Inspection on 09/10/06 for Greenbushes Nursing Home

This inspection was carried out on 9th October 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Greenbushes Nursing Home 09/04/09

Greenbushes Nursing Home 14/04/08

Greenbushes Nursing Home 10/05/07

Greenbushes Nursing Home 31/01/06

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

CARE HOMES FOR OLDER PEOPLE Greenbushes Nursing Home 10 Weymouth Avenue Dorchester Dorset DT1 2EN Lead Inspector Gloria Ashwell Key Unannounced Inspection 10:00 9 &18th October 2006 th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000064427.V302512.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. DS0000064427.V302512.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Greenbushes Nursing Home Address 10 Weymouth Avenue Dorchester Dorset DT1 2EN 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) 01305 262192 01305 261117 Dorchester Care Limited Liability Partnership Mrs Elizabeth Anne Moore Care Home 42 Category(ies) of Old age, not falling within any other category registration, with number (42) of places DS0000064427.V302512.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 10 places for service users receiving intermediate care, all to be located in the extension to the original building. One named person (as known to CSCI) under the age of 65 may be accommodated to receive care. 31st January 2006 Date of last inspection Brief Description of the Service: Greenbushes is registered to provide nursing care to older people. It is a detached house on the southern edge of Dorchester, within walking distance of the town centre. The house is surrounded by gardens laid to lawns and flowers beds, with space for car parking. During 2004 an extension providing ten additional bedrooms and a large communal room was completed. The home comprises thirty-two single and five double bedrooms; seventeen bedrooms have en-suite toilet facilities. All registered parts of the home can be accessed without the necessity to negotiate steps or stairs; there is a passenger lift and some corridors are sloped. Laundering of clothing and household linen is carried out within the home at no additional cost to residents; items requiring dry cleaning are charged additionally because it is necessary to send them out of the home for this service. A hairdresser visits the home each week; there is an additional charge forthis service. A public transport bus stop, for buses to the nearby town centre, is opposite the home. Fees are charged weekly; at present fees range between £500 and £675 per person. DS0000064427.V302512.R01.S.doc Version 5.2 Page 5 Information regarding the subjects Value for Money and Fair Terms in Contracts can be obtained from the web link: www.oft.gov.uk A report entitled Care Homes in the UK - A Market Study is available on web link http:/www.oft.gov.uk/NR/rdonlyres/5362CA9D-764D-4636-A4B1-A65A7AFD347B/0/oft780.pdf DS0000064427.V302512.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was a statutory inspection required in accordance with the Care Standards Act 2000. The inspection was unannounced; the inspector arrived at 14.00 on 9 October 2006, toured the premises and spoke to residents and staff and arranged the next visit which took place at 10.00 on 18 October 2006 when documentation relating to care provision and the premises was discussed and examined. The duration of the inspection (both days combined) was 9 hours. During the inspection, particular residents were ‘case tracked’; for example, for evidence regarding Standards 3, 7 and 8, records relating to the same resident were examined, and the resident spoken with. Additional information used to inform the inspection process included the monthly reports regularly sent to the Commission by the provider organisation, the Pre-inspection Questionnaire completed in advance of the inspection by Mrs Moore and comment cards completed and sent to the Commission by service users (7), doctors (2), social care professionals (4) and the relatives of service users (20). During this inspection compliance with all key standards of the National Minimum Standards was assessed. Since the previous key inspection a random inspection took place on 15th September 2006 to investigate concerns arising from an Adult Protection enquiry regarding the care of a particular resident. What the service does well: Comments received by the Commission in advance of the inspection included the following observation, made by a health care professional: “In the last 12 months the atmosphere in this nursing home has lightened and morale has improved. The patients are now getting the equipment they needed and as a result the nursing care has improved. Changes in staff have also led to improved quality of care.” Residents are assisted to maintain as much independence as possible and are encouraged to maintain contact with the local community. DS0000064427.V302512.R01.S.doc Version 5.2 Page 7 The premises are comfortable, with a variety of communal lounges, a large dining room and attractive grounds. Residents say that staff are kind and helpful to them. Residents say they are treated with respect, their privacy is protected and staff understand their needs. Residents say they feel well cared for. 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. DS0000064427.V302512.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 DS0000064427.V302512.