Inspection on 02/10/06 for Manor House

This inspection was carried out on 2nd October 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

Manor House 30/01/06

Manor House 13/06/05

Manor House 06/01/05

Manor House 14/07/04

Similar services:

22 Sandown Road

The Highlands

Turret Villa Retirement Home

Dilston College Of Further Education

West View House

Moor House

Prince Bishop Court

Park View (15)

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

CARE HOMES FOR OLDER PEOPLE Manor House Manor House Station Road Annfield Plain Co Durham DH9 7UZ Lead Inspector Mr Stephen Ellis Unannounced Inspection 1:30 2 October 2006 nd 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 Manor House DS0000031192.V311747.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. Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor House Address Manor House Station Road Annfield Plain Co Durham DH9 7UZ 01207 232 313 01207 282510 Jackie.hunter@durham.gov.uk 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) Durham County Council Mrs Jacqueline Thompson Care Home 28 Category(ies) of Dementia - over 65 years of age (9), Learning registration, with number disability over 65 years of age (6), Old age, not of places falling within any other category (28), Physical disability (8) Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Physical Disability Persons with a physical disability over the age of 55 years may be accommodated, commensurate with the home’s Statement of Purpose. 30th January 2006 Date of last inspection Brief Description of the Service: Manor House is registered to provide care (but not nursing care) for up to 28 people. The home is divided into three units on two floors. One unit provides a service for people who need care for a short period, with the aim that with intensive support and physiotherapy they can return to their own homes. The other units provide care for some older people with learning disabilities, up to nine people with dementia and other older people. The home was purpose-built and is part of a complex, which includes sheltered flats and a day centre. The home can provide limited support and meals to people in the flats. The home is in the centre of the village of Annfield Plain, with a supermarket, shops, pubs, club and surgeries within easy reach. There are good bus services to the town centres of Consett and Stanley. The weekly residential charge is £432.32, although the actual amount people pay depends on individual circumstances. This covers accommodation, personal care and all meals and beverages. The only additional costs concern voluntary purchases such as newspapers, toiletries and hairdressing. People using the intermediate care service do not pay any charges. Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4.5 hours. It included a tour of the building, examination of a number of records and discussions with 10 residents, 5 relatives and 4 staff. The overall quality rating for this care home is: ‘good’. This judgment has been made from evidence gathered both during and before the visit to this service, including written comments received from one resident and 2 relatives. What the service does well: The service is solid and reliable and achieves good outcomes for its residents, in keeping with its aims and objectives. A unique feature to this home is its division into 3 interconnected units, plus an adjoining day centre and block of 30 flats. Durham County Council provides the home, but Derwentside District Council provides the flats. There is good cooperation between the two providers to ensure good outcomes. For example, the home’s manager oversees some aspects of support for the tenants in the flats. Residents and relatives spoke very highly of the care and attention shown to them by staff. As one resident said: “Fantastic service. Everyone is absolutely kindness itself. Better than any hospital”. Another said: “The staff are always pleasant and cheerful…meals are very good and attention is paid to things that suit…from early morning to late at night the home smells clean and fresh…this could be a model for other establishments”. All said that the home was clean and the food was very good. One relative said: “This is a first class home. Because the home is in small units it feels like a real home for a family. When you visit it has a family atmosphere with both clients and staff. To me it’s just like visiting my mother at home; home from home; go anytime, welcome any time…twice while out walking my mother, comments were passed by outsiders about how nice my mother was dressed by the home.” Another relative said: “Manor House gets top marks from myself and family for the good care of my Mam. The staff are always caring and courteous.” Staff training and development is to a high standard. The home has a good location close to the centre of the village and is well supported by the local community, including the Health Centre (with visiting doctors and nurses) and Pharmacists. The home’s intermediate care unit (8 beds) is proving to be very successful in carrying out short term, intensive rehabilitation (usually a return home within 6 weeks of Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 6 admission, involving several health and social care agencies working together): 96 admissions between 1st October 2005 and 1st September 2006. 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. Manor House DS0000031192.V311747.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 Manor House DS0000031192.V311747.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): 1, 3 and 6 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. Prospective residents and their representatives have the information needed to choose a home that will meet their needs. They have their needs assessed and a contract which clearly tells them about the service they will receive. EVIDENCE: Comments received from residents and relatives confirmed that full assessments of needs were carried out prior to admission to the home. They said there was enough information from which to make a choice about being admitted. Comprehensive service user guides and clear statements of terms and conditions of residence are supplied routinely. Care plans revealed comprehensive, detailed assessments of need being carried out both prior to admission and afterwards, as confirmed by members of staff. These assessments showed that the home only admitted people whose assessed needs it could meet. Over the past 2 years, the home has developed an 8Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 9 bedded intermediate care unit (“Morrison”). This unit only admits people for short-term, intensive rehabilitation from hospital or the community, with the vast majority returning home. The people it admits undergo assessment prior to admission to ensure that the unit is appropriate for their needs. This unit is proving to be very successful: 96 admissions between 1st October 2005 and 1st September 2006, with an average length of stay of less than 6 weeks. Health and social care agencies work very closely with the home in the rehabilitation of the Morrison unit’s service users. Elsewhere within the home, there are 2 other units (“Louisa”, 8 - 9 beds and “Eden”, 9 beds) with a small number of those beds provided for respite care. The majority of beds are for long-term care. Manor House DS0000031192.V311747.