CARE HOMES FOR OLDER PEOPLE
Hunningley Grange 327 Doncaster Road Stairfoot Barnsley South Yorkshire S70 3PJ Lead Inspector
Valerie Hoyle Key Unannounced Inspection 11th July 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000018258.V344856.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000018258.V344856.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Hunningley Grange Address 327 Doncaster Road Stairfoot Barnsley South Yorkshire S70 3PJ 01226 287578 01226 245348 none NONE Mr Azad Choudhry 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) Mrs Julie Scholey Care Home 36 Category(ies) of Old age, not falling within any other category registration, with number (36) of places DS0000018258.V344856.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 10th July 2006 Brief Description of the Service: Hunningley Grange is a detached residence with a purpose built extension, registered to provide personal care for 36 residents. All accommodation and services are on the ground floor. The home is located in the centre of Stairfoot, approximately two miles from Barnsley town centre and situated on a main bus route. The home is within walking distance of a full range of shops e.g. chemist, newsagent, hairdressers, dentist, supermarkets, post office, health centre, cafes and fast food outlets. There is car parking at the front and side of the home. The home provides information to service users and their relatives prior to admission into the home. Service Users Guides are available in all bedrooms or on request from the manager. The last published inspection report is available on request and a copy is available in entrance for visitors to read. Information gained on the 11th July 2007 indicates the current fees £333.50. Additional charges include private chiropody £7, hairdressing from £4.00 £12.00, and newspapers and transport. The registered manager supplied this information in the Annual quality Assurance Assessment dated June 2007. DS0000018258.V344856.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 two days (10.5 hours), this included a partial inspection of the building. Three peoples care plans and supporting documentation were examined. Seven people who use the service, three relatives, four staff and two health professionals were spoken to during the visit, their views are included throughout the report. Occupancy at the home remains high with 31 of the 36 beds occupied. Nine ‘Have your say about…’ surveys were returned from relatives and advocates. Two were returned from health professionals and three were returned from people who use the service. The information has been collated and their views are contained within this report. The registered manager was present throughout this visit and assisted with the inspection process. The registered manager had completed and returned the Annual Quality Assurance Assessment (AQAA) and the information gained is included in this report. The inspector wishes to thank the manager, staff, residents, relatives and health professionals for their assistance and co-operation. What the service does well:
The home is well managed ensuring the safety and protection of people who use the service. There was a stable staff group who had worked at the home for a good length of time, and they spoke positively about improving the standard of care to enhance the homes reputation within the community. There was a clear sense of working together to make sure the people were well cared for and happy. There was a lot of laughter and banter between staff and residents. Comments from relatives and people who live at the home included: “Staff are like angels, we could not manage without them”. “Julie and her staff are so caring, you can see that they care so much for all of us”. “Everything is in the interest of the people they are caring for, well done to an excellent team”. “Staff are friendly and approachable, and they always tell me what’s going on”. “The food is very good, we only have to ask for something and it’s put on the menu”. DS0000018258.V344856.R01.S.doc Version 5.2 Page 6 People’s medication were well managed to ensure they receive their medication as directed. Staff at the home are commended for achieving NVQ Level 2 qualifications. The investment in vocational training means that staff understand the care needs of people who live at the home, and can deliver the care. Recruitment procedures were robust which ensure the safety and protection of people who use the service. What has improved since the last inspection? What they could do better:
The staff were confident that they can deliver the care needed to people who use the service, although some information contained in care plans examined needs to be updated. The changes need to reflect where people’s mental health needs had changed. The care plan did not give clear direction to staff, to ensure they could support people who display anxiety and agitation. Night care arrangements and social interactions need to be clearly stated, to enable staff to meet all the needs of people who use the service. The smoking lounge must be refurbished as the furnishings and carpet were in poor repair. The room also smelt of stale cigarettes, which was quite offensive. The provider should review their smoking policy to ensure it complies with the recent introduction of the ‘smoke free England legislation’. Some refresher training is required in areas of health and safety, food safety and infection control. This would ensure that staff, keep themselves and people safe and protected.
