Inspection on 16/01/07 for Lennox Wood

This inspection was carried out on 16th January 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 but made no statutory requirements on the home.

Other inspections for this house

Lennox Wood 04/12/07

Lennox Wood 24/07/06

Lennox Wood 31/10/05

Lennox Wood 10/05/05

Lennox Wood 17/01/05

Lennox Wood 24/11/03

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

CARE HOMES FOR OLDER PEOPLE Lennox Wood Petham Green Gillingham Kent ME8 6SY Lead Inspector Sue McGrath Key Unannounced Inspection 16th January 2007 10:00 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 Lennox Wood DS0000028942.V332113.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. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lennox Wood Address Petham Green Gillingham Kent ME8 6SY 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) 01634 263631 www.kcht.org Kent Community Housing Trust Glynis Margaret Bingham Care Home 50 Category(ies) of Dementia - over 65 years of age (50) registration, with number of places Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Fifty (50) Older People with a Mental Infirmity 60 years of age and over. 24th July 2006 Date of last inspection Brief Description of the Service: Lennox Wood is purpose built on two floors with a basement that is used as separate offices and for training. There is a courtyard garden in the centre of the quadrangle building, which houses a sensory garden. The home is situated in a residential area close to local shops and amenities. There are local bus routes nearby. Gillingham and Chatham town centres are approximately 2 miles away where there are main line stations. The service has limited access to transport. The home has 46 single rooms and 2 shared rooms, none have en-suite facilities. To support care staff there are additional staff employed to undertake regular activities with service users. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a second key unannounced inspection and took place over the course of one day. The key inspections for care home services are part of the new methodology for The Commission For Social Care Inspection, whereby the home provides information through a questionnaire process and further feedback is gained through surveys sent to service users and relatives and information provided from professionals associated with the home, wherever possible. The actual date of the site visit is unannounced. Following a ‘Poor’ rating at the first inspection the home was inspected again to ensure it had met the improvement plan provided by the home. Comment cards were not sent to service users or families this time and the visit was unannounced. At the site visit, service users and staff were spoken to, records were viewed and a tour of the environment was undertaken. Some judgements have been made through observation only. Overall this was a much more positive inspection with generally good outcomes for residents. Clearly there had been major improvements. Fees range form £433 to £449. What the service does well: The home provides care in a homely setting and families spoken with on the day confirmed that they were happy with care provided and were always consulted over any changes in the care offered. The food offered was of a good quality and residents stated there were always sufficient quantities. Discussion with residents, relatives and staff confirmed that staff were committed to providing a caring environment in which to live and staff were seen to interact well with the residents. Staff had moved from task orientated work practices to a more person centered care. This has benefited the residents and staff now felt empowered to spend time with the residents. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Although the old butler sink in the laundry room has been replaced, the area around the new sink needs to be made safe. The required work on other areas of the laundry still has not been started, however it has been approved and is expected to be completed by the end of February. The broken sinks in the bedrooms have also not been replaced as required from the last inspection; again the work has been approved but not completed. The organisation is strongly advised to put a monitoring procedure in place to ensure that approved work is actually completed. Oral health needs to be added to the care plans and staff need to be more aware of this area of care. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 7 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. Lennox Wood DS0000028942.V332113.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 Lennox Wood DS0000028942.V332113.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be confident that they will be provided with the information they need to make an informed choice about moving into the home. Residents benefit from a comprehensive assessment of their needs prior to moving into the home to ensure their assessed needs can be met. Residents and families benefit from the opportunity to visit the home prior to admission to assess the quality, facilities and suitability of the service. EVIDENCE: Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 10 The evidence obtained at the last key inspection on 24th July 2006 was confirmed as not having changed. The outcome for residents remains good. Evidence gathered at the previous key inspection. The home’s Statement of Purpose and Service User Guide were viewed and provided comprehensive and detailed information about the service as required by regulations. Both documents were presented in a clear and concise format. Copies of both documents were given to residents prior to admission and were readily available via the manager. Each room had a copy of the home’s Service User Guide. As seen during previous inspection, the last report was available on the resident’s notice board. Evidence seen in residents’ files confirmed that each resident was provided with a statement of terms and conditions. A relative or representative had signed the ones viewed. Evidence was also seen that each resident had a full needs assessment completed by a senior member of staff prior to admission to ensure all assessed needs could be met. The normal practice was to visit the prospective resident in their home or hospital setting to ensure the necessary information was current and appropriate. If the resident was admitted through Care Management then information gained from both assessments formed the basis of the care plans. Families were also encouraged to become involved in the care planning process. One visitor to the home confirmed this. The Acting Manager confirmed that trial visits were encouraged and these were an opportunity for the prospective resident and their family to identify how appropriate the home was from them in meeting their needs. The home does not provide intermediate care or nursing care. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from having clear and in-depth care plans that identify their individual needs and give clear guidance to staff. Residents’ health needs are met and they benefit from having full access to all professional health care services as required. Residents are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: The new care plans that were discussed at the previous key inspection were in place and provided better information to care staff and ensured a more Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 12 consistent level of care was delivered. They were clear and concise and well presented. It could not be evidenced that all care plans were being reviewed on a monthly basis. The assistant manager stated that the plans were being reviewed but that not all staff were completing the paperwork. It is the management’s responsibility to ensure this paperwork is completed as required. For residents with a diagnosis of diabetes new comprehensive risk assessments were in place as required from the last inspection. The care plans need to continue to be developed to include adequate mouth care as required from the last inspection. Not all residents had a completed nutritional assessment in their care plans as mentioned in the last report. Better recording of health professionals recommendations were seen. Generally the plans had improved but some further improvements need to be made. All of the residents were registered with a local GP and had access to other professionals such as opticians and chiropodists ensuring health care needs were met. Medication was reassessed as is was assessed as poor at the last inspection. Improvements had been made in all areas of administration and could now be considered to follow the guidelines recommended by the Royal Pharmaceutical Society of Great Britain. The inspector does recognise that a lot of hard work had been applied to this area. The system for ordering medications was now more robust and all staff involved with the administration were working as a team and supporting each other to ensure mistakes did not occur. A robust system was now in place when taking instructions for Warfarin changes as recommended in the last report. All residents were now clearly identified on Mar records as recommended in the last report. The medication room had been moved and was improved. Staff practices seen on the day indicated that residents were well respected at all times and that their preferred terms of address were used. Good interaction between staff and residents was observed. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to maintain contact with family and friends as they wish. Residents receive a wholesome, appealing, balanced diet in pleasing surroundings. EVIDENCE: The home cares for people with varying degrees of dementia and lifestyles can be very challenging for some. The home does have designated activity staff who work hard to try to meet the social and recreational needs of the residents. The home now has access to a minibus, usually for two days a month. The manager stated that it was hoped another people carrier would be available soon. Staff confirmed that some residents now go out on trips to local schools and go shopping etc. Several entertainers had visited Lennox Wood in Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 14 recent months and these included a guitarist, a belly dancer and a Christmas pantomime had entertained the residents. The majority of the entertainers had been booked to visit again. It was noted at this inspection that the home had moved to a more person centered care and away from a task orientated care. This was a definite improvement as it meant that the resident’s needs were a priority. The home had a warm friendly atmosphere. With the levels of dementia within the home it was not always easy to ensure full choices were given at all times, however staff were seen to offer choices where possible and where not possible gave full support and consideration. From the number of visitors seen on the day of the inspection it was evident that visitors were encouraged to come at any time and were familiar with the staff and felt comfortable in the home. Residents and families now benefit from a regular newssheet that is produced by the home. Residents and family meeting were once again taking place and the senior team dealt with issues raised. The home continues to deliver food to a high standard. A new comfortable visitors room has now been provided. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by a robust complaints system and service users and relatives feel their views are listened to and acted upon. The home has robust adult protection policies and procedures to ensure that residents are protected from abuse. EVIDENCE: The home had a complaints procedure in place, which included all the information required by this standard. Discussion with the Acting Manager confirmed that the home tries to resolve issues informally in the first instance. Evidence was seen of appropriate recording of complaints. There had been no complaints since the last inspection The home had an Adult Protection Policy including Whistle Blowing, which complied with the Public Disclosure Act 1998 and the Department of Health’s guidance No Secrets. Some staff spoken with at the previous inspection were able to demonstrate a good understanding of Adult Protection issues. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 16 Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some areas of the home continue to need to be refurbished for the benefit of service users. Infection control procedures have improved and residents now benefit from living in a safe, clean and hygienic environment. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 18 EVIDENCE: The badly chipped sinks in some of the bedrooms had still not been replaced. The acting manager stated that although the work had been approved it had not been completed. It was stated that the work should have been completed recently but an outbreak of diarrhoea and sickness in the home meant the work had been delayed. The inspector was assured the work would be completed by the end of February. The manager was asked to inform CSCI when the work was completed. The new beds recommended in the last report had been purchased and were in use. The laundry was again inspected and it was very disappointing to see that requirements made at the last inspection had not been fully complied with. The very old Butler sink had been replaced but the area around the sink had been left in an unsafe state with broken tiles and old support bars just left. This is a health and safety risk to staff who could easily cut themselves on the sharp edges. This area needs to be made safe. The acting manager confirmed that a new door was to be added to laundry so that a one-way system for dirty and clean clothing could be introduced. This has been mentioned many times in the past. The acting manager again stated that the work had been commissioned but again not completed. The organisation appears to have a problem with monitoring that work has been completed once approved and it will be recommended that a system be put in place to ensure that commissioned work is completed in a timely fashion. The manager was asked to inform the commission when this work had been completed. Infection control procedures had been improved, however the home does require a second dedicated container to ensure all soiled items are correctly and hygienically stored prior to collection. At the last inspection the refurbishment of the hairdressing room was discussed. Funding had been approved but the work had not started. It will be recommended that this work be completed for the benefit of the residents. The residents now benefit from having a small shop within the home to purchase sweets and toiletries. This is run by the staff. A new fridge had been purchased for the kitchen and the damaged shelves in the dishwasher had been replaced. A new carpet had been purchased for the acute dementia lounge. