Inspection on 03/09/07 for Heffle Court

This inspection was carried out on 3rd September 2007.

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 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

Heffle Court 30/07/08

Heffle Court 26/06/06

Heffle Court 03/03/06

Heffle Court 03/01/06

Heffle Court 07/12/04

Heffle Court 29/06/04

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

CARE HOMES FOR OLDER PEOPLE Heffle Court Station Road Heathfield East Sussex TN21 8DR Lead Inspector Sandra Crosby Unannounced Inspection 03rd September 2007 09:45 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 Heffle Court DS0000021402.V346252.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. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Heffle Court Address Station Road Heathfield East Sussex TN21 8DR 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) 01435 864101 01435 868046 Harebeating Care Company (Holdings) Ltd Care Home 34 Category(ies) of Dementia (0) registration, with number of places Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 2. The maximum number of service users to be accommodated is 34. Date of last inspection 26th June 2006 Brief Description of the Service: Heffle Court is a large, purpose built home providing residential care and support for 34 older people with a dementia type illness. The premises are well maintained, safe and accessible and comprise of service user accommodation on two floors, in single rooms. All rooms are fitted with an alarm call system and all but four have en-suite facilities. Communal areas on both floors include comfortable lounges, spacious dining areas, bathrooms and toilets. Outside, there are safe and secluded courtyard gardens where service users may sit and relax. The home is located close to the centre of town and is close to local shops and a public house. The Regional Manager stated that the current fees range from £475.00 £700.00 per week. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Company purchased the home in May 2007 and this was the first key unannounced inspection visit. Company Management acknowledge that the initial months have been difficult with many changes taking place. A new manager was appointed but has subsequently left; the Company has now put in management support for the home until the newly appointed manager starts in September 2007. The key inspection visit was unannounced and carried out on Monday 03 September 2007 between 09.45 and 16.45. During the inspection the Inspector spoke mainly with the Regional Manager, a Registered Manager who manages another home owned by the Company and is currently providing support for the home, a Clinical Nurse Specialist who is currently working full time at the home, four members of staff, several Service Users, and two relatives who were visiting at the time of the inspection visit. Some records were seen, and an accompanied tour of some areas of the home was undertaken. The Annual Quality Assurance Assessment (AQAA) documentation had not been returned at the time of the inspection visit, and the Regional Manager agreed to address this issue. As this completed documentation had not been returned no surveys could to be sent out in order to collect information about the service. The information in the report has been collated from discussion with management, staff, service users, their relatives, and by observing practices and looking through records. It was indicated that the management team is working hard to improve the standards within the home, and concerns that had previously been raised by relatives were being addressed. A new manager is to start in September 2007, and several people are awaiting appointment as care staff once the CRB check has been returned. A person to provide recreational activities is also due to start in September 2007. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Although this is a new service the Management Team provided an action plan that had been drawn up to address areas of concern. ‘Sit on’ weighing scales have been purchased for the home. The Care Planning System is being improved. The Provider for the medications is to change this month, and appropriate equipment to be provided. Compliments both verbal and written were seen in relation to the food provided at the home. A thorough recruitment system was seen to be in operation. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 7 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. Heffle Court DS0000021402.V346252.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 Heffle Court DS0000021402.V346252.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): Standards 1,3 and 6 were inspected at this visit. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users have comprehensive information on which to base the decision to move into the home. They can feel confident that their needs will be fully assessed and met. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 10 EVIDENCE: As this is a newly registered service with new Registered Providers the Statement of Purpose and Service User Guide will have been approved as part of the registration process, and these documents were not seen at this visit. It was seen that only the second page of the Registration Certificate was on display, the first page was found, and the Regional Manager agreed to address this issue. Currently the Clinical Nurse Specialist who is working full time at the home (in the absence of a Manager – the new Manager for the home is due to commence work at the home in September) carries out the assessment of prospective new Service Users. Completed comprehensive pre-assessment documentation was seen as part of one individual service user plan. The company provides appropriate contracts/terms and conditions of residence for Service Users. The service does not provide intermediate care. Heffle Court DS0000021402.V346252.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): Standards 7,8,9 and 10 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care planning system is currently not clear and consistent, and may not contain all necessary information needed to meet Service Users needs. The systems for medication administration is due to change this month, and it was indicated from the records seen that improvement in recording practices is necessary to ensure Service Users’ medication needs are met. Personal care is mainly offered in a way to protect Service Users’ privacy and dignity. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 12 EVIDENCE: Four Service User Plans were viewed, and the Clinical Nurse Specialist explained that she was in the process of implementing the Companies documentation for care planning. This documentation was seen to contain all components as required by regulation, however the documentation seen was not fully completed. The Regional Manager agreed that this was a work in progress and that currently this standard was not fully met. Discussion took place in relation to District Nurse visits, and it was seen that insufficient information was contained in the Service User Plan in relation to the current situation. This was discussed and the Regional Manager agreed to address this issue. One set of medication records for the first floor of the home were seen and indicated that there were some gaps together with an inappropriate written wording that was discussed with the Clinical Nurse Specialist. The medication storage was seen for the First Floor, and the Inspector was told that the company providing the medications is due to be changed this month and the Boots monitored dosage system for administration of medication is to be introduced with appropriate equipment provided for administering and storage the medications. Heffle Court DS0000021402.V346252.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): Standards 12,13,14 and 15 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Currently Service Users do not have opportunities for a variety of appropriate leisure activities, and may not be able to access the wider community. Service Users are able to maintain contact with family and friends. The meals provided at the home are good. EVIDENCE: Currently there is no person employed to undertake recreational activities, however the Regional Manager said that the previous person had left and that a person was to start in September who would be undertaking this role. It was observed during visits to both lounges at mid morning that in the upstairs lounge five of the nine Service Users were dozing, and a number of Service Users seen on the Ground floor were also dozing. At the time the Clinical Nurse Specialist then asked staff to address this issue. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 14 Visitors are always welcomed and the Inspector was able to speak with a couple of relatives who confirmed that although the home had been through a difficult period due to the change in ownership, lack of manager and staff having left, the standards within the home were now beginning to improve. They stated that since the current cook (employed by the Company and moves from home to home) has been at the home that the food provided is good. Interaction between staff and service users was seen to be good at the time of the main meal of the day. The cook served from the meal from a heated trolley and it was well presented, and one Service User spoken to later in the day said that she enjoyed the meal. It was seen that there was a good range of food supplies stored for kitchen use including fresh fruit and vegetables. Heffle Court DS0000021402.V346252.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): Standards 16 and 18 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints system if used appropriately that indicates that Service Users feel that their views are listened to and acted on. Staff indicated a knowledge and understanding of Adult Protection issues and policies and procedures are in place to safeguard Service Users from abuse. EVIDENCE: Issues of concern have been raised with the Commission since the Company has taken over. One of the complainants has now stated that the situation is improving, and that overall they are satisfied that their concerns will now be listened to by management. A concern remains in relation to the staffing levels at the home, and it is indicated by management that the Company has appointment a manager, a person to undertake activities together with three care staff waiting for a start date following the completion of the recruitment process. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 16 It was seen that the Company has appropriate complaints documentation, and that a number of complaints have been recorded by the home for the month of August, together with information as to the action taken and the outcome recorded. The Company has the necessary policies and procedures in relation to Adult Protection, and six staff have recently undertaking training in relation to Safeguarding Adults. Since the inspection visit, an adult protection alert has been raised in relation to staffing levels, cleanliness of the home and the nutritional needs of a person at the home. Currently this is an ongoing investigation. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19,20,21,22,23,24,25 and 26 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is a safe and reasonably maintained environment. Whilst the home was mainly clean and pleasant at the time of the inspection visit the health and safety of service users may be compromised because of poor practice with regard to good infection control practices. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 18 EVIDENCE: All rooms are fitted with an alarm call system and all but two have en-suite facilities. The rooms have been individually decorated. Many have been personalised with the service user’s own furniture and other possessions. Communal areas on both floors include comfortable lounges. The service also has three dining areas. The premises require regular maintenance, and a number of areas need updating, together with areas of carpet that need renewing. The Regional Manager stated that an improvement plan was being implemented that would address these areas of concern together with action being taken in relation to the renewal of bedding, towels and flannels. Outside, there are safe and secluded courtyard gardens where Service Users may sit and relax. In relation to good infection control procedures the Inspector was told that an audit was to be undertaken this month in relation to the provision of liquid soap and paper towels that was to be made available in all appropriate areas. A representative from a Company is coming in to provide this service and also to provide COSHH training to staff. An inappropriate container housing clinical waste was seen in a Sluice Room and the Regional Manager took immediate action to address this issue. During the accompanied tour of the home it was observed hot water in individual shower units was too hot and the Regional Manager was asked to monitor this and take whatever action was needed in order to make these areas safe for Service Users. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 and 30 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service User’s needs are mainly met by suitably experienced and supervised staff. However it is indicated that there have been occasions when insufficient numbers of staff have been on duty to meet the needs of Service Users. Service Users are protected by the home’s thorough recruitment procedures, and staff training is ongoing. EVIDENCE: Information was provided by staff and relatives that indicated that since the Company has been registered there have been occasions when there has been insufficient staff on duty to meet the needs of the current group of Service Users. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 20 The staff rota was seen, and indicated for the current week that sufficient numbers of staff are on duty, other than persons to provide recreational activities. This rota includes the addition of one or two agency staff covering the morning or afternoon shift each day. Previous weeks staff rotas also indicated that there had been occasions when there were insufficient staff on duty to meet the needs of the Service Users. The Regional Manager agreed that there had been a difficult period since the Company was first registered, but that now the staffing levels have improved, and new staff are in the process of being appointed. Two staff files were seen for starters since the company was registered, and the documentation seen indicated that the company undertakes and operates a thorough recruitment system. The Regional Manager said that the Company implements the Skills for Care Induction training for new starters. Currently there is insufficient numbers of staff qualified to NVQ Level 2 as required by regulation, however the Regional Manager said that two care staff are currently undertaking NVQ Level 2 and 2 staff are undertaking NVQ Level 3. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,36 and 38 were inspected at this visit. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service Users currently do not benefit from a well run home, and the health, safety and welfare of service users and staff are not always promoted and protected. Service Users are safeguarded, by the accounting and financial procedures of the home and systems are in place in relation to the safe storage of records. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 22 EVIDENCE: Since the Company has been registered the previous Registered Manager has left and a new manager was appointed and employed for only a few weeks. A new manager is to start in September. Currently the home is being managed by the Clinical Nurse Specialist, and is supported by a Registered Manager from another home owned by the Company, and the Regional Manager. The home has gone through a difficult transitional period, however it is indicated that action is being taken by the Company to address the issues raised and to provide additional support for the home until the new manager is in post. The Company has procedures in place for quality assurance these include annual customer satisfaction surveys, stakeholder surveys, staff satisfaction surveys and surveys in relation to the food provided. In the near future the Regional Manager said that the Company will be sending out post acquisition surveys. The Company carries out the required Regulation 26 visits. The Report for August was seen, and it discussed that these report should contain more comprehensive information, and that this could later be used to inform the quality assurance systems in use. The Regional Manager agreed to send copies of the Regulation 26 Visits to the Commission office for the months of October, October and November 2007, in order that the improvements being made at the home could be monitored. The Company has procedures in place for the safe handling of residents monies The Clinical Nurse Specialist has started supervision session with staff, but to date this has involved the senior staff, and in order to comply with regulation needs to be undertaken regular with all staff at the home with written records kept. The Company are working hard to ascertain the training needs of staff and training sessions are planned and ongoing, for example Fire Marshall training and updating Moving and Handling training has been undertaken. However, from the information seen it is indicated that staff require for example Dementia Awareness, Health and Safety and Infection Control training in order to comply with the requirements of regulation. Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 2 3 3 3 3 2 2 2 STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 2 X 2 Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 OP7 Regulation 15 Timescale for action A service user plan of care 31/12/07 generated from a comprehensive assessment (see Standard 3) is drawn up with each service user and provides the basis for the care to be delivered The registered person promotes 30/09/07 and maintains service users’ health and ensures access to health care services to meet assessed needs The registered person shall make 05/09/07 arrangements for the recording, handling, safekeeping, safe administration and disposal of medications received into the care home The registered person ensures 05/09/07 that there is a simple, clear and accessible complaints procedure which includes the stages and time-scales for the process, and that complaints are dealt with promptly and effectively The registered person shall ensure that any complaint made Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 25 Requirement 2. OP8 12 3. OP9 13(2) 4. OP16 22(3) under the complaints procedure is fully investigated 5. OP19 16 A programme of routine 31/12/07 maintenance and renewal of fabric and decoration of the premises is produced and implemented with records kept The heating, lighting, water 30/09/07 supply and ventilation of service users’ accommodation meet the relevant environmental health and safety requirements and the needs of individual service users. Monitor the hot water temperature – especially the individual showers The premises are kept clean, 30/09/07 hygienic and free from offensive odours throughout and systems are in place to control the spread of infection, in accordance with relevant legislation and published professional guidance Provide appropriate waste containers clinical 6. OP25 23 7. OP26 13(3) Provide liquid soap and paper towels in all appropriate areas 8. OP27 18(1)(a) Ensure that at all times suitably 05/09/07 qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users A minimum ratio of 50 trained 31/03/08 members of care staff (NVQ Level 2 or equivalent) is achieved by 2005, excluding the registered manager and/or care manager, and in care homes DS0000021402.V346252.R01.S.doc Version 5.2 Page 26 9. OP28 18 Heffle Court providing nursing, excluding those members of the care staff who are registered nurses 10. OP31 8 The registered manager is 30/09/07 qualified, competent and experienced to run the home and meet its stated purpose, aims and objectives Visits by the Registered provider 30/11/07 - Prepare a written report on the conduct of the home - and provide to the Commission a copy of the reports for the months of September, October and November 2007 to enable the improvements made to be monitored The Regional Manager agreed to send copies of these Regulation 26 reports to the Commission 12. OP38 18 The registered manager ensures 31/12/07 so far as is reasonably practicable the health, safety and welfare of service users and staff All staff to be trained in Dementia Awareness and all required mandatory training for example Health & Safety and Infection Control 11. OP33 26 (2)(c) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 27 Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Heffle Court DS0000021402.V346252.R01.S.doc Version 5.2 Page 29 - 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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