Inspection on 09/05/06 for Inglewood House

This inspection was carried out on 9th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Inglewood House 08/08/07

Inglewood House 05/01/06

Inglewood House 21/09/05

Inglewood House 18/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

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

CARE HOME ADULTS 18-65 Inglewood House Inglewood House 56 Middle Gordon Road Camberley Surrey GU15 2HT Lead Inspector Denise Debieux Key Unannounced Inspection 9th May 2006 09:30 Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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 Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Inglewood House Address Inglewood House 56 Middle Gordon Road Camberley Surrey GU15 2HT 01276 64776 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) The Regard Partnership Limited Mrs Elizabeth Gail Hayes Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. The home may accommodate up to 1 (one) named resident with both LD & MD, Learning Disability/Mental Disorder within the total number of residents. The age/age range of the persons to be accommodated will be 24 - 65 years. The home may accommodate one service user with a mental disorder (Category MD) In the case of one named service user the age category will be reduced from 24 to 20 years of age. The home may accommodate up to 1 (one) resident with both LD & PD, Learning Disability/Mental Disorder within the total number of residents accommodated 21st September 2005 Date of last inspection Brief Description of the Service: Inglewood House is a semi detached house situated in a residential area of Camberley, and is within a few minutes walking distance from the town centre. The home is registered to provide care for up to 12 service users in the category of younger adults. The accommodation is provided over two floors, with communal areas on the ground floor, and bedrooms on the ground and first floor. All bedrooms are single, with a wash hand basin. There is a pleasant rear garden which is accessible to service users. Parking is mainly on-street parking. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over 6 hours and was carried out by Denise Débieux, Regulation Inspector. Mrs Liz Hayes (Registered Manager) and Ms Becky Morris (Deputy Manager) were present as the representatives for the home. A tour of the premises took place. Five of the service users and two members of staff were spoken with during the visit. Some of the comments made to the inspector during the visit are quoted in this report. The service user care plans and individual risk assessments were sampled, as were the home’s policies and procedures, staff training and recruitment records, fire safety log, home risk assessments, menus, activity records and medication records and storage. The home provided a pre-inspection questionnaire and comments cards were received from seven service users. The inspector would like to thank the service users and staff for their time, assistance and hospitality during this visit. What the service does well: What has improved since the last inspection? The ongoing maintenance and redecoration of the home and gardens provide the service users with homely and comfortable surroundings in which to live. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 6 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. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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 Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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 at least once during a 12 month period. 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. Service users’ needs and aspirations are fully assessed and documented prior to admission and on an ongoing basis in monthly reviews. EVIDENCE: There have been no new admissions to the home since the last visit. However, the company policy is that all service users are fully assessed prior to being invited to visit the home as part of the home’s pre-admission procedure. The manager also stated that the current service users would be involved in this process, and their opinions sought, prior to a prospective service user being offered the opportunity to move in on a trial basis. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users’ individual plans are clear and comprehensive and include details of needs and goals. They also incorporate known or indicated preferences and in depth risk assessments. EVIDENCE: From observations made at this visit it was clear that the staff respect the service users’ rights to make decisions. There are service user meetings once a month, which are ‘chaired’ by one of the service users. The inspector was advised that staff only attend these meetings at the service users’ invitation. All service users spoken with were happy with the care they receive at the home and were eager to talk about the new layout of the garden and the recent changes they had decided on and helped to implement. Care plans inspected were comprehensive and set out actions which need to be taken by care staff to ensure that all aspects of the health and personal care Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 10 needs of the service users are met. All care plans sampled had been signed by the service user or their representative. Daily recording showed that staff provide care and support to the service users in the way they prefer. The care plans also fully evidenced that staff enable service users to take responsible risks. These risks are assessed and included in each care plan with appropriate actions/training identified to reduce the level of risk. A recommendation has been made that that daily recording relates more specifically to the care plans and demonstrates staff action taken to meet the service users’ identified goals. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users have opportunities for personal development and to take part in appropriate activities within the home and in the local community. They are supported and enabled to maintain and develop appropriate personal and family relationships. Systems are in place to ensure that service users’ rights are respected. Meals are well-balanced and varied. EVIDENCE: The daily routines at the home reflect the requirement to promote independence, individual choice and freedom of movement with service users observed to be making choices of what to do and when. The inspector was advised that one service user helps to look after the animals at a local small animal centre. Service users are able to attend the local day centre and also participate in classes at local colleges. These classes include: computer work; literacy; number work; arts and crafts and cooking. