Inspection on 12/12/06 for Meadowside

This inspection was carried out on 12th December 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

Meadowside 25/02/09

Meadowside 23/11/05

Meadowside 16/08/05

Meadowside 11/01/05

Meadowside 13/07/04

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

CARE HOME ADULTS 18-65 Meadowside 35 Plymouth Road Tavistock Devon PL19 8BS Lead Inspector Helen Tworkowski Key Unannounced Inspection 12th December 2006 9:30 Meadowside DS0000003752.V323744.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 Meadowside DS0000003752.V323744.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. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowside Address 35 Plymouth Road Tavistock Devon PL19 8BS 01822 614336 01822 614336 anne.hine@virgin.net 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) Mr Roger Hine Mrs Anne Hine Mrs Anne Hine Care Home 11 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (11) of places Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Three named Service Users over the age of 65 years Date of last inspection 23/11/05 Brief Description of the Service: Meadowside is a large extended Victorian House close to the centre of Tavistock. The home offers care to 11 people (under the age of 65) who have mental health needs. The majority of people who live at Meadowside have done so for many years, and whilst the home promotes independence the home does not offer intensive rehabilitation. The house has a lower ground floor where there is the kitchen, dining room/lounge, bedrooms and a shower room. There is a lounge, three single bedrooms on the ground floor. On the first floor there are four bedrooms and on the second floor there are two bedrooms. The home is staffed 24 hours per day, at night there are sleep in staff. There is a large garden to the rear of the property, with a decked area that is easily accessed from the lounge/dining room. The fees for Meadowside start at £350 per week. The fee does not include: hairdressing, chiropody, holidays, toiletries, magazines and leisure activities outside the home. A copy of the Service User’s Guide and most recent inspection report is on the Residents’ notice board and Staff notice board. There is also a copy of the Statement of Purpose in the Office. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was “unannounced” and covered all of the key standards. The inspection included surveying the views of service users (11 were sent out and 11 were returned), staff (11 were sent out and 11 returned), and of visiting health and social care professionals (4 were returned). In addition to this the registered provider completed a pre-inspection questionnaire, providing an up date on the running of the home. A visit was made to Meadowside on 12/12/06 (9.30am to 3.30pm). This visit included a tour of the areas of the home that had been changed when the new extension was built and of exiting communal areas. A number of records were looked at as part of this inspection- these included staff recruitment and training files, service user files and health and safety filed and the medication system was inspected. The Inspector ate lunch with two service users, and looked at the records relating to three individual service users. The inspector spoke with two service users about the care they receive, a third person did not wish to talk. The inspector spoke with the registered provider: Anne Hine and the deputy manager, and also met with two of the care staff on duty. What the service does well: What has improved since the last inspection? A major extension to the rear of the building has been completed. The number of people who live at Meadowside has been increased by one. The work included moving the dining room to the lower ground floor. The room is also used as a sitting room. It is large, well furnished and provides a comfortable Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 6 sitting area and kitchenette for making snacks and drinks. The changes have meant that the main office is on the upper ground floor, close to the main lounge and front door. A new walk in shower has been created on the lower ground floor, and three of the bedrooms now have en-suite toilets. These changes have not only improved the facilities for staff and service users but have changed the dynamics of the house. Staff are now having more contact with service users and spending less time in the kitchen. The additional space in the office means records are better organised. Meadowside has recently purchased a “people carrier” vehicle which is to provide service users with trips out on a more frequent basis. 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. Meadowside DS0000003752.V323744.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 Meadowside DS0000003752.V323744.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, 2, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are given clear information about what they can expect at Meadowside when they move. Their needs will have been thoroughly assessed before they move, so that they can be assured that they will met at Meadowside. EVIDENCE: One person has moved to Meadowside since the last inspection. The person concerned knew something about the home before moving and came for a few days trial stay before deciding to move. Mrs Hine confirmed that she had been given the individual a copy of the Service User’s Guide and the “terms and conditions”. This is information that explains what Meadowside is like, the facilities and what a person would need to pay for themselves and what is included in the fee. On the file there was a copy of the terms and conditions for the individual. Further copies of the Service User Guide and Statement of Purpose are available on the resident’s notice board and on the staff notice board. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 9 Before any individual moves to a care home- it is important that an assessment of their needs is carried out. This should ensure that the Care Home is ready and able to meet those needs. An assessment had been carried for the individual concerned, prior to the move to Meadowside, by staff from Meadowside. There was also an assessment and information from psychiatric services. Mrs Hine had written to the individual and had confirmed that their care needs could be met at Meadowside. The individual had stayed for a few days at Meadowside to see if they felt it was where they wished to live, and this was a positive decision had moved very quickly. All of the eleven service users who responded to the Survey said that they had received sufficient information about Meadowside before they had moved. