Inspection on 14/06/07 for Kilburn Gardens, 53

This inspection was carried out on 14th June 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kilburn Gardens, 53 02/08/06

Kilburn Gardens, 53 08/11/05

Kilburn Gardens, 53 12/05/05

Kilburn Gardens, 53 14/12/04

Kilburn Gardens, 53 26/07/04

Kilburn Gardens, 53 04/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Kilburn Gardens, 53 53 Kilburn Gardens Collingwood Park, Station Road North Shields Tyne & Wear NE29 6HD Lead Inspector Hilary Stewart Key Unannounced Inspection 14 ,21 and 29th June 2007 12:30 th st Kilburn Gardens, 53 DS0000000357.V338253.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 Kilburn Gardens, 53 DS0000000357.V338253.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. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kilburn Gardens, 53 Address 53 Kilburn Gardens Collingwood Park, Station Road North Shields Tyne & Wear NE29 6HD 0191 2728714 F/P 0191 272 8714 No email 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) New Prospects Association Limited Mrs Michelle Anne Coleman Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users are also categorised as having physical disabilities. Date of last inspection 2nd August 2006 Brief Description of the Service: 53 Kilburn Gardens provides residential care for three adults with a learning disability. Nursing care is not provided. The home is a bungalow on a housing estate in an outlying area of North Shields. The design of the house is in keeping with the other houses on the estate. Public transport is available a short distance away. The nearest local amenities are in North Shields. The home has a variety of aids and adaptations to assist people with physical disabilities. All of the bedrooms are single. There is a large bathroom, which has an assisted bath, a shower and toilet. There is also a separate toilet. The house has a reasonably sized garden at the rear and a small garden to the front. There is a ramp providing wheelchair access to the front door. The home charges from £1277.56p to £1900.00p per week. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 2nd August 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service and the staff . The Visit: An unannounced visit was made on 14thJune 2007. During the visit we: • • • • • • Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit . We told the manager what we found. What the service does well: Staff on duty at the time of the visit were friendly and helpful. The needs and wishes of each person who lives at the home have been assessed. This means that staff know about the needs of each person and what care and support they require. The staff team at the home value the differing needs of the people who live there and make sure that they are aware of each person’s preferences. They treat the people as individuals and support them to live the life they choose as much as possible so they will have new experiences and know that their opinions are valued. People who live at the home experience a variety of activities. This gives them choice as well as building their self-esteem and confidence. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 6 The staff team make sure that the home is clean, warm and pleasantly furnished so the people who live at the home have a comfortable place to live. Staff support the people to use local services so they are part of the community. The staff are supervised and trained so they know how to provide the people who live at the home with good care. The staff make sure the people’s health care needs are met so they remain in good health. All of the people who live at the home have plans of care and risk assessments. This is so staff have the information they need to support each person and keep them safe. The home has procedures for staff for the administration and recording of medication. This is to make sure the people who live at the home receive their medication when they need it and at the correct times. The home has procedures for dealing with complaints and protecting the people who live there from abuse. This means that the people who live at the home feel safe, know they can talk to the staff and that their views are listened to. What has improved since the last inspection? The homes statement of purpose has been updated and it is now in pictorial form. This means that the people who may want to use the service in the future will be able find out about the home more easily, which will help them to decide if the home is the right one for them. All of the care plans have been completed so the staff have accurate information about how to care for the people who live at the home. All of the staff have been trained in how to protect vulnerable adults so they will be able to keep the people who live at the home safe from abuse. The cupboards in the kitchen have been repaired so the room looks more pleasant for the people who live at the home. The company who run the home pay £200 to each person who lives there to spend on a holiday. This gives them more choice of where they can go. The people who live at the home have their money paid directly into their own accounts so they have more control over their finances. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 8 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 Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The needs and wishes of each person who live at the home have been assessed. This means that staff know what care and support they require. EVIDENCE: The people who live at the home have their own individual files called “all about me”. They show that the people have had their needs assessed and they describe the actions the staff need to take to meet their needs. The manager and staff said that no one new has moved into the home since the last visit and a person could only move into the home if the manager and staff are certain that the persons needs can be met there. When the last person moved into the home they had been gradually introduced by having visits before they moved in permanently. The home has a statement of purpose and a guide for people so they can decide if the home is where they want to live. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home get personal support and at the same time staff make sure that their privacy, dignity and independence are respected. They are supported to become more independent at the same time staff try to reduce the risks so they are kept as safe as possible. EVIDENCE: The manager and staff confirmed that the people who live at the home have had their needs assessed. They take part in writing their own care plan as much as possible so they can record their hopes and wishes for the future. They also have a record of the likes and dislikes of individuals as well as how to care for them. One person had said that they did not like watching soaps on the television another did not like going to certain shops. The manager and staff said that the people who live at the home are supported to be as independent as they can be safely. Staff assess the risk, Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 11 which then shows how they can reduce risk as much as possible for people when they for example take part in activities. The people are encouraged to make choices and decisions about what they want to do. There are house meetings where they discuss things such as activities and holidays. The manager said that at one meeting the people discussed how new householders should be introduced to the home before they move in. The people who live at the home have life style meetings every 3 months where they decide on their action plan. One person decided they wanted to go and visit a friend they had not seen for a while. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home lead healthy stimulating lifestyles, supported by staff who value them, while maintaining links with their families and friends. EVIDENCE: The manager and staff said that the people who live at the home have the same rights as everyone else to make choices but they have to look at the risks at the same time. Sometimes for instance some people are not able to go out on their own, as they may not be able to keep themselves safe. The staff and manager said that they regularly look at the options open to the people in relation to work, leisure and social activities. At the same time they have to be realistic about the choices. People go to the bank to get their own money then go shopping. They go to the library and go bowling. Every year they decide individually where they would like to go on holiday. One person went to a holiday camp and another went to Blackpool. Staff said that the Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 13 people who live at the home use the local shops and the neighbours say “hello” when they are out. One person said “ I like going to the pub the best”. The friends and family of the people who live at the home are encouraged to keep in contact with them. They can visit the home or staff will support the people to visit them. The staff were observed and they said that they always ask before they enter people’s bedrooms. Staff said that the people who live at the home could always have privacy if they want. Staff said that they work with the people who live at the home around enabling them to have appropriate relationships and behave in ways that will help them get on with people. Staff said that the people’s rights are respected. The home’s menus are based on the known likes and dislikes of the people who live at the home. Staff said that they are always trying to find new menus and to provide interesting things for them to try. The staff said that at least three meals are served to the people, which are varied and nutritious. They have 5 choices. One person said, “the food is alright” and that their favourite was “probably chips”. Fresh fruit and vegetables were in the kitchen. Some of the people who live at the home do not use the spoken word so staff said they observe their facial expression and gesture to learn about their preferences. For instance one person will push something away if they don’t like it. Records of food served are not recorded. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at the home have personal support when they need it so they can be as independent as possible. The staff monitor and promote the health of the people who live in the home to maintain their well-being. EVIDENCE: The health needs of the people at the home are written up in detail so the staff have accurate information and know how to care for the people. The staff said that the health and welfare of the people who live at the home is constantly being monitored. Their health and well-being is discussed in staff meetings. If there are concerns about a person’s health appropriate action is taken. The manager and staff could describe and records showed how people are provided with personal support when they need it. One person has stated that they would prefer their personal support delivered by staff of the same gender. As a result of this the manager is actively trying to recruit appropriate staff but is finding it difficult. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 15 The manager said that they have recently looked at the medication procedures in the home to make sure they are working. All of the medication is checked weekly. The medication records were up to date. Any discrepancies are taken very seriously and the staff have a procedure to follow to make sure medication is given correctly. The manager and staff said and records showed that they have had training in how to administer medication. If it is thought to be safe following a risk assessment the people who live at the home can control their medication. The manager said that they have arranged for their local pharmacist to come and check the home once a year. Details of health checks, visits to their GP and hospital appointments are recorded in each individuals file. One person said that they go to the hairdressers and the dentists. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A satisfactory complaints procedure is in place, it is easy to read and clearly displayed. This means that complaints are dealt with effectively and to the satisfaction of the person who made the complaint. Staff know about adult protection procedures, so the people who live at the home are kept safe. EVIDENCE: The manager and staff said and records showed that they have had training in how to protect vulnerable people from abuse. Staff could describe the procedure to be followed if an allegation of abuse was made. One person who lives at the home when asked if they felt safe living there said “if I had any problems I would tell the staff”. Some of the people at the home do not communicate with spoken words but they looked comfortable and relaxed during the visit. They approached staff and used gesture and facial expression to communicate with them. The home has a complaints procedure. Staff said that they would support the people who live at the home if they wanted to make a complaint. One person who lives at the home said that they knew how to make a complaint and would tell the staff if they were worried about anything. There had been complaints from neighbours about staff parking their cars on the street but this has now been resolved, as the front garden has been made into car parking. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 17 The home has a tenants handbook which is in pictorial form which tells the people who live at the home what they can expect and how they can make a complaint. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People live in a safe, comfortable and clean home, although some updating and repair are necessary. EVIDENCE: There are enough bathrooms and showers for the people who live at the home. In one of the bathrooms specialist equipment is being stored in the shower area, as there isn’t room elsewhere. The worktops in the kitchen are damaged and worn. In the living room the walls are marked and the three-piece suite is worn and stained. The bedrooms looked comfortable and the people who live at the home had personalised them. They had been made very individual. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are supervised and get training so they know how to give the people who live at the home good care and meet their needs. The homes has a recruitment procedure. This makes sure that only suitable people come to work there. There are enough staff working at the home so the people who live there are provided with the care they need. EVIDENCE: Records showed and staff said that they receive training, which helps them with their work. All have mandatory training such as first aid and food hygiene. The manager and 4 staff have vocational qualifications. Staff felt supported by their manager who said and records confirmed that staff are supervised when they should and they have regular staff meetings. Staff get individual supervision and are supported to do their job. Sufficient staff were on duty at the time of the visit and the manager and staff said that enough staff work at the home but sometimes they find it difficult to Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 20 cover staff sickness. Records showed that on other days enough staff had been on duty. The manager said that all staff have been CRB (Criminal Records Bureau) checked at an enhanced level to make sure they are suitable people to work at the home. Some records were looked at and they showed that staff had been checked to make sure they are suitable people to care for vulnerable people before they started to work at the home. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager has the experience and vocational qualifications to run the home so the people who live there are well cared for. Householders opinions are sought about how the home is run so they know their views are valued and are used to improve the service. Monitoring visits of the home take place to check that the people who live there get the care they need and their health, safety and welfare is always promoted. EVIDENCE: The manager said that they have the relevant experience to run the home and have a recognised vocational qualification. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 22 Safety checks have been carried out on the equipment in the home; such as testing electrical equipment and the servicing the central heating boiler. A health and Safety inspection had taken place in May 2007. Fire safety risk assessments had been completed. The manager asked the Local Fire Service to inspect the home, which they did in January 2007. The fire logbook showed that regular fire drills and fire instruction take place. Staff said that they have fire drills and instruction. Records showed that regular training is provided for staff in fire safety, food hygiene and first aid. The manager said and records showed that regular monitoring visits take place at the home. Some of reports from the visits had not been sent to home so the manager did not know the outcomes. The manager said that the people who live at the home are asked their views about the running of the home as much as possible and the home has a yearly improvement plan. One person said “the staff listen to you” and “the staff help you”. It was observed and staff said that they have a good relationship with the manager at the home. The people who live at the home were seen talking with the staff and manager in a confidant manner. One person was observed informing staff of their opinions during the visit. Staff spoke to the people who live at the home explaining to them what they were doing i.e. “ I’m going to get you wheelchair now” and “ I’m going to help you put your cardigan on”. Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 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 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 3 X Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 24 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Regulation 17 Requirement A record of the food provided to people who live at the home must be kept in sufficient detail to show that they are getting w ell balanced nutritious diet and special diets are being catered for. The home must have adequate storage space. The living room decorated and, three piece suite cleaned or replaced and the kitchen worktops replaced or repaired. Copies of the reports from the monitoring visits are lodged at the home. (Previous timescale of the 01/11/06 not met) Timescale for action 01/08/07 2. YA24 23 01/10/07 3. YA39 26 01/10/07 Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 25 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 Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kilburn Gardens, 53 DS0000000357.V338253.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!