Inspection on 01/02/07 for Knaresborough Two Group

This inspection was carried out on 1st February 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Knaresborough Two Group 09/12/08

Knaresborough Two Group 31/01/06

Knaresborough Two Group 03/08/05

Knaresborough Two Group 01/03/05

Knaresborough Two Group 21/09/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Knaresborough Two Group 17 Park Way Knaresborough North Yorkshire HG5 9DP Lead Inspector David White Key Unannounced Inspection 1st February 2007 09:00 Knaresborough Two Group DS0000061615.V324728.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 Knaresborough Two Group DS0000061615.V324728.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. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Knaresborough Two Group Address 17 Park Way Knaresborough North Yorkshire HG5 9DP 01423 546326 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) www.homestogether.net Homes Together Ltd Post vacant Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to have an associated sensory impairment. Date of last inspection 31st January 2006 Brief Description of the Service: The Knaresborough Two Group is registered to provide residential, personal and social care for ten service users with learning disabilities and an associated sensory impairment. The Group is comprised of three homes; 21 Farfield Avenue, 17 Park Way and 13 Rievaulx Avenue. The three homes are all on residential housing estates close to Knaresborough town centre and have good access to the local services and amenities. The registered provider is Homes Together Ltd. At the time of the site visit the fees for the home ranged from £750 to £1250 per week and do not include costs for holidays, hairdressing, chiropody and toiletries. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit undertaken on the 1 February 2007. This visit was carried out by one Regulation Inspector and took 6.5 hours with 4 hours preparation time. The home was able to return the requested information before this site visit. Eight surveys were received from service users and three from relatives of the service users. Information was used from the Regulation Inspector’s inspection record, which detailed the history of the home and relevant information about what had been happening in the home since the previous inspection visit. The site visit comprised of an inspection of the premises. Three service users’ care records were examined and these included their assessments, care plans and medication records. Staff rotas and health and safety documentation were inspected. Time was spent talking to three service users, three members of care staff, a health professional who was visiting the home and the manager. The activity in the home and the interaction between service users and staff was observed. The focus of the inspection was on a number of key standards and inspecting the case records of a number of service users to establish whether they corresponded with their experiences of life in the home. The manager was available throughout the inspection and the findings were discussed at the end of the inspection. A director of the organisation was also present for the feedback from the site visit. What the service does well: Service users are encouraged to be independent and to make their own choices about how they live their lives. Service users have opportunities to contribute their skills towards developing policies in the organisation. Service users enjoy a range of activities and are involved and have access to a number of resources in the local community and this supports them with their occupational and learning needs. Service users receive good care and support from staff and have access to a number of health care specialists so that they are able to receive the health care they need to meet their needs. A health care specialist said that staff are “on the ball” in ensuring service users get the care they need. The homes are clean, bright and comfortable and this means that the living environment is pleasant for service users. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 6 The home has a settled staff team who are very familiar with the needs of the service users and this helps service users to receive a consistent standard of care. The home is managed in the best interests of service users so making sure that any concerns are dealt with and good standards are maintained. What has improved since the last inspection? 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. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Proper pre-admission procedures are in place so that prospective service users can feel confident that their needs will be met by the home. EVIDENCE: Although no service users have been admitted into the home since the previous inspection visit it was noted in the care records of three service users that the home has proper pre-admission procedures in place. All the care records contain information that has been obtained from other sources such as placing authorities before any decision is made about whether the home would be able to meet the person’s needs and the home also carries out their own assessment of the person’s needs to support this process. Prospective service users and their relatives are invited to spend time at the home and have an overnight stay before making any decision about moving in. Surveys returned by service users all state that they were given information about the home and had a choice as to whether they wanted to live there or not. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. 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. Service users are encouraged and supported by the staff to make their own decisions and to be as independent as possible whilst taking into account any possible risks from this. EVIDENCE: The home is introducing a new care planning system for all of the service users who will have an “Individual Service Plan”. This new documentation is more specific in detailing how each service user wishes to be cared for and encourages their involvement in the planning of their care and their aims and objectives in life. Some of the new documentation is in place and provides clearer information about the service users’ personal, social and health care needs. Each care record is individualised and takes into account the very specific needs of each service user. Information is available about the type and level of support needed and there are clear guidelines as to what actions staff Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 10 are to take in ensuring needs are met. The information also includes service users’ preferences about aspects of their daily living and what is important to them in their lives. One service user particularly likes to watch Welsh television and has a television in his bedroom with connection to specific Welsh channels. The new documentation is well organised and staff made comments that it is “easy to follow” and they particularly like the behaviour management plans which specify how they are to manage difficult behaviours. Each service user has a key worker and are aware of who this person is. The key worker system enables staff to spend time with service users on an individual basis and service users said they like this and feel that the care they receive is “very good”. A number of risk assessments are in place to promote the service user’s independence and choice and take into account any risks to the service users. Within the care records there is information about medical and other appointments that service users have attended and it is intended that more detailed health information will be developed for each service user as part of the new documentation. Service users said that they regularly meet up with their key worker to discuss their care plans. Care plan reviews are organised with the involvement of the service user, their relatives and care manager where possible although these need carrying out on a more regular basis. One service user said that she has not had a care plan review for two years and the care records supported this. This needs addressing so that any changes to a person’s needs can be identified and acted upon. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. 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. Service users enjoy a varied lifestyle to suit their individual preferences, are involved in the local community and have access to family and friends at all times. EVIDENCE: The Commission has received information since the last inspection visit stating concerns about service users’ having a lack of activities and poor diets. The evidence from the site visit shows that service users enjoy a range of activities and have a varied diet. The service users are encouraged to continue and develop their own interests with the support of the staff team. Each service user’s care records include information about their individual activity programme and their social likes and dislikes. Some service users attend the local resources and colleges and take part in such things as computer classes, whilst another service user is a member of the local men’s choir. Some service Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 12 users enjoy going to the local gym and hydro pool and one of them goes to the local church most weeks. Trips are also organised to go out shopping and to the pubs. The home has a minibus so that service users are able to go on trips out and some service users enjoyed a recent trip to Euro Disney in Paris. Activities are planned within service user meetings so that staffing resources can be put in place to support service users in meeting their social needs. The home has flexible visiting times and service users are encouraged to maintain their friendships and relationships with family and friends. One of the service users is having some support from a relationship counsellor to help him to develop more appropriate skills in his relationships with others. Relative surveys indicate that they are very satisfied with the care and services on offer at the home. Service users feel that the quality of the food is “good” and that they are involved in the planning of the menus. Fresh meats and vegetables are bought and these are cooked by the staff although service users are encouraged to be involved with the food preparation. Service users’ weight is monitored on a regular basis so that any health issues can be identified and acted upon. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. 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. Service users’ are supported in a dignified manner and their physical and health care needs are well met. EVIDENCE: Staff interact well with the service users and treat them in a respectful manner. Service users made comments that staff treat them respectfully and this could be seen at the time of the site visit. Those service users needing personal support said that this is done in a sensitive way. Service users all have their own key to their bedroom and the front door of the home. Each service user is registered with a General Practitioner through whom specialist services are accessed. Service users receive support from staff in attending dental and other health care service appointments. The records show that service users have regular physical health checks and reviews of their medication. A health professional who was visiting the home at the time of the site visit feels that the home is “responsive” to people’s needs and said that staff are “always on the ball and are helpful and informative”. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 14 All the service users require assistance with the administration of medication. The Medication Administration Records are up to date and accurate and medications are received and disposed of correctly and this is recorded. The staff have drug information stating the purposes of the medication being prescribed and their possible side effects. All the staff team receive appropriate medication training and are about to undertake some further training. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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. Service users views are listened to and acted upon and their interests are safeguarded. EVIDENCE: Complaints procedures are clear and easy to understand and are available in Braille, audiotape and large print format. Since the previous inspection visit the Commission has received some information about the home and this was referred to the local authority under their adult protection procedures. The local authority asked the registered provider to investigate the issues raised and they provided information to the local authority and the Commission about the outcomes from their investigations. This information showed that the management of the home had complied with the directions from the local authority and had followed proper procedures to safeguard the service users from any possible harm. The information showed that the home’s complaints procedure was followed and that there was no substance to the issues raised and the care to the service users’ was not compromised and this was supported by the findings from the site visit. Two service users made comments within surveys that they are not aware of who they would need to speak to if they have concerns. However since the surveys have been returned it was noted in the service user meeting records that the procedure for raising concerns has been discussed with the service users and from discussion with service users it was evident that they are now aware of whom to see about any issues. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 16 Adult protection policies and procedures are in place and staff demonstrated a good understanding of what would constitute abuse and the actions that would need to be taken in response to abuse happening. Staff have all had some abuse awareness training and this is covered within the induction programme for new staff. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, homely and comfortable for service users. EVIDENCE: The Knaresborough Two group consists of three small homes that are all located close to Knaresborough town centre. One service user said he “loved living here” and likes the location of his home. All the bedrooms are personalised and lockable and service users have secure facilities within their rooms to keep monies and valuables safe. Within each home there is a bathroom and toilet area and these are located close to bedrooms. There is ramped access to the home and tracking and hoisting equipment available to support service users who have mobility problems. There are call bells in bedrooms for people with mobility difficulties to enable them to access staff support, however one service user said their call bell had not been working for the last two months. On one occasion the service user had needed some assistance during the night and was unable to access staff because of this and this led to an “embarrassing” situation for the service user. The problem with Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 18 the call bell needs addressing as a matter of priority in order to make sure that the service user is able to access staff at all times. The homes have a friendly and welcoming atmosphere and service users said that they mainly “get on with each other”. Each home is clean and comfortable and the kitchens are well maintained and regular checks are carried out to promote safe food hygiene practices. There is a fire risk assessment in place that covers all the homes and the manager is seeking guidance from the local fire authority as to whether the assessment meets fire safety requirements. Hot and cold water temperatures are regularly monitored and recorded and any problems are referred to the appropriate people. A random check of the bath water temperature was found to be within safe limits. The home has an ongoing programme of re-decoration and refurbishment. Knaresborough Two Group DS0000061615.V324728.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, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive good standards of care from a competent, trained, motivated and well-supported staff team. EVIDENCE: The duty rotas show that there is a sufficient number of staff on duty at all times and service users said they are always able to access staff. Activities are planned in advance with service users so that staffing resources can be allocated to accommodate service users’ social needs. The atmosphere in the homes is friendly and staff said that morale is “good”. One service user said “it is brilliant living here, all the staff are friendly and enjoy having a laugh with you”. There is a low staff turnover in each home and this helps the service users to receive a consistent standard of care. Staff have a good understanding of the specific needs of the service users and are able to communicate well with them. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 20 Through looking at two staff records it is evident that proper recruitment procedures are being followed to make sure that the interests of the service users are safeguarded. Two service users have recently been involved in the interview process for recently appointed members of staff. The Commission has received information since the last inspection visit stating concerns about the lack of staff training. The evidence from the site visit shows that staff receive a range of training specific to the needs of the service user group. This includes training in a number of different areas including health and safety practices, non-violent crisis intervention and autism awareness. Some staff have also received some visual impairment awareness training to give them a better understanding of the needs of people with visual difficulties and it is intended that all staff will receive this training. The home has an ongoing commitment to NVQ training. Staff receive regular supervision and appraisals and records of these were found in the staff files. Knaresborough Two Group DS0000061615.V324728.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 home is well run in the best interests of the service users and overall proper attention is given to ensuring their health and safety. EVIDENCE: Since the previous inspection visit the registered provider has appointed a new manager. The manager has experience in managing other care homes and has recently completed a management qualification to enhance her management skills. However she has yet to make an application for registration to the Commission although it is intended that this will happen shortly. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 22 Service users and staff spoke in complimentary terms about the manager saying she is “approachable and pleasant”. Staff feel well supported and said that they now have more training opportunities. Since the previous inspection visit there has been improvements to the quality assurance system and questionnaires have been sent out to and returned by relatives. Examples of these were available at the time of the site visit and gave positive feedback about the care and services on offer at the home and there was evidence that areas for improvement are addressed. One relative made a comment about how one aspect of the laundry system could be improved and this has been acted upon. Two service users have recently been involved in the home’s recruitment process for the employment of new members of staff and another service user has helped the organisation to develop their policies and procedures in Braille. Both staff and service users have regular meetings and are kept informed of developments in the organisation. Relative surveys indicate that they are kept well informed of matters affecting their relative. The home has proper arrangements in place to make sure that health and safety practices promote a safe environment and a random selection of the required health and safety certificates are up to date and satisfactory and all accidents are recorded to safeguard the interests of the service users. All staff receive health and safety training. The fire records showed that one service user would have difficulty in evacuating the home by himself in the event of a fire. However there is no record to show that an individual risk assessment has been carried out on this service user to minimise risks from this. Knaresborough Two Group DS0000061615.V324728.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 3 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 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. 1. Standard YA24 Regulation 16 & 23 Requirement Timescale for action 15/02/07 2. YA37 8 3. YA42 13 The registered person must make sure that the problem with the service user’s call bell as identified at the time of the site visit is rectified so that the service user is able to access staff at all times. The registered person must 01/03/07 submit an application for registration of the appointed manager to be considered by the Commission. The registered person must carry 15/02/07 out a risk assessment on all service users who may have difficulty evacuating the home in the event of a fire in order to identify possible risks from this and to put in place measures to promote their safety. Knaresborough Two Group DS0000061615.V324728.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. 1. Refer to Standard YA6 Good Practice Recommendations Care plan reviews need to take place on a more regular basis in order to address service users’ changing needs. Knaresborough Two Group DS0000061615.V324728.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Knaresborough Two Group DS0000061615.V324728.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!