Inspection on 02/08/07 for Grosvenor Hall Care Home

This inspection was carried out on 2nd August 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 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

Grosvenor Hall Care Home 10/04/06

Grosvenor Hall Care Home 26/10/05

Grosvenor Hall Care Home 19/05/05

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

CARE HOMES FOR OLDER PEOPLE Grosvenor Hall Care Home Newark Road Lincoln Lincolnshire LN5 8QT Lead Inspector Roger Harrison Unannounced Inspection 2nd August 2007 09:00 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 Grosvenor Hall Care Home DS0000061942.V340583.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. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Grosvenor Hall Care Home Address Newark Road Lincoln Lincolnshire LN5 8QT 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) 01522 528870 grosvenor.manage@btconnect.com Mr Kanagasooriam Ravivaruman Diane Dunn Care Home 31 Category(ies) of Dementia (12), Old age, not falling within any registration, with number other category (25) of places Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care with nursing for service users of both sexes whose primary needs fall within the following categories: Old Age, Not falling within any other category (OP) 25 Dementia - Over 65 years of age (DE(E)) 12 The maximum number of service users to be accommodated is 31 Date of last inspection 10th April 2006 Brief Description of the Service: Grosvenor Hall is a large two-storey, Victorian, listed building which is situated on a main road, south of the city of Lincoln and is within walking distance of local shops. Public transport is available to the city amenities. The home is set in its own grounds with a secure garden at the rear of the home. A patio has been constructed which provides an attractive, safe area for residents to sit in. Car parking is available to the front of the building. The home provides nursing and personal care for up to thirty-one people of both sexes, over 65 years of age, with emphasis on providing care for people with dementia. Accommodation is in twenty-three single and four shared rooms, some of which are ensuite, on the ground and first floor. A lift gives access to the first floor. The home has undergone extensive renovation and refurbishment since the present owner purchased the property in 2004. Fee rates range from £388.00 - £533.00 per week depending on peoples assessed care needs. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken by an inspector reviewing all the previous inspection records available, looking at information sent to us by the manager about Grosvenor Hall before making the visit, and by undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. The inspection visit was completed over a period of six and a half hours and involved identifying individual residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. The inspection was also used to check that information provided by the manager before the visit matched the individual experiences of residents. This was done by talking to the manager, residents, family carers and care staff whilst observing day-to-day care practice within the home. What the service does well: What has improved since the last inspection? What they could do better: The manager needs to employ an activity organiser to ensure the social and cultural needs of all residents can be fully met. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 6 The manager must notify the Commission about any events or incidents, which may affect the health and safety of residents who live at the home. There is a need to keep reviewing and taking action to improve the overall maintenance needs of the home. 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. Grosvenor Hall Care Home DS0000061942.V340583.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 Grosvenor Hall Care Home DS0000061942.V340583.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): Standard 3 [Standard 6 N/A] Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager completes an assessment of residents’ needs and provides information to confirm that their needs can be met before any admission to the home takes place. EVIDENCE: Before this inspection visit took place the manager provided copies of the homes service user guide and statement of purpose, which set out clearly what residents should expect from the care team and their responsibilities as residents of the home. Residents also sent written comments to the Commission stating that they had been given information and received an assessment of their needs before deciding to move in. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 9 During the inspection visit the manager showed that copies of the user guide and statement of purpose are available for residents at any time in the reception area of the home. Copies of the user guide were also clearly made available in resident’s rooms. Residents said that they were aware of this information and that they had their own copy. The manager provided information on care plans for residents who live at the home showing that an assessment had been completed before admission took place and that this had been used to create a care plan. The manager said that trial visits and reviews had been used together with residents and family carers to make sure that any changes in need could be met. Where one urgent admission had taken place the manager had recorded this on the assessment information and showed how she had made contact with other professionals to get the information needed to create a care plan to support the new residents immediate needs. During the inspection visit residents and family carers made positive comments about their experience of planning and moving into the home. One family carer said “We found it all worked well and the manager helped ease our concerns, since arriving here mum has found it good and caring and they asked about our needs together so that we could get all our questions answered”. Grosvenor Hall does not provide an intermediate care service. Grosvenor Hall Care Home DS0000061942.V340583.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): Standards 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and personal care needs are set out in an individual care plan and their health needs are met. There are policies and procedures in place, which staff use in order to support residents with their health and personal care needs. Residents are treated with respect and are supported to maintain their dignity. EVIDENCE: Before carrying out the inspection visit residents provided written comments about what they think of the care provided. The comments were positive and one resident wrote that “I always receive the care needed and the care is good”. During the inspection visit the manager provided copies of individual care plans, which were set out in separate sections showing how the assessment completed at the time of admission is used to create the overall care plan. