CARE HOME ADULTS 18-65
Hookstone Chase (66) 66 Hookstone Chase Harrogate North Yorkshire HG2 7HS Lead Inspector
Mrs Irene Ward Key Unannounced Inspection 14th June 2007 09:30 DS0000007887.V333274.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 DS0000007887.V333274.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. DS0000007887.V333274.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Hookstone Chase (66) Address 66 Hookstone Chase Harrogate North Yorkshire HG2 7HS 01423 541888 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) Henshaws Society for Blind People Mrs Susan Jane Bodoano Care Home 5 Category(ies) of Learning disability (5) registration, with number of places DS0000007887.V333274.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for 5 service users with Learning Disabilities all of whom also have an additional Sensory Impairment. Date of last inspection 1st February 2006 Brief Description of the Service: 66 Hookstone Chase is registered to provide accommodation and personal care for 5 people under the age of 65 years who have a learning disability and an additional sensory impairment. The home is a detached dormer bungalow situated on a main road close to a retail park and other local facilities. There is a garden to the rear of the home and on site car parking to the front of the property. All bedrooms are designed for single occupancy. The weekly fees on 14th June 2007 range from £683.00 to £863.80 and do not include costs for leisure, hairdressing, chiropody treatment, toiletries, activities and transport. This information was supplied to the Commission For Social Care Inspection via the pre-inspection questionnaire received on the 8th May 2007. Service users/relatives and other interested parties are able to have access to inspection reports by requesting them from the home. DS0000007887.V333274.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • • • • A review of the information held on the homes file since its last inspection. Information submitted by the Registered Provider in the Pre Inspection Questionnaire. Surveys received from five people who use the service, one-care manager and three relatives. An unannounced visit by one inspector to the home lasting five hours. This visit included a tour of the premises; examination of records, observation of care practices and talking to four service users, care staff and management. A visit was carried out to the support services office to look at staff files. Looking at two people’s care files in detail. • • People who live at the home are known as service users. What the service does well:
The staff at 66 Hookstone Chase continue providing a clean, warm and comfortable home for service users to live in. The home provides excellent care for service users and supports them to maintain their independence. Members of staff were observed to provide appropriate care when supporting service users in maintaining their independence in daily tasks. One service user said, “I like living here” another said, “I am really happy living here” and another person said, “Staff are all good ”. Comments received via surveys sent to service users, and one social care professional were positive. A care manager made positive comments when asked what the service does well and said, “A person-centred approach and individualised approach. Review reports always thorough and person focussed (person contributes and is always made aware of contents of reports”. Relatives on the whole were also positive and made comments on surveys such as “I think that the family atmosphere of 66 Hookstone Chase is one of its
DS0000007887.V333274.R01.S.doc Version 5.2 Page 6 strengths. I am pleased at the leisure choices offered, particularly the annual holiday, and day trips to the coast”. Another relative said, “Have never had any problems staff have always managed my son. Giving my son a good life teaching him independence and tasks of doing his own washing, cooking, shopping etc. Encouragement to join groups out of Henshaws – such as walking – I have complete faith in them and my son is happy and fulfilled”. One relative said “Very good relationship with all carers. This is the best house that my son has been in and meets all of his needs”. When asked how the home could improve a relative said, “I can honestly say that with the present team I personally do not think they can. It is a happy ‘family home’. Only to say that my son does not wish to leave and he is well cared for and catered for in a homely environment. I for one am happy and can go away with no worries about my son”. 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.
