Inspection on 02/11/05 for Davlyn House

This inspection was carried out on 2nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Davlyn House 22/01/07

Davlyn House 07/12/04

Davlyn House 19/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Davlyn House 41 Bull Lane Brindley Ford Stoke-on-trent Staffordshire ST8 7QL Lead Inspector Peter Dawson Unannounced Inspection 2nd November 2005 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Davlyn House Address 41 Bull Lane Brindley Ford Stoke-on-trent Staffordshire ST8 7QL 01782 512269 01782 517645 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) Mr David Heath Mrs Heath Mrs Lesley Ann Flatley Care Home 20 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (20), of places Physical disability over 65 years of age (2) Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th May 2005 Brief Description of the Service: Davlyn House is a detached modern building situated in the village of Brindley Ford, surrounded by countryside. The garden has been extended and landscaped and covers one acre of land. The home accommodates up to 20 elderly people – four of whom may require dementia care and two a physical disability. There is one shared bedroom the remainder are for single use. There are three lounge areas, conservatory and separate dining area. There are two assisted bathrooms and a shower facility on the ground floor and there is a first floor bathroom. There are no en-suite facilities but adequate number of toilet areas. Furnishings, fittings and equipment are to a high standard and there has been a very commendable improvement and replacement programme over recent years, providing a comfortable, homely environment. Davlyn House provides a very personalised and individualistic service to residents. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this unannounced inspection there were 20 people in residence including one person on respite care. The home has a high occupancy rate. The home has a good record of care provision and compliance therefore in the current year will have two unannounced inspections. This is the second of those inspections. As usual there was a very relaxed atmosphere in the home and the usual welcomes for all visitors throughout the morning. Arrival at 9a.m. evidence choice of retiring times ranging from 6 a.m. to 10.30 a.m. There has been a slight increase in the overall dependency levels of residents due to deterioration in health and physical conditions. The staffing levels are adequate for the present dependency levels with additional staffing provided at peak times of care need. There were three people on duty including manager and the deputy manager came to the home to relieve the manager for the inspection purposes. This is the usual practice in this home and other examples have been seen when additional staff have arrived for exceptional circumstances e.g. hospital appointments for residents. Visitors are always welcomed into the home in a warm and friendly way, this applied to a visiting Health Care Assistant arriving to dress wounds etc. The majority of residents were seen and approximately half spoken to. Some were enjoying the morning in their bedrooms, others sitting in the different lounge areas. All stated they were satisfied with the care provided at Davlyn House and the personal care they received from staff. All spoke highly of food provision, visiting arrangements, occupation and quality of life issues. All staff were spoken to. Visitors were not seen/spoken to on this visit. There was inspection of all areas of the environment including a sample of bedrooms. Throughout the home there was evidence of a high standard environment and standards of hygiene throughout were also high. Records seen included: care planning information, staffing files, staff rota, and medication records. The home have introduced a new system of key working – this includes two key workers allocated to each resident both with responsibility for recording and reviewing care planning information and ensuring continuity of health, social and emotional care needs for the specific person. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 6 The home are considering extension of categories for admission to include MD (mental disorder) and are in the process of arranging appropriate staff training prior to making application. This is a very homely environment. Visitors are welcomed readily into the home and residents spoken to were highly satisfied with care and had no complaints. What the service does well: What has improved since the last inspection? The new key worker system has been introduced with two workers allocated to each resident, further enhancing the individualistic knowledge and checking of care delivery for all residents. All corridor areas, the kitchen, landing, hall and stairs have been redecorated. Further uPVC double glazing has been provided – half the building has now been fitted with double glazed windows and doors. A smaller vehicle (in addition to seven seater mini-bus) has been provided for staff use for resident need. All health and personal care information has been completed in care planning information. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 7 The statement of purpose has been updated. 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. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 Adequate information is available for prospective residents to make informed decisions about placement. All placements are subject to review/confirmation after six weeks. The information available and pre-admission procedures comply with all required good practice. Standards relating to Choice of Home were found to be met. EVIDENCE: The statement of purpose/service users guide have been updated as recommended in the last report this was mainly to update factual information regarding the home. A copy will be sent to the Commission. All residents have contract supplied by local sponsoring local authorities and for self funding residents contracts between resident and home. Care Management assessments are obtained for all residents. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 10 The home carries out their own assessment and all aspects covered as required using the tool in Standard 3.3. Prospective service users are invited to the home prior to admission and the home has a good record of securing such visits even for people in hospital. Relatives are always involved in preadmission discussions, visits and care planning information. Visits to the home prior to admission are usually for half or full day and wherever possible for overnight stay. A recently admitted resident admitted as an emergency was seen in her previous environment for assessment purposes prior to admission. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 – 11 Care plans are of excellent standard and contain all required information to cover the physical, social, emotional and health care needs of residents. Needs are fully met. There is a safe system of medication in the home with a good track record of this. On this visit the home were asked to check medication of new resident with the prescribing GP to confirm accuracy. The principles of dignity and respect were clearly being applied daily in personal care situations. The service provided prior to and following death were evidenced to be of equally good standard. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 12 EVIDENCE: Care plans were sampled in relation to recently admitted resident and a long stay resident. Plans were of good standard and based upon assessed need, they were reviewed regularly and where significant changes required in providing care, plans were re-written. In relation to recently admitted resident (three days previously) a Care Management assessment had been obtained, the homes own assessment carried out and documented all prior to admission. Documentation in care plans was comprehensive, adequate and contained all information required to provide care. There is a summary of care requirements with detailed information/instructions to meet needs. The home has recently introduced a new key worker system – allocation of two care staff as key workers to each resident involving where possible day and night staff to provide a more comprehensive cover of needs and progress. This has focussed further on the need to carefully assess and record progress and more readily ensures staff record and communicate changed needs. Key workers are responsible for monthly reviews - jointly and with residents wherever possible. There was previous good staff awareness of need and the importance of identifying any changes swiftly – but the introduction of the new key worker system has further enhanced that. There has been an overall increase in the dependency levels of residents e.g. strokes, reduction in mobility, significant changes physical/medical conditions. The District Nursing Service are currently visiting relating to would care following diagnosis of serious medical condition in hospital, there are regular outpatient appointments and the importance of supporting the resident through this distressing process understood and given. A resident previously requiring pressure are management is now healed and on specialist (Pegasus) mattress. Physiotherapist has been requested following recent stroke to try to secure improvement in mobility and independence. A resident is hoisted at all times and requires virtual total care – feeding routines documented and followed, catheter care now provided with assistance sought as necessary from the District Nursing Service. Medication is supplied to the home in blister packs (MDS) by local pharmacy which has had change of ownership, the previous and new service reported to be satisfactory. MAR sheets were inspected and found to be accurately completed. In relation to medication for a resident admitted three days prior to the inspection one prescribed drug did not contain the recorded information Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 13 relating to name, date, time and dosage, this must be checked immediately with the prescribing GP. Only written information had been supplied by the relative prior to the respite period. The home has a good record of promotion of independence and works closely with the nursing service to achieve improvements wherever possible. Residents were seen to be spoken to with respect and understanding and personal care given respecting the principles of privacy and dignity. This was confirmed in discussions with residents during the inspection. Standards relating to dying and death were discussed in relation to a recent death in the home and it was clear that sensitivity and support had been given to the resident and family prior to death. Six staff had attended funeral and family and friends returned to Davlyn House following the funeral for tea. This resident had been cared for over a long period in the home and her quality of life vastly improved due to the tenacity of staff. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 Daily Life and Social Activities are provided to the confirmed satisfaction of all residents seen and spoken to. This was confirmed in observations and records seen. Standards 12 – 15 were found to be met. EVIDENCE: Routines of daily living are seen to be flexible e.g. breakfast served until 10.30 – at 9.30 a.m. Three residents were still asleep, half remainder having breakfast other half up preparing for breakfast. Breakfast is served in bedrooms if preferred. There are no rules relating to rising, retiring, bathtimes etc. all residents have free choice. Preferences, likes/dislikes are all known to staff and recorded in care plans. Plans record the preferred lifestyles of residents and these are promoted in the care provided. The usual range of indoor activities are provided and small group or individual activities of interest to residents are lead by staff or a resident of a relative who provides creative type craft activity much enjoyed by residents. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 15 Regular entertainment is provided in the home and the excellent garden area provides a peaceful and comfortable setting where residents walk or sit during the summer months, the garden provides a bright and interesting back-drop from the lounge area during the winter months. There is choice of sitting area with small lounge and larger lounge with kitchenette facility this area having recessed areas allowing smaller groups. There is a separate conservatory, a resident dines there by choice. The dining area is compact but pleasant with well laid tables and doubles as a dining and/or socialising area. The home has its own dedicated transport with recently purchased seven seater mini-bus and smaller vehicle with good access. Visits to local areas of interest, particularly during the summer months are provided and there is transport readily available for whatever purpose. Visitors are welcomed at any time and their part in care provision is sought and welcomed. Many visitors have confirmed this in discussions on past inspections. The importance of involving family all changes in care needs are understood an example being recent joint visits to hospital Consultant by relatives and staff with a resident, the relatives had requested staff support in a complex and sensitive situation. Residents confirmed that food provision was good with choice and type of food being provided to their satisfaction. There have been no complaints about food in recent memory Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 – 18 All procedures relating to complaints and protection of residents are in place and satisfactory. Standards relating to Complaints and Protection were found to be met. EVIDENCE: There have been no complaints to the home or to the Commission since the last inspection. The home keeps a record of domestic type-complaints or concerns and none have been relevant since the last report. The complaints procedure is clear and concise and posted in the home for residents and visitors. There is a policy/procedure relating to the reporting of suspected or actual abuse. This is known to staff and re-enforced in meetings and supervision of staff. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 - 26 This is a high standard environment exceptionally well maintained by attentive proprietors. Any requirements made in relation to the environment are actioned immediately by the proprietors. It is a safe and well maintained environment. Most areas have been upgraded. EVIDENCE: The majority of accommodation is on the ground floor – only four bedrooms and bathroom are located on the first floor – access is via stairs or stair-lift. The bathroom on the first floor is unused and only the toilet presently in use, residents prefer to use the assisted bathing facilities on the ground floor. There are no en-suite bedrooms in the home but all rooms have wash-hand basins and commodes are provided as required for most residents. There is an assisted bathroom and separate shower room on the ground floor. There are Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 18 seven toilet areas throughout on the ground floor located near to communal areas and bedrooms. There is an Oxford mini-hoist presently used for two residents. Furniture, fittings and equipment are to a high standard and exceptionally wellmaintained. Most areas have been refurbished and the proprietors make consistent improvements to the environment. Since the last report there has been redecoration of all the corridor areas, landing hall and stairway and also the kitchen area. Replament uPVC windows and doors were made to the lounge and rear windows of the home earlier in the year and since the last inspection there has been further replacement of windows – half the building has now been fitted with replacement windows and doors. The communal areas are bright, well furnished and comfortable. Most bedrooms were seen, were bright comfortable and well personalised reflecting individual interests. Several residents access their bedrooms for a large or lesser part of the day and have good facilities – TV/music facilities, one has Sky TV. A self-closing device on a bedroom door had malfunctioned and needs repair. This is referred to in Standard 38. Access within the home is good with appropriate aids and adaptations provided in communal areas and bedroom areas where required. Access to the garden area is good including for wheelchairs. Since the last inspection a ramp has been provided to access the opening doors onto the garden area following fitting of new uPVC doors and the inherent “step” the uPVC system brings. There is only one shared bedroom and there is privacy curtain in use. At least one bedroom is below 10sq. m and this information is reported to have been included in the revised statement of purpose (copy not seen – but being sent to the Commission). Standards of hygiene as always were seen to be good throughout the home. Domestic hours are well used and organised with good cleaning routines. There are continence management issues in two bedrooms, but there was no evidence of this – the home clearly managing these situations extremely well. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Staffing levels are maintained as required and are satisfactory for the present dependency levels of residents. The home has a good record of staff training which continues. The requirement of 50 of NVQ trained staff by 2005 has been met. There is a good recruitment policy/procedure in place which protects residents. Standards relating to staffing were found to be met. EVIDENCE: The staffing levels remain at formerly agreed and required standards – there are 403 care hours per week plus ancillary staff. There is a good mixture of age, experience and length of service. Three members of staff have left since the last inspection. Records of new staff appointed were inspected and all appropriate checks, references, general information had been obtained. There is a good recruitment practice/procedure in place. The home were awaiting CRB clearance for a new member of staff to commence duties and approval was given to obtain a POVA First check due to the urgent staffing need at this time. Shifts were being covered by existing staff but illness etc had exacerbated the situation. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 20 The home more than the required 50 of care staff trained to NVQ2 standard or above. – Presently over 70 of staff are trained to this standard. Statutory staff training has been provided for all staff, there has been updating of first aid and moving and handling as required. The home has an approved trainer. A course has been booked to provide dementia care training in house on 10.1.06, this will include recently appointed staff and updated training for other staff. The home is considering extending the categories of admission to include MD (mental disorder). Suitable training has been sourced and this is to be arranged in the near future. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 33 and 36 – 38. The home is well managed and run. There is positive leadership and an inclusive style of management. Record keeping is to a good standard and residents health, safety and welfare are promoted and protected. EVIDENCE: The Registered Manager has the required experience and qualification to run the home. The Manager gives a positive lead in the home. A good training programme ensures staff are aware of the required principles and standards of care required. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 22 There are positive working relationships between all staff, managers and proprietors. Areas of responsibility are clearly defined and present no problems. The proprietors play an active role within the home. They live close to the home are in constant contact with the home and visit several times each week. The Manager is given the required autonomy to run the home and there are open and positive dialogues and exchanges observed between staff, managers and proprietors. Formal staff supervision is in place and recorded. The standard of recording in the home was seen to be to a high standard from records inspected during this visit Fire records were not inspected on this visit. It was noted that a self-closing device on a bedroom had become inoperative and required repair. The Manager reported that this was being addressed by the proprietor. This must be made safe. Risk assessments relating to resident activity were sampled, found to be in place as required and reviewed as part of the monthly reviews of care planning information. All reportable incidents under regulation 37 had been notified to the Commission. Induction and foundation courses comply with NTO standards. Staff are working to new induction pack/procedures following changes from TOPPS induction. Two new staff have completed these one is to commence. Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 3 2 Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP9 OP38 Regulation 13(2) 23(4) Requirement Timescale for action 02/11/05 Medication for new residents to be checked with prescribing GP Repair/replace self closing device 02/11/05 in bedroom identified. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Davlyn House DS0000008221.V263498.R01.S.doc Version 5.0 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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