Inspection on 18/10/07 for Hollyhead

This inspection was carried out on 18th October 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 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

Hollyhead 19/01/07

Hollyhead 19/09/05

Hollyhead 06/05/05

Hollyhead 13/12/04

Hollyhead 05/07/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Hollyhead 224 Shawfield Road Ash Aldershot Hampshire GU12 6SQ Lead Inspector Nigel Thompson Unannounced Inspection 18th October 2007 11:30 Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 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 Hollyhead DS0000013677.V353239.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 Adults 18-65. 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. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hollyhead Address 224 Shawfield Road Ash Aldershot Hampshire GU12 6SQ 01252 345161 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) sharon.down@apt-lpd.co.uk Atlas Project Team Ltd Post Vacant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The age/age range of the persons to be accommodated will be 30 - 55 years 19th January 2007 Date of last inspection Brief Description of the Service: Hollyhead is a large detached bungalow situated in the village of Ash and is close to local amenities and transport links. The registered home provides care, accommodation and facilities for up to three service users with learning disabilities. All service users (clients) take up single occupancy and have access to communal facilities, which comprises of a large lounge/dining area, domestic style kitchen, laundry and bathroom. To the rear and side of the building is a large secluded garden. There is parking for several vehicles to the front of the building. The home benefits from its own vehicle. Information about the service, including the recently updated Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective residents or their relatives, on request, as part of the admission process. The current weekly fees at Hollyhead, as of 18th October 2007, range from £1,770 to £1,841. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five and a half hours in October 2007. It found that all of the key National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was satisfactory. Residents (clients), observed during the inspection, expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were three clients living at the home. The inspection involved a tour of the premises, observation of working practices, examination of the home’s records and discussion with two members of staff, the appointed manager and three Regional Managers. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. The focus of the inspection was on the quality of life for people who live at the home. What the service does well: Clients at Hollyhead clearly benefit from having an experienced manager and dedicated staff team who are evidently committed to providing a consistent level of care. Staff work closely with clients and have developed a sound understanding of their individual care and support needs. The relaxed, homely and welcoming environment has evolved over many years and reflects the commitment within the staff team and the open and inclusive management style. Despite limited communication, clients are encouraged and closely supported to make decisions about their individual lives. They are involved and regularly consulted on many aspects of life in the home, including menu planning and activities. An impressive support system for the home has been developed, which ensures that a senior member of staff is always ‘on call’ and available to be Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 6 contacted directly by telephone and who if necessary would be on the premises within fifteen minutes. 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. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The thorough admission policy and procedure ensures that service users are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective clients know that the home is able to meet their individual care and support needs. EVIDENCE: Although there have been no clients admitted to Hollyhead since the previous inspection, comprehensive information relating to the home is made available to all prospective clients, their relatives and associated care managers. Relevant documentation including an updated Statement of Purpose ‘ and ‘Service User Guide’ was examined and found to be satisfactory. Following a referral to the home, one of the management team will visit the prospective client and carry out a full pre-admission assessment, including any personal and emotional care and support needs, mobility issues, social and cultural needs and family involvement. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 9 In clients’ files that were examined it was evident that a comprehensive needs assessment had been undertaken in each case. In addition to establishing whether the individual’s care and support needs can be met within the home, the appointed manager also stressed the importance of ensuring compatibility with existing clients. As well as being invited to visit the home to look around and meet with existing residents and staff, prospective clients have the opportunity to stop overnight before moving in. The manager confirmed that all new clients undergo a flexible trial period at the home, during which time their suitability and compatibility are fully assessed and it is established whether their identified care and support needs are able to be met. In documents that were examined it was evident that individual contractual agreements had been signed and dated by the client themselves, or a relative or representative on their behalf. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Clients’ care plans enable staff to meet assessed needs in a structured and consistent manner and individual plans, including risk assessments reflect changing support needs. Systems for consultation and participation remain effective and clients are treated with respect and encouraged and enabled to make decisions about their day-to-day living. EVIDENCE: Staff spoken to during the inspection confirmed that, despite the variable and limited verbal communication of the clients, effective and regular interaction and consultation takes place constantly throughout the home. This was evident from direct observation of staff supporting clients in a professional, sensitive and respectful manner. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 11 Direct staff support continues to be in the form of a communication board for each client, individually linked to their assessed level of understanding. A picture board with magnetic pictures enables effective communication between clients and staff. ‘Objects of reference’ are routinely used, including car keys and a picture of a car to indicate a proposed drive out somewhere. The appointed manager confirmed that the individual client themselves and, where appropriate, a relative or representative have the opportunity to be involved in regular care plan reviews. In a sample of personal progress files that were examined, it was evident that recent reviews had taken place. Plans were found to be comprehensive and linked to the individual’s current assessments, containing risk assessments and detailed ‘step by step’ guidance for staff on how to meet identified care and support needs in a structured and consistent manner. Independence and individuality is evidently encouraged and promoted within the home and is reflected in the personalising of clients’ rooms, the choice of bedclothes and colour schemes and individual preferences for occupational and leisure activities. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Clients are enabled and supported to maintain contact with family and friends as they wish and effective links with the community enrich their social and educational opportunities. Clients benefit from generally appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: The recreational and leisure interests of clients are identified and recorded in their in their personal care plan and they continue to be supported to access activities and facilities, reflecting their individual needs and abilities. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 13 Community participation remains a focus in the home and clients are evidently encouraged and supported to visit the cinema, theatre, local shops and other amenities. The appointed manager confirmed that, where appropriate, clients’ family links are encouraged and supported, however not all clients have regular family contact. He added that a successful and well-attended barbeque had been held in the garden during the summer. Visiting to the home is largely unrestricted and relatives and friends are made welcome at any reasonable time. Menus examined were found to be varied and balanced and are evidently based on clients’ identified likes and preferences. An alternative to the main meal is always available. Staff confirmed that clients are encouraged and closely supported to help out in the kitchen with meal preparation. This was evidenced through direct observation during the inspection. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff have developed close and positive relationships with clients and demonstrate an awareness and sound understanding of their individual care and support needs. Clients are protected by clear and comprehensive policies and procedures in place for the control and safe administration of medication. EVIDENCE: The appointed manager emphasised the importance of staff developing close working relationships with individual residents and being aware of changes in mood or behaviour. He confirmed that dependency levels varied and support for individual clients with personal care and other daily routines was provided very much ‘in their own time’ and ‘as and when they required it.’ Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 15 Documentary evidence was in place to demonstrate that the health and emotional care needs of individual clients are continuing to be met within the home. In accordance with their care plan, clients are fully supported and enabled, as far as practicable, to exercise control over their lives and maintain maximum levels of independence and individuality. During the inspection, staff were observed interacting with clients in a professional and respectful manner. All clients are registered with local GPs and have access to other health care professionals, including district nurses, physiotherapists and dentists, as required. It was evident, in care plans that were examined, that all appointments with, or visits by, health care professionals are appropriately recorded. Up to date, detailed policies and procedures relating to the control, storage, administration and recording of medication are in place. Medicines are stored and recorded appropriately. All staff responsible for administering medication have received training and are individually assessed and authorised to do so. The appointed manager confirmed that, following risk assessments, no client currently self-administers their own medication. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home’s complaints procedure ensures that clients, staff and visitors feel able to express any concerns, confident that they will be listened to and acted upon. Clients are protected through relevant staff training and satisfactory policies and procedures relating to abuse and safeguarding adults. EVIDENCE: As previously documented, clients are generally able to make their feelings known to the staff, who are aware of and sensitively respond to gestures, facial expressions and subtle changes in mood as well as the ‘objects of reference’ and picture boards. A clear, simple and concise complaints procedure has been developed by the organisation and a copy is included in the Statement of Purpose. However it is evident that the close working relationships, within the home, and effective and ongoing communication and consultation with clients and their families provide adequate opportunity for any concerns to be raised and discussed, before they become complaints. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 17 Members of staff confirmed that they would have no hesitation in speaking to the appointed manager or making a complaint if necessary and each person was confident that they would be listened to. Since the previous inspection an anonymous complaint was received by the home. However following a full and comprehensive internal investigation, which failed to uncover any supportive evidence, the complaint was not upheld. No complaints have been received by CSCI in respect of this service since the previous inspection. The home has produced detailed policies and procedures, recently reviewed, relating to adult protection and abuse, including a whistle blowing policy. These documents have evidently been drawn up in accordance with the multi agency guidelines for the protection of vulnerable adults (Safeguarding adults). The manager confirmed that all care staff have undertaken appropriate training regarding abuse awareness and procedures relating to ‘Safeguarding Vulnerable Adults.’ This was supported through discussions with members of staff during the inspection and evidenced through individual training records. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The service is accessible, safe and clean and remains clearly suitable for it’s stated purpose. Clients benefit from pleasant accommodation that is comfortable, generally well maintained and decorated to a satisfactory standard. EVIDENCE: During my ‘guided tour’ of the premises it was evident that the well maintained décor and adequate furniture and furnishings continue to provide a comfortable, pleasant and generally homely environment for the client. The appointed manager confirmed that independence and individuality continue to be promoted within the home and, as previously documented, this Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 19 is evident from the personalising of clients’ rooms, reflecting individual preference and interest. Identified maintenance requirements are appropriately documented and addressed, as necessary. Infection control policies and procedures are in place and clearly adhered to. Clients, with support from staff, are evidently responsible for keeping bedrooms clean and tidy and on the day of the inspection, levels of cleanliness and hygiene throughout the home were found to be satisfactory. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. There is always sufficient trained and competent staff on duty to meet the assessed needs of the residents. Residents are protected by satisfactory staff recruitment policies, procedures and documentation. EVIDENCE: Through discussion with the acting manager, care staff and residents, it is evident that sufficient staff are employed to meet the current assessed support needs of residents and to ensure consistency and continuity of care. One of the regional managers confirmed that staffing levels within the home are closely monitored and are directly linked to the clients’ current identified levels of dependency. A duty rota has been developed and implemented to detail the staff on duty at any given time and their designation. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 21 In addition to a comprehensive induction programme, appropriate core skills training is provided for all care staff, including first aid, moving and handling, food hygiene and fire safety. Training is also provided in the administration of medication, the protection of vulnerable adults, communication and learning disability. The Learning Disability Award Framework training had been followed and National Vocational Qualifications at level two and three had been achieved. This was confirmed through discussions with staff and evidenced by training records examined: ‘There is always plenty of opportunity for training here – they are very hot on it’. Formal and structured staff supervision is provided on a regular basis and is appropriately recorded. The management team is clearly aware of the need for thorough and robust recruitment procedures, to ensure the protection of clients. Individual files that were examined, relating to recently appointed members of staff, were found to be well maintained, containing all relevant and necessary information, including two satisfactory references, proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Clients benefit from a competent and experienced manager. They are protected by satisfactory health and safety procedures and their best interests are safeguarded by effective quality monitoring systems. EVIDENCE: Following the departure of the previous registered manager, since the last inspection, an experienced manager from another home within the organisation has been appointed to Hollyhead and has been in post since April this year. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 23 As well as having extensive experience in the care and support of people with learning disabilities, he has achieved the NVQ, level 4, in Management and Care and in January this year completed the Registered Manager’s Award (RMA). An impressive support system for the home has been developed, which ensures that a senior member of staff is always ‘on call’ and available to be contacted directly by telephone and who if necessary would be on the premises within fifteen minutes. The presence of the three regional ‘hands on’ managers during the majority of the inspection ensured that not only were clients supported at all times but the appointed manager was able to be more directly involved in the inspection process. Monthly quality monitoring visits are undertaken and all findings, including any required actions are documented. In addition to this the manager confirmed that the views of clients and their relatives are routinely sought as part of the regular review meetings. Positive comments recorded from a recent meeting indicate a high level of satisfaction with the home, the staff and the services provided: ‘Hollyhead has proved to be the best place that ………… has lived in’. The appointed manager confirmed that the health, safety and welfare of clients and staff remain of paramount importance within the home. As previously documented, staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. All staff training is satisfactorily recorded. COSHH assessments and guidelines are in place. Regular fire drills are undertaken and recorded. Fire alarm systems are regularly checked and records maintained. Temperature regulators are fitted to all hot water outlets, accessible to clients. All accidents, incidents and injuries are recorded and reported, as required. Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement 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. Refer to Standard Good Practice Recommendations Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Area Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South Cowley Oxford OX4 2SU 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 Hollyhead DS0000013677.V353239.R01.S.doc Version 5.2 Page 27 - 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!