Inspection on 12/07/07 for David Lewis Centre

This inspection was carried out on 12th July 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

David Lewis Centre 19/10/06

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 David Lewis Centre - College Community House 94/96 Mill Lane Macclesfield Cheshire SK11 7NR Lead Inspector Julie Porter Unannounced Inspection 12 July 2007 15:00 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 David Lewis Centre - College Community House DS0000066418.V334301.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. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service David Lewis Centre - College Community House Address 94/96 Mill Lane Macclesfield Cheshire SK11 7NR 01565 640000 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) David Lewis Centre Deborah Gittins Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 8 residents to include: * Up to 8 people in the category of LD (learning disability) * Up to 8 people in the category of PD (physical disability) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance which may be issued through the Commission for Social Care Inspection 19th October 2006 2. 3. Date of last inspection Brief Description of the Service: The David Lewis Centre’s community house in Macclesfield is registered to provide care and support for eight people, aged between eighteen and sixtyfour. It is in the centre of Macclesfield, within easy reach of public transport with a train and bus station nearby. The house is made up of three flats each with a bedroom, bathroom, kitchen and living room, and five single bedrooms, which all have en-suite facilities. The house also has a shower room, bathroom, toilet, kitchen, lounge and computer room. The house is close to local shops, takeaway food shops and pubs. Many of the people living in the house go to Macclesfield College, which is about 10 minutes drive away. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The people who live in the Macclesfield Community House are called students throughout this report, as this is how they like to be referred to. This unannounced visit, part of the first inspection for this service, took place on 12 July 2007 and lasted four hours. The house manager was told about the findings of the inspection. This visit was just one part of the inspection. Other information received by CSCI about the home was also looked at. Before the visit, the manager was asked to complete a questionnaire to provide up to date information about the service. CSCI questionnaires were given to students, their families, health and social care professionals (such as doctors, nurses and social workers) to find out their views about the home. Comments from forms that were sent back to CSCI have been included in the report. During the visit, various records were looked at as well as the house itself. All the students, the staff on duty and two family members were also spoken with and they gave their views about the service. These are also included in the report. What the service does well: What has improved since the last inspection? Students are now involved in drawing up the agendas for house meetings and also have the responsibility of these meetings so that they can influence the way in which the home is run. A record is maintained of all complaints made including the nature of the complaint the investigation and the outcome so that students can be confident that their concerns will be listened to and acted upon. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment of the students’ needs usually takes place before they move in and they can make short visits so that the students and staff know their needs can be met at the home. EVIDENCE: The visit was made to the home at the end of the college year and some of the students were preparing to move away from the area. The new students who will move into the home in September at the start of the college year have been identified and their needs have been assessed. On the day of the visit, one student was living in the home temporarily for assessment and getting to know the home and staff before they move in next term. The student was observed throughout the visit chatting with others living in the home, talking with staff, joining in activities and planning for that evening. He appeared comfortable and relaxed. He said that he liked being in the home and was looking forward to the move if he could come. On the day of the visit seven students were living in the home. One student had moved in from another house managed by the David Lewis Centre in April 2007. No placement agreement or assessment documents were available for this student to identify why their needs could be better met by living in this house. Because of health problems, he had not had the opportunity to visit David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 9 the house regularly to see if he liked it, or to develop relationships with others living in the home before his move. This was discussed with the student who confirmed he was happy that he had moved. David Lewis Centre - College Community House DS0000066418.V334301.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. The involvement of the students in developing their own plan of care means that they have an opportunity to contribute to all aspects of their life in and outside the home. EVIDENCE: There was a person centred care plan on the file that was checked. The student had brought this with them when they moved from their previous accommodation at the David Lewis Centre. The plan described what the student was good at and what areas they would like to develop or what “dreams” they had for their future. The student had been involved in the tutorial review meetings each term, which involves all interested parties from college and the residential service that support him in achieving his goals. The documents provided information David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 11 of the steps necessary for the student to take in order to succeed. Tutorial reviews had been signed by the student. Students are involved in their annual review and an annual report was available on file. One student spoken with was celebrating his success of passing the computer exam he needed to go on for further training at college next year. One parent spoken with was very complimentary about the way in which the staff had supported her daughter in achieving so much educationally, emotionally and with “growing up.” Evidence was seen that students participate in house meetings and discussions about the running of the home. The minutes were checked and included suggestions made by students to improve the service offered. However no records were kept to then show what action had been taken or what improvements had been implemented as a result of these suggestions. The home has now been open for a full college year. Since the last inspection, improvements have been made between the students and staff regarding the expectations of the students and the staff anxieties in supporting them to live more independently. Risk assessments are in place for students’ daily living, going out unsupervised, managing the own medicines and social activities. Three students currently manage their own medicines following a risk management process. One student spoken with was disappointed that her flat only had a bath and due to her epilepsy she needed a shower. A communal shower is available on another floor near to the office but the student had been unhappy with this arrangement. David Lewis Centre - College Community House DS0000066418.V334301.