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 12 Service users are encouraged to become part of and participate in the local community. The inspector was advised that service users utilise local swimming pools, bowling, cinema, shops and facilities such as restaurants, parks and horse riding with arrangements currently underway for one service user to try carriage driving at a local centre. Service users are all offered the option of a minimum seven days annual holiday, which they help choose and plan. There are no restrictions to visiting and service users can see visitors in the privacy of their own rooms if they wish. The menu for the week of this visit was seen to be varied and well-balanced. The inspector was advised that service users plan their own meals, usually on a Friday, with assistance and guidance from the staff where needed. The service users then also participate in shopping for the ingredients. The main, hot meal is in the evening. The lunchtime meal was taking place during the visit, the food was presented in an appetising manner and there was a relaxed, family atmosphere in the dining room. Ample staff were present and offered help or assistance where needed in a discreet and sensitive way. All interactions observed between the staff and service users were seen to be respectful and caring. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Personal care and healthcare support and assistance is planned and was seen to be provided, where needed, in a respectful and sensitive manner. Sound policies and practices are in place for the administration and management of medications. Issues surrounding bereavement are handled with care, understanding and sensitivity. EVIDENCE: Service users spoken with confirmed that staff provide personal care and assistance, where needed, in the way they have indicated they prefer. This was seen to be clearly set out in their individual plans. The care plans sampled also provided evidence that service users’ healthcare needs are being met. Very detailed and easily followed instructions for an exercise plan were seen in one file. Service users are all registered with a local GP and referrals to other health care professionals are obtained, as necessary, from the GP surgery. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 14 Medication administration record (MAR) sheets, medication storage and controlled drug storage, recording and count were checked during this visit and were all seen to be in order, in line with the home’s policies and procedures. Staff were observed to always knock and ask permission to enter service users’ private rooms and all personal care was carried out behind closed doors. Assistance is provided to promote and maintain independence where appropriate. Very recently the service users and staff at the home suffered a sudden and unexpected bereavement. Regard Partnership and the staff at the home are commended for the supportive and sensitive manner this was handled at the time, and for the ongoing support, assistance and guidance that is being provided by the staff to the service users. Staff spoken with were all very appreciative of the input and guidance from their area management team and were also very complimentary regarding the way the registered manager is helping everyone to work through this sad and difficult time. Bereavement counselling has been made available to the service users and staff, and some basic bereavement counselling training is being arranged for the staff to help them understand and continue to support the service users. An area of the garden has been set out as a remembrance area and all the service users were involved in the planning of the layout. One service user spoke about, and showed, the inspector the work he had been doing on this area of the garden. This standard has been assessed as ‘exceeded’. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. All required policies and procedures are in place to ensure that service users feel their views will be listened to. Policies are in place to protect service users from abuse but lack of robust staff recruitment procedures are placing them at possible risk of harm or abuse. EVIDENCE: The home has a complaints procedure in place that is accessible to all service users in picture format. Service users spoken with were aware of who to talk to if they were not happy. All service users have an allocated key worker and meet with their key worker at least once a month. One service user said that they would ask a member of staff to help them fill in the ‘Speak Up’ form if needed. Service users told the inspector that they felt safe at the home and were comfortable and at ease with the staff that were on duty. Staff spoken with were aware of the local, Surrey Multi-agency Procedure for the Protection of Vulnerable adults. Staff recruitment is addressed in the ‘Staffing’ section of this report. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for it’s stated purpose. The home was found to meet service users’ individual and collective needs in a comfortable and homely way. EVIDENCE: On the day of this visit the home was seen to be warm, bright and clean with a homely atmosphere. The service users’ individual rooms have all been highly personalised with the service users’ own belongings and mementos. One service user told the inspector how she had chosen the colour scheme and accessories for her newly decorated room and how pleased she is with the result. During this visit, service users were seen to be entering communal rooms and their own rooms with confidence and at will. It was obvious that the service users have a sense of ownership over their home whilst at the same time respecting the other service users’ personal rooms. Policies and procedures are in place for the control of infection with a high standard of housekeeping apparent at this visit. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home has a staff training programme which is designed to ensure that service users are supported by competent and qualified staff. Arrangements for staff recruitment are not satisfactory and are placing service users at possible risk of harm or abuse. EVIDENCE: The home is working towards having 50 of their care workers qualified to National Vocational Qualification (NVQ) level 2 in care or higher. At present three of the nineteen staff are qualified to NVQ level 3, the manager holds a Registered Manager’s Award and eight further staff began NVQ level 3 training in January this year, with the expectation that they will have completed the course by January 2007. The home has a comprehensive induction and ongoing training programme which covers all areas required by the Skills for Care organisation (previously TOPSS). Staff training records were inspected and found to be well maintained. The recruitment files for three members of staff were sampled. On two of the three application forms the members of staff had not given a full employment history and there were unexplained gaps. In both cases, previous places of employment had not been checked, reasons for leaving were not explored and Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 18 references had not been verified. One file had no proof of identity and the passport and work permit on another file were only valid until 5/4/06 and had expired. The home had obtained enhanced Criminal Records Bureau certificates for all three members of staff. This area was of concern at the last visit in January 2006 and a requirement was made that staff files be reviewed and all missing information obtained. However, this requirement has not been met, has been carried forward with a limited timescale and must now be addressed in full and without delay. Additional requirements have also been made and the registered person must ensure that the home’s recruitment practices do not continue to place service users at risk. All service users surveyed confirmed that they felt well cared for with one service user commenting ‘All the staff are good and help us a lot.’ All interactions observed between staff and service users were seen to be respectful and caring and the service users were relaxed and comfortable in the company of the staff they were with. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a quality assurance and monitoring system in place that is based on seeking the views of the service users. All policies and procedures are in place to ensure, so far as is reasonably practicable, the health and safety of service users and staff. EVIDENCE: Mrs Hayes has been the manager of Inglewood House for the past four years and holds the Registered Manager’s Award. Service users’ views are sought on a regular basis and monthly visits by a representative of the responsible individual take place as required. The manager has recently carried out a survey of service users at the home and is in the process of correlating the results. A recommendation has been made that the home also includes GPs, Care Managers and other health and social care professionals in their quality assurance surveys. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 20 During this visit a service user proudly introduced the inspector to ‘our dog.’ The inspector was advised that last year all service users had decided they would like to have a dog. After many meetings and looking for a solution as to who would take responsibility, it was agreed that the deputy (who wanted a dog anyway), would buy a dog which would live with her, be her dog but come to the home whenever she was working. The service users all participated in deciding which breed of dog and four service users went on a trip to Wales to chose the dog from the breeder. Service users were also involved in naming the dog. During this visit the dog was very much at home with all service users and was seen to take an active part in all activities, much to the amusement of the service users. All necessary health and safety checks are carried out by the staff at the home with documentary evidence inspected of routine fire practices and evacuations, fire equipment checks, daily checks of fridge and freezer temperatures and general home risk assessments. All records were up to date and well maintained. Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 21 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 1 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 2 33 X 34 1 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 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 4 3 X 3 X X 3 X Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19(1)(b) Schedule2 Requirement The registered person must not employ a person to work at the care home unless he has obtained the information and documents specified in paragraphs 1-9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). (Ongoing timescale from 5/1/06 not met). The registered person must ensure that staff files for all persons employed since 26th July 2004 contain all information and documents specified in paragraphs 1-9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004) and be satisfied as to the appropriateness of the references obtained.(Timescale of 05/03/06 not met) DS0000013686.V293700.R01.S.doc Timescale for action 09/05/06 2. YA34 19(1)(b) Schedule2 09/07/06 Inglewood House Version 5.1 Page 23 3 YA34 18(1)(a) 19(1)(a-c) Schedule2 4 YA34 5 YA38 The registered person must ensure that any staff that do not have all the required checks and documentation in place, are not left in charge of the home and are closely supervised until all requirements of Regulation 19 and the amended Schedule 2 of the Care Homes Regulations 2001 are fully met. 18(1)(c)(i) The registered person must 19(1)(a-c) ensure that all staff responsible Schedule2 for staff recruitment are aware of, and understand, the requirements of The Care Homes Regulations 2001 and Schedule 2 (as amended by The Care Standards Act 2000 (Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). This must take place before any further recruitment of staff. 10(1) The registered person must submit, to the CSCI, Eashing office, an improvement (action) plan, setting out exactly how requirements 1-4 will be met in full. The plan must include specific timescales for completion of each requirement. 09/05/06 09/05/06 09/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA6 YA39 Good Practice Recommendations It is recommended that daily recording relates more specifically to the care plans and demonstrates staff action taken to meet the service users’ identified goals. It is recommended that the home includes GPs, Care Managers and other health and social care professionals in their quality assurance surveys. DS0000013686.V293700.R01.S.doc Version 5.1 Page 24 Inglewood House Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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 Inglewood House DS0000013686.V293700.R01.S.doc Version 5.1 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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