Inspection on 19/07/07 for Derwent Lodge

This inspection was carried out on 19th July 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Derwent Lodge 17/07/06

Derwent Lodge 10/11/05

Derwent Lodge 01/06/05

Derwent Lodge 06/09/04

Derwent Lodge 16/04/04

Derwent Lodge 30/10/02

Similar services:

Trevayler Residential Care Home

Thornham Grove

Thistle Hill Hall

Conifer Lodge

Westwood Lodge

Egerton Lodge Care Home

Alfred Minto House Care Home

St Matthews Unit

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

CARE HOME ADULTS 18-65 Derwent Lodge Derwent Lodge 11 Beaufort Street Chaddesden Derby DE21 6AX Lead Inspector Nancy Bradley Unannounced Inspection 19th July 2007 09:00 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 Derwent Lodge DS0000031165.V341297.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. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Derwent Lodge Address Derwent Lodge 11 Beaufort Street Chaddesden Derby DE21 6AX 01332 347597 F/P 01332 347597 derwentlodge@rethink.org www.rethink.org Rethink 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 Richard Egglington Care Home 16 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (16) of places Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th July 2006 Brief Description of the Service: Derwent Lodge care home provides nursing and personal care for up to sixteen people, eight males and eight females, aged 18 to 65 years, with mental health needs. Residents are supported to take part in daily living and social activities, and lead a more independent lifestyle. The home is a purpose built detached bungalow in Chaddesden, close to local shops, facilities and a bus route, and is a short distance from Derby city centre. All bedrooms are single rooms with en-suite facilities. The home has male and female facilities, with separate lounges (smoking and non-smoking) dining room and kitchen. The home has a large garden. The local Primary Care Trust funds the residents currently living at the home. This is because these residents moved from the local hospital to this accommodation. Consequently information about the fees was not available. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection was unannounced and took place over five hours. The inspector spoke with the Registered Manager and care staff. During the site visit the inspector made a tour of the home and spoke with service users. There were nine service users in the home on the day of the inspection. Currently the home has no vacancies. Additionally, time was spent in preparation for the visit, looking at the Annual Quality Assurance Assessment questionnaire. The inspector observed throughout the visit how the staff were meeting service user needs. No family or relatives were present during this visit. Records were examined relating to the service users and the general running of the home. The Commission for Social Care Inspection did not send out the “Have Your Say” questionnaires. Although service users spoken with during the visit confirmed they were happy at the home and were looked after by the staff. The Home’s Statement of Purpose and Service user Guide are displayed in the main entrance with previous inspection reports from the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? What they could do better: Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 6 The home needs to ensure that robust recruitment policy and procedures are in place and they are adhered to. Staff must receive supervision and support in line with the National Minimum Standard 36.4. The home needs to consulate more widely when assessing its quality of care and service provision. 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. Derwent Lodge DS0000031165.V341297.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 Derwent Lodge DS0000031165.V341297.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): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that service users’ needs are fully assessed and met prior to admission this ensures that all potential service users holistic needs are appropriately met. EVIDENCE: The care needs assessment records of two service users were examined in detail during the visit. All service users have been at the home for a long time and there are no plans for any further admissions at this stage. There have been no new admissions since the last inspection The home has reviewed its assessment documentation following the last inspection and all the required information was available for inspection. There was evidence on file to show that the care needs assessments of the service users were are being reviewed on a regular basis by the referring agency. The home has a robust assessment and admission procedure where all referrals are assessed prior to service users being admitted to the home. Service users confirmed they are invited to the home before coming to live there and they have a copy of the licence agreement, which, they had signed. Where service users do not wish to sign this is also recorded. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a care planning and review system in place, which ensures that service users’ individual needs are met EVIDENCE: During the visit care plans of two service users were examined. The key worker had compiled the care plans and evidence was seen of care plans being reviewed on a regular basis. Care plans included services users’ individual lifestyles preferences and choices; the interventions prescribed by outside healthcare professionals were appropriate. Daily records are also maintained on each service user. The care staff confirmed that service users knew about their care plans; they were personalised and reflected the individual needs of the service user. Several of the service users had signed their care plans and were they had not this had been recorded. The home offers a structured multi disciplinary care planning and rehabilitation approach for service users. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 10 Throughout the visit care staff were observed encouraging service users to make decisions, which affect their daily lives. Minutes of service users’ meetings were seen confirming that they were able to express their views. Risk assessments were in place and these included actions to be taken by staff. The care staff recognised the need for these to be updated and reviewed in line with care plans. The Registered Manager is updating the format and style of the risk assessments to include activities and trip out for service users. The home has a system for reviewing service user care plans and these were fully recorded. Generally records were well presented, indexed, and contained the required information. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were arrangements in place to enable service users to maintain and develop appropriate relationships, and to participate in activities both in the home and outside in the wider community in accordance with their preferences and wishes. EVIDENCE: From discussions with care staff and direct observation, service users are supported and encouraged in life skills such as household tasks cooking, preparing drinks and light snacks. Daily routines are flexible with the service users being able to make their own decisions about how they spend their day. The service users are settled in their daily lifestyle with a number of service users involved in activities outside the home. On the day of the inspection service users had been shopping in town and going to the theatre The home takes small groups of service users on holidays and trips out. The relationships observed between care staff and service users were friendly and good-humoured with care staff being open and honest with service users Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 12 when needed. Both care staff and service users recognise the need for a consistent approach and clear boundaries for establishing good relationships with service users. As part of improving service users life style the home as signed up to the Lilly health care programme looking at providing a more holistic approach and support to service users with mental health difficulties. Service users were encouraged to maintain regular contact with family and friends. Individual service users religious and cultural needs were recognised incorporating their End of Life Wishes. The home operates a set weekly menu with service users being given a choice if they do not like the options on the menu. From examination of the menus the home is providing a well-balanced and nutritious diet. However the home is not fully recording all meals or variations to the menu. Service users’ weekly weights are recorded. The menu is displayed on service users’ notice board and in the kitchen. Discussions with the cook demonstrated she had a good knowledge of the service users’ dietary needs and preferences. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal and health care support in a way, which promotes their independence and is in accordance with their preferences and beliefs. EVIDENCE: The majority of the service users who currently live at the home require little or no help with personal care. They are actively supported and motivated by the care staff to undertake their own personal care and daily household task. Where service users require help this is recorded in care plans. Discussions with care staff showed a good level of understanding of service users’ needs and abilities. Service users were all dressed in clothes appropriate to their age and personal preference. From records examined and from discussions with staff, service users’ health and personal needs were being met. Service users access health care facilities within the local community. Service users were generally healthy and records showed that staff promptly contacted the appropriate medical services. A multi-disciplinary team approach support service users and information on all health care professionals was recorded. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 14 The home operates and monitors service users’ medication. None of the service users are able to administer their own medication at the time of this inspection. All staff have received training on medication training procedures and only qualified staff administers service users medication. The arrangements for receipt, storage, administration and disposal of medication were also examined and found to satisfactory. However the home needs to review its recording procedures on homely remedies/ none prescribed medication. There is no clear audit trail for recording of medication once administered. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to safeguard resident’s welfare and ensure that their concerns are listened to and acted upon. EVIDENCE: The home has a complaints procedure, which is readily available to all service users and is displayed in the home. Service users are given a copy of the complaints procedure with their licence agreement. The complaints policy includes Rethinks national complaints procedure with the home having a local policy. However the local policy needs to be updated to show the Commission for Social Care Inspection current contact details. At present it refers to the National Care Standards Commission. Discussions with the service users confirmed that they are fully informed about the complaints procedure and would have no hesitation in putting their concerns to the Registered Manager. On examination of the complaints procedures all complaints would be responded to within agreed timescales. The Commission for Social Care Inspection has received no complaints about the service since the last inspection. All service users have access to Advocacy services from MIND. The homes policy and procedure on adult protection was examined. This needs updating to reflect the change of emphasis from abuse to safeguarding of adults. The policy needs to be linked in to local safeguarding procedures as operated by Derby City Council Social Services Department. The home has the Authority’s procedures from 2004. The home had a copy of the Department of Health“ No Secrets” guidance. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 16 The Registered Manager has details on Social Services safeguarding of adults courses and is looking to update staff knowledge and skills in this area. There has been no reported incident of safeguarding of adults since the last inspection Systems are now in place to protect service users monies and finances. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe and well-maintained environment, which suits their needs and promotes their independence and privacy. EVIDENCE: The Inspector carried out a full tour of the home, accompanied by the staff on duty. All communal areas were inspected together with staff facilities. Service users’ bedrooms were inspected with their agreement and all rooms had been decorated and furnished to their personal choice and were being personalised. All bedrooms have en-suite facilities with showers and bathrooms were available for both male and female. The home has two domestic style kitchens within each section of the house completed with two domestic washing machines were service users can make drinks, meals or do their personal laundry. In addition to this the home has a main kitchen and laundry. The home has a dedicated maintenance person to deal with all maintenance issues within the home. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 18 As part of the on going refurbishment programme the home is replacing beds, mattress and pillows. The facilities are comfortable and free of unpleasant odours as was the case on the day of the visit The home has satisfactory hygiene procedures in place. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has robust recruitment procedures and practices in place which ensure the safety and protect the service users. However these are not always being adhered to. Attention should be given to staff supervision. EVIDENCE: From discussions with staff and service users confirmed that current staffing levels provided sufficient staff with the appropriate skills to meet the individual needs of the service users. The service users have benefited from a stable staff team with the majority of the staff having worked at the home for some considerable time. Current staffing levels allows for individual and small group work with service users. The home has policy and procedures in place for the recruitment and selection of staff with the Rethink Charity’s Human Resources Department carry out all the recruitment and selection process. The home is then supplied with copies of the information, which is held centrally. However from the four staff recruitment records examined did not confirm that recruitment procedures had been adhered to. Records did not provided proof of identity, a full employment history, Criminal Records Bureau details, medical declaration and a record of interview. This has been high lighted at previous inspections. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 20 The Registered Manager acknowledged the shortfall in this area. The home is staffed by six Registered Mental Health Nurses, supported by general care staff. Discussions with the Registered Manager confirmed that they have achieved the fifty-percentage target of care staff who have attained the NVQ level 2 or above. From discussions with the Registered Manager home is providing good training and development opportunities. However individual staff records did not fully support this. Training records examined for one member of staff showed that no training had taken place since 2002. Although staff supervision has been taking place and records examined did not fully support this. The Registered Manager acknowledged the shortfall and agreed to agreed to address this Records examined confirmed that annual staff appraisal had been undertaken. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure that service users have a voice and their views are listened to EVIDENCE: Following consultation with Commission for Social Care Inspection the Registered Manager post is shared between Rethinks sister home at Shipley. This is to be reviewed within the next three to six months. The Registered Manager is a qualified Mental Health Nurse and has completed a recognised mangers award. The Rethink Charity has quality assurance systems in place with the Company committed to improving its quality of care and services it offers to service users. The Registered Manager reported he is looking in to develop quality assurance systems within the home and is setting up a series of service users meetings to disuses food and menus with the home. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 22 The Company has a dedicated quality assurance team, which undertakes an overall adult of the home, and obtains views from service users. However the current quality assurance systems do not allow for consultation with family and stakeholders The findings from the quality assurance audit are not made public. A sample of service/maintenance records was examined (including gas and electricity services) and there was confirmation that all the equipment had been properly maintained. Evidence of checks having been carried out was provided by way of the Annual Quality Assurance questionnaire. Systems were in place for the monitoring and maintaining the hot water temperatures. However records indicated that the temperature in some areas was slightly above the maximum temperature allowed. The Portable Electrical Testing certificate is due. Derwent Lodge DS0000031165.V341297.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 3 33 X 34 2 35 2 36 2 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 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 24 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Schedule 4. 2. 3. 4. 5. YA20 YA20 YA34 YA34 13 13 13 Schedule 3. 19 Schedule 2 and 4 Regulation Requirement The home must maintain a record of all meals taken by services users. This must also include any variation to the set menu. The home must have in place a policy and procedure on none prescribed medication The home must obtain written consent to administer none prescribed medication. All none prescribed medication must be recorded and there must be a clear audit trail All staff employed must comply with the home policy and procedures on recruitment as detailed in Schedule 2 of the National Minimum Standards for Younger Adults 2001. This is a previous requirement. Staff files must contain all of the required information in accordance with Schedules 2 and 4. This is a previous requirement All staff records must be available for inspection. DS0000031165.V341297.R01.S.doc Timescale for action 31/08/07 31/07/07 31/08/07 31/08/07 31/08/07 6. YA34 19 Schedules 2 and 4 31/08/07 7. YA34 17 31/08/07 Derwent Lodge Version 5.2 Page 25 8 YA35 9. YA36 18 18 The home must maintain an up to date record of all training undertaken by the staff. All staff must have regularly supervision in line with the National Minimum Standard 6.4. As part of assessing the quality of care provided by the home consultation with stakeholders and service user representatives must be undertaken. The hot water temperatures to the baths and showers must be maintained within safe temperatures. This is a previous requirement. 31/08/07 31/08/07 10. YA39 24 31/08/07 11. YA42 13 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. 2. 3. 4. 5. Refer to Standard YA22 YA23 YA23 YA39 YA42 Good Practice Recommendations The homes policy on complaints must be and updated to reflect the current contact details of the Commission. The homes policy on Safeguarding Adults must make reference to local procedures. The homes policy on adult protection must be revised and updated to reflect current practice. The results of any quality assurance survey should be published. The home should have a current Portable Electrical Testing certificate in place. Derwent Lodge DS0000031165.V341297.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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. 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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