Inspection on 22/11/06 for Magnolia House

This inspection was carried out on 22nd 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Magnolia House 03/09/07

Magnolia House 22/11/05

Magnolia House 11/07/05

Magnolia House 30/01/05

Magnolia House 27/07/04

Magnolia House 08/01/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Magnolia House 11 Station Road Biggleswade Bedfordshire SG18 8AL Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 22nd November 2006 3:35 Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Magnolia House Address 11 Station Road Biggleswade Bedfordshire SG18 8AL 01767 315562 01767 317586 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.communitycaresolutions.com Community Care Solutions Limited Bridget Uffang Care Home 5 Category(ies) of Learning disability (7) registration, with number of places Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home can accommodate a maximum of 7 people, 5 in the main house and 2 in the bungalow. The home can accommodate a maximum of 7 people in the category learning disability (LD) The home may accommodate up to 1 person who has a service user physical disability or sensory impairment if their primary assessed need is a learning disability. This person must be accommodated in the ground floor bedroom of the main house. The bungalow must only be used for those service users that are working towards more independent living as part of their agreed plan of care. 24th April 2006 4. Date of last inspection Brief Description of the Service: Magnolia House was first registered in 1999 to provide residential care to 5 adult service users - 3s with learning disabilities. The home is a family house which has been extended to provide five single bedrooms, one of which is on the ground floor, a large kitchen/diner, lounge and conservatory. There are bathing and toilet facilities on both floors and a small office/sleep-in room on the first floor. The home is within walking distance of Biggleswade town centre, with its shops, library, pubs and places of worship. The current service user group are all between 25 and 50 years and all have learning disabilities. They also need varying degrees of support with behaviour that may be challenging. The home aims to enable people to live as independently as possible whilst receiving care and support to enable them to access the local community. The fee was in the range of £ 946/- to 1,628/-. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the unannounced key inspection carried out on 22/11/06 over 3 hours by pursotamraj hirekar. The method of inspection included review of outstanding requirements, study of care plans, risk assessments, staffs’ files. Discussion with the service users’, staffs on duty and the manager, partial tour of the premises and observations. The manager had coordinated the entire inspection. What the service does well: 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. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 6 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 Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements for the assessment of individual aspirations and needs. However, 2 service users’ assessed needs fall outside the categoty of registration. EVIDENCE: The random inspection report of 25/04/06 noted that in response to the recommendation made in the unannounced inspection report of 22/11/05. Two service users whose case were tracked on this random unannounced inspection indicated that needs and risk assessments were reviewed by the manager and the key worker on 20/12/05 and for their details please refer under outcome group individual needs and choices in this report. 1 new service user was admitted to the home on the 07/04/06 prior to the random inspection of 25/04/06. The individual service user’s care plan that was presented on this inspection had taken into account the needs and associated risks which included behaviour, accommodation, personal care, medication, medical needs, domestic tasks, technical aids, communication, choice/freedom/protection, family, personal counselling, social life, activities, day care, faith issues, financial, transport, illness, ageing, death & dying wishes. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 8 The home had 2 service users’ assessed with schizophrenia and 2 service users’ assessed with autism disorders. This issue was discussed with the manager, area manager, and the operations manager. The operations manager had agreed to make an application to the commission for varying category of registration. Since, the current registration is for learning disability category of service users’. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had reviewed the risk assessments and updated the careplans to incorporate the changing needs and aspirations of the service users’. EVIDENCE: The random inspection of 25/04/06 detailed the service users’ case tracked as follows. Service user –1 risk assessment reviewed on 20/12/05 - passive smoking reviewed on 20/12/05 status continues, front door of the home saftey - not reviewed because service user - 1 doesnot leave the home without staff - this need to be recorded, service user - 1 - challenging behaviour not reviewed yet manager suggested to complete the review before 26/04/06. Breakdown of skin condition due to poor hygeine - reveiewed on 20/12 and the status continues, using the shower unaided not reviewed because service user - 1 does not use shower any more need to be recoreded in the file. Service user Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 10 1 hurting herself whilst having bath unassissted not reviewed because service user - 1 does not have bath unassissted need to be recorded. Service user - 1 hurting herself whilst using razor unassissted not reviewed because service user - 1 doesnot use razor any more need to be recorded, service user - 1 suffers from epilepsy revieweed on 20/12/05 - satus continues, service user 1 not maintaining heaservice user - 3hy diet not reviewed because service user - 1 doesnot over eat and maintains heaservice user - 3hy diet need to be recorded, service user - 1 manuevering and handling objects around the house reviewed on 20/12/05 - status continues, service user - 1 cleaning her home reviewed on 20/12/05 - status continues, service user - 1 preparing hot drinks not reviewed because there is no risk in this