Inspection on 22/02/06 for Kerr House

This inspection was carried out on 22nd February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kerr House 25/01/07

Kerr House 23/09/05

Kerr House 17/11/04

Kerr House 18/05/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kerr House 50 Morley Road Staple Hill South Glos BS16 4QS Lead Inspector Wendy Kirby Unannounced Inspection 22nd February 2006 09:30 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 Kerr House DS0000035488.V278017.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 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. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kerr House Address 50 Morley Road Staple Hill South Glos BS16 4QS 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) 01454 866295 01454 866297 South Gloucestershire Council Mrs Lynda Dicks Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd September 2005 Brief Description of the Service: Kerr House is a purpose built Local Authority residential care home that is registered to provide personal care and accommodation for up to thirty one service users aged 65 or over. One room is designated for service users to receive respite care on a regular basis. The home is located on the Kingswood/Staple Hill borders approximately a quarter of a mile from local amenities/shops including banks, a post office and various shops. The home is well served by bus services that stop within easy walking distance from the home. Accommodation is provided on one level and is sited around a courtyard and garden area. All rooms are single occupancy. Rooms do not have en suite facilities. Each room has a wash hand basin set into a vanity unit. Communal rooms are situated on two floors and comprise of five lounges, two separate sitting areas, a large dining room, activities rooms, a small kitchen, a hairdressing room, library area and a designated smoking room. There is a choice of lift or stairs to the first floor. The grounds and gardens are well maintained and are fully accessible to service users from lounges and corridors. All exits have ramps and handrails. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection conducted as part of the annual inspection process. The inspection lasted one day. During the visit the inspector spent time in discussions with the manager, duty manager, and staff on duty including two care staff, the cook and her assistant. A number of records were examined. Care files and action plans to meet the care needs of four residents were reviewed and records relating to the day-today running and management of the home. The inspector undertook a cursory tour of the premises and had the opportunity to observe various activities throughout the day including a staff meeting, the residents enjoying a Flexicise class in the morning and later that day the residents had entertainment from a regular visitor to the home. What the service does well: What has improved since the last inspection? Last year the home enrolled on a two-year pilot scheme whereby staff receive training in basic nursing skills. New skills they are acquiring have provided a holistic approach to the care they deliver and has enabled staff to provide consistency and continuity to the resident Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 6 Residents continue to benefit from ongoing developments in the homes staff training programme and quality assurance initiatives to improve services. 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. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 7 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 Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Prospective residents and their families are able to access clear information to enable them to decide whether the home is suited to their needs. Pre admission procedures were able to demonstrate that resident’s needs were identified to ensure that the home would be a suitable place for them to live. EVIDENCE: Information on the home and the services offered was on display in the entrance to the home to take away. The information was well presented and included a statement of purpose, a user-friendly welcome pack, a copy of the latest inspection report and results of quality assurance surveys. The content of the welcome pack provided prospective residents with valuable information on the facilities and services available to them within the home. Prospective residents are encouraged to visit the home either for the day or perhaps for lunch dependent on their wishes. The Inspector looked at four pre-admission assessments, which were completed fully and were informative. The prospective resident, family and carers are involved in the pre-assessment and all information is used to Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 9 determine the suitability of the placement. Where possible the manager had also obtained comprehensive assessments and care plans from other professionals involved for example, social workers and hospital staff. One resident spoken to as part of the inspection confirmed that they had received relevant information prior to admission and had made a visit to the home before making a decision where to live. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. The service had good systems for meeting and monitoring residents’ health and personal care needs in consultation with residents There are safe systems of practice in receiving, storing, administering, and disposing of drugs. Staff have a good awareness of individuals needs and treat the residents in a warm a respectful manner, which means that they can expect to receive care and support in a sensitive way. EVIDENCE: Care Files were examined of four residents living in the home. Each resident had a comprehensive portfolio and person centred assessments, which means that staff put the views, wishes, likes and dislikes of each resident at the centre of all care provided. The information for each resident was very informative and useful enabling staff members to identify individuals and how to support their health and social needs. All four care files showed consistency in assessing, planning, implementing and reviewing the resident’s care. The home operates a key Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 11 worker system (named staff member who relates closely with the resident). The key worker role includes the monthly updating and reviewing of care/action plans. Monthly reviews were signed by the resident, key worker and a manager ensuring the residents changing needs and new requests were acted upon. From the assessments staff had identified residents needs enabling them to form written care plans. These were written clearly and concisely and in a sense that the residents had contributed in the implementation of each plan. Care records and discussions with staff provided evidence that residents were involved in the planning of their care and the running of the home. Discussion with the manager demonstrated that residents’ healthcare needs were closely monitored in consultation with primary health care services. Designated staff had received NVQ level 3 training that included supporting residents with their health needs. Last year the home enrolled on a two-year pilot scheme whereby staff receive training in basic