Inspection on 25/09/06 for Durban House

This inspection was carried out on 25th September 2006.

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

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

Other inspections for this house

Durban House 11/09/09

Durban House 09/10/08

Durban House 28/08/07

Durban House 06/02/06

Durban House 10/10/05

Durban House 19/01/05

Durban House 24/05/04

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

CARE HOMES FOR OLDER PEOPLE Durban House Hodgsons Road Blyth Northumberland NE24 1PN Lead Inspector Suzanne McKean Key Unannounced Inspection 25 September 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 DS0000000507.V295568.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. DS0000000507.V295568.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Durban House Address Hodgsons Road Blyth Northumberland NE24 1PN 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) 01670 - 354181 01670 362236 durban.house@ashbourne.co.uk Exceler Healthcare Services Limited Mrs Ann Mielnik Care Home 50 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (45) of places DS0000000507.V295568.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user is under 65 years of age. The Commission for Social Care Inspection must be notified immediately should this service user leave the home so that this condition can be removed. 6th February 2006 Date of last inspection Brief Description of the Service: Durban House two-storey building of traditional brick and tiled roof construction. It has a car park to the front of the building, which allows level access to the main entrance. The home is situated in a predominantly residential area with easy access to the centre of Blyth town with its shops and other public amenities. It is also on a main bus route being only about one mile from the main bus terminal. The home is registered to provide care to a maximum of forty-five service users within the category of Nursing and Social Care for people who have dementia. The home also has a small unit registered for adults who in addition to the registered category also have learning difficulty. The home charges fees of between £383.52 and £555.62 per week depending upon the needs and requirements of the individual residents. As the home provides nursing care the free nursing care element of the funding is provided in addition to the costs charged to the resident. The home provides information about the service through the service user guide and a copy of the last inspection report from The Commission for Social Care Inspection is available in the entrance to the home. DS0000000507.V295568.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a total of 10 hours during two visits. Nine residents and five staff were spoken to and others chatted to briefly. Four relatives were spoken to directly although others were in the home. Four care plans, training records and records for medication were examined. Also staff files, training records and health and safety documentation was looked at. There were no requirements or recommendations made at the last inspection. During an additional visit a requirement was identified for all staff to use safe moving and handling methods at all times. This was met by providing additional training and increased monitoring. No requirements were made following this inspection. What the service does well: What has improved since the last inspection? There was one requirements identified at the last inspection and this was to ensure that all staff had received raining in moving and handling service users The standard of decoration has continued to improve and is now a good standard. Recent introduction of coloured bedroom doors, corridor pictures and interest boards assist in making them more interesting to the resident. The number of social activities offered has been significantly increased since the last inspection with a large variety of choices available. DS0000000507.V295568.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000000507.V295568.R01.S.doc Version 5.2 Page 7 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 DS0000000507.V295568.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4 & 6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are admitted into the home after they have had a comprehensive assessment by the home staff. This then forms the basis for the development of the care plan. Residents are given information to show that they can be cared for by before they move in. The home does not offer intermediate care. EVIDENCE: Four care plans were looked at and each contained a comprehensive preadmission assessment. The Manager or the senior staff had carried this out. The records are detailed enough to form the basis of the care planning. They use a variety of sources for the information including the people close to the resident, including their carers or relatives. Information is also recorded sent from the hospital or a care home if the resident was in one at the time of the admission. The information depends on where the resident was at the time the assessment was carried out. DS0000000507.V295568.R01.S.doc Version 5.2 Page 9 The care plans also contained a care management assessment, provided by the residents Care Manager who works for the Social Services department. This is information is given to the home on, or just before admission and from all of these documents an individual care plan is developed. DS0000000507.V295568.