Inspection on 15/09/06 for Foley House

This inspection was carried out on 15th September 2006.

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

The inspector 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

Foley House 23/08/07

Foley House 12/02/06

Foley House 13/07/05

Foley House 26/01/05

Foley House 09/07/04

Similar services:

Coopers Mill Ltd

Pocklington House

Newton Court (1-2)

Newton Court (3-4)

St Raphaels

Elkington House

Read House

Clacton Family Trust

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

CARE HOMES FOR OLDER PEOPLE Foley House 115 High Garrett Braintree Essex CM7 5NU Lead Inspector Kay Mehrtens Unannounced Inspection 09.00 15 September/5 October 2006 th th th 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 Foley House DS0000017819.V312284.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. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Foley House Address 115 High Garrett Braintree Essex CM7 5NU 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) 01376 326652 01376 326652 info@foleyhouse.org.uk Foley House Trust Mrs Brenda Weavers Care Home 20 Category(ies) of Dementia - over 65 years of age (1), Sensory registration, with number impairment (20), Sensory Impairment over 65 of places years of age (20) Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Persons of either sex, under the age of 65 years, who require care by reason of a sensory impairment (not to exceed 20 persons) Persons of either sex, aged 65 years and over, who require care by reason of a sensory impairment (not to exceed 20 persons) One person, aged 65 years and over, who requires care by reason of a sensory impairment and dementia, whose name was made known to the Commission in February 2006 The total number of service users accommodated must not exceed 20 persons No more than five persons may attend the home on a daily basis in addition to those 20 accommodated 12th February 2006 Date of last inspection Brief Description of the Service: Foley House offers residential care to deaf and deaf/ blind adults. The premises have three floors and were originally built in 1881. Some areas of the home would not be easily accessible for those requiring the use of a wheelchair. The main building has seventeen rooms, most of which have ensuite facilities. There is a choice of several sitting areas and there is a separate dining room. In addition there is a purpose built unit providing modern facilities which comprises of four en-suite bedrooms, assisted bathroom, training kitchen, dining area and recreation room. This facility is also used for activities for the service users. The home is currently registered to cater for 5 day care service users. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on the 15th September and a second visit on the 5th October 2006. The inspection lasted 8.5 hours in total. The inspection process included discussions with the manager and the deputy. The inspector was accompanied and assisted by a British Sign Language interpreter, Dominic Berry, for two hours on the first day of the inspection. In addition to the day spent at the home, the inspector reviewed written material submitted to the Commission since the last inspection in order to reach the conclusions identified in this report. This included three surveys returned from residents and four from relatives. All of the Key National Minimum Standards (NMS) for Older People and the intended outcomes were assessed in relation to this service during the inspection. There were sixteen residents accommodated at the time of the inspection. The home does accommodate younger adults and this inspection showed a continued improvement in the home’s meeting of the standards for younger adults. The inspector had the opportunity to meet with service users that came under the standards for younger adults and their comments will be included within this report. The home was clean and well maintained. The manager and her staff team were very co-operative throughout the inspection. The inspector was invited to have lunch with the residents and would like to thank them, the cook and staff for their hospitality. What the service does well: • The commitment to improving staff training with regard to British Sign language was evident in that the majority of staff have achieved BSL level 1. The care plans were of a very high standard. Service users’ comments included, “very nice, good food…staff help me…they always see to what I want”. Relatives’ comments included, “very satisfied with the care given to my [relative]…. my [relative] is very happy at the home”. DS0000017819.V312284.R01.S.doc Version 5.2 Page 6 • • • Foley House • Service users told the inspector that they were happy with the changes made to the dining and living rooms. They found them brighter and more relaxing. What has improved since the last inspection? • The variety of activities for younger adults had improved since the last inspection. There opportunity for service users to access activities at weekends and evenings had increased. The manager and her deputy had worked well on improving the level of training available to staff. A review of the quality of care has been undertaken and revisited 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. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Pre admission assessment records contained determine a prospective service user’s needs. sufficient information to The home does not provide intermediate care and therefore Standard 6 is not relevant to this service. EVIDENCE: A sample of residents’ files examined contained thorough assessments of needs, including social, psychological, health and spiritual needs; providing sufficient introductory information from which the home could determine whether they could meet the needs identified and commence an individualised plan of care. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 9 Initial assessments are done by the manager and senior staff at the home of prospective residents, if possible. Service users and their families are encouraged to visit the home as part of the admission and assessment process. Additional information from social workers is kept on files and used to inform the assessment and care planning process. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 and 11 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. Service users were looked after well in respect of their health and personal care needs. Care plans were clearly detailed the care and support required by each resident. Policies and procedures for medication management were adhered to ensuring the safe administration of medication to residents. Service users are assured that at the time of their death their needs and wishes are treated with sensitivity and respect. EVIDENCE: The manager and deputy had introduced a new filing system that provided clear and well-organised files. They had undertaken an audit of the files, which ensured that all the required information was in place. Care files contained Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 11 information regarding service users’ property, nutritional assessments and accident records. A sample of service users’ files were examined. They contained clear and detailed plan, which gave precise information for care staff on how to meet personal, social and psychological needs, ensuring consistent and structured support. The plans were regularly updated and the necessary action taken to respond to changing needs. They