Inspection on 22/01/07 for Dolphin Court

This inspection was carried out on 22nd January 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Dolphin Court 10/12/08

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Dolphin Court 9 Bulbeck Road Havant Hampshire PO9 1HN Lead Inspector Mrs A Taggart Unannounced Inspection 22nd January 2007 02:30 Dolphin Court DS0000067251.V322569.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 Dolphin Court DS0000067251.V322569.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. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dolphin Court Address 9 Bulbeck Road Havant Hampshire PO9 1HN 0207 4540454 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) H4037@mencap.org.uk Royal Mencap Society Mrs Denise Jane Redman Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Dolphin Court is a purpose built service registered to accommodate twelve people in the category (YA) younger adults with a learning disability. The service is built around an enclosed courtyard and designed to be managed as three separate but adjoined houses, each with it’s own front door and separate facilities, all at ground floor level. Each house has a large lounge/dining room, quiet lounge/sensory room, kitchen and laundry room and all bathrooms are en-suite with specialist equipment installed. The home is situated close to Havant town centre, where a variety of shops and local facilities can be found. Dolphin Court is owned by the Royal Mencap Society and the Registered Manager, who is responsible for the day to day running of the home is Mrs Denise Redman. Current fees are £1,636 to £1,972 per week. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first key inspection for Dolphin Court since being registered. In preparation for the visit, the inspector read any relevant information and correspondence relating to the service and completed a planning document. A pre-inspection questionnaire was sent to the manager for completion, survey forms were sent to service users, comment cards to families and letters to two doctors and a care manager. Three cards from families were returned, making positive comments about the home. The inspector also held telephone interviews the manager of the day service used by service users and two family members, who were very pleased with the service provided. The unannounced visit was carried out at 2pm and lasted until 6pm at which time all service users were at home. The inspector made a tour of the three separate but adjoined houses that make up the service and spent time with service users and the staff members on duty in each house, observing interactions and activities. The people using the service have complex needs and many do not use verbal communication so observations were used to assess outcomes for service users. The inspector saw the main meal of the day being prepared and served and also checked the medication system and records. A care plan from each house with supporting evidence of implementation was tracked and any relevant queries were discussed with the staff team or registered manager. Three staff recruitment files were seen and were in good order. The inspector saw records for the running of the business including the complaints book, accident and incident recording, maintenance records and staff training and supervision files and held interviews with four staff members. The registered manager had completed the pre-inspection questionnaire and information from this document has also been used to inform the visit. The Registered Manager, Mrs. Redman was present for part of the time and received feedback at the end of the visit. What the service does well: Dolphin Court provides a safe, warm, comfortable, homely and well equipped home for the people who live there. Service users have access to a variety of educational and community activities and are offered fresh, home cooked food, with occasional meals out. Access to healthcare professionals is provided and support is offered in a “person centred” way in order to meet individual needs. Service Users attend the local day services, access the local community and are able to have annual holidays. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 6 The staff team are well trained and well supported and families and the staff team made positive comments about the skills and commitment of the Registered Manager. The environment has been specially designed to meet the needs of current service users and families, the staff team and manager say that the move to the new home has had positive outcomes and service users seemed very much at home. A staff member said, “ People have so much more freedom to move about and it is very much their home”. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 7 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. Dolphin Court DS0000067251.V322569.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 Dolphin Court DS0000067251.V322569.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 4 and 5 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Service users and their families have been involved in ensuring that the home meets their needs and wishes. EVIDENCE: There is a Statement of Purpose and Service User Guide in place, which give detailed information about the facilities on offer for prospective new service users and their families. All of the service users currently living in the home moved there as part of a re-provision programme and have lived together for many years. Family members confirmed that service user’s needs and wishes were assessed, with input from themselves, advocates and care managers and service users made visits to the home as the building works progressed. A parent said, “The move went very well and everyone’s feelings were taken into consideration. The service users were taken to the house to see it being built so they knew where they would be moving to. Each service user has a contract of terms and conditions of residency and three were seen during the visit. The manager of the home had signed the documents, but as good practice they should also be signed service user or their representative. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. In order to ensure that the staff team are aware of the individual needs of the people they support, comprehensive person centred care plans are in place. EVIDENCE: For each person living in the home there is a comprehensive plan of care in place which details the way each person should be supported by the staff team. Plans are very “person centred” and have been complied using information gained from assessments with input from care managers, families and other professionals involved with the home. Plans include personal care choices, risk assessments, both personal and environmental, how to manage challenging behaviour, communication profiles and short and long-term development goals with support plans for how they will be achieved. As most of the people living in the home have complex needs and use nonverbal communication, plans are drawn up in an accessible format using Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 11 pictures, photographs and symbols. Plans are regularly reviewed and updated and formal reviews are carried our every six months. A parent said, “My son has good medical care and we are made welcome in the home and involved in reviews”. Every area of individual service user’s lives are documented in the care plans and the staff on duty were aware of their contents and were involved in reviews and daily recording. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 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. Service users have opportunities for educational development and social activities and are offered a variety of fresh, home cooked meals. EVIDENCE: Most of the people in the home attend the local day services, where they are supported in a variety of activities. The manager of the day services said that there was a positive relationship with the home said that regular meetings between himself and the manager of Dolphin Court were held to discuss joint working. Each person has an activity plan in place, which includes social events, visits to families, annual holidays and days out. The staff on duty said that moving from a rural area to a town centre meant that there were many more opportunities for people to access the local community and records showed that people go to the park, seaside, swimming pool, local shops, church, cafes and restaurants. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 13 The service has two vehicles available to enable people to go out and about and people also use local taxis. One person’s plans show that accessing the community or being in crowds causes stress anxiety and this person has a plan in place for individual swimming sessions and regular in-house activities. During the visit people came home from day care happy, animated and looking forward to a cup of tea. A parent said that they were always made welcome in the home and kept informed, but said that sometimes they would like more feedback on the little positive things that happened during the week. Each of the three houses has a different four weekly menu in place, which has been devised using the likes and dislikes of each service user. The inspector saw the evening meal, which is the main meal of the day being prepared in one house and being prepared and served in the others. In one house chicken curry, rice and naan bread were on offer, spaghetti bolognaise in another and chicken in red wine sauce with rice in the third. There was evidence in care plans of input from a dietician and service user’s weights are recorded on a regular basis. Where specialist feeding methods are used, there are records to show that staff have received training from community nurses. During the mealtime, where service users needed support with eating there were sufficient staff available to support people to eat together in a homely and unhurried manner. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In order to ensure that service users are well-supported, the home works with a variety of healthcare professionals and specific training is accessed. The medication recording in one house needs to be improved. EVIDENCE: There are very comprehensive health plans in place for each service user and in order to ensure that individual needs are met, there is evidence that the home works with a variety of healthcare professionals, including the community learning disability team, local doctors, psychiatrists, speech and language therapist and nutritionists. Records show that service users have access to their own doctor and also attend the chiropodist, dentist and optician on a regular basis. The manager Mrs. Redman and the staff on duty said that the move to the new home had caused positive outcomes for service users as they had more space and freedom and records show that incidents of challenging behaviour and self-harm have dramatically decreased. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 15 The staff team in each house received training in the specific needs of the people they are supporting, for example epilepsy and autism and guidance and detailed plans are in place, which are reviewed on a regular basis. In each house medication is stored in a locked cabinet in the quiet lounge and the shift leader holds the key. A monitored dose system is in use, all staff who administer medication receive training and certificates are held on file. Medication was generally well managed and storage was clean and neat. In one house there were gaps in the medication recording sheets on one day and a Requirement has been made regarding this Standard. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are recorded and acted upon in a timely manner and the home’s policies procedures and staff training are designed to protect service users from risk of abuse. EVIDENCE: There is a complaints procedure in place and each service user has a copy in an accessible format in their care plan. There is evidence from the complaints book that complaints are recorded and acted upon by the manager in a timely manner. There was also a copy of a complaint on file that had been made by the home to an outside agency on behalf of a service user. Policies and procedures are in place regarding the protection of vulnerable adults from abuse and the staff members on duty were aware of the home’s Whistle Blowing procedure. During the last six months there have been two Adult Protection referrals made, regarding allegations of abuse to service users. Mrs. Redman confirmed that after investigations were held, one allegation was unfounded and the outcome of the second was that a staff member was dismissed and referred to the Protection of Vulnerable Adults list. All staff members receive training on abuse awareness as part of the induction process but as yet not all have attended training in the Hampshire local procedures. Mrs. Redman said that this training had been booked and all of the team were due to attend in the near future. Dolphin Court DS0000067251.V322569.