by members of staff for a picnic. The home is a short distance from Fareham town centre with nearby access to public transport. Service users also go to clubs and there was evidence of service users being supported to attend religious meetings. Family links and friendships are supported and documented in care plans and a service user talked about how they enjoyed seeing their friends at Croft House. Service user’s relatives and representatives are involved in assessments and reviews as appropriate. Involvement is also encouraged through a service user survey that is sent to service user’s homes. The deputy manager said that the home provided transport for a service user to visit their parents after the day service on regular occasions. The rules of the home are covered within the Terms and Conditions of residence and are not unnecessarily restrictive for people who use the service, being mainly based on maintaining people’s safety, privacy and dignity. Daily routines are based around activities and mealtimes but are flexible enough to accommodate the particular needs and wishes of individual service users. Service users have a key to their room, based on assessment, and to the lockable drawer within it. No service users have a key to the front door and agreements are made with service users who go out for the evening on their own that they will be back at a particular time. The home’s administrator collects the mail and this is passed unopened to service users who are offered appropriate support for dealing with correspondence. Service users were observed moving freely around the communal areas of the home. Individual nutritional needs are highlighted in care plans and catered for appropriately. A menu was seen in the kitchen and this showed a variety of balanced meals was provided with a choice of two main meals. The deputy manager said that menus are planned with service users and that mealtimes are usually about 5pm but could be flexible around service user’s activities. One service user did their own shopping list and shopping. A service user confirmed that they liked the food provided. Croft House DS0000033288.V298502.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 at least once during a 12 month period. 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. Service users receive personal and healthcare support to meet their individual needs and are protected by the home’s medication policies and procedures. EVIDENCE: Care plans contained information and guidance for staff in relation to service users’ abilities to self-care and their preferences with regard to male or female staff support. Each service user has a key worker from the staff team assigned to them and there was evidence that this was done thoughtfully. For example a newly admitted young service user had a key worker of a similar age to provide support with personal shopping and other matters identified in their care plan. The new care plan format focuses more on individual likes and dislikes and how people spend their day. People are able to get up when they choose and dress to suit themselves, although support is given to people with issues around self-image and confidence. A service user confirmed that staff supported them well. Health and medical profiles were included in the sample of care plans seen, along with strategies for dealing with anxieties and maintaining emotional wellbeing. Service users who come to the respite service have their own Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 14 doctors and those who become longer-stay service users are referred to the local health centre. Evidence was seen of the involvement of external health and social care professionals to meet service users changing needs. The home’s medication policy had been recently reviewed and new procedures were due to come into operation in late July. Service users can retain and administer their own medication subject to a risk assessment. The deputy manager said there were plans underway for all service users to be able to keep their medication in their rooms, for which suitable storage facilities were being provided. Members of staff involved in administering medication had received training. Clear records were kept of all medication coming into and leaving the home, along with records of what medication each service user had received during their stay. A sample of two service users’ medication records was inspected and these matched the amount of medication remaining in stock. Croft House DS0000033288.V298502.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 at least once during a 12 month period. 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. The home has systems for ensuring that residents’ views are listened to and responding to any complaints. Residents are protected by the home’s policies and procedures for responding to any form of abuse. EVIDENCE: The home has a complaints procedure that is available to all service users and their families and copies were seen in service users’ files. It was also available on audiotape and the deputy manager said there were plans to provide the procedure in picture format so as to be accessible to a wider range of service users. The procedure explains how service users can complain to key workers and senior staff about things they are not happy with. A service user confirmed that they would speak to a member of staff if they had a concern or complaint. The deputy manager said that the home kept records of all complaints and how they were responded to. The record was not available for inspection at the time of the visit, however the home’s manager later confirmed by telephone that this was in place. The home has procedures in place for responding to issues of suspected abuse, including a whistle blowing policy to protect staff. The deputy manager and another member of staff were both clear about how to report any issues and the limits of their own involvement. Mandatory staff training in responding to issues of suspected abuse is given during the induction and there is follow up training for all staff. All staff members take part in SCIP (Strategies for Crisis Intervention and Prevention) training. The deputy manager confirmed that the home does not use any physical interventions. Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 16 Croft House DS0000033288.V298502.