Inspection on 21/12/06 for Docking House

This inspection was carried out on 21st December 2006.

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 but made no statutory requirements on the home.

Other inspections for this house

Docking House 12/01/09

Docking House 19/12/07

Docking House 27/04/07

Docking House 25/05/06

Docking House 25/01/06

Docking House 30/10/05

Docking House 18/05/05

Docking House 17/02/05

Docking House 06/01/05

Docking House 01/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Docking House Station Road Docking Kings Lynn Norfolk PE31 8LS Lead Inspector Kim Patience Unannounced Inspection 21st December 2006 09:30 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 Docking House DS0000042254.V324702.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 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. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Docking House Address Station Road Docking Kings Lynn Norfolk PE31 8LS 01485 518243 01485 518243 care@dockinghouse.co.uk 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) ARMS Associates Ltd Vacant Care Home 28 Category(ies) of Dementia - over 65 years of age (18), Old age, registration, with number not falling within any other category (10) of places Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th May 2006 Brief Description of the Service: Docking House is a residential home for 28 older people in the village of Docking situated between the towns of Hunstanton and Fakenham. There is a post office and shop close by. The home is supported by two G.P. practices. It cares for 18 older residents who have dementia and 10 older residents who need care in a residential setting. The accommodation is all on the ground level, which is divided into two units to offer the support to the two types of older people requiring care. The home has shared and single bedrooms with hand wash basins. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was the second unannounced key inspection within a period of 12 months. In addition, five random visits were held in 2006, three of those conducted by the pharmacist inspector Mr Mark Andrews. This inspection focussed on the outstanding requirements from the last random inspection. During the inspection, several residents were spoken with, two members of staff were interviewed and the manager was spoken with. In addition, records relating to residents, staff and the running of the home were inspected. Observation of residents and staff engaged in their daily routines also were made. The proprietor, Mr Sehgal was present throughout and provided with feedback at the close of the inspection. Since the last inspection the home has appointed a new manager who has been instrumental in driving improvement in the service. The home has made much progress and can now be rated as an adequate service. What the service does well: • • The management have shown a commitment to raising the standard of the service and improving outcomes for residents. The registered provider has made positive changes to ensure that progress continues and is supportive of the new manager, providing the necessary resources to enable change. Care staff have a kind and friendly approach to residents and have increased their knowledge of people with dementia and the benefits to those individuals are evident. • What has improved since the last inspection? • • New care plans have been introduced and the information relating to each individual is much improved. New risk assessments have been introduced. DS0000042254.V324702.R01.S.doc Version 5.2 Page 6 Docking House • • • • • • • • Peoples social and emotional needs are now being assessed and new social care plans have been introduced. Individual plans of activity have been introduced and the home is working towards providing meaningful activity. Medication arrangements have improved and are now considered safe. Care staffing levels have been increased in the afternoons to allow time for activity. There were no significant issues relating to peoples privacy and dignity. Domestic hours have been increased and a kitchen assistant has been appointed to prepare and serve the teatime meal. Improvements have been made to the physical environment, some new furniture has been purchased and the home appeared cleaner and tidier. Improvements have been made to the provision of specialist equipment. Call bells were available, signage has improved, aids and adaptations that promote independence were seen. A risk assessment has been completed on the premises and action taken to reduce risk. Recruitment practice has improved and systems introduced to ensure continued compliance. A quality assurance system has been introduced and a consultant employed to complete quality audits and regulation 26 visits. • • • What they could do better: • • • • • The home needs to continue to make improvement to care plans and risk assessments to make them good. Progress needs to continue with the provision of meaningful activities. The meal and mealtime experience must be improved. Menus must be developed taking into account resident’s preferences and offering choice. The cook must be provided with training on nutrition in order to cater for people with special dietary requirements. Food served to all residents must be wholesome, appealing and of good nutritional value. DS0000042254.V324702.R01.S.doc Version 5.2 Page 7 Docking House • • • The home should find a way of displaying the menu of the day. The home should consider a review of staffing levels to ensure that they are sufficient to meet people’s holistic needs. The home should consider producing a training plan that demonstrates a commitment to training each year. 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. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 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 Docking House DS0000042254.V324702.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is adequate, as there is a pre-admission process that enables the home to determine whether they can meet the individual’s needs and the resident to decide if the home offers a service and accommodation that will meet their expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident’s files were inspected in general and information relating to the preadmission process was provided by the manager. One resident who was admitted a few weeks prior to the inspection was spoken with. The home has a policy and procedure on admissions to the home. This includes a visit to the prospective resident to complete an assessment and an invitation for the resident and their relatives to visit the home and view the accommodation. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 10 The assessments include a life history form and as much information as possible is gathered from relatives before admission, as this helps to provide a person-centred service. Residents and relatives are provided with a copy of the statement of purpose and service users guide and are directed to the homes website for further information about the facilities and services. The resident spoken with confirmed that she was provided with adequate information about the home and was satisfied with the pre-admission process. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is adequate as the home has made significant efforts to make the necessary improvements and must continue to make progress in this area before it can be rated as good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the last inspection concerns about care planning remained. The home has now introduced new care plan documents, which are much improved. They contain information relating to personal details, social history and other aspects of care. In addition, a care plan summary and review sheet has been introduced, providing care assistants with clear succinct information about peoples needs and how they can be met, considering personal preference and choice. The home needs to continue to make improvements to the care plans to make them more person-centred, particularly for those people with dementia. See recommendations. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 12 Care plans now show that relatives and residents have been involved in the planning process, communication with relatives has improved the level of personal information held and this is important in providing adequate care to people with dementia. The daily care notes are much improved with the introduction of new documentation and now provide good information about individual’s activities of daily living. New risk assessments have been introduced and have been written for some risks. However, the home now needs to ensure that they assess all risks associated with individual’s daily living. See recommendations. For instance, risk associated with certain behaviours, which make them more vulnerable. Since the last key inspection four inspections have been conducted by the pharmacist inspector and as a result of unresolved issue, a statutory notice was issued in November 2006. A random visit on the 11th December 2006 showed that improvements had been made and the arrangements were then adequate. At this inspection no issues with the privacy and dignity of residents were identified. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is poor, as the home cannot demonstrate that they provide nutritious wholesome food based on peoples choice and personal preference. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans show that the home is gathering some good information in relation to residents life history and this is crucial for people with dementia, in order to provide care that is consistent with their previous life. Two new Care assistants were spoken with and had good knowledge of the people they were caring for. One spoke about her role as a key worker and how this involved her in gathering information about the people she worked with in order to provide person-centred care. The home did not have a structured plan of activity, however, there was evidence that activities were taking place, such as art and craftwork. Residents had been involved in making Christmas decorations and these were Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 14 on display in the lounge and dining room. During the afternoon of the inspection, staff were engaged in activity with residents, some were engaged in one to one conversations, others were engaged in artwork and one resident was knitting. New activities charts have been introduced at the home and show the activity that each individual has been engaged in. The home needs to make further progress in this area to ensure that they use the information about peoples life experience to develop individual plans of activity that are meaningful, based on peoples previous interests and hobbies. See recommendations. The home has increased the staffing levels to four care assistants in the afternoons to allow staff time for activities. This is an improvement. Meals and the mealtime experience was observed in part. The cook was spoken with and those residents that could express a view about the food were also spoken with. The cook stated that she prepares menus on a four weekly rota. Menus showed that only one main meal choice was available each day. From speaking to the cook and examining records there was no evidence that menus were based on peoples likes, dislikes and preferences. The cook did not actively seek feedback from residents or staff, but did monitor the returned food to ascertain whether the meal was enjoyed or not. When questioned about how the menus were developed the cook said they were based on her ideas about what residents would enjoy. See requirements. It was noted that four residents are on soft food diets and on the day of inspection the meal provided to them was mashed potatoes and gravy, which did not appear to be of sufficient nutritional value as a main meal of the day. The cook stated that she has not received any training on nutrition or catering for special dietary needs and this would be beneficial to her. She also stated that she has not so far consulted with a dietician about providing food that is suitable for people with special dietary requirements and again this would be beneficial. She has completed a basic food hygiene course. See requirements. The meal offered to others was fish, mashed potatoes and beans. Residents spoken with stated that they enjoyed the meal and food served on other days. When asked if a choice of meals was offered, the response was no, however, residents were happy with the arrangements. Menus were not on Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 15 display in the home and this is recommended. See recommendations. A random inspection was conducted on Saturday 28th October 2006 in response to a complaint. One element of the complaint related to the quality of the food and during the inspection there was sufficient evidence to say the complaint was upheld. The home must consider offering more choice of food that is varied, of good nutritional value and based on people’s preferences. A requirement is made for the third time. See requirements. Some improvements have been made to the dining room in the dementia unit, new table clothes have been purchased and the tables have been rearranged and moved into one area to create a single dining room, as opposed to the previous arrangement where some tables were placed in the lounge area. This is an improvement for people in the dementia unit and also enables the home to provide a better service to people during the lunchtime period. Since the last key inspection the home has appointed a kitchen assistant to serve food at teatime. This is an improvement. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate, as the home can demonstrate that they now have a complaints procedure that is well publicised and people can feel confident that complaints will be handled appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure that is now displayed clearly in key areas of the home. The print has been enlarged to make it easier to read. Since the last inspection there have been three complaints, two made anonymously, one of which was investigated by the Commission and the other two investigated by the home. Those investigated by the home were completed in accordance with the complaints procedure. An adult protection issue was also identified by the home and referred to the appropriate adult protection team following the correct procedures. This is currently under investigation and no further information is available at this time. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 Quality in this outcome area is adequate, as the home provides a reasonable standard of accommodation and facilities, however, improvements need to be made before it can be rated as good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was completed and several resident’s rooms were entered. No significant odours were detected on the day of inspection. The domestic hours have been increased and there is an improvement in the overall standard of cleanliness and resident’s rooms appeared cleaner and tidier. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 18 It is clear that there is still some work to be done to raise the standard of décor and of the communal facilities, however, plans have been submitted to make significant alterations to the internal layout and to move the kitchen to a more suitable part of the building. The proprietor wishes to complete this work before starting on the overall refurbishment. Some improvements have been made such as directional signage to assist people with poor memory and recall to orientate around the building. The requirement to complete a risk assessment on the premises has now been met and the risk assessment was available for inspection. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate, as the home has made overall improvement to staffing. The home should continue to make progress in this area, as recommended. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has increased its staffing levels since the last inspection and rosters show that five care assistants are employed in the mornings and there are now four in the afternoons. In addition, a kitchen assistant has been employed to prepare and serve meals at teatime. This is an improvement and allows more staff time to engage in activity with residents. There was no evidence that people’s needs were not being met with the current staffing levels and the introduction of a key worker system and evidence of activity is an improvement. However, these levels are still the minimum given that the home accommodates 18 residents with dementia and 10 older people without dementia. Therefore, it is recommended that the home consider whether the staffing levels are still sufficient to meet people’s holistic needs. See recommendations. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 20 Two new members of staff were interviewed and other spoken with during the inspection. Both new members of staff were enthusiastic about their role and showed a real interest in the residents they were caring for. Both had good knowledge of residents and this will enable them to deliver a more effective service. The home has a key worker system in place and one member of staff discussed her involvement in gathering information about residents through discussion with them and their relatives. She demonstrated a good understanding of how important it is to know the life history of people with dementia in order to understand patterns of behaviour, but also to be able to deliver services consistent with their previous lives. One member of staff interviewed had received training in dementia care and the another was scheduled to attend the next session. Dementia care training has been provided to all staff and is delivered by an external training provider. Staff also talked about the other training they had been provided with, such as fire safety, moving and handling and infection control. Other training completed includes, effective communication, challenging behaviour and food hygiene. Further training is planned in Moving and handling, medication management and dementia care. The home does not have a training plan, but uses an external training provider to provide mandatory updates and specialist training in dementia care. It is recommended that the home develop a training plan that identifies mandatory training and specialist training. See recommendations. Staff are being encouraged to complete NVQ training and the home is waiting for funding for the next group of staff to register. So far, four members of staff have completed NVQ 2, one is in the process and one is completing an NVQ 3. In addition, the home employs two care assistants with nursing qualifications. At the last inspection, a requirement about the completion of pre-employment checks was made for the fourth time. The homes recruitment practice was reviewed again on this occasion and files were in order. New staff appointed had completed an application form and the home had taken two written references and a POVA or criminal records check before staff commenced work. A staff file checklist has also been introduced in order to reduce the chance of errors. This is an improvement. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 21 Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 38 Quality in this outcome area is adequate, as the home has made overall improvements to the management systems. Further progress is still to be made before this area can be rated as good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection the management of the home has changed. The manager in post at that time has left and on the 4th September 2006, Ms Tracy Norman was appointed as new manager of the home. An application for registration with the Commission is to be submitted following receipt of a Criminal Records check. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 23 Since Ms Norman has been in post, significant overall improvements have been made. New care plans and risk assessments have been introduced and staff are being trained and supported to deliver better care to residents. Staff work routines have been reorganised and staffing levels have been increased. Staff speak very positively about the changes and feel well supported by the new manager. The manager stated she has been well supported by the proprietor who has shown commitment to raising the standard of the service by influencing positive change. The home has introduced a quality assurance system that includes stakeholder surveys. Quality audits are being completed as part of a continuous quality assurance process. The home employs a consultant to complete the audits and monthly regulation 26 visits. The home is intending to produce a quality assurance report, a copy of which should be made available to residents, relatives and the Commission. Staff supervision was not fully assessed on this occasion, however, staff spoken with talked about being given the opportunity to discuss their work practice and any issues arising with the manager and stated she was very approachable. The home has made improvements to health and safety. A premises risk assessment has now been completed and should serve to identify any issues arising. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X X STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X X X X 3 Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? YES 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 OP15 Regulation 16(2)(i) Requirement It is required the home provides varied wholesome and nutritious food that is both appetising and appealing. This also applies to choice and the way that food is presented and served. Timescale for action 30/03/07 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 Refer to Standard OP7 OP12 OP15 OP27 Good Practice Recommendations It is recommended that the home continue to make improvements to care plans, risk assessments and social care plans. It is recommended that the home work towards the provision of meaningful activities for people with dementia. It is recommended that the home display the menu of the day in a manner that suits the range of needs in the home. It is recommended that the home conduct a review of staffing levels to ensure they are sufficient to meet DS0000042254.V324702.R01.S.doc Version 5.2 Page 26 Docking House 5 OP30 people’s holistic needs. It is recommended that the home develop a staff training plan. Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Docking House DS0000042254.V324702.R01.S.doc Version 5.2 Page 28 - 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!