Inspection on 13/11/06 for Hartsholme House

This inspection was carried out on 13th 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

Hartsholme House 24/02/06

Hartsholme House 02/08/05

Hartsholme House 07/02/05

Hartsholme House 11/08/04

Hartsholme House 08/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Hartsholme House Ashby Avenue Hartsholme Lincoln Lincs LN6 0ED Lead Inspector Elisabeth Pinder Key Unannounced Inspection 13th November 2006 09:00 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 Hartsholme House DS0000002369.V318847.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. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hartsholme House Address Ashby Avenue Hartsholme Lincoln Lincs LN6 0ED 01522 683583 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) The Orders Of St John Care Trust Mrs Jacqueline Luke Care Home 42 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (35) of places Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following category:Old age, not falling within any other category (OP) - 35 and Dementia - over 65 years if age (DE(E) - 7 The maximum number of service users to be accommodated is 42. 2. Date of last inspection 24th February 2006 Brief Description of the Service: Hartsholme House cares for older people needing personal care with seven places specifically registered to care for people with dementia. The home is a detached property surrounded by gardens and is situated in a residential area to the south of the historic city of Lincoln. Car parking is available at the front of the building and local facilities include shops, library, post office and church. Transport is required to access the main city and is provided at no extra cost. The home has two floors and there is a passenger lift to the bedrooms on the first floor. There are a variety of aids and adaptations around the building to allow residents to move around the home more independently. All of the bedrooms are single but none have en-suite facilities. The home is one of 16 operated by the Order of St John Care Trust, which is a Registered Charity. The current weekly fee range is £335.00 - £449.00. Additional costs are made for hairdressing, personal toiletries, newspapers, holidays and chiropody, these are all private arrangements and costs are met by individual residents. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit to the home was undertaken by one inspector and formed part of a key inspection. The visit lasted five and a half hours and took into account any previous information held by The Commission for Social Care Inspection (CSCI) including the homes pre-inspection questionnaire, previous inspection reports, their service history, records of any incidents that had been notified to the CSCI since the last inspection and reports of monthly visits by a company representative. Prior to the visit 24 residents ‘Have your say about’ questionnaires were received and comments from these will be mentioned throughout this report. The site inspection consisted of case tracking a sample of four residents’ records, talking to them and assessing their care. Some policies and procedures were seen together with some records concerning the safety of the home. A period of observation was undertaken whilst residents were taking part in movement to music and whilst residents were waiting for lunch and a general conversation was held with residents. Two care staff were spoken to, one being a new employee and the other responsible for health and safety in the home. The site visit focussed on key standards and checking whether issues raised at the previous inspection had been addressed. What the service does well: This home is well managed by a competent registered manager. Residents and their relatives/representatives are given sufficient information about this home to help them make a decision before moving in on a permanent basis. The building is generally well maintained and the staff group are well trained and knowledgeable about the needs of the residents. Residents made many positive comments about the home during the inspection; one resident said ‘I have lived here for two years and the staff are very nice’ and another resident said ‘you can’t beat this place, I am very happy’. A designated activity co-ordinator is employed for 25 hours per week and a variety of activities are offered including, glass painting, card making and hand massage. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Hartsholme House DS0000002369.V318847.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 Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3, standard 6 is not applicable Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home clearly sets out what it intends to do for its residents and this information is freely available to residents and their relatives. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The home’s statement of purpose and service user guide have recently been updated to show the change in Responsible Individual (RI). These have been issued to residents together with a new brochure written in an easy to read format. Residents living in the home also receive a copy of the quarterly Trust magazine. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 9 Care records examined showed that a full needs assessment had been carried out prior to admission, and where social workers have been involved, a copy of their care plan was available. Prospective residents are written to by the manager after the assessment confirming that they can or cannot meet the residents care needs. One resident said that he had lived in the home for about two years and ‘you can’t beat this place’. During the visit a resident was admitted and her relatives confirmed that they had been given sufficient information about the home, they had been to look around and the resident had been for the day. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: Care plans set out clear information on how residents’ needs should be met. Short term care plans are signed and dated by care staff and residents showing their involvement in the process. However, although one had not been signed by the resident since 2004, there was clear evidence that a review of care had been undertaken involving relatives. One resident said he felt that his needs were being met and another resident said she ‘would soon say if they weren’t’. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 11 The Trust also use a document called ‘Long term needs assessment and care plan’ and two of those sampled did not have any signatures identifying who had written the document or dates of when they were written. This was discussed with the care leader who said she would address this issue. During the visit a discussion was held with a visiting district nurse who said she had been coming into the home for about ten years and feels ‘the staff always make appropriate referrals, there has never been any issues with the attitude of staff and staff always follow our instructions’. There is a detailed medication policy and the last visit from the pharmacist was in September 2006 and there were no issues from this. Specific comments were ‘the home continues to maintain a high standard of medication ordering, receipt, administration and records’. Medication being given to residents during the lunch time period was observed and was administered using safe procedures. Comments taken from residents questionnaires identified that there has been a problem with emergency prescriptions and this was discussed with the care leader who said that a meeting had been held with the supplier and this had now been addressed, but will be monitored to ensure no further delays occur. Staff members were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. Hartsholme House DS0000002369.V318847.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): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to express choices in their daily lives and receive a nutritious, varied diet meeting individual preferences and health requirements. EVIDENCE: The home has a designated activity room and 12 residents were observed taking part in a movement to music activity. They were all smiling and chatting with the leader and later said how much they had enjoyed it. A discussion was held with the activity co-ordinator who works 25 hours per week offering a variety of activities including, glass painting, card making, outings, coffee mornings, quizzes and reminiscence. Records showed that all activities undertaken are documented and the co-ordinator said that her aim is to spend time with each resident at least once a month. If residents are unable to take part in chosen activities she will spend time on an individual basis either writing letters, talking to them or giving hand massage. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 13 Residents said that the staff offered them choices such as, what they preferred to eat, the time they preferred to get up and whether or not they wished to join in activities and social events. Staff outlined how they supported people to make decisions within their capabilities so that they could remain as independent as possible. Details of peoples preferences including nutritional requirements, likes and dislikes are recorded in their care plans so that staff are aware of them. A recommendation given during the previous inspection for information held in the kitchen being comprehensively completed, and updated as necessary has been addressed. Menus seen showed that a varied, well balanced diet is offered, a new menu has been implemented and four choices of main course are now offered to residents at lunch-time. However, none of the residents spoken to could remember what they had ordered. Tables were nicely laid with tablecloths/napkins and condiments and each table had a written menu. During a period of observation staff started to take residents to the dining room half an hour before the first course was served. A further 25 minutes passed before their main course was served. During this time one resident began to wander and two others made comments about sitting in a draught and having to wait for their food. This was discussed with the care leader who said she will look into this immediately. The home also provides alternatives for people requiring special diets, such as diabetics, vegetarians, and residents needing a soft diet. Residents questionnaires identified that ‘most’ usually like the meals at the home. Some people were seen using specially adapted cutlery to enable them to remain as independent as possible. Residents meeting minutes confirmed that menus are frequently discussed and residents are asked for their choices of future meals. The cook had a good knowledge of people’s dietary requirements and preferences. The recommendation given during the previous visit has been addressed and information held in the kitchen is now comprehensively completed, and updated as necessary, ensuring staff are aware of any changes. Hartsholme House DS0000002369.V318847.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): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to. There is a robust safeguarding adults procedure with ongoing training for staff. EVIDENCE: Information taken from residents’ questionnaires identified that the majority of residents know who to speak to if unhappy and know how to make a complaint. One specific comment was ‘not needed to make a complaint but feel I would be listened to and taken seriously’. An anonymous complaint was made to the manger in September regarding an unpleasant odour. This has now been addressed. There is a clear safeguarding adults protection procedure, linked to the Local Authority procedures. Since the previous inspection there has been two safeguarding adult referrals made, both have now concluded. Information taken from the pre-inspection questionnaire identified that 11 staff had not had any training in safeguarding adults, however, during the visit it was established that training was held on 13th October when a further 8 staff Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 15 completed training and this will be ongoing until all staff have attended. Two members of staff were spoken to, one said she had not had this training, however, both were knowledgeable about complaints. Information was given about the Commission’s procedures for reporting complaints and the address and telephone number was given for the Central Registration and Compliance Team (CRCT) Hartsholme House DS0000002369.V318847.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): 19,22 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents living in this home live in a clean, pleasant and hygienic environment, however, there is a potential risk as some bedroom windows on the first floor open wide. There are not enough signs and pictures to enable residents with dementia to find their way around. EVIDENCE: A partial tour of the building showed that the home was well maintained with well-kept lawns and gardens. Bedrooms of residents traced were viewed and these had been personalised by the residents or their families with photographs, mementoes and small items of furniture. However, windows in Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 17 two of the bedrooms viewed on the first floor windows opened wide and therefore present a health and safety risk to residents accommodated in these rooms. This was brought to the attention of the care leader assisting with the inspection who agreed to ensure risk assessments are written and action taken to minimise risk. Residents said that they were happy with their rooms and the facilities provided in the home, however, a comment on one resident questionnaire read ‘ground floor toilet area near admin office could do with updating’, this was viewed and discussed with the care leader who said she would raise it with the manager. Other comments received were ‘the home is always fresh and clean’ and ‘there has been some issues but these have been dealt with by the manager and staff’. During the visit some residents were observed to be quite restless and although corridors have recently been re-decorated a discussion was held regarding using more pictures/signs and photographs to help residents with dementia to find their way around. A subsequent telephone conversation with the registered manager was held and she said pictures and signs are presently on order. The report after the home was visited by their Environmental Health Officer (EHO) on 30th March 2006 read ‘high standards of hygiene observed and the extensive systems to monitor and control food safety. However, recent changes in legislation require food businesses to implement a documented food safety management system’. Information received prior to the visit identified that this is currently under review. On the day of the inspection the home was clean, tidy and odour free throughout. Hartsholme House DS0000002369.V318847.