Inspection on 15/09/06 for Belmont Lodge Care Centre

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 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

Belmont Lodge Care Centre 20/12/07

Belmont Lodge Care Centre 26/01/06

Belmont Lodge Care Centre 27/07/05

Belmont Lodge Care Centre 20/12/04

Belmont Lodge Care Centre 28/06/04

Belmont Lodge Care Centre 11/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Belmont Lodge 392/396 Fencepiece Road Chigwell Essex IG7 5DY Lead Inspector A Thompson Unannounced Inspection 15th September 2006 10:15 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 Belmont Lodge DS0000017768.V312618.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. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belmont Lodge Address 392/396 Fencepiece Road Chigwell Essex IG7 5DY 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) 020 8500 5222 020 8559 8100 Diomark Care Limited Manager post vacant Care Home 46 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (46) of places Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, age 65 years and over, who require care by reason of old age (not to exceed 46 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 10 persons) The total number of service users accommodated in the home must not exceed 46 persons 26th January 2006 Date of last inspection Brief Description of the Service: Belmont Lodge is a large detached house located in a residential area in Chigwell. The home is registered to provide residential care to 46 older people (i.e. over the age of 65), with varying degrees of dependency. Residents are accommodated in 34 single rooms and 6 double rooms. The home has five day rooms including a large dining room and a library. Accommodation is provided on both floors of the home and there are two passenger lifts. Belmont Lodge provides facilities, aids and adaptations that enabled staff to deliver quality care. At the rear of the home there is a good size rear garden with patio area. Ample off road car parking is provided to the front for visitors, and bus services pass the building along the main road. Local shopping facilities are a short walk away. Information from the home states that weekly fees range from £435 to £650. Past inspection reports are available from the home, and from the CSCI internet website. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on Friday 15th September 2006. The content of this report reflects the inspector’s findings on the day of the inspection along with information provided by the service and feedback by service users, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions took place with nine service users, the manager, administrator, four members of staff and two visitors. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. All residents spoken to expressed satisfaction with the care they received and with the quality of the food and accommodation offered. Visitors spoken with were complimentary of the care and support provided to residents by the staff and management team. Questionnaires were left at the home so that relatives not spoken with on the day had the opportunity to make their views on the service known to the Commission. Staff confirmed they received support from management. They also confirmed that they had been offered NVQ training. Twenty-six standards were inspected with twenty-two met and four almost met. What the service does well: The residents living in Belmont Lodge benefit from an established and experienced staff group who aim to offer professional care. Relatives and visitors are made welcome, and residents considered that management and staff had done everything possible to ensure that their relationships were maintained. The home was considered comfortable, clean, safe and well maintained. There had been good in-house training provision for staff. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 6 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. Belmont Lodge DS0000017768.V312618.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 Belmont Lodge DS0000017768.V312618.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 judgement has been made using available evidence including a visit to the service. The home’s assessment format and process ensured that initial perceived needs were identified upon admission. EVIDENCE: The manager visits prospective new residents to undertake an assessment of need. Evidence of this process was seen in care plan files for residents admitted since the last inspection. Assessment headings covered included: communication, mobility, personal hygiene, dire, vision, continence, behaviour, manual handling, sleep, medication, foot & oral care, falls social & risks. In addition there may be a Social Services assessment on file which supplements the home’s process. A care plan is compiled after admission. Belmont Lodge DS0000017768.V312618.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health, personal and social care needs of residents were adequately detailed in individual plans of care. Health care needs of residents were met and residents felt they were treated with respect. EVIDENCE: Three care plans were inspected. Included was background information, personal details, next of kin contacts. The residents’ needs/action sheet included desired outcomes taking account of the headings assessed when carrying out the initial assessment (see standard 3). In addition, further sections added after admission were, risk assessments, environment considerations, elimination, spiritual, dressing, healthcare and pressure care needs and risks. Care plans seen included records of residents’ weight, consultations, had been regularly reviewed on a monthly basis and included an evaluation record sheet. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 10 District Nursing services support the home in pressure sore assessment and will also supply appropriate aids and treatment. A dentist visits the home, as does a chiropodist and a hairdresser. Some residents continue to see their dentist in the community. The homes medication policy and procedure covered ordering, receipt, storage, administration, homely remedies and returns of unused stocks. The home also had a policy and procedure covering when residents wish to retain control of their own medication. The most recent training provided to staff on medication had been in July 2006, written evidence of this was seen. There is one good practice recommendation noted under medication which is that before staff are permitted to take on the role of administering medication, they are subject to an in-house written competency assessment. Medication administration records were inspected no shortfalls were noted. Discussions with individual residents indicated that they were treated with respect by staff, as did observation of staff going about their duties and interactions with residents. Staff on duty were seen to be courteous, caring and professional in their dealings with residents, and residents spoken with said staff were helpful and considerate. Visitors spoken with were also complimentary regarding staff attitudes and the care provided. Treatments and consultations are provided in private, residents’ also confirmed that they wear their own clothes and that staff use their preferred term of address. Belmont Lodge DS0000017768.V312618.