nursing skills under the direction and supervision of the General Practitioner (GP), treatment room nurses and district nurses. Care staff were very motivated and spoke positively about the new skills they are acquiring and how through learning these skills they have been able implement them effectively within the home to the residents. Through this training the staff are able to meet basic health needs including venepuncture, taking observations and specialist feeding. This holistic approach to care has enabled the staff to provide consistency in delivering care to the residents without involving resources within the community e.g. district nurses and GP. One resident was able to come straight home from hospital after receiving a blood transfusion, because the staff had developed the skills to monitor for any adverse effects from the transfusion and act accordingly. Risk assessments were in place with detailed information to ensure safe procedures for example, manual handling, the correct use of bed rails and how to reduce the risk of falls. Records of the General Practitioner visits/contact with residents and the outcomes were also available. Specialist referrals and visits from other professionals including Community Nurses, Chiropractors and Dentists were also evident. Policies and procedures for receiving, storing, administering and disposing of medications were examined and correct. There were photographs of each resident on their medication charts to help ensure that medication was dispensed to the correct person. The Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 12 administration charts were legible and continuity of administration was shown with a signature from the person dispensing. The local pharmacy were providing six-monthly medication reviews. Staff who are on the “New Roles” scheme were currently enrolled in “Medication Administering Competency” training. The atmosphere in the home on the day of the inspection was relaxed. Staff, the manager and residents were observed to have good relationships. Staff responded to residents in a sensitive and professional manner. Staff were witnessed knocking on residents doors before entering confirming respect for the residents individual privacy and dignity at all times Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Residents benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. Residents maintain family contact and staff encourage family and friends to join in with household activities. Residents receive a varied and wholesome diet that they are able to influence. EVIDENCE: Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 14 In conjunction with the residents the staff develop a monthly timetable of activities and forthcoming events. A copy of this is placed in communal areas throughout the home, to ensure that all residents and visitors are aware of planned activities. The inspector witnessed fifteen residents thoroughly enjoying themselves taking part in a “Flexercise” class before lunch, these classes operate three times a week and aim to improve muscle tone, strength and balance. In the afternoon a gentleman came to entertain the residents by singing to music. There was a large group gathered for the entertainment and the songs were appropriate to the group. The inspector saw residents singing along and tapping their feet. Residents take part in a range of social activities including reminiscence therapy, organised games, quiz sessions and arts and crafts. The home also has a mobile shop and residents can buy a range of useful day-to-day items, including toiletries, sweets and a selection of greeting cards. As the warmer weather arrives the home provides fortnightly trips to places of interest including pantomimes, parks, garden centres and local events. The home also organises fundraising events for example a “bring and buy sale” which residents and families support, providing an enjoyable social feel. The funds raised are used to facilitate more activities and trips for the residents. The home has a monthly residents meeting and produces a monthly newsletter. The newsletter provides relatives and visitors to the home with all the latest gossip about staff, forthcoming events, special features and a welcome section where existing residents are able to receive information about any new residents to the home. The newsletter finishes off with a quiz and the winner receives a gift. The home operates an open door policy for visitors. Residents were able to see visitors in the privacy of their rooms and there were several semi-private seating areas around the home. There was a payphone in a quiet area that could also be used in residents’ rooms for full privacy and residents are given the option to have a telephone line installed in their rooms. The hairdresser visits weekly. The size and layout of the dining room made it possible for all residents to enjoy the social advantages of dining together. Staff had used their expertise and knowledge of the residents, personalities, preferences and ability to eat independently, when seating them for lunch. The dining room was light, spacious and the tables were attractively laid with tablecloths and flowers. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 15 Residents that required assistance with eating their meals were supported by staff members, this was performed in a respectful, sensitive way, for example without rushing the residents and staff were sat at the same level as the resident. Staff were seen to be polite and helpful when serving the meals giving explanations and making comments to the residents such as, “would you like me to cut your food up for you”, and “would you like any salt or pepper”. The meal on the day of inspection was cheese flan or Cornish pasty, potato and fresh vegetables followed by a choice from the vast selection on the sweet trolley, including Jam tart, fruit with cream and semolina with sauce. Comments from the residents were “the pasty was very tasty” and “the food was lovely I’m so full”. All residents were served squashes with their meals and throughout the day. The inspector spent time with the cook and her assistant. The cook was able to demonstrate an awareness of individual requirements and needs of the residents, including special dietary requirements and personal preferences. The 4-week menu rota displayed traditional meals and choice was available at each setting. The menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. The inspector was saw that special requests were catered for whereby residents had asked for their favourite food and drinks to be ordered. The cook explained that she spends time with the residents on a daily basis to see if they have enjoyed their meal and if they are happy with the menus. Fresh fruit and vegetables are delivered daily and bowls of fruit are passed around to residents throughout the day. The kitchen was very clean and spacious. Stores exhibited a good range of foods. Food hygiene training was up to date for all staff. Documentation was provided to show the inspector that required temperature checks were being carried out on fridges and freezers and that food was also being probed after being cooked before serving. Risk assessments were in place and up to date. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 16 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 A clear complaints process was in place and had been properly implemented in the home. Procedures to protect residents from abuse were in place and staff were made aware of the processes involved. EVIDENCE: The homes complaints policy and procedures were displayed around the home. The policy was also included in the statement of purpose and welcome pack. The inspector examined policies and procedures on the protection of vulnerable adults. South Gloucestershire Council systematically trains its entire staff group on the protection of vulnerable adults and this training is organised as a running programme. The manager also advised that protection of residents from abuse was covered in NVQ level 3 training and staff had to write aspects of the policy. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,23,24,26 Kerr House is purpose built, well maintained and provides safe, comfortable surroundings for residents. EVIDENCE: Kerr house is a local authority thirty-bedroom purpose built home. Information on the premises and bedrooms is included in the homes Statement of Purpose. There is wheelchair access throughout the building. The inspector walked around the inside of the home and viewed, most of the bedrooms, bathrooms and the communal living areas including the dining room, and lounges. Room sizes are generally adequate for their stated purposes, particularly the lounges and dining room. All areas of the home were tastefully decorated, clean and well maintained. Great attention has been given to ensure that all areas are homely. Residents had been supported to personalise their bedrooms with pictures, photographs and ornaments. Residents are able to bring items of furniture should they wish. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 18 Residents were making full use of these areas and their bedrooms on the day of the inspection. One resident said how much she enjoyed her own company and sanctuary in her bedroom and that she also had the opportunity to meet up with fellow residents in various lounge areas throughout the home when she so desired. The home was clean and free from unpleasant odours. The home employs domestic staff on a daily basis. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,29,30 Residents are supported and protected by the homes recruitment policy. The residents are cared for by skilled staff that are trained, supported and supervised by management. The relationships between staff and residents are good and create a warm positive environment to live in. EVIDENCE: The recruitment process was examined and all staff records examined showed that the home follows the correct recruitment procedure and policies. Records contained application forms, references, and a CRB (Criminal Records Bureau) disclosure. All nineteen care staff have an NVQ2 or NVQ3, six staff are currently working towards gaining their NVQ3. Staff are encouraged and supported by the manager to develop new initiatives and as mentioned previously in the report staff are very positive and motivated by their inclusion on the “New Roles” scheme. The manager and her staff are conscientious in attending training relevant to the care needs of the residents. Last year the team focused on training in the Protection of Vulnerable Adults and this year they are looking at courses to address equality and dementia awareness and in particular, areas around depression and effective communication. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 20 The home is in the process of developing a training manual whereby staff are able to identify strengths and weaknesses and in what areas they wish to develop. Records and discussions with staff were able to demonstrate that they receive regular updates in mandatory training. The inspector spent some time throughout the day sitting in the communal areas observing staff carrying out their duties and assisting residents. Staff were respectful, warm in manner, good humoured and sensitive towards the residents within a relaxed homely environment. The inspector spoke to several residents who expressed very positive views about staff and the care they receive providing comments like, “I am so lucky to be here” “I am well looked after by the girls” Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,36,38 Residents’ needs and best interests are central to the management approach in the home. Staff are supervised adequately through supervision and staff meetings. The health and safety of residents, staff, and visitors is protected. EVIDENCE: As documented at the previous inspection, the home continues to consistently demonstrate good, effective leadership and management that relates to the aims and purpose of the home. The home’s registered manager Mrs Lynda Dicks has over twenty years managerial experience working in Kerr House and is well qualified both in management and training. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 22 It was evident from discussions with Mrs Dicks and her duty manager that the home has a stable management team that supports a commitment to providing quality care for the benefit of the residents. This was further confirmed in conversations with staff and residents who stated, staff work as a team and without the support the management team we would not have had the opportunity to enrol on the “New Roles” scheme and I am thoroughly enjoying it. Further evidence of this was obtained when the inspector attended the arranged staff meeting. The attendance of staff was high and staff off duty had made every effort to be there. The agenda was informative and useful ensuring that staff were kept up to date with new initiatives and issues within the home. Staff were given opportunity to express their ideas and any concerns they may have during the meeting and it was clear that relationships between staff were respectful and supportive. Staff receive supervision with the manager once every eight weeks. Arrangements in place confirm that individual supervision is based on an agreement between the manager and staff member. The policy and procedure for holding residents pocket money was examined and three individual accounts were looked at. It was evident that good accounting methods are adopted which account for all transactions documented and receipts for sundries were available to see. Some of the Health and safety records in the home were examined. Documentation showed that all relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services, and manual handling equipment. Fire safety training for staff is given on induction at then at the recommended given intervals. The provider is completing monthly visits and copies of the reports are being sent to the Commission for Social Care Inspection. Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 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 3 x 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 3 X 3 Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 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. Standard Regulation Requirement Timescale for action 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 Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Kerr House DS0000035488.V278017.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!