Inspection on 29/06/06 for Jessie Place

This inspection was carried out on 29th June 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Jessie Place 26/11/07

Jessie Place 28/01/06

Jessie Place 22/06/05

Jessie Place 04/10/04

Jessie Place 05/04/04

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

CARE HOME ADULTS 18-65 Jessie Place 39 Stanthorpe Road Streatham London SW16 2DZ Lead Inspector Barbara Ryan Unannounced Inspection 29th June 2006 9.30 Jessie Place DS0000022737.V295634.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 Jessie Place DS0000022737.V295634.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. Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Jessie Place Address 39 Stanthorpe Road Streatham London SW16 2DZ 0208-769-3591 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered deputizing manager (if applicable) Type of registration No. of places registered (if applicable) Jane’s House Limited Mr Raja Manikam Paramal Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th January 2006 Brief Description of the Service: Jessie Place is a large semi-detached house in a residential area. It is within a few minutes walking distance from a main shopping area, which has full community facilities and public transport links. It is a privately owned home, registered since November 1999, which provides long-term residential care for people with mental health problems. The home is registered for 6 service users, who are accommodated in six single bedrooms, one with an en-suite bathroom. There are three communal areas, one of which is a large conservatory with steps leading down to a large landscaped back garden and there is a front garden area that has been converted for parking use. The staff team is small, but fairly stable and experienced with this service user group. The home is not designed to cater for people with physical disabilities, although wheelchair users would have access to the ground floor, which has one bedroom, a toilet and all the communal areas. The home aims to encourage service users to take part in daily activities and to reach their optimum level of functioning, with current service users attending a variety of regular daily activities outside the home. The home has a service user guide and statement of purpose which give information about the home and there are copies of the CSCI report in the dining room, lounge and office. The home’s fees are from £511 to £669.50 per week. Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place on 29th June 06 between 9.30 and 5.30 pm. The manager of the home was on annual leave and the manager from another home in the organisation, who was on call came to the home for the inspection. The method of inspection included looking at four care plans, a tour of the building, discussion with a deputising manager, discussion with three residents, an inspection of the management of the medication, and of the management of residents’ money. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that they give evidence of all money withdrawn from residents’ bank accounts and that evidence is available at the home. Risk assessment reviews should be clearly dated and signed. All medication in the home must tally with the amount recorded, and a photo of each resident should be attached to his or her mar chart. The home should have advocacy information for residents use if they wish to contact an independent advocate and the home should have to hand its policy on the protection of vulnerable adults. The fire alarms should be tested once a week rather that once a month and the fridge and freezer temperature tested every day. Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 6 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. Jessie Place DS0000022737.V295634.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 Jessie Place DS0000022737.V295634.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5 Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. Prospective residents would have information when making a choice about the home and would have their needs assessed, they would be able to have a trial visit and receive a written contract. EVIDENCE: The home has a service user guide and statement of purpose. This contains all the information required with the expectation of information about independent advocacy. (See complaints sections). The home has had no new residents for over three years. The home has a policy of assessing all prospective residents prior to admission. The resident would be able to visit the home prior to any move there. The home would work with the mental health team that was involved with the new residents around visits to the home and admission. Residents have contacts of terms and conditions on their files. Jessie Place DS0000022737.V295634.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is adequate. This judgment is made using available evidence including a visit to the service. Care plans were up to date and changing needs were recorded. Risk assessments were reviewed annually, but at times the date this was done was confusing; they did not always contain information about physical health need. Were the home supports residents to manage their money there should be evidence of cash withdrawals in the form of receipts or the equivalent from the bank and this should be held on the premises. EVIDENCE: Four care plans were looked at, all had up to date care plans, and these had sections for identifying needs, objectives and actions to be taken. Care plans are reviewed and evaluated on a regular basis. Residents are supported to make decisions about their lives and the residents spoken to said that they were able to decide how they would spend their day and what they wishes to do. The home is client led with regard to care planning. Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 10 All the files looked at had risk assessments; these were comprehensive, although they were mainly geared to issues around residents’ mental health rather than any physical health risks there might be. One resident can be unsteady on their feet at times; this was not included on the risk assessment. There was evidence of risk assessments being reviewed annually, however this was recorded on some assessments by changing the date, it would be better to write the date of the review under the original date and sign it if there are no changed to the assessment of risk. Only one file had a photo of the resident on it. All files had up to date daily records and these outlined activities and changes of mood or signs of deterioration in residents mental health, they showed evidence of contact with the community mental health team and visits by other health and social work professionals. Residents’ money was inspected; one resident has as their appointee the manager in the Jane’s House home, another has a relative as their appointee, but the home holds cash for the person. All the other residents manage their own money and hold their own cash. All the money held in the safe tallied with the amounts recorded in the resident’s cashbooks. One resident will ask for cash and signs for this. The home will get receipts for any items purchased if they go with the person. However, the resident mainly purchase small items on their own and does not get receipts for these. The home will purchase items for one resident and will escort them to the bank to withdraw money from their account. There were receipts for purchases made for the residents; these were kept in the safe with the resident money but were not entered in the book as individual purchases. There was a record of cash being withdrawn from the resident’s bank account and brought to the home, there was no receipt from the bank and the bank book was not available to be inspected to give evidence that the money entered in the ledger at the home tallied with evidence of the amount withdrawn from the bank. Jessie Place DS0000022737.V295634.