Inspection on 22/11/06 for Meadow View 1

This inspection was carried out on 22nd November 2006.

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

The inspector 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

Meadow View 1 13/12/05

Meadow View 1 22/07/05

Meadow View 1 08/03/05

Meadow View 1 04/08/04

Meadow View 1 23/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood Hall

Muston Road (70)

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

CARE HOME ADULTS 18-65 Meadow View 1 The Lawns Bempton Lane Bridlington East Yorkshire YO16 6FQ Lead Inspector David Blackburn Key Unannounced Inspection 22nd November 2006 08:45 Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View 1 Address The Lawns Bempton Lane Bridlington East Yorkshire YO16 6FQ 01262 400985 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) H4037@mencap.org.uk Royal Mencap Society Mrs Nancy Eileen Turner Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1) of places Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may also have a physical disability (PD) The category for LD(E) only applies to the named service user. Date of last inspection 13th December 2005 Brief Description of the Service: 1 Meadow View is a purpose built semi detached bungalow owned and maintained by New Dimensions Housing Association. The care input is organised and managed by the Royal Mencap Society. The home is situated in a residential area of the town. An adapted motor vehicle is provided for service users. Public transport to the town passes nearby. The home offers long term accommodation for adults with a learning disability and associated health and behavioural problems including some challenging behaviour. The staff seek to provide a holistic regime offering personal care, help, advice and guidance with daily living skills and activities, a catering service, a laundry service and domestic and cleaning services. Activities are offered both on and off site. Nursing care is not given but can be provided on a short-term basis by community healthcare services. There is a garden accessible to those service users who have mobility problems. The four bedrooms are of a good size and take into account service users’ physical needs. There is a bathroom provided with specialist bathing facilities. Other specialist equipment is provided as necessary. Communal space consists of a lounge and dining room. A Statement of Purpose and Service User Guide are available in the home. The fee level advised at the time of the inspection was from £889 to £1113 per week depending on assessed needs. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection upon which this report is based comprised a review of the evidence held by the Commission including written information given by the registered provider and a site visit. Relatives, general medical practitioners and care managers had been contacted for their written views. The comments and observations made are included within the relevant sections of this report. An unannounced site visit was carried out, by one inspector, over one day, with a total time at the home of approximately 3.5 hours. A number of bedrooms, communal areas and services, for example the laundry facilities and kitchen were inspected. An examination was made of some service users’ care records, the home’s policies and procedures and other documents, for example staff records. Conversations were held with a number of service users. Responses varied according to the individual’s communication skills. Observation of service users’ normal routines was undertaken throughout the site visit. The registered manager, two staff on duty and an outreach worker (a person working with people with disabilities to ensure their access to community facilities activities) were spoken with in confidence. Feedback to the registered manager was made at the end of the visit. 1 Meadow View is one of four similar properties located in a small cul-de-sac owned by the housing association and managed by the society. What the service does well: The staff team had achieved the overall aim of the home in providing service users with, as far as was possible, a normal and meaningful lifestyle. All activity in the home whether care, domestic services or planned social activities was focused firmly upon service users’ assessed needs. A care manager said “The staff in the bungalows provide a caring and effective service. The paperwork is always excellent, being detailed and informative. If they have concerns they are not afraid to seek advice.” Service users said they were “very happy” in the home. Good information was available about the home enabling any prospective service user to make an informed decision about admission. Good care plans were in place. They were detailed, clear and precise in giving staff the necessary information to help them offer the required care in the most appropriate manner. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 6 All service users were involved and integrated into the local community ensuring they had a wide and varied range of different life experiences. Personal care was offered in a discrete manner with the accent firmly on the maintenance of service users’ privacy, dignity and independence. Proper procedures were in place to give service users’ protection from harm. The home was domestic in style and a pleasant and comfortable place in which to live. The provision of the necessary specialised equipment enabled service users to take full advantage of all available facilities. Staff appeared well-motivated, committed and well-trained. Their continued hard work, attention to detail and provision of individualised care meant service users’ assessed needs were met in a suitable manner. The registered manager was competent and experienced giving service users a well-managed environment in which to live. 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. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had the information available to make an informed decision about admission and had confidence their needs would be properly assessed. EVIDENCE: A Statement of Purpose and Service User Guide were available. They had been produced in a large type print with good use made of pictures, photographs and symbols. Together they gave a clear indication of the care, services and facilities on offer in the home. They were supported by other documents including the Aims and Objectives and Residents’ Charter. The available information affirmed that all service users, irrespective of disability, would be afforded full adult rights and responsibilities as far as each individual was able. The Statement of Purpose and various policies and procedures of the registered provider showed the admission criteria. The last admission had been in March of this year. Full assessment and admission documentation was seen. This ensured the person’s needs were fully known, understood and with the confidence they could be met appropriately and competently. A care manager said “My client was supported admirably by all staff to help them settle.” Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear and consistent care planning system was in place providing staff with the information needed to appropriately meet service users’ needs. EVIDENCE: A number of case files were examined. Each service user had a number of files detailing different aspects of their life in the home. Care plans had been developed where possible in partnership with the service users, families, health and social care professionals and other interested parties. They clearly set out how requirements would be met through positive and planned interventions. Cultural and spiritual needs were recorded where appropriate. Care plans had been regularly reviewed, updated and signed. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 10 The profound nature of service users’ disabilities did affect their ability to make day-to-day choices. However staff ensured they were given every opportunity to make decisions about their lives. Limitations and restrictions were only imposed where there was a threat to safety. Several discussions were observed throughout the site visit where staff offered advice, guidance and encouragement to service users about care matters, activities and visits. Observation showed staff’s good attention to detail and the understanding of each service user’s needs. They responded quickly and appropriately to indicators. Service users appeared relaxed and comfortable in staff’s presence. There was a good relationship between the two. The registered manager handled the personal money for service users in accordance with the signed financial agreements. Proper procedures were in place to ensure all money was correctly accounted for. Bankbooks were in service users’ names. Risk assessments were available indicating the anticipated risk and how it was to be managed. None of the service users was denied an activity because a risk could be identified. Rather staff were pro-active in arranging activities but with evidence they had noted the risks involved and taken action to minimise or eliminate them. Service users said they were happy with their care. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users were provided with every opportunity to establish and maintain good links with the community thereby enriching and stimulating their lives and developing their social skills. Service users were offered meals that met their likes and choices and catered for any special dietary needs. EVIDENCE: None of the service users was able to undertake any form of paid employment. One undertook work of a voluntary nature under supervision. Some service users attended adult learning classes. The registered manager and staff demonstrated an awareness of the importance of enabling service users to achieve their goals, follow their interests and be fully integrated into community and leisure activities. Service users were able to enjoy a full and stimulating lifestyle with a number of options available to them. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 12 They were able to access numerous activities in the home and at outside locations. Good use was made of the local Outreach Service, designed to give people with disabilities the opportunity to access and take part in community activities. The home’s location gave good access to local facilities and amenities. The use of the minibus ensured service users were able to make full use of the wider community. Service users described their day-time activities to the inspector. Staff had encouraged and maintained family contact where this was appropriate and possible. The level of contact depended upon the location of relatives, their ability to travel to the home or have home visits from service users and their willingness to maintain contact. The service users’ care plans showed how care was to be provided and by whom. Despite multi and differing needs staff were able to maintain individual choice and maximise independence. Routines were designed around service users. Privacy and dignity were maintained through attention to details such as knocking on doors, addressing service users in a proper manner and the provision of door locks and keys and privacy locks to bathrooms and toilets. Menus were devised by the staff based on the known likes, dislikes, preferences and choices of service users. Observation by staff of a service user’s reaction to additions to the menu gave a clear indication as to whether or not a particular item was liked. A variety of food was offered. The registered manager was confident any dietary needs could be met. A dietician was involved with one service user. Service users were asked for their preferences for breakfast and lunch including the type of drinks. Special crockery and cutlery were available. Service users were involved in shopping for food and in clearing away dishes. Service users said they enjoyed the food. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ personal and health care needs, including medication, were met with good evidence of multi disciplinary working taking place on a regular basis to the benefit of service users. EVIDENCE: The case files examined detailed how each service user’s personal and health care needs were to be met. There was a clear emphasis on the maintenance of the individual’s privacy, dignity and independence. Male and female staff of differing ages were employed so service users could choose their preference when receiving personal care. All care was given behind closed doors. Service users went shopping for clothes and personal items assisted as necessary by staff. A number of personal services, for example hairdressing, were provided in the town. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 14 An excellent liaison and relationship was maintained with a variety of health care professionals including physiotherapists, occupational therapists and speech and language therapists. The extent of any involvement was fully recorded. Specialist equipment had been provided to ensure service users could access and use all facilities in the home. These included special beds, baths and toilet aids. A medication policy and procedure were available. Discussion with and observation of staff carrying out medication administration and recording showed these procedures were being properly followed. All staff who administered and recorded medication had completed suitable training at induction and from an external trainer. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were provided with information in an appropriate form to enable them to express their concerns and to have the confidence they would be properly investigated. EVIDENCE: The formal complaints procedure was in the registered provider’s Operational Manual. The Statement of Purpose and Service User Guide had copies in pictorial form and therefore more easily understood by the service user group. No complaints had been recorded since the last inspection. The registered provider’s Operational Manual had a detailed and comprehensive adult protection policy and procedure. A simplified but relevant version was in the Service User Guide. A copy of the Multi-Agency Agreement on the Protection of Vulnerable Adults was available together with updated staff information leaflets. Some staff had undertaken further training in safeguarding. Others were programmed to do the training in the near future. The home had an open culture that enabled service users to express their views and concerns in the knowledge they would be handled quickly and appropriately. Responses through comment cards raised no concerns about any aspect of the service. The registered provider’s recruitment and selection procedure ensured the protection of service users through the obtaining of written references and enhanced disclosures from the Criminal Records Bureau. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had a homely and attractive place in which to live, adapted to meet their individual assessed needs enabling them to take full advantage of all facilities. EVIDENCE: 1 Meadow View is a large purpose built bungalow situated in a quiet location on a large residential development. It is convenient for access to all local facilities and amenities. The bungalow shares a small cul-de-sac with three other similar properties. The property appeared in good structural and decorative condition internally and externally. There was level access to and from all external doors. There was a private and secluded garden that could be accessed by service users in wheelchairs. Outdoor furniture had been provided. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 17 Four single bedrooms were available. Non had an en-suite facility. All bedrooms were of a good size and spacious. They were provided with suitable furniture and all were personalised. Service users said they were happy with their rooms. There was one bathroom with specialist bath. Sufficient toilets were available. The communal areas consisted of a sitting room, dining room and sensory room. All parts of the property were spacious, with wide corridors and door openings. Furniture, fixtures and fittings were strategically placed so they did not cause an obstruction or impede the progress or movement of any service user. There was a small laundry adequate for the needs of the home. Good systems were in place for the laundering of bedding, linen, towels and personal clothing. The premises were clean, tidy and free from unpleasant odours. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A well-motivated, competent and well-trained staff team was working positively with service users to improve their whole quality of life. EVIDENCE: The numbers and skill mix of the staff group met service users’ needs. The staffing complement in the home consisted of the registered manager and six support workers. They were no vacancies. Night staff were jointly managed with the adjoining service (3 Meadow View). Staff were of differing ages and from a variety of backgrounds. Male and female staff were employed. Responsibility was not only taken by staff for personal care of service users but also catering and domestic duties. There was a stable staff group who had worked at the home for a number of years. Any gaps in the rota were filled by existing staff or peripatetic staff employed by the registered provider. This gave a consistency of care for service users. Of the six current support workers four had a National Vocational Qualification in care to at least level 2. Service users said they liked the staff. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 19 All staff recruitment and selection was done through the published procedures of the registered provider. The file of the last permanent staff to be employed was examined. It contained application forms, written references and the necessary clearances required prior to employment, for example enhanced disclosures from the Criminal Records Bureau. Staff received the necessary induction, foundation and on-going training to enable them to carry out their duties in the most appropriate manner. A number of training certificates were seen. Staff confirmed they had undertaken courses to refresh their knowledge and skills, for example first aid, fire safety and moving and handling and to increase their knowledge, for example epilepsy. Supervision was offered to staff and records were seen. A care manager said “Staff are always well prepared with notes for reviews. The keyworker system seems very good. They have good relationships with service users.” Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager provided clear and competent leadership ensuring service users lived in a well-managed environment. EVIDENCE: The registered manager had worked for the registered provider for over 13 years. She had secured registration as manager with the Commission. She had achieved the registered managers (Adults) NVQ4 award and a National Vocational Qualification in care to level 4. She undertook the relevant training to update and increase her knowledge. The registered manager was knowledgeable about the service users in her care, staffing needs and managerial responsibilities. Staff said they had confidence in her abilities. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 21 Quality assurance and quality monitoring systems were in place known as the annual service review. This was carried out by two managers from another part of the registered provider’s service and with no direct knowledge of the home and care on offer. The level of care, services and facilities were thoroughly and rigorously assessed with a final rating (from one to five) being offered to the home based on the findings. The last review of 2005 was seen and the staff had achieved an overall score of 4, seen as good. No review had been undertaken since 2005. The registered manager said that following a reorganisation of the registered provider’s senior management reviews would recommence in the New Year. Proper attention was being given to matters of health and safety. A number of safety reports and certificates were examined. All were relevant and up-todate. Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Meadow View 1 DS0000019693.V319245.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!