Inspection on 01/11/06 for Magdalen House

This inspection was carried out on 1st November 2006.

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

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

Other inspections for this house

Magdalen House 23/10/08

Magdalen House 15/03/06

Magdalen House 24/08/05

Magdalen House 07/03/05

Magdalen House 27/09/04

Magdalen House 16/02/04

Magdalen House 22/09/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Magdalen House 98 London Road Gloucester Glos GL1 3PG Lead Inspector Mrs Eleanor Fox Key Unannounced Inspection 1st November 2006 09:15 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 Magdalen House DS0000016497.V314537.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. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magdalen House Address 98 London Road Gloucester Glos GL1 3PG 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) 01452 386331 01452 384368 The Gloucester Charities Trust Mrs Hazel Newman Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2006 Brief Description of the Service: Magdalen House is a purpose built care home, which provides nursing care to twenty-nine elderly residents. The home is within walking distance of the city of Gloucester and is on a main bus route. A qualified nurse is on duty at all times. Health care services are available to all residents. The accommodation is arranged on two floors, accessed by a large passenger lift. There are twenty-seven single rooms and one double room, all with ensuite facilities. There are four well equipped bathrooms to suit all needs and level of ability. All rooms have a call bell. The communal areas include comfortable lounges on each floor, a dining room attached to the lounge on the ground floor, a garden room and seating in the reception area. There is level access to the spacious gardens that surround the property. There is a daycentre adjoining Magdalen House. This area is used by other organisations, and also for evening and weekend functions arranged by the home. Residents from the warden-controlled flats, within the complex, also have access to the home’s catering facilities if they wish. A dining area is available on the first floor for this purpose. The provider supplies information about the home, including the most recent CSCI report to anyone who has expressed an interest. The details are maintained in a file, which is displayed in the front hall of the home. Current fees are £605 per week and £650 per week for respite care. Hairdressing and any personal items are charged extra; the individual prices are available in the home. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the home and takes into account the views and experiences of people using the service. One inspector undertook this unannounced inspection of Magdalen House over two days in November 2006. During the visit, she chose the care of three of the residents for particular scrutiny. She spoke to each of these people, read their care records, visited their bedrooms and, where possible, observed their interaction with members of staff. The inspector read selected personnel and recruitment records, walked around the property, observed the service of a mid day meal and watched the residents’ participation in a social event during her visit. She also spoke with some of the staff who were on duty on these days. Finally, she had the opportunity to talk to the Manager and the two administrators, particularly in relation to general management issues. All were open and most cooperative in providing information as requested. CSCI surveys were distributed to residents, relatives and members of staff working at the home. Sixteen were returned from residents although in the majority of cases, a relative or named member of staff completed the form for them; two completed surveys were received from staff and seventeen comment cards were sent in from relatives and advocates. Many of their comments and opinions are reflected in the content of this report. What the service does well: Thorough assessments are undertaken on each prospective resident to ensure that Magdalen House is able to meet all their care needs. Detailed care documentation is prepared for each person; the thorough content gives clear information to the carers of the particular needs of each resident. Residents are treated with courtesy and friendly respect. Fourteen of those people who responded to the questionnaires made positive comments about the staff with one person saying, “The staff are so kind; they always come straight away if I need anything.” Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 6 A very good standard and variety of food is served in this home; every effort is made to satisfy individual needs and preferences. Residents are accommodated in most attractive and comfortable surroundings; the furniture and furnishings have been chosen to suit the needs and preferences of the people living in the home. Each staff applicant for a post at Magdalen House is subject to robust recruitment processes. All new members of staff are fully inducted to their roles. The home has the benefit of strong leadership and committed focussed management. There is also a good focus on improving the quality of care provided to residents at the home. 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. Magdalen House DS0000016497.V314537.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 Magdalen House DS0000016497.V314537.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A thorough assessment process gives prospective residents assurance that their needs will be met at Magdalen House. EVIDENCE: Each person is fully assessed prior to admission to Magdalen House to ensure that the home is able to meet his or her needs. All the completed records for one person who had recently been admitted to the home were read on this occasion. Not only had the Manager completed a very thorough documented assessment, but the hospital staff had also provided an informative document about this person; the home also had a copy of the Social Worker’s assessment on file. These details had all been available to assist the nurse in developing the care planning documentation when the resident was admitted to the home. Intermediate care is not provided at this home. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The care planning systems in place provide the staff with the guidance they require to care for the residents’ needs. Some minor improvements in the medication administration systems are required to ensure that residents are not put at any risk of potential errors. Residents are treated with courtesy and respect. EVIDENCE: Written care plans are developed for each resident based on a full assessment of care needs. In each example seen on this occasion, clear and appropriate guidance had been recorded for the members of staff providing care. Where there had been any changes in condition, these had been identified at the reviews and documented. It is recommended that reviews be undertaken once a month to ensure that any changes in condition are identified in a timely fashion. At present there is no documented evidence that residents are Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 10 involved in the preparation of their plans. However, discussion with one lady showed that she was quite satisfied with the care she received. Discussion with the residents and observation of the care documentation shows that the residents are receiving care from external medical personnel when required. Regular monitoring of residents’ weights is conducted, particularly if there is any deterioration in the resident’s physical condition. Nutritional supplements are provided when required. The risk of possible vulnerability to developing pressure sores is also assessed and pressure relief equipment provided if required. Medications are ordered and stored correctly. Photographs of each resident are provided to aid identification. A recently published pharmaceutical reference book is provided to aid staff when administering medications. The medication policy was reviewed and updated in July 2006; it is readily available to all the staff. It was observed that handwritten medications relating to two of the selected residents had not been signed by the nurse making the record and countersigned by another witness. This good practice should be introduced at the home. It is recommended that clear English should be used on the medication administration sheets; there should be no abbreviations or instructions in Latin to ensure complete clarity. Members of staff were observed speaking to residents in a polite but friendly manner. Interaction between the staffing team and the residents was particularly positive during the service of the lunchtime meal and during an activity, which was arranged; there appeared to be a very good rapport between all those present. There is a notice in the main hall confirming that it is part of the home’s philosophy to respect residents’ privacy and dignity. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Improved opportunities are provided for varied and stimulating activities and social contacts, as desired. A commendable choice and variety of meals ensures residents receive a nutritious and balanced diet. EVIDENCE: The home is working to build on the provision of suitable activities and stimulation for residents living at Magdalen House. An assistant has recently been employed to help the activities coordinator who covers all the Gloucester Charities premises. Entertainers come into the home on a regular basis. During the inspection residents enjoyed singing and in some cases, dancing to the music provided by a lady playing the organ. Trips out in the minibus are arranged, usually once a week. Quizzes, music and movement, games and other events are also arranged. A firework evening was planned shortly. There is a Chaplain living near to the home who provides Communion Services and pastoral care for the residents, as desired. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 12 Family and friends are welcome to visit whenever the resident wishes. Families are invited to attend special events when they are arranged at the home. The majority of relatives who spoke to the inspector and who responded to the questionnaires were extremely supportive of the home and the staff working there, one person writing, “Magdalen House provides the highest standard of resident care out of any care home I have seen in the Gloucester area”. A visitor said,” It is so friendly here, I enjoy calling in”.. Staff were observed offering residents choice during the day, particularly about food, how they spent their day and about the care they received. The preparation and service of the main mid day meal was observed during the visit. The majority of the residents ate their meals in the main dining room; some chose to remain in their bedrooms. A commendable standard of food was offered and most people appeared to enjoy what they were eating. Some required some degree of assistance or gentle encouragement. Staff were seen to be attentive and supportive, giving residents time to consume their meal at their own pace. Nutritional supplements were offered where appropriate. Discussion with the catering staff on duty showed that any particular catering needs or requests had been communicated and were addressed. One person suffers from a digestive disorder; another has specific religious requirements. Arrangements are made to ensure that these people’s dietary needs are met. Although one person commented on “the bland food”, in the main, all those who responded to the surveys or spoke to the inspector were very positive in their comments. One person said, “The food is wonderful” and another said, “If I don’t like what is being offered the chef always makes me something else”. The kitchen was clean, tidy and well organised. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A satisfactory complaints system enables residents and their families to feel assured that their views would be listened to and acted upon. Some additional staff training is required to ensure that residents are offered a good level of protection against abuse. EVIDENCE: The complaints procedures are well advertised in the home, providing residents and their families with clear guidance on the processes to follow if they wish to raise a concern. One relative wrote, “ I did have to make a complaint but it was dealt with very quickly and I have had no further problems.” One complaint has been referred to the Commission for Social Care Inspection in recent months. This was thoroughly investigated internally and the matter resolved. The home does have documented policies to address abuse issues and whistle blowing processes; these have now been reviewed and updated appropriately. All the policies are readily available to staff and those questioned were aware of the contents. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 14 Although these matters are addressed during National Vocational training, the remaining staff employed at Magdalen House have not received recent training on this important subject. This must now be rectified. POVA (Protection of Vulnerable Adults) legislation is correctly followed at Magdalen House. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 24 and 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. A comfortable and homely environment has been created for the residents living at Magdalen House. EVIDENCE: During a walk around the building it was observed that the whole home was warm, well ventilated, clean and fresh. The garden was also well maintained. Attractive furnishings and sturdy furniture has been provided throughout the property to suit the needs of the residents living at Magdalen House. Since the last inspection a replacement call bell system has been installed. A visit was made to the bedroom of each person who had been selected for case tracking. All the rooms had been personalised with photographs and Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 16 treasured possessions. Each had the benefit of en suite facilities. One lady was particularly delighted with the view from her window. She commented, “This is my refuge. I feel safe and sound with all my bits and pieces. I love to look out at the pretty view – it is so peaceful here.” The laundry is equipped with industrial style machines; it was tidy and organised with washing segregated appropriately. Residents’ clean personal clothing was discreetly named and stored separately in preparation for return to their bedrooms. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents receive care from a stable care team, which is subject to robust recruitment processes but additional training opportunities would help to ensure the residents are fully protected. EVIDENCE: There were twenty-eight residents living in the home at this time. During the inspection it was observed that there were two nurses and eight carers on duty each morning (these reduce to seven carers at weekends), a nurse and five carers each evening and a nurse plus three carers during the night to care for the residents living at Magdalen House. Those questioned considered that these numbers were adequate at the current time. However, two relatives have remarked in the questionnaires that the home is sometimes short of staff. The residents have confirmed that the staff are normally available when they need them. Of the twenty-eight carers employed at the home, nine have achieved a National Vocational Qualification, Level 2 or equivalent, and four are undergoing the training. A further three carers have been awarded an NVQ, Level 3 in care. The home is progressing well towards ensuring that at least 50 care staff are trained to National Vocational Qualification, Level 2 in Care or equivalent. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 18 Personnel files relating to the three staff employed since the last inspection were read in detail. Each person had completed an application form providing a full employment history. Records had been maintained of the interview processes and POVA (Protection of Vulnerable Adults) and CRB (Criminal Record Bureau) screening had been completed. Two written references were provided for each applicant. There was also comprehensive evidence that each person had been fully inducted to his or her respective post. Thorough induction is provided at this home. It was confirmed that only a limited number of staff have attended any formal training courses in recent months. However, most of the staff were updated in manual handling earlier in the year; those that still require this mandatory tuition will be addressed before the end of 2007. The staff have not received any recent training on abuse issues or caring for people with dementia care needs or for managing aggressive behaviour. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The effective implementation of the home’s policies and procedures ensures that the home is well managed and the residents’ rights upheld. EVIDENCE: The Registered Manager, an experienced trained nurse has successfully completed the Registered Manager’s Award. She has not had the benefit of a deputy for the last five months, which has added to the pressure of the role but does receive able support from her two part time administrators. Verbal comments and remarks in the completed questionnaires show that the manager is well respected by the residents, their families and the staff. There are procedures in place to monitor the quality of the service provided by Magdalen House. Quality assurance questionnaires are circulated to residents Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 20 and their families on an annual basis. Any issues identified for improvement are then addressed. This exercise has not yet been undertaken for 2006 although completed documentation for previous years was seen in the files. In addition, residents’ meetings are arranged at least twice a year; residents’ suggestions about improved activities have now been addressed. Medication processes are audited four times a year. Trustees from the Gloucester Charities Trust also monitor the performance of the home on a monthly basis. The administrators look after the personal monies for some of the residents. These are kept in individual envelopes and are locked away securely. All transactions are fully documented and countersigned. Checks of the files relating to the residents selected for case tracking showed that these are all recorded accurately. Each resident’s status in relation to ‘Power of Attorney’ is also maintained on file. Health and safety is generally addressed reasonably well at this home. An external specialist has just undertaken a full risk assessment of Health and Safety issues and the identified concerns will now be addressed. At present there is no evidence that water temperatures are tested at outlets on a regular basis. This practice should now be introduced. However, it was confirmed that residents are always supervised if they are having a shower or bath and there are temperature controls installed in the hot water system. The home was also not able to demonstrate that the hot water systems have been tested for Legionella. Records were provided to show that maintenance of equipment is addressed in a timely fashion and arrangements are being made to rectify the ongoing passenger lift problems. The cupboards in the laundry, used for the storage of chemicals and cleaning agents, are now kept securely locked. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 3 x x x x 3 x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13(2) Requirement The person making the record in the drug administration documentation must sign any handwritten amendments. A witness must also countersign the record. Staff must receive training on abuse issues. Staff must receive training in caring for people with dementia care needs and in dealing with aggressive behaviour. The home must demonstrate that the hot water systems are free from Legionella. Timescale for action 30/11/07 2 3 OP18 OP30 18 (1c) 18 (1c) 28/02/07 28/02/07 4 OP38 13(3 & 4) 28/02/07 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 OP7 Good Practice Recommendations It is recommended that the resident or advocate should DS0000016497.V314537.R01.S.doc Version 5.2 Page 23 Magdalen House 2 3 4 5 OP7 OP9 OP28 OP38 sign the care plan to signify agreement with the content. It is recommended that reviews of care plans should be undertaken once a month to ensure that any changes in condition are identified in a timely fashion. It is recommended that clear English should be used on the medication administration sheets – no abbreviations or instructions in Latin. At least 50 care staff should be trained to National Vocational Qualification, Level 2 in Care or equivalent Hot water temperatures should be checked at outlets on a regular basis. Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Magdalen House DS0000016497.V314537.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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