provided evidence of the service users’ choices and preferences with regard to their personal needs, likes and dislikes and preferred terms of address. The manager and the staff team had worked well, since the last inspection, to greatly improve the standard of care planning, reviews and recording. The care plans sampled were of a high standard. They evidenced good input from service users, their families and representatives, as appropriate, and gave clear and detailed information to address the identified needs of service users. The care plans were very detailed with regard to the physical and mental health of service users. There was good evidence of systems and records in place to monitor service users’ health, with good records of medical appointments and comments. The homes medicine administration system was inspected. This was a monitored dose system (MDS). The pharmacist had undertaken an audit of the homes’ medication systems and storage and their comments were very positive. There was good evidence of advice being sought from doctors and pharmacists regarding medication concerns. Based upon the sample of records inspected the receipt, administration, storage, security and disposal of medication was found to meet National Minimum Standards. Staff responsible for the administration of medication had received training. Specialist training had been undertaken with regard to understanding and working with people with epilepsy. Service user’s consent to medication administration, by the home, was sought and recorded on the care files. The home operates a key worker system and the staff were aware of the role of the key worker. The service users were aware of their key workers. Service users told the inspector that they felt their privacy and dignity was respected. They were pleased that more of the care staff had learnt BSL signing. They felt that staff signed more with them now and talked less to each other. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 12 Any infringement of service users’ rights, for example holding cigarettes or monies, was recorded on individual care files with the consent of the service users involved. Personal wishes of service users, with regard to death and dying, had been sensitively discussed and recorded by care staff with the individual service user. The format introduced, by the manager, allowed the service users to understand the questions asked and to inform their responses. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The provision of suitable activities to stimulate social and recreational interests for residents had improved. Visiting arrangements are open and relaxed and family and friends links with the service were strongly encouraged and well developed. Meals provided in this home are of good quality, wholesome and freshly prepared; and mealtimes were a dignified social occasion. EVIDENCE: Several service users told the inspector that they are supported to go out and meet friends in the local area and their friends are always made welcome when they visit the home. The level of activities, especially at weekends and evenings, had improved since the last inspection. The home does accommodate younger adults and there was good evidence of more age appropriate activities for this group. The home employs one full time and one part time activity workers and their programme was varied and interesting. Several service users were enjoying Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 14 ”armchair aerobics” during the inspection whilst others were out shopping with staff. They told the inspector that they enjoyed buying new clothes and showed off some of their recent purchases. Service users told the inspector that they had enjoyed planning and going on a summer holiday this year. One resident stated in their survey form, “Happy, always out”. Another said that they “go out and make things here”. Service users’ bedrooms were full of their personal possessions and they are encouraged to bring in pictures and personal items when they move into the home. Service user meetings are now held regularly and the minutes evidenced that they are encouraged to voice their opinions about their life in the home. The inspector joined some service users for lunch and the meal was well presented and tasty. The service users commented positively about the food. The meal was taken leisurely and unhurried. Some staff had lunch with service users and sign with them. Staff were observed assisting those service users that needed help with patience and dignity. A good choice of nutritious food was provided at all meals. The cook was aware of the individual dietary needs of service users and responded to their requests, especially if the meal on offer was not wanted. The cook provided a selection of home made cakes for afternoon tea, which was much appreciated by the service users. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality outcome in this area is good. This judgment has been made using available evidence including a visit to this service. Arrangements for responding and acting upon any complaints or concerns were satisfactory. Service users were protected by policies and procedures within the home. EVIDENCE: The home or the CSCI had not received any complaints from service users or relatives since the last inspection. The home has a complaints procedure that is made available to service users and visitors to the home. All concerns and complaints received by the home were well recorded. The service users are provided with access to advocates from the local RAD office, if required. The service users told the inspector that they could talk to the manager and some of the staff if they were unhappy. However, some of them did feel awkward about talking to some staff as they felt that they would not be receptive to their comments and they also felt a little intimidated by them. The service users were happy for the inspector to raise this with the manager as well as the comment about some staff rushing them in the mornings. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 16 The manager was receptive to the comments shared by the inspector, on behalf of the service users, and she offered to talk to them in private, reassuring them that their comments would be heard. An adult protection policy and procedure was in place, including Whistle Blowing, providing information and guidance for staff to follow in response to a suspicion, allegation or evidence of abuse. All staff had received the appropriate training in recognising and protecting vulnerable adults from abuse. Appropriate recruitment procedures were in place that enhanced the service users protection. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area was good. This judgment has been made using available evidence including a visit to this service. The home was well maintained and provided a homely warm and welcoming environment. EVIDENCE: The home was clean and well maintained. There was no evidence of any offensive odours. The standard of hygiene was very good. The laundry was well organised and residents were pleased with the laundry service. Some service users do their own laundry. The home is well equipped, with specialist equipment, to meet the needs of service users. As previously mentioned, the service users were pleased with the changes to the dining and living rooms. The service users now have a designated activity and craft room. The sensory kitchen/dining room (known as the flat) is well Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 18 used by some service users to prepare meals and entertain friends. The larger dining room is brighter and so better meets the needs of service users that lip read and use sign language, as well as providing better access for wheelchairs. The health and safety files were well organised. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area was good. This judgment has been made using available evidence including a visit to this service. Records relating to staff recruitment were satisfactory. Staff receive training in areas pertinent to the residents assessed needs. Staff awareness of equality, diversity and disability rights needs to improve. EVIDENCE: There were only 16 service users in the home at the time of the inspection. The staff roster indicated that there were 3 staff on duty for the waking day. The staffing levels were sufficient met the needs of the residents accommodated. Additional catering, activity and domestic staff are employed in sufficient numbers. Staff were generally observed to engage positively with each individual and demonstrated a good relationship with the service users they were supporting, treating them with dignity and respect. However, some service users told the inspector and interpreter that “some staff were rough and rushed them in the mornings”. The inspector was impressed by the positive interaction with service users, through the use of signing, demonstrated by some of the staff team. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 20 One service user stated in their survey from, “staff always listen to me…. and staff help me”. At the time of inspection, the home had almost achieved the recommended proportion of carers having attained a National Vocational Qualification (NVQ) level 2. The manager informed the inspector that additional staff were currently doing the course. The manager and her deputy were aware of the Skills for Care programme, the newly formed occupational training council for the social care sector, which came into operation from September 2006. They had organised workbooks for some staff and were aware of the need to ensure that newly recruited staff must start the programme. This will be monitored at the next inspection. The files of recently recruited staff were examined during the inspection, all of which contained appropriate levels of documentation in respect of recruitment to promote the protection of residents from abuse. Further examination of staff files did highlight some concerns regarding some staffs’ attitude towards other members of staff. The manager was aware of these issues and was advised by the inspector to monitor through supervision and to provide training with regard to equality and diversity. In addition, the comments made by some service users indicated the need for improved disability awareness. The deputy manager provided the inspector with a copy of the staff training records matrix. This clearly indicated the training attended by staff and highlighted areas for development. Examination of the records showed that lots of training had been provided for staff especially with regard to Protection of Vulnerable Adults, manual handling, fire training, infection control and manual handling. The home benefits from the input of a member of staff who is a qualified staff trainer. Some of the staff spoken to were very positive about the training opportunities provided by the manager. They also felt well supported by the senior staff especially through supervision sessions and training support. The inspector observed a senior member of staff ably assist and support a team member with their work on care planning and record keeping. In addition all staff have now achieved BSL level 1 and some are to move onto level 2. The managers’ commitment to improving the communication skills of staff and in so doing, the life of service users in the home, is to be commended. Service users told the inspectors that they were pleased that more staff could now sign with them. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to this service. The Registered Manager is a person of good character and is fit to be in charge of the home. The Registered Manager has a clear vision for improving the service users quality of life. EVIDENCE: The manager and deputy have worked well with the staff team to improve many aspects of care in the home. The care plans, activities for younger adults and staff training have been the most improved standards from the last inspection. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 22 The manager has good relationship with the service users and is aware of the areas that require more development within the staff team. She has developed the input of service users into influencing their life in the home and their care planning. The providers were now undertaking their duty to monitor the home, on a regular basis, and produce reports under Regulation 26 of the Care Standards Act. The inspector requested that copies of the regulation 26 reports be forwarded to the commission until the next inspection. The manager had worked well with the homes’ charitable trustees to inform them of the inspection and regulation process. The manager has delegated a member of the staff team to undertake a quality review of the care with service users. A recent survey had been completed but lacked clear timescales and actions to address the issues raised. A more “service user friendly” version of the outcome of the survey needs to be developed. The manager was aware of the need for this standard to develop and this will be monitored at the next inspection. From discussion with service users, and from examination of some of the complaints made by agency staff, the inspection highlighted the need for training, for some of the staff, to raise awareness of the rights of people with disabilities and an awareness of equality and diversity. This was discussed with the manager, who recognised the issues raised at the inspection and acknowledged the need to develop this shortfall through staff training and staff supervision. The home does manage some service users’ finances, though they are supported and encouraged to maintain their independence by managing their own finances. The records sampled were well managed and organised. The homes policies and procedures support the health and safety of service users and staff supporting them. The certificates relating to equipment and services to the home were in place and updated as required. Staff training related to health and safety issues needs to be monitored more closely to ensure mandatory training is received and updated by all staff employed. This includes food hygiene and infection control. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 2 X 3 X X 3 Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP32 Regulation 12(4)(b) Requirement The registered manager must ensure that staff receive training with regard to improving the awareness of equal opportunities, diversity and disability awareness. Timescale for action 05/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations The registered manager should develop the quality review process to ensure that a clear timescale of actions and a “service user friendly” format are produced as part of the process. Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Foley House DS0000017819.V312284.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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!