DS0000007887.V333274.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 DS0000007887.V333274.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): 2 and 5. People who use the service experience excellent quality outcomes in this area. People’s needs are properly assessed prior to admission, this makes sure Hookstone Chase is the right place for them to live. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The registered manager confirmed that a service user guide would be sent to all service users/relatives when making an enquiry about the home if they had a vacancy. The Statement of Purpose and the Service User Guide remain unchanged. Both these documents are available on audiotape, Braille and large print. However there have been no new admissions into the home for sometime, the last being three years ago. The manager confirmed that if there was a vacancy the service user would be given the opportunity to visit the home and stay for a meal or overnight or a weekend, whatever they felt comfortable with. DS0000007887.V333274.R01.S.doc Version 5.2 Page 9 Two service users files were looked at. Both files held initial assessments, care plans or (Individual Service plan) and risk assessments. Each service user had an individual statement of terms and conditions or licence agreement, which had been agreed between the home and the service user and held on their individual file. Pre-admission assessments are in place and held on service users individual files. A care needs assessment from local authorities was also in place where necessary. DS0000007887.V333274.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 and 9. People who use the service experience good quality outcomes in this area. The care provided to people was good and encouraged them to make their own decisions about how they wanted to live their lives. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Whilst staff were supporting service users during the morning it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. Four service users were spoken to before they went to college and various appointments like the dentist as one service user was doing on the day of the site visit. Service users’ looked well cared for and made comments about the care they received. One service user said, “I like living here” another said, “I am really happy living here” and another person said, “Staff are all good”.
DS0000007887.V333274.R01.S.doc Version 5.2 Page 11 The care plans of two service users’ were looked at. These detailed how needs had been assessed and what actions were needed to meet the identified needs. Care plans also detailed service users likes and dislikes, history and medical appointments, daily and weekly programmes and if service users are able to spend time alone in the house. Individual risk assessments, which were clear and well detailed, had been carried out to promote independence and safety. A care manager made positive comments when asked what the service does well and said, “A person-centred approach and individualised approach. Review reports always thorough and person focussed (person contributes and is always made aware of contents of reports”. The care plans contained detailed information about service users, which helped staff know about the service users’ preferences about how they wished to live their life. Through discussion with the manager and the contents of the care plans it was clear that service users are able to make clear choices. Service users plans are written with service users, reviewed regularly and audited monthly by the homes manager. The organisations scheme manager also audits them regularly. Service users are continually consulted on a regular basis about how the home runs and have the opportunities to voice their views. DS0000007887.V333274.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, 15, 16 and 17. People who use the service experience excellent quality outcomes in this area. People who use this service are able to make choices about their lifestyle and are supported by staff to carry these out. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Service users have the opportunity to attend specialist day centres, college or work placements and have days at home to participate in personal shopping, laundry and household tasks. They have also opportunities to pursue other interests outside of the home. A number of them enjoy visits to the pub, discos, walking, shopping, swimming, horse riding, and tandem riding. Service users also enjoy going out on trips, as they all recently had been to Scarborough for the day. DS0000007887.V333274.R01.S.doc Version 5.2 Page 13 Service users also have the opportunity to go away on holidays as they had been to Blackpool last year and have chosen to go to Llandudno this year. They all had a long weekend in the Lake District over the Christmas holidays. It was clear on the day through the discussions with the manager and people who live at Hookstone Chase that they are given every opportunity in accessing community facilities. Observation of care practices in the home shows that people living at the home are encouraged as much as possible to make their own decisions, although for some people this is more difficult due to their complex needs. People living in the home feel that they are able to choose their daily routines as they wish and made comments that they are encouraged to be independent. One survey from a relative said, “I think that the family atmosphere of 66 Hookstone Chase is one of its strengths. I am pleased at the leisure choices offered, particularly the annual holiday, and day trips to the coast”. Another relative said, “Have never had any problems staff have always managed my son. Giving my son a good life teaching him independence and tasks of doing his own washing, cooking, shopping etc. Encouragement to join groups out of Henshaws – walking – I have complete faith in them and my son is happy and fulfilled”. There was written information / weekly plans in service users care plans / Individual Service Plan on how service users spend their days. These arrangements are discussed with service users and their representatives and staff. Details about family, friends and significant events are recorded in the plans. Service users’ who are able to planned their own menus, in advance and shopping was purchased on a weekly basis. Service users who are able to also cook their own meals as one said, “I like cooking for myself”. Although other people living in the house said, that staff cooked their meals and one service user said, “the food is really, really good here, all of the staff are good cooks”. DS0000007887.V333274.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 and 20. People who use the service experience good quality outcomes in this area. Service users’ personal and healthcare is provided appropriately and sensitively according to individual needs. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staff aimed to promote the independence of service users and to provide support in a sensitive manner. People’s preferences as to how they wished to be supported were recorded within individual care plans. Daily record entries reflected the care that was being provided. Each service user had a GP and access to chiropody, dental and optical services and referrals were made to specialist services such as the Behavioural Support Team as needed. Service users attend Harrogate District Hospital for all A & E (Accident and Emergency) and for most out patient appointments.