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 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 judgment has been made from evidence gathered both during and before the visit to this service. The health and personal care, which a resident receives, is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Residents and relatives said that they believed the health and social care needs of service users were well known by staff and were being fully met. They said that the community nurse or doctor would see service users whenever required. Residents’ personal and social care needs were known, understood and respected by the staff team. Residents and relatives said that they felt service users were treated with respect and sensitivity. As one resident said: “Fantastic service. Everyone is absolutely kindness itself. Better than any hospital”. Another said: “The staff are always pleasant and cheerful…meals are very good and attention is paid to things that suit…from early morning to late at night the home smells clean and fresh…this could be a model for other establishments”. One relative said: “This is a first class home. Because the Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 11 home is in small units it feels like a real home for a family. When you visit it has a family atmosphere with both clients and staff. To me it’s just like visiting my mother at home; home from home; go anytime, welcome any time…twice while out walking my mother, comments were passed by outsiders about how nice my mother was dressed by the home.” Another relative said: “Manor House gets top marks from myself and family for the good care of my Mam. The staff are always caring and courteous.” Care plans were detailed and comprehensive about service users’ health and social care needs, providing clear guidance to staff. They were subject to regular review, in keeping with National Minimum Standards. Staff training, such as National Vocational Qualifications (NVQ) level 2, has included the important issues of privacy and dignity and a high percentage of care staff (62 ) have achieved NVQ in care. There are good arrangements for the safe administration of medicines. Most care staff members, including residential supervisors and manager, have completed the Safe Handling of Medicines course. There is good support from a local Pharmacist who supplies most of the medication in Monitored Dosage form (in blister packs with the medication clearly identified for the individual resident). There are good storage systems and care staff check all medication when it is received into the home. The home requires medication to be administered only from the container(s) into which the pharmacist dispensed it originally. Medication is kept securely in lockable cabinets and trolleys. Residents may attend to their own medication, but in practice most prefer to delegate this responsibility to staff. Unwanted medicines are returned promptly to the Pharmacist and the home is careful not to stockpile large quantities. Care staff carry out medicine audits routinely. Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 12 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 judgment has been made from evidence gathered both during and before the visit to this service. Residents are able to choose their lifestyle, social activity and keep in contact with family and friends. Social, cultural and recreational activities meet residents’ expectations. Residents receive a healthy, varied diet according to their assessed requirement and choice. EVIDENCE: Residents and relatives said that service users enjoyed living at Manor House. They described the staff as being caring and helpful. Residents could exercise choice in their daily lives. For example, they could decide what clothes they wore and how they spent their days, including what times they got up and went to bed. They said that there was a varied programme of social and recreational activities, including visiting entertainers about once every 2 – 3 months, board games, crafts, videos and DVDs (musicals are very popular), reminiscence and outings. There is a visiting hairdresser and beautician. Residents’ meetings are held every 2 months, at which matters of interest and suggestions are discussed. Residents could pursue individual interests if they Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 13 wished, such as reading, television, gardening or knitting. People’s religious needs were being addressed. Residents and relatives said that visitors were always made welcome and could call at any reasonable time. Some residents went out with relatives or friends for part of the day. Many residents said they liked the atmosphere in the home, describing it as being peaceful, friendly, supportive and caring. They liked the small groups in the various units. They were free to sit in any lounge, in their own bedroom, or in the reception area or dining room. All were satisfied with the arrangements for daily life in the home. All the residents spoken to said the catering was very good. One resident said “The food is out of this world, really lovely.” Another resident said: “The food is lovely – too much. I just take what comes”. Service users felt there was a good choice and the Cook understood their preferences. Residents mainly dined together on each unit. They could, however, eat their meals elsewhere (such as their bedrooms) and at different times if required. Décor and furnishing in dining areas was basic but attractive, creating a relaxed and welcoming environment. Records are kept of meals served. A choice of menu is provided. Birthdays were celebrated with a cake and, sometimes, a special tea if it was a ‘special’ birthday. Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 14 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 judgment has been made from evidence gathered both during and before the visit to this service. Residents have access to a robust, effective complaints procedure and are protected from abuse. EVIDENCE: Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training to ensure they have the right knowledge and skills to do their jobs competently. All care staff members have completed Protection of Vulnerable Adults training. Residents reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. Residents and relatives described staff as being supportive, kind and helpful. They expressed every confidence in the staff team and said they would not hesitate to approach staff with any concern or complaint. They knew that such matters would be taken seriously and acted on appropriately by the staff and management of the home. Members of the care staff team confirmed that they had completed adult protection training and would not hesitate to refer any suspicions of abuse or neglect to the appropriate authorities. Manor House DS0000031192.V311747.