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. Residents have opportunities for personal development, and are able to access community and leisure activities and maintain links with family. Residents are able to choose what they would like to eat, but are encouraged to eat a healthy diet. EVIDENCE: The residents at the home live quite individual lives. The home will support residents to maintain links with their family, either by supporting them to visit their family or by their family visiting them at the home. Residents have in the past attended the local college and three at present attend a mental health day centre. Residents are encouraged to access the local community and are supported as needed to do this. However, residents are free to make decisions about the activities they undertake and some residents spend more time in the home than other. There is no curfew, but the home likes residents to be in by 11 pm. Residents are free to have visitors and are able to visit their families. Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 12 The home will escort residents as needed to activities or events. Residents are encouraged to undertake some housework in the home, and undertake their own shopping and supported with this if needed. All the residents have keys to their rooms and to the front door. There is an activities organiser who visits the home twice a week and will arrange activities. This is done on a flexible basis depending on residents’ wishes. The home will support residents to cook if they need this. They keep a record of the meals residents eat. Resident’s are encouraged to eat a healthy diet, however residents are also given a choice with regard the food prepared. Records of what residents eat are kept; chips and pizzas appeared quite often on the record sheets. The deputizing manager said that it is difficult at times to support residents to access a more healthy diet without reducing their choice in this area. The home will provide fruit and vegetables and try to offer salads, which they find are more popular in the evening, particularly in the summer. Jessie Place DS0000022737.V295634.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21, Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. The home support residents to maintain their mental and physical health. They work effectively with other health and social care professionals. There were some discrepancies with regard to the medication in the home and the running total kept when a pill count was done. The home will support residents to make plans with regard to illness and death. EVIDENCE: The home supports residents around personal care as needed, this is mainly done with supervision and encouragement. There was evidence on resident files that the home works closely with other mental health professionals and that they have alerted the mental health team with regard to deterioration in a resident’s mental health. Some residents have had quite serious physical health issues that the home has supported them with. There was evidence on file of residents attending for physical health tests. Some more detail with regard to residents’ physical health and conditions may be needed at times. With regard to one resident with challenging behaviour around eating, this had been discussed at a CPA meeting; staff are aware that this was an issue. Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 14 The home has a form to complete with regard to residents wishes around illness and end of life. Some residents had completed this form, but others had not wished to and this had been recorded on the form. With regard to medication at the home a random pill count was undertaken. Of the seven undertaken there were 2 incidents when the running total kept on the mar charts was one out with what medication was in the home. The home have a record of all medication that comes into the home and a record of medications returned to the pharmacist. All medication is kept in a locked cupboard in the office. The home did not have any photos of residents with the mar charts. Whilst the staff and residents have all been at the home for a considerable time and all residents are well known to all the staff a photo should be on the mar chart to ensure that all residents are clearly identified. Jessie Place DS0000022737.V295634.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. The home has a complaint policy and residents felt they are listened to. The home should have information about an independent advocate for residents to contact if they would like. The home must ensure that it has a vulnerable adults policy available and that all staff have training in this area. EVIDENCE: The home has a complaints policy and a complaints book; the book had no complaints recorded in it since 2003. The home’s policy does not have information about how to contact an independent advocate. Residents spoken to said that they would raise any issues they had with staff or the manager, and felt that they would be listened to. The home did not have its policy on protecting vulnerable adult to hand, although the deputising manager said that they did have one. Some staff had been on training around this issue but not all, and the home should ensure that all staff have training in this area and a policy available in the home. Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 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): 24,26,27,28,30 Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. The home offers a safe, non-institutional, comfortable and well-maintained environment, with a pleasant outdoor space for residents to use. EVIDENCE: The home is situated in a three-story house in a residential street off Streatham High Road. The home has installed shower cubicles in three of the bedrooms, installed a new kitchen, downstairs WC, a new bathroom and replaced and refurbished the separate WC on the first floor. Three residents on the first floor now share a bathroom and all other residents have their own showering facilities either en-suite or in a cubical in their room. This has all been done to a good standard. There are still some making good and redecoration to be finished in the kitchen. The deputizing manager reported that some residents with new showers need support in some respects to get used to using them and are being supported around issues of privacy and familiarising themselves with the new showers. The stair carpet has been replaced. The home has a living room and conservatory leading to a pleasant garden at the rear of the house. The home communal areas are homely and pleasantly furnished. Resident’s rooms are Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 17 personalised and meet their needs. The home offers a comfortable and wellmaintained environment for residents. Due to the redecoration there was some paint tins still in the conservatory on the day of inspection these should be removed. The home was clean and hygienic throughout. Jessie Place DS0000022737.V295634.