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 10 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, 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 know Service Users’ needs and offer a good level of support. Service Users are encouraged to be independent and risks are managed. EVIDENCE: Each person has a “Service user Plan” this document explains what the persons needs are and how they will be met. Three Service user Plans were looked at as part of this inspection. Each plan included clear information about what each person needed help with, some were also signed by the Service Users concerned. There was also evidence of these needs being reviewed. There were letters on file about referrals for different health services, and records of appointments. It was clear that where needs had been identified- for example in relation to visiting the optician or dentist that these were followed up. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 11 Two of the flies had risk assessments, though for the most recent person who had moved to the home these had not yet been completed. These risk assessments are important as they help to keep people safe and to avoid unnecessary risk. The Inspector spoke with Service Users about the care and support they received and they felt that the staff were very kind. All of the eleven service users responding to the surveys said that said that they made decisions about what they did each day. Care Workers spoken with had read Service User Plans and were observed consulting and involving people. Service user told the Inspector that they have regular residents meetings where they area to raise issues or talk about things that are happening at Meadowside. The minutes of these meetings confirmed this. Mrs Hine said that she arranged the staff meeting to follow the service users meetings so that staff could take note and act up on the issues raised by Service Users. The surveys from visiting health and social care professionals also indicated that they were happy with the care and support provided to Service Users: “this is an excellent care home who look after their residents very holistically” and “all the residents appear happy and well cared for. I would highly recommend it I find the staff helpful and supportive to both residents and professionals”. One of the recent changes to the physical layout of the care home has meant that the old tea making area on the upper ground floor has been removed. There is now a kitchenette in the lower ground-floor lounge dining room. Mrs Hines said that they are now encouraging Service Users to do more for themselves- preparing their own breakfasts, and lunches. Meadowside is not focused on rehabilitation, however Mrs Hine said that they wanted to get Service Users to do as much as they can for themselves. Information about Service Users is kept in the office, in a lockable cupboard. The improvements in office space has meant that meant that there are now two rooms that could be used to meet privately with Service Users or professionals if needed. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service Users are supported to lead active lives. Staff support individual service users to maintain contact with their family and friends. Meals are nutritious and enjoyed by Service Users. EVIDENCE: Service users who responded to the surveys all said that they were able to do what they wanted during the day, during the evening and at weekend. During the time the inspector was at Meadowside, many of the Service Users were busy going out and about- Christmas shopping, attending appointments, going swimming. One person was helping the handy person with jobs around the home. There was a list of activities planned at Meadowside on the notice board. Mrs Hine said that Service Users had been on holiday this year- to Butlins- and that it was very successful. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 13 Mrs Hine said that Service Users were able to get out and about more, as “people carrier” had been purchased earlier this year. The vehicle meant that trips could be organised at last minute- to suit people’s moods and to suit and the weather. Service Users files had information about how individuals were spending time- for example some Service Users were attending mental health support group. Service Users were preparing for Christmas during this inspection, staff were advising and supporting people buying presents and helping them to make travel arrangements for the Christmas period. Staff were positive and supportive. The Service users said that they enjoyed the meals at Meadowside. Service Users are able to make their own breakfast, with support from staff. Mrs Hine said that they are going to be encouraging Service users to prepare their own lunches. Service Users were out shopping with staff during this inspection, and Mrs Hine said service users were involved in day-to-day shopping. There is a set traditional menu, on the day of the inspection the meal was belly pork, with apple crumble for desert. Service Users said that they discussed the menu at their meetings and this was confirmed by the minutes. There was a bowl of fresh fruit in the dining room, for service users to help themselves. Where Service Users had health issues these were noted and staff were responding by for example encouraging individuals to have a high calorie diet. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are well supported, and treated with respect. Medication is well managed. EVIDENCE: Staff manage medication for the majority of people living at Meadowside, one person self- medicates. The home uses a monitored dose system that is prepared by the local pharmacist. The medication cupboard is well organised and there was no excess medication. The community pharmacist had recently checked the system and had no concerns. There was information about the effects of medication, and staff who handled medication had attended training. Service Users were well dressed, and some obviously took a pride in what they wore. A new level access shower had been installed on the lower ground floor and Mrs Hine said that many of Service Users now preferred to use this shower. It was particularly useful as a few people at the home had mobility difficulties. Feedback from mental health professionals who have contact with Meadowside were very positive about the home. One professional commented “All Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 15 residents appear to presenting happy and well cared for. I would highly recommend it. I find the staff helpful and supportive back to residents and professionals”. All four professionals who responded to the survey said that they were satisfied with the standard of care. Service users files contained good information about health needs, and it was clear that where there were concerns advice and assistance was sought from relevant professionals. All eleven Service Users who responded to the Survey said that they were always or usually treated well, and that staff listened and acted upon what they said. One of the Service Users told the Inspector that the staff were very kind, and that they did not shout, but took her out. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 16 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): 23 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 feel able to make their views known, and there are good systems in place to protect them from abuse. EVIDENCE: All eleven service users responding to the survey said that they would know who to speak to if they were not happy. The Service User Guide contains a copy of the complaints procedure, new service users are given a copy and there is a copy on the notice board. No complaints have been received by Meadowside or by the Commission. There are regular residents meetings, and Service Users confirmed to the inspector that they are able to have their say at this meeting. Service Users were clearly confident about approaching staff, and were in and out of the office during this inspection. Criminal records bureau checks had been completed for staff to ensure that they are suitable work with vulnerable people. All the staff responding to the staff survey said that they were aware of adult protection procedures. Staff had received training with regard to abuse. There was a copy of the local procedures for dealing with concerns. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 17 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meadowside provides a very good standard of accommodation; it is homely and clean. EVIDENCE: This Inspection included a tour of the areas of the building that had been changed or were part of the new extension. The building works that were completed earlier this year included re-siting the office so that it is near the main entrance of the house. There is now sufficient space for storage of records, the office was well organised, and the location meant that staff on duty are able to be better aware of what is happening. The old office on the lower ground floor has now been converted to a staff bedroom/ study. The new lounge/ dining room on the lower ground floor leads directly on to a decked area in the garden. This room provides a pleasant sitting area. There is a kitchenette where Service Users can make drinks and snacks. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 18 A new walk in shower area has been created on the lower ground floor. Where bedrooms have been altered en-suite toilets have been added. These changes seem to have changed the dynamics of the home. Staff seem to be less focused on the kitchen area. There appears to be more interaction between the staff and service users. The new lounge dining area is a very pleasant place to sit and talk. All the staff and service users spoken with thought the home had been much improved by the new extension. All areas of the home seen were clean and tidy and in good order, all of the eleven service user who responded to the survey thought that the home was fresh and clean. One of the points raised in feedback from visiting professionals is that they thought the home was very homely, and that Service Users were encouraged to consider Meadowside as their own home. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 19 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, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users are well supported by well trained and competent staff. EVIDENCE: The care staff rota shows that there are usually 4 on the rota, thought this is reduced to two care staff on call in the building at night. Mrs Hine said that there are never less than two care staff left in the building. This level of staffing is sufficient for the needs of the service users. All of the seven people who responded to the Survey said that they had sufficient time to provide care. Only one member of staff has started work at Meadowside since the last inspection. The recruitment of the individual showed that the person had completed an application, had been interviewed and references and a criminal records bureau check has been made. These checks are important to ensure that the person is suitable and capable of working with vulnerable people. The system of recruitment could be improved by ensuring that any gaps in employment history are accounted for. Also, the Protection of Vulnerable Adults Check should be carried out before the individual is employed. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 20 There are records of staff training on each person’s file and overview of staff training, so it was easy to see what training had occurred and what was needed. 70 of the staff at Meadowside have an NVQ2 or above, Mrs Hine and her deputy are NVQ assessors. Recent staff training has included training in relation self harm, supervision skills, and total communication. From discussions with Mrs Hine it was clear that they be putting was learnt into action - for example making staff rotas and policies more accessible to Service Users. All of the seven staff responding to the survey said that they felt that they had sufficient time to care for the people at Meadowside. Comments from workers included: Staff are trained to a good standard and work well together. Communications lines are open at all times and there is an open door policy to the office.. “ and “…provide good opportunities to train for NVQs”. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 21 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. Meadowside is a well managed and safe home. EVIDENCE: Mrs Hine manages Meadowside. She is a registered Mental Nurse, and holds a qualification in operational management and is undertaking the Registered Managers Award. The deputy Manager also holds relevant qualifications in care and management. There are regular staff and service user meetings, and the views of Service Users are thought through surveys. The inspector discussed with Mrs Hine how the results of these surveys could be collated and how any actions taken could be noted. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 22 The home has already achieved the Investors in People Award, which recognised good staff management. Mrs Hines said that they had just received confirmation that they have kept this award, when the service was reviewed. The IiP assessor provided a very complimentary report. Over the last two years considerable progress has been made at Meadowside, this is particularly obvious in relation to the organisation of the home. There are risks assessments in relation to the general environment. Risk assessments are one way that Service Users are protected from unnecessary risk. There were risk assessments for fire, Legionella, and asbestos, as well as other risks. The home is well maintained and in good order. Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 23 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 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 x 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 X 3 X X 3 X Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 24 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 Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Devon Area Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Meadowside DS0000003752.V323744.R01.S.doc Version 5.2 Page 26 - 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!