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The lifestyle experienced within the home matched the expectations of residents. They were able to maintain contact with family, friends and participate in the local community. Residents were offered a varied, appealing balanced diet and were supported to exercise choice in their daily lives. EVIDENCE: Residents meetings had taken place, minutes of issues discussed and decisions made were inspected. The home had an activities programme, included sessions were: reminiscence, music & movement, sing-a-longs, cards and manicures. Since the last inspection training had been given to staff on the subject of ‘therapeutic activities’ for residents, and further training was booked for September 2006. The manager advised that each day one or two staff are designated to lead activities and records had been kept of those offered. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 12 In addition to the programmed choices there had been recorded: crafts, music, keep fit, quizzes, games, fashion show, films and 1-1 discussions. The training to staff on this subject had included communication skills, awareness, motivation, practical sessions, resources and creating activities. Records showed that outside entertainers visit regularly, this was also confirmed in discussion with residents. A church minister visits to hold a service in the home once a month. Residents spoken with confirmed they were satisfied with the choices and options made available to them regarding daily routines and leisure interests on offer. Visitors spoken with said they were always made welcome by staff. Some personal allowance monies are held for safekeeping and records of transactions and receipts are kept. The manager advised that the home does not act as appointee for any of the residents. Advocacy support is available and a notice about this is on display. Inspection of private rooms confirmed that residents had been permitted to bring their own personal items with them on admission. There was also confirmation of this direct from residents, who told the inspector of the furniture and personal items they had been permitted to bring in with them. Nutrition records and menus evidenced choice and variety. The main daily meal is lunch with two choices, there is also a choice at tea. All residents spoken with were complimentary about the food. Two said it was very good and that there was always a choice. Meals may be taken in private rooms if preferred, evidence of this practice taking place was seen. Belmont Lodge DS0000017768.V312618.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 inspected at least once during a 12 month period. 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. Residents knew how to complaint and the home’s complaints procedure allowed for residents and relatives to formally raise any concerns or areas of dissatisfaction with the service. The home’s adult protection policies, procedures and practices were aimed at ensuring residents welfare. EVIDENCE: The home’s complaints procedure contains guidance on how to make a complaint and who to complain to. Also included were timescales for responses from the home. Evidence was seen to confirm that records are maintained in the home, of complaints received and of any investigation and resulting outcomes. Residents spoken with said they knew who to speak to in the home if they any concerns, and that in the past management had responded positively to any queries/issues they had raised. The manager is an accredited POVA trainer (approved by Berkshire County Council). This had qualified him to provide in-house training to staff which included clarifying types of abuse, recognising signs and required actions if abuse suspected. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 14 The homes policy on adult protection was inspected, there was written guidance for staff on recognising and reporting abuse and action to be taken by staff and the person in charge if abuse is suspected. The home was being provided (by CSCI) a copy of the latest POVA guidelines. Already on site were the Essex & Redbridge Councils adult protection guidance manuals, and all staff are issued with the Essex Vulnerable Adults Protection Committee guidance booklets on abuse. Induction and NVQ training also includes adult protection issues. The home also had a ‘whistle blowing’ policy which provided guidance to staff on their responsibilities to report any concerns to management. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,23,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Furnishings in the home looked comfortable and areas of the premises seen were well maintained. Private accommodation was comfortable and suited to needs and preferences. The home appeared safe, accessible, clean and was considered to be hygienic. EVIDENCE: The home was fully accessible to residents’ currently accommodated and was well maintained externally and internally. The rear garden was well laid out and maintained. Individual private accommodation and facilities are all considered to be of a good standard. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 16 Lighting in communal rooms was considered domestic in character and sufficiently bright. The furnishings of communal rooms were mainly domestic in character, of good quality and appropriate to the range of needs of residents. Twenty five private rooms had en-suite facilities, there were also eleven communal wcs around the home. Staff call systems were located in all private rooms and communal rooms seen. The home is equipped with two shaft passenger lifts to provide access between floors. Private rooms were well decorated, comfortable and evidenced individual taste. During discussion with residents all said their rooms were comfortable. Door locks and keys are provided according to individual choice and risk assessment. All rooms seen were naturally ventilated with windows and all were centrally heated. Hot water supply in the home is regularly tested by staff and records were seen to confirm this. All radiators in the home that were seen were guarded, and lighting in residents’ rooms was considered domestic in character and fully appropriate for individuals requirements/needs. On the day of the inspection the premises were considered to be clean and hygienic. Policies and procedures were available for inspection confirming that working practices are in place to control the spread of infection. The laundry rooms were inspected and were equipped with appropriate washing machines and tumble driers. Washing machines were seen to be equipped with sluice cycle programmes. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels met the needs of residents. Staff had been provided good inhouse training opportunities to equip them with the skills for their role. Staff recruitment procedures aimed at the protection of residents had been followed EVIDENCE: The home’s staffing rota was inspected and confirmed that staffing levels are being maintained at one senior and five care staff on duty on morning shifts, with one senior and four carers on duty afternoons. Night staffing is one senior and two carers on waking duties. The manager post is sumernumery. Separate and additional rostered staff were employed to undertake cooking, kitchen assistant, administrative, and domestic duties. Maintenance is undertaken as and when needed by a contractor, and the home also has a weekend handyperson. Discussion with staff and records confirmed that regular staff meetings are held. Agenda items included care plans, allocations, equipment, medication, shifts, training and health & safety. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 18 Staff records and discussion with staff employed since the last inspection evidenced that application forms had been completed, interviews held (with notes kept), written references obtained, written terms & conditions issued and criminal records checks undertaken. Copies of proof of ID and photographs were also on file. The manager reported that the home meets the standard for 50 (14 individuals) of carers holding NVQ 2 or equivalent. Evidence of pass certificates were seen. New staff undergo the home’s own induction programme. Records of this were seen, and staff spoken with who had employed since the last inspection confirmed they had received induction training. In addition to the basic induction package the home has a five unit modular pack. This includes principles of care, resident care, role of the worker, health & safety, effects of the setting on service provision and safety. At the next inspection records will be checked to ensure that this package is used for all new employees. The manager of the home is a qualified trainer on food hygiene, manual handling, health & safety, fire awareness, first aid and POVA. Training records and discussion with staff confirmed that staff had been provided training on all these subjects by the manager. External training provided had included NVQ, activities and medication. Training planned for September 2006 includes awareness of dementia care issues. Content of this will be checked at the next inspection. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,37,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had been run and managed efficiently and effectively, however there needs to be a registered manager in place. Procedures for gaining the views of residents and relatives were in place and had been implemented. Records required by regulation were in place. Financial practices in the home appeared to have been competently managed. The health and safety of residents and staff appeared to have been assured. EVIDENCE: The home did not have a manager registered with the Commission. This is an issue that has been on-going for a lengthy period and requires addressing. There is a statutory requirement on this matter in this report. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 20 However it should be noted that the acting manager appears to have managed the home effectively and efficiently since the previous registered manager left. An annual quality assurance questionnaire exercise takes place. The last survey had taken place this year and responses received were inspected. Questions included asked residents and relatives their views on the care provided, staff attitudes, food, laundry, cleanliness, facilities, rooms, garden, activities, complaints and atmosphere. Staff views were also sought and recorded. There should be a summary of the responses and of any resulting actions available for inspection, and for viewing by contributors to the process. During this inspection it was evident that the manager wishes residents to consider that they can speak with him whenever he is free, if they have any queries or concerns they want clarified. Some residents personal allowance monies were held for safe keeping by the home. Records of transactions, receipts and balances held were kept and were inspected. The standard relating to staff supervision was not inspected but evidence of formal staff supervision meetings having taken place was seen. The manager advised timescales of these meetings was six times a year. The home had COSHH data sheets and their own risk assessment sheet for cleaning substances used. There were comprehensive and impressive premises risk assessments in place. These had been devised by the manager and included identified hazards, control methods and risk rating. This was reviewed and updated annually. Random samples of records required to be kept were inspected. These included: complaints, assessments, staff rotas, staff recruitment, accident records, visitors book, fire drills, regulation 37 notices, regulation 26 reports, menus, medication, background info’ and next of kin details, cash held for safekeeping and fire procedures. All seen were satisfactory. Discussions with staff, management and inspection of records confirmed that training is provided to staff in moving and handling, fire safety, food hygiene, first aid and basic training in infection control. Certificates and service records were available for inspection to confirm that the home’s fire equipment, passenger lift, hoists, call alarms, emergency lights, gas supply, portable electrical appliances and electrical installation supply had all been tested/serviced within recommended timescales Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 21 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X 3 X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X 3 3 Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 22 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 OP31 Regulation 8,9 Requirement The registered person must ensure that the home has a registered manager. Timescale for action 30/11/06 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 OP9 Good Practice Recommendations The registered person should ensure that that home’s medication training for staff includes a recorded assessment of competency for undertaking the role of administering medication. Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 23 2 OP30 The registered person should ensure that the home’s induction for new staff includes records of the full in-house process and modular package. The registered person should ensure that an action plan summary is produced from the annual quality assurance process. 3. OP33 Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 24 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 Belmont Lodge DS0000017768.V312618.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!