DS0000007887.V333274.R01.S.doc Version 5.2 Page 15 A monitored dosage system is now in place. No service users currently are able to self-medicate. There is a policy in place for the storage and administration of medication. The Medication Administration Records were up to date and well maintained. All stock medication was securely stored in a locked cabinet. All staff that administers medication have undertaken accredited training. The home does not hold any controlled drugs. DS0000007887.V333274.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 and 23. People who use the service experience excellent outcome in this area. People who use the service have access to an effective complaints procedure and are protected from harm. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Service users are provided with a complaints procedure, which is produced in different formats such as Braille, large print or audiotape. The complaints procedure is also summarised within the service user guide and service users knew whom they needed to speak to if they had a complaint and felt confident that any concerns would be addressed properly. One service user said, “If I had any concerns or a complaint I would see my key worker, the manager or a social worker”. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. All staff receives training in adult protection issues during induction and further training organised by the organisation. The recruitment procedure continues to be robust, and ensures that only suitable people are employed, which helps to safeguard residents from abuse.
DS0000007887.V333274.R01.S.doc Version 5.2 Page 17 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 and 30. People who use the service experience good quality outcomes in this area. Service users live in a clean, comfortable and safe home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home is a large detached dormer bungalow house with a garden area to the rear. All areas of the home are accessible by service users and are on the ground floor. This includes a lounge a large dinning kitchen, shower room and bathroom. All service users have single bedrooms, which are also on the ground floor. There is on site car parking to the front of the property. The ground floor bathroom needed attention. The tiles around the bath the grouting has discoloured and so had the sealant around the bath. The shower curtain was faded. The bathroom suite is dated although still functional. One
DS0000007887.V333274.R01.S.doc Version 5.2 Page 18 relative had commented on their survey and said, “I think that the main bathroom could benefit from a makeover. The shower often breaks down”. This was discussed with the manager who said that there had been some problems with the shower sometime ago but the problem had been addressed. The home was decorated and maintained to a good standard in most areas and a good standard of cleanliness is maintained throughout the home. However, the carpet in the hallway was badly stained and in need of cleaning or replacing. The organisation may need to consider an alternative or possibly look at what is the most appropriate floor covering for Hookstone Chase. Three service users showed the inspector their bedrooms, all rooms had been personalised with posters and their various possessions such as CD players, television and items they had collected and made. Rooms have been decorated and furnished appropriate for their age and to a good standard. However one relative commented on their survey that they had concerns regarding the untidiness of a service users room. This was discussed with the manager who said that they would look at how the staff team could further improve their support with the persons living skills in this area. A range of maintenance checks is completed on a regular basis to make sure that the house is safe and secure. DS0000007887.V333274.R01.S.doc Version 5.2 Page 19 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, 34 and 35. People who use the service experience good quality outcomes in this area. Sufficient staffing levels, proper recruitment procedures and good staff training meant that service users’ needs were met and their interests were safeguarded. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Staffing levels were sufficient for meeting the needs of the service users’. The duty rota showed that there were two members of staff on duty both in a morning and evening when service users are at home doing their living skills. This does not include the manager’s hours. In an afternoon through to the evening there are also two staff members on duty. This is increased at peak times such as evenings and weekends if service users are going out, as staff rotas are based around what service users are doing. This makes sure that service users social activities are not compromised. At night there is one member of staff on sleeping-in duties. The organisation operates an on-call service in case there is an emergency. DS0000007887.V333274.R01.S.doc Version 5.2 Page 20 Hookstone Chase has a stable staff team and does not have a large turnover of staff. The newest member of staff has been working at the home for 3 years. This is good for the people living there, as service users know all of the staff team well. However