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 and 26 Quality in this outcome area is adequate. This judgment has been made from evidence gathered both during and before the visit to this service. The physical design and layout of the home enables residents to live in a safe, reasonably well-maintained and comfortable environment, which encourages independence. EVIDENCE: There were no unpleasant odours and the home was found to be clean in all the areas inspected. Care staff members have completed training in Health and Safety, Infection Control and Food Hygiene. Paper towels and liquid soap were provided in toilets and bathrooms in wall-mounted containers, to promote hygienic practices (although residents have personal flannels and towels in Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 16 their rooms). Residents said that they were pleased with the premises, finding them comfortable and homely as well as practical. They also described the home as being clean. The home is reasonably well maintained, with repairs and servicing being carried out fairly promptly and according to schedule. However, décor, including wallpaper and paintwork, requires attention in places such as some bedrooms and communal rooms; and external woodwork would benefit from being repainted. Some window frames need further repair/replacement and then to be repainted. Also, one or two carpets need to be replaced because they are threadbare in places. As one relative said: “It could do with refurbishment. The décor is very tired and dowdy and a new carpet in the lounge would do wonders. A lick of paint on the outside of the building wouldn’t go wrong to give the village a nicer look. Manor House is a nice looking building but the paintwork lets it down.” Manor House DS0000031192.V311747.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 judgment has been made from evidence gathered both during and before the visit to this service. Staff in the home are trained, skilled and in sufficient numbers to fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: On the day of inspection, there were 26 residents being accommodated, including 6 on the intermediate care unit (8 beds). During the day (7 am to 10 pm), there are 6 care staff on duty (2 on each unit), plus one residential supervisor. At night, there are 2 members of care staff on duty. Catering and domestic hours are sufficient for the needs of the service and there is a dedicated administrator (25 hours). The full time registered manager works weekdays. Her hours are not included in the care hours available. A full staff training and development programme is in operation, including moving and handling, first aid, safe handling of medicines, protection of vulnerable adults, fire awareness, health and safety, infection control and food hygiene. Staff confirmed that they had undergone extensive induction and foundation training. Eighteen out of the 29 members of care staff (62 ) (including residential supervisors) had achieved National Vocational Qualifications (NVQ) at level 2 or 3, which is commendable. Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 18 Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau and Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to try to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training to ensure they have the right knowledge and skills to do their jobs competently. All care staff members have completed Protection of Vulnerable Adults training. Residents and relatives reported a caring, supportive atmosphere in the home, which is well established. There is good leadership and teamwork evident and these features reinforce the caring culture and provider policies concerning adult protection. Manor House DS0000031192.V311747.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, 32, 33, 35, 36 and 38 Quality in this outcome area is good. This judgment has been made from evidence gathered both during and before the visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: The registered manager is experienced and competent in her role. Residents, relatives and staff spoke well of her leadership skills and commitment to good outcomes for residents. She was described as being approachable and caring. She has completed her Registered Manager’s Award at NVQ level 4. Staff Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 20 confirmed that they are regularly supervised (bimonthly) and have an annual appraisal. Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving residents’ personal monies, in which the home is involved, wherever practicable. Relatives look after the personal monies of some residents. In those situations where the home helps look after residents’ monies, such as pocket monies, clear individual accounts and records are maintained. These are subject to regular, independent audit. An independent adult protection team is involved in overseeing the financial affairs of 5 residents. Comments received from staff and management confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of residents and staff. All staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This helps reinforce the registered provider’s written policies on Health and Safety. Health and Safety issues are also discussed at bi-monthly staff meetings. Residents, relatives and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. They said they believed the home was safe and run in the best interests of residents. For example, there are regular surveys of residents’ satisfaction carried out, plus consultation meetings, and the findings are reported within the home. The home has the Investor in People (IIP) award plus Charter Mark award, which are both reliable indicators of quality assurance being carried out to a good standard within the service. Manor House DS0000031192.V311747.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 3 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 x 3 3 x 3 Manor House DS0000031192.V311747.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 OP19 Regulation 23 Requirement Décor, including wallpaper and paintwork, requires attention in places such as some bedrooms and communal rooms; and external woodwork would benefit from being repainted. Some window frames need further repair/replacement and then to be repainted. Also, one or two carpets need to be replaced because they are threadbare in places. Timescale for action 01/05/07 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 Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Manor House DS0000031192.V311747.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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