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): 24 25 27 28 29 and 30 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. Dolphin Court provides an attractive, clean, warm, comfortable and wellequipped home that has been designed and built around the needs of the people who live there. EVIDENCE: Dolphin Court is a purpose built service, which has been designed and built around the needs of current service users with input from occupational therapists and other healthcare professionals. The home is made up of three separate but adjoined houses, each with it’s own front door and managed as a separate unit within the service. Each house has a large lounge/dining room, an additional quiet lounge/sensory room, well-designed kitchens and well-equipped laundry. The standard of building and décor and are of very high quality and the houses are light and airy with attractive good quality furnishings, ornaments, pictures and widescreen televisions. Each house has an enclosed garden area, wide corridors Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 18 and aids and adaptations such as handrails and grab handles are fitted to aid mobility. There is also a separate unit, which contains the main office and staff training room. Each service user has a large bedroom designed around their specialist needs and all were very homely and individual with personal possessions such as televisions, music and sensory equipment, fish tanks, ornaments and lots of photographs of families and friends. All bathrooms are en-suite and some contained specialist baths and other equipment in order to meet the specific needs of each person. The home is situated in a busy town but gives the appearance of being isolated from the community by there being a large, solid, electric sliding gate in place. The Registered Manager Mrs. Redman said that because of the vulnerability of service users on the busy main road, there was a need to keep people safe but there was a future plan in place to replace the solid gates with a more open wrought iron type. Service users moved freely about their houses and seemed very much at home and the staff said they had settled very quickly following the move. Each house has a regular maintenance plan in place and the service was clean and hygienic throughout. Dolphin Court DS0000067251.V322569.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): 32 33 34 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a competent, well-supported and trained staff team and are protected by the home’s robust recruitment procedures. EVIDENCE: Each of the houses in the service is separately staffed, with a deputy manager responsible for the day to day running of each house. Staffing rotas showed that there were a minimum of three people on duty in two of the houses and a 1-1 ratio of four people in the third in order to meet service user’s complex healthcare needs. During the night, each house has one person awake with a sleep in person to provide on call cover across the three houses. The manager’s hours are in addition to the rota. All of the staff team have attended an intensive six-week induction during which time they received mandatory training. In each house service user specific training is also accessed including autism awareness, deafness awareness, challenging behaviour and Strategies for Crisis Intervention and Prevention. Mrs. Redman said that the local community learning disability team provides training specific to individual service users and evidence of this Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 20 was seen in care plans and records. All staff members have a training plan and records of training are kept on file. The manager said that 44 of the staff team hold NVQ2 or above and several others are working towards gaining the award. Deputy managers also hold or are working towards NVQ4. One of the deputy managers said, “ I see my job as trying to be a good role model and helping the staff team to work in a pro-active way to support service users”. The staff members on duty were friendly, kind and patient in their dealings with service users and displayed an awareness of people’s individual needs and communication methods. For each staff member there is a supervision and development plan in place and records of supervision are kept on file. In order that service users are protected, there is a robust recruitment procedure in place. Three staff files were seen all contained the required documentation including current Criminal Bureau Checks and two references. There was also evidence of specialist support being accessed to enable staff members with disabilities to undergo training and take a full part in the team. Dolphin Court DS0000067251.V322569.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): 37 38 39 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed by a committed and capable manager and policies and procedures are designed to protect service users and enhance their lifestyles. EVIDENCE: The Registered Manager Mrs. Redman hold the Registered Managers Award, NVQ 4 in Care and also attends further training and seminars in order to update her skills and knowledge. Families and staff members said that Mrs. Redman was committed and caring and managed the home in an open and inclusive manner. Comments included, “We get lots of support and the manager is always willing to help” and “ The manager is approachable and very supportive”. There is no formal quality assurance process in place as yet but Mrs Redman has written to the families of service users asking for feedback on the move to Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 22 the new home and how people think service users have settled. There are a number of very positive responses on file and families say they have seen a marked improvement in the quality of the service provided. Mrs. Redman said that a full quality assurance process, using Mencap’s organisational procedures, would be implemented at the end of the home’s first year. Area managers carry out regular Provider visits and action plans resulting from these visits were seen during the visit. Each house has a copy of the service policies and procedures and during induction staff members sign to say they have read them. At the present time the registered manager acts as financial appointee for the service users in the home. As good practice, the possibility of service users having independent appointees or legal representatives was discussed. Mrs Redman said that this was already under consideration. Where the service hold monies on behalf of service users, records and receipts are kept and each person has a locked cash box safely stored in the home. A sample was checked in each house and found to be correct. Records for the running of the business were seen including maintenance, fire, accident and incident and health and safety files and all were current and in good order. Dolphin Court DS0000067251.V322569.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 3 2 3 3 3 4 3 5 3 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 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 X 3 3 3 x Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA5 Regulation 13 (2) Requirement In order that the terms and conditions of the home are clearly communicated, the service user or their representative as well as the registered manager, should sign contracts of residency. In order to ensure that service users are protected from risk of a medication error, records should be kept completed and current at all times. Timescale for action 15/02/07 2. YA20 13 (2) 15/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA42 Good Practice Recommendations In order to ensure that the management of service user’s finances are from an independent source, the home should consider the use of legal advisors or advocates. Dolphin Court DS0000067251.V322569.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Dolphin Court DS0000067251.V322569.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. 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