Inspection on 03/05/07 for Housemartins

This inspection was carried out on 3rd May 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Housemartins 03/08/06

Housemartins 07/12/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Housemartins Housemartins Colebrook Lane Cullompton Devon EX15 1PB Lead Inspector Belinda Heginworth Unannounced Inspection 3rd May 2007 08:10 Housemartins DS0000063698.V333913.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 Housemartins DS0000063698.V333913.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. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Housemartins Address Housemartins Colebrook Lane Cullompton Devon EX15 1PB 01884 35443 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) Jason Stuart Collins Mrs Anne Morey Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A person meeting the criteria for registration as a manager under the Care Standards Act 2000, as described in Standard 37 of the National Minimum Standards for Care Homes for Adults (18-65) and Regulation 9 of the Care Home Regulations 2001, must be appointed at all times. 3rd August 2006 Date of last inspection Brief Description of the Service: The home provides support and personal care for 5 people with a learning disability. The home is owned by Mr Jason Collins and managed by Anne Morey. Housemartins is a detached two-storey property on the edge of the town of Cullompton, which is within walking distance. There are five single bedrooms with a bathroom on both floors. On the first floor there is a bedroom, office, kitchen with a dining area and a lounge. To the front of the property there is an enclosed garden. At the rear of the property there is a larger garden, which includes a patio area with garden furniture. Information received from the home prior to the inspection indicated that current fees range from £490 - £600 per week. Additional costs are charged for transport, holidays, chiropodists and personal items. CSCI reports are pinned to the notice board in the kitchen and are discussed with the staff team and the people who live at the home as appropriate. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during a weekday, starting at 08.10am. The manager was present during the majority of the inspection. Some of the people living at the home have limited communication skills and were therefore unable to fully contribute verbally to the inspection process. Time was spent with all people and observations were made throughout the inspection. Two people were consulted fully and their views on the home discussed. We also spoke with two members of staff and the manager. Prior to the inspection the manager completed a questionnaire, which provides information about the people living at the home, staffing, fees and confirms that necessary policies and procedures are in place. This information helps the commission to prepare for the inspection, send out surveys to appropriate people and helps the commission form a judgement on how well the service is run. Before the inspection took place, surveys were sent to the people living at the home. They were also sent to staff, relatives and comment cards were sent to professionals who are connected to the home. Four relative’s one staff survey were returned. Two comment cards from health care professionals and three surveys from the people living at the home were returned. During the inspection we “case tracked” three people living at the home. This means we spoke with them, made observations, spoke with staff and read records, starting from the admissions process through to the present. Medication practices were looked at and a tour of the peoples’ bedrooms took place. We also looked around the home and inspected other records. These included, the fire safety information, staff training records, menus, quality assurance records and recruitment files. What the service does well: The small staff team work hard to encourage and support people to become independent. The atmosphere is warm, friendly and fun. It is clear there are good relationships between staff and the people living in the home. Staff were observed being caring and respectful, offering choices and supporting people in a kind manner. One person said “the staff are kind”, another said “we have fun”. Relatives provided very positive feedback, some examples - “the service appears to meet the needs of residents”, “the whole atmosphere is of caring and concern, for the well-being of the residents”. The people living in the home lead an active life, using local and surrounding communities to obtain social and educational facilities. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 6 The records kept in the home help staff assess, understand and monitor peoples’ needs and risks. Good policies, procedures and practices ensure people and staff are kept safe, this includes good recruitment, health, safety and financial practices. Good systems are in place to assess and monitor all practices, seek views of people, staff and outside professionals, to ensure the home is run in the best interests of the people living there. 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. Housemartins DS0000063698.V333913.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 Housemartins DS0000063698.V333913.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process provides staff with the information they require to ensure peoples’ needs can be met. EVIDENCE: The majority of people living at the home have done so for a number of years. One person was admitted within the last 2 years. A detailed assessment was carried out prior to admission. This enabled the home to establish whether they were able to meet their needs. One person was able to confirm visits to the home before admission. Relatives said they were involved in the process and had received good information about the home. Carers confirmed that there was good information about people to help them understand their needs. The manager has developed an admission form that complements care management assessments. It includes assessments of all areas of need. Discussion took place abut adding information about medication and consent issues. The manager intends to add this as well as information about how well the person would fit in with the other people living in the home. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 9 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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning is completed with the person ensuring their wishes and needs are considered. This information helps staff to meet peoples’ needs consistently and safely. Decisions are made in full consultation with the people living in the home wherever possible and their relatives or representatives. This ensures decisions are made in peoples’ best interests. EVIDENCE: Care plans are produced through consultation with the person and relatives. Some people living in the home confirmed this as did some relatives. The plans provide short-term goals, how they will be met, assessments of risk and good monitoring. Daily records are kept of all areas of need, including health care appointments, activities, foods eaten and achievement of the goals in care plans. Discussions took place about the need to expand on some of the recorded information. For example, under activities, some entries said “ride on Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 10 bus”, “pub”, “shopping”, under personal care said “wet”, “bathed before breakfast”. These short sentences provided limited information about peoples’ choices, although through talking with some of the people living in the home and through observations, it was clear that choices are offered. People living in the home talked about how they are supported to make choices and said their requests and wishes are usually listened to and acted on. The manager said she would advise the staff to expand on some of the recorded information to ensure it is clear that people have chosen to carry out what is recorded. Care plans goals are reviewed regularly and updated as necessary. This ensures care plans are a document that is used as a working tool, showing the progress made towards goals. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 11 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 excellent. This judgement has been made using available evidence including a visit to this service. People are supported to make choices about their lifestyles through using the local community, taking part in appropriate activities and maintaining relationships with families and friends. People are treated respectfully and consulted in all decisions about their lives. People are provided with choices of well balanced meals which they help prepare and cook. EVIDENCE: Two of the people living in the home confirmed that staff treat them in a kind and caring way. During the inspection staff were observed being respectful, offering choices and being supportive. Relatives spoke highly of the staff team saying “staff ensure the residents are well cared for and happy”, “the home makes every effort to choose work and activities that are suitable”. The home Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 12 is working hard to encourage people to be as independent as possible, for example some people living at the home are able to use the local facilities and public transport independently now. Care plan goals and risk assessments reflect this work. People talked about the varied activities they do. These ranged from art & craft sessions in the house, where many of the products could be seen, swimming, college, keep fit, clubs, pubs, tenpin bowling, cinema, walks, shopping, picnics and many more. Some people had requested to go to see Spider Man 3 at the cinema, which staff were arranging. Photographs are displayed throughout the home of the many activities. Some of the people living at the home enjoyed talking about the photographs. A time table of organised activities is displayed in the kitchen so people can see what is planned. Daily records confirmed activities take place but did not always reflect they were the person’s choice. Most activities take place during the day or early evening although staff said they are happy stay on later to accommodate peoples’ requests to go to clubs that go on later. The manager said she is about to change some of the shifts to have staff start later in the morning and therefore will stay on later in the evening. This will suit the needs and wishes of the people living in the home. At the last inspection the cost of holidays were highlighted and it was recommended that this was discussed with relatives and care manager. Relatives have been consulted and care managers will be at care plan reviews. This ensures that peoples’ monies that are spent on the cost of holidays are openly discussed and agreed. This year, people talked with excitement about their planned holiday to Butlins which they helped to chose. Pictures are used to display menus of food on offer. At the start of the inspection people were having their breakfast. It was nice to see people helping themselves to drinks, cereal and toast. The atmosphere was relaxed, chatty and full of fun. Records are kept of foods eaten, they show a healthy, well balanced diet is provided and encouraged. Some people living in the home talked about how much they enjoyed shopping, preparing and cooking meals. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 13 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. Peoples’ dignity and privacy is fully respected and people benefit from their health needs being closely monitored. Medication practices protect peoples’ health and welfare. EVIDENCE: Some people said they were happy with how staff supported them with personal care. Staff were observed offering care in a supportive manner. Staff had a good knowledge of how people preferred to receive their care and care plans provided good information on personal care and how much support is necessary. Health care needs are assessed and monitored regularly with health professionals involved when necessary. Responses from two health professionals confirmed they felt the home meets health needs well. Some additional staff training on topics such as dementia and communication would further ensure all needs are fully understood and met. (See staffing section) Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 14 Medication practices are good ensuring appropriate policies and practices are followed. All staff have received training in good medication practices and the manager assesses their competencies regularly to ensure they continue to understand safe practices. Homely remedies are agreed with a GP and form part of the home’s policy. The manager is in the process of including information about peoples’ consent to administer medication and considering how people could become more independent with their own medication. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 15 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. People living at the home are assured they are listened to and complaints are dealt with appropriately. More appropriate complaint formats for people with limited communication needs might help them to express when they are unhappy. There are good systems in place to ensure people are protected from abuse. EVIDENCE: The home or commission have received no complaints since the last inspection. Some people living at the home said they would talk to staff or the manager if they weren’t happy with anything. They said when they have raised concerns it is always dealt with properly and quickly. Out of the four responses from relative surveys, three said they have never had a need to complain and one said only minor concerns have been raised, which were dealt with quickly and to their satisfaction. The manager holds house and individual meetings where complaints or concerns can be raised. Staff said their knowledge of the people living in the home helps them to recognise when someone if unhappy and to try and resolve the problem. The complaint’s policy is not in a format suitable to the communication needs of the some people living in the home. The manager intends to find a suitable Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 16 format through discussions with the staff team, the people living in the home and if necessary a speech and language therapist. All staff have received training in the protection of vulnerable adults. Staff demonstrated a good awareness of types of abuse and knew what to do if they suspected any. Peoples’ finances are managed well. People said they had their own bank accounts where benefits are paid and a standing order is set up to pay their contribution towards the home’s fees. All financial records were accurate. Housemartins DS0000063698.V333913.