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,34,35,36 Quality in this outcome area is good. This judgment is made using available evidence including a visit to the service. The home has sufficient qualified staff to meet resident’s needs. The staff team is stable and know residents needs. The home should ensure that they identify and explore anomalies in application forms, reference and CRB checks. Staff have undertaken training however a clear programme of training that meeting the needs of residents and staff needs to be produced and put in place. EVIDENCE: The rota was inspected and was accurate and fully completed. Of the six care staff employed, five have NVQ level two or are doing it. Two have level three or are in the process of doing it. The staff group have been very stable with the last worker having being employed over 18 moths ago. Staff were observed to be friendly and relaxed when interacting with residents and residents spoken to said that they found staff helpful and supportive. Staff files were inspected. There were some application forms which did not have references from the last employer. One staff member had a CRB check from another residential home, which she had not put down in her application form as a reference although the CRB was obtained around the time she was applying for the post at Jessie Place. Whilst Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 19 this may be something that had no bearing on the well being of residents, there was nothing recorded on the file that explained this. The home have arranged staff training around mental health issues with a series of in house training on risk, assessing risk, violence and risk and self harm have been undertaken in the last 12 months. The staff have also all been attending a six-month course on medication. They have purchased some modules on basic first aid training, but there was no evidence that mandatory training had been updated since the last inspection. The deputising manager said that they will review their training programme at the end of the summer with regard to what training needs remain. The staff files contained up to date supervision notes. Jessie Place DS0000022737.V295634.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgment is made using available evidence including a visit the service. The home is well run, with a relaxed and non-institutional ethos. A more formal means of gaining residents views with regard to the running of the home needs to be in place. The home needs to provide a thermometer for the fridge and test the fire alarms once a week. EVIDENCE: The manager was not present on the day of the inspection. However, there was evidence that the home was well run, and resident’s needs were being met. The deputising manager for another home run by the organisation was on call and came to the home. They were knowledgeable about residents needs, familiar with the working of the home and were used to covering when the manager was away. The home has in the past undertaken surveys of relativities views and of residents, but there was nothing available for the last 12 months. Residents Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 21 spoken to said that they felt there views were listened to and that they raise any issues with the staff when they wanted to. The home holds some residents meetings, however the meeting book was not available. There was evidence that the home carries out an audit approx every six months. The dates for the last two being October 05 and April 06. The home needs to have in place better methods of gaining residents views with regard to the running of the home. With regard to health and safety, there was a record of the freezer temperature being taken once a week. There was evidence of the fridge freezer being taken, although there was no thermometer in the fridge. These temperatures should be taken every day. The home completed fire drills and tested fire alarms once a month. The home should test the fire alarm once a week. The home said that they had tried to do this in the past, however neighbours had complained about the noise, however these should be tested for a very short period once a week. Jessie Place DS0000022737.V295634.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 3 2 X 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 X 2 X X 2 X Jessie Place DS0000022737.V295634.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 YA6 Standard Regulation 13(4)(b) Requirement The registered manager must ensure that when managing residents money that i. All receipts are properly filed. ii. That evidence of withdrawals from bank accounts i.e. receipts or entries in a bank passbook are kept at the home. The registered manager must ensure that all identified risks are included on risk assessment, and that reviews are clearly dated and signed. The registered manager must ensure that all mediations at the home tallies with the amount recorded on the running total and a photo of each resident is held with the mar chart. The registered manager must ensure that the complaints procedure has information about independent advocates. The registered manager must ensure that the home has an up to date multi agency adult protection guidelines DS0000022737.V295634.R01.S.doc Timescale for action 11/09/06 23 YA9 4(1)(c) 4 (22) 11/09/06 3 YA20 17 (1) (a) 11/09/06 4 YA22 5 YA23 22(2) 11/09/06 13 (6) 11/09/06 Jessie Place Version 5.2 Page 24 6 YA32 18(1)(c)(i) 7 YA39 8 YA42 9 YA42 The registered person must ensure staff working in the home has training appropriate to the work they perform. Previous timescale of 15/01/06 and 31/0506 partially met. 24(2)(3) The registered manager must ensure that they put in place a system for gaining residents views as part of their self monitoring and quality assurance 23(4)(c)(v) The registered manager must ensure that there is a programme of testing the homes fire alarms once a week 16(2)(j) The registered manager must ensure that the fridge and freezer temperature are monitored and recorded every day 11/09/06 11/09/06 11/09/06 11/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection SE London Area Office Ground Floor 46 Loman Street Southwark SE1 0EH National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Jessie Place DS0000022737.V295634.R01.S.doc Version 5.2 Page 26 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 Jessie Place DS0000022737.V295634.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. 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