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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students are supported in a variety of ways to enable them to become as independent as possible. EVIDENCE: Students living in the home have a full 24-hour curriculum which includes attending college and continued learning at home. Computer facilities are available in the home to support the students with their learning and with maintaining contact with family and friends. One student has completed a National Vocational Qualification in hairdressing and was waiting for her results. One student had recently had an interview to continue education at the nearby college next term for a qualification in sports science. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 13 During the visits students were seen coming and going to the shops, with varying degrees of staff support. The students have settled well in the local area and are more familiar with the facilities available; they knew where the local pubs and restaurants were. On the evening of the visit the students were planning to go out to the pub to have a meal before the official end of term; the debate about where to go was lively and everyone was given the opportunity to give ideas and comment before a decision was made. Parents of one of the students were spoken with during the visit. They were very complimentary about the support their daughter had received during her time at the David Lewis Centre and at the Macclesfield house. The parents spoke of regular contact with the home and of their confidence in the staff team. Students are helped to recognise the responsibilities of daily living, as they have to keep their own rooms and the house clean, do their laundry, do their own or some collective shopping and take it in turns to cook a meal one day a week for the other members of the house. The students are involved in deciding the meal that they will cook each week and are encouraged and advised about healthy eating. David Lewis Centre - College Community House DS0000066418.V334301.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. Students are supported in managing their health, on-going monitoring by staff ensures that they receive the care/support the need to keep well. EVIDENCE: The level of personal support needed by each of the students is described in their care plans. Some of the students are largely independent in this area and may only require verbal prompts with occasional physical intervention, depending on the activity. One student spoken with had enjoyed living in the home and was now preparing to move on. She felt that the fact that she had a flat had helped her develop life skills and given her the appropriate knowledge to live more independently. Two areas of concern she had were the fact her flat did not have a shower; she described this as “stupid” because she could not be truly independent. She also needed to alert staff when she knew she was going to have a seizure. This involved coming downstairs which she also said was “stupid” because she may injure herself on the stairs and her seizure would be in view of other students. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 15 The students are registered with the local GP surgery. Other health needs are maintained by community services. Staff at the home and the social work team at the David Lewis Centre provide services/activities to meet the students’ emotional needs. Staff administer the medication for those students who cannot keep their own medicine safely or don’t remember to take it on time. Each of the students has a lockable cupboard or drawer in their flat/bedroom so that they can safely store their own medication if they look after it themselves. The manager said that three students are responsible for keeping their own medication locked in their room. The decision as to whether each student looks after their own medicines would depend on their risk assessment to do so. David Lewis Centre - College Community House DS0000066418.V334301.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. Processes for protecting adults from abuse and for dealing with complaints are in place but improvements are needed in recording and following through complaints and comments made by the students, so they can have confidence that their concerns are taken seriously. EVIDENCE: The David Lewis Centre has a comprehensive complaints policy. Since the last inspection improvements have been made to the recording of complaints/ concerns made by the students. Two student questionnaires returned said that they felt that complaints were not handled appropriately. Fourteen complaints have been recorded, mostly around the difficulties of group living. A discussion with students identified that they felt that some students got away with more than others when there was conflict in the home. The complaints records did not reflect this, but some of the information was of a confidential nature and could not be shared with students. Some students felt they had not been given satisfactory feedback regarding the outcome of their complaint, or they had been given verbal feedback and they had since forgotten or were unclear. A family member said that any of her concerns regarding the care/support for her daughter had always been listened to. She felt that staff were very competent in dealing with any worries and that regardless of the nature of any complaint the staff always had the welfare of her daughter in mind. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 17 Matters concerning adult protection are referred to the social work team at the David Lewis Centre in line with the Centre’s current guidance. No records were available in the home, as they are kept centrally at the David Lewis Centre. However, as this house is registered separately and is away from the main campus, a log of allegations made/referred should be available and stored safely in the house. