Inspection on 22/07/05 for Highbarrow

This inspection was carried out on 22nd July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Highbarrow 15/05/06

Highbarrow 25/11/05

Highbarrow 10/01/05

Highbarrow 03/11/04

Highbarrow 05/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Highbarrow Toothill Road Uttoxeter Staffordshire ST14 8JT Lead Inspector Berwyn Babb Unannounced 22 July 2005 10:40am 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. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Highbarrow Address Toothill Road Uttoxeter Staffordshire ST14 8JT 01889 566406 01889 569799 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) Mrs Regina Hayes and Mr Robert Michael Hayes Mrs Regina Hayes Care Home 22 Category(ies) of DE(E) - 5 registration, with number OP - 22 of places PD - 1 PD(E) - 15 Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1- PD over 54 years Date of last inspection 10 January 2005 Brief Description of the Service: Highbarrow is a large detached house that has been extended to provide residential accommodation for 22 older people, 16 of whom may have a physical disability, and five of whom may have dementia care needs, and one of whom may have a physical disability and be under the age of 65. The home is situated in rural areas but within a short drive of the town of Uttoxeter. Accommodation is provided in two double and 18 single bedrooms. There are two double and three single bedrooms on the first floor and 16 single bedrooms (10 with en-suite, 3 of those with showers) on the ground floor. The two double bedrooms on the first floor are being occupied as single, and it is the policy of the home as stated in the service users guide, that double rooms are only shared by partners or friends requesting to do so. Communial facilities consist of a large lounge, smaller quiet lounge, and a dining room. On the first floor there is an assisted bathroom with WC and two separate WCs, and on the ground floor there is an assisted bathroom with WC, a shower room with WC, and three separate WCs. These toilets are situated within close proximity of both lounges and of the dining room. The kitchen and laundry are situated on the ground floor as is the care office and proprietors offices. There is also a staff bathroom, bedrooms and kitchen. Externally there are large landscaped gardens all around the building, with lawns and patios, that are fitted with garden furnature, and are accessable to all residents. At the front of the building there is space for car parking. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This six and a half hour annual inspection had been pre-arranged with the proprietor, but in following the format introduced in 2005/06 will concentrate on those core standards identified in that new format. Those not covered in this inspection will be addressed at the following unannounced inspection. There are additional comments as noted during the inspection relating to further standards. The inspector toured all parts of the building internally, and made a visual scan of the environment from the exterior. He examined a number of care plans, some chosen at random and some meeting case tracking requirements, belonging to residents he spoke to. He also conducted a formal interview with a member of staff. One of the proprietors Mr Robert Hayes gave valued assistance thought the whole inspection, as did all members of staff encountered. What the service does well: 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. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 6 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 Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 7 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) 1, 3, 5, 6 Information was seen to be being made available to perspective residents, relatives of perspective residents were visiting the home during the inspection, and the home states that it does not accept admissions for intermediate care. These occurrences suggest that residents seeking permanent care will have all the information that they need to make a choice about entering a home that is able to meet their assessed needs. EVIDENCE: During the course of this inspection, the home was visited by the relatives of a perspective new resident, and the inspector was able to observe one of the proprietors furnishing them with verbal information, and a copy of the statement of purpose, and service users guides for the home. They were able to meet existing residents, and question them about life in the home, and left the proprietor with much information about the needs of their mother, her lifestyle, and the things she liked and disliked, prior to the home being furnished with a care management assessment from the social worker. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 8 Reference to the care plan of the most recently admitted resident demonstrated that as well as paperwork, meetings had taken place with the social worker, the resident, and relatives, in order to establish how best her identified needs could be met, and whether Highbarrow was a home able and willing to provide care for those needs. In discussion with Mr Hayes (The Proprietor), it was established that sometimes, for reasons to do with their assessed needs, new residents were visited by himself the care manager or one of the senior members of staff in hospital or where ever they were situated, rather than them visiting the home prior to their admission. Highbarrow does not currently offer the service of providing intermediate care. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 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, 10 Records examined, practices observed, and the comments of residents and staff suggest that their health and personal care needs are being met by the home in association with other identified professionals, clinics, surgeries, and diverse health care facilities. This, where necessary, has included making arrangements for a more appropriate alternative placement following multidisciplinary reviews. EVIDENCE: The inspector looked at care plans of residents who had identified their needs in discussion with him, and also spoke to some residents where observation of their private environment or personal situation had prompted him to pick their care plan for examination. What he found was a good digest of the health and personal care needs of residents, and how these were being met on a daily basis in the home, and through clinic appointments with health care professionals. There was also good evidence of professionals visiting the home both for direct intervention with residents, and to advise staff. It was felt that the inclusion of a section on what would be a ‘normal day’ for each individual resident, was extremely beneficial for the use of new and agency staff coming into the home. This included not only assessed needs, but choices in terms of where the resident wanted to be at different times of the day, the activities they generally liked to engage in, favourite warm drinks and how they like Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 10 them served, rising and retiring times and the type of bathing preferred and if they liked to take a rest or simply spend private time in their room during the course of the day. In relation to more specific needs of individual residents, the inspector was pleased to find copies of detailed information obtained from suitably qualified sources, included in the care plans for the instruction of staff and benefit of residents. The home were seen to be making creative use of information available on websites on the Internet, as well as from leaflets and other publications recommended by nurses and other health care professionals. An examination was made of the storage facilities for medication, and of the documents used for recording their administration. A member of staff was also observed during her administering of a medication round and she demonstrated both competence and safe practice. The MAR sheets were closely scrutinised without finding any discrepancies, and the proprietor was able to assure the inspector that they had good service from their local pharmacy, who continues to dispose of medications for them that are either out of date, or have been discontinued. At all times during the inspection staff were seen to be treating residents with respect and dignity, and this was confirmed by those residents who were spoken to in private, as well as those in the communal areas. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 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, 14, 15 Residents informed the inspector that they were extremely satisfied with the way the home met their social needs, encouraged their family and friends to visit, allowed them to take decisions affecting their lives, and maintained a good choice and provision of food. EVIDENCE: From conversations with residents and details taken from their care plans, there was evidence that they were able to carry out those things in their life that they had become used to, enjoyed, or practiced as part of their religious observation. Holy Communion and Mass were brought into the home on a regular basis and at the request of residents, it had recently been arranged that an entertainer visit the home every fortnight to lead the singing of well known and loved songs of the past. Comment cards returned prior to the inspection all praised the level of care given in the home and satisfaction with the freedom that residents have to choose whether or not to join in with any organised activities. Interviewed in private, one resident was at great lengths to impress upon the inspector how kind people were to her, how considerate they were with regard to her dietary limitations, and the joy she gained from being able to take a constitutional walk around the grounds everyday during the fine weather. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 12 All residents who spoke to the inspector had contact with their family and their friends, though it was evident that the residents who came from the Uttoxeter district had greater contact than those who came from a distance. None of the residents who spoke to the inspector had any concerns about not being able to fulfil the choices that they had expressed, not with standing but some of them were being realistic both about the calls upon the time of their family members, and with regard to the consequences of the aging process on their own body and hence abilities. The inspector was able to sample the main cooked meal of the day, and found this to be both wholesome and appealing, and in discussion with residents he was assured that it was representative of the quality of meals that they were used to enjoying at all times within the home. Examination of one care plan in particular, demonstrated that when a person had been plagued with a poor sleep pattern she was able to enjoy a cup of tea and a couple of rounds of buttered toast provided by caring night staff, who records demonstrated, had undertaken appropriate food and hygiene training. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 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, 18 The evidence gathered supported the statement that residents and their supporters were able to feel confident that their complaints would be listened to taken seriously and acted upon, and that all steps possible were being taken to prevent them from abuse. EVIDENCE: The inspector spoke in detail to two residents about their understanding of the complaints procedure, and they were able to describe to him a reasonable interpretation of the written policy, in so far as they knew who in the home to complain to if they were concerned about anything, and who to take the matter up with further if they were not satisfied with the result of complaining within the home. The inspector also undertook an in-depth interview with a member of staff during which discussion focused on the subject of abuse. This lady correctly identified that any body could be the perpetrator of an abuse on the vulnerable adult resident at Highbarrow. She was able to elaborate on a range of events that would constitute abuse, specifying not only those things which could be done to a person that could be abusive but also those things that can be termed as acts of omission. This included leaving people for an unacceptable length of time after they have requested assistance, not providing adequate monitoring of someone whose care plan demonstrated inadequate communication ability as to their current needs, or failing to treat people with the dignity and respect that they deserve as fellow humans. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 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, 20, 21, 24, 26 Observation, discussion, and the examination of records, confirmed to the inspector that residents are living in a safe and well maintained environment, with easy access both internally and externally, serviced with adequate washing and toilet facilities, and the whole, including comfortable and personalised bedrooms, being well maintained, clean, and free from odours. EVIDENCE: The inspector undertook a full internal tour of the premise, visiting both private accommodation and communal space, and then progressed onto a visual examination of the grounds and exterior condition of the building. Residents accommodated on the upper floor have the benefit of a chair stair lift to bring them to the ground floor, from where all internal and external facilities are accessible on the level. The sitting areas and grounds of Highbarrow are maintained to a very high standard, with pleasant views over a rolling farm land in the distance, and a variety of features such as lawns, flowerbeds, bowers, shrubs, and patios, within the gardens of the home. The exterior is Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 15 well painted and preserved without any signs of decay and many windows and garden access doors have been renewed in UPVC by the present proprietors. The program of improvement has been continued with a downstairs toilets being the most recent beneficiary, and it was noted that ten of the single rooms have en-suite facilities of which three are further fitted with showers. In addition to this there is a shower room and a bathroom of the ground floor with appropriate lifting equipment being available, and an assisted bathroom and further toilets are available on the upper floor. The inspector was concerned about the lack of toilet rolls in the later facilities, but was shown the care plan of a confused resident which explained the need for residents using the upper storey to maintain their own toilet rolls. He made suggestions to the proprietor regarding alternative means of overcoming this problem, that would not leave the toilets without necessary items of equipment. The bedrooms that were occupied were easily distinguishable as belonging to an individual, by the inclusion of items of personal choice such as photographs, ornaments and small pieces of furniture, and after the necessary fire precautions and risk assessments, some residents had furnished the rooms themselves. Those residents the inspector spoke to assured him that the rooms were comfortable, met their needs, and whilst not being a total substitute for their own home, were good enough for them to recommend to him, living at Highbarrow. The home was clean, fresh, neat and tidy throughout, with suited privacy locks on all of the residents doors, and an emergency alarm system that had to be cancelled at the point of activation, with all radiators and pipe works guarded against the incident of accidental burning, and those hot water outlets randomly tested in residents rooms being regulated to provide a flow that was not uncomfortable to the naked hand. All furnishings provided by the home were of a good standard with deep carpeting and comfortable seating in the communal areas. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 16 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, 29, 30 Discussion with management and staff, and an examination of training schedules and certificates on display, confirmed the opinion expressed in the formal interview by a member of staff, that the training and experience of those caring for residents in this home, and the steps taken to screen perspective members of staff, were all designed to ensure appropriate response to the needs of residents and the confidence of staff that they were trained and able to do their jobs. EVIDENCE: The inspector undertook an in-depth formal interview with a member of care staff, during which discussion around training and experience both of herself and her colleagues, suggested that there was adequate prevision made to meet the assessed care needs of residents admitted to the home. She confirmed that supervision of staff took place once every two months, and that this was a two-way conversation, but that the basic agenda always covered training, development and staff dynamics. Recent courses identified included the infection control course, diabetes course at the Burslem campus of Stoke College, a dementia awareness event, medication handling, foot care and NVQ level 2 and 3 training for members of staff paid for by the proprietor. She confirmed that during employment of new staff references were taken and a telephone check was made to validate them, nobody was started on a permanent contract, or without clearance from the Criminal Records Bureau, and that equal opportunities requirements were met by using the local job centre to advertise current vacancies. She did add that most vacancies were Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 17 actually filled by word of mouth, though there have also been uses of the Internet to recruit overseas staff. During the inspection observation and discussion with staff lead the inspector to conclude that they had a sufficient level of knowledge and skills to carry out their duties under the supervision of the proprietor/care manager and her deputy. Current certificates of competence were displayed on the walls for members of staff, variously for moving and handing, continence care, fire safety, first aid, and competence in food and hygiene. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 18 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) 33, 35, 38 From record discussion and observation, the proprietors of this home are aware of the primacy of the needs of their residents and therefore seek to meet their best interests, ensuring that they receive the best financial advice, and taking all possible steps to promote their health safety and welfare of the individual. EVIDENCE: Comments cards from relatives, and from residents, as well as the outcomes of discussions with most the current residents some in-depth and some less so in the communal setting of the lounge, reflected an appreciation on their part that this was a home devoted to meeting their individual needs and choices, within the generally accepted guidelines of duty of care. From reference to individual care plans it was seen that delicate issues of condition and behaviour were so managed as to maximise the dignity of individual residents, whilst keeping in balance the needs of the whole resident group. Records showed the access to other professionals in a multi-disciplinary manor, to review any Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 19 changing needs of residents, and where these could not be comfortably met within the home, to pursue and to co-operate with alternative arrangements for their placement. Records show that six of the current residents handled their own financial affairs, and that a further 12 residents have arranged power of attorney for someone else to manage finances on their behalf. Mr Hayes the proprietor facilitates the finances of one lady, and the inspector examined the receipt books kept on this ladies behalf and noted that there were two signatures for every entry made in the book, confirming the managing or the taking out of money on her behalf. With this exception there are no general managing of personal allowances for residents. A tour in the inspection of the premises both internally and externally was conducted without revealing any areas of concern, for the health and safety of residents or of staff or visitors to the home. Maintenance is of a very high standard, and the proprietor was discussing future plans to improve the facility with the inspector during the course of this inspection. Records of fire safety and training, medication administration training, accidents, complaints, servicing of gas and electrical appliances, water temperature testing, and details of food served together with three times daily checking of temperatures of fridges, freezers and food stuffs further confirmed the view that health safety and welfare of residents and any other person in the home was being promoted by the proprietors of Highbarrow. Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 20 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 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 4 3 x x 4 x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 4 x 3 x x 3 Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 21 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 Regulation Requirement No requirements within this report Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 24 Good Practice Recommendations The registered person is recommended to regularly tour the building and disuade residents from storing potentially heavy items on top of wardrobes or other high pieces of furnature. The registered person is recommended to ensure that the language used within the complaints book is always appropriate and directly reflects the actions taken in responding to any concerns raised by residents. The registered person is recommended to implement a regular program of touring and inspecting the building to ensure that all areas, even those not in general use, are maintained to the same high standard of cleanliness. 2. 16 3. 26 Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 22 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 Highbarrow E51-E09 S4954 Highbarrow V245272 220705 Stage 4.doc Version 1.40 Page 23 - 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!