Inspection on 09/05/07 for Deepdene Court

This inspection was carried out on 9th May 2007.

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.

Other inspections for this house

Similar services:

1 Marten Road

Daubeney House

Three Gables

Aldwick House

49 Glendale

The Springs Community

Crossways Community

Belle Vue Country House

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

CARE HOME ADULTS 18-65 Fieldings 2-3 St Catherine`s Road Littlehampton West Sussex BN17 5HS Lead Inspector Mrs D Peel Unannounced Inspection 09th May 2007 10:40 Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fieldings Address 2-3 St Catherine`s Road Littlehampton West Sussex BN17 5HS 01903 725 602 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) fieldings@deepdenecare.org www.deepdenecare.org Deepdene Care Limited Post Vacant Care Home 22 Category(ies) of Past or present alcohol dependence (1), Mental registration, with number disorder, excluding learning disability or of places dementia (22), Mental Disorder, excluding learning disability or dementia - over 65 years of age (8) Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection N/A Brief Description of the Service: Fieldings is a care home registered to accommodate up to 22 people between the ages of 18 and 65 years who have a past or present mental disorder. The property comprises of two linked semi-detached houses with gardens to the front and rear. It is situated in a residential area close to Littlehampton town centre and the seafront. There is access to local train and bus services. The Responsible Individual on behalf of Deepdene Care Limited is Dr Ludmila Iyavoo and the post of Registered manager is currently vacant. The current scale of fees being charged at the home is from £305 to £750 per week. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to Fieldings was carried out by Mrs Diane Peel on the 9th May 2007. During this visit the intended outcomes for 35 standards were assessed; these included the key standards for care homes providing a service to Adults aged 18-65. Prior to the visit to the home the inspector reviewed information gathered during the process of Registration of Deepdeene Care Limited in December 2006 and other correspondence between the organisation and The Commission for Social Care Inspection (CSCI) since the date of registration. An Annual Quality Assurance Assessment (AQAA) and Service User surveys were sent to the home prior to the visit but they were not returned before the visit on the 9th May 2007. The inspector arrived at 10.40 am and during the course of the visit met and spoke with six of the residents currently living at the home. A case tracking exercise for three residents was undertaken to look at how the assessed needs of this group of residents were being met by the home and other outside professionals. Staff were observed assisting and interacting with residents during the visit and the inspector spoke with, two members of staff, the acting manager and the responsible individual for the company who visited the home, whilst the inspection was in progress. The companies quality assurance questionnaires returned to the manager were sampled to see what resident’s views of the home and services provided. The records of two of staff were examined to see if the homes recruitment policy was being put into practice and staff training records were also viewed. Samples of other records required to be kept by the home were examined during the visit to ensure that the provider is meeting their obligations with regard to the administration of the home. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? This was the first visit to the home since registration with Deepdene Care Limited in December 2006. There had made major improvements in the administration and management of the service, which was evident in the improved documentation and systems being used in the home. The environment was a much cleaner and safer place to live. Some areas of refurbishment had already taken place with communal areas and some bedrooms being redecorated and bedroom furniture being replaced. Risk assessments had been reviewed and continue to be improved to ensure that staff and people living at the home are not at risk from unsafe practices. Complaints are being properly investigated and records of outcomes to complaints recorded. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 7 New systems for recording the money received by people living at the home are in use and are being audited by those people visiting the home on behalf of the organisation for quality assurance purposes. 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. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 People who use the service experience good outcomes in this area. People who are considering moving into the home are provided with information, have an opportunity to visit the home, and know that their needs have been assessed to ensure that the home will be able to provide the service, which they expect. EVIDENCE: The home has a Statement of Purpose and Service user Guide, which along with a number of other booklets about the organisation, can be provided to prospective people who may be looking to move into the home. These were observed to be present in the office. The acting manager said that they had had one person come to live at the home since Deepdene Care Limited took over the running of the home. This person had come to look around the home, had been given a copy of the Statement of Purpose and Service Users Guide and the moved into the home some weeks later. However this person was in hospital on the day of this visit and so the inspector was unable to find out if this person felt that they had had sufficient information. One person living at the home was keen to say that they had “lived at the home for four years and had looked first.” Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 10 The responsible individual acting on behalf of Deepdene Care Limited told the inspector that each individual who may want to come and live at the home are having their needs carefully assessed to make sure that a package of care can be provided and that the level of need will be reflected in the fees being paid. Care records viewed at this visit included a needs assessment, which had formed the basis of a care plan. It was observed that one person living at Fieldings uses English as a second language. Review records showed that this person had been offered an interpreter but they had declined the offer. There was clear information available for staff to understand the best way to communicate with this person who could understand the English language but had more difficulty making their needs verbally understood. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 People who use the service experience good outcomes in this area. Care planning systems are person centred so that people using the service know that their assessed needs and changing circumstances will be reflected in their individual plan. EVIDENCE: Three care plans were examined at this visit and were observed to be well documented and had been developed from an assessment of need. A new care planning system is being brought into use as each person has his or her care needs reviewed. The new format was observed to be in use for two of the three plans examined and it was observed that they had been signed as agreed with those people with whom they had been devised including the person using the service. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 12 The plans gave clear information about the level of intervention needed by staff to ensure that people received a level of care and support, which they required, allowing for people to maintain differing levels of independence. Individual likes and dislikes, were seen to be documented in care records together with details of any areas where limitations had been put in place about choice which could effect the health and welfare of people, such as self neglect. Daily records are being kept to record the changing needs of individuals so that staff can read and keep up to date with peoples care. Risk assessments were in place, detailing action taken to minimise identified risks and hazards, these also included the risk of fire from those people who smoke in their rooms. The responsible individual told the inspector that a recent quality audit had identified that there were some elements of Health and Safety risk assessment which should be incorporated into the individuals personal risk assessment. It had already been agreed that the acting manager would be supported by the Care Director to carry this out. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 People who use the service experience good outcomes in this area. People living at the home take part in a variety of activities, have opportunities for personal development and are encouraged to take part in the day to day running of the home so that they feel valued and have fulfilling lifestyles. EVIDENCE: The care home is situated in an area of Littlehampton, which is near to local shops and community facilities. When the inspector arrived one person was just leaving the home shouting out to the acting manager that she had a visitor. A person living at the home is undertaking an NVQ in catering at a local further education college. The inspector was told that this person prepares all the fresh vegetables for the cook each day. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 14 Another person has just recently decided that they might want to leave the home and so through the review process and involvement of other professionals a package is being put together to encourage them to develop some independent living skills. They have voluntary job in a charity shop and the staff are assisting this person to get a paper round to earn some money of their own. Other people use the local Drop In centre whilst one person goes to the MIND day centre and others to the Tamarisk centre in Littlehampton. A new activities programme was spoken about in the minuets of the last service users meeting which the inspector read. A gardening club is held once a week and an exercise group takes place twice a week which staff report is well attended. The notice board in the entrance hall advertised a Sunday afternoon video and people living at the home confirmed that someone different each week chooses a DVD, which they can watch together if they want. Both people living at the home and staff working at the home confirmed that people are encouraged to clean their rooms weekly with the assistance of staff and do their own laundry The acting manager spoke about occasional organised trips out and visits to shows at local theatres. People living at the home have the opportunity to discuss variety and choice of menus at their group meetings. The minutes of the meeting held in February 2007 recorded that the new five weekly menu was discussed, with all residents in favour, although it had been noted by one person that baked beans were on the menu too often for their personal liking. The notes recorded that there would always be a vegetarian option and the acting manager told the inspector that special diets are catered for. Service users surveys viewed in care records seen at this visit reported favourably about the standards and choice of food. It was observed that the menu for the day of the visit to the home was on display in the entrance hall and the cook confirmed that the main meal of the day was braised kidneys, roast potatoes and fresh vegetables followed by fresh fruit and ice cream. People living at the home who spoke with the inspector after lunch said that they had enjoyed their meal and when asked about the meal to be served later in the day the inspector was told that it was “soup and bread roles and sometimes it is sandwiches or quiches or something like that”. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 15 The acting manager told the inspector that all meat and vegetables are delivered fresh from local suppliers. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use the service experience good outcomes in this area. People receive personal support in the way that they want so that they can maintain individual levels of independence and a variety of healthcare professionals are involved in maintaining the physical and emotional needs of people living at the home. EVIDENCE: The levels of support needed with personal care are identified in each persons care plan. For some people this involved prompting and encouragement with personal care when there had been identified a risk of self-neglect. All care plans viewed recorded the name of the Doctor with which that person was registered and recorded involvement with healthcare professionals such as reviews and attendance at appointments. The acting manager spoke about the visits by District Nurses to the person who been admitted to hospital and commented how effective their treatment had been for the person living at the home. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 17 Two people living at Fieldings administer their own medication. Other people who have the staff look after their medication have signed an agreement giving permission for the home to take charge of their medication. Risk assessments had been put in place for those two people who were selfmedicating and locked storage has been provided in these two peoples rooms. Medication was observed to be stored in lockable cabinet and medication administration records viewed on the day were in good order also recording when people had not taken medication for various reasons. A monitored dosage system is in use with pharmacy advice being provided by the supplying pharmacist. It was observed that a recent internal audit carried out by the responsible individual had identified lapses in the storage of inhalers and creams with advise being given to staff about the security of such items. Staff have undertaken an introductory course to the safe handling of medication before completing the full programme. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use the service experience good outcomes in this area. People living at the home are safe guarded by the systems in place to promote their safety and welfare. EVIDENCE: Fielding has a complaints procedure, which was observed to be included in the Statement of Purpose and Service User Guide. The record of complaints was viewed and observed to have a number of complaints recorded which detailed how the complaints had been investigated and what the outcome had been for those people making the complaints. A copy of the West Sussex Adult Protection procedures is held in the home and available to staff and people living at the home. The acting manager confirmed that there had been no Safe Guarding Adults incidents reported and the responsible individual confirmed that the majority of people working at the home had had Adult Protection Awareness training. Staff records viewed showed that those people whose records were seen had had Protection of Vulnerable Adults training and that that those staff had also received Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) clearance. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 19 It was also noted that Abuse in the Care Home is a subject covered in the induction programme for new staff. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 People who use the service experience adequate outcomes in this area. The environment has improved and with further refurbishment planned by Deepdene Care, people living at the home will have a more homely, comfortable environment to live in. EVIDENCE: Improvements to the environment were observed at this visit to Fieldings. The entrance hall, dining area and lounge have all been redecorated and carpets cleaned. A programme of redecorating bedrooms has begun and those bedrooms already redecorated have modern new furniture. New fire doors with a lockable facility have been fitted to all bedrooms so that people who live at the home can lock their doors if they wish, with staff having an override key to enter in emergencies. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 21 Bedrooms and bathrooms and toilets now have paper towels and soap dispensers for use by staff and people living at the home. The bathrooms and toilets visited were observed to be clean as was the remainder of the property seen during this visit. The office has been moved from the basement to the first floor, which is much brighter and provides improved facilities and equipment. The responsible individual on behalf of the organisation told the inspector about major refurbishment plans for the home which will involve people moving into the property next door which has been purchased by Deepdene Care Limited and is currently being refurbished. Once out of use Fieldings is to be completely refurbished and people will have a much improved home to move back into. People living at the home that the inspector spoke with were pleased with the improvements to the lounge and dining areas. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33,34,35,36 People who use the service experience good outcomes in this area. People living at the home are protected by the homes recruitment policy and practices and have support from staff that appropriately trained and supervised. EVIDENCE: A staff rota was on the wall in the office. People living at the home have the support of staff day and night and those people spoken with felt that there were enough staff to help them if they needed help. In addition to the support staff there is a cook, a cleaner and a handy man. At present there is no separate cook at the weekend but the responsible individual told the inspector that they were already looking to change this arrangement and recruit for a weekend cook. The records of two staff recently recruited to Fieldings were examined at this visit. They were observed to include an application form, interview questions, evidence of identity and evidence of CRB and POVA checks. References for Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 23 both staff had been obtained. The application form requests information about people’s health and includes an equal opportunities monitoring form. There was documented evidence that new staff undertake an induction programme based on the Skills for Care Common Induction standards. Work place monitoring forms were observed in the staff files viewed which showed how new staff are observed at work during their induction period. The organisation provided the inspector with an annual training plan for next year which included both internal and external training for all staff and was observed to include an extensive range of training and development which will continue to give the staff the combined skills to meet the needs of the people living at the home. Staff records observed showed that staff have an individual training and development plan and had attended Health and Safety training, POVA, Hygiene Awareness, Elder Abuse since recently joining the organisation. A supervision programme is in place and the acting manager told the inspector that the registered manager who had recently resigned had undertaken supervision with everybody before she left the home. Staff records viewed for one of the two people recently employed included supervision documentation the other person had evidence of supervised practice but had not yet had formal supervision. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42,43 People who use the service experience good outcomes in this area. The health and welfare are of people living at the home are being protected by management systems and monitoring of practices within the home. EVIDENCE: The manager has recently resigned and left the home. The acting manager has worked at the home for ten years and is being supported by the responsible individual, the operations manager and care director form Deepdene Care Limited The acting manager told the inspector that she felt supported. At the time of this visit the home was being managed to a good standard with managerial systems being audited by representatives from the organisation Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 25 and action plans being raised to address any identified issues. Two such audits were provided to the inspector during the visit. There is a system in place for surveying the views of people living at the home, which includes regular service users meetings during which notes are taken. The notes taken form the most recent meeting were viewed by the inspector and it was observed that people using the service had taken the opportunity to address some important issues which showed how they are involved in the day to day running of the home. The results of satisfaction questionnaires were observed to be included in care records viewed during this visit and the acting manger is aware that the annual questionnaires were due to be distributed to the people living at the home. The responsible individual on behalf of the organisation told the inspector that an external company had recruited to carry out a full health and safety audit of the premises so that immediate issues coming to light can be dealt with and then a action plan be devised to deal with other matters. Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 2 26 2 27 2 28 2 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 3 X X 3 3 Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 27 N/A 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 Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Fieldings DS0000068679.V336091.R01.S.doc Version 5.2 Page 29 - 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!