DS0000018258.V344856.R01.S.doc Version 5.2 Page 7 To ensure peoples money is handled appropriately the manager should ensure that receipts are numbered and all transactions should include two people’s signatures. The registered provider should also indicate clearly where she had undertaken an internal audit of money. The induction programme for staff should be reviewed to ensure it meets the ‘Skills for Care standards’. Criminal records bureau checks for staff should be reviewed, (every three years) to ensure people remain safe. 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. DS0000018258.V344856.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000018258.V344856.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were assessed before moving into the home to ensure their needs can be met. EVIDENCE: All new people receive a full comprehensive needs assessment before admission this is carried out by manager or responsible person who had the required skills and competencies. The service is highly efficient in obtaining a summary of any assessment undertaken by the placing authority, and insists on receiving a copy of the care plan before admission. Staff confirmed that information contained in the assessment was essential to understand what they needed to do to ensure people’s needs were met. Three assessments were examined and they focused on achieving positive outcomes for people who use the service. Before agreeing admission the
DS0000018258.V344856.R01.S.doc Version 5.2 Page 10 manager and staff carefully considers the needs assessment for each individual prospective person and the capacity of the home to meet their needs. Prospective people who use services were given the opportunity to spend time in the home, before making final decisions about where to live. All surveys received confirmed that people who use the service are provided with sufficient information before moving into the home. One person said “I chose to live at Cunningly Grange because friends told me it was a nice home, they were right the staff are friendly and kind”. One relative said, “nothing is too much trouble for this great staff – I feel confident my mum is in safe hands and well looked after. My mum loves it here”. DS0000018258.V344856.R01.S.doc Version 5.2 Page 11 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans generally provided staff with sufficient information to meet the needs of people who use the service. Arrangements for dealing with health issues were met with support from health professionals. Medication policies and procedures were well managed ensuring the safe administration of medication. EVIDENCE: Three care plans were examined; they contained sufficient information, although some areas of the plans required updating to reflect changes to peoples care needs. Nutritional assessments had been completed, although the information had not been followed by a referral to the dietician to be involved. Therefore it was not clear if people receive the supplements to maintain a healthy diet. One person’s mental health care plan did not describe what actions staff must take to reduce the person’s anxiety state. Two care plans did not contain any reference to the intervention needed during the night. It was difficult to determine how their needs were being met. The daily records
DS0000018258.V344856.R01.S.doc Version 5.2 Page 12 and monthly evaluations were very brief and did not reflect outcomes for people who use the service. The registered manager acknowledged the shortfalls in the current documentation and said a new format was to be introduced to address the issues. Although some information is required to make the care plans more accurate, the inspector is confident that staff were able to deliver the care needed by the people who use the service. All surveys received confirmed that people’s needs were always met by staff that were well trained. Surveys said that staff always listens to people who use the service. People said staff were excellent, well trained and always provided a good service, that was value for money. Records examined and discussion with the staff confirmed people’s healthcare needs were met. The manager said doctors provide a good service, and staff were trained to recognise health problems and report them to the person in charge of the shift. Two professional surveys confirmed that staff always provides a good standard of care. A visiting district nurse said the staff were always helpful, and kind. An audit of medication stocks and records were examined and were found to be correct ensuring the health and safety of people who use the service. Senior carers had responsibility for administering medications and they had attended training to update their knowledge. This ensured medicines were administered safely. The local pharmacist is contracted to undertake periodic checks to ensure the stock levels are maintained and procedures are followed. Medication was stored securely, there were separate, locked rooms for storing medication that contain a locked fridge and a controlled drugs cabinet. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. All people were referred to by their first name and this was agreed in the care plans examined. Surveys received confirmed that staff always treated people who use the service with respect and maintain their dignity at all times. Relatives praised staff and said nothing was too much trouble, to ensure their family was cared for in a kind sensitive manner. DS0000018258.V344856.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can maintain contact with family and friends, however there were little opportunities for people who use the service to take part in social activities. Food provided is of good quality, menus were well balanced with good choice. EVIDENCE: Surveys received and discussions with people who use the service indicated that activities were not regularly arranged. The manager had recently interviewed someone to be employed to co-ordinate activities. The manager hoped that the new appointment would address the lack social stimulation. The menus were well balanced with a good choice for each meal. Mealtimes were observed and the food looked good quality and was well presented. Several people said they really enjoyed the meals. One person said her lunch of braised steak and vegetables, followed by apple pie and custard was very nice. Although the person felt that the meals were too big. One person said she
