Inspection on 22/09/08 for Friars Lodge

This inspection was carried out on 22nd September 2008.

CSCI found this care home to be providing an Adequate service.

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

Friars Lodge 04/08/09

Friars Lodge 28/09/07

Friars Lodge 15/11/06

Friars Lodge 01/12/05

Friars Lodge 09/08/05

Friars Lodge 09/03/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Friars Lodge 18 Priory Road Dunstable Bedfordshire LU5 4HR Lead Inspector Mrs Louise Trainor Unannounced Inspection 22nd September 2008 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 Friars Lodge DS0000062259.V369431.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. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Friars Lodge Address 18 Priory Road Dunstable Bedfordshire LU5 4HR 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) 01582 668494 F/P 01582 668494 no email as at 28.6.7 Friars Lodge Ltd Manager post vacant Care Home 20 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (20), of places Physical disability over 65 years of age (20) Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide accommodation for twenty people over the age of 65, four of whom may be accommodated in two rooms for double occupancy where it can be shown that the decision to share was a positive choice. 28th September 2007 Date of last inspection Brief Description of the Service: Friars Lodge is a private residential care home and is registered to provide care for twenty older people. The home is located in a pleasant residential area of Dunstable and is within close proximity to the Priory and the towns amenities. The bedrooms are on three floors that are accessible by a staircase and a newly installed shaft lift. Toilets and adapted bathing facilities are located for convenient access throughout the home. A large lounge with dinning area and a small visitors/quiet lounge are situated on the ground floor. The lounge area overlooks an established and well-maintained garden to the rear of the home. Parking is available for a few vehicles at the front of the building. However there is also some road parking close to the home. Fees for the home are between £457.06 and £650 a week depending on the room provided. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was carried out in accordance with the Commission for Social Care Inspection’s (CSCI) policy and methodologies, which require review of the key standards for the provision of a care home for older people that takes account of service users’ views and information received about the service since the last inspection. Evidence used and judgements made within the main body of the report include information from this visit. This was the first Key Inspection for this year for this service. Regulatory Inspectors Mrs Louise Trainor carried it out on the 22nd of September 2008 between the hours of 10:00 and 15:30 hours. The home Manager was on leave on the day of the inspection, however the deputy manager was present throughout the visit to assist with any required information. Verbal feedback was given periodically throughout the inspection and at the end of the visit. During the inspection the care of three people were case tracked. This included the most recent admission to the home. This involved reading their records and comparing what was documented to the care that was being provided. Documentation relating to: staff recruitment, training and supervision and medication administration, complaints, quality assurance and health and safety in the home were also examined. We also spent some time in the communal areas of the home, talking to staff and residents and observing the care practices that were carried out during this five and a half hour inspection hour inspection. We would like to thank everyone involved for their support and assistance during this visit to the home. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 6 What the service does well: The home understands the importance of having enough information when choosing a care home. Admissions are not made until a full assessment of needs has been carried out, so that prospective residents and their representatives can be sure their needs will be met. Medications were appropriately stored in a locked trolley that was secured to the wall in a locked room. There was photographic identification for each resident in the file with their MAR sheet, and monthly deliveries had been appropriately signed in on the MAR. All the MAR sheets were accurately completed with signatures and omission codes where appropriate. People who live in this home are encouraged to maintain relationships with families and friends. Residents are involved in meaningful activities of their own choice, which are risk assessed where necessary. There is a four-week rolling menu system, and meals are nutritious and varied, giving choice and variety to the residents. The complaints procedure is accessible to everyone living in the home. Staff working at the home understand the procedures for reporting safeguarding issues. This service recognizes the importance of training and delivers a programme that meets the National Minimum Standards. Recruitment procedures are fully adhered to so that residents are protected. The staff that we spoke to during this visit were confident and competent in their roles, and were able to talk in depth about individual residents needs and the care that they require. The manager understands and follows the reporting processes for accidents and injuries in this home. We checked three accident forms, and were able to cross reference them correctly with the regulation 37 notification forms. Residents and their representatives are encouraged to attend meetings two or three times a year, where they can express their opinions and ideas, and a Newsletter is also produced by the home on a monthly basis, keeping everyone up to date with home gossip and news. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 8 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 Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4, 6 People who use this service experience adequate quality outcomes in this area. The home understands the importance of having enough information when choosing a care home. Pre Admission documentation was in place, however we were unable to find signatures on these documents indicating who had completed them. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: There is a combined Service User Guide and a Statement of Purpose in place for this home. This document is held electronically and reviewed at regular intervals, then issued to people as they enquire about the home. The Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 10 document we were shown had been reviewed within the last year, and correctly reflects the details of the present manager and contact details for The Commission for Social Care Inspection (CSCI). Although there was no evidence of the range of fees charged for living in this home in this document, there are clear details of what is included in the fees, and what is provided at an additional cost, such as hairdressing. The individual fee for each resident is clearly identified within their contract of terms and conditions. We viewed the files of three residents in the home. There were pre admission assessments in place in each file, however had some difficulty finding dates and sign signatures on two of them, so it was difficult to ascertain if these had been carried out in advance of the admission. The Operations manager has since identified where the date can be found, and has agreed to ensure these documents are signed in future. Generally these documents contained sufficient details relating to individuals’ needs, and were then used to generate initial care plans following admission. This home does not provide intermediate care. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use this service experience adequate quality outcomes in this area. People receiving care in this home are generally happy with the way most staff deliver care and respect their dignity, however due to limited information being documented in some care plans, there may be an inconsistency in the delivery of care. Medication records are fully completed, contain required entries and are signed appropriately by staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: During this visit we checked the Medication Administration Record (MAR) sheets for approximately half of the residents. Medications were appropriately stored in a locked trolley that was secured to the wall in a locked room. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 12 There was photographic identification for each resident filed with their MAR sheet, and monthly deliveries had been appropriately signed in on the MAR. All the MAR sheets were accurately completed with signatures and omission codes where appropriate. The stocks remaining for five residents were checked against their MAR sheets and all reconciled correctly. Bottles and topical applications such as creams and eye drops had been dated on opening. Controlled drugs (CD’s) were stored appropriately and all administrations had been recorded accurately with two signatures in the CD registered. The CD Register would benefit from numbered pages and an index page. During this inspection we looked at the personal files of three residents, and spoke briefly to other residents as the opportunity arose throughout the day. Comments from the residents were generally very positive and complimentary of staff. All residents had numerous care plans and risk assessments in place that were being reviewed on a regular basis, however we noted some omissions in the files that we looked at. One resident’s file gave a detailed overview of their needs. It identified that this person suffered with depression, dementia, and asthma. It detailed information and risk assessments relating to medication, pressure area care, moving and handling and dietary intake, and the care plans contained specific information about the level of assistance required. It was also identified that this resident had a catheter in situ, however there was no care plan to give any catheter care instructions to staff. Another residents case file identified that they have a tendency to abscond from the home and also to lock himself in his room at night. Again we were unable to locate any care plan to identify how these issues should be managed. Friars Lodge DS0000062259.V369431.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use this service experience good quality outcomes in this area. People who live in this home are encouraged to maintain relationships with families and friends. Residents are involved in meaningful activities of their own choice, which are risk assessed where necessary. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Residents in this home are encouraged to make personal choices about their daily activities. There are activities available for the residents, however it is the choice of the individuals whether they participate or not. On the day of the inspection there were some one to one activities such as cards in progress, and a group of residents were enjoying My Fair Lady on the television. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 14 The home also has visiting entertainers from time to time, and a travelling ‘clothes shows’ which enable residents to choose and purchase outfits without going to the shops. The atmosphere in the home was relaxed and friendly, and the staff were responding to the residents efficiently and effectively. When residents required assistance to go to the toilet, their privacy was being respected. Where possible people were left in private, until the staff were required for further assistance. However results of a recent resident satisfaction survey indicated that not everyone shared this view. One resident had stated. “Staff can be a little short at times, sometimes it can feel like an effort that they have to take the residents to the toilet”. Another had said. “Staff should ensure that they knock on the doors of residents rooms prior to entering.” There is a four-week rolling menu system, and meals are nutritious and varied, giving choice and variety to the residents. On the day of the inspection there was a choice of liver and bacon, or lamb mince with a cheese crumble topping, accompanied by fresh vegetables and potatoes. Jacket potatoes and salads were also available for those that preferred them. Dessert was plum sponge and custard or melon and pineapple. The meals were well presented, and all smelt and looked appetising. The cook, who has worked at the home for nearly 20 years, told us that she tries to include fresh fruit into the desserts, however it is also readily available for anyone who wants it at any time. Cupboards and fridges were well stocked, and all opened produce had been dated and labelled on opening. Visitors are welcome to the home at any time, and outings are encouraged. For a small cost of £2.00, friends/ relatives can enjoy a meal with their loved one in the home. Residents and their representatives are encouraged to attend meetings two or three times a year, where they can express their opinions and ideas. A newsletter is also produced by the home on a monthly basis, keeping everyone up to date with homes’ gossip and news. Minutes from a recent meeting included: wishing one resident a happy 100th birthday, and wishing the cook a happy retirement. Friars Lodge DS0000062259.V369431.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use this service experience good quality outcomes in this area. The complaints procedure is accessible to everyone living in the home. Staff working at the home understand the procedures for safeguarding, and know when incidents need to be reported externally. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: This home has a complaints policy, which is displayed in the reception area and is easily accessible to residents and visitors to the home. It details expected timescales for responses, and guidance for any complainant that remains dissatisfied with investigatory outcomes. We viewed the complaints and compliment files. The home had not received any complaints since the previous inspection. There were however numerous cards of thanks. One read. “Thank you for everything you did for -----. Her life for the last few years was as comfortable as it could be and she always seemed content”. The staff at Friars Lodge have received training in safeguarding and were able to demonstrate clear and up to date knowledge on the subject. Staff that we spoke to during this inspection were able to demonstrate their understanding Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 16 of what type of incidents should be reported and what processes they need to follow. Recent safeguarding issues have been referred and acted upon appropriately. Friars Lodge DS0000062259.V369431.