Inspection on 27/09/07 for George Potter House

This inspection was carried out on 27th September 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

George Potter House 24/05/06

George Potter House 08/11/05

George Potter House 01/04/05

George Potter House 09/09/04

George Potter House 15/04/04

George Potter House 20/10/03

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

CARE HOMES FOR OLDER PEOPLE George Potter House 130 Battersea High Street Battersea London SW11 3JR Lead Inspector Louise Phillips Unannounced Inspection 27th September 2007 08:30a 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 George Potter House DS0000019091.V351559.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. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service George Potter House Address 130 Battersea High Street Battersea London SW11 3JR 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 7223 3224 020 7223 6984 info@georgepottercare.org Sovereign (George Potter) Ltd Miss Adri Jane Leonie Skipper Care Home 69 Category(ies) of Dementia (33), Old age, not falling within any registration, with number other category (36) of places George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Exception to age of one service user Agreement is given for the home to continue caring for the service user currently resident in the home who is aged 39. However, an urgent review must take place by the 30/09/03 to look at her needs, as this home is not suitable for this service user long term. The service user has a mental health problem as well as a mild learning difficulty. From the assessment made at the time of placement it is not clear why this home was deemed suitable for her. Staffing Levels No of Service Users 8am – 2pm 2-8pm 8pm-8am TN CA TN CA TN CA 51-553 8 3 7 2 3 56-603 9 3 8 2 4 61-653 10 3 9 2 5 66-694 10 4 9 2 5 Reviews The organisation must ensure that the above minimum staffing levels remain under review and that at all times suitably qualified, competent and experienced persons are working in the home in such numbers as are appropriate for the health and welfare of service users. Distribution of Staff The number and distribution of nurses care staff and ancillary staff must be reviewed at regular intervals. If at any time the evidence indicates that there is insufficient staff of any categories available to meet the assessed needs of service users, the NCSC will require additional; staffing as appropriate. 28th November 2006 2. 3. 4. Date of last inspection Brief Description of the Service: George Potter House is registered to provide accommodation and nursing care for sixty-nine older people. This may include thirty-three individuals with dementia. The home is privately owned by Sovereign (George Potter Ltd) and is situated in Battersea, within easy reach of local shops and Clapham Junction train station. Accommodation is provided over two floors serviced by a lift. The first floor unit is for residents with dementia. Information about the home is provided to residents in a written guide. The current range of fees are between £700 and £800 per week. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 5 George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one day by two inspectors. Time was spent talking seven staff, three residents and viewing paperwork. A tour of the premises was carried out and care records were inspected. Information has also been gained from the inspection record for the home and surveys received from four residents, some with the support of their relatives. What the service does well: 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. George Potter House DS0000019091.V351559.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 George Potter House DS0000019091.V351559.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 and 6 Quality in this outcome area is good. The residents are well assessed prior to moving to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A number of residents were spoken to, all who have lived at the home for varying amounts of time. Each residents’ reason for choosing to live at the home was different, one saying they had chosen it under the recommendation of their doctor, another said their “…family had chosen the most suitable place for them…”. One resident spoke to us about their move to the home, stating that the staff “…were wonderful and helped me to settle in…”. The file for two residents recently admitted to the home was examined. Findings indicate that the home has a good process for assessing and George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 9 admitting new residents, with appropriate referral information being sought from the social worker, psychiatrist or other care professionals as necessary. The manager and deputy manager are involved in assessing new residents to the service, using the home’s own assessment format that provides good information about the residents social and medical history, personal care issues, and any lifting and handling needs. Intermediate care is not provided by the home. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. The residents’ needs are well met through attention to individual needs, preferences and care planning. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents said that they feel they get good care and support, one commenting that: ‘…they look after you well here…’, another saying that ‘…the staff are really caring…’. A number of residents discussed openly with the inspector the help they receive with personal care. Each spoke about how this is carried out in an unhurried manner by the staff, at the resident’s own pace and with respect to their privacy. During the inspection staff were seen to knock at bedroom and bathroom doors before entering. The care files are very organised, and it is easy to access relevant information about the care and support needs of each resident. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 11 Six care plans were looked at during the inspection. These are in a good format, covering significant areas such as personal care, communication, social activities and expressing sexuality. The information contained is very detailed, indicating that staff know the residents well and take time to find out about them as individuals. An example of this is where the potential for isolation and loneliness was highlighted in a care plan for a resident. The care plan then detailed ‘…(resident) loves to see friends. Encourage friends visits by warmly welcoming them in the home when they come to visit…’. In addition, a care plan for a resident who has dementia and is unable to express themselves states: ‘…use simple language…bend to their level…talk to (resident) when in room… re-orientate to time/place… explain reality…’. Where relevant, there is care information regarding such areas as nutritional assessments, pressure area care, moving and handling, and falls assessments. All care plans and healthcare assessments are kept up-to-date and reviewed monthly. Generally the record-keeping was to a good standard, apart from some areas noted. On one occasion an entry in a residents care notes stated: ‘…sometimes she can be demanding...’