Inspection on 22/11/07 for Manson House

This inspection was carried out on 22nd November 2007.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Manson House 26/02/07

Manson House 08/05/06

Manson House 13/01/06

Manson House 21/10/05

Manson House 17/03/05

Manson House 13/01/05

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Manson House Manson House 111 Northgate Street Bury St Edmunds Suffolk IP33 1HP Lead Inspector Brian Bailey Unannounced Inspection 22nd November 2007 10:15 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 Manson House DS0000032883.V355402.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. Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manson House Address Manson House 111 Northgate Street Bury St Edmunds Suffolk IP33 1HP 01284 753106 01284 763553 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) The Royal Agricultural Benevolent Institution Mrs Delphine Yvonne Bonas Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th February 2007 Brief Description of the Service: Manson House is a care home providing care and accommodation for 24 older people. The Royal Agricultural Benevolent Institution (RABI) owns the home and has been providing care and accommodation to older people from the farming and agricultural community for approximately 28 years. The home is situated in a residential area of Bury St Edmunds and is within a few minutes walk of the town centre. The building spans three floors and is served by a shaft lift and two stair lifts. All bedrooms have en-suite WC facilities. There are assisted bathrooms on all three floors. The bedrooms to the front of the house face the street, whilst the bedrooms to the rear have a pleasant outlook over the gardens. The RABI also own 19 sheltered flats, which are located in the grounds of Manson House. People living at Manson House have access to a range of communal rooms that include a lounge, library, hobbies room and the summerhouse. There is a small car park at the rear of the property. As at February 2007, the fees range from £388.75 to £420.00 per week and are reviewed annually. Extras to the fees include newspapers, toiletries, hairdressing and chiropody. Inspection reports are available from the home and from our website at www.csci.org.uk Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection looking at the core standards for the care of older people. This report is based on a range of information that has been accumulated from our inspection records, a site visit to the home that took place on 22nd November 2007 at 10.20am, a tour of the property, discussions with the manager, staff, people that live at the home, records kept at the home, questionnaires and the home’s annual quality assurance assessment (AQAA), which was returned to us in July 2007. The home is registered to provide accommodation and care to 24 people and on the day of the visit the home had no vacancies. Questionnaires were returned to us from 11 people that live at the home, 5 relatives, 9 staff and 3 health care professionals. These all provided a very positive feedback about the services provided. At this inspection, 26 key National Minimum Standards and the outcomes of these for people living at the home were assessed. 22 areas were assessed as meeting the required standard, there were 3 areas where the service was considered to exceed the standards, and one area of shortfall was identified resulting in a requirement. What the service does well: The home provides accommodation that is of a very good standard. The property is well maintained and the decoration and furnishings are in keeping with the period of the house. People at the home are provided with their own door key and are able to come and go as they please. The excellent garden and patio area to the rear of the house are easily accessible and provide a peaceful place for people at the home to relax and entertain visitors. As noted previously by inspectors, “there is a noticeably happy, relaxed and homely atmosphere with a real sense of community” which continues to exist. The dining facilities are spacious and well laid out and provide people with a good experience where they can enjoy well home cooked food using fresh ingredients. People spoken with at the home were very complimentary about the quality of the food, the caring attitude of the staff and the accommodation. The home has an established and experienced team of staff that offer a high degree of consistency and are knowledgeable about the people they support. Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Manson House DS0000032883.V355402.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 Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6. Quality in this outcome area is good. Prospective users of the service can expect to receive information about Manson House and the service they provide. They can also expect to have an assessment undertaken to ensure the home can meet their specific needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a statement of purpose and a ‘Residents Handbook’ providing detailed and relevant information about the home. The ‘Resident’s Handbook’ includes the contract setting out the terms and conditions of residence with the Royal Agricultural Benevolent Institution (RABI). The contracts include the method of payment, the resident’s current fee and what is/is not included. From discussion with one person that had recently moved to the home, a handbook had been provided, which was in their bedroom and the person was making use of the information. The files of three people that had moved into the home during recent months were checked. Each person had a pre admission assessment completed prior Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 9 to admission. These were detailed and provided information about the person’s previous history, current health, personal care, contacts and general well being. The home does not provide an intermediate care service. Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. People that use this service can expect that the health and personal care they receive will be based on their individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the feedback received from surveys returned by relatives indicated that they felt that the home provided the care and support that people needed and that staff had the skills and experience to look after people properly. Comments made included “I can’t fault the home, generally an excellent service, patient clean and warm, very good entertainment” and “We think this is a wonderful home for.…, .... is very happy and is not restricted in anyway. The staff are kind and considerate and treat everybody with respect. They also communicate with us if there are any problems”. Eleven people that live at the home also returned surveys and together with people spoken with during the visit, provided a very positive picture of life at the home. Comments made included “Excellent help and care at all times” and “This home is extremely well run”. Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 11 Staff were observed to treat residents’ respectfully, and care practices promoted privacy and dignity. One healthcare professional commented on a survey form “The carers at Manson House are very professional, polite, helpful and courteous, the care they give the residents is a very high standard”. The care records of three people that had moved into the home in 2007 were inspected for evidence of how the home plans and meets personal and healthcare needs. The last inspection of this home required the manager to develop care plans and provide staff with more guidance as to how any identified needs are to be met. The manager had taken steps to address the issues raised and from observation the care plans covered a wide range of information. From detailed discussions with five staff about the care needs of people, it was evident that as a group of trained and experinced staff, they were fully aware of how people expected staff to support them. Care records checked showed that reviews of care take place. The manager reported that medication training is provided to all staff members responsible for the administration of medications and that these staff were due to attend further training in November 2007. Medication administration records (MAR) were pre-printed by the pharmacist with details of each person’s medication. Systems were in place to record any medication returned to the pharmacist. Each person’s MAR was accompanied by a clear photo of the person to ensure accurate identification. Administration records viewed contained no gaps in recording. Manson House DS0000032883.V355402.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. People who use this service can expect to be encouraged to maintain contact with family and friends, to be offered enjoyable and meaningful activities and to be offered a well balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: These standards were inspected in February 2007 and all were found to be well met. From observation and discussion with staff and people that live at the home, it is evident that the home has continued to provide the same level of service. One person commented in a survey form sent to us “We feel very grateful that we have such a nice home available to us” and a relative commented “I can’t fault the home, generally excellent service, patient clean and warm, very good entertainment. The manager’s opinion as to what the home does well, has stated in the Annual Quality Assurance Assessment (AQAA) sent to us in October 2007, the home “Provides residents with a full and stimulating lifestyle. Manson House is home from home and residents go about freely enjoying activities, organised or of their own making”. During a tour of the building, a group of six people were observed sitting in the dining room making and preparing Christmas cards supported by a volunteer. Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 13 From observation, the majority of people tend to return to their private rooms after they have taken a meal in the main dining room. One person spoken with said that there were no restrictions about movement around the home, but it was nice to be quiet and to be able to write letters in private and spend time with other people when company is wanted. The visitor’s book in the hallway continued to show that relatives visit frequently and a few people were observed during the visit to the home. The dining room is a spacious and well-furnished room that overlooks the garden and provides people with an attractive and comfortable place to enjoy a meal. The tables were well laid out and the atmosphere was totally relaxed when staff served the meal and then allowed people to eat their meal without being hurried. The cook described the provision of food as good. All food is freshly prepared and cooked using fresh ingredients. A genuine choice of meal was available with cook being made aware of the various selections made. The food stores were seen and held a wide range of home baked cakes, (delicious shortbread) dry goods, fresh and frozen foods. All were being stored appropriately and in line with food safety regulations. Three people spoken with in the dining room confirmed that they liked the food, which was also the view that is reflected in the survey forms returned to us from people living at the home. Manson House DS0000032883.V355402.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. People using this service and their relatives can expect to have their concerns or complaints listened and responded to and are protected by the home’s adult protection procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: These standards were inspected and found to be met at the last two inspections, which took place in May 2006 and February 2007. No complaints had been received by the home or by CSCI since the last inspection. The complaints log showed that the last recorded complaint had been dealt with satisfactorily when the Royal Agricultural Benevolent Institute (RABI) undertook a full investigation. Ten people at the home returned survey forms and all that they were aware of how to make a complaint. Three people spoken with also confirmed that they knew the procedure. The home has detailed and robust policies and procedures that deal with the management of allegations of abuse, which link to the Suffolk Adult Protection Committee inter agency policy. Five staff spoken with were aware of the procedures regarding the protection of older people from abuse and all confirmed they had received training. The training log also showed that all staff had received training. Manson House DS0000032883.V355402.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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 25 & 26. Quality in this outcome area is excellent. Residents can expect to live in a home that is decorated and presented to a high standard, which is comfortable and well maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Manson House is a large detached period house with a large landscaped rear garden. The house is decorated to an excellent standard, retaining many of its old features. The décor is in keeping with the period of the house and is bright, clean and well maintained. The grounds are attractive and well kept providing a good place for people to look at and to walk and sit in the warmer weather, which according to staff, a number of people like to make use of. A well laid out patio area outside the dining area with raised flowerbeds so that people can take part in gardening was completed during 2007. Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 16 The house was clean and tidy throughout and had no odour control problems. A passenger lift and two stair lifts provide access to the first and second floor. One person at the home commented that the door to the lift is rather heavy to open without the support of staff and would like to be able to be more independent around the home. The manager was aware of this and said that the style and age of the lift meant that there were no solutions available to make access easier. A range of communal facilities is available including a large sitting room situated to the rear of the house overlooking the garden. There is also a library and a conservatory, which is a designated smoking area for the people of the home. The library had a selection of newspapers, some comfortable easy chairs and a table with two recently purchased computers for people to use. The dining room is a large and spacious room for people to meet socially and to enjoy their meals. During the visit a group of people were using the room for some activities with the support of a volunteer. All bedrooms are for single occupancy and have en-suite toilet facilities. Bedrooms seen were clean, tidy and personalised to meet their needs and tastes and from discussions some people had brought their own items of furniture and ornaments. Call alarms were provided in the bedrooms seen and were from observation in working order. People are offered a key to their bedroom door and have lockable storage space provided for personal items. Two previous inspections have identified the need for the home to find alternative storage space for equipment when not in use. The manager has acknowledged that equipment being stored in the downstairs bathroom is unacceptable, but has been unable to find a complete solution. There are two laundry rooms and each has a tumble dryer and a washing machine with a sluicing facility. The home uses red dissolvable bags for the soiled laundry, which are put directly into the machine for sluicing. Each bathroom had hand washing facilities and a good supply of liquid soap and paper hand towels available. Manson House DS0000032883.V355402.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. People that use this service can be certain that the home has an established staff team, that are trained to meet the specific needs of older people and are available on duty in sufficient numbers to support them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no changes to the staffing levels since the last visit to the home in February 2007. From discussions with staff and with people at the home there is sufficient staff on duty each day. The home operates with 1 senior and 2 carers on duty between the hours of 7.30am to 2pm and 1 senior and 3 carers between 2pm and 9pm. The home has 2 cooks and a team of 5 domestic staff and 1 full time maintenance person. There are 2 waking night staff on duty between 9pm and 7.30am with a senior on the premises during the night who is on call in case of emergencies. Additionally the manager and deputy manager take it in turns to be on call at night. Information provided by the manager states that the home employs 32 care staff of whom 66 have obtained a National Vocational Qualification (NVQ) at level 2 and above. These figures confirm that the home meets the recommended minimum ratio of 50 of staff are trained with a recognised qualification. Five staff spoken with considered the home to be an enjoyable place to work; they described the training they have received, which included Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 18 NVQ 2 and 4, POVA and Health & Safety. Several of the staff spoke of having worked at the home for many years. Recruitment procedures were checked and all staff records relating to employment were kept confidential and accessed only by the manager and deputy. Criminal Record Bureau (CRB) disclosure checks were available for all staff employed. No new staff have been employed since the last inspection when it was found that a member of staff had been employed without first obtaining a CRB disclosure. From discussion with the manager, it was evident that the procedure for obtaining CRB’s was known and that the correct procedure would be adhered to. Staff files checked contained references, identification, application forms, supervision records and training certificates. Staff files confirmed that new staff undertake induction training, which meets the Skills for Care Common Induction Standards (CIS) through Suffolk County Council training and educational department. Manson House DS0000032883.V355402.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. People at the home can be confident that there are systems in place to safeguard their interests; they will be consulted about the service and all health and safety matters will be addressed promptly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has many years experience in the care of older people and has gained a National Vocational Qualification (NVQ) level 4 in management. The manager is supported by a team of experienced and qualified staff, several of whom have worked at Manson House for a number of years. The home’s administrator looks after any money held for safekeeping on behalf of people living at the home. The money was kept secure and a system for maintaining separate accounts was in place. A sample of the accounts was not Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 20 checked as the home’s accountant and an auditor were in the process of checking all financial matters. Verbal feedback provided confirmation that the system was being operated correctly. The home has a good quality assurance system in place for people living at Manson House, their relatives and visitors to provide feedback about the services provided. Records seen showed that satisfaction questionnaires were issued to people in 2007 and although a summary of the findings was not readily available, observation of the returns showed that people were well satisfied with the service. CSCI also issued surveys to gauge what people think of the service. Three surveys were retuned from people that live at the home, two from relatives, nine from staff and three from health care professionals. An analysis of these shows that all considered the home to be providing a good standard of service. Comments from relatives included “They meet and care for all the residents individual needs, and is very good at motivating them with a wide range of activities” and “I can’t fault the home, generally an excellent service, patient, clean and warm, very good entertainment. Staff felt well supported and commented on the training opportunities and people living at the home provided favourable comments such as “ “This home is extremely well run” and “I have a very pleasant room and am very comfortable here”. The Manager is aware of her health and safety responsibilities. Observation showed that the home has clear policies on health and safety matters. Information provided to us by the manager confirms that equipment and services are serviced at the appropriate intervals and are up to date. There was evidence that fire, moving and handling, infection control, food hygiene, first aid training had been provided. Staff confirmed the various training courses they have attended and information was available of staff files. Evidence was available to show that monthly-unannounced visits to comply with Regulation 26 of the Care Home Regulations 2001 are carried out. Manson House DS0000032883.V355402.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 4 X X 2 X X 4 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP22 Regulation 13 (4) (a) Requirement The bathroom on the ground floor must be free from hazards for the safety of the residents and a suitable provision must be made for the storage of wheelchairs and equipment. The previous timescale of 06/04/07 was not met. Timescale for action 01/04/08 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 Manson House DS0000032883.V355402.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Manson House DS0000032883.V355402.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. 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