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with clean, safe and comfortable surroundings that meet their needs. EVIDENCE: The accommodation is homely, domestic in style, bright and cheerful. On the day of the inspection the home was clean. People said they take turns at cleaning parts of the home. Bedrooms are personalised to peoples’ tastes and preferences. Those who are able have a key to their room. There is an ongoing maintenance programme of updating and re-decorating. People who live in the home said they enjoyed using the fairly new lawned area to play football, volleyball and have barbecues. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 18 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, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by enough caring, experienced and well recruited staff. People would benefit further through staff who have enhanced knowledge. EVIDENCE: The home provides two staff from 8am until 8.30pm and one sleep-in staff. People living in the home said there are enough staff to enable them to go out and about as they chose. If activities or social events go beyond 8.30pm staff will stay on and any planned evening activities that take place beyond 8.30pm are always accommodated. However, the manager intends to change some shifts so that some day shifts will start at 9am and therefore end at 9.30pm. This will provide more opportunities for add hoc evening social events. Relatives who responded to surveys said that the home works hard to ensure people live as full as life as possible. Recruitment practices have improved with all staff now having CRB’s completed. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 19 Staff demonstrated a good understanding of peoples’ needs, health & safety issues and were able to describe training they had received and what they had learnt from it. Examples were adult protection, fire training and first aid. This means that peoples’ needs and welfare are met and protected by appropriately trained staff. In addition to this training, 50 of care staff have obtained NVQ qualifications level 2 and above. However, much of the training staff have completed since the last inspection has been mandatory health & safety training. Good practice training is recommended to ensure that staff are up to date with their knowledge. For example, updates on autism, forms of communication. The manager supervises and advises staff daily and holds staff meetings to update them on care issues. Formal recorded supervision takes place every ten weeks. This provides staff with the time and opportunity to identify training issues, look at care practices in more depth and have individual and confidential time with the manager. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 20 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. People benefit from a well managed and safe home that takes into account their views and wishes. EVIDENCE: The manager has many years of experience in working in learning disability services and as a registered manager. She has obtained management and care qualifications. Staff and the people living in the home spoke highly of the manager saying she was very supportive and people focused. The also said she provided good advice and training. This was also confirmed by relatives and two health care workers. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 21 The home has good systems in place to audit the quality of services delivered in the home. The manager has developed the home’s quality assurance policy. It highlights areas to develop, with goals and action on how it will be achieved, including time scales and who will be responsible. These include people who use the service’ and relatives’ satisfaction questionnaires. A yearly newsletter updates relatives, people living in the home and other interested parties of any issues relating to the home or care. Feedback received by the Commission from relatives was positive and said they felt included in decisions about their relatives’ lives. Care plan reviews take place regularly, house and staff meetings are also used to review the services to ensure the home is being run peoples’ best interests. The provider visits the home and talks to the people living there and the staff and manager. However, these visits have not been recorded regularly. This should be completed as stated under Regulation 26 of the Care Home Regulation. This requirement was made during the last inspection and is repeated due to the infrequent reports. When a provider does not have day-today charge of the home, it is important for these audits to take place to ensure the home is being run appropriately and the reports will help form part of the home’s quality assurance system. The fire logbook was found to be up to date and accurate. Fire risk assessments and staff training were completed, therefore protecting peoples’ safety and welfare. A questionnaire was completed by the manager prior to the site visit. This provides information about the people living in the home, staff, and fees and indicates whether necessary policies are in place. The information helps the commission prepare for the inspection and send surveys to appropriate people. It is also used to help the commission form a judgement as to whether the home is being run appropriately and safely. In this instance this information, the site visit and responses to surveys indicates the home is being run well. Housemartins DS0000063698.V333913.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 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 X 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 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 3 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA39 Regulation 26 Requirement The registered provider must visit the home monthly, carry out an audit and complete a report. This is repeated with a previous time scale to be achieved by 30/09/07) Timescale for action 30/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA35 Good Practice Recommendations Staff should complete some good practice training to ensure their knowledge is up to date, for example up dated training on autism and forms of communication would be beneficial to the needs to the people living at the home. Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Housemartins DS0000063698.V333913.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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