. Also, in the care plans for one male resident an inappropriate entry was made regarding expressing sexuality. Both of these areas were raised with the manager on the day of inspection. Some areas were noted as needing improving, such as ensuring that there are clear records regarding use of bedrails, photographs to show progression of wounds/ pressure sores, wheelchair assessments and the use of pressure reliving mattresses for those people at risk of developing pressure sores. The residents spoke about being able to access the dentist, chiropodist or optician whenever they want, with one commenting that: “…I can see my doctor when I need to…”. A record of all healthcare appointments is maintained in the individual care files, and the manager discussed good links that the service has with the tissue viability nurse and local GP practices. The risk assessments are individualised, covering areas such as, risks relating to dehydration, weight loss and poor vision. Medication at the home is managed well, with appropriate storage and monitoring systems in place to ensure that this is given correctly. All staff who give out medication have received training on how to do this safely. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 12 It was observed on the first floor that prescribed creams and lotions are stored in a locked trolley in the hallway. On further examination a number of discrepancies were noted, where labels were missing, some had unclear labelling with the name of the resident not readable and others stating ‘ as directed’, with no clear instructions either on the label, or medication administration record (MAR). The Registered Persons must ensure that all medication is administered appropriately in accordance with good practice guidelines. George Potter House DS0000019091.V351559.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 and 15 Quality in this outcome area is good. Residents have the opportunity to be involved in activities offered and are able to enjoy lunch in relaxed surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: “…Everyone is nice and laughing all the time...”, “…I can have visitors anytime…”, “…this is my home…”. These were comments from residents who say that they enjoy living at George Potter House. The home has a full-time activity co-ordinator, and is awaiting recruitment checks for a volunteer activity assistant to provide additional support. The activity co-ordinator was on duty on the day of inspection and was seen arranging activities around the home with the support of the care staff. During the morning some residents on the ground floor participated in a game of dominoes, enjoying this and interacting with the staff and each other. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 14 Prior to lunch some staff were observed sitting and talking to residents, with discussion around the headlines in the daily paper. On the first floor the activity worker was carrying out reminiscence work with a group of residents, looking at photos of popular historical figures and singing old-time songs. The activity co-ordinator spoke about how she arranges similar, but different activities for the ground and first floor units, due to the differing needs of the residents. She also said about some one-to-one activities that she does with different individuals, and various trips that have happened throughout the year. The notice-boards around the home gave information about the daily activities, entertainers coming to the home and a visiting librarian. All residents have a care plan about activities they like to be involved in, and these were reflective of those offered by the home. Good interactions were observed between staff and residents and with each other. And staff were seen to speak to residents in a genuinely caring and respectful manner. Residents are also enabled to walk freely around the corridors and between the lounges. During the inspection the chef spoke to us about how the menu for the home is prepared around information gained from residents on admission to the service, and from regular meetings with the manager. Comments from residents is that: “…he food is alright…”, “…the food is nice…”. The lunch was observed being served in the large dining area on the ground floor, though some residents preferred to have their meals in their bedroom. The food looked nutritious and appetising, with good portion sizes and plenty of cold drinks available to accompany this. Where necessary, staff were also observed sitting with residents to assist them to eat and drink. George Potter House DS0000019091.V351559.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 and 18 Quality in this outcome area is good. There are systems in place to minimise risks to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a complaints procedure that is provided in the Service Users Guide and Statement of Purpose for the home. Of those surveyed, all the residents said that they would know how to make a complaint if there was something they were not happy about. The manager maintains a log of all complaints received, along with all actions taken and any correspondence relating to these. Staff records indicate that they have received recent training in elder abuse awareness and safeguarding adults, so to minimise risks to residents. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 16 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 and 26 Quality in this outcome area is adequate. The staff and residents make the environment welcoming, however the windows at the home need replacing to make the house more comfortable for the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous inspection gave a number of requirements that the home needed to meet to ensure the comfort and safety of the residents. The home has addressed most of these, although a number of curtains still need to be replaced around the home. New requirements have also been made as a result of the findings from this inspection. The manager has a good awareness of areas needing improvement, particularly the replacement of all windows throughout the home, as they are in a poor state of repair. She said that quotations have been obtained by the George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 17 organisation for refurbishment of the windows and that this will be addressed but work has not yet started. The manager stated that the kitchen is due to be refurbished in the near future. She gave a copy of the report from an Environmental Health Officer who visited the home recently. A number of requirements and recommendations were made regarding the kitchen area, and these are currently being addressed by the service. On the day of inspection the kitchen was seen to be in need of a thorough, deep clean, as the floors were dirty. George Potter House is very spacious and with good natural lighting throughout. Residents said that they are happy with their bedrooms, which they are able to personalise. It was observed that a number of lounges around the home are not used and consideration should be given to making use of these for the benefit of the residents. The lounges, particularly those on the first floor, should be made more homely and comfortable for the residents. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. The service provides training so that residents receive a good level of care, and recruitment procedures protect the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: George Potter House maintains a number of staff, most who have worked at the home for a number of years and have a good working knowledge of the residents, and working with older people. Feedback from residents is that staff are generally always available when they need them. The manager stated that the home is appropriately staffed to meet the needs of the residents. A deputy manager has been employed since the beginning of August 2007 to support the manager, and an administrator has also been working at the home for a number of years. There are also Registered General Nurses and Registered Mental Health Nurses to meet the needs of the residents throughout the service. The home holds recruitment information on each member of staff. The staff files contain relevant information such as proof of identification, correspondence relating to offer of job, Criminal records Bureau check, George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 19 statement of terms and conditions of employment, two references and record of the interview of staff. All new staff receive an induction to the service which covers areas such as fire safety, first aid and lifting and handling, with this training accessed via Wandsworth local authority. A record is maintained of all training done by staff, which includes the training listed above, plus safeguarding adults and elder abuse awareness. On the day of inspection the staff were due to receive training on diet and nutrition from a visiting trainer to the home. The manager stated that there are currently six staff undertaking NVQ training in care practices. Nurses are able to access more specialist training in wound care, diabetes and medication. The staff training record indicates that approximately half the staff team have received relevant training in the past year, and further improvements are needed to ensure all staff are up-to-date. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 20 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, 32, 33, 35, 36, 37 and 38 Quality in this outcome area is good. There is a committed and competent manager at the home who has helped to progress the service for the benefit of the residents. However, record-keeping in residents files needs to be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The improvements since the last inspection demonstrate that the home has a committed and competent manager who promotes the choices and interests of the residents and who sets good standards. One relative commented that the manager is approachable, and that they “…can speak to her about any issues…”. Relatives also felt that they are kept George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 21 well informed about issues concerning their relative and significant issues in the home. Observations and discussions with residents and staff during the inspection were positive, indicating that the manager is respected and well-liked by the those living and working at the home. One staff member commented that “…the manager is very, very good…very supportive…”. The manager stated that she is currently undertaking the Registered Managers Award and was hoping to complete this by December 2007. Quality assurance is carried out by the service through annual questionnaires sent to relatives for feedback on various aspects of the care, service, furnishings and accommodation. Visits by the registered provider are also conducted monthly. The manager reported that home is involved in the Gold Standard Framework and is working closely with Trinity Hospice to help achieve the best end of life/palliative care for residents based on good practice. There are currently two nurses from the service involved in this. One-to-one supervision of care staff is carried out by the nurses, who supervised by the manager or deputy manager. The schedule detailing the frequency of supervision varies significantly, with some staff only receiving supervision every three or six months. Staff must receive a minimum of six supervision sessions a year, at regular intervals. The home holds a personal allowance for each resident that is funded by themselves, their family or through social services. This money is used for when a resident wants to go shopping or use the hairdresser, etc. Three residents cash balance was checked and found to correspond with the records and receipts. The cash is kept in an individual wallet for each resident, in the safe. The administrator explained that the company is corporate appointee for some of the residents. As highlighted earlier in the report, the record-keeping is generally a good standard, apart from some comments observed in the care records for residents. This was raised with the manager on the day of inspection, and a requirement made to address this. The home maintains records to demonstrate that appropriate health and safety checks are carried out on the fire system and equipment, fridge and freezer temperatures and water temperatures, gas safety and Portable Appliance Testing, etc. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 22 The home carries out health and safety risk assessments on the laundry, kitchen and COSHH (Control of Substance Hazardous to Health) products. On the day of inspection some tins of paint were found stored in an unlocked cupboard in a lounge on the first floor. This was reported to the manager at the time who stated that these were removed to a more appropriate storage area. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 2 3 3 X X X X 2 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 3 3 3 X 3 2 2 3 George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Requirement The Registered Persons must ensure that medication is stored and administered appropriately in accordance with good practice guidelines. The Registered Persons must ensure staff use appropriate terminology in written records regarding residents. Timescale for action 31/10/07 2. OP10 OP37 12(4) 31/10/07 3. OP19 23 (2) (b) The Registered Persons must 31/12/07 ensure that the curtains provided in the ground floor communal lounge are replaced. (Previous timescales of 01/10/06 and 01/04/07 not met) The Registered Persons must ensure all curtains are replaced throughout the home. 4. OP19 23 (2) (b) The Registered Persons must ensure that the ‘rotten’ windows throughout the home are replaced. 31/03/08 George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 25 5. OP26 23(2)(d) The Registered Persons must ensure that the kitchen is thoroughly cleaned daily. 31/10/07 6. OP30 18 (1) (c ) The Registered Persons must ensure that all staff are up-todate on training in relevant areas, eg. first aid, lifting and handling, fire safety. 18(2) The Registered Persons must ensure that staff receive a minimum of six supervision sessions a year, at regular intervals. 31/03/08 7. OP36 30/11/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP15 OP19 Good Practice Recommendations The Registered Persons should consider making better use of the lounge areas throughout the service. It is recommended that the home look at ways of making the first floor lounges more homely for residents. George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 George Potter House DS0000019091.V351559.R01.S.doc Version 5.2 Page 27 - 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. 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