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Minimum staffing levels are being met. The procedures for the recruitment of staff are robust and therefore offer protection for people living at the home. Staff are well trained and supported in their roles. EVIDENCE: During the previous visit a recommendation was given for the continual review of staffing levels to ensure that the changing needs of residents continue to be met. This is being addressed and an extra member of care staff is now on shift from 06:00 – 11:00 to help during the busiest time of the day. Staff spoken to said that there are enough staff on duty to meet the current needs of residents and information taken from residents questionnaires identified that most felt that staff are ‘always’ or ‘usually’ available when needed. The ‘Trust’ has a robust recruitment procedure in place and written references and C.R.B. (Criminal Record Bureau) checks are made before potential staff are offered employment ensuring they are suitable to care for the people living at the home. The files for two members of staff contained all the necessary documentation to show that the procedure had been followed and one recently Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 19 recruited member of staff confirmed that she had been recruited in line with this procedure and had completed induction training. The Trust has a training manager, who organises an extensive programme of training for all staff, including mandatory and specialist training to make sure that staff have the necessary knowledge and skills to meet the needs of the residents. Records and staff comments confirmed that training recently provided included; induction, safeguarding adults, moving and handling, fire safety and dementia. However, records and staff comments identified that health and safety training was last undertaken in March 2003. One member of staff spoken to said she had recently been designated as ‘health and safety officer’ for the home but has not undertaken training to assist her with this role. A subsequent telephone conversation was held with the registered manager who said that the ‘Trust’ has developed a new health and safety manual, she has attended training and has set up a small group of staff who are due to undertake training later this month. The staff member designated as health and safety officer is due to attend this training. A discussion was held regarding equality and diversity issues and staff spoken to had limited knowledge of this subject and it is recommended that training is provided. Eighteen staff have attained an N.V.Q. (National Vocational Qualification) in care. Twelve staff have a current first-aid certificate. Hartsholme House DS0000002369.V318847.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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient leadership, guidance and direction to staff to ensure residents receive a good standard of care. Satisfactory procedures are in place for handling residents’ monies and the health and safety of residents is promoted. EVIDENCE: This home is run by a registered manager who has the appropriate qualifications and experience to manage the home. Residents were aware of Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 21 the management arrangements in place and said that they felt able to talk over any problems they had with the manager or staff. Residents and staff meetings are held and both meetings have an agenda and minutes are taken. However, minutes from resident meetings do not show what action has been taken to address issues raised at previous meetings, this was discussed with the care leader who said she will address this. Monthly reports of visits by a representative of the organisation monitoring the service are kept within the home and the Commission is informed of any events affecting the well being of residents. The home has a recognised quality monitoring award (Investors in People award) and the ‘Trust’ undertook a full internal quality audit in January of this year. However, a report written after quality assurance questionnaires received from residents, their representatives and other stakeholders involved in the service could not be located and the care leader was asked to forward this report to the Commission. The organisation has a range of policies and procedures and these are regularly reviewed and updated. Pre-inspection information provided identified that equipment is regularly checked and serviced and records kept at the home showed that there are systems in place to monitor any maintenance issues. A recommendation given during the previous visit regarding the need to ensure residents financial records contain more detail has been addressed and those sampled were found to be satisfactory. The health and safety of residents is promoted, appropriate equipment is provided and policies and procedures are in place. Residents comments on the day of the visit were that they felt safe at the home and staff spoken to said that they felt supported by the systems in place. Hartsholme House DS0000002369.V318847.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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X 2 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 3 Hartsholme House DS0000002369.V318847.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 OP19 Regulation 13[4][c] Requirement It is a requirement that action is taken to minimise risk to residents accommodated in rooms on the first floor where windows open wide. Timescale for action 15/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP7 OP15 OP22 OP30 Good Practice Recommendations It is recommended that all care planning documentation is signed and dated by all those involved. It is recommended that the lunch-time arrangements are reviewed to ensure mealtimes are relaxed and flexible. It is recommended that signs and pictures should be used to help residents with dementia to find their way around. It is recommended that staff undertake equality and diversity training. Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 24 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 Hartsholme House DS0000002369.V318847.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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