Inspection on 20/11/06 for Harpwood

This inspection was carried out on 20th November 2006.

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

Harpwood 28/10/08

Harpwood 02/08/06

Harpwood 25/10/05

Harpwood 12/04/05

Harpwood 12/11/04

Harpwood 15/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Harpwood Harpwood Seven Mile Lane Wrotham Heath Sevenoaks Kent TN15 7RY Lead Inspector Eamonn Kelly Key Unannounced Inspection 29th November 2006 10:30 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 Harpwood DS0000023952.V323535.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. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harpwood Address Harpwood Seven Mile Lane Wrotham Heath Sevenoaks Kent TN15 7RY 01732 882282 01732 886833 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) Marcford Limited Mrs Anna Christine Budd Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (50) of places Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd August 2006 Brief Description of the Service: Harpwood has 42 single and 4 shared bedrooms on the ground and first floors. The policy is to offer single bedroom occupancy with the capability of providing residence to a couple wishing to have a shared room. Twenty-nine bedrooms have an en-suite facility. Residents have the benefit of a passenger lift. There are extensive grounds surrounding the premises. Bus services are nearby and the home is close to major road networks. Additional car parking facilities have been provided off the drive near the main road. Twenty-four hour support for residents is provided. This includes 3 members of staff on duty every night. All bedrooms and communal areas have call bells that enable residents to summon immediate assistance. The weekly fee ranges from £400 to £430. Local authority fees are £330 per week. As well as payment of weekly fees, residents are charged for hairdressing (perms only charged for), chiropody, contribution to TV licence (free for over 75’s), newspapers and phone bills (for private phones in bedrooms). Prospective residents and their advocates/families receive a copy of a Resident’s Guide to enable them to assess if the home is likely to meet their current and future support needs. This also shows the schedule of costs. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection visit between 10.30am and 4pm consisted of meeting with residents, visitors and members of staff on duty. Most bedrooms and communal areas were visited and a number of records associated with resident care and safety were assessed. A visit was made during the previous inspection visit to the staff house located close to the care home. Survey questionnaires (“Have Your Say About...”) were sent by the CSCI to the home prior to the inspection visit in August 2006. Residents, relatives and care managers returned 18 completed survey questionnaires. Comments made were positive. The inspection visit concentrated on the care and support in place for residents. Meetings with members of staff and residents served to give a broad understanding of how resident’s current and changing needs are addressed. The results indicated that residents are well cared for at the home. Visitors met were satisfied with the support their relatives at the home received. What the service does well: Good pre-admission assessments are made. Care is taken to help new residents settle-in and start to enjoy the benefits of their retirement years. Care plan records are begun at this stage. Personal and health care needs of residents are identified and met. Residents receive personal care discreetly and they are treated with respect. They are supported in maintaining choice and autonomy. Visitors are made to feel welcome. People are protected at a vulnerable stage of their lives from exploitation and abuse. The premises are suitable for the needs of residents. There are excellent gardens and woods surrounding the home. Bedrooms are comfortable and well personalised with personal possessions. Most bedrooms have en-suite facilities. The policy of the home is to provide single rooms and shared rooms are available to couples requiring this facility. Residents who use wheelchairs can be accommodated with ease. There is a good staff mix to meet the support needs of residents. There is an excellent staff house situated in the grounds. Members of staff receive training to carry out their work effectively. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The owner and manager have placed considerable emphasis on achieving a range of quality assurance measures over the past 6 months as described in the previous paragraph. These improvements included a revised Resident’s Guide and better care plan recording. The initiatives have not yet been fully completed and the manager has undertaken to do so. The improvements relating to staff participation in improving support for residents to remain physically and mentally active should also be monitored for continuing effectiveness. The improvements in induction training, mandatory training, staff supervision and recruitment procedures need also to be maintained. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 7 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. Harpwood DS0000023952.V323535.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 Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, 6. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Prospective residents have the benefit of having their support needs fully assessed before being offered a place at the home and information provided in the form of a Resident’s Guide prior to admission helps them to make a decision about entering the home. EVIDENCE: Before moving into the home prospective residents have a full assessment of support needs. Residents, families, medical practitioners and care managers are involved in this process. It covers areas of physical, social, emotional and personal needs. A resident’s care plan is begun at this point. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 10 A personal contract is provided to each new resident, whether the resident is privately funded or local authority funded. The Resident’s Guide provides adequate information about services and facilities. This is being brought further up to date and a copy will be given to each new resident or his/her main supporter. From information given by residents and visitors, residents were confident that their support needs were being met by the home. This conclusion was also supported by information provided by residents and their relatives to the Commission via completed survey questionnaires. The admission process includes one or more visits by the manager or deputy manager to the resident’s home or other location, a visit by the resident to the home, provision of information about services and a “trial” stay at the home. The manager was clear that residents are not admitted to the home for the purpose of regaining independence (after, for example, a hospital stay) and returning home. The home does not have facilities or adequate staffing levels for this type of care and support. Respite care is however provided if the individual can be appropriately cared for and supported. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Residents have a care plan that meets their needs including good provision for their health needs. They are protected by safe procedures for administering their medication. Residents are treated with respect. EVIDENCE: Each resident has a care plan file. These contain information about their support needs and how these are being met including risk assessments, weight charts and daily records completed by carers. Improved care plan records have been recently introduced. These have not yet been completed for all residents. The examples seen contain good information about support needs and resident’s changing health and personal support needs. The manager was confident that the care plans are a useful additional aid for staff in caring for residents. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 12 Individual profiles of residents were discussed with the manager and it was clear that they (and other members of staff) had a good knowledge of the support needs of each resident and of how they were receiving appropriate support. Residents receive good medical and other support. This was evidenced from care plan records and comments from residents and visitors. Part of a medication round was seen during the previous inspection visit. The carer completed administration records at the time and took care that medicines were administered correctly. The manager stated that staff are supervised and are encouraged to disclose if mistakes were made in medicine administration so that lessons are learned to avoid these mistakes in future. There is a medicines room where the locked medicine trolley, controlled drug cupboard and record book and fridge are kept. Residents may keep their own medicines subject to recorded risk assessment. Relatives are aware that the home must be advised if any over-the-counter medications are taken in to residents. A new medication training procedure has been introduced. All staff administering medicines will undertake this training. The home has procedures supported by training and supervision to enable and encourage staff to treat residents with respect. Bedroom doors are lockable and some residents keep their doors locked. Residents requiring assistance are helped with letters and correspondence. Male and female carers work at the home and there are agreed procedures for ensuring that personal care is appropriately given. Visitors stated that they feel that members of staff are knowledgeable about resident’s support needs and vulnerabilities. There was also positive comment in this respect in completed survey questionnaires. The manager is looking at appropriate way of enabling care plan records to contain information about resident’s wishes following death. Previously this information was not obtained and recorded. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Residents have the benefit of a number of choices and opportunities for activities and leisure pursuit. EVIDENCE: A range of activities is provided within the home. These include occasional entertainers, games and puzzles, newspapers and magazines, knitting, music and bingo. The gardens are suitable for use by relatively active residents who can walk for some distance and for frail older people who need personal assistance. Previous inspection reports refer to comments from residents requesting encouragement to undertake stimulating activities. The home does not employ an activities co-ordinator. The manager previously undertook to obtain funding from the owners to provide specific and professional support for residents to remain more physically and mentally Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 14 active. This would not involve the displacement of carers in the morning or afternoon/evening who were already relatively hard pressed to meet the support needs of frail older people over a dispersed area. The new arrangement is that a member of staff is allocated several hours each day where the member of staff would be responsible solely for this type of support work. The staff rota reflected the new arrangements. The initial feedback is that the procedure is working well. The manager is monitoring arrangements to see if they are effective in the ways intended. Information from the National Association for Providers of Activities for Older People was recommended during this inspection visit to enable members of staff undertaking activities to obtain requisite skills and knowledge in this area. Several visitors were met. They are made to feel welcome at all times. They were positive about the levels of care and attention their relatives received at the home. Residents have choice and autonomy about their daily routines and they can choose when to get up and go to bed. Residents choose where they would like to eat their meals. Some opt to have their meals in their bedroom. A copy of the CSCI’s guidance on food provided to older people in residential homes was sent to the home after the previous inspection visit in August 2006. This was because shortfalls were identified in meal provision at that time. On this occasion, the manager was confident that the shortfalls had been addressed. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Residents and their relatives may be confident that their concerns are taken seriously and residents are protected from abuse. EVIDENCE: Residents spoke openly about aspects of life at the home. Some made reference to concerns they had and brought these to the notice of the manager or members of staff. There have been no reports of complaints since the previous inspection visit. There is a complaints procedure. The manager addressed the previous complaint satisfactorily. Residents said they knew how to comment about things they were concerned about. Residents receive guidance if they need independent support with legal and financial issues. The home has contact with an advocacy service that specialises in legal matters if a resident requires independent advice. An adult protection policy is in place. Senior carers understand this policy. It is included in the induction procedure. The manager is aware of Social Services procedures for adult protection. The induction procedure includes tuition for Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 16 staff on disclosing concerns they may have where poor practices or abusive behaviours towards residents is suspected. The owners and members of staff are aware of the circumstances where staff should be referred to the POVA manager in Darlington. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Residents have the advantage and benefit of living in a comfortable and safe home. EVIDENCE: The premises are comfortable and well maintained. There are 42 single and 4 shared bedrooms. The policy is to provide single occupancy in most cases. Many bedrooms have an en-suite facility. There are extensive gardens surrounding the premises used by residents throughout the year. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 18 There are comfortable lounge and dining room facilities. The premises have a hairdressing salon. Some residents have phones in their bedrooms. Some have the benefit of having adapted cutlery, a fridge and tea-making facility. Bedrooms are personalised with resident’s own possessions including their own furniture in some cases. Some bedrooms are not carpeted. In at least one instance, the reason is to assist a resident who has significant incontinence. This arrangement is covered in the resident’s care plan record. Where this reason is not present, the manager previously agreed to arrange for suitable carpets to be fitted as part of normal furnishing of bedrooms. A number of improvements have recently been made or are imminent. The hairdressing salon has been refurbished. Five bedrooms are to be re-carpeted and redecorated. Plans for extension of the kitchen have been approved. All lounge chairs have been replaced. A tour of the premises indicated that successful efforts have been made to keep the home clean and tidy and free from odours. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. A range of staff comprising management staff, carers and senior carers, cook, laundry assistant, domestic assistants and maintenance staff provide good support for residents. Residents have the benefit of being in the care of staff supported by good training and recruitment procedures. EVIDENCE: The home has a manager, deputy manager, carers and senior carers, cook, laundry assistant, domestic staff and maintenance person/gardener. The owners provide good day-to-day support. Arrangements are in place for staff to spend several hours each day supporting residents to remain physically and mentally alert. These care hours are additional to direct care hours. Staffing levels on the day the inspection visit was made were as follows: • • • • • Deputy manager: 7am-2pm. Senior carer: 7am-8pm. Carer A: 7am-8pm. Carer B: 7am-2pm. Carer C: 2-8pm. Carer D & E: 7am-8pm. DS0000023952.V323535.R01.S.doc Version 5.2 Page 20 Harpwood This staffing position for the day was consistent with the staff rota seen. Three members of staff are on duty (awake and on the premises between 7.45pm-7.45am) at night. The staff house on the home’s grounds provides a high standard of accommodation for up to 6 members of staff. Currently three members of staff are in residence. Significant problems were identified during the previous inspection relating to the taking up of references, CRB and POVA-first checks. A problem was also identified with the deployment of staff from abroad. Application forms also failed to obtain adequate information and applicants were not required to disclose full information about convictions and cautions. Checks of current procedures indicated that these shortfalls have been satisfactorily addressed. The deputy manager is a trained trainer for moving & handling frail older people. The policy is for all members of staff to receive this training together with refresher sessions annually. New training procedures have been introduced for medication administration and food safety. The home is close to reaching its target on the numbers of staff completing NVQ Level 2 and 3 in Care. The home has a number of staff from abroad with nursing qualifications but who have not undertaken “adaptation” training to receive their UK nursing qualification. When these members of staff have completed a full induction course at the home and completed all mandatory training, the manager considers them for the post of senior carer. This promotion based on experience and skill enables them to supervise shifts during the day and at night. At least one member of staff on each shift has a first aid qualification. Examples of formal supervision were seen during the inspection visit. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38. Quality on this outcome area is good. This judgement was made using available evidence including a visit to this service. Residents have the benefit of living in a home that is conducted in ways that serve their best interests. EVIDENCE: The manager, Mrs Anna Budd, has wide experience in the care and support of older people. She has achieved the Registered Manager’s Award. The owner, Mrs A Majithia, has also achieved this qualification. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 22 The manager and other members of staff have a good knowledge of the care needs of all residents, of how these needs were being met and of how to ensure that residents changing support needs are identified and met. The manager carries out periodic surveys of resident’s views and these views are taken into account. Resident’s meetings are held to discuss their comments, views and concerns. Six residents, 10 relatives and 2 care managers returned completed survey questionnaires to the CSCI prior to the previous inspection visit in August 2006. The responses were positive. Two responses referred to possible pressures on staff and some lack of opportunities for leisure activities. The pre-inspection questionnaire contained a declaration that all relevant safety checks and associated maintenance records are maintained up-to-date. A number of those seen on that occasion were satisfactory. The home achieved an award in September 2006 from the environmental health department. Fire safety records seen were also satisfactory. The manager stated that a new risk assessment has been carried out in accordance with the new fire safety regulations. A copy of the report was not yet available. Risk assessments in relation to each resident are carried out and included in resident’s individual care plan files. The legal and financial interests of residents are safeguarded in 2 particular ways: close relatives or next of kin are responsible for these matters and the home has contact with an advocacy agency that could advise residents about gaining independent advice. The overall management approach has been substantially strengthened over the past few months. There is immediate access to a list showing the relevant data relating to CRB checks and POVA-first checks for all members of staff. Procedures carried out by the owner and manager have been clarified to enable each to meet their responsibilities. All aspects of administration and management are under the control of the manager. This has benefits for the owners, staff and residents. The process of recruitment and retention of staff have improved. Senior carers receive comprehensive induction and a programme of mandatory training. The training matrix displayed provides clear information about all aspects of training planned and completed. Formal staff supervision has improved. Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 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 Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Harpwood DS0000023952.V323535.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!