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from staying in a safe, clean and comfortable environment. EVIDENCE: A tour of the premises was undertaken and the home appeared safe and comfortable. Records are kept of regular maintenance checks and a new carpet had been provided in one room. The home is very large and provides a lot of space for the number of service users catered for. Lounge areas were furnished comfortably with good quality furniture and appeared homely. There was sufficient lighting, heating and ventilation throughout the building. Service users’ rooms are of varying shapes and sizes, some having large bay windows providing a lot of light and good views. A service user confirmed that they liked their room and staying at Croft House. All rooms are for single occupancy although arrangements can be made to accommodate couples as necessary. Service users who use wheelchairs are restricted to rooms on the ground floor as there are no facilities to enable them to get to the first floor. Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 18 There are five bathrooms and three separate toilets throughout the building, which was sufficient for the number of service users. Overhead hoisting equipment was available for service users who needed it. The home was clean and tidy and infection control procedures were in place. Paper towels and liquid soap were provided in the laundry area, which is outside the main building. There is a contract for the disposal of clinical waste. Croft House DS0000033288.V298502.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home must improve its staff recruitment records in order to demonstrate that service users are protected. Staff receive training and supervision but the home should improve on the numbers of NVQ or equivalent qualified staff. EVIDENCE: There is a mix of both male and female staff at the home and staff members were observed interacting with service users in a friendly and respectful manner. The deputy manager reported that out of the eleven staff members working at the home, currently four had either obtained an NVQ qualification or were working toward achieving this, which is below the target indicated in the National Minimum Standards (NMS). It is recommended that the home have an action plan to increase the number of NVQ qualified staff. Two members of staff were spoken with and they demonstrated understanding of their roles and responsibilities and issues relating to service users. Through conversation a service user indicated that staff did a good job of supporting service users. Staff records were viewed in relation to four members of staff but only the most recent one of these gave clear evidence that recruitment procedures had been appropriately undertaken and recorded. The three older records Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 20 contained relevant information but did not include proof of Criminal Records Bureau (CRB) checks and two written references for each employee. The deputy manager provided evidence that this had been reported to the office responsible for obtaining the information. The home’s manager later confirmed by telephone that she was aware that not all the relevant information was on file. It was not clear whether a written agreement was in place in order for these records to be held centrally and this will be addressed separately to this report. It is a requirement that clear evidence of all relevant staff recruitment checks having been carried out is held in the home and available for inspection. There is structured induction training and a further training and development programme for staff at the home. Records showed that staff received training in health and safety, first aid, moving and handling, fire safety, food hygiene, SCIP (Strategies for Crisis Intervention and Prevention) and adult protection. Training certificates were held on individual staff members’ files. A member of staff confirmed there is regular refresher training in relevant subjects. Records in the home showed that regular staff supervision was taking place and this was confirmed through discussion with members of staff. Supervision topics included service user, key worker, staffing and personal issues and staff said that they found supervision useful. Staff meetings are held once every five weeks and staff members have opportunities to contribute to the agenda. Croft House DS0000033288.V298502.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38 & 39 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home that seeks their views and promotes the health, safety and welfare of service users and staff. EVIDENCE: The home’s manager had attended a registration interview just prior to the inspection visit and is about to commence working toward an NVQ level 4 Registered Managers Award (RMA). The manager is supported by a deputy manager who has an NVQ level 4 award. Staff confirmed that the manager and senior staff members at the home are approachable and supportive. A service user survey is sent to people’s homes and the results of one of these conducted earlier this year had yet to be analysed and fed back. The survey asks people whether they enjoy their stay at Croft House, what they think about the support they get from staff, the environment and their views about matters such as activities, personal care, food, privacy and dignity. A business Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 22 plan for 2006/2007 was in place and showed that quality assurance processes were being reviewed and improved. Regular monitoring visits to the home by a senior management member are conducted and reports of these are held on file. Records showed that the home promotes safe working practices. Entries in the fire safety logbook were up-to-date and action was being taken in relation to recommendations made in the fire officers’ report following a visit on 05/06/06. Maintenance records for the home were on file and test/service certificates/reports were seen for portable electrical appliances, assisted bath and hoists. The deputy manager reported that gas and electric safety certificates were sent directly to the county office in Winchester. Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Croft House DS0000033288.V298502.R01.S.doc Version 5.2 Page 24 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 YA34 Regulation 19(1)(b) Schedule 2 Requirement Staff recruitment records or proforma as agreed with CSCI must be held in the home with all required information. Timescale for action 12/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA32 Good Practice Recommendations It is recommended that the home have an action plan to increase the number of NVQ qualified staff. Croft House DS0000033288.V298502.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: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Croft House DS0000033288.V298502.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. 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