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 (The home does not provide intermediate care so Standard 6 does not apply) Quality in this outcome area is sometimes poor. This judgment has been made using available evidence including a visit to the service. Prior to admission, the needs of each proposed resident are not always comprehensively assessed and in consequence, when the new resident arrives in the home staff may not have the information necessary to guide their work and ensure they properly care for them. EVIDENCE: The records of two recently admitted residents included details of preadmission assessment which had been carried out in advance of admission and contained sufficient information to guide staff in their practice. The preadmission assessment recorded for a third person failed to provide much essential information and the document was unsigned and undated, so did not provide robust evidence of having been completed in advance of the resident’s admission and did not provide staff with an appropriate guide to ensure their actions/interventions would meet the needs of the person. DS0000064427.V302512.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is poor. This judgment has been made using available evidence including a visit to the service. Care plans are not provided during the first weeks after a new resident’s admission and in consequence staff do not have sufficient information upon which to base their care practice. Periodic audit of accidents is recorded but the home does not have a falls management policy and procedure so opportunities to minimise risks of recurrence may not be identified and residents may thereby be placed at risk of harm and injury. Records of medicines prescribed by doctors must be improved to ensure the correct administration of medicines and the associated promotion of residents wellbeing. Residents wishing to do so can manage their own medicines in accordance with risk assessment. Residents are treated with respect and their privacy and dignity is protected at all times. DS0000064427.V302512.R01.S.doc Version 5.2 Page 11 EVIDENCE: Care records of 4 residents were examined; each was of very good standard with risk assessments forming the basis for care plans and daily records describing the care of each resident. However, most of the assessments and care plan components had not been written until some weeks after the respective residents had been admitted to the home; during the first weeks following admission care plans were minimal and did not contain all information necessary to enable staff to safely and properly care for the residents. It is required that during the first days of admission of each new resident the home must record a comprehensive care plan based on relevant assessments, taking into account all relevant known needs and circumstances, to ensure that staff have available the necessary information upon which to base their care practice. All accidents are recorded and the home periodically audits accidents to identify any trends or patterns and subsequently to introduce measures to reduce the risks. In accordance with a requirement included in the report of a previous inspection the home is at present in the process of developing a policy and procedure for the management of falls. Residents wishing to do so can manage their own medicines in accord with a risk assessment process; at present none of the currently accommodated residents manage their own medicines. For those whose medicines are administered by staff, records indicated that on most occasions medicines had been accurately administered and residents said that they receive the correct medicines at correct times. However, during the morning of 18 October 2006 a number of prescribed medicines had not been signed for to confirm administration and general improvements must be made to the recording systems including signing and dating and countersigning all handwritten instructions, stating the actual dose administered on each occasion when a variable dose is prescribed, always signing or entering the code (e.g. R : refused) for all instances of administration. It is required that records of medicine handling meet current standards and provide accurate evidence ensuring that medicines are accurately administered in accordance with the prescribers’ instructions, to ensure that residents health needs are properly met. Residents believe they are properly cared for; comments received by the Commission in advance of the inspection included “Staff give me the DS0000064427.V302512.R01.S.doc Version 5.2 Page 12 medication I need” and “I have found Greenbushes very caring” and during the inspection a resident said “all the carers are quite prepared to do anything”. DS0000064427.V302512.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. The quality of daily life in the home is generally adequate; social and leisure activities are provided but not suited to the preference and ability of all residents. Residents are encouraged to maintain contact with the local community and visits by their friends and relatives are welcomed by the home. Meals appear to provide good nutrition but are not always liked by all residents. Most residents take meals in the large dining room on the ground floor; others receive them in their bedrooms. EVIDENCE: The home employs an Activities Organiser for 30 hours each week to arrange local excursions, visiting entertainers, one-to-one and small group social and recreational activities. However, the role of this person includes ‘escort duties’ and in consequence, when residents require accompanying to hospital, DS0000064427.V302512.R01.S.doc Version 5.2 Page 14 shopping or elsewhere, recreational activities for those remaining in the home rarely take place. The home should have a service which reliably provides equality of opportunity to all residents. Few of the