Inspection on 15/04/08 for Lyncroft

This inspection was carried out on 15th April 2008.

CSCI found this care home to be providing an Adequate service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Lyncroft 12/05/06

Lyncroft 25/11/05

Lyncroft 27/01/05

Lyncroft 04/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Lyncroft 81 Clarkson Avenue Wisbech Cambridgeshire PE13 2EA Lead Inspector Alison Hilton Unannounced Inspection 15th April 2008 07:50 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 Lyncroft DS0000015124.V362427.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. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lyncroft Address 81 Clarkson Avenue Wisbech Cambridgeshire PE13 2EA 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) 01945 475229 01945 582497 www.countrycourtcarehomes.com Mr Abdulaziz Alykhan Kachra Position Vacant Care Home 39 Category(ies) of Dementia - over 65 years of age (3), Old age, registration, with number not falling within any other category (36) of places Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named individuals in category DE(E) for the duration of their residency 12th November 2007 Date of last inspection Brief Description of the Service: Lyncroft is a care home providing accommodation, care, and support for up to 39 older people. The home is situated approximately half a mile from the centre of the Fenland market town of Wisbech. The home is in an established building, which has been substantially extended. The rooms on the ground floor all have en-suite facilities and meet the requirements of the National Minimum Standards for care homes for older people. Rooms in the older part of the home on the first floor can be accessed by a stair lift. The home has recently extended its ground floor accommodation by four single en-suite bedrooms, but has not increased the number of people who can live in the home. There is also a new conservatory at the side of the home. The garden has been tidied now that work has been completed to ensure residents have a pleasant area to sit in. Five care staff are on duty during the daytime and three staff are on duty at night. The current charges are between £340 and £500 per week. There are extra charges for hairdressing, chiropody, toiletries and papers/magazines, telephone lines, TV licences, electrical tests for personal items and any other specialist service such as dry cleaning and escort duties to hospital, GP or other appointments. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We, the Commission for Social Care Inspection (CSCI) carried out a key unannounced inspection of Lyncroft on Tuesday 15th April 2008 at 07:50 hrs using the Commission’s methodology described below. This report makes judgements about the service based on the evidence we have gathered. A random inspection was undertaken on 12th November 2007 to follow up on concerns raised at an adult protection meeting. The findings were that the issues had been addressed. One requirement regarding medication was made. The contracts department for Cambridgeshire County Council completed a monitoring visit on 22nd February 2008. Staff, people who live at the home and the new manager were spoken to. An Annual Quality Assurance Assessment (AQAA) was completed and returned to the Commission prior to this inspection. It was received at the Commission on 16th January 2008. Surveys were sent to care workers, relatives and people living in the home. Five out of twelve staff surveys were returned. Two out of twelve relative’s surveys were returned and two from people living in the home. Information they provided will be in the body of the report. A number of records were seen, together with three staff personnel file and four files of people living in the home. There were thirty-six people living in the home on the day of inspection and three beds were vacant. The Manager was present for all the inspection and the area manager for the company for some of the inspection. What the service does well: Meals are freshly cooked and the choice of meals on the day of inspection was good. The cook asks each person about his or her preference for the meal. Appropriate referrals are made to the continence advisor. The home does not use bank staff or agency staff; therefore people living in the home have continuity in their lives. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 6 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. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 7 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 Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 8 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): 1,3,6 Quality in this outcome area is good. People are provided with information so they can make certain the home can meet their needs before they go to live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does not provide intermediate care and so Standard 6 is not applicable. Information supplied in the AQAA showed that the home has an up to date Statement of Purpose and Service User Guide, which clearly indicate the aims and objectives, range of facilities on offer in the home. It also shows that full assessments are completed before people come to live in the home to ensure their needs can be met. This was confirmed when the files for some of those living in the home were inspected. People spoken to during the inspection Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 9 could not remember if they had been part of a formal assessment of need before they came to live in Lyncroft (to assess the suitability of the home), but they did say they or a member of their family visited prior to their admission. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10, 11 Quality in this outcome area is adequate. There are care plans in place but these need to be implemented by staff, to ensure the well-being of people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Details provided in the AQAA showed that a plan of care for each person is completed to ensure their needs are met. Individuals’ preferences and choices are recorded. Changes to care plans are recorded and the person and their family are informed. Relative’s surveys showed that the home contacts them when accidents have occurred. Care plans and risk assessments are written but staff must ensure they complete and sign entries, and follow up on issues raised. For example one entry under mental health was “Wanders around the ----”. The score on one Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 11 nutritional risk assessment had not been fully completed. This could have meant that a high risk was not recognised, although this was not the case on this occasion as the person was already seen as high risk. The falls risk assessment for one person was high and family had been asked to provide supportive shoes in October 2007 but they had not been received (according to the care plan) and there was no evidence of what had been done about it. One family had signed an agreement that food could be liquidised but this was not dated. There was evidence in one file that the manager had requested a mental health assessment for someone in the home. A community psychiatric nurse (CPN) completed this on 9th April and a report was awaited. There was evidence on another file that the dietician had been involved with another person in the home. Information in the file of one