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. All resident have a care plan and the care is given as it describes in these plans. The residents are having their needs met. They are being given their care with respect and in privacy. The residents receive their prescribed medication according to safe working practices. The medicines in the home are well managed and safely disposed of as necessary. EVIDENCE: Every resident has a care plan. Four care plans were looked at closely during the visit and were completed to a good standard. These care of the four residents whose care plans was looked at as part of the inspection and was appropriate to their needs. Relevant risk assessments are completed for, prevention of falls, wound care, moving and assisting, and continence promotion. There is an assessment to look at the resident’s food and fluid intake and if needed a plan is then drawn up to prevent any further weight loss. This included in one care plan getting advice from a dietician and speech DS0000000507.V295568.R01.S.doc Version 5.2 Page 11 therapist and in another speaking the residents General Practitioner. See standard 15 for information about the changes the Manager has introduced regarding residents dietary needs. The care plans are regularly looked at make sure they are still accurate. They are also brought up to date by checking them with the residents and or their relatives or representatives. The care plans showed that the home staff make sure that the residents use NHS services and facilities if they need to. There is a good range of pressure relieving mattresses to reduce the risk of resident getting pressure sores. The pressure mattresses in use are labelled with the resident’s name, and their weight to make sure that it is set correctly for them. Records of what the nurses are doing to treat wounds were good with evaluations being dated and signed. Staff get expert advice for wound care for individual residents. This suggests that they are making sure that they are using best practice in wound care. The home also gets specialist advice for residents with different conditions for example physiotherapist or occupational therapist. Medicines management was appropriate. The staff record the medicines correctly when they are ordered. The prescriptions are then checked when they are received in the home from the General Practitioners and are then sent to the Chemist for dispensing. The medicines that are sent from the pharmacy are then again checked against the record of what was ordered and prescribed so that any errors can be picked up. There are no residents who manage their own medication. DS0000000507.V295568.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgment has been made from evidence gathered both during and before the visit to this service. The residents are offered a variety of social activities and are encouraged to take part in those they find interesting and able to take part in. The residents are being encouraged and supported to maintain contact with their families. The residents are given a balanced, nutritious diet given at appropriate times in a satisfactory environment EVIDENCE: There are changes being made to the care plans to further develop the way the social needs of the residents are recorded. The manager explained that this is so that they will have more detailed information about the residents past life, experiences and aspirations. She said that this would give information to help them to find activities the residents would find interesting. This will also give the staff suitable topics of conversation to make day-to-day conversations more relevant to the individual resident and make them feel more valued. The Manager has arranged for each of the care staff to collect this information. These are not yet available although a social care plan is in the care plan, which meets the standard. DS0000000507.V295568.R01.S.doc Version 5.2 Page 13 The care plans are regularly looked at to make sure they are up to date. This is done involving the resident and or their representatives. The residents’ bedrooms were personalised according to the taste of the resident and where possible they are asked to choose decoration when it is necessary to redecorate. Two residents asked about their bedrooms said they were happy with the decoration and that they had a lot their own personal items around them. There are few residents who could say how they are encouraged to take control of their daily routines. However, the care plans have information about their past lives so staff know the way they chose to live prior to admission into the home. This includes the time they prefer to get up, what and when they eat and how they spend their time. There are a lot of organised activities taking part in the home. These are advertised on the walls in both writing and pictures, some have items attached to the board to show the activity for example cooking utensils for the cookery activity. Examples of the activities are Arts and crafts, Pie and Pea supper, cheese and wine parties, Prize bingo, and weekly trips out in the mini bus, and baking days. These are available to all residents and relatives are invited to take part. Staff said that residents could choose if they want to take part. The staff write in the care plans if the resident has taken part and if they enjoyed it. Depending on the resident’s dependency level and ability to take part they may be offered less active and more “one to one” activities. The Manager and staff work hard to make sure that residents maintain their contact with their families. This is particularly evident where a resident has a partner/husband/wife. Two relatives said that on their wedding anniversaries the home arrange a celebration for them and there is always a present bought for them on behalf of the resident. The resident is also given flowers and or chocolates or something they would enjoy. The relatives also said that at holiday times they are