Inspection on 22/02/07 for Highstone Mews Care Home

This inspection was carried out on 22nd February 2007.

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

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

Other inspections for this house

Highstone Mews Care Home 02/02/09

Highstone Mews Care Home 29/11/05

Highstone Mews Care Home 15/06/05

Highstone Mews Care Home 05/01/05

Highstone Mews Care Home 06/07/04

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Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Highstone Mews Care Home Highstone Road Worsbrough Common Barnsley South Yorkshire S70 4DX Lead Inspector Michael O’Neil Key Unannounced Inspection 09:10 22nd February 2007 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 Highstone Mews Care Home DS0000006484.V325082.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. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highstone Mews Care Home Address Highstone Road Worsbrough Common Barnsley South Yorkshire S70 4DX 01226 733966 01226 779427 none www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Debra Ann Owen Care Home 60 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) Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30) Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 30 beds in one unit are registered for N, Nursing Care or PC, Personal Care in the category DE/E, Dementia for people aged 65 or over OR MD/E, Mental Disorder for people aged 65 or over. Of the 30 beds above two can instead be used for the category DE or MD for people aged 55 or over and 28 for people aged 60 and over. The remaining 30 beds in a separate unit are registered for PC, Personal Care in the category OP, Older People. Two of these beds can be used instead as PD, Physical Disability for people aged 55 or over. For the DE/E, MD/E unit, minimum staffing levels and the manager supernumerary hours must be maintained as agreed with the previous registration authorities, see attached, Appendix 1. For the OP unit, staffing levels must be maintained as follows: one member of staff must be on duty when 1 to 10 service users live at the home; two staff for 11 to 20 service users; and three staff for 21 service users and above. 29th November 2005 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Highstone Mews is a registered care home for 60 older people. The home is divided into two units, which comprise of a 30-bed unit providing residential care and a 30-bed unit providing dementia/mental disorder nursing care. The home was purpose built. Both units share the same facilities for kitchen, laundry and administrative support. The home is situated in the residential area of Worsbrough Common on the outskirts of Barnsley, close to the M1 motorway and local bus routes and shops. All 60 places are accommodated in single en-suite rooms. Resident’s rooms are located on the ground and first floors and the home is equipped with handrails, other adaptations and a lift to assist people in moving around the home. Similarly, aids for residents are provided in bathrooms and toilets. The home had a range of communal areas. An enclosed garden and car park are provided. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection carried out by Mike O’Neil, regulation inspector. This visit took place between the hours of 09:10 am and 3:20 pm. Debra Owen, registered manager, was present during the visit. The manager submitted a pre inspection questionnaire to the CSCI prior to the actual visit to the home. Some information from the questionnaire is included in the main body of the report. Opportunity was taken to make a partial tour of the premises, inspect a sample of care records, check records relating to the running of the home, check the homes policies and procedures and talk to 3 visiting health professionals, 5 staff including a student nurse on placement at the home, 3 relatives and 7 residents. The inspector wishes to thank the staff, relatives and residents for their time, friendliness and co-operation throughout the inspection process. A copy of the previous inspection report was displayed and available in the foyer of the home. Information about how to raise any issues of concern or make a complaint was on display in the entrance hall. What the service does well: Visiting health care professionals and relatives said that the standard of care delivered at the home was good. Some residents were not able to say whether they felt that they were being well cared for; these residents were well dressed in clean, age appropriate clothing and attention had been paid to hair and nail care. The inspector saw staff consistently treating residents in respectful and friendly way. Residents said that they had a choice of food and that the quality of food served was good. Residents and relatives said that activities were organised and held in the home. The home was clean and tidy. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 6 Staff said they were encouraged to attend training on various care topics and that there were good training opportunities available to them. Residents, staff and relatives said that they met regularly with the manager of the home and spoke positively about her approachability and helpfulness. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. Standard 6 is not applicable to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ assessments prior to admission took place. These enabled staff to be aware of residents needs to ensure that they could be met. This home does not provide intermediate care services. EVIDENCE: Two care plans were checked and these contained assessments of the service users’ needs. The assessments were formulated into a plan of care for each person. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ health, social and personal care needs were generally well documented in the care plans meaning that the resident’s needs could be met. A range of health care professionals visited the home to assist in maintaining the health care needs of residents. Residents themselves said that the care they were receiving was good and added other positive comments. Three relatives interviewed confirmed that they felt the needs of their relative were being met. Some medication practices and storage procedures provided a risk to the residents’ health and welfare. Residents’ privacy and dignity was maintained. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 10 EVIDENCE: Two resident care plans were checked. Two previous requirements made had been met. The plans included risk assessments for the use of bedrails or other specialist equipment and included information on resident’s wishes relating to their care after death. The residents’ health, social and personal needs were well recorded and the care plans identified that a range of health professionals visited the home to assist in maintaining the residents health care needs. The care plans were not adequate however because there was no evidence to suggest that the resident or their relatives were involved in the drawing up or the reviewing of the care plans. Staff interviewed showed a good knowledge of the residents diagnosis and their health and social needs. Visiting health care professionals said that staff at the home communicated well with them and felt that the standard of care delivered at the home was good. Residents said that the care they were receiving was good. Residents consistently added comments such as “staff are lovely”. Relatives made comments such as “the staff are caring” and “the care at Highstone Mews is very good “. Some residents were not able to say whether they felt that they were being well cared for; these residents were well dressed in clean, age appropriate clothing and attention had been paid to hair and nail care. Residents’ health and safety was not maintained because not all Medicine Administration Records (MAR) and other medication procedures were adequate. • One MAR sheets contained hand written instructions with no signature as to the prescriber. Two staff members, who check that the correct information is documented, or ideally the General Practitioner must sign any handwritten instructions on the MAR sheets. Staff had not used the appropriate coding on the MAR sheet to indicate why a medication had not been given. • Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 11 Morphine Sulphate Tablets (MST) which is a controlled drug were not stored in a drug cabinet which complies with the Misuse of Drugs regulations 1973.The MST must be stored in a locked metal cabinet within a drugs cabinet. There was a lack of space in the cabinet because there was too larger stock of one particular medication and the MST had been dispensed in blister packs as apposed to a bottle. Eye drops were found in the drugs fridge that did not contain a label or details as to the resident for whom they were prescribed. The other positive outcomes in this area have enabled an overall quality rating of “good” to be made under Health and Personal Care. However, the inspector discussed the shortfalls with the manager and advice was given regarding the need to audit the medication systems in more detail on a more frequent basis. Staff interviewed said they had received training on the safe administration of medicines. The inspector saw documentation to support this training having taken place. All the residents and relatives spoken with said that the staff were respectful and friendly. The inspector saw staff consistently treating residents in respectful and friendly way. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had a choice of lifestyle within the home and they were able to maintain contact with family and friends ensuring that they continue to be involved in community life. Meals served at the home were of a good quality and offered choice to ensure residents receive a healthy balanced diet. EVIDENCE: Residents said they were able to get up and go to bed when they chose, and were seen to walk freely around the home, if able. Relatives spoken to said they were able to visit at any time and were made to feel very welcome. Residents and relatives said that activities were organised and held in the home. Some activities that residents had participated in were recorded in their care plans. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 13 Two activity coordinators are employed at the home and activities were occurring during the inspection. Residents said that staff tried to help them maintain links in the community. On the day of inspection some local residents had been invited to the home for a game of bingo with the residents. Residents said that they had a choice of food and that the quality of food served was good. Lunch was served in a pleasant relaxed manner and residents were sat at tables, which had been nicely set. Residents said that they enjoyed their lunch. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints procedures are in place to enable residents and relatives to feel confident that any concerns they voice will be listened to. Staff had an understanding of the procedures to be followed should they suspect any abuse at the home, so helping to ensure residents are protected from abuse. EVIDENCE: Complaints procedures were displayed in the home. Residents and relatives said that if they had any concerns that they would feel comfortable in talking to the manager and they knew that the problems would be dealt with immediately. Staff interviewed had received training on adult protection and were aware that there were procedures in place to report any concerns. There was regular staff training on adult protection. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 15 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 19,21,24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment within the home was generally well maintained and clean providing a comfortable, safe environment for residents. EVIDENCE: The home was clean and tidy. Lounge and dining areas were domestically furnished to a good standard and felt “homely”. Since the last inspection the bathroom door on Dillington unit had been repaired. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 16 A bath on Dillington Unit however was not in use as a seal was damaged. The manager said that this bath had been waiting to be repaired since November 2006.Residents in the meantime had been using a shower on the unit. The bathrooms checked were bright and airy and staff had made an effort to make the rooms more homely. The corridor carpets were showing signs of wear and tear and were marked in several areas. The carpets need replacing. (Previous requirement not met) The Dillington Unit ground floor lounge carpet was marked and stained and needed cleaning or replacing. Bedrooms checked were comfortable and homely. Residents said their beds were comfortable. Bed linen checked was clean and in a good condition. No unpleasant odours were noticeable in the home. Relatives and residents said that the home was always kept clean. Window restrictors were fitted to all windows checked. The hot water temperature in one bathroom checked measured a safe temperature below 45 degrees centigrade. This will assist in maintaining resident safety. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 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 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were employed in sufficient numbers to meet the residents needs. Recruitment procedures promoted the protection of residents. Staff have completed training that ensures these staff have the competences to meet the residents needs. Staff undertook induction training to ensure they had the skills needed to carry out their duties. EVIDENCE: The manager stated that agreed staffing levels were being maintained and the staff rota identified agreed staffing levels had been met. Staff said staffing levels were adequate. Relatives said that staff were very visible around the home when they visited. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 18 The required 50 of care staff had not achieved their level 2/3 NVQ qualifications, although the manager said a number of staff had enrolled or were undertaking their NVQ training. The recruitment records of 2 recently employed staff members were checked. The staff had provided employment histories and the home had obtained two written references for each of them. These were satisfactory. Protection Of Vulnerable Adults (POVA) checks had been made. Enhanced Criminal Record Bureau (CRB) checks had been obtained for the staff members. There was a training and development plan for the staff. Staff said they were encouraged to attend training on various care topics and that there were good training opportunities available to them. Staff interviewed said that when they started work they received induction training in the first two months of their employment. A staff file checked identified that the member of staff had received induction training when they commenced work. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a positive style of management in the home. This would have a positive affect on the quality of the service the residents receive. Some of the homes financial procedures did not fully promote the welfare of the residents. In the main the homes policies and procedures promoted the health, safety and welfare of residents and staff. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 20 EVIDENCE: The manager is a qualified nurse and has achieved her NVQ level 4 award. The manager was very positive about the inspection process and was committed to improve the service of Highstone Mews and meet the National Minimum Standards and Care Home Regulations. Residents, staff and relatives said that they met regularly with the manager of the home and spoke positively about her approachability and helpfulness. The home had an active quality assurance system. There was evidence of internal auditing of the homes environment, services and records. Staff meetings were held and minutes of these meetings were seen. The responsible individual visited the home on a regular basis, a report was written following the visits. A copy of the responsible individuals monthly report has always been sent to the local office of the CSCI. The home handles money on behalf of some residents. Account sheets were kept, receipts were seen for all transactions and a second individual witnessed all transactions. However, residents’ financial interests were not fully safeguarded because residents’ personal money accounts had not received any interest payments despite some residents having around £1000 held in a Highstone Mews resident bank account. The health and welfare of residents could not be fully protected, as although practice fire drills had been conducted in the home the records did not identify the length of the drill, the time the drill was held or any corrective action taken after the drill had been completed. Staff said they had received recent fire safety and other health and safety training .A sample of records showed that staff were receiving this statutory training. Records showed that weekly testing of the fire alarm system and the monitoring of hot water temperatures were being carried out. (Previous requirements met) A sample of records showed servicing of the homes utility systems had occurred. At the time of inspection fire exits were clear and window restraints were in situ at first floor windows checked to prevent falls. Hazardous products were safely stored in the home. This will promote the safety and welfare of the residents. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 2 X X 3 X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 X X 2 Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 12,15 Requirement Reviews of the care plans must include the wishes and opinions of the residents or their advocates. The Medication Administration Records (MAR) must contain General Practitioners or two members of staffs’ signatures alongside any directions regarding the dosage of the medication or the time the medication is to be dispensed. Medication must be administered in accordance with instructions unless there is a documented reason why this was not done. (Coding systems on the MAR sheets) Medication must be securely stored as required under the Misuse of Drugs Act and Regulations. (Cabinet) All medication must be clearly labelled and include the name of the resident for whom the medication is prescribed. The plan to replace the corridor carpets must be implemented.(Previous DS0000006484.V325082.R01.S.doc Timescale for action 01/06/07 2. OP9 13 01/04/07 3. OP9 13 01/04/07 4. OP9 13 01/03/07 5. OP9 13 01/03/07 6. OP19 23 01/06/07 Highstone Mews Care Home Version 5.2 Page 23 7. OP19 23 8. 9. 10. OP21 OP28 OP35 23 18 13,16,17 11. OP38 23 requirement) All areas of the home used by residents must be well maintained. (Carpet Dillington Unit lounge) The bath in Dillington unit must be repaired. 50 of care staff must be trained to NVQ level 2 or equivalent. Residents’ financial interests must be safeguarded by interest being paid on any savings held on their behalf. Fire Drills records must identify the length of the drill, the time the drill was held and any corrective action taken after the drill had been completed. 01/06/07 01/04/07 31/12/07 01/06/07 01/04/07 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 OP9 Good Practice Recommendations Excessive stocks of medication should not be kept in the home. This would create more space to safely store other medication. Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Highstone Mews Care Home DS0000006484.V325082.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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