Inspection on 10/01/07 for Margaret House

This inspection was carried out on 10th January 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 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

Margaret House 17/12/08

Margaret House 25/01/06

Margaret House 08/08/05

Margaret House 01/03/05

Margaret House 22/06/04

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

CARE HOMES FOR OLDER PEOPLE Margaret House 221 Manchester Road Burnley Lancashire BB11 4HN Lead Inspector Mrs Marie Dickinson Unannounced Inspection 10:00 10 & 11 January 2007 th th 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 Margaret House DS0000009578.V323191.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. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Margaret House Address 221 Manchester Road Burnley Lancashire BB11 4HN 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) 01282 423804 Mr Gordon Fell *** Post Vacant *** Care Home 11 Category(ies) of Dementia - over 65 years of age (6), Mental registration, with number disorder, excluding learning disability or of places dementia (5), Mental Disorder, excluding learning disability or dementia - over 65 years of age (6) Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Within the overall total of eleven, a maximum of 5 named service users who fall into the category of Mental Disorder Within the overall total of eleven, a maximum of 6 service users who fall into the categories of either Mental Disorder Elderly or Dementia Elderly Should any of the named service users referred to in condition 1 above be no longer the resident in the home or reach the age of sixtyfive, registration should revert to the original registration of the home. 11MD(E), 11 DE(E) 25th January 2006 Date of last inspection Brief Description of the Service: Margaret House is registered with the Commission for Social Care Inspection to provide personal care and accommodation for 11 people, whose main care needs are mental health difficulties. The home is located in a residential area of Burnley and is adjacent to Scott Park. There are pleasant accessible garden areas to the front and sides with a lawn area to the side and rear of the home. There is a bus stop near the home, on route to the town centre. Accommodation offered is in single and one double room, fitted with an emergency call system. The home was furnished and decorated to a domestic style. Mr Fell the owner manages the home on a day-to-day basis. Information about the service is available from the home for potential residents in a Statement of purpose and Service User Guide. Weekly charges for personal care and accommodation range between £360:50 and £528:40. Residents are responsible for purchasing optional extras such as hairdressing, and private chiropody. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was conducted in respect of Margaret House on the 10th & 11th January 2007. Information about the service was received at the Commission prior to the inspection. The inspection involved getting information from staff records, care records and policies and procedures. It also involved talking to residents, staff on duty, the registered provider, and included a tour of the premises. Fifteen responses were returned to the Commission from residents and visitors who gave their personal view of the services provided. Areas that needed to improve from the previous inspection were looked at for progress made. The home was assessed against the National Minimum Standards for Older People. What the service does well: Before any services are provided, resident’s needs were assessed. They were consulted about the level and type of care they required and could visit the home to look for themselves at the facilities offered. Important information needed to support them in every day living was recorded and used to plan the care they required. This helped to personalise care and show staff what they should do to achieve this. Contracts given to residents informed them of the terms and conditions of residence. Staff were trained in dementia care, which meant they understood the diversity of residents special needs. Residents living in the home benefited the support of a named worker referred to as a Key worker who took responsibility to make sure care needs for individuals was personalised. Healthcare needs were also monitored and staff worked with visiting medical professionals for the benefit of residents. Relatives who sent written comments for the inspection said they were made welcome to the home and could make a visit in private if they wished. Relatives also said they were always kept informed of any changes in their relatives care needs. Social activities were managed very well and some residents had enjoyed a holiday at Blackpool. Visitors who sent written comments for the inspection said they were made welcome to the home and could make a visit in private if they wished. One comment read ‘As a casual visitor, the home appears to be well run and the Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 6 residents appeared to be happy and well cared for.’ Relatives also said they were always kept informed of any changes in their relatives care needs. There were no rules in the home and routine was personal to each resident. Residents said their meals were ‘good’ with choices offered. Complaints were taken seriously and residents and relatives had confidence any issue they raised would be dealt with properly. Residents said the home was a nice place to live, as one resident said ‘you’ll not find any better’. They were comfortable and warm. They considered staff to be polite, always there for them and respected them. Recruitment and selection of staff was thorough and protected residents. The level of staffing maintained, training provided and supervision was excellent which meant residents were care for by competent qualified staff. Residents and staff benefited from regular meetings and were informed of any changes planned. The home was organised and managed efficiently. 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. Margaret House DS0000009578.V323191.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 Margaret House DS0000009578.V323191.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): 2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were given a contract informing them of the terms and conditions of living in the home. They had their needs assessed which helped staff who were trained in dementia care to look after them properly. EVIDENCE: Comments sent to the Commission from residents confirmed that they were issued with contracts that outlined the cost of staying at the home and terms and conditions of residency. Details of admissions showed assessments were completed prior to a resident being admitted to the home. The assessment showed essential information was recorded to provide staff with sufficient information about the resident’s circumstances and level of support required to give the right care. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 9 Before people are admitted they can visit the home and can arrange to stay overnight. Assessment notes taken on the days of such visits showed for example, ‘stayed for lunch and socialised. Invited to a birthday party, went to the park for a walk.’ Records showed that the changing need of residents was responded to by seeking advice taken from other professionals such as social worker, district nurse and psychiatric healthcare workers. The range of needs of residents had been considered. Staffing levels were good and staff training programme-included specialist training to care for people with dementia. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff used care plans. This meant residents care was personalised and their privacy and dignity and independence taken into account. Assistance with medication was given in accordance with the homes policies and procedures. EVIDENCE: Staff work to a key working system, which meant they had particular responsibilities for a number of residents. Needs assessed on admission were written into a plan of care how those needs would be met. There was evidence residents were involved in care planning and their views were recorded for example ‘I do have hearing difficulties so people need to speak clearly to me. I need eat a well-balanced and regular diet and to drink plenty of fluids’. Particular attention staff must give to residents when providing care was recorded such as ‘observe discreetly’, Reviews of residents needs was ongoing. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 11 The residents’ healthcare needs were also detailed in the care plan. This included visits from medical professionals such as General Practitioners. To support residents with mental healthcare needs, community psychiatric nurses visited individual people and gave staff written advice on their care. Risks to resident’s well being was also detailed and were excellent in how these were recorded. These included potential consequences should the risk materialise, and what should staff do to prevent/minimise the risk. If risk occurs how staff respond now and later and what can be done to protect the resident and the staff. Staff had signed completed risk assessments. Responses sent to the Commission show that residents felt they received care and support at the home and received medical support they needed. Continence care was managed and necessary products used. The residents spoken to felt the staff respected their right to privacy. Privacy and dignity was included in care planning such as ‘when immersed in his bath would like five minutes privacy. Action by staff, to be discreet and observe.’ Residents were complimentary towards the staff, for instance one resident said ‘When you come you don’t really know what to expect. Staff are always there for you, and we’re here to help’. “They’re very good’ and ‘helpful’. Relatives who sent comments to the Commission also praised staff for the care they gave. ‘thankyou for the wonderful care you gave her. She did enjoy her time with you’. Residents who had difficulty in saying what they wanted during the inspection were treated with respect, and staff had taken care in making sure their appearance was good. The home operated a monitored dosage system for the administration of medication. This was audited by the supplying pharmacist. An appropriate recording system was in place to record the receipt, administration and disposal of medication. A record of medicines received into the home had been maintained and medication had been returned to the pharmacy for disposal. Records of medication administered were up to date. Information sent to the Commission by the provider showed that staff were trained in medication procedures. Margaret House DS0000009578.V323191.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): 12,13,14,15, Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The level of staffing and choice of activities made available enabled the residents have their social, cultural, religious and recreational interests and needs met. Visiting arrangements were very good which meant residents could stay in contact with their relatives and friends. Catering arrangements were to the resident’s satisfaction. EVIDENCE: The residents’ preferences in respect of social activities had been sufficiently recorded as part of their assessment. These included for example ‘snooker, dominoes and television but no music Is happy with his life and would like to maintain contact with his friend’. Care planning showed how these needs were catered for such as ‘will visit friend every Friday’. Activities for residents were organised and offered a personal touch. An activity weekly planner was used for each resident showing their lifestyle in the home. Residents went to clubs such as over 60 club, cinema, shopping, and snooker hall. Residents who wished also had holidays. Those who had been away talked about their last Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 13 holiday at Pontins in Blackpool. Staff were given opportunity and time to support them. Comments from residents returned to the Commission as part of the inspection show everyone thought there was always activities arranged by the home they could join in. Staff said the residents enjoyed festive celebrations and birthday parties and were interested in what was generally going on in the home. one resident said he had enjoyed Christmas, he went to the pub twice and visited his sister on new years eve. Residents were supported to continue with their chosen religion. They could go to a place of worship in the community or attend a service in the home. Representatives from local churches will visit the home on a regular basis for prayers and communion. The residents were able to receive visitors at any time and were able to entertain their guests in private. There was evidence seen in care records that relatives regularly visited the home. Comment cards supported this, and from observations and the experience of visiting, showed staff were considerate to and made visitors feel welcome. Reidents bedrooms were personalised. They were able to bring in personal belongings and arrange their rooms how they wished. The routines in the home were flexible to suit the residents, such as when they went to bed or got up, when they had a bath. Preferred routines had been recorded such as ‘would like a bath on Thursday’. Residents could choose where to eat their meals and were observed mainly sitting at the dining tables. Comments about the food such as ‘it’s good’ and ‘no complaints’ were made. The main meal was a set menu with two choices provided. The care staff cooked the meals as part of their duties. If someone didnt like what was on the menu, they would be offered something else. Margaret House DS0000009578.V323191.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): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure was clear which helped residents have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in adult protection issues. This meant residents safety and welfare was promoted. EVIDENCE: Information received at the Commission from residents and relatives showed they knew how to make a complaint. Residents also knew who to speak to if they had any concerns. A copy of the complaints procedure was given to current and prospective residents. The procedure gave clear directions on whom to make a complaint to, and the timescales for the process. There were no complaints recorded. The home had an appropriate internal procedure for staff to follow should they suspect or witness an incident of abuse. Abuse procedures and whistle blowing had been covered during staff induction training, and continues to be considered a high priority with staff. Staff knew their responsibility to protect residents from abuse and considered it their duty to follow abuse procedures if necessary. A condition of employment for staff in the home prevents them having any financial gain from residents. Margaret House DS0000009578.V323191.