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 23, 24, 25, 26 People who use this service experience good quality outcomes in this area. The home provides a clean, comfortable and safe environment for the people who live here. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: A full tour of the premises took place during this inspection. The home was clean and free from offensive odours, and generally well maintained. Individual rooms were decorated and furnished individually to meet with personal tastes. Photographs and ornaments on display in some of the rooms clearly reflected the family and personal history of the residents. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 18 Although small, this home was tidy, and areas of concern raised at the last inspection regarding the environment have now been addressed and risk assessed to ensure the safety of both residents and staff. The communal lounge area was well occupied throughout the day. There were orientation boards in place in this area, however the wrong date was displayed on the day of the inspection. Bathing and shower facilities have been updated since the last inspection, and a new wet room installed. Bath hoists and other equipment was appropriately labelled and signed to identify that servicing had been carried out. The garden to the rear of the home was well tended, and provides a pleasant environment where residents can spend time weather permitting. Friars Lodge DS0000062259.V369431.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People who use this service experience good quality outcomes in this area. This service recognizes the importance of training and delivers a programme that meets the National Minimum Standards. Recruitment procedures are fully adhered to so that residents are protected. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: This home is presently fully staffed, however is presently recruiting to its ‘bank’. The staffing numbers are presently four care staff on the a/m shift, four staff on the p/m shift and two staff on duty at night. The manager and the deputy are an addition to these numbers, and the care team are generally supported by kitchen and cleaning staff, although two days each week the care staff are responsible for the preparation and service of the evening meal. We examined the personal files of three members of staff. All contained fully completed application forms, appropriate references, induction checklists and training agreements. Criminal Record Bureau (CRB) checks had been carried out on all staff, and home office paperwork was present where required. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 20 However the deputy manager was unable to locate evidence of one of the CRB checks, and informed us that these documents are generally kept at head office. We suggested that the home should keep a CRB reference number and clearance date, where the document is not present. Training is taken seriously in this home and evidence from staff files and discussions with individual staff, indicated that staff attend training regularly keeping up to date with mandatory subjects. Other training such as Dementia, Care Planning, Epilepsy, Diabetes and Parkinsons Disease is also available and encouraged. The staff that we spoke to during this visit were confident and competent in their roles, and were able to talk in depth about individual residents needs and the care that they require. Friars Lodge DS0000062259.V369431.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37, 38 People who use this service experience adequate quality outcomes in this area. The manager is aware of the importance of record keeping in the home. However omissions in daily records, indicates that auditing process may require improving. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager in post at this home was not present for this inspection. Although she has been in post for approximately a year, she has not yet submitted her Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 22 application to the Commission for Social Care Inspection as Registered Manager. She is presently supported by an experienced deputy manager who has been at this home for approximately 2 years. Staff in the home indicated that they felt well supported, and that the manager and her deputy were visible and approachable for them. We viewed the supervision records for three members of staff, and spoke to three others. This confirmed that all staff are now receiving supervision either from the manager or the deputy on a regular basis. The manager understands and follows the reporting processes for accidents and injuries in this home. We checked three accident forms, and were able to cross reference them correctly with the regulation 37 notification forms however this information was not always reflected in the individual’s daily care notes. We looked at health and safety documentation, including the fire log and maintenance book. There was evidence to indicate that fire call points and the emergency lighting were being tested on a regular basis, and that fire drills are carried out periodically. Maintenance issues are being addressed in a timely fashion. The management in this home monitors the quality assurance, by using questionnaires that are given to the residents to complete. We saw a report, which had recently been written following the completion of questionnaires by twelve residents in the home. This included resident’s views relating to, staffing, entertainment, the garden, food and the complaints procedure. A residents meeting, where improvements and actions were discussed and minutes recorded, had followed this up. The Operations Manager informed us that the home have attempted to get views from other professionals who work with the home, however to date this has not proved very successful due to the limited responses received. The residents in this home have safes in their rooms, where they can store their money and valuables. There had recently been a safeguarding referral raised following some anomalies found when auditing individual’s money. The home has now changed it’s policy, and all keys for safes are locked in the office. However we were still a little concerned to hear that there was some confusion relating to the processes for one resident, whose family held her key. The Operations Manager is addressing this. Friars Lodge DS0000062259.V369431.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 3 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 2 3 3 3 Friars Lodge DS0000062259.V369431.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 OP7 Regulation 15 (2) (b) Requirement People who use this service must have all their care needs identified and addressed in individual care plans. All people who live in this home must be safeguarded by records, which clearly identify all transactions that take place relating to personal expenditure. Timescale for action 30/10/08 2. OP18 16 30/10/08 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 manager should consider more regular auditing of medication stocks, with a particular focus on those not provided in blister packs. Friars Lodge DS0000062259.V369431.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Friars Lodge DS0000062259.V369431.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!