Inspection on 16/08/05 for Heathside House

This inspection was carried out on 16th August 2005.

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

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

Other inspections for this house

Heathside House 17/02/09

Heathside House 12/08/08

Heathside House 25/06/07

Heathside House 01/02/07

Heathside House 21/06/06

Heathside House 09/01/06

Heathside House 30/03/05

Heathside House 30/09/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Heathside House Heathside Lane Goldenhill Stoke on Trent Staffordshire ST6 5QS Lead Inspector Wendy Snell Announced 16 August 2005 9:30 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 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. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Heathside House Address Heathside Lane Goldenhill Stoke on Trent Staffordshire ST6 5QS 01782 234551 01782 234552 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Stoke on Trent City Council Mr Karl Shepherd Care Home 44 Category(ies) of 44 DE(E) registration, with number 2 LD(E) of places 5 MD(E) 44 OP 44 PD(E) Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 2 Learning Disability over 65 years of age (LD(E)) - Places for existing residents only Date of last inspection 30 March 2005 Brief Description of the Service: Heathside House is registered to care for 44 older people. It provides long term and respite care and includes an eight bed EMI unit.The home is situated in Goldenhill, on the outskirts of Stoke-on-Trent. The home was purpose built approx 25 years ago and is managed by Stoke-on-Trent City Council. It is registered under the Care Standards Act 2000. The home is well placed for public transport, which gives frequent access to the main centres of Kidsgrove, Tunstall and Hanley that provide a wide range of facilities. There are good local community links including churches, pubs, shops and community centre. The home is situated in its own grounds surrounded by secure fencing. Limited car parking is provided although parking in the surrounding side roads is possible. The home is purpose built with accommodation provided on two floors. There is a shaft lift and also stairs access between floors. All bedrooms are single occupancy with a wash hand basin although none provide en-suite facilities. There is a range of assisted bathing facilities, including one providing a Parker bath and another a walk-in shower room. There are adequate assisted toilet facilities throughout the home.The home is divided into four areas, all of which have their own sitting rooms and dining areas. In addition, there is a small smoker’s lounge situated off the entrance hall. Three of the lounges offer a domestic style of environment with a kitchenette area for preparing breakfasts, snacks and drinks. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection, which took place on a Tuesday. Two service users, two visitors, four staff, the manager and a GP were spoken with. Four service user and four relative comment cards and one letter were received prior to the inspection. What the service does well: What has improved since the last inspection? All staff have now received fire training. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 6 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. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home has clear assessments of the service user’s individual needs, which enable staff to support them appropriately. EVIDENCE: A random sample of four service user’s care files were inspected. Care management assessments were found to be in place and areas of need highlighted within the assessments were also present within the plans of care drawn up within the home. This home does not provide intermediate care and therefore this standard was not assessed. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9 Care planning and health needs are well documented providing staff with the appropriate information to meet service user’s needs. Medication administration is satisfactory however staff guidance and understanding of PRN administration needs to be addressed to ensure that service users are adequately protected from potential misuse. EVIDENCE: Four service users completed the Commission for Social Care Inspection (CSCI) comment cards. All four stated that they feel well cared for at Heathside House. Four comment cards and one letter was received from relatives and visitors. All stated that that they were happy with the overall care provided. Four service user’s care files were inspected and care plans were found to be in place. The manager stated that the care planning system is being reviewed with the aim of ensuring that all older peoples homes within Stoke on Trent use the same care planning method. There is a need to review the system for ease of use as the present system is, in places, repetitious and overly complicated, but that said the sample of care plans inspected were Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 10 clearly written and provided good detailed instructions to enable staff to appropriately met the needs of the service users. During the inspection the inspector spoke with a visiting GP. He stated that the referrals from the home were always appropriate, very detailed and provided him with good background histories of the service user’s medical history. The care files inspected contained details about the health needs of the service users. It was noted that a range of health professionals are involved in the care of service users at Heathside House. The manager stated that home has a system in place whereby all appointments are entered into the diary. This information is then transferred to a daily planner so that staff can be assigned to assist with appointments. The outcome of appointments is then recorded on a separate sheet, which provides a running record of each service user’s health appointments. Staff spoken with demonstrated a good understanding of when it was appropriate to contact health professionals regarding service user’s health needs. Two visitors were spoken to both stated that the staff keep them informed about any changes in their relative’s health and that they are always informed if a GP is called. It was noted that appropriate assistance was given to a service user who was unwell and required hospital admission. Medication is stored appropriately in a locked cabinet in a locked room. This room was not locked on the day of the inspection. This was discussed with the manager at the time. An assistant manager stated that all medication is checked when it is delivered to the home. Incorrect medication is returned to the pharmacist. It is the inspectors understanding that all senior staff, apart from the manager, have received medication training and administer the medication within the home. Controlled medication was appropriately stored. An item of medication was noted to be out of date and must be returned to the pharmacist and a PRN protocol was also needed for one service user’s medication. This is to ensure that staff are guided to have a consistent and safe approach to the administration of this medication. A random sample of MAR sheets and medication were inspected and found to be in order. Pharmacist reviews take place four times yearly. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 & 15 Service users are offered choice within the daily routines of the home but there is little capacity within the staffing rota to satisfy the social and recreational interests of the service users. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Four service users and four relatives completed the Commission for Social Care Inspection comment cards prior to the inspection. One service user commented that more activities should be offered within the home. A relative also commented that ‘some sort of simulation, or some activities’ should be available within the home. Staff stated that they try to organise activities such as jigsaws and watching videos but staffing and transport difficulties have meant that trips out have not happened as often as service users and staff would like. The manager stated that they try to arrange for a musical entertainer to visit the home on a monthly basis. He stated that where possible each lounge within the home has different activities available for service users in the afternoon. A visitor confirmed that there are occasional ‘sing-a-longs Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 12 and entertainers’ in the home. One service user stated that she would like more activities and would like to go out for a walk but this did not happen very often because there is not enough staff available. (Staffing will be discussed in Standard 27). A service user stated that there are routines to each day but confirmed that she is able to go to bed and get up when she wants to. She stated she is also able to go for a lie down if she is feeling tired in the day. The meals times in the home are set but staff confirmed that snacks and meals are available if main meals are missed. The Commission for Social Care Inspection received four comment cards and one letter from relatives prior to the inspection. All stated that there are no restrictions on visiting the home and that they are made to feel welcome. One relative stated that the staff have ‘been very good to both parents’ during their stay at Heathside House. There is one full time and one temporary cook working within the home. The cook demonstrated a good understanding of the health and safety measures required within a kitchen environment. The cook stated that care staff pass on information regarding any service users who require a special or cultural diet. Two service users were spoken with who confirmed that they are offered a choice of meals from a menu system. Their comments about the variety, quality and quantity of food were positive. Four service users completed comment cards prior three stated that they liked the food and one stated that they liked the food sometimes. There are three lounges and dining areas within the home where service users have their meals. Each of these areas has a kitchenette where beverages and some snacks are stored. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Improved documentation of all complaints is necessary to demonstrate and ensure that service users and relatives complaints are listened to and acted upon. EVIDENCE: Two service users were spoken with both said that they would go to the staff or manager if they wanted to make a complaint. Four service users returned SCI comment cards all of which stated that they know who to speak to if they are unhappy with the care and support they receive. Relatives visiting a service user stated that the home listen to concerns and act upon them. They had raised concerns about items of clothing being lost when they are sent to the laundry. They were aware that staff had looked for the items but they were not found. This issue was not recorded as a complaint or a concern within the home’s complaints paperwork. There must be a record of any complaints about the operation of the care home, and the actions taken by the registered manager in respect of any such complaint. The manager stated that he was considering implementing a ‘grumbles’ book to record issues that, whilst not formal complaints, are of concern to service users or their relatives. It is recommended that this be implemented to demonstrate how service user views and relatives views are listened to and acted upon. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 26 There are outstanding issues in relation to the environment that have been raised by CSCI and the fire authorities, which Stoke on Trent senior management are responding to. Domestic arrangements within the home are good but the handling of soiled laundry must be reviewed to avoid cross contamination and control infection. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 15 EVIDENCE: There are requirements and recommendations regarding the premises made by the Commission for Social Care Inspection (CSCI) and Stoke on Trent fire service which remain outstanding. CSCI is aware that an audit of outstanding works to the premises has been carried out and that talks are underway regarding the future plans for this home. There are regular discussions between CSCI and members of Stoke on Trent’s senior management team in relation to progression and resolution of these matters. A costed plan of works has also been shared with CSCI. The home is purpose built with accommodation provided on two floors. There is a shaft lift and also stairs access between floors. All bedrooms are single occupancy with a wash hand basin although none provide en-suite facilities. There is a range of assisted bathing facilities, including one providing a Parker bath and another a walk-in shower room. There are adequate assisted toilet facilities throughout the home.The home is divided into four areas, all of which have their own sitting rooms and dining areas. In addition, there is a small smoker’s lounge situated off the entrance hall. Three of the lounges offer a domestic style of environment with a kitchenette area for preparing breakfasts, snacks and drinks. There is a small patio area situated at the side of the building. On the day of the inspection it sunny and very warm but service users were not seen to be using this space. It was noted that there was no shade within this area to allow service users to comfortably sit out. The manager stated that there used to be a gazebo but this had to be removed as the structure had become worn. It is recommended that further consideration is given to this area to provide adequate shaded areas. It was noted that in the bedrooms of service users with dementia that, as with the other rooms, pull cords were in place to call for staff assistance during the night. The ability of service users with dementia to summon help in this way was discussed with the manager. Consideration should be given to floor pads which alert staff when a service user is no longer in bed. A handyman is employed within the home to carry out some decorating, general maintenance and safety checks. The home has a laundry. There are corporate policies in relation to the control of infection however, on the day of the inspection a temporary staff member was working in the laundry. The staff member stated that had not received any training. The staff member was uncertain of the appropriate procedures in relation to soiled laundry and issues of cross infection. The staff member was aware of the need to wear protective clothing but was not sure where aprons were stored. The need for all staff to be appropriately trained before using the laundry was discussed with the manager at the time of the inspection. It is also recommended that a notice is available within the laundry which outlines Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 16 soiled laundry procedures to ensure that all staff are aware of measures to reduce the potential spread of infection. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Progress needs to be made in addressing staffing shortages to ensure service user’s care and social needs are consistently met. EVIDENCE: On the day of the inspection there were 5 care staff, 2 assistant managers, 1 cook, 2 domestics and a handy man on shift. This included 1 extra care staff who was assisting with a hospital escort. The assessed needs of the service users within the home vary. Some are quite independent and require minimum support whilst others are quite dependent and require much more staff input with their daily needs. Discussions with staff and the manager revealed that there are 4 vacancies on the staff team and therefore staff cover extra shifts or agency and bank staff are used. The manager confirmed that attempts have been made to recruit to this home but applicants have not been forthcoming. The manager stated that uncertainty regarding the future plans for this home might have deterred people from applying. The use of bank and agency staff was discussed with the manager. Records indicate that during the month of June 33 bank and agency staff were used to cover shifts in the home. The Commission for Social Care Inspection is concerned that this does not offer consistency of care to the service users. A relative visiting at the time of the inspection was complimentary about the staff group but stated ‘that there are never enough of them’. Discussions with staff also highlighted concerns that the staff vacancies have not been filled and that the home is heavily dependent upon bank staff to cover shifts. In discussions with service users one stated that if there were more staff there would be more activities and another was aware that the home used agency staff and was able to differentiate between the permanent and temporary members of the staff team. A review of the care Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 18 staffing numbers in relation to the care needs of the service users needs to take place. This was required at a previous inspection and remains outstanding. Staff recruitment to this home must also be reviewed in order that there is a stable staff group to consistently meet service user’s needs. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 In general service user health, safety and welfare are satisfactorily promoted and protected, however the Commission for Social Care Inspection is concerned that satisfactory records of servicing are not available within the home. EVIDENCE: Fire records were checked appropriate checks and drills had taken place. Staff demonstrated an understanding of the fire procedures and confirmed that regular drills take place. Two service users also confirmed that tests and drills take place. An up-to-date insurance certificate was in place. Regular water and Legionella testing takes place. Accidents were appropriately recorded. Certificates were not available for the gas and electricity testing and service records indicated that there was work outstanding in respect of the lift. Evidence that this checks Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 20 and any work needed has been satisfactorily carried out must be forwarded to CSCI. Two permanent care staff were spoken with both confirmed that they had received core health and safety training, moving and handling, fire safety and food hygiene. Issues in respect of the laundry have been identified in standard 26. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 1 x x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x x x x 2 Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 22 YES Are there any outstanding requirements from the last inspection? 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 2 Regulation 5(1)(b)(c) Requirement Each Service User must have a written contract/statement of terms and conditions with the home(Previous timescale of 1.7.05 not met) To review staffing hours provided in relation to care and support, leisure and therapeutic activities(Previous timescale of 1.9.05 not met) The manager must undertake medication training(Previous timescale of 1.7.05 not met) A protocol should be developed for PRN medication(Previous timescale of 1.9.05 not met) All staff working in the laundry must be appropriately trained in relation to health and safety. Further efforts must be made to fill staf vacancies within this home. Gas servicing records must be forwarded to CSCI. Electricity servicing records must be forwarded to CSCI Evidence that the lift has been satisfactorily serviced and repaired must be forwarded to CSCI Planned dates for the completion Timescale for action Novemeber 30th 2005 2. 27 24 (1)(2) 18(1) November 30th 2005 3. 4. 5. 6. 7. 8. 9. 9 9 26 27 38 38 38 18(1)(i) 13(2) 18(1)(i) 18(1) 23(2)(b) 23(2)(b) 23(2)(b) November 30th 2005 Immediate Immediate 30th September 2005 Immediate Immedaite Immedaite 10. 19 23(4)(a)( 30th Page 23 Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 b) 11. 12. 13. 14. 16 17(2) of outstanding works as outlined in the latest fire report must be agreed with the fire authority and forwarded to CSCI . All complaints made by service user, relatives or staff must be recorded October 2005 Immedaite 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. 5. Refer to Standard 19 19 26 16 Good Practice Recommendations Consideration should be given to the use of alert mats within bedrooms of service users with dementia as a means of calling for staff assistance. Consideration should be given to providing adequate shade within the patio area. A poster should be available in the laundry area which reminds staff of the procedures of handling soiled laundry. The manager should consider the use of a grumbles books for issues and concerns that do not constitute a complaint to be recorded. Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Heathside House E51-E09 S30493 Heathside House V239683 160805 Stage 4.doc Version 1.40 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. 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!