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 11 Care plans contained risk assessments, with records to show they had been reviewed each month. Reviews had been completed in detail showing who was involved and were signed to show they had been agreed with. Since the last inspection the manager has produced “A brief guide for residents relatives and visitors about dementia needs” to enable greater understanding and awareness. The manager said that this would be shared with relatives at the relatives and carer meeting to be held on the evening of the inspection visit. Care plan information also contained details about the support given to people with their medicines. Storage was secure and the manager showed that she uses a recognised system for storing and administering medicines. The manager confirmed that she checks medication records regularly and had found an error on one record, which she had acted on immediately and was assisting the home owner in the process of investigating the incident. The manager confirmed that this error did not affect the safety of the resident concerned. [See also standards 16 and 18 for further information]. Current records matched the details provided on care plans about how medication needs should be met for each person. One senior member of staff was observed using the right procedure in place for helping residents with their medicine needs. The staff member was supporting one resident to take his medication in a safe way, helping the resident to take control of the overall actions needed. The staff member used gentle communication and showed an understanding of how the resident liked to be supported. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 12 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): Standards 12,13,14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents can choose how they spend their time, and are supported to maintain and develop community links, as they prefer. Relatives and friends of service users are made welcome. However, The activities provided by the home are insufficient to meet all service users needs and expectations. EVIDENCE: Before the inspection visit took place the manager provided written information, which stated that a staff member is employed for twenty hours a week to plan activities with residents and to arrange for entertainers to visit the home. During the inspection visit the manager said that the activity person had recently left and that she is currently in the process of recruiting a new staff member to take on this role. The manager said that all staff members are involved in supporting residents with activities and during the visit staff were observed talking and listening to residents, supporting them with some individual activities and one resident Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 13 was observed being supported to play a keyboard with a staff member providing accompaniment. Other residents with dementia needs were listening to music and using this to talk about their memories with staff. Family visitors were also observed coming and going and one relative commented that “Mum likes being here, we visit regular, its difficult for her to get involved in physical activities at the moment but they always talk to her and she is happy with the arrangements in place”. There was some information available about visiting entertainers coming to the home and one resident sent written comments to us before the inspection visit saying, “I enjoyed a musical duo that came to the home”. However, information about future activities was limited and residents said that they do not have access to a full range of activities at this time. A record of the last relatives and family carers meeting held in June 2007 at the home was provided by the manager showing that relatives had made comments about the need for more activities to be available. Some of the residents activity needs were recorded on care plans but this was limited. The manager described how she will soon be employing an activity organiser who will be supported to further develop social history profiles with residents and their family carers in order to ensure activity needs are met in the way residents wish them to be. Since the inspection visit took place the manager has confirmed that a new activity organiser will soon be starting and that the homeowner has agreed to increase the number of hours available for planning and undertaking activities from twenty to thirty a week. Menus were available in the reception area of the home, which showed that a range of choices are available at meal times. Residents said they liked the food at the home and one resident commented “I’m a vegetarian and there is always a choice of food” and another said, “I like the meals, its altered and it’s a lot better than it was”. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 14 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and care team take complaints seriously and wherever possible involve residents and carers in resolving issues as soon as they are raised. The manager and care team know how to act in order to protect residents from abuse. EVIDENCE: Before the inspection visit took place the manager provided a copy of the home’s statement of purpose, which contained information about what to do and who to speak to if people have concerns. During the inspection visit, information about how to raise concerns was readily available at the entrance to the home. There was also a suggestion box available, which the manager confirmed is kept locked and that only the home owner has the key. The manager confirmed this is checked regularly for comments. The manager said that she always keeps a record of any formal concerns or complaints received and confirmed that she keeps a complaints log. Records showed that no informal concerns had been made about the services provided since the last inspection. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 15 One formal complaint was raised about medication just before the inspection visit took place. The manager provided records to show how she had responded to the issues raised and during the visit the home owner visited the home to investigate the complaint in order to provide a full response to the commission. Residents and visiting family carers commented that they felt happy to raise any concern direct with the manager and residents said, “I know I can talk to any member of staff” and “I never have anything to complain about”. The manager and staff members described how they had received training in order to identify and know how to report concerns and take action in order to protect people from abuse. There has been one adult protection incident during the last year, which was addressed by the manager and residents were safeguarded from abuse. A copy of the adult protection policy and procedure for Lincolnshire was available in the home. Grosvenor Hall Care Home DS0000061942.V340583.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): Standards 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is clean and hygiene is maintained by the staff team, however the internal and external areas of the home would benefit from a decorative update. EVIDENCE: Before the inspection visit took place the local fire officer sent a letter to the Commission, which confirmed that the homeowner is meeting fire safety standards. During the inspection visit rooms were observed to be well personalised and decorated with a range of equipment available throughout the home to enable staff to support residents safely through the use of aprons, washing hands and by using a range of equipment to support residents personal needs in a safe way. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 17 The homes communal dining and living areas were clean tidy and the outside areas of the home were fenced to make them safe. However, one area of the garden contained a summer house, which had a broken pane of glass in one of the windows. The manager recognised this was a potential hazard and had it removed immediately by the maintenance person. Residents were observed spending time in the lounge areas of the home and some residents were observed trying to watch television but the reception was poor. One resident said “I’m trying to watch this programme but it’s hard with the bad picture”. This was discussed with the manager who confirmed that the television is to be replaced with a larger screen and better reception ariel very soon. The manager did recognise that some parts of the home are in need of ongoing decoration and maintenance and said that an internal audit of the home environment is about to be completed in order to identify areas of the home that should be further improved in order to set out a plan for the ongoing improvement of the home environment for residents use. The manager said that the home owner is planning to extend the home to offer more rooms for potential residents. As part of the plans to increase the size of the home the manager said she is reviewing the current colour scheme, décor and layout of the home to make sure it matches the needs and expectations of all residents, particularly those who have dementia needs. Grosvenor Hall Care Home DS0000061942.V340583.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): Standards 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are currently sufficient numbers of safely recruited care staff available at the home with appropriate training and skills to meet the needs of residents. EVIDENCE: Before the inspection visit took place the manager provided a staff rota along with information about who works at the home, and during the visit the manager described how the staff team work together, using their different skills as a team to provide appropriate levels of support for residents who live at the home. The manager stated that all staff are recruited using proper checks to ensure residents are safely supported, and staff files held by the manager contained information, which showed that staff have been recruited safely. Staff files showed details of staff induction and training. The manager confirmed that training has been provided to make sure staff know how to provide support for residents. Training events were detailed on the managers training plan and included; adult protection, fire safety, moving and handling, food hygiene, equality and diversity and dementia training. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 19 Staff members were able to describe how they apply their training to the work they do, for example, how to act in order to protect residents from the risk of fire. Staff were observed supporting residents with their mobility needs and applying what they had learned through moving and handling training to keep residents safe. Residents made positive comments about the way staff support them and one resident sent written comments to us before the inspection visit was made stating, “They are good staff, I cant say any different credit where its due”. Staff members also said that they are encouraged to undertake nationally recognised qualifications and comments were made during the inspection visit by staff which included, “The induction was good we didn’t get left to work on our own until we were confident” and “We have mandatory training that we all have to do which helps us all to understand the roles we have” Grosvenor Hall Care Home DS0000061942.V340583.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): Standards 31,33,35,37 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager supports the staff team to care for residents safely. However, appropriate agencies must be notified about any events or incidents, which may affect the health and safety of residents who live at the home. The manager encourages feedback from residents and staff and there is a system in place for consulting residents and family carers about the quality of care provided. The manager safeguards residents’ financial interests. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 21 EVIDENCE: Before the inspection visit took place the registered manager provided information to show that she has completed a nationally recognised qualification and has a wide range of experience in the management of care services. During the inspection visit group of staff members talked to the inspector about how they feel that the manager supports them and how she runs the home. Staff members made comments, which ranged from, “This is the best manager we have had here” and “We respect the manager and know where we stand” to “The manager is always available when we need to talk and “The home owner visits regularly and we all feel he is very approachable”. The manager provided information to show that she arranges regular residents and family carer meetings at the home and arranges to be available for all residents and visitors in a structured way by advertising dates and times that she keeps to talk specifically to people about any ideas for developing the home or concerns. The manager also confirmed that the suggestion box is available and that the home owner is the only one who holds the key to this so that he can check it whenever he visits. There was also a supply of comments/complaints or suggestions forms in the reception area for residents or visitors to complete whenever they wished. One family carer who was visiting the home said, “The manager is easy to talk to and if we need to talk to he she is there”. During the inspection visit the manager confirmed that she undertakes a regular audit of the way staff support residents with their medication and that during her last audit she had found an error on the records. The manager immediately provided detailed records showing the actions she had taken in order to address the issues raised. The manager had addressed the incident by arranging additional training and a full investigation by the home owner is being carried out. However she did not notify the Commission of the incident at the time it occurred. Residents said that they are able to manage their own financial arrangements either individually or with support from family members. The manager confirmed that when requested she does have arrangements in place to help support residents to make sure that they have access to their own day-to-day money. The manager said that whenever she is asked for support with managing daily finances she keeps a detailed record to make sure she knows how much money each resident has. A check made during the inspection visit showed these records were accurate. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 22 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 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 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 2 3 Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 23 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 OP12 Regulation 16 (2) Requirement Timescale for action 01/10/07 2. OP37 37(e) Following consultation with residents, a programme of group and individual activities must be developed; to provide opportunities through leisure and recreational activities to provide residents with mental stimulation, paying particular attention to residents who have dementia related needs. Confirmation must be received 02/09/07 regarding any significant event which may affect the well being or safety of any resident who lives at the home RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP19 Good Practice Recommendations It is strongly recommended an internal environmental audit be completed in order to produce a clear action plan with timescales, which fully identify and address all the DS0000061942.V340583.R01.S.doc Version 5.2 Page 24 Grosvenor Hall Care Home environmental needs of the home. Grosvenor Hall Care Home DS0000061942.V340583.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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