DS0000018258.V344856.R01.S.doc Version 5.2 Page 14 enjoyed curries although they were not as good as when they used to make them. Staff asked each person in the morning offering three choices for lunch. The cook produces the meal, which is served to people in the dining area. Some people were also served their meal in their bedroom. The meals were accompanied with a drink; some people had soft drinks while others enjoyed alcoholic beverages. Staff were available throughout the meal and were able to give assistance where needed, they appeared to be unhurried and had time to chat to people who use the service. Second helpings were available for both the main course and the sweet. Relatives and visitors can visit the home at any time, visitors said they were always welcomed into the home people always have a smile. All surveys received confirmed they were happy with how the home was managed. Staff always kept them informed about changes to their relative. A partial tour of the building provided evidence that people who use the service are able to personalise their bedrooms, many had brought in small items of furniture and pictures of their family. Two people said they liked spending time in their bedrooms and enjoy entertaining their family/friends who visit regularly. One person said she enjoyed reading articles from magazines about diets and health, and staff brought in newspapers to help keep up to date with current affairs. DS0000018258.V344856.R01.S.doc Version 5.2 Page 15 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can access the complaints procedures and the manager ensured any concerns were recorded and investigated appropriately. Adult protection Policies, procedures and training of staff ensured the protection of service users from abuse. EVIDENCE: There is a complaints procedure that is available to people who use the service and visitors. The procedure also referred to in the service users guide, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure. Examination of the complaints records showed that a number of complaints had been recorded since the last visit to the home. The records indicated they had been appropriately investigated and resolved to the satisfaction of the complainant. People who use the service said they were confident that the manager or the responsible person would deal with any concerns they may have. Complaints are generally recorded in a complaints book, which means that it would be difficult for people to make a complaint anonymously. Consideration should be given to make the complaints procedure more accessible by creating a format that records complaints, which could be left in the entrance for people
DS0000018258.V344856.R01.S.doc Version 5.2 Page 16 to pick up and use. This would ensure confidentiality of information required by the Data Protection Act. There is a comprehensive Adult Abuse and Whistleblowing policy. Staff follow the procedures to those standards. The registered manager would investigate fully any allegations of abuse and would follow the necessary procedures if any were substantiated. The registered manager holds discussions with staff to talk over issues and how to recognise different forms of abuse, although training records indicate that formal training on the protection of vulnerable adults is required. DS0000018258.V344856.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are provided with a clean, comfortable environment, although some refurbishment is needed to improve communal areas. There were sufficient staff to maintain good hygiene standards. EVIDENCE: The registered providers continue to make improvement to the fabrics and furnishings at the home. Bedrooms are generally decorated as they become vacant. However the smoking lounge currently used by people who use the service is in need of major refurbishment, the carpet was badly marked and the furnishings looked tired and worn. The smell of stale cigarette smoke was offensive. The corridor carpet needs replacing as it is badly stained following a spillage of cleaning solutions.
DS0000018258.V344856.R01.S.doc Version 5.2 Page 18 Other areas of the home were clean and fresh, and staff were commended for maintaining good standards. The gardens were well maintained and people said they enjoyed sitting out, although the weather had not been very good recently. DS0000018258.V344856.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff had the skills and knowledge to fulfil their roles within the home; a stable staff group ensures continuity of care by staff that knows the people who use the service. Recruitment policies are followed ensuring the safety and protection of people who live at the home. EVIDENCE: Staff rotas and observation during this visit show there were sufficient staff to meet the needs of people who live at the home. Surveys received confirm that people who use the service are cared for by sufficient staff who are trained. Staff had the required skills to meet the needs of people, and they are commended for exceeding the requirement of 50 NVQ level two qualified staff. Staff said they gained new skills and knowledge by completing the training at the home. There were robust recruitment and selection procedures that ensure people who use the service are safe and protected. A number of staff recruitment files were examined, evidence that all the required employment checks had been undertaken prior to commencing work at the home. Evidence confirmed all staff had a CRB check, where staff’s CRB’s are over three years old, the registered provider should consider renewing them.