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 18 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, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The quality of the décor, furnishings and facilities available for the students ensures that they are living in modern, comfortable and well-maintained surroundings. EVIDENCE: There are 3 purpose built flats and 5 bedrooms with en-suites. All of the bedrooms, including the flats, are single rooms, with sufficient storage and doors with locks that can be opened easily in an emergency. The students can keep their own door key if they wish and this was observed to be in practice during the site visit. There are television, telephone, satellite and internet connections in each of the rooms. Each of the three flats has a lounge/kitchen/diner. The kitchens have plenty of storage and workspace and have lino flooring for easy cleaning. The living David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 19 area of the room is carpeted and has comfortable modern furniture. There is also a television/video cabinet and a small dining table with 2 chairs. There is a communal lounge that is furnished to the same standard as the flats. There are two bathrooms for general use; however, all of the bed-sits have en-suite facilities and the flats also have private bathrooms, although two of the flats only have baths fitted. There is a separate laundry room for use by all eight residents. Although the machines are not of domestic style, they are all electronically programmable. The students have responsibility for keeping their own flat or bedroom clean and tidy. They all share the responsibility for the other areas of the house, with staff support at whatever level is required. There is a ramp to the front door as well as steps. A bedroom is available on the ground floor for any students who have a physical disability that would make it difficult or impossible to negotiate stairs. No call alarm system is available in the home to enable students to get help/support should they need to. The environment and facilities, including lighting, ventilation, doors and windows are checked monthly to identify any problems. The housing organisation from which the house is rented attends to any of the jobs identified at the audit. On the day of the site visit the home was clean, fresh and tidy. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thorough recruitment processes, on going training and supervision for staff ensure that students are supported by a qualified staff team and are protected from harm and possible poor practice. EVIDENCE: Training and refresher training for staff is available throughout the year in the training centre at the David Lewis Centre. The David Lewis Centre provides a full programme of training to ensure that staff have the opportunity to achieve all their mandatory training. Staff attend training more during the college holidays when it is easier to release them from their duties and refresher training has been planned for the staff in the home. Staff spoken with confirmed their commitment to attend training during the summer. Only one member of staff has been employed since the last inspection and information provided by the house manager before the inspection confirms that as part of the recruitment process and a Criminal Record Bureau check (CRB) has been obtained. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 21 A supervision structure is in place for staff, in that the staff performance is monitored by the house manager who in turn is supervised by the registered manager of the home. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is knowledgeable and experienced and there is a structure so that the students living in the home can contribute to make sure that it is run in their best interests. EVIDENCE: The registered manager for the home has achieved NVQ Level 4 and the Registered Manager’s Award. She has worked for the David Lewis Centre for many years, gaining internal promotion and transferring to the Macclesfield House. She has maintained and increased her knowledge through attending additional training courses provided by the David Lewis Centre. Since the last inspection the frequency of house meetings for students has improved. In discussion with the students they said they found them “boring” David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 23 and the staff reported that at times it is difficult to get students to all agree on having the meetings. Often the meetings are cancelled when some students do not wish to attend. However, students have the opportunity to add to the agenda of the house meetings before the meetings, which is available in a written format in the communal area of the home. Where necessary other formats should be considered to meet the needs of the students moving to the home next term. All gas and electrical equipment and the fire safety equipment are checked to make sure that they are working properly David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 24 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 4 25 4 26 4 27 3 28 4 29 3 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000066418.V334301.R01.S.doc 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X 3 X 3 X X 3 X Version 5.2 Page 25 David Lewis Centre - College Community House Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA2 Regulation 14 Requirement The needs of all students must be assessed before they are admitted to the home, so that they can be assured their needs can be met there. A system must be in place to alert staff that students may need help without students putting themselves at risk of further injury. Timescale for action 31/08/07 2 YA18 13(4) 31/08/07 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 Refer to Standard YA8 Good Practice Recommendations A record needs to be kept of the actions taken and any improvements made following suggestions made by students regarding the running of the home so that students can see that they are being listened to. Bathing facilities in the flats should be appropriate to the needs of people so that the risks are minimised and independence can be achieved. Students should be given written feedback about the outcome of their complaints so that each complaint is DS0000066418.V334301.R01.S.doc Version 5.2 Page 26 2 3 YA18 YA22 David Lewis Centre - College Community House 4 5 YA23 YA39 managed consistently and to their satisfaction. A log of referrals made under adult protection should be available in the home including the outcome of these referrals. Student house meetings should be scheduled throughout the year and take place to make sure that students get regular opportunities to give their feedback and suggestions about the way the home is run. David Lewis Centre - College Community House DS0000066418.V334301.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 - 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. 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