Inspection on 17/01/06 for Little Ingestre

This inspection was carried out on 17th January 2006.

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

Other inspections for this house

Little Ingestre 18/06/08

Little Ingestre 30/11/06

Little Ingestre 29/09/05

Little Ingestre 23/03/05

Little Ingestre 07/01/05

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Little Ingestre Ingestre Park Near Great Haywood Stafford Staffordshire ST18 0RE Lead Inspector Lorraine Mavengere Unannounced Inspection 17 January 2006 13:00 Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 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 Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Little Ingestre Address Ingestre Park Near Great Haywood Stafford Staffordshire ST18 0RE 01889 270410 01889 270410 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) Platinum care Homes Ltd Mrs Alison Jane Giles Care Home 15 Category(ies) of Learning disability (3), Physical disability (15) registration, with number of places Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 Service user over the age of 65 years Date of last inspection Brief Description of the Service: Little Ingestre is registered to care for 15 younger adults with physical disabilities including 3 who may have associated learning disability. The home is managed by Platinum Care Homes, based in Wolverhampton. Little Ingestre has been established for 20 years and many of the residents have lived there long term. The home caters for people with a range of disabilities, including visual impairment, epilepsy, cerebral palsy and head injury. The home is originally part of the Little Ingestre Estate and has extensive and well laid out gardens. The property has been extended and provides 13 single bedrooms, 6 with ensuite facilities and 2 double rooms, both with ensuite facilities. In addition there are assisted bathing facilities on both floors and adequate toilet facilities on both floors. A new shower room has been added to the ground floor. There are two lounge/dining areas on the ground floor, one smaller and quieter than the other. The home is situated in a rural setting on the outskirts of Great Heywood, Nr. Stafford. Access is via on unadopted road that, despite being re-laid several times is potholed. The home does not currently have access to a mini bus, consequently there is a reliance on staff vehicles and taxi transport to access the community and attend appointments. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place during the afternoon and early evening. Most of the service users were at the home during the inspection and some of them were able to contribute to the process. Information was gathered mostly through document reading, case tracking, discussions with the service users, the manager and staff and observations. The inspection was focused on inspecting the standards that were not assessed during the last inspection and focusing on the requirements made. Time was also spent interacting with service users and getting their views on the service, comments made are included in the inspection report. What the service does well: What has improved since the last inspection? What they could do better: The process for changing all documentation into the correct company name is still ongoing. The manager stated that this would take a little bit longer than Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 6 anticipated due to the organisational nature of the paperwork. In light of this, additional time has been allocated to ensure the standard is completed to a satisfactory level. Some gaps in care information were identified and must be filled. The manager must ensure that no blank spaces are left where important information should be. The quality assurance systems are still falling short of the standards and need to be developed in order to reach a level of compliance. Staff supervision is not taking place as frequently as is recommended by the standards. 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. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 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 Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Service users can only be admitted into the home following a full assessment. This enables service users to be appropriately placed. EVIDENCE: The home’s admissions policy was seen during the inspection. The home’s admissions policy enables prospective service users to be provided with a thorough assessment before entering the home. The initial assessment is carried out by the funding authority, once this is done, the home looks at the referral and if they feel they can possibly meet the prospective service users needs they will then go out and meet them their own environment and complete their own assessment. The assessments seen on care files during the inspection show that all areas specified in standard 2.3 are addressed. The statement of purpose specifies who the service is intended for and is clear that the home only accepts service users with physical and learning disabilities. It is recommended that the statement of purpose is amended to include the age range of the service users admitted to the home. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed on this occasion as they were covered in the last inspection. A requirement was made for standard 9 for the registered manager to ensure that an individual risk assessment was put in place for the mobile radiator in the bedroom of one of the service users who has a visual impairment. This has now been complied with. No other requirements were made in relation to the above standards. EVIDENCE: Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 15 Service users are given the opportunity to maintain and develop social, emotional, communication and independent living skills. Opportunities are made available for service users to participate in age, peer and culturally appropriate activities that meet their educational/ occupational needs. This enables service users to lead a more fulfilling life. Appropriate personal and family relationships are encouraged within the home enabling service users to have links and friendships with both people at the home and outside. EVIDENCE: The registered manager confirmed that service users are provided with opportunities to develop and maintain their social, emotional, communication and independent living skills. One service user participates in some of the household chores. The manager stated that in the home, household chores are not compulsory but residents are encouraged to take part in tasks such as tidying their rooms and living space. They are also greatly encouraged to participate in the daily running of the home. The rest of the residents choose not to participate in developmental programmes. The home ensures that Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 11 service users do not loose their living skills through input from the Occupational Therapist. Some service users still take care of their own personal care needs. The manager confirmed that service users are continually encouraged