Inspection on 14/11/07 for Hinderton Mount

This inspection was carried out on 14th November 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

Hinderton Mount 13/01/09

Hinderton Mount 11/01/07

Hinderton Mount 14/02/06

Hinderton Mount 21/04/05

Hinderton Mount 21/10/04

Hinderton Mount 30/06/04

Hinderton Mount 10/02/04

Hinderton Mount 30/09/03

Hinderton Mount 12/09/02

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

CARE HOMES FOR OLDER PEOPLE Hinderton Mount Chester High Road Neston South Wirral Cheshire CH64 7TA Lead Inspector Helena Dennett Unannounced Inspection 14 November 2007 09:30 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 Hinderton Mount DS0000006633.V347595.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. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hinderton Mount Address Chester High Road Neston South Wirral Cheshire CH64 7TA 0151 336 1019 0151 353 1619 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) Weatherstones House Care Ltd vacant post Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 26 service users to include: * Up to 26 service users in the category of OP (old age not falling within any other category) may be accommodated * Within the maximum of 26, one named service user in the category of LD (learning disability) may be accommodated 11th January 2007 Date of last inspection Brief Description of the Service: Hinderton Mount has been operating as a care home since 1985. Weatherstones House Care Limited has owned and run it since 1998. The home is a converted large house, providing 26 places for older people. It is situated on Chester High Road, a mile-and-a-half from Neston town centre, and close to a pub and service station with a shop. The twenty-two single and two double bedrooms all have ensuite toilets and washbasins. There are two lounges - one with a large conservatory extension and a separate dining room. The home has very pleasant and well-maintained gardens/grounds to the front and side, as well as adequate car parking. The fees range from £353.61 to £468.00 per week. Additional charges are made for hairdressing, chiropody, visiting entertainers and outings. The last inspection report is available from the manager on request. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit by one inspector took place on 14 November 2007. The visit was just one part of the key inspection. Staff at the home were not informed of the date the visit was to take place, but a few weeks before the visit the manager was asked to complete a questionnaire to provide the inspector with some information about the service. The manager was also asked to distribute questionnaires to residents, relatives and health and social care professionals to help the inspector find out what they think of the home. Responses were received from residents, relatives and health professionals such as social workers and doctors. All were positive about the standard of care provided by staff in the home. During the visit the inspector spoke with the manager, staff, residents and visitors. A tour of the premises took place and various records were looked out throughout the course of the day. What the service does well: All of the residents said they were well looked after by the staff. Everyone spoken with said the meals were good and a choice is offered. The following comments were made on survey forms returned to CSCI before the site visit: ‘Hinderton Mount is a very warm and homely place; it welcomes clients and their families. It feels as if nothing is too much trouble for the staff. The home is clean, it doesn’t smell, the residents appear happy and relaxed and well cared for. The menu is good with a choice of meals on offer.’ ‘Hinderton Mount is home from home and the staff cannot be faulted. The food is good and the place never smells.’ The home is clean, tidy and well maintained so that people live in comfortable, safe surroundings. Bedrooms are furnished with residents’ own possessions so they are more homely. The dining room is spacious and bright and provides a very pleasant room for people to eat in. Staff are professional in their approach and were seen to treat residents with respect and with dignity. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 6 There is a good policy and procedure in place in relation to complaints and adult protection so that any concerns are acted on quickly thus promoting the well being of the residents. Good recruitment practices also ensure that the staff employed are suitable to work in the care industry. 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. Hinderton Mount DS0000006633.V347595.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 Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments are carried out before a person is admitted to the home to ensure that the staff team can provide the care and support needed. EVIDENCE: Information about the service provided was available in the home. This included details about the staff, the manager and some of the procedures in the home including the complaints procedure. The manager said that she was also distributing booklets about the Mental Capacity Act to make residents, relatives and staff aware of residents’ rights. Prospective residents and/or their relatives are encouraged to visit the home before making a decision on whether they should move in. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 9 A senior member of staff visits prospective residents before they move into the home. An assessment is carried out to make sure that staff at the home can meet that person’s needs. Intermediate care is not provided so Standard 6 does not apply. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 &10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are developed so that people living at the home receive health and personal care that is based on their individual needs. Their dignity is maintained at all times. EVIDENCE: Three care records were looked as during the visit. An assessment is carried out when a person first moves into the home and from this a care plan is developed. Care plans generally have improved since the last inspection as they were more focussed on individual needs. However further work needs to be done to make sure that all needs are documented in the care plan in particular mental health needs. Risk assessments were also done so that risks to individuals can be identified and minimised wherever possible. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 11 There was evidence that the GP and district nurses are asked to visit residents when needed. One resident spoken with was happy with the care and said that the district nurse visits her regularly. The following comment was made by a care manager, the second comment by a relative on a survey form returned to us before the inspection: ‘My client was placed at Hinderton Mount following my assessment. Staff at Hinderton could evidence that the client’s needs were being met. My client has had occasions where she has been unwell, the GP is always called promptly, medication is administered at the correct times and when required other health professionals have been involved. Staff always take into account client needs also when family or professionals with client is supported to go into own bedroom or private room.’ ‘My mother had a stroke and lost her sense of time. This is being managed very well so far – a great improvement on the first home we went to.’ Medicines are generally managed satisfactorily. There was one instance where a resident did not have their prescribed medicine, as they were asleep when the medicine round was done. The member of staff acknowledged that they should have returned to offer the medicine once the resident had woken up. One person had run out of their stock of medicine (Gaviscon liquid) and so there is a risk they may not get their medicines as prescribed. Discussion with the manager before the site visit showed that correct action was taken with regards to a risk assessment for one person giving his or her own medicines. The privacy and dignity of residents was maintained during the visit. Staff pulled curtains in residents’ rooms and all doors were shut when personal care was being carried out. Members of staff were also seen chatting to residents in a friendly but respectful manner. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are some activities available during the day; however more needs to be done to ensure that the emotional and social well being of residents is promoted. EVIDENCE: The provision of activities needs to improve in the home. A list of activities was displayed on the notice board; however there was little evidence that activities are part of the residents’ care. For example: it was identified in one resident’s assessment when she first came into the home that she enjoyed painting and gardening. The following activities were recorded in her care records: ‘quiet day in lounge’, ‘chatty’, ‘watched television’, ‘chatting to staff and visitors’. There was no evidence that any other activity or stimulation was offered to this person or that she had been encouraged to paint or pursue any of her interests. Similar entries were made in other residents’ social care plans indicating that people are not always enabled to pursue their interests. Additional charges are made when outside entertainers visit or for trips out. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 13 The manager has tried to address this issue to some extent in that seating in the lounge area has been reorganised so that people can sit together in smaller groups thus encouraging them to socialise. However a member of staff was seen sitting in the lounge whilst the inspector was there. There was no attempt made during that time to engage residents’ in activities. After the inspection the manager told us that chair skittles were carried out during the morning the inspector visited. The owner of the home also said that quizzes were also done during this time. The following comments were made on survey forms submitted to CSCI before the site visit: ‘Very rarely activities in the home. This is about the only criticism I would make. The staff of necessity spend hours writing reports so that it appears they have little time left to organise any activities.’ ‘It is difficult to encourage clients to engage in activities but if this could be encouraged when a client is first admitted into the home, the activities may be accepted better.’ ‘I think there could be regular (say weekly) simple entertainment from outside – say music, choirs, school choirs.’ ‘The number of organised activities, indoor and outdoor should be increased, in order to motivate the residents. The nature of such activities should be suitable for elderly people.’ In the information submitted to CSCI before the inspection, the manager stated that it was her intention to continue and develop a more varied activity programme. Visitors are welcome at any reasonable time of day. Residents said that they have visits from priests, vicars and lay preachers as they wish. Residents were positive about the food provided in the home. Those spoken with said they were given a choice and that the quality of food provided is good. There is a large dining room, which is nicely laid out. Residents are encouraged to have their meals in this dining room. A member of staff is always present, sits with residents and has a meal or a drink One member of staff was observed assisting a resident to eat. This was done in a sensitive way. The following comment was made on a survey form submitted to us before the site visit: Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 14 ‘The meals are very good and moreover they ensure that the food is eaten – proof of this is that my relative has recovered the weight she lost in ……….’ (Care home she moved from) Hinderton Mount DS0000006633.V347595.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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a procedure covering safeguarding of adults and complaints are dealt with in an efficient and effective manner so residents know that their concerns will be taken seriously and addressed quickly. EVIDENCE: There is a complaints procedure in the home, which identifies the action to be taken if someone has a concern or complaint. Residents spoken with knew whom to approach if they had a concern and confirmed that they were confident their concern would be dealt with. Two complaints have been received by the home in the last twelve months. Both of these were acted on within the set timescales. There is a procedure covering safeguarding adults and a whistle blowing policy and procedure in place. These ensure that staff can raise concerns and that the correct action will be taken if an allegation of abuse or neglect is made. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 24 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hinderton Mount is well-maintained environment so residents live in clean, homely, comfortable and safe surroundings. EVIDENCE: The home is set in its own grounds. It is situated close to a very busy main road; however there is ample parking space in the grounds for staff and visitors. The front door is kept locked with a keypad in place so that residents’ safety is maintained. There is an ongoing maintenance and decorating programme in place. The inspector walked around most of the inside of the home and visited some of the residents’ bedrooms. All areas were clean and tidy. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 17 Residents’ rooms contained pictures, photographs, and ornaments giving them a more personalised feel. Some of the resident’s rooms had large windows overlooking the corridors. Curtains are provided to ensure the privacy of residents if personal care is being carried out, however in other instances anyone walking past the room could look in which could compromise the privacy of the person. Discussion took place with the manager regarding the use of privacy curtains so that people walking past the rooms would not be able to see in. The manager agreed to discuss this with the residents involved and get their views. The kitchen has been repainted since the last inspection and new fire doors placed on the one of the conservatory doors and the linen cupboard. New bedding has also been purchased since the last inspection. There are enough communal areas for residents to use. There is a large conservatory off the lounge area; this could get cold in winter so the temperature of this room needs to be monitored. A large dining room is also available with a small sitting area to the rear should a resident require a quiet place to sit. One of the windows on the upstairs floor had the potential to open wide, which could be a risk to residents. The manager confirmed in writing after the inspection that a check of all windows had been done and restrictors placed on those windows that could be opened wide thus conforming to health and safety guidelines. Ancillary staff are employed to make sure that the home is kept clean and tidy and that residents clothes are laundered. Residents said their clothes were looked after well. No complaints were made. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough suitably trained and competent staff working at the home to meet the needs of the residents. Good recruitment procedures mean that resident are not put at unnecessary risk. EVIDENCE: There were enough staff working at the home on the morning of the visit to meet the needs of the people living there. The manager was working in addition to the deputy manager and carers. Ancillary staff were also in the home doing the laundry and others cleaning bedrooms etc. All staff appeared professional in their approach. The manager confirmed that with the exception of one member of staff all had completed moving and handling training. After the inspection arrangements were made to make sure that the remaining member of staff completed this training so ensuring that residents would not be put at risk through poor moving and handling techniques. A resident made the following comment during the site visit: ‘Staff always speak in a pleasant manner to patients, they are very good.’ Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 19 There has been little change in the staff group at Hinderton Mount Care Home and the turnover of staff is relatively low thus ensuring continuity of care. Two staff files were looked at. There was evidence that all the necessary checks had been done before the member of staff had been employed to work in the home. This means that residents can be confident only people suitable to work in the care industry would be employed. Although there are records indicating staff have an induction before working in the home, these are the same for every member of staff. There was nothing to show how the competency of care staff is checked to make sure that they are competent to carry out their role when they are first employed to work in the home. Records showed that staff have attended several training courses since the last inspection. All but one of the care staff have an NVQ Level 2 qualification or higher in care. This means they should have the skills and knowledge to adequately care for the residents. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32, 33, 35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Hinderton Mount Care home is generally well managed and run for the benefit of the residents. EVIDENCE: A new manager has been appointed since the last inspection. She has previously worked in care homes in management positions. Residents spoken with knew the manager. All said they found her approachable and they would feel comfortable going to her if they had a problem or concern. The manager discussed the changes she has made since she has come to work in the home and the further work that needs to be done. This included getting residents’ views on how the home is run through Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 21 meetings and questionnaires. According to the information submitted before the visit, there are plans to develop a residents’/relatives’ committee in the next twelve months. The owner visits the home regularly to check on the quality of the home. Audits are also carried out to ensure that the home is run efficiently and effectively. Residents are enabled to manage their own money if they wish. Small amounts of money are kept on behalf of some residents. Records of all transactions are kept and receipts obtained whenever possible so that residents know their money is being managed appropriately. The company representative confirmed that all essential equipment has been serviced regularly. A sample of certificates was seen. Although there was evidence that the lift had been serviced, there was no written evidence to suggest that the service had been done within the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER). After the inspection an engineer from the company responsible for servicing the lift confirmed that the lift had been serviced in accordance with the above regulations. As stated previously a window in a resident’s bedroom on the first floor could open wide and so could compromise the safety of residents or visitors. Prompt action was taken by the company to make sure that restrictors are in place for all windows assessed as a potential risk to residents. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X 3 x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 X X 2 Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 23 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 OP9 Regulation 13 Requirement Residents must receive their medicines as prescribed; stocks of medicines must be adequate and the medicines are offered later (if possible depending on a particular medicine) if a resident is asleep. Suitable activities to keep residents active and stimulated must be provided regularly. (Timescale 28/02/07 not met) An application for the manager to be registered must be made to CSCI. Timescale for action 14/12/07 2 OP12 16(2)(n) 14/01/08 3 OP30 8(1) & (2) 14/03/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP24 OP30 Good Practice Recommendations The manager should consider providing privacy curtains for those rooms that overlook the corridors. The induction programme should be robust enough to ensure that the member of staff is competent in carrying DS0000006633.V347595.R01.S.doc Version 5.2 Page 24 Hinderton Mount 3 OP33 out their role. A record of how this competency is assessed should be maintained. Residents’ and relatives’ views should be sought in a more formal way through questionnaires and meetings so staff can address any issues early and also ensure that the home is being run for the benefit of the residents. Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Hinderton Mount DS0000006633.V347595.R01.S.doc Version 5.2 Page 26 - 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. 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