Inspection on 03/03/06 for Falkner Square 12

This inspection was carried out on 3rd March 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Falkner Square 12 23/04/08

Falkner Square 12 21/08/07

Falkner Square 12 18/07/06

Falkner Square 12 24/11/05

Falkner Square 12 07/01/05

Falkner Square 12 17/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Falkner Square (11/12) 11/12 Falkner Square Toxteth Liverpool Merseyside L87NU Lead Inspector Lynne Lynch Unannounced Inspection 3rd March 2006 10:00 Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 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 Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 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. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Falkner Square (11/12) Address 11/12 Falkner Square Toxteth Liverpool Merseyside L87NU 0151 330 9540 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) www.peterhouseschool.org Autism Initiatives Ms Jane Troy Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 11 learning disabilities (18-65 years) and 1 named young person with a learning disability under the age of 18 years. That the registration reverts back to 12 persons with a learning disability (aged 18-65) on 19 December 2002. 24th November 2005 Date of last inspection Brief Description of the Service: 11 and 12 Falkner Square is a care home registered with the CSCI to provide accommodation and care for up to 12 adults with a learning disability. The home is part of a network of homes managed by Autism Initiatives. 11 and 12 Falkner Square is situated in the Toxteth area of Liverpool and is close to local amenities, bus and rail routes. 11 and 12 Falkner Square are separate units, which are both accessible via doorways from the main street. 11 Falkner Square is currently an assessment facility for young adults with Aspergers Syndrome. 12 Falkner Square provides care for young adults with Autism. Briefly, the building comprises of three floors with the ground floor providing kitchen, W.C, office and communal space and the first and second floors providing service users’ bedrooms, bathing, W.C, and staff sleep in facilities. The laundry provision is located in the basement area. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced, started at 10.00 am and took place over five and a half hours. At the time of the inspection there were 8 people resident within the two houses, however not all were in the building as some of the service users were on home visits. The inspector spoke with four members of staff including the team leader on duty for 12 Falkner Square. All the people living at the home have either Autism or Aspergers and therefore have specific communication needs making discussion with these individuals limited. The team leader of 11 Falkner Square was not present. Care plans, Risk assessments, health records, activity plans and some of the written policies were viewed. Comment cards were issued prior to this inspection with three being received back from both relatives and service users. What the service does well: What has improved since the last inspection? The unit manager’s post has been advertised with interviews planned to take place within weeks of this inspection. Some of the environmental issues raised at the last inspection have been dealt with and plans for carpet replacement and redecoration are in place to commence on the 8/03/06. Training has been planned on respect of the protection of vulnerable adults and positive intervention. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 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. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected at this visit EVIDENCE: Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Individual care plans and are reviewed People are supported to make decisions and risks are assessed and managed in such a way as to maximise independence. EVIDENCE: Each person has a named key worker. An individual care plan with each area identified having a support plan, detailing the practical support required is in place. These had recently been reviewed and staff confirmed that the organisation’s policy is to review each support plan at least every six months. The team manager explained that there would be an annual review with the family and social worker, which will consider long-term goals and future plans. The internal monthly reviews provide good opportunities for any changes and practical needs to be addressed. The organisation has a written policy regarding service user rights, which includes the right to be consulted and to make decisions. Decision-making and how individuals make choices are addressed within the care plans. Regular meetings are held for the people living on 11 Falkner, where views and opinions can be shared, however this approach is not suitable for the people living on 12 Falkner due to their socialisation and communication needs. Any limitations or restrictions are Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 10 agreed via the care planning process, made only in the person’s best interests and follow a risk assessment process. From discussions with staff working at the home and comments made on comment cards by service users it is clear that choice and decision-making are supported, such as choosing holidays, activities and decoration within the home. Risk assessment and risk management are addressed within each care plan, with specific guidance provided for staff. The file for one person shows that guidance is in place regarding one gentleman going out, with specific advice in respect of his behaviour and mental health difficulties and the need for increased support in this area whilst his confidence is regained. Staff clearly balance the need for independence with the need for safety, as reflected in the individual arrangements for the different people living at the home. One relative via a comment card said, “I am generally very impressed with the level of care”. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15 and 17 Individuals are involved in a range of meaningful activities, including household activities, which promote personal growth and independence. EVIDENCE: The people living at the home have complex needs, including specific communication needs and challenging behaviour, which limit opportunities for employment. However, two of the gentleman attend a workshop and plant nursery, where they are supported to develop work related skills. Individuals are involved in a range of appropriate activities and staff work hard to help people to grow and develop skills. Set activities include college attendance, horse riding and visits to local cafes or pubs in the area. The daily handover sheets show which staff member is supporting each person with set activities, such as college attendance. Each person also has a weekly chart, which is completed with the individual on a Sunday detailing household tasks and pre-arranged activities for that week. Records show that individuals are supported to access a range of community facilities. On the day of this inspection there were several of the people engaged in planned activities or on home visits. The home has its own vehicle provided by the organisation. The Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 12 rotas show that there are generally sufficient staff on duty each day, to enable individual activities to take place. Some people require the support of two staff for certain activities. Some of the people currently living at the home can display difficult and challenging behaviour, which limits the occasions they can access the community and can place staff in difficult situations whilst support is being given in a community setting. The health and welfare of staff in these situations was discussed with the Team Leader. The inspector suggested that the staff should carry contact cards that could be issued to members of the community should they be effected by a service users behaviour to ensure that a situation can be effectively diffused without staff being at risk. She advised that this was something that the organisation had done in the past and would be worth introducing again. Excellent support is provided to ensure that individuals are fully involved in the day-to-day routines of the home wherever possible, however this involvement is dependant on the persons mood. Staff have good guidance in place to advise when and how to approach people. One gentleman in the home is reluctant to take part in any form of activity during certain hours of the day and staff are slowly working with him to encourage him to break this very limiting habit. Good records are kept, with staff completing daily sheets, showing the level of involvement in activities such as, cooking, setting the table, doing laundry etc. All household activities are arranged around the needs of the people living at the home. Each file contains guidance and protocols for supporting individuals with household activities, such as cleaning bedrooms. Independence in daily routines is supported and actively promoted at all times and this was observed during the inspection. Staff have built up close working relationships with the people living at the home particularly on 12 Falkner where communication and social interaction is more difficult, and they promote choice and independence within their day-to-day work. There is a range of communal space within the home, which, allows for individuals to spend time alone, should they choose to do so. Most of the people currently living at Falkner Square need full support in keeping contact with friends and relatives, many of whom live a distance from the home. Records are kept of all contacts with family and friends, and each file contains a list of significant dates such as birthdays. One person is supported to visit his mother on a weekly basis and stays overnight. Some of the other people in the home also go home to visit relatives. One gentleman visited relatives abroad over Christmas with his father. Records also show that people have many opportunities to make new social contacts outside of the home. On the day of the inspection two relatives contacted the home via telephone and were given good detailed information about their relatives progress and one was assisted to arrange a visit to the home. One relative via a comment card said “The standard of care given and the progress made is excellent, they are an excellent team”, another commented “a well managed good team of staff, who work well together, my son is happy there”. Food preferences, likes and dislikes are recorded on care files. Staff clearly know the people at the home very well and are aware of their favourite foods Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 13 and dislikes. A member of staff explained the meal arrangements for the day and how people on 11 Falkner prepare there own meals and have free choice each person has a lockable cupboard for their own food. People on 12 Falkner generally share the same meal which is prepared by staff with help from the service users who are able, however there is always choice available for anyone who does not like the meal being prepared. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Personal care is provided in the way individuals prefer. Health care needs are met. EVIDENCE: Some people living at the home require support with maintaining personal care. The staff have got to know individuals extremely well and understand their needs and preferences. Each person has a personal support assessment. Files show that individual protocols and guidance are in place, regarding such activities as bathing, shaving and teeth cleaning. Service users are supported to choose there own clothes wherever possible, everyone in the home was well dressed and well presented on the day of the inspection. Times for going to bed and getting up are flexible, according to the needs and preferences of each individual. A medical profile is completed for each person, providing details of past illnesses; allergies etc and staff sign to confirm that they have read this information. Staff keep good records of all health care appointments and outcomes. For one person this has included a recent medication review and specialist mental health support. There is good evidence that staff are working closely with the GP in relation to medication changes. There was evidence on one service users file of clinical psychology input in relation to a possible move Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 15 to a new care facility nearer to his hometown. The team leader advised that the organisation had a clinical team to give staff advice and support. There was evidence on files of psychology, language therapy and psychiatric support being accessed. A member of staff spoken to advised that the home has a good working relationship with a local dentist who understands the service users needs and limited toleration of procedures. There was clear evidence on files of optical and chiropody services being accessed on a regular basis. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected at this visit EVIDENCE: Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected at this visit EVIDENCE: Although none of the above standards were inspected, the following observations were made. A new cooker had been installed in the kitchen of 11 Falkner and plans were in place to replace carpets and redecorate the areas highlighted within the last inspection. This work was planned to commence on the 8th March 2006. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected at this visit EVIDENCE: Although none of the above standards were fully inspected, the following records were viewed. Recruitment records for staff working on 12 Falkner were viewed however records for 11 Falkner were not accessible at the time of the visit. Therefore the inspector was unable to ascertain whether recruitment procedures had been followed and Criminal Records Bureau Clearance obtained for staff on that unit. The Team Leader on duty was advised that as per Schedule 2 of the National Minimum Standards these documents must be available for inspection. The documents viewed on 12 Falkner in relation to recruitment were appropriate with Criminal Record Bureau Clearances for all staff employed on this unit. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of the above standards were inspected at this visit EVIDENCE: Although none of the above standards were inspected, the following information has been received. The organisation was due to carry out interviews for the post of unit manager during the week following this inspection. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X X X X X X Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA23 Regulation 18 Requirement The registered person must continue to make adequate arrangements in order that all staff receive appropriate and adequate training in relation to managing challenging behaviour. (Previous timescale of 31/03/06 not met) The registered person must make adequate arrangements for training in respect of protection of vulnerable adults (Previous timescale of 31/03/06 not met) Timescale for action 31/05/06 2. YA23 13(6) 31/05/06 3. YA24 23 The registered person must 31/03/06 ensure that the necessary action is taken in relation to the following: The painted walls were marked in the ground floor corridor and stairs leading to the first floor, entrance hall wallpaper ripped. The dining room wallpaper had a number of rips above the radiator and marks on the wall. The first floor corridor carpet had some staining and an iron burn. Gs room had a missing DS0000025344.V283367.R01.S.doc Version 5.1 Page 22 Falkner Square (11/12) washbasin door. The ground floor lounge wallpaper was damaged and the room was sparse, the gas fire had been disabled and there was only a small radiator to heat the room. D’s bedroom stain remains on the ceiling following a leak. 1st floor shower room damage to wallpaper near show due to damp, ceiling damaged due to a possible leak. P’s room damage to ceiling, mirror missing from wall with exposed plaster. First floor bathroom/toilet - expel air requires cleaning clogged up with dirt, cobwebs hanging from ceiling, bath side panel warped and damaged. 2nd floor N’s room walls require redecorating, very sparse room furniture old and inappropriate for bedroom, carpet in room very badly stained, radiator rusting, paintwork very dirty. Stairs to attic badly stained. C’s room sink damaged and unit needs replacing, carpet badly paint stained needs replacing. Laundry wall damaged behind washing machine, drier not working, ceiling water damaged needs repair. No11 The first floor hallway carpet was stained in various places and was lifting at the join been sellotaped down still poses a risk. The stair landing rails and stairway walls were significantly marked. The stair carpet was found to be very stained. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 23 The ground floor corridor carpet was found to be worn near areas around the office and kitchen Shower room 1st floor, tiles loose taped on at the moment need replacing, very damp smell in room flooring mouldy needs replacing. Top stairs carpet creasing in several areas if left unattended will become worse and pose a risk of tripping. Stairs leading to attic badly stained. T’s room carpet badly stained needs replacing. Two walls on the 1st floor had holes in them. The lounge walls need repainting; the ceiling is stained and requires attention. A cooker in the kitchen is still out of order and has been for a considerable amount of time, thus restricting the cooking facilities available, the ceiling is damaged and the towel rail has been pulled off the wall. The general standard of accommodation particularly bedroom areas are poor the inspector appreciates that some individuals can cause damage, however this does not excuse the non-action in this area despite requirements made. Standards are not being met and further deterioration is noted. Staff advised that requests for redecoration and repairs have not been acted upon. 4. YA34 19 schedule 2 Records of all staff employed should be available in the home and meet Schedule 2 of the Care Home Regulations 2000. 31/05/06 Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 24 5. YA37 8 and 9 The registered person must 31/05/06 ensure that a manager is appointed to manage 11/12 Falkner Square and that a registered manager application is submitted to the CSCI. (Previous timescales of 07/02/05 and 30/01/06 not met) 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 YA2 Good Practice Recommendations It is recommended that the staff who have responsibility for delivering direct care be involved in initial assessment procedure, as it would further ensure that the prospective service users needs can be fully met. The homes complaint procedure should contain the contact details for the Commission for Social Care Inspection and contact names for the organisation should be updated. A domestic staff should be employed to support care team staff in maintaining hygiene standards in 12 Falkner Square. The home requires an intensive cleaning programme to ensure areas previously neglected are in a position to be easily maintained. At least 50 of care staff should be qualified to NVQ Level 2. Care staff in the home must receive appropriate training and clear records be maintained of qualifications held. Staff should be given formal recorded supervision at least six times a year. DS0000025344.V283367.R01.S.doc Version 5.1 Page 25 2. YA22 3. YA24 4. YA30 5. 6. 7. YA32 YA35 YA36 Falkner Square (11/12) 8. 9. YA39 YA13 An annual development plan should be available to the management staff of the home. Staff should carry contact cards that could be issued to members of the community should they be effected by a service users behaviour to ensure that a situation can be effectively diffused without staff being at risk. Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS 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 Falkner Square (11/12) DS0000025344.V283367.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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