person showed that he should be sat in a chair to eat meals and this was seen by the inspector. The care plan also showed that his food should be liquidised and this was also seen. The different foods had been liquidised separately and presented on the plate individually. Although the overall interaction between staff and people living in the home was good, there were times when staff missed opportunities to do so. This was the case for one lady who was confused and who was constantly getting up from her chair and ‘wandering’ out of the room. She was brought back into the room, told to sit in the chair and then staff left. The area of mental health in the care plan for this lady clearly states, “ Take time to sit with X.” This was not done all the time the inspector sat in the room, which was over 2 hours. This was discussed with the manager during the inspection. The medication administration record (MAR) sheets were correctly dated and the medication was recorded appropriately. The controlled drugs register was also seen and the details of medications were correct. The manager said that the District Nurse deals with pressure areas, but she is encouraging staff to accompany them so that they understand things like what pressure areas look like and how they are graded. Staff do complete turn charts where needed and these were seen as part of this inspection. The administration of creams for one person in the home was discussed with staff and they were clear when this should be done although this was not being recorded. The continence advisor was in the home to provide some training to staff. She commented that the manager makes appropriate referrals to her service. End of life wishes were detailed in the files inspected. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 12 Lyncroft DS0000015124.V362427.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): 12,13,14,15 Quality in this outcome area is good. People who live in the home are provided with some activities that encourage choice and control, although this could be improved. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Details provided in the AQAA showed that there are clothes parties, which enable people living in the home, who are unable to go to the shops, to choose their own clothes. There are parties for special times such as Mothers Day, Easter, Halloween, Bonfire Night and Christmas. Birthdays are celebrated with a cake. There is a yearly fete, which involves people who live in the home, staff, family members and those living in the community. There are entertainers, quizzes, religious services and outings. The home now has use of a minibus, which will allow trips out when the weather improves. People living in the home said that they liked exercises but this had not happened for some time. They confirmed there are sometimes quizzes but they were quite content to sit, read, watch TV and spend time in their rooms. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 14 Some said they did not want to join in activities, and although invited they were not forced to join in unless they wanted to. The manager said that the home has an activities co-ordinator for 20hrs per week, but they are looking at what activities are provided and intend to discuss this further with people in the home. Activities in March included Easter egg hunt, Easter bonnet judging, St Patrick’s Day celebrations, bingo, massage and nail painting. In April the organiser has been sorting out the activities room. The inspector gave the manager details of the National Association for Providers of Activities, (NAPA). The choice of meals on the day of inspection was good and the cook asked each person about their preference for the meal. On the day of inspection the choice was liver and bacon, sausages or vegetarian burger with mash, cabbage and cauliflower. Dessert was banana and custard, fruit or yoghurt. People spoken to said they enjoyed the meals in the home and there was always a choice. Relative’s surveys showed that meals are good and one said that her relative had started to eat since being at Lyncroft. People said they did not know if they had things to eat between meals but tea and biscuits were seen to be provided mid morning. Information from the relative’s surveys was “there is a monthly newsletter and notice boards”. Relatives spoken to during the inspection and some of the people living in the home said that visitors are always welcomed and tea is always provided. Details were displayed in the foyer of a coffee morning on 11th June and Fete on 2nd August. Lyncroft DS0000015124.V362427.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): 16,18 Quality in this outcome area is good. The home has a complaints procedure to ensure people who live in the home are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The AQAA showed that there had been one complaint at the home and that it had not been upheld. There have been no complaints received by the Commission at this time. There were no occasions when safeguarding adult referrals were made and no safeguarding adult investigations. Further information showed a quality assurance programme in place to improve services. The complaints policy is displayed in each bedroom and in the entrance hall of the home. There has been one Safeguarding Adults meeting in relation to people living in the home on 17th April 2008, which was attended by the new manager. Staff received training in Safeguarding Adults (formerly Protection of Vulnerable Adults or abuse training) in March 2008. Staff were able to inform the inspector about types of abuse and whether abuse could be resident on resident. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 16 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): 19,20,22,23,24,25,26 Quality in this outcome area is adequate. People living in the home have comfortable bedrooms containing many personal items providing a homely environment, however the conservatory has not been completed and means people not are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The garden has been tidied and there is now grass at the front of the building. The garden is secure, but there were wires protruding from the ground where lights should have been fixed, making it unsafe for people living in the home. The extension/conservatory has no electricity and there are bare wires where lights or fans should be attached. There need to be blinds or other methods of Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 17 protecting people who wish to sit and eat meals in the room as the sun can make the room very warm. The carpet in the hallway near the incline is worn. The manager was aware and said that this is being addressed. The area manager confirmed it. One lady who needs oxygen was moved into a much brighter room (formerly the office) so that her oxygen could be stored safely. The office is now in what was a back bedroom. There are some bedrooms that do not have en suite facilities. Bedrooms seen during the inspection were filled with personal items such as photo’s, pictures, soft toys, flowers and some items of furniture. The home smelt pleasant throughout the inspection. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 18 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): 27,28,29,30 Quality in this outcome area is good. The homes recruitment procedures have not been followed and this means that people who live in the home are not protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided in the AQAA states that there are 17 permanent care staff and 9 have NVQ Level 2 or above. Five further staff are working towards that qualification. The home does not use bank staff or agency staff; therefore people living in the home have continuity in their lives. It was evident that staff and people living in the home got on well and were seen laughing and joking together. Staff had good knowledge about individuals and how to meet their needs. Information given at other times showed that there should be 5 staff on duty in the morning, four in the afternoon and three at night. Staff had previously had staggered start times and it was difficult to ensure the correct numbers were in the home at the appropriate times. Staff rotas showed that there had been many nights when only two staff were on duty instead of three. The last Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 19 date this occurred was 11th April 2008. It was relevant that on several dates when only two night staff were on duty there had been falls reported. On speaking with the new manager she said that staff did not have staggered start times any more, there were five staff on duty all day, and three every night since she took over the management of the home. The rotas seen since her appointment confirmed this. One relatives survey showed that sometimes when the call bell is rung (for assistance) it is not answered quickly enough meaning their relative has “an accident”. Speaking to people living in the home this was not the general opinion although there were times when it was recognised that staff were busy and not always able to come instantly, but it was felt calls were usually answered in good time. One person commented that there was one call bell that was not working. This was discussed with the manager who said that she was aware of this and had bought replacement batteries to fit that day. The home has appointed an administrator who deals with what is necessary in the office. There are two domestics who work Monday to Friday 8am-1pm. (Care staff complete any cleaning tasks over the weekend.) The domestics said all their statutory training was either up to date or planned. One has NVQ Level 2 in Care and the other is undertaking NVQ Level 2 in cleaning. The laundress was spoken to and she is also doing NVQ Level 2 but in laundry services. Care staff said they had either had training recently or it had been arranged over the next few months. The manager pointed out training dates displayed on the notice board and they included incontinence training, care planning and an all day event to cover First Aid, Health & Safety and dementia. Training that had already been provided in 2008 included catheter care, eye care, adult abuse, infection control, manual handling and fire safety. The three staff files seen as part of the inspection had most of the necessary information. One file had one written reference. All had terms and conditions and details of training and supervision. There has been one staff meeting since the new manager took over. There has also been one involving people who live in the home and their relatives. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 20 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, 33, 35, 36, 37, 38 Quality in this outcome area is good. The home has a manager who is providing the necessary guidance and direction to ensure residents receive consistent care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The area manager said that the owners had informed the Commission that they had appointed a new manager for Lyncroft. The new manager started work at the home on 31st March 2008 and shadowed the previous manager for two weeks. She has made considerable changes within the home since taking over on 14th April. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 21 The manager is aware that she must apply for registration with the Commission. She has NVQ Level 4 in Care and the Registered Managers Award. She has been a manager within the company that own Lyncroft for some years and has the necessary experience. The manager said that only personal allowances are held in the home and credit and debit entries are made. The manager audits these once a month. Families are requested to top up when necessary. Some people have major finances dealt with under Power of Attorney and some with the assistance of their family. Fire evacuation information is now by each fire exit so that staff and the fire service have details of where people are situated and the layout of the building. How to exit the building and other information is also detailed. The Environmental Health service inspected the home in February 2008 and provided a good report. There were wires protruding from the ground in the garden where lights should have been fixed, making it unsafe for people living in the home. The extension/conservatory has no electric and there are bare wires where lights or fans should be attached. There need to be blinds or other method of protecting people who wish to sit and eat meals in the room as the sun can make the room very warm. These issues have also been raised in the area of Environment, (Standards 19-26). The office is now situated at the back of the building in what was a bedroom so that a person with special needs could be accommodated in a suitable room. All the necessary fire checks are completed and recorded in the appropriate book. Accident forms were checked as part of this inspection. An effective quality assurance system should be in place to ensure the aims and objectives in the home are being fulfilled. This should be done using the views of people living in the home, their families and any other people such as GP’s, District Nurses and Care Managers. The manager said that the last manager had carried out a survey but no report had been completed. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 22 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 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 3 X 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement Timescale for action 01/06/08 2 OP19 3 OP19 4 OP25 5 OP29 Care plans and risk assessments must be fully completed, signed and dated to ensure the safety and well being of people living in the home. 23 (2) ( c) The conservatory extension must have the necessary lights and fixtures to ensure the comfort of people living in the home. 23 (2) (o) Bare wires and other wiring in relation to garden lights must be dealt with to ensure the safety of people walking in the garden. 23 (2) (p) Ventilation and shade must be provided in the conservatory so that it is suitable for people who live in the home. 19 All staff must have the necessary Schedule checks and information on file to 2 ensure the safety of people living in the home. 01/07/08 01/07/08 01/07/08 15/04/08 Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 24 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 OP33 Good Practice Recommendations There should be an effective quality assurance system so that any improvement in the provision of care can be measured. Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Inspection Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Lyncroft DS0000015124.V362427.R01.S.doc Version 5.2 Page 26 - 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!