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Inspection on 23/10/06 for Favorita House

Also see our care home review for Favorita House for more information

This inspection was carried out on 23rd October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is clean, well maintained, and odour free. The majority of service users are happy and content and comments included, ""I like it here", and "I`m so grateful, they are so good for me". Visitors are made welcome and commented, "Its good, its like a big family", "When we walked in here we thought this is the place for us", and "I would recommend it to anyone, I would give it 5*". Staff are well trained with 70% currently having obtained NVQ level 2 or above.

What has improved since the last inspection?

Medication practices have improved since the last report and all staff who administer medication have now received appropriate training.

What the care home could do better:

In the interests of infection control the home are recommended to provide a washing machine with the correct infection control and sluicing programme. It is also recommended that a sign be placed on the washing machine in the kitchen reminding staff that this machine is to be used solely for the washing of tea towels and kitchen aprons, and that staff be reminded that no laundry should be taken through the kitchen.

CARE HOMES FOR OLDER PEOPLE Favorita House 28 Canterbury Road Herne Bay Kent CT6 5DJ Lead Inspector Chris Randall Key Unannounced Inspection 23rd October 2006 09:10 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 Favorita House DS0000023411.V306092.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. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Favorita House Address 28 Canterbury Road Herne Bay Kent CT6 5DJ 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) 01227 374166 Mr Kevin Gordon Post Mr Peter Post, Mrs Teresa Post Mrs Pauline Anne Gough Care Home 16 Category(ies) of Learning disability (1), Old age, not falling registration, with number within any other category (15) of places Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 person has a learning disability has a dob of 16/11/44 Date of last inspection 8th December 2005 Brief Description of the Service: Favorita House is registered to provide care for up to 16 older people. There is also a condition of registration which enables them to care for one service user with learning disabilities. The home is located on the main road into Herne Bay. Local shops and the sea front are all close by and local transport is easily accessible. Although there is on street parking outside the home this is restricted to 1 hour. There are 14 bedrooms including 2 that are registered for double occupancy but these are currently used as singles. The home is laid out over 2 floors and there is a stair lift available to access the upper floor. Communal facilities include 2 lounges, one with a small dining area; a dining room; and a small conservatory where at present smoking is allowed. The current fees for the service at the time of the visit range from £303.25 to £450 per week. Information on the Home’s services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address of the home is admin@favorita.co.uk Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on information gained from a pre-inspection questionnaire completed by the manager; a survey of a sample of next of kin and care professionals; and an unannounced sit visit to the home of just under 7 hours. The site visit included a tour of the building; observation of the interactions between staff, service users, and visitors; discussion with the manager and the provider; discussion with service users, visitors, and staff; inspection of a variety of records; and observations of a mealtime, administration of medication, and various other practices in the home. What the service does well: 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. 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. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 6 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 Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have their needs assessed; are issued with sufficient information, including a contract; and are able to have a trial visit; in order to make an informed choice about admission to the home. This home does not offer intermediate care facilities. EVIDENCE: All service users are issued with a contract that states the room to be occupied, the fees payable, any additional charges, and responsibilities of the home and of the service user. The manager and provider visit prospective service users to undertake a thorough assessment of their needs, and to ensure that the home are able to Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 8 meet these needs, prior to admission. Joint assessments are also obtained for service users who are care managed. The home does not offer any specialist services, other than being registered for one service user with learning disabilities whose needs are being met by the staff team supported by the community multi-disciplinary team. When specialist services are needed these are accessed from the community. Prospective service users are invited to the home for a trial visit and can stay for a meal if they wish. The first month of occupation is classed as a trial visit and this is clearly indicated on the contract. The home does not offer the facility of intermediate care. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have their health and personal needs recorded in their care plans; the staff supported by a multi-disciplinary health care team meet their health care needs; their medication is dealt with appropriately; and their privacy and dignity are upheld. EVIDENCE: Each service user has an individual and person centred care plan, which is reviewed monthly. The care plans include various risk assessments; information on things the service users are able to do and things they would like help with, and details of their activities, hobbies and past times. A nutritional assessment is completed and weights are recorded monthly. Visits to doctors and other health care professionals are recorded, and a daily report is completed at least twice daily. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 10 The home promotes and maintains service users health. District nurses visit when needed to assist in the care of service users who become more dependent or who have the need for their input. Any suspected pressure areas that are identified they are reported to the district nurses who give assistance and support. One service user has been provided with an electric bed, pressure relieving mattress, and cot sides. A service user was observed being assisted to go for a bath and on return to the lounge she said how much she had enjoyed it. Signs of well being were observed from the majority of service users, although a newer service user was obviously having difficulties coming to terms with the necessity to live in a care home. Service users commented, “They look after me”, and “they look after me properly”. When visitors were asked what they thought of the care in the home they commented, “its very good care”, and “Good, its like a big family, within 2 weeks of being here she was so much better”. Care professionals surveyed indicated that they are satisfied with the care provided, and a family member surveyed commented, “I know she is very well looked after”. The recording of receipt, administration and disposal of medication in the home is sufficient to allow an audit trail. The storage of medication meets current good practice. At present there are no fridge line medications but the manager stated that a lockable drugs fridge was being provided. There are photographs of the service users in the medication administration record book. 2 members of staff carry out all administration of medication to ensure safety. Staff observed administering medication did so discreetly and appropriately. All members of staff who administer medication have now received training. There are very few homely remedies used in the home but on the occasions when they are required they are agreed in advance by the G.P. When asked how they maintain the privacy and dignity of service users staff commented, “We chat in confidence, they like to talk when bathing or getting up, and we report anything untoward to Pauline (manager)”, “We close doors, give them adequate coverage, knock on doors”, and “We put towels over them, keep doors shut and curtains closed when doing personal tasks, make sure they always have their own clothes, and we call them by the name they prefer”. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live a life that suits their expectations, with few choosing to participate in organised activities; their visitors are made welcome; they have choices in all aspects of their daily life; and the meals they are served are balanced, wholesome and nutritious. EVIDENCE: Service users preferred activities, hobbies and past times are recorded in their plan of care. On the day of the inspection site visit music was played in front lounge on and off during the day and service users joined in singing along with the music; the television was also on at various times in both lounges. The manager explained the homes activities, they like music; one does her knitting; we have chats and reminiscence; they play games and, Bingo; they have something at least 3 – 4 times a week and all activities are recorded but most service user prefer not to do activities. When staff were asked what activities are available they commented, “We try to do activities. We have sing songs, music and movement, skittles, balloons”, “There is a lot of apathy from the residents”, and “Skittles, catch, old tapes and sing along. Service users Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 12 commented, “I went to the pub last week”, “I prefer my music”, and “I go shopping for the home”. Visitors commented, “Mother has got back into knitting”, “I take him out sometimes”, and “They don’t do many activities”. Service users religious needs are recorded in their care plans. Very few service users choose to goes to church regularly or to participate in any religious activity. The home used to have a visiting vicar but this tailed off through lack of response. The manager recently offered to rearrange services but the service users declined the offer. Service users commented, “I’m not religious”, and “I don’t practice”. The manager said she would arrange for religious leaders to visit if requested. Visitors are welcomed into the home at any reasonable time. When asked about their visitors service users commented, “they are made welcome, and they sometimes give them a cup of tea”, and “Yes, they are made welcome”. Visitors commented, “Yes we are made welcome, and we are always offered a drink”, “Very welcome, its like home from home day and night. We are always offered a cup of tea and biscuits”, “Yes I’m made welcome – but I don’t always get a cup of tea”, and “There are no restrictions. We can use the dining room if more of us are here, or can go to her room if we want”. Service users have choices in all aspects of their daily lives and commented; “we have choices in time of getting up and going to bed. Meals – they know what I don’t like and always give an alternative if you want it”, “they are flexible – if you don’t feel like getting up you don’t need to”, and “we have choices in everything”. When staff were asked what choices they give service users they said “Meals, clothes, drinks, have own choice of times of going to bed and getting up”, and “Own clothes, food time of going to bed and getting up, whether they want a bath, and where they sit or wander”. The home has a 7-week menu plan. Although only one main course is listed alternatives are always available and this was witnessed on day of inspection. The meal observed was attractively presented and served at an appropriate temperature. Assistance was given to service users as needed. Service users comments about the food included, “I love it, no complaints at all”, and “I like all the food I have here”. Staff commented, “The food is quite good”, and “Residents get nice quality, quantity and choice of food”. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that their complaints will be taken seriously and investigated and that they will be protected from abuse. EVIDENCE: The home has a clear complaints policy a copy of which is on display in the entrance hall. There have been no complaints made to the home since the last inspection. Relatives and visiting professionals surveyed confirmed that they had no complaints about the home. One visitor commented, “Not one complaint”. The home has an adult protection and a whistleblowing policy to protect service users from abuse. The majority of staff have attended adult protection training and the remaining few are scheduled to attend forthcoming courses. Staff spoken to indicated their awareness of the actions to take if they suspected abuse and were aware of the whistleblowers policy. The home submits an enhanced disclosure to the Criminal Records Bureau and the obtains a satisfactory check against the Protection of Vulnerable Adults register before new staff are employed. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 2, 25, & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is clean, comfortable, well maintained and generally meets their needs; although some additional infection control procedures would further ensure their safety. EVIDENCE: The home is suitably located, with easy access to the facilities of Herne Bay and to the seafront. It is well maintained, comfortable and homely. Visitors commented, “Very homely”, “When we walked in here we thought this is the place for us”, and “I’ve been in maintenance for years, I walked round and could not find anything wrong”. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 15 Communal facilities include a lounge and a separate dining room at the front of the house, and a smaller lounge with dining area at the rear of the property. There is also a small conservatory leading off of the back lounge and smoking is currently allowed in this room. The furnishings, fittings, and lighting in the communal rooms are all domestic in character and suitable for the needs of the service users. There is sufficient dining space for all service users to be comfortably seated to enjoy their meal. Bathing and toilet facilities consist on one assisted bathroom on the ground floor, an assisted bathroom, and a separate shower room on the first floor, and a total of 5 toilets. There are 14 bedrooms in the home and, although 2 are registered as suitable for use as double rooms, all are currently used for single occupancy. Although some of the bedrooms are on the smaller side they have all been individually decorated and furnished to meet the needs of the service users. A service user commented, “I like my bedroom”. Service users are able to bring some of their own belongings into the home to further personalise their rooms, and a staff member commented, “They can bring bits into their rooms”. All rooms are fitted with nurse call system, and all bedroom doors are fitted with locks with service users being able to have their own keys. All rooms are naturally ventilated. Radiators have been fitted with covers; and water temperatures are regularly checked to protect service users health & safety. The home is clean with no unpleasant odours. A service user commented, “They keep it clean”. Visitor comments included, “Its always clean, no old peoples smell, no dust, I’ve never seen a cobweb”, and “Its always clean and tidy”. The home has an infection control policy and in general suitable infection control procedures are in place. However currently the home does not have a washing machine with the specified programming ability to meet disinfection standards and a recommendation has been made that a suitable machine be purchased. In addition access to the laundry room, which is separate from the main house, could possibly be gained through two external doors therefore, to ensure that infection control procedures are not breached, a recommendation is made that the manager should remind all staff that laundry should not be carried through the kitchen at any time. There is a washing machine in the kitchen area, which is used solely for the washing of tea towels and aprons, however the notice that was on this machine reminding staff of its exclusive use is no longer in place and therefore a recommendation has been made that a replacement notice be displayed. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are cared for by a sufficient number of properly recruited and well-trained staff. EVIDENCE: Staffing levels are sufficient to meet the assessed needs of the service user and include 2 waking night staff on duty each night. There are sufficient domestic and catering staff to ensure the home is kept clean and hygienic and that the service users dietary needs are met. 70 of care staff employed have qualified to NVQ level 2 or above. The home operates a thorough recruitment process with no new member of staff being employed until two satisfactory references have been obtained; an enhanced disclosure has been submitted to the Criminal Records Bureau; and a satisfactory check has been obtained against the Protection of Vulnerable Adults register. Staff files need some updating to meet the requirements of the revised Schedule 2 and a recommendation has been made regarding this. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 17 All new staff have a thorough induction based on the Skills for Care common induction package. Mandatory training is up to date with only a few exceptions, and the majority of staff have had adult protection training. All staff who administer medication have received training in the safe handling of medication. Staff members commented, “I’m a moving and handling trainer”, and “I did First Aid last week”. Service users comments about the staff included, “Marvellous – we have a good rapport. They are very kind”, “The staff are all nice”, and “The staff are good”. Visitors said, “The staff are excellent”, and “The staff are very kind”. One staff member commented, “I’m happy here”. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home with a friendly and open atmosphere, run by a qualified and experienced manager who ensures the home is run in their best interests and that their health and safety is protected. EVIDENCE: The registered manager has the necessary experience and qualifications to run the home effectively. Service users commented, “She is lovely”, and “The manager is good”, a visitor said, “Pauline is very good, she really cares”. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 19 There is a friendly and open atmosphere in the home. Staff spoken to confirmed they felt supported by the manager. Staff comments included, “There is a nice atmosphere, friendly and homely”, they also said, “The owners are pretty good”, and “The owners are really friendly”. The home has quality assurance strategies in place to ensure that the home is run in the best interests of the service users including questionnaires; regular audits; and a development plan. All Policies and procedures are reviewed annually. The owners visit the home virtually daily although at present these visits are not recorded. Staff meetings are held quarterly or more often if needed; and a combination of Residents meetings, or individual discussion with residents is carried out regularly. The home do not deal with service users money. Most service users finances are looked after by their families. One of the providers had been appointee for one service user but this person now manages their own finances. The health, safety and welfare of service users is protected by the home. There is a health and safety policy; staff attend mandatory training in health and safety related subjects; accident records are all in order; and regular safety checks are being undertaken. Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 20 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 3 3 3 3 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 X X 3 3 2 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 21 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. 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. 1 2 3 4 Refer to Standard OP26 OP26 OP26 OP29 Good Practice Recommendations The home should provide a washing machine with the specified programming ability to meet disinfection standards. A notice should be placed on the washing machine in the kitchen to remind staff that this machine is to be used solely for the washing of tea towels and kitchen aprons. In the interests of infection control staff should be reminded in a suitable way that laundry should not be carried through the kitchen at any time. Staff files should be updated to meet the requirements of the amended Schedule 2 Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Favorita House DS0000023411.V306092.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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