area however need to be reviewed and recorded in the the risk assessment of service user - 1, service user - 1 using technical aids reviwed on 20/12/05 status continues, service user - 1 communication revewied on 20/12/05 status continues, service user - 1 family contacts reviewed on 20/12/05 status continues, service user - 1 presenting socially unacceptable behaviour reviewed on 20/12/ status continues, service user - 1 attending day care reviewed on 20/12/05 status continues, service user - 1 cuservice user - 3ural needs reviwed on 20/12/05 status continues, service user - 1 financial management/exploitation by others reviewed on 20/12/05 status continues, service user - 1 using company vehicle reviewed 20/12/05 status continues, service user - 1 being approached by other people regarding her vulnerability reviewed on 20/12/05 status continues. Careplan reviewed on 20/12/05 signed by the manager, service user - 1 and key worker. careplan of service user - 1 reviwed and recorded under personal care and hygeine that service user - 1 would be encouraged to be independent in washing her her and shaving (razor) and regarding overwieght of service user - 1 the care plan reviewed on 20/12/05 recorded that the home should provide staff assisstance to help service user - 1 maintain heaservice user 3hy diet this was not reviewed in the risk assessment. The manager need to build a linkage between the risk assessment and the careplan in other words the outcome of risk assessments have to be reflected in its totality in the care plan incliding all changes that have taken place from the previous risk assessment . Service user - 2 Risk assessment was carried out on 27/10/05 for smoking, front door lock saftey, and further risk assessment was carried out had no specific date but in 12/05 for using shower unaided, maintaining a heaservice user - 3hy diet, administartion of medication, using vacum cleaner, preparing hot drinks, preparing cold snacks, manouvering and handling of objects around the home, using technical ids, communication, being approached by outsider regarding sexual exploitation/ vulnerability, family contacts, challenging behaviour, day care activities, financial exploitation, using company vehicle, displaying socially unacceptable behaviour. The risk assessment were not signed by the manager or key worker. Service user - 2 careplan was prepared in the month of 12/05 and a brief quarterly review was carried out in the presense of social worker in the month of 02/06. However, the dates recorded Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 11 on the careplan are 08/05. and quarterly review dated 11/05 and signed by the manger, social worker, key worker and service user, social worker dated as 24/02/06. The manager had explained that since service user - 2 had moved in 08/05 therefore the careplan dated 08/05 but however the risk assessment were carried out in 12/05. How can the careplan be prepared without carrying out a complete risk assessment. Service user - 3 does not like the help of any staff for bathing. However, the risk identified include service user - 3 would need some assisstance whilst bathing, The manager said she would review and the need and appropriately provide the care. Service user - 4 expressed to have the help of the female staff to help him whilst bathing instead a male staff. The manager said it was not appropriate for a female staff to help service user - 4 whilst bathing because service user - 4 may demonstrate unacceptable behaviour during the bath. Therefore, the manager would review the needs of service user - 4 and explain him what the home can provide to him. The manger suggested that she will redo the careplan to reflect the risk assessment outcomes carried out in 12/05. This would be completed before 15/05/06. On this key inspection of 22/11/06, 3 service users’ were case tracked. 1 service user was common and the other 2 service users’ were different from the random inspection of 25/04/06. There has been an improvement over the previous gaps indentified in the random inspection of 25/04/06. Individual risk assessments of service user – 1 was carried out in april 2006, service user – 2 on 17/05/06 and service user –3 in may 2006. The areas of risk assessments included accomodation risk assessments, personal care risk assessments, medication, domestic tasks, technical aids, communications, choice/protection/freedom, family, counselling, day care activities, financial, transport and other. the 3 service users’ who were case tracked, their care plans were prepared on the basis of the current risk assessments and the outcomes of the care plan review. the care plans have taken into account the changing needs and aspiration s and the associated risks for the overall well being of the service users’. the details that included were changing behaviour of the service user, visit to gp, visit to community nurse, chiropodists, dentist, optician, psychiatrist, psychotherapist and service user - 4ysiotherapist. the details have included; accomadation, personal care, medication, medical needs, domestic tasks, technical aids, communication, choice, freedom and protection, heaservice user - 3h, family, personal counselling, social lofe and day care activities, faith issues, financial management, transport and death and dying wishes. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had consultations with all service users’ and developed activites that meet the individual service users’ needs and aspirations to achieve quality of life goals. EVIDENCE: The random inspection of 25/04/06 noted that weekly activity review and report of all the 7 service users were seen. They were regularly reviewed and updated. That include inhouse activities such as music, doing puzzles, walks, watching movies, dancing, coloring, going out for a drive and swimming. These were decided in consultation with the service users. The service users were comfortable with the proposed changes. However, the manager will have to sign all the records. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 13 On this key inspection, it was found that the home had a flexible food menu and meal times that would enable the service users’ to have their choice of food that meet their dietary needs. individual service user specific weekly day care and inhouse activitiy plan was prepared. these activities included wood work, animal welfare, wash wipe, snoozeleen, food preparation, tidy room, aromatherapy, pub putting, drama, escort gateway club, art&craft, service bus, cinema and hoovering. the home had encouraged the service users’ to have meaningful realationships with their family members. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed personal and health care needs of the service users’ were met as per the care plan. EVIDENCE: The random inspection of 25/04/06 noted that the documents relevant to receipt, store, administration, and disposal of medicines were seen. The home had maintained records relating to receipt, returned medecine, and administration of medicine service user wise. The medicine were stored in a locked cupboard accessible only to the designated staff member of the home. The administartion of medecine was handle by trained staff of the home. On this key inspection it was found that a separate weekly drug check record was maintained for each service user. Please refer under individual needs and choice outcome group of this report for additional information. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements with regard the complaints policy and procedures. EVIDENCE: The random inspection of 25/04/06 noted that the home had a robust complaints policy and procedure which was discussed and explained to the service users in their monthly residents meeting - 09/01/06. This was confirmed by the service users spoken too. The service users were aware of whom to complaint if need be. On this key inspection, it was found that there were no complaints recorded since the random inspection of 25/04/06. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and safety checks of the home were carried out. EVIDENCE: The random inspection of 25/04/06 noted that the home now had made arrangements in the shower room on the ground floor with mirror fitted on the wall and toilet seat had been replaced. On this key inspection it was found that, the home had an improved system and procedures in place to regularly monitor the bath and shower water temperature checks. unit specific record is now mainatined. Weekly temperatures of upstairs, down stairs and medicebne/kitchen area were recorded. weekly fire alarm break glass point test and inspection record was maintained. Monthly fire evacuation record was maintained, monthly alarm activated door release checks were recorded, monthly emergency lighting Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 17 record was maintained, monthly nurse call alarm system was maintained, fridge/freezer temperature records were maintained. The lounge, kitchen, and the dinning had new flooring and were decorated. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had a good skill mix of staff. However, additional staffs’ needed training to ensure sustainable delivery of care for those service users’ who were assessed with mental health needs. EVIDENCE: The home had developed a summary information for all the staffs’ detailing their profiles and statiutory checks, 3 staff’ summary information was seen and found satisfactory. 7 staffs’ supervision that had taken place on 19/9/06, 20/09/06, 21/09/06 and 25/09/06, all these supervisions were carried out by the manager and signed by the supervisee and the manager. The home had a service user key worker system in operation. The home had prepared a detailed staff training assessments, as on november 2006, 4 staffs were currently part of the medication work book training and 1 staff was booked on pova and 1 staff was booked on manual handling training for november 2006. The home currently had 2 service users’ assessed with Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 19 shizophrenia and 2 service users’ assessed with autism. the home should plan to train additional staffs in tune with the assessed needs of service users’. Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The home was managed well. The manager and the staffs work as a team in the interest of service users’. EVIDENCE: The random inspection of 25/04/06 noted that the manager had made several attempts to meet the outstanding requirements and recommendations as was narrated under various outcome groups. the care planning review are discussed in detail under individual needs and choices outcome group, please refer for details. the home now had a registered manager. it was observed from the preinspection questionnaire record that the home had completed the review of all the relevant policy, procedures and codes of practice in the month of March Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 21 2006 and all the staffs had access to the same. the home had monthly quality system audit in place. The home had internal monthly monitoring system which included areas such as medication, staff meetings, supervision and appraisal, careplans, risk assessments, that had reinforced qualitaive improvement in the home. the home had weekly activity monitoring system which included care plan reviews, staff supervision/appraisal, service users’ daily activities, staff issues, service users’ issues, complaints and compliments. the latest weekly review was dated 20/11/06. The manager and staffs appeared to be working as a team and had good working relationships that benefit the service users’. Magnolia House DS0000014934.V318243.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 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 1 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEASERVICE USER - 3HCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 23 No 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. Standard YA3 Regulation 14 Requirement The home must ensure to make an application to the commission for varying category of registration of service users’ with mental health needs. The home must make arrangements, by training adequate staffs’ to work with service users’ who have mental health needs. Timescale for action 31/12/06 2. YA32 13 (6) 15/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Magnolia House DS0000014934.V318243.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Teleservice user - 4one: 0845 015 0120 or 0191 233 3323 Textservice user - 4one: 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 Magnolia House DS0000014934.V318243.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. 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!