Inspection on 20/12/07 for Belmont Lodge Care Centre

This inspection was carried out on 20th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Belmont Lodge Care Centre 15/09/06

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 20th December 2007 10:00 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.V356858.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.V356858.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.V356858.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 23rd January 2007 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 including 10 places for people who have dementia. 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. 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 regarding fees is available from the home. Past inspection reports are available from the home, and from the CSCI internet website. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place on 20th December 2007. 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 residents, relatives, staff and other parties. Practice and procedures occurring after this inspection will be reported on in future inspection reports. Discussions took place with residents, visitors, the manager, the administrator, care staff and other staff on duty. Random samples of records, policies and procedures were inspected and a tour of parts of the premises and grounds took place. Eight residents were spoken with and questionnaires were also left at the home for others to comment on the care provided. All who expressed an opinion confirmed that they were satisfied with the home and with the care and staff attitudes. Actual comments received included, ‘staff are good here’, ‘I have no complaints’ ‘the staff are very helpful’ and ‘they are always around if I need them’. Comments on the food included, ‘the food is really quite good’ and I get more than enough to eat’ and ‘the meals here are very good, I get a choice and they are well cooked’. Those spoken to also said that they were satisfied with the quality of accommodation offered, comments made included ‘my room is very comfortable and I have my own washing facilities’. ‘I’ve got my own room and I like it’ and ‘I like my room but it’s a bit small’. Visitors spoken with were complimentary of the care and support provided to residents by the staff and manager. Questionnaires were also left at the home so that relatives had the opportunity to make their views on the service known to the Commission. Four forms were returned, comments made included: ‘the staff are excellent, ‘I cannot speak more highly of Belmont Lodge, the staff provide excellent care, ‘very pleased with cleanliness, staff friendly’. One comment indicated that the person thought staff were overstretched because of the amount of admin’ work they had to do, but that they were kind and did excellent work. Staff confirmed had been provided good training opportunities, including NVQ training. Some comments and feedback from staff did suggest that they thought more staff should be rostered to work on daytime shifts, especially in the mornings. The main reason for this being it was sometimes difficult to have all residents ready in time for breakfast. Other comments included the view that the training provided did not always equip them to fully meet residents needs. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 6 Twenty four standards were inspected and the outcomes for residents for twenty of these was good with four adequate. As a result there are three statutory requirements for action and one good practice recommendation included on page 24 of this report. What the service does well: What has improved since the last inspection? What they could do better: Management of the home need to ensure that staffing levels meet the needs of residents. Residents need to be offered stimulating and meaningful activities from a member of staff rostered solely for that role. The floor covering in one of the bathrooms needs replacing. --------------------- 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. Belmont Lodge DS0000017768.V356858.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.V356858.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. 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 this service. People considering moving into the home can be confident that the admission processes ensure that the home can meet their needs. 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, diet, 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.V356858.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. EVIDENCE: Three care plans were inspected. Included was background information, personal details, next of kin contacts. The residents’ needs/action sheet included predicted 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 and included an evaluation record sheet. 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, an optician and a hairdresser. Some residents continue to see their dentist in the community. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 10 The homes medication policy and procedure was unchanged and 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 May 2007. This was entitled Medication Management Training and included reasons for prescribed medications, types and side effects of medicines, handling and compliance. Certificates were seen to confirm staff attendance. The training had included a visual competency assessment, evidence of this was seen shortly after the inspection site visit. Medication administration records were inspected, those seen were acceptable. 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. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not always support people to engage in daily activities and lifestyles of their choice. Individuals health is maintained through the provision of a satisfactory diet, and the enjoyment of meals is promoted through the variety and choice of food. EVIDENCE: Activity records were inspected. There was a weekly scheduled programme which is good practice. However the role of providing activities in the home is undertaken by care staff. This practice is regarded as a ‘drain’ on care staff resources, and it may lead to activities being offered by staff untrained for this task and/or residents general care needs not being met. It should also be noted that comments made to the inspector did not fully confirm that residents expectations were met regarding activities and interests available. During the inspection an entertainer was seen singing to residents in one of the lounges, however at least two residents spoken with in other areas of the home had not been told about this event and missed it. For these reasons this report includes a requirement on the subject of activities and recreational interests. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 12 Some personal allowance monies are held for safekeeping and records of transactions and receipts are kept. A random sample of these checked were acceptable. Advocacy support is available and a notice about this was in the service user guide. 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. The manager confirmed that cooked breakfasts were menued at weekends and that residents could have supper snacks. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Belmont Lodge are able to express their concerns with the confidence that they will be listened to and taken seriously. 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. Abuse and POVA training had been provided in-house by the previous manager. This included clarifying types of abuse, recognising signs and required actions if abuse suspected. Evidence of this training was seen and staff spoken with said they knew what action to take if they suspected abuse had occurred. The homes policy on adult protection also contained 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. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 14 The home had a copy of the latest POVA guidelines and the Essex & Redbridge Councils adult protection guidance manuals. The manager said that 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.V356858.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 25 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Belmont Lodge benefit from a well-maintained environment but cannot expect that all areas of the home will have been decorated recently. EVIDENCE: The home was fully accessible to residents currently accommodated and was well maintained externally and internally, except in one bathroom seen, where the floor covering was not sealed resulting in water/fluid ingress and malodours. The rear garden was well laid out and maintained. Individual private accommodation and facilities are all considered to be of a good standard. 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. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 16 Twenty five private rooms had en-suite facilities, there were also a reported 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. 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.V356858.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care staff in the home are experienced and trained to provide effective personal and healthcare support to the people living there. However staffing levels may not fully meet residents day to day needs and expectations. EVIDENCE: The home’s staffing rota was inspected and confirmed staffing levels as 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. The manager advised that recently the home had a number of vacant rooms and at the time of this inspection some morning shifts had been reduced by one carer. Separate and additional rostered staff were employed to undertake cooking, kitchen assistant, administrative, and domestic duties. Maintenance is undertaken by the recently employed maintenance man. There does not appear to have been any increase in care staffing levels since the addition in 2006 of 10 places for ‘DE’ service users within the home’s registration category. Observations made and information received by the Commission could indicate that residents dependency levels have risen since the variation to registration. For this reason there needs to be a review of the ratios of care staff to service users according to the assessed needs of residents. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 18 Staff meetings take place. Discussion with staff and records confirmed this. The last minuted meeting had been on 23/10/07, where agenda items had included care plans, equipment, medication and training. 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 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. The manager of the home is a qualified trainer on manual handling and dementia awareness. Staff training records and discussion with staff confirmed that staff had been provided training on these subjects as well as fire safety, falls, infection control, POVA & abuse, NVQ, food hygiene and medication. Belmont Lodge DS0000017768.V356858.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, but it was not possible to confirm that all areas of the home were safe. EVIDENCE: Since the last inspection a new manager had been appointed, who had applied to the Commission for registration as registered manager. The manager is a registered nurse with previous experience of managing a care home. She also has experience relating to the care of people who have dementia. An annual quality assurance questionnaire exercise takes place. The last survey had taken place in 2007 and responses received were inspected. Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 20 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 was a summary of the responses and of any resulting actions, this was presented for inspection and evidenced notice was taken of feedback received. Staff had received 1-1 supervision. The format used was seen and included records of issues discussed. The home had COSHH data sheets and their own risk assessment sheet for cleaning substances used. There were comprehensive premises risk assessments in place. These included identified hazards, control methods and risk rating. Random samples of records required to be kept were inspected. These included: complaints, assessments, staff rotas, staff recruitment, visitors book, fire drills, regulation 37 notices, 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 and portable electrical appliances had been tested/serviced. The electrical installation supply test was overdue (last test shown as August 2002). Belmont Lodge DS0000017768.V356858.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 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 2 Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP12 Regulation 12, 16 Requirement The range of activities and recreational interests available to residents must satisfy their expectations and needs. Timescale for action 30/04/08 2. OP27 OP4 18,14(2) A full review of residents needs 30/04/08 must take place to ensure that care staffing levels meet the needs of residents. The results of this process must be available for inspection by the Commission. The home’s electrical installation supply must be serviced/retested to ensure all reasonable action has been taken to promote the safety of residents and staff. 30/04/08 3. OP38 13 Belmont Lodge DS0000017768.V356858.R01.S.doc Version 5.2 Page 23 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 OP19 Good Practice Recommendations Bathroom no 25 should have new sealed flooring laid to ensure that residents live in a well maintained environment. Belmont Lodge DS0000017768.V356858.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: 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 Belmont Lodge DS0000017768.V356858.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!