to maintain and develop their current level of skill and independence. Both staff and service users confirmed that they do have various leisure activities that the home organises; these are activities such as cinema evenings, body shop parties, garden parties, entertainment and theme food nights. In addition to this, some of the residents have their own leisure interests and hobbies. One resident enjoys his art work extensively and spends a lot of time doing that, another resident loves to read and will often ask staff to order Braille volumes of literature that she is interested in (she is visually impaired hence the Braille). These are just two examples of some of the individual hobbies that service users at the home engage in. The manager stated that some of the service users are due to be enrolled into college for the ‘Towards Independence Living’ course. Records show that service users access suitable educational and occupational activities through organised groups such as Scope and the Blind Club. The service users spoken to verified that they were happy with this level of provision and felt that their educational/ occupational needs were being adequately met by the home. It was quite clear that service users have the opportunity to maintain relationships with friends and family outside the home. Residents at Little Ingestre spoke very fondly of visits that that they had received form friends and family and the times that they had visited their loved ones. The registered manager confirmed that service users get the opportunity to make new friends outside the home through organisations such as scope, blind club, pubs and general outings. The manager reported with great excitement that the new mini bus that was talked about in the last inspection has now been purchased and now service users can go out a lot more. The service users themselves are thrilled at the prospect of more outings. The mini bus was seen during the inspection and is appropriate for its stated purpose. Service users therefore get the opportunity to spend time with friends and family who do not have the same disabilities as they do. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 Service users are provided with sensitive and flexible personal support. Their privacy, dignity and independence is upheld. The service users health needs are met and their welfare is safeguarded by the home’s policies and procedures. Administration of medication is carried out to a satisfactory level. EVIDENCE: Records show that many of the service users in the home receive personal care. Care plans seen outline individual personal care needs and give clear instruction as to how these are to be carried out. The more recent admissions to the home have new care plan formats that are highly individual and give room for service users to be consulted on their personal care preferences. The manager confirmed that the home is in the process of up dating all the care plans to be as individual and person specific as the recent ones. Discussions with service users confirmed that they are treated with respect at all times when personal care is being delivered; they stated that they felt that their privacy and dignity was upheld in as much as possible. Service users spoken to also verified that they chose their own clothes and staff preferences are never imposed on them. It was clear from records seen that additional specialist input is provided as required. There is currently a high level of input from Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 13 physiotherapists, occupational therapists and district nurses. Staff spoken to said that the times for going to bed and getting up are flexible. The manager confirmed that all staff are trained in first aid. There is a first aid box in the home and stocks for that are checked regularly. The home’s policy for administering medication was examined. The policy is robust and covers all areas highlighted in the standards. The policy covers the receipt and storage of medicines. There is a separate procedure for dispensing and administering medicines. The home uses a monitored dosage system provided by Boots Pharmacy. The system is colour coded with each colour representing a different time of the day. The home has an order sheet that ensures that medication is ordered in a timely fashion. The process for the receipt, storage and administration of medication is clear. At present, the home does not use any medication requiring refrigeration. The process for returning/ disposing of medication is also clear. During an examination of the drug room, it was noted that the home stocks controlled drugs. The system for managing and recording this is transparent. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home’s policies and procedures aim to protect service users from potential or actual abuse and act to promote their safety. EVIDENCE: The home’s policies and procedures for managing alleged, suspected or actual abuse are in line with the Staffordshire Interagency Policy on Vulnerable Adult Protection. The policy ensures the safety and protection of service users and is in accordance with the Public Interests Disclosure Act 1998 and Department of Health guidance No Secrets. The training schedule seen during the inspection shows that all staff have undertaken Adult Protection training. This training is also covered in the home’s induction programme. Since the last inspection, no concerns have been raised regarding the home, nor have any vulnerable adult proceedings taken place. The service users spoken to stated that they knew how to report any incidents of abuse and demonstrated that they felt well supported in so doing. Some of the service users at Little Ingestre have limited communication. Staff spoken to stated that they felt confident in recognising any out of the ordinary behaviour that might alert them to abuse. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The premises are suitable for their stated purpose and provide adequate living accommodation for the service users EVIDENCE: A brief tour of the premises showed that the location and layout of the home is suitable for the intended purpose; it is safe and well maintained; meets service users’ individual and collective needs in a comfortable and homely manner. Since the last inspection, the ramp has been replaced and is more user friendly. The gardens remain well maintained and the home is currently undergoing a programme of carpet renewal, general redecoration and major refurbishment of the kitchen. Although the home is in an isolated location, a mini bus has recently been purchased for their use to enable them access the local community more frequently. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35, 36 The home’s recruitment practices safeguard the safety and wellbeing of service users. The training and development programme ensure staff competence in dealing with service users’ care need. The minor short fall lies in the home being behind with training updates. Although staff are well supported and supervised, the supervision is infrequent and inconsistent. EVIDENCE: Staff records examined and discussions held with the manager indicated that a thorough recruitment procedure was carried out in accordance with the General Social Care Council (GSCC). Which complied with meeting the standard. All files contained two references, CRB clearance and a statement of terms and conditions. The home’s recruitment policy is also thorough and enables only suitable candidates to be considered far a post at the home. Documentation seen shows that the home has a comprehensive training schedule. The schedule highlights all assigned training for staff. The manager confirmed that all staff have to undergo an induction programme at the commencement of employment. Records seen show that staff are provided with training in all safe working practices such as manual handling, first aid, food hygiene and fire safety. All of these are, however, due for renewal. The Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 17 registered manager was able to show confirmation of these training dates; Health and Safety training and Infection Control Training are due in January 2006, Fire Safety will commence in February 2006 and Manual Handling training has been booked for April 2006. The manager is still awaiting date confirmation for the first Aid training and the NVQ enrolment. Supervision records were seen during the inspection. The frequency for staff supervision was not satisfactory. The registered manager must ensure that supervision is carried out at least six times a year. Discussions with the manager confirmed that the elements specified in standard 36.4 were generally included in the supervisory process. This was however not apparent in the supervision documents. The registered manager must evidence that all relevant areas are addressed during supervision. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 42 The home’s quality assurance systems fall below the required standard and therefore do not ensure that all views are taken into account and used to continually raise standards. The health, safety and welfare of service users is protected through its safe working practices and policies with some room to improve. EVIDENCE: Little Ingestre has a complaints procedure. The manager confirmed that this is used as a monitoring tool for quality assurance purposes. The Statement of Purpose, along with other policies and procedures, is reviewed every twelve months. The monthly (regulation 26) visits are carried out by the area manager, records of these are routinely sent to CSCI. The home provides service user questionnaires annually. As well, service users have the opportunity to discuss matters of quality at their monthly residents’ meetings. Records show that service users questionnaires are in depth and user friendly, addressing all relevant areas. The relatives’ questionnaires also provide service users’ family the opportunity to give their opinions on the service offered. The Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 19 home currently does not have stakeholder questionnaires. The company strategy was not seen during the inspection. The manager must ensure that stakeholder s’ opinions are sought and incorporated into the home’s annual plan. The annual plan must show that all opinions and views have been taken into account and are used to raise standards. The home’s electrical installation test certificate has now expired and is due for renewal. There was evidence that this has been initiated but a date for the work to be completed has still not been confirmed. The manager must ensure that this work is carried out as soon as possible. Water temperature records were seen to be fine on the day of inspection. The home has had two environmental Health inspections. Some requirements were made and most of them have been complied with. The home was required to completely replace the kitchen. The home proposes to start the work end of February 2006. The home is currently awaiting quotes from companies that are able to carry out this level of work. The other requirements were around ramp being redone and the garden being cleared. Both of which have been complied with. The only other outstanding requirement was the driveway that needs levelling out for health and safety purposes. Records show that all Health and Safety policies and procedures are in place. A check of some of the portable appliances showed that all portable appliances are tested annually. The last test for portable appliances was in July 2005. The home has a comprehensive Fire policy that states that all employees have to be trained in action to be taken on discovering a fire or on hearing the fire alarm It also states that fire alarm call points and emergency lighting is to be tested weekly. Records seen show that the home carries out these tests accordingly. Training records show that Fire safety last took place in April 2003. The registered manager confirmed that all members of staff have been booked for re training in this area in February 2006. Records show that the home has eight fire extinguishers and one fire blanket. There is a smoke/ heat alarm in every bedroom and throughout the premises. Automatic door releases are also checked once a week. Records seen show that fire drills take place once a month on average. The last fire systems service was carried out in September 2005. The home has a generic risk assessment file that covers all areas of environment and general risk. Records seen show that staff are provided with training in all safe working practices such as manual handling, first aid, food hygiene and fire safety. All of these are, however, due for renewal. The registered manager was able to show confirmation of these training dates; Health and Safety training and Infection Control Training are due in January 2006, Fire Safety will commence in February 2006 and Manual Handling training has been booked for April 2006. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 20 The manager is still awaiting date confirmation for the first Aid training and the NVQ enrolment. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X X X 2 X X 2 X Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA36 YA39 Regulation 18(2) 12(1), 24(1)(2) Requirement Staff supervision must be carried out at least six times a year. Quality assurance systems must be developed to include the views of relatives and stakeholders. The information must then be included in the home’s plan to raise standards. The electrical wiring test and service must be completed as a matter of urgency. Timescale for action 31/03/06 31/05/06 3. YA42 13(4) 31/01/06 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. 2. Refer to Standard YA2 YA35 Good Practice Recommendations It is recommended that the home’s statement of purpose include the age range of service users admitted by the home. It is recommended that all dated for proposed training are confirmed. Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Little Ingestre DS0000004973.V278450.R01.S.doc Version 5.1 Page 24 - 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. 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