encouraged to be with their partner to have meals and spend time together. Cards and presents are exchanged at these times even though the resident may no longer be able to manage this themselves and rely on the staff to do it for them. This is funded by the home. Residents have visitors at any time and are able to use their own rooms, or the lounges to see them. Four relatives said that they are welcomed into the home; they said they were given information within the residents’ guide about visiting arrangements. Residents said they were happy with the arrangements for visitors. The Manager has recently found that some residents were loosing weight. Although this is found in some residents with chronic conditions she has taken action to change practices in an attempt to improve the residents food intake. This has meant changing the layout of the lounge and dining room, which has DS0000000507.V295568.R01.S.doc Version 5.2 Page 14 not yet been completed. The residents are now eating their main meals in two sittings so that the staff can spend more time with residents who require assistance. Also the residents are no longer being asked the day before for their choice of meals (there is two choices for the main meal) but are being shown the meals at the time of serving. When the resident sees and chooses the one they prefer a meal is then plated for them of the appropriate portion size specifically for them. If the meal shown is of the appropriate choice and size it is given to them on choosing it. This allows choice and portion control. The effectiveness of these changes is to be determined by the Manager so that she can further change it if necessary and or maintain the changes if they are effective in increasing the diet intake of the residents. The morning “tea trolley” offered a varied selection of both fluids and food. There was tea, coffee, choice of four cold drinks including Cranberry Juice, and milk. There were biscuits, T cake, and small snack sized sandwiches. There was a selection of fruit available including banana, apple, grapes, and orange. These were prepared by peeling if necessary and then chopping it into small bite size pieces. Each resident was given a small selection of the snacks on a plate, so that the resident could pick from the plate the things they wished to eat and did not need to choose prior to serving. The manager agreed that small tables next to the resident’s chairs would offer them somewhere to put teacups and plates. Cooler jugs and glasses are kept with a choice of juices in the lounges and residents were being given drinks during both of the visits. DS0000000507.V295568.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The residents and relatives know about the complaints policy and how they would make a complaint. There is a good system for managing and dealing with complaints. It makes sure that they can react and take action as necessary to improve the service. The residents are protected form abuse by staff training, recruitment and selection and effective documentation and training. EVIDENCE: The complaints procedure is available in the service users guide and a copy is displayed in the home. The record of complaints made and investigated was looked at. There have been eight complaints received in the last twelve months. The record of these was detailed and it included the response to the complainant. It also identified if any action was taken to improve the service as a result of the issue being raised. The Manager records all expressions of concern so she can use the information in the companies quality assurance system. There is also a mechanism for analysing the complaints and a monthly report is sent to headquarters to that the company can monitor it centrally. There have been two protection of vulnerable adult investigations in the last twelve months. One of the issues was raised by the Manager and the other by a visiting professional. Both of these have been resolved and the manager has taken action to make sure that they have learned lessons from the issues DS0000000507.V295568.R01.S.doc Version 5.2 Page 16 being raised both in improving the documentation and changing practice as necessary. Three relatives who were visiting the home were aware of the complaints procedure but had not needed to use it. Staff are given protection of vulnerable adults training both as part of the inhouse training package as “Residents welfare training” and from external Northumberland Care Trust. The Qualified nurses also have more extensive training in this area, as they are responsible for being the “person in charge” of the home when the Manager is not present. DS0000000507.V295568.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 22, 24, 25, 26 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home is clean and well organised and the staff are knowledgeable regarding the ways to prevent the risk of cross infection in the home. The environment is well decorated and maintained. Good records are maintained of the health and safety practices and maintenance of the building and facilities. EVIDENCE: A tour of the home was conducted both with staff and alone; the home is clean and was odour free on the day. The residents’ and relatives who were asked about the bedrooms said they were happy with the decoration and that they were kept clean by the staff. The bathroom and toilet areas were tidy and clean. The laundry was clean, organised and well equipped. The sluices were tidy, clean and odour free and the disinfectors operational. Staff follow infection control policies and use appropriate equipment. The kitchen area was DS0000000507.V295568.R01.S.doc Version 5.2 Page 18 clean and well organised and there is an up to date