CARE HOME ADULTS 18-65
Dixons Farm Wigan Road Bamber Bridge Preston Lancashire PR5 6AS Lead Inspector
Val Turley Unannounced Inspection 6th July 2006 09:45 Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dixons Farm DS0000064059.V297158.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. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Dixons Farm Address Wigan Road Bamber Bridge Preston Lancashire PR5 6AS 01772 334832 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) Progress Adult Services Limited Miss Jessica Elizabeth O`Neill Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The home is registered for a maximum of 6 service users in the category LD - (Learning Disability). The Service should 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 guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 23rd January 2006 Date of last inspection Brief Description of the Service: Dixon’s Farm is one of the three homes operated by Progress Adult Services Ltd, which is a company caring for young adults whose severe learning disabilities are compounded by severe challenging behaviour. The service aims to provide an individualised, integrated service within which, communication therapy and high quality care, combine to reduce challenging behaviour and reinforce and maintain positive changes. The home is a detached property with a large enclosed secure garden to the rear and side, and parking area to the side of the property. The home offers accommodation over three floors to six young adults who each have their own bedroom. There are two bedrooms located on the first floor, which have en-suite facilities and are adjacent to a bathroom. There are two further bedrooms on the second floor. The property has a self -contained annexe with its own lounge with dining area, a kitchen, bedroom and bathroom. In addition, the home has a large lounge, a dining room and kitchen. There is a small conservatory to the rear of the house. There is a separate staff area, office and laundry. The basic fee range is £113,000 to £134,000, with additional charges for any extra staffing support required. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The key inspection of a service takes place over a period of time and involves gathering and analysing written information. A site visit was also made to the home as part of the inspection process and this involved discussion, where possible, with young adults living at the home, discussion with and observation of the staff working there, an examination of records, policies and procedures and a tour of the premises. A questionnaire was completed by the manager prior to the site visit. These all provided information that was included in the report. As part of the inspection, the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allowed the inspector to focus one of the young adults living at the home. Records relating to that individual were inspected and discussion took place with the young adult, where possible, the management team and the young adults key worker. What the service does well:
Dixon’s farm provides a pleasant, clean and safe and well-maintained environment for the young adults living there and the staff who support them. The bedrooms were decorated and furnished with the needs of the young adults in mind and are influenced by any health and safety issues. The home had a good procedure in place to ensure that the needs of young adults new to the service are assessed before they are admitted and that the staff are well prepared and informed of their support needs. Care plans were detailed and thorough giving staff clear guidance as to how best they should support each of the young adults. As far as is possible the young adults were given opportunities to make choices and decisions as to what activities they would like to be involved in. Staff had very good knowledge of the individual young adults support needs and were actively involved in helping to develop care plans. The local advocacy service was involved to ensure that the needs and wishes of the young adults are given full consideration during the review procedure. The health care needs of the young adults were attended to and there were good links with local health professionals. The support staff monitored the health care needs of the young adults on a daily basis and took appropriate action as needed. Medication in the home appeared to be well managed. The young adults had opportunities to be involved in a range of both home based and community based activities and staffing was arranged around these activities. The staff team were well trained and enthusiastic about their role. They were sensitive to the needs of the young adults and respected their privacy and
Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 6 dignity. Links with family were encouraged and supported through regular contact and visits home were possible. The home had good recruitment procedures in place to help ensure that the young adults were protected from potential abuse. The home was generally well managed with the registered manger having the skills to fulfil her role. The home had a number of quality assurance processes in place enabling them to improve on their performance and respond to any worries that the young adults representatives may have. What has improved since the last inspection? What they could do better:
The homes Statement of Purpose and Service User Guide needs to be updated to ensure that they reflect the service that the home offers. The psychology service which provides advice and guidance to the home should be requested to become involved in any decisions regarding the management of challenging behaviour and physical intervention strategies to help ensure that the strategies are appropriate to the young adults needs. The management of the young adults monies in the home could be done more safely to help reduce the possibility of errors being made or the incidence of financial abuse. The reports from the homes monthly monitoring visits should be made available for the Commission for Social Care Inspection to examine and the views of involved health professionals should be sought. Some improvements must be made in respect of health and safety issues, as moving and handling training should be provided on an annual basis and the homes fire policy, risk assessment and training needs to be reviewed to ensure
Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 7 that staff are provided with clear guidance and training. The development of a training matrix would help the home identify and plan training. 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. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 8 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 Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and Standard 1 was partly assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The pre-admission process was in sufficient detail to ensure that prospective young adults supports needs are fully assessed before admission. EVIDENCE: Although no new young adults had been admitted to the home since the last inspection, the home was in the process of assessing the support needs of a young adult with a view to providing a placement at the Dixons Farm. The home had been given information by the young persons present placement, a pre-placement meeting had been held and the young adult and his family had visited Dixons Farm. The manager stated that the admission process would be carefully planned taking the young adults needs into consideration. There were plans to decorate his bedroom prior to admission to reflect his specific needs and interests. One of the members of staff told the inspector that before one of the other young adults was admitted to the home, the staff had been given a presentation of his particular support needs. The homes Statement of Purpose and Service Users Guide need to be updated to reflect the recent involvement of psychological services in organisation and so enable those interested in using the service, to make an informed decision about it. Dixons Farm DS0000064059.V297158.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The home had a positive and effective approach to meeting the individual support needs of the young adults, although this would benefit from the involvement of all relevant specialists to ensure that the approaches used are the most appropriate. EVIDENCE: The file of one of the young adults was examined in detail. This contained a very detailed and individualised care plan, which gave support staff clear information as to how they should support the young adult safely in all situations. Key workers were encouraged to feed through any ideas they had about improving the support provided to the young adults, to the care planning meetings in the home. The young adults were involved in this process as far as was possible and staff were heard to talk to them, throughout the course of the day, offering them choices in terms of the activities they may wish to be involved in. The young adult appeared to be relaxed and comfortable in the presence of the staff and sought them out for support and guidance. The key worker of the young adult whose file was examined, had a very clear and detailed knowledge of the support needs required by the young adult and was involved in helping to develop the care plan.
Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 11 The care plan gave detailed information to staff regarding the management of any challenging behaviour that the young adult may present and any physical intervention that may be required in such situations. The home had involved other professionals in decisions made with regard to any physical intervention strategies. As the home now receives guidance and support from a psychology service it is required that the home request their involvement in any decisions regarding physical intervention to help ensure that these approaches are the most appropriate for the young adults concerned, with a view to safeguarding their health and wellbeing. The home involved a representative from the local advocacy agency in the annual review for each of the young adults, again to help ensure that the health and wellbeing of the young adults is protected. Dixons Farm DS0000064059.V297158.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The support staff encouraged the young adults to make decisions and choices in their daily lives and supported them in these, taking into account any health and safety issues. EVIDENCE: The young adult, whose file was examined, was involved in a range of activities both at the home and in the community including swimming, walking, shopping, meals out and home based activities including baking. Staff were observed providing the support to enable these activities to take place, providing a structured but flexible routine that also met the young persons health needs. The details of these activities were included in the young persons care plan, along with the details of the support that the staff needed to provide for each activity. Wherever possible the home promoted the independence of the young adults. They knocked on doors before entering their bedrooms, included them in all discussions and gave them the opportunity to spend time alone in their rooms when they wished to. Details in the care plans, discussion with staff members and the management team and observation of the staff supporting the young adults demonstrated the homes commitment to maintain the young adults family links. Where
Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 13 appropriate the young adults were supported by the staff to visit their family. Families were also encouraged and supported to visit the home. Meals provided appeared to be nutritious and well balanced. Where possible the young adults were encouraged to help prepare their meals. Mealtimes were unhurried and the young adults could eat in their own rooms if they wished to. The staff had an awareness of the meal preferences that the young adults had and these were recorded in their files. A record was kept of the young adults weights as one way of monitoring their health and well-being. Dixons Farm DS0000064059.V297158.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 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. The home had procedures in place to assess the health needs of the young adults they supported and worked appropriately and sensitively to ensure that their health needs were met. EVIDENCE: The care plan examined in detail during the course of the inspection, clearly outlined the needs of the young adult and how their personal care needs should be met. A record was kept of all appointments kept indicating that the health needs of the young adults were attended to. In addition to this the young adults well-being was monitored on at least a daily basis. There was clear guidance for in place for the staff should the young adult become ill and support staff carried appropriate medication with them at all times. The home was in the process of collating all health information relating to each of the young adults and the manager stated that the intention was to use this to develop health action plans for each of them. The manager stated that the staff team worked hard to ensure, as far as they were able, that the young adults received good health care. She stated that they had good working relationships with a number of health professionals. It was recommended that the home approach the continence advisor for specific advice in relation to one of the young adults.
Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 15 The medication in the home appeared to be well managed. Where the consent of the young adult could not be given this was recorded plus the reason why consent could not be given. The care plan included details of how best to give the young adults their medication. The company provided its own medication training but the manager said that accredited training had just commenced and that this would be made available to all staff over time. The manager also stated that she monitored staff competency in relation to the management and administration of medication approximately every six months. Dixons Farm DS0000064059.V297158.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had some good policies and procedures in place in order to protect the young adults although these should be further developed and improved. EVIDENCE: The home had some comprehensive policies in place regarding the protection of young adults. Training had been provided for the majority of staff to ensure that they were fully aware of their responsibilities, should they become aware of any concerns regarding the care provided for the young adults. It was intended that all staff would receive this refresher training. Discussion with a member of staff indicated that they were aware of the action that they needed to take should they become of any concerns any allegations of abuse. The management of challenging behaviour, including physical intervention, in the home was well documented and thought through, however these strategies must be agreed, if possible, by the company now providing psychological guidance and support (See Standard 6). This involvement would help ensure that the approaches used are the most appropriate for the individual young adults. The home must review its handling of the young adults monies to ensure that it is managed safely. A policy must be developed in respect of this and more frequent auditing introduced to ensure that any possible discrepancies are identified quickly. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and comfortable and provided a pleasant and safe environment for both the young adults and support staff. EVIDENCE: The home was clean, tidy, well decorated and homely. It was well maintained with repairs being attended to promptly by the companies own maintenance team. The young adults bedrooms were decorated and furnished with their needs and preferences in mind, taking into account any health and safety issues. The laundry was adequately equipped for the needs of the young adults and was situated so that there was no need to carry laundry through any of the food preparation areas. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had a robust recruitment process and provided staff with good training opportunities with a view to protecting the young adults as far as possible, although additional training in moving and handling must be provided enabling staff to support service user in all situations. EVIDENCE: The home had good recruitment procedures in place with all the relevant checks being made prior to a prospective member of staff starting work. The home had a recruitment matrix in place that indicated when references and CRB checks had been returned. Discussion with the head of adult services and the manager of the home showed that they were very clear as to what needed to be in place before anyone could start work. On the day of the site visit the inspector was able to observe the staff supporting the young adults. They spoke to them appropriately, involved them in any decision-making processes and were sensitive and patient in their approach. Those staff spoken to were very enthusiastic about their role and demonstrated a good understanding of the individual needs of the young adults. The staff said that training opportunities were good and they felt very well supported by their manager. The home was continuing to work towards having 50 of its staff achieve a nationally recognised qualification in care. The company provided in depth induction training for all new staff and refresher training at appropriate intervals after that. The development of a
Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 19 training matrix would be a useful tool for the home, enabling the manager to have an overview of the staff teams training achievements and needs. Moving and handling training as an annual mandatory course must be provided so that staff are trained to provide assistance to the young adults in all situations. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is generally well managed and there is a willingness to work towards improving the service. Some improvements should be made to ensure that the health and safety of both the young adults and the staff is maintained. EVIDENCE: The home was generally well managed and benefited from having a wellsupported and well-trained staff team. The registered manager was working towards her NVQ Level 4 and had undertaken additional training to maintain her skills and update her knowledge. The home had a number of quality assurance processes in place. The manager undertook a number of checks to ensure that support staff had a good approach to their work and worked to meet the needs of the young adults. Team meetings were held regularly as were individual supervision sessions. The home had achieved the Investors in People Award which is a quality assurance award accredited by an external body. Policies and procedures were reviewed and updated in line with changes in legislation and best practice advice and guidance. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 21 The company had undertaken a survey of parents and care managers views in April 2006. The returns had identified some areas where it was thought the company could improve and these issues had been considered and appropriate action taken to resolve them. This process should be repeated with involved health care professionals. The views of the young adults were sought on a daily basis with staff striving to ensure that activities and experiences were safe, fulfilling and worthwhile. The Quality Assurance Manager had made monthly monitoring visits to the home to audit the service provided. The reports of these visits should be made available for the Commission for Social Care Inspection to examine. The home had ensured that all its equipment and systems were inspected and serviced at appropriate intervals. There was evidence that food hygiene, first aid and health and safety training were provided. There were only two areas of concern and these related to manual handling training (see standard 35) and fire safety. There were some ambiguities in relation to the link between the fire risk assessment, the fire policy and fire training. The company must ensure that these ambiguities are resolved and that staff receive appropriate training and guidance. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 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 2 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 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 X X 2 X Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4(1) Requirement The Statement of Purpose and Service User Guide must be updated to reflect the range of services provided. The psychology service must be requested to become involved in any decisions regarding the management of challenging behaviour and physical intervention strategies. A policy dealing with the safe management of the young adults monies must be developed Moving and Handling training must be provided on an annual basis. The fire policy, risk assessments and training must be reviewed. Timescale for action 31/08/06 2. YA6 YA23 13(4)(c) 31/08/06 3. 4. 5. YA23 YA35 YA42 13(6) 13(5) 23(4) 31/08/06 31/10/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA19 Good Practice Recommendations The home should seek guidance and advice from the
DS0000064059.V297158.R01.S.doc Version 5.2 Page 24 Dixons Farm 2. 3. 4. 5 YA32 YA35 YA39 YA39 continence advisor. The home should continue to work towards 50 of its staff achieve a relevant qualification in care. A training matrix should be developed. The views of health and social care professionals should be sought as part of the homes quality assurance audits. Monthly monitoring visit reports should be made available for inspection. Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Dixons Farm DS0000064059.V297158.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