DS0000018258.V344856.R01.S.doc Version 5.2 Page 20 Training records examined showed some refresher training (infection control, food hygiene, health and safety) was required to ensure staff maintain their competencies to deliver a good service to people who live at the home. Discussion with the manager and staff confirmed there was a stable staff group who had worked at the home for a good number of years. Staff said they enjoy working at the home, and feel supported. The manager only confirms permanent employment when satisfied that competence and progress has been shown to be satisfactory against their high standards. Induction programmes are used to assess the competencies of new staff, although the current format does not meet the ‘Skills for Care’ induction standards. DS0000018258.V344856.R01.S.doc Version 5.2 Page 21 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were protected by sound management practises, and their views were actively sought to improve the service. The financial interests of people were safeguarded, although some changes to the way records were maintained was required. Good health and safety procedures ensured they are protected. EVIDENCE: The manager leads by example and is respected by staff, relatives and people who use the service, comments from surveys received included “the manager always makes herself available, nothing is too much trouble”. “The manager always encourages us to talk about any issues that we may have, she is very sincere”.
DS0000018258.V344856.R01.S.doc Version 5.2 Page 22 The manager continues to work towards attaining the Registered Managers Award, and hopes to finish the qualification in the next few months. Staff and group meetings ensured that staff were informed about training opportunities and the day to day running of the home. Staff were encouraged to be involved in decision making. The manager consults with people on an individual basis to gain their views, and there was evidence that there was a quality assurance system to record these views. The manager said the laundry service, and activities were identified as areas requiring improvement, and work had commenced to address the issues. People who use the service were able to manage their own finances, although most prefer the manager to assist with dealing with their personal allowances. A number of peoples personal allowance records were examined and checked, the records were accurate, although they had only been signed by the manager. Receipts were kept for all transactions, although it was difficult to audit the receipts, as they were not numbered. Accident reports were analysed by the manager to ensure risk assessments were developed where required. Maintenance and service records examined were up to date and current to the services provided. The manager had the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures were in place and service records were examined and were current, ensuring the safety of people who use the service. The provider should review their smoking policy to ensure it complies with the recent introduction of the ‘smoke free England legislation’ DS0000018258.V344856.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 Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 DS0000018258.V344856.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 OP7 Regulation 15 Requirement Timescale for action 01/09/07 2. OP12 16 Care plans must contain further information to give staff direction with regard to nutrition, social, psychological needs/mental health needs along with basic care needs to care for people who use the service. Residents must be consulted 01/09/07 about their social interests and a programme of activities implemented. The smoking lounge must be refurbished to make it a more pleasant environment for people who use the service to spend their time. Staff must receive refresher training in the protection of vulnerable adults, health and safety, infection control, and food hygiene to ensure they retain the necessary competencies to undertake their role within the home Receipts must be numbered to assist with auditing people’s personal allowances. Two signatures must be used for
DS0000018258.V344856.R01.S.doc 3. OP19 23 01/09/07 4. OP30 18 01/10/07 5. OP35 13(6) 01/09/07 Version 5.2 Page 25 all financial transactions in relation to people who use the service. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard OP16 OP29 OP30 OP38 Good Practice Recommendations The method of recording complaints should be reviewed to ensure data is protected. CRB checks should be renewed after 3 years New staff should receive induction that meets the ‘Skills for Care’ induction standards. A review of the homes smoking policy should be undertaken to ensure it meets the new smoke free legislation. DS0000018258.V344856.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000018258.V344856.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!