one survey received from a relative who said “It would be good if staffing could be increased at weekends, so that all the residents could have a choice about leisure activities e.g. shopping trip”. This was discussed with the manager who said that the staff roster is flexible and is always based around what service users are doing. The staff roster confirmed this. The staff files of two members of the staff team were looked at. These showed that all the necessary pre-employment checks had been carried out prior to the new workers starting in post. All staff files are held centrally at the providers support services office, which is now based on the campus of Henshaws College. Staff training records examined showed a good training programme. Staff have undertaken training in health and safety, fire safety, moving and handling, first aid, food health and hygiene, protection of vulnerable adults and equality and diversity. Two staff have completed the National Vocational Qualification Level 3. The registered manager has completed the National Vocational Qualification Level 4 Registered Managers Award. Staff receive regular supervision every 6-8 weeks and annual appraisals are carried out. Staff meetings are held regularly and minutes of meetings are recorded. Records of supervision were seen on both staff files. Surveys sent to relatives were positive and comments made were “The key worker always contacts me by telephone if there is anything to discuss or arrange. This is helpful”. Another said, “The key worker policy works well and improves communication between parents and home. The staff are mature and are able to deal with difficult behaviour if it arises”. One relative said “Very good relationship with all carers. This is the best house that my son has been in and meets all of his needs”. When asked how the home could improve a relative said, “I can honestly say that with the present team I personally do not think they can. It is a happy ‘family home’. Only to say that my son does not wish to leave and he is well cared for and catered for in a homely environment. I for one am happy and can go away with no worries about my son”.
DS0000007887.V333274.R01.S.doc Version 5.2 Page 21 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 and 42. People who use the service experience excellent quality outcomes in this area. The service users benefit from a well managed home in which their needs and wishes are put first. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The registered manager has been at the home since it first opened. She has completed the National Vocational Qualification Level 4 Registered Managers Award. The manager has experience in working with people who have a learning disability as she has worked for the organisation for sometime. The manager and the staff team are known well by service users, as there has been a consistent staff team for sometime. DS0000007887.V333274.R01.S.doc Version 5.2 Page 22 Service users and social care professionals all commented highly about the home. Relatives on the whole were also positive. The issues regarding areas of the environment that needed attention were discussed and the manager confirmed that they would be addressed. A care manager when asked what the service does well said, “A personcentred and individualised approach. Review reports always thorough and person focussed (person always contributes and is always made aware of contents of reports”. Service users are able to voice their views through the regular house meetings that are held which are also recorded. Information provided from the pre-inspection questionnaire and the examination of selected health and safety documents show that regular checks to electricity and gas and fire safety equipment are regularly undertaken. An accident book is maintained in line with the requirements of Data Protection. Service users finances were not checked at this site visit. Historical evidence from previous reports gives evidence that service users financial interests are safeguarded. Quality Assurance systems are in place. A manager’s monthly visit is carried out and a report is written. This is completed by one of the managers from another of the community houses. A copy of the report is then sent to the Commission for Social Care Inspection. The schemes manager carries out regular three monthly visits to the home and reports are completed and a copy sent to the Commission. Record keeping is of a consistently high standard. DS0000007887.V333274.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X 2 3 3 X 4 X 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 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000007887.V333274.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA30 Regulation 23 (2) (d) Requirement The grouting around the tiles in the bathroom and the sealant around the bath requires attention. The hallway carpet was badly stained and needs cleaning or replacing. To make the home a comfortable place for people to live in. Timescale for action 31/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000007887.V333274.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 DS0000007887.V333274.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. 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!