Inspection on 16/06/06 for Kilpeacon House

This inspection was carried out on 16th June 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

Kilpeacon House 16/04/08

Kilpeacon House 26/04/07

Kilpeacon House 11/01/06

Kilpeacon House 19/07/05

Kilpeacon House 17/01/05

Kilpeacon House 21/06/04

Kilpeacon House 17/01/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Kilpeacon House Grey Road Altrincham Cheshire WA14 4BU Lead Inspector Michelle Moss Key Unannounced Inspection 16th June 2006 9:45 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 Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kilpeacon House Address Grey Road Altrincham Cheshire WA14 4BU 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) 0161 928 2784 Mr James Skeath Mrs Lina Margaret Skeath Mrs Dianne Joan Chapman Care Home 24 Category(ies) of Dementia - over 65 years of age (0), Old age, registration, with number not falling within any other category (0) of places Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users will be aged 65 or over. Service users will require care by reason of either old age or dementia and may in addition have a physical disability. 11th January 2006 Date of last inspection Brief Description of the Service: Kilpeacon is a care home providing personal care and accommodation for 24 service users of pensionable age (65 and over). It is owned by Mr. and Mrs. Skeath. The home is located in an established residential area of Altrincham, close to shops, bus and train routes and other amenities. The home is a detached twostorey building comprising of 14 single and 5 double bedrooms. En suite faculties were available in most rooms. There is a dining room, lounge with dining area and a conservatory. A passenger lift is available to the second floor. The home has gardens to front and rear. Parking is available to the front of the premises. The fees for the home at the time of this report were £380 - £450 per week. The home’s inspection reports are made available to resident, families and professional on request. A copy of the home’s Statement of Purpose and Service Users Guide is always made available to read at the home. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector went to the home without telling anyone she was going to visit on Friday 16th June 2006. A total of 3 ½ hours was spent at the home. This included speaking with a number of residents, staff and visitors. The Inspector also: • Looked at some care records. • Watched how the residents and staff got along together. • Completed a tour of the premises. To help the Inspector to write this report the home were asked to provide a self-assessment report/questionnaire, which was completed by the manager and received by the Commission on 30th May 2006. The Inspector also took into account other information, which the Commission knew about the home. There were some important things the Inspector wanted to find out about the care given by the home. These were: • How the health needs of residents were met. • How the Personal care needs of residents were met. • How the staff helped to kept residents safe. • How the home respected resident’s rights, diversity and identity. If you want to get a full picture of what it is like to stay at Kilpeacon you might like to read the last report as well. You can find the address or website details on the front page where you can obtain the report. The term of address preferred by the users of the service was confirmed as “residents”. It was felt that this best reflected the function and purpose of the service. What the service does well: These are some of the good things that the Inspector found out about the home. What • • • • • • • residents said: “The staff are fantastic”. “The staff really look after you” “The food is gorgeous and all homemade.” “You can have you breakfast in bed”. “The staff really work hard”. “We have things to do” “You can talk to the manager” Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 6 All these things showed that the residents’ felt well cared for and helped by the staff in their day-to-day life at the home. Also, that the meals were a particularly good. Many residents described the meals as being “the best”. Relatives Said. “The staff were approachable”. “Kept families informed about things important” “There was always staff around”. “The staff always appeared caring”. These comments showed that staff were providing care in a way, which was centred on the needs of residents, and that the staff were available in adequate numbers. The care planning system was very informative and provided alot of important information that the staff needed to know to make sure they were able to meet the residents’ care and health needs. This showed that the staff caring for the resident’s were being well informed about how to keep the residents’ healthy, safe and the importance of respecting individual’s identity. The training provided to the staff was good. This showed that the staff had knowledge, which helped them better understand about the health and care needs of older people. What has improved since the last inspection? What they could do better: Overall, the home was meeting nearly all the National Minimum Standards that were looked at during the visit. However, there were some things that could be better. Maintaining a safe environment for residents by making sure repairs were done and that good hygiene standards were maintained. This included: • • • Two bedrooms, which were found to have an odour present, even though the room was clean. There were some damaged to the plastered areas on bedroom walls. A shower tray was damaged. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 7 All these areas required attention. By making these areas better it would help to make sure that the residents and staff safety and health is adequately safeguarded. Residents’ prescribed medications are not always correctly administered in accordance with the instruction given by the GP. This needed to be made better to make sure the health of residents is not affected. 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. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 4, 5 & 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents were having information made available to them and their individual needs and aspirations assessed, which meant the home was sufficiently informed to meet their needs and prepare for their admission. EVIDENCE: Wherever possible the home would encourage prospective residents to visit the home and spend time getting to know the staff and other residents. It was acknowledged that this was not always possible. However, families were equally given the same opportunities. The home had a booklet/brochure, (Service User Guide) which informed families and prospective residents about the home. The home’s manager was completing the assessment of needs of the prospective resident. On examining a sample of these assessments, they were found to be detailed and informative about the needs of the resident. The home did not provide intermediate care. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Positive outcomes through the care planning meant residents’ needs were both assessed and reviewed which in turn provided staff with updated information that helped them deliver individualised care. However, these positive outcomes were compromised by the continual weaknesses found in the management of medication, which had the potential to affect the health of a resident. EVIDENCE: A sample of care plans were examined. Overall, these were found to be well maintained. They included having a summary at the beginning of the plan that informed staff about the preferred care of the resident. This was written from a person centred approach, which showed respect for the residents’ independence and privacy. A new area for the care plan entitled “The Family Tree” was examined. This was aimed at gaining a greater insight into each resident’s life, which helped the staff to be able to be more sensitive over matters that had affected the residents’ personal life. Furthermore, it assisted staff to support residents to recall their lives and things and people important to them in a positive way. One Family Tree examined had a lot of detail and explained the reasons for the Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 11 resident’s admission to the home. The style in which the record was made was respectful of the resident and valued their life. The care planning records were found to be well maintained, with evidence that they had been reviewed on a monthly basis and updated where changes in needs were identified. The information showed that the home was making sure that they were meeting the changing needs of residents due to illness and frailty. A hospital admission transfer care plan was in place that informed the hospital of essential health information about the resident. Good use of weight records, dietary monitoring and body mapping charts showed that the home was putting the health and welfare of residents as a high priority. The risk assessment process was comprehensive and resident specific. The risk assessments address the use of bedroom keys, window safety and the use of bedrails. Residents had details within their care plan specific to their medication. This was found to help staff have a greater understanding behind the reasons why medication was important to a resident’s health. Overall the medication records were detailed. However, on examining a sample of residents’ medication records, some questions over short course treatments were raised. This included a record, which indicated that the medication should be administered for 5 days (a course of 15 tablets three times a day). The recording made on the medication chart this showed that the staff had signed the medication out to the resident 19 times. Furthermore, on checking the lunchtime medication it was found that on two occasions the medication remained in the blister pack and no explanation on the carers notes had been made to indicate why these tablets had not been administered. The manager was made aware of the findings and advised to investigate what had happened. Added to these finding following the home’s last inspection, weaknesses in medication were found during the Commission’s investigation into a complaint, which resulted in requirements being made. Previous inspections have highlighted concerns about the management of medication and a failure of the home to comply with the Care Home’s Regulation 2001. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were able to exercise their rights, including having their cultural/religious needs, privacy and their diverse needs valued by Kilpeacon. Furthermore, the home enabled residents to choose their own daily routines, develop their independence and have a varied and nutritious diet. EVIDENCE: From talking with residents, relatives and reviewing information received in by the home it was noted that a range of activities were provided to residents. In most cases, these were on a small scale including informal activities such as card games, dominos, skittles, bingo, quizzes, sing a long and indoor bowls that mainly happened in the afternoons. Other activities were planned, including visiting entertainers where the theme was entitled “Past times”, church services and one activity that was found to be the most popular with the residents “TAI CHI”. This was a form of Chinese exercise, which happened once a month. However, relatives indicated during many of their visits they had not observed any of these activities. It was recommended that the home commenced a “What’s on” notice board which informed residents and relatives about activities completed in the home. A number of residents and their relatives said that the meals were very good and tasty. They spoke about the meals being all home made with good fresh Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 13 produce being used. At lunchtimes there was always a three-course meal. Residents spoke described the meals as “lovely soups” and “roast dinners”. One resident said, “it was gorgeous and that they had never eaten so well”. The care plan included a section about the dietary needs of residents including likes and dislikes, which were shared with the cook. The families spoken with indicated that they were made to feel welcome by the staff during their visits and when they telephoned to enquire about the wellbeing of their family member. When residents’ were taken ill the home used an additional daily care plan, which recorded the resident’s dietary intake. The care plan carried lots of information, which demonstrated that the diverse needs of residents were being considered by the home. This included acknowledging through the “Family Tree” the resident’s faith and family values. Also, it recorded the preferred ways the resident wished their care needs to be delivered by the home and how they wished to practice their religious beliefs. One example given to support this good practice was the home acknowledging a resident’s wish to have a male Priest rather than female for Holy Communion. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents felt able to raise their views and to be listened to. Furthermore, policies and procedures and training programmes were in place that staff were required to attend and adhere to which ensured that residents were safeguarded from all forms of abuse. EVIDENCE: The staff team had received training in adult protection and the recruitment of staff was completed in a way, which protected residents from potential abuse. The home had a complaints procedure, which meant that residents could raise concerns about any aspect of their care and be given assurances that the matter would be investigated. However, on speaking with a family they were not aware of the home’s complaints procedure, although the residents spoken with all said that they were able to make the views known about their experiences at the home. They also, stated that they were happy. One complaint about the home was investigated by the CSCI in February 2006, which related to the admission procedure of a resident. The findings of a joint investigation between the home and the CSCI found that the home had been in breech of some of the Care Homes Regulation 2001, which resulted in requirements being made. These were addressed by the home immediately and from the finding of this inspection improvements were evident in procedures and overall care. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 15 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, 24,25 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents were able to accommodate their possessions, pursue their chosen interests and activities and were offered sufficient privacy. However, the premises were not being kept in a good state of repair and free from unpleasant odours, which compromised the residents’ health and wellbeing. EVIDENCE: A sample of bedrooms were seen. These were all found to be clean and tidy. Furniture was colour co-ordinated and residents were given the opportunity to bring in personal belongings. There was an adequate amount of seating available in the communal areas, for residents to socialise. At a previous inspection concerns over a damaged carpet in the lounge area had resulted in a requirement being issued. This potential hazard had been addressed and the residents’ safety secured. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 16 There were some areas of the home, which had the potential to compromise the health and safety of residents. These included an unpleasant odour being present in two of the bedrooms seen. The manager was present during the tour and the unpleasant odour raised at the time. One bedroom doorframe, which had in the past been identified as unsafe due to loose plaster, was again found to have pieces that moved independently on contact. This had the potential with the continuous use of the door for the plaster to totally dislodge placing the resident or staff at risk of injury. A further bedroom had paint peeling away from the wall, which the manager said had been caused by damp, which had been treated. The ease in which the paint was peeling could cause a risk to a resident that was confused. The provider was required to ensure that the area is made safe and decorated to a good standard. A bathroom shower tray was found to have a crack across its base. It was unclear if this was causing any water leakage underneath the unit. However, on touching the cracked area it felt sharp. The crack required investigating to ensure the health and safety of a residents is not compromised. From completing a tour of the premises, evidence was found that the home held a good stock of disposable aprons, gloves and paper towels to manage infection control effectively. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 17 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): 27, 28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team were appropriately trained, recruited, employed in numbers and with the skills necessary to meet the needs of residents and to protect them form potential abuse. EVIDENCE: Three care staff were on duty to meet the needs of 23 residents. In addition, there was a housekeeper and cook on duty. The residents’ spoken with described the staff as “very hard working” and “very caring”. Resident’s were seen to be at ease with staff and the general rapport between the staff and residents was seen as very positive. During 2005 a high priority had been given by the home to training and supervision. This training had resulted in staff being more informed about the different health conditions that affected the elderly and about practices of care, which secured the well being of residents and staff. Of the 22 staff 14 held a certificate in first aid and 95 of the staff had achieved an NVQ qualification at Level 2 or above. The manager was continuing to investigate different training courses, which would assist staff to better meet the health and social care needs of the residents. A record of staff training was being held which showed that staff training was exceeding the National Minimum Standards. Some examples of the training Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 18 was confirmed by the Provider to include Fire training, Food Hygiene level 1 & 2, Pressure Care, First Aid, Life Support and Dementia care. The retention of staff was in general good at the home with many of the staff with a long service history. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 19 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): 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The overall outcomes for residents in the area of management were positive. This was because the manager showed leadership and managed the home in the best interest of residents. This included having good health and safety procedures and by monitoring standards of care through a quality assurance system. EVIDENCE: The home did not take responsibility for any aspect of residents’ financial matters. The management of the home was continually improving the service to meet the needs of residents. Improvement in areas of care planning, care practices and training were all seen to be benefiting the residents’ overall care. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 20 Additional comments of relatives and residents also indicated the management team were approachable and caring. Aspects of fire safety and water temperature testing were both being well maintained to ensure the safety of residents and the staff team were adequately protected. The home was in the process of getting feedback from relatives about the care provided by the home. Of the questionnaires seen they indicated that the staff and management were approachable and caring. The manager was advised of the need to draw together an annual report where the findings of all surveys would be made available to residents, family and the Commission. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 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 2 X X X X 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP19 Regulation 23 Requirement The home must be kept in a good standard of repair. The provider must: • Investigate what has caused paint to peel away for a bedroom wall and to repair the wall. • Investigate and repair damaged plaster around a bedroom doorframe. • Investigate and repair damaged shower unit. All repairs must be completed sufficiently to reduce the risk of potential injury and harm to residents. Medication must be administered in accordance with the GP’s instruction. This includes maintaining an accurate record of what medication has been administered by staff. The unpleasant odours noticed in two of the resident’s bedrooms must be investigated and steps taken to eliminate the odour. Timescale for action 31/07/06 2 OP9 13 31/07/06 3 OP26 16 31/07/06 Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP12 Good Practice Recommendations The home should consider introducing a “What on” notice board which informs both resident’s and relatives about activities within the home. Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Kilpeacon House DS0000005618.V300762.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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!