Inspection on 16/04/07 for Harry Booth House

This inspection was carried out on 16th April 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

Harry Booth House 06/04/09

Harry Booth House 15/04/08

Harry Booth House 03/01/06

Harry Booth House 19/07/05

Harry Booth House 20/01/05

Harry Booth House 10/07/04

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

CARE HOMES FOR OLDER PEOPLE Harry Booth House 2 Atha Crescent Beeston Leeds LS11 7BD Lead Inspector Catherine Paling Key Unannounced Inspection 16th April 2007 09:15 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 Harry Booth House DS0000033228.V333034.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. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harry Booth House Address 2 Atha Crescent Beeston Leeds LS11 7BD 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) 0113 2760672 Leeds City Council Department of Social Services Mrs Michelle Haunch Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (1) of places Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd January 2006 Brief Description of the Service: Harry Booth House is located not far from Elland Road football ground and is situated off Dewsbury Road. There are a number of small shops close by and good public transport links to Leeds and Wakefield. The home can accommodate up to forty service users over the age of 65 years who require personal care. Four of the forty beds are used for respite care and registration allows for one service user who may be disabled to be accommodated. Nursing care is not provided but the home is supported by local health care services. All service users are accommodated in single bedrooms that have en suite facilities. Accommodation is over two floors with a passenger lift giving access to the first floor. Information about the service is available in the form of a statement of purpose and service user guide as well as a home brochure. These documents are reviewed regularly to make sure that the information is up to date. The fees range from a minimum of £70.85 to £485.86 per week. Additional charges are made for chiropody, hairdressing and toiletries. This information was provided as part of the pre-inspection requested in advance of the visit to the service in February 2007. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. All regulated services will have at least one key inspection between 1st April 2006 and 30th June 2007. This is a major evaluation of the quality of a service and any risk it might present. It focuses on the outcomes for people using it. All of the core National Minimum Standards are assessed and this forms the evidence of the outcomes experienced by residents. More information about the inspection process can be found on our website www.csci.org.uk This visit was unannounced by one inspector who was at the home from 09.15 until 17.15 on 16th April 2007. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who use the service and in accordance with requirements. Before the inspection accumulated evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the inspection visit. A number of documents were looked at during the visit and all areas of the home used by the people living there were visited. A good proportion of time was spent talking with the people who live at the home as well as with the manager and staff. A pre-inspection questionnaire (PIQ) had been completed before the visit to provide additional information about the home. Survey forms were sent out before the visit to the people who use the service, relatives, carers and advocates, general practitioners and other healthcare professionals. Several were returned and information provided in this way will be reflected in the report. What the service does well: The home is very welcoming and visitors are able to visit at any time. Staff and residents have a good rapport. There is a stable staff team, supported by the manager, committed to making sure that the people who live at the home enjoy a good quality of life. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 6 The staff are well trained. They are knowledgeable and understanding about the needs of the people living at the home. A relative commented that the people at the home are ‘looked after…with compassion’. The manager works hard to seek out the views of the people at the home as well as their relatives and the staff. She demonstrates an open approach of management and is committed to running the home in the best interests of the people who live there. What has improved since the last inspection? What they could do better: Discussion with the manager, staff and the people living at the home indicate that the health, personal and social care needs are met. However, care records do not provide clear evidence of this and there is a potential risk that care needs could be overlooked. The manager should make sure that detailed care plans are in place for all the people living at the home to make sure that there are clear instructions for staff and to provide evidence that care needs are met. There are two staff on the night shift to provide care for up to 40 people overnight. This may not be enough staff to make sure that the people living at the home are properly supervised overnight and their care needs met. The provider has been asked to review this situation to make sure that the well being and safety of the people at the home and the staff is not being compromised The laundry facilities and practices need to be reviewed with particular regard to the control of infection. Recommendations have been made and appear at the end of the report. If the home addresses the issues concerned with care records the quality rating would move from adequate to good. Harry Booth House DS0000033228.V333034.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. Harry Booth House DS0000033228.V333034.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 Harry Booth House DS0000033228.V333034.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 and 3. (Standard 6 does not apply to this service) People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People have enough information to be able to make an informed choice about moving into the home. The admission process is good and includes introductory visits wherever possible. EVIDENCE: There is a wide range of information available to people who currently live at the home as well as those who are thinking about moving into the home. In addition to the statement of purpose and resident guide there is also a brochure. These documents are all reviewed on a regular basis; the statement of purpose was updated in January 2007. Copies of these documents can be found around the home together with other useful information on the many notice boards situated throughout the home. People and/or their representatives are also very welcome to visit the home to help them make a decision about moving in. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 10 Detailed information about people is gathered prior to admission. This includes the local authority assessment documents as well as information from other healthcare professionals who may be involved. The manager and her staff are very knowledgeable about the people living at the home and their specific needs. Harry Booth House DS0000033228.V333034.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 and 10. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Health care needs are met but care plans do not always provide full details of people’s needs providing the potential for care needs to be overlooked. People living at the home are protected by safe medication practices. The staff respect the privacy and dignity of the people living at the home. EVIDENCE: The case records of four people at the home were looked at in detail. All have individual plans of care in the form of a Lifestyle plan. The standard of recording information about the residents on these documents was good. There is some useful personal detail in some plans clearly indicating personal preferences about care needs and how these can be met. For example, that one person preferred a bath in the evening. It was not always clear who had Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 12 recorded the information or made additions to the plans and entries were not always dated. Summaries of the lifestyle plans were completed and there was a record of regular reviews. The summaries provide an overview but no detail of care needs. Nutritional risk assessments had been completed and monthly weights were recorded. Where risk had been identified a specific and clear care plan on how to address the risk had not resulted, although the appropriate action had been taken. There were regular reviews carried out involving the resident and family. Support and guidance is also sought from other healthcare professionals when necessary and written information was included in the records although had not been included on a care plan. For example, the care of one person had been reassessed elsewhere and although the result of that assessment was available in records it had not been included on a care plan so there was no written evidence that suggestions and guidance had been made available to staff. One person was an insulin controlled diabetic with some specific dietary requirements. There was no care plan in the records providing staff with guidance on the care of this person. For example, if they had an episode of too high or too low blood sugar. There were clear records of the involvement of other healthcare professionals. General Practitioner (GP) visits in particular were very well documented. The Lifestyle plans had been signed by the person concerned and relatives had also been consulted. Care staff were knowledgeable about the individual care needs of the residents who said that they felt well looked after by the staff. The medication room is a well-organised area. Staff involved in the administration of medication have had training. The local pharmacist also provides good support to the home as well as some training and update for staff. A new drug fridge has been purchased. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People who live at the home are able to exercise choice in their daily routines and overall their social expectations are met. People living at the home are provided with a varied and nutritious diet that meets their needs. EVIDENCE: There is a range of activities and outings available for people to join in if they want to. A programme is displayed on the notice board and a regular newsletter is also circulated with information about forthcoming activities and other issues. The April edition includes an invitation to relatives to join in planned outings, information about the annual gardening competition and a bingo evening planned for the bank holiday weekend. The people living at the home are encouraged to continue links with the community and are supported in pursuing particular lifestyle choices for example, through religious beliefs. Visitors are welcomed at the home at any Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 14 time. There is a small quiet lounge which can be used by visitors and they are invited to make refreshments in the dinettes situated around the home. In addition there is overnight accommodation available if a person living at the home was particularly unwell and family needed to stay. A number of relatives returned survey forms prior to the inspection and there were many positive comments. These included the comment that the home ‘keeps relatives well informed’ and ‘ the staff are kind and caring and do their utmost to meet the needs of the residents’. Surveys returned by residents had been completed with help and overall responses were positive. There is a wide choice of food available and the views of the people living at the home are taken into account with the menu planning. People said that the food was good. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. There is a clear complaints procedure that is readily available. People can be assured that they will be listened to and action taken when necessary. There are robust adult protection procedures and staff have received training. People can be assured that they are safe at the home. EVIDENCE: There is a clear complaints procedure in place. Information about how to complain and the procedure to follow is displayed on the notice boards that can be found throughout the home. People were not necessarily aware of the complaints procedure but felt confident that they could talk to staff about any concerns and they would be taken seriously. All spoken with felt safe and well cared for at the home. The manager keeps a simple log of complaints made and action taken. All the staff have received training with regard to adult protection and there is a whistle blowing procedure in place. There have been recent complex situations at the home regarding adult protection. The manager is dealing with the situations with sensitivity and has involved other healthcare professionals as necessary. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Overall, people live in a safe and well maintained environment. Some practices put people at potential risk of cross infection. EVIDENCE: All areas of the home which were visited were clean, tidy and in a good state of repair. There was evidence of ongoing refurbishment of some areas with a new fully assisted shower facility having been provided on the ground floor. Other communal sanitary facilities are in need of refurbishment. One bathroom is out of use currently but plans are in place for the total refurbishment of this area. There are a number of linen store cupboards along the corridors. All had signs on the doors saying that they should be kept locked shut; the majority were Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 17 open and none had smoke detectors fitted. The manager said that the fire officer had recommended that these should be fitted. Bedrooms were comfortable and inviting. People are involved in the decoration of their rooms and are encouraged to personalise them. All the rooms are for single occupancy and have large en suite toilets. The laundry area is cramped and small making the separation of clean and dirty laundry very difficult. Access to the wash hand basin and the sink was completely obstructed. There was no soap or paper towels available. Staff said that they have to go into the toilet next door to the laundry to wash their hands. This is not acceptable and poses a risk of cross infection. Although there is a sluice cycle washing machine at the home staff are hand sluicing soiled laundry. In the interests of the prevention of cross infection this practice should cease. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People who use the service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Overall the number and skill mix of staff is sufficient to meet the needs of the people living at the home. Staff are well trained and competent to meet the needs of the people living at the home. EVIDENCE: Duty rotas indicated that there were sufficient staff available to meet the needs of the residents on day duty. The care staff are also supported by a team of ancillary staff carrying out domestic, laundry and catering duties with a handyman also providing day-to-day support for the staff team. There is little staff turnover with the majority of the staff, including the manager having worked at the home for a number of years. The stability of the staff team means there is continuity and familiarity for the residents. There are just two care staff rostered for the night shift to provide care for up to 40 people overnight. The current dependency levels of the people at the home combined with the layout of the building suggest that this may not be enough staff to make sure that they are properly supervised overnight and their care needs met. Up to seven people need two staff to see to them meaning that when they are receiving care there is no one else to respond to Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 19 the other people at the home. In addition, of the small sample of accident records looked at the majority occurred at night. The night staffing levels should be reviewed taking into account the dependency levels, the number of accidents and the layout of the building and the provision of additional care staff at night should be considered. There has been very good progress in staff achievement of National Vocational Qualifications (NVQ) in care at the home. 84 of the care staff have achieved NVQ level 2 in care, far exceeding the standard of 50 . There is also a small number of staff that have achieved NVQ in care at level 3. Domestic staff have also been given the opportunity to do NVQ in the relevant topic areas. New staff undergo an induction programme and all staff have formal supervision sessions and appraisal where training needs are identified. There is also a variety of other training in such topics as dementia, nutrition and care of the dying available to staff. There is a clear commitment towards training and making sure that all designations of staff are equipped to carry out their roles and to care effectively for the residents. Recruitment is carried out centrally and records held at the home are photocopies. There was evidence that the required checks are carried out before staff commence work at the home. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home is well managed. The interests of the people who live there are seen as very important to the manager and staff and are safeguarded at all times. EVIDENCE: The manager has worked at the home for a number of years; she has been the registered manager since 2002 and provides clear leadership and stability at the home. She is very experienced and has gained an NVQ in management at level 4, a City and Guilds certificate in advanced management and will complete the Registered Managers’ Award (RMA) in May 2007. The manager is working hard with her senior staff team to develop the quality assurance programme. This consists of a whole range of survey material sent Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 21 out to the people living at the home, relatives, visiting healthcare professionals and the staff. The results of the surveys are collated and an action plan developed to address any shortfalls identified through the process. Meetings are held regularly with the people who live at the home and a separate meeting for their relatives. The attendance at the relatives meetings is poor and the manager has been exploring reasons for this. Relatives visit the home regularly and say that they feel that they are kept up to date with changes and events on an informal basis. It was suggested that minutes from the relatives meetings are placed by the signing in book to make sure that all have the opportunity to find out what was discussed at the meetings. The manager also meets regularly with the different designations of staff and notes are also kept of these meetings. All the meetings notes provide evidence of the manager’s openness and willingness to involve others in the running of the home. The home looks after a small amount of personal allowance for some of the people. The manager and the senior staff team carry out regular checks of the money and the system is also subject to regular external audit. There is a system in place for ongoing risk assessment within the building to make sure that residents are safe. A particular potential problem has been identified with stairways and the safety of some of the people at the home with sight problems accidentally accessing the stairwells. Methods of ensuring safety are under consideration. Health and safety as a topic is discussed at every staff meeting and staff are clear that they all have a responsibility to be aware of health and safety in the home. Records are kept of any accidents occurring at the home. These are held in a central file initially and then filed in individual care files. The ten available for inspection dated from the end of March and seven of these had occurred overnight. It was recommended to the manager that she should carry out a simple ongoing audit of the accidents to help identify any trends or issues which could be addressed in an attempt to reduce the number of accidents. Harry Booth House DS0000033228.V333034.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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 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 2 STAFFING Standard No Score 27 3 28 4 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 Harry Booth House DS0000033228.V333034.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. 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. 1 Refer to Standard OP7 Good Practice Recommendations The individual records should provide detail and evidence of care with specific instructions and guidance for staff to follow. The care plans should be reviewed and updated if needed on a monthly basis. The advice of the fire safety officer should be taken and smoke detection fitted in the linen cupboards. The laundry facilities should be reviewed to make sure that the area is clean and that there is separation of clean and dirty laundry. Full hand washing facilities should be easily accessible to staff working in the laundry. The practice of hand sluicing foul linen should cease in the interests of the prevention of cross infection. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 24 2 3 OP19 OP26 4 OP27 The numbers of care staff on night duty should be reviewed taking in to account the dependency of the people living at the home and the layout of the home. This is to make sure that the safety and well being of staff and the people at the home is not compromised. Harry Booth House DS0000033228.V333034.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Harry Booth House DS0000033228.V333034.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!