frail and seriously unwell residents were able to express an opinion regarding the standard of recreational activities and social life within the home. A number of more able residents said that activities did not meet their needs or preferences; comments included “there’s not much on” and “you have to make your own entertainment”. It is recommended that the frequency and variety of organised recreational and social activities be improved, and extended to all residents able to participate (albeit at their own level of capability); the programme should reflect the expressed wishes of residents. Visitors are welcome at any time and those the inspector spoke to said they are always made to feel welcome and placed at ease by the staff. Residents believe they are shown respect and properly treated; comments received by the Commission in advance of the inspection included “Whenever I ring my bell someone comes to see me immediately although they respect my personal space and allow me to be as independent as possible”. During the inspection the inspector observed the serving of lunch in the dining room; residents appeared to be generally satisfied with the quality, choice and quantity of food provided but comments received by the Commission in advance of the inspection included “the food could be improved and presented more attractively”, “We have complained about the food several times – we’ve been told this is being dealt with” and “Cooking could be improved and presented more appetisingly”. It is recommended that the home periodically audits the standard of food provided, and conducts an associated survey of user satisfaction. DS0000064427.V302512.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The complaints procedure provides information on the procedure to follow to persons wishing to make complaint; all complaints are recorded and investigated. The home protects residents from harm and abuse. EVIDENCE: To ensure residents and their representatives have access to the complaints procedure it is included in the service user guide to the home and a copy is provided to each resident. Residents know how to complain and feel confident that if they had concerns or complaints they will be listened to and taken seriously. Comments received by the Commission in advance of the inspection included (from a resident) “I can always speak to Liz Moore the home manager”. The home keeps records of all complaints received and investigated. Since the last inspection an Adult Protection allegation was received and investigated by the local Social Services department and followed by a random inspection by CSCI; the findings of these undertakings partly substantiated the allegation, which involved aspects of staff competency. The report of the random inspection included requirements related to care planning, the management of DS0000064427.V302512.R01.S.doc Version 5.2 Page 16 falls, medicine handling, staffing levels and staff supervision and more must be done with particular regard to care planning and medicine handling to ensure compliance with the National Minimum Standards, and thereby to ensure the provision of good care to all residents. The home adheres to a policy/procedure for the prevention of abuse and all staff have received training in this subject to ensure that they remain vigilant to protect vulnerable residents from risks of abuse and know how to properly manage any allegation or suspicion of abuse. DS0000064427.V302512.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgment has been made using available evidence including a visit to the service. Most parts of Greenbushes, particularly the newest parts of the premises provide a well-appointed and comfortable home. Some bedrooms and a sitting room in the older part of the building should be improved to promote the comfort of residents. On the day of inspection the home was clean, pleasant and hygienic and there was evidence indicating that this is the usual standard of provision. EVIDENCE: Greenbushes is a partly traditionally built house, and partly purpose built extension. There are bathrooms equipped for the use of persons requiring assistance and comfortable communal rooms. DS0000064427.V302512.R01.S.doc Version 5.2 Page 18 In the older part of the building there are first floor bedrooms (including those for shared use) and a small sitting room which present a somewhat bleak and institutional appearance; there are plans for the eventual improvement of these areas and it is recommended this work be carried out at the earliest opportunity to ensure provision of an attractive and essentially domestic environment. On the day of inspection the home was clean, tidy and comfortable throughout; there were no unpleasant odours. In written responses made to the Commission in advance of the inspection there was evidence that this is the usual good standard; a resident’s relative described it as “spotlessly clean”. DS0000064427.V302512.