cleaning schedule which identifies all areas to be cleaned, how often they are completed and who was responsible for undertaking it. There have been significant improvements to the décor in the home. There are areas, which have been made into small sitting areas, including the entrance. The corridors are decorated with three-dimensional pictures including activity boards with items, which can be touched and have different textures and items to stimulate and add interest to the environment for the residents. There are two doors, which have full size pictures of a telephone box. On asking a resident what he thought of his bedroom his visitor reminded him of where it was by describing that it as being next to the telephone box, he recognised this as being the case. Items such as hats, and ornaments are around the home and are picked up by the residents and moved about. Resident bedrooms have a “front door” appearance with a brass door number, door knocker and a letter box, they also have a sign next to the door, with a picture of the resident and sometimes one of them when they were younger as well as a picture of something the resident is interested in for example dogs or flowers. Bathrooms were pleasantly decorated and tidy. DS0000000507.V295568.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. 28, 29 & 30 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The home has an effective recruitment and selection system, which ensures that residents are cared for by well-trained, skilled staff and are in safe hands. The training programme is up to date for all staff and a large amount of training is being given to the staff in health and safety, as well as statutory and clinical areas of practice. EVIDENCE: Staff records are completed according to the company policies and procedures, including two references and a completed application form. The requirement to have a CRB and POVA check is applied to all of the staff in the home. On both of the visits there were sufficient staff to meet the needs of the residents. The first day of the visit there was the Manager, two qualified nurses, five carers, one domestic, the cook, one kitchen assistant, and the administrator. The training records kept by the Manager so that she can plan training was looked at. It was very clear and offered a good system. There is a large amount of training in both statutory and clinical areas and all staff are now receiving training in line with the company policy and statutory requirements for moving and handling and fire training. DS0000000507.V295568.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The Manager, Mrs Mielnik, has systems in place to manage the home effectively taking into account the needs and wishes of the residents. The home effective health and safety systems, which include staff training and risk assessments. Staff receive supervision at least six times a year. Resident’s personal finances are managed appropriately. EVIDENCE: There is a system and records to review health and safety; it involves all of the staff. There are records of regular staff meetings and the contents suggest that there is broad spectrum of relevant issues discussed. Those staff unable to attend these meeting are required to look at the notes from the meetings to make sure they are up to date with the information they need. Mrs Mielnik has DS0000000507.V295568.R01.S.doc Version 5.2 Page 21 weekly head of department meetings and these are used to set targets depending upon the changes or improvements needed. The Manager also arranges meetings with the relatives and residents as appropriate. The Manager continues to consult the residents, staff and other interested parties to review the service provided and manage the staff in a way to improve care delivered. The Manager has recently used resident and relative questionnaires to find out their opinions on the home. The relatives were given them to complete themselves. The residents were asked for their views individually by the activity coordinator asking set questions and the responses were recorded. This was either their verbal reply of any facial expressions or reactions without a judgement being made. The Manager then interpreted the outcome of the questionnaires as part of the quality assurance process. The responses form all of the questionnaires were anonomised, and put onto the wall as part of a display. Positive feedback displayed on one side and negative ones on the other side. The ones, which identified any concerns, were also displayed with a response as to how the home was improving around these issues. Regular audits are carried out in a number of areas. These include Medication; care planning and nursing documentation, kitchen, and domestic audits. These are ongoing and are used for quality assurance at both the local home level and by the company. The personal records kept in the home of residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. There is a system in place to review health and safety in the home involving the staff for which records are available. Training records around health and safety are in place and are up to date. The staff are given supervision six times a year and as well as the core issues discussed the Manager uses them to focus on improvements being made to ensure that staff are aware of the changes and understand them. DS0000000507.V295568.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 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 DS0000000507.V295568.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000000507.V295568.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 DS0000000507.V295568.R01.S.doc Version 5.2 Page 25 - 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!