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): 19,21,22,24,25,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents were provided with a warm, comfortable, clean environment that suited their needs. Resident’s bedrooms were furnished and decorated to their liking. EVIDENCE: Margaret House is a large adapted Victorian style property adjacent to Scot Park in Burnley. Since the last inspection the bathroom upstairs had been refurbished, and a thermostatic valve for temperature control fitted. Some decoration had been done. This included the kitchen, dining room and some bedrooms. Nearly all of the bedrooms in the home were nicely decorated and furnished. Residents were very pleased with their accommodation. The lounge area was Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 16 comfortable, and plans were discussed regarding having it redecorated. Most residents used the separate dining room at meal times. Residents said they liked the home. They thought it was ‘comfortable’ and it was ‘their home’. The entrance hall provided a nice sitting area with homely furniture, and was popular with the residents. Residents liked their bedrooms, which had everything they wanted in. Comments were made such as ‘nice’ and comfortable’, and ‘liked the bed’ and ok. Residents who had difficulty managing the stairs could use the stair lift. There were no restricted areas and residents had access to outdoor garden areas to the side and rear of the home. Also provided was a ‘pool room’ and residents said they enjoyed playing the game. The overall standard of hygiene and cleanliness in the home was very good. Domestic staff employed, were thorough with cleaning and the laundry was organised for efficiency in the care of resident’s clothes. . Margaret House DS0000009578.V323191.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 excellent. This judgement has been made using available evidence including a visit to this service. Good staffing levels meant there was sufficient staff on duty to meet the needs of residents. The recruitment and selection procedures were thorough and protected residents. Staff received training and supervision, which meant they had the skills and knowledge to care for residents. EVIDENCE: Comment cards from relatives show they considered enough staff on duty in the home. Rotas showed good levels of staffing on all shifts. Staff had delegated responsibilities and one to one care and social activities was part of the staff role. The residents spoke highly of the staff and written comments showed they were very happy with how staff cared for them in general. They had no complaints. For instance one relative wrote ‘Thank you for the wonderful care you gave’ Staff files showed recruitment checks to be complete and satisfactory. References and Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check had been applied for, prior to employment. Staff were given a contract of employment and job description. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 18 All the staff in the home had attended training following their induction. Records were kept showing carers individual training profile showing the homes commitment to providing both specialist and mandatory training such as dementia care and moving and handling. Information received at the Commission show training was planned and arranged for all staff during the year. Staff confirmed they were properly supported with training. The percentage of staff having completed a national vocational qualification in care level 2 and above was near 100 . Staff felt the home was run in the interest of the residents, and were committed to give residents a high standard of care. Margaret House DS0000009578.V323191.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): 31,32,33,35,36,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well organised and managed efficiently. This ensured it was run in the best interests of service users. Guidance and support was given to staff, which contributed towards the resident’s quality of life experience in the home being positive. EVIDENCE: Mr Fell the registered provider manages the home with the support of senior carers. He holds relevant qualifications in management and care. A new member of staff has been appointed to help Mr Fell in his role. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 20 Since the last inspection residents have been having ‘chats’ about the service they receive and a record kept of their comments. For example ‘is happy with all care given by staff’; ‘was not used to having large meals. Has got used to the food given to him and the choices offered’; ‘happy and content. Likes his room and the privacy he has.’ This information supports resident care and is an opportunity for staff to look at how well they are meeting residents’ needs. Views about the home were both formal and informal with residents and staff meetings. However views of residents and other people from anonymous questionnaires should be sought. The findings of this survey should then be published and made available for people to look at, and a copy sent to the Commission. Residents were pleased about all aspects about living in the home. One resident said ‘I’d not find better’. Staff confirmed they were supervised, and had an appraisal. Staff supervision records showed for example personal development, review of workload, and targets met. Staff said they felt supported in their work, and supervision was organised and beneficial. Staff meet together daily and have ‘shift meetings’ to discuss residents and other issues relevant to their work for the day and night. Routines for staff in the home were established, and good teamwork was evident. As staff said ‘that’s the good thing about here, we all work together as one team.’ A quality assurance for the home had not been carried out for the year. This should be done, the results published and made available for all interested parties. The health, safety and welfare of residents and staff had been considered. All staff trained in mandatory training and staff had access to policies and procedures for safe working practice. Information contained in the pre – inspection questionnaire indicated that essential services such as gas and electricity were regularly serviced. Records showed work required by the fire department had been completed satisfactorily. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 3 3 3 N/A 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 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 X 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 2 X 3 3 X 3 Margaret House DS0000009578.V323191.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP33 Good Practice Recommendations It is recommended a formal quality assurance be carried out for the year and the results published. Margaret House DS0000009578.V323191.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Margaret House DS0000009578.V323191.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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