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the service. The home employs enough staff to meet the needs of residents and to ensure their safety and comfort and maintenance of the good condition of the premises. Recruitment practices ensure the protection of residents from potentially unsuitable staff. Staff receive appropriate training and are competent to carry out their jobs. EVIDENCE: The home is at all time in the charge of a trained nurse and staffing levels are provided in accordance with the assessed needs of residents to ensure that at all times sufficient staff are available to properly meet their needs. All staff spoken with during the inspection were enthusiastic about their work and felt that they provided a good standard of care to residents and are properly supported by the management and training provision. The records of two recently employed staff members were examined and found to contain all essential information including written references, an interview DS0000064427.V302512.R01.S.doc Version 5.2 Page 20 assessment, health details, evidence of identity and of induction training. Criminal Records Bureau (CRB) disclosures are obtained for all staff in advance of employment. In accordance with recommendations contained in the report of the last inspection the home has developed and implemented a comprehensive induction process for all trained nurses, designed to ensure their familiarity with all aspects of the home and a clear understanding of their responsibilities. There is an enthusiastic approach to staff training; each month 2 training days are arranged and all staff are required to undertake (and as necessary update) training in core subjects including fire safety, moving and handling, food hygiene and emergency aid. At present 45 of the care staff currently employed by the home hold a National Vocational Qualification in care; the home is thereby close to meeting the standard for at least 50 of the care staff to hold an NVQ in care. DS0000064427.V302512.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is generally good although the home is at present without written policies/procedures to guide staff on a number of essential subjects. This judgment has been made using available evidence including a visit to the service. Systems have been introduced to ensure staff understand their work and receive training enabling them to properly care for the accommodated residents. Residents and their representatives are generally satisfied with the home and feel staff care for them well and put them at their ease. The provider organisation has implemented a quality assurance system to ensure that residents remain satisfied with all aspects of the home. The home does not manage the finances of residents. DS0000064427.V302512.R01.S.doc Version 5.2 Page 22 The premises and equipment are properly maintained in good condition to ensure provision of a comfortable and safe environment. EVIDENCE: Registered manager Mrs Moore has notified the provider organisation and CSCI of her intention to retire from employment and expects to cease working in the home during December 2006. The provider organisation has implemented systems of quality assurance during July 2006 an extensive audit was undertaken including assessment of furnishings, facilities, clinical practice, infection control and other aspects associated with health and safety. To ensure continuity of approach the home operates in accord with a variety of policy and procedure documents, including those for care provision, management and the premises but must extend this selection to include the subjects of falls management. The home does not manage the finances of residents who must therefore manage their own finances or arrange for a representative to do this on their behalf. Staff trained in emergency response are on duty in the home at all times. All staff are supervised and each has a personal profile containing records of appraisal ensuring that performance standards are moitored and training needs are identified, in the interests of providing good care to residents. Details of equipment servicing and maintenance were provided to the Commission in advance of this inspection. The inspector examined some records to verify this information including the following: - passenger lift: routine service 1 June 2006 - mobile hoist: routine service 22 September 2006 - records of regular checks/tests of fire safety equipment. DS0000064427.V302512.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 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000064427.V302512.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 OP3 Regulation 14 Requirement In advance of each new resident’s admission the needs and circumstances must be comprehensively assessed and records kept of the findings. For each resident the home must record a comprehensive care plan based on relevant assessments, taking into account all relevant known needs and circumstances. Timescale of 15/10/06 not met. A written policy and procedure for the management of falls must be developed and implemented. Timescale of 15/10/06 not met. All prescribed medicines must be accurately administered and recorded. Repeated from previous inspection report. Timescale for action 18/10/06 2 OP7 15 & 13 01/12/06 3 OP8 13 01/12/06 4 OP9 13 18/10/06 DS0000064427.V302512.R01.S.doc Version 5.2 Page 25 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 When a variable dose is prescribed (e.g. ‘give one or two tablets’) the actual amount given on each occasion should be recorded. This recommendation is repeated from the previous inspection report. It is recommended that to promote the equality of opportunity of all residents the frequency and variety of organised recreational and social activities be improved, and extended to all residents able to participate. It is recommended that the home periodically audits the standard of food provided, and conducts an associated survey of user satisfaction. It is recommended that the appearance of the first floor shared bedrooms and sitting room is improved at the earliest opportunity. 2 OP12 3 OP15 4 OP19 DS0000064427.V302512.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000064427.V302512.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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