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 19 The call system had recently been serviced and the seven missing/broken handsets had been replaced /repaired. The home was clean and free from offensive odours. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents needs are met by the number and skill mix of staff. Residents benefit from staff that are caring, well trained and competent to do their jobs and who enjoy good morale. EVIDENCE: At the last inspection comments from several relatives included concerns over the staffing levels, particularly at weekends. This was again discussed with the Acting Manager who confirmed that it remained difficult to recruit staff to the weekend posts but that one permanent and some relief staff had been recruited thus ensuring a more stable staff group. The number of night staff was again discussed. Evidence was seen that the number of falls at night had reduced and the acting manager stated that this was mainly due to night staff no longer completing domestic duties such as laundry. They now had more time to spend caring for the residents. It is Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 21 acknowledged that some residents do not sleep regularly at night and these staff must continue to make them a priority. Management must ensure that this level of care remains in place A training matrix was examined and indicated that a considerable amount of training had taken place since the last inspection. All team leaders and completed an infection control course and a safe administration of medication course. All staff had completed a basic dementia course as required from the last inspection. Team leaders and relief team leaders had completed first aid course and had been booked to start a health and safety course in the near future. The majority of staff had completed manual handling and only a few remained untrained in this area. These were due to either sickness or childcare problems. The organisation is now training a team leader to enable her to become a moving and handling trainer. Both the assistant manager and the handyman had completed fire wardens courses and all staff had completed a basic fire awareness course. The acting manager was actively looking to source COSHH and palliative care training. The home has a high level of staff that have completed NVQ care level two or above. The home has sound recruitment procedures to ensure the protection of residents. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a service which is safe and well managed and run in their best interests. Sound financial procedures protect residents. Current arrangements were sufficient to protect the health, safety and welfare of residents and staff. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 23 EVIDENCE: The acting manager had been in post for approximately eight months. In that time she had clearly worked hard to improve the service and had improved the lines of management and accountability within the team. The staff had accepted that some changes had been necessary and had work well to accept the changes. As mentioned earlier in the report staff now worked to a more person centered care and away from a task orientated care. The acting manager is to move back to her substantive post as the registered manager has now returned.The home had benefited from her ethos, leadership and management skills. The home now had regular residents’ meetings and was run for the benefit of the service users. As mentioned in the last report sound financial procedures were in place to ensure residents financial interests were well managed. Comments from the last report: Residents’ personal monies were well managed. Families were encouraged to handle financial affairs but the home did deal with minimal amounts of personal monies for use within the home, such as hairdressing and chiropody. These accounts were seen to be well maintained and accurate. Three accounts were checked and found to balance. The home does have a safe and correct procedures for the receipt and storage of items were maintained. All of the records seen were secure and in good order. Checks to ensure the Health and Safety of the residents and staff were undertaken and found to be satisfactory. Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X 2 X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 X X 3 Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? yes 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 OP26 Regulation 13(3) Requirement Timescale for action 28/02/07 2. OP8 12(1) 3. OP19 23(b) The Registered Person shall make suitable arrangements to prevent infection; toxic conditions and the spread of infection at the care home in that the laundry is refurbished to the required standards. This has been carried over from the last inspection The registered person shall 28/02/07 ensure that the care home is conducted so as it promotes and makes proper provision for the health and welfare of service users in that oral hygiene is maintained. This has been carried over from the last inspection The registered person shall 28/02/07 having regard to the number and needs of the service users ensure that the premises are of sound construction and kept in a good state of repair in that the damaged hand basins in service users rooms are replaced. This has been carried over from the last inspection Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 26 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 OP26 Good Practice Recommendations It is again recommended that a door is provided in the clean laundry area to access the main corridor and prevent clothing being taken through the ‘dirty laundry’ area It is again recommended that training be provided in Palliative care It is again recommended that future maintenance planning takes into consideration the poor state of the window frames in some areas of the building. It is recommended that care plans be reviewed on a monthly basis. Records to be maintained that confirm reviews have taken place. It is recommended that the proposed work on the refurbishment of the hairdressing room be completed. It is recommended that the registered person ensures that a system is in place that confirms environmental work that has been approved for completion is actually completed in a timely fashion. 2. OP30 3. OP19 4. OP7 5. 6 OP19 OP19 Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Lennox Wood DS0000028942.V332113.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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