Inspection on 10/04/07 for Michael House

This inspection was carried out on 10th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Michael House 09/01/06

Michael House 23/08/05

Michael House 23/11/04

Michael House 05/07/04

Michael House 24/03/03

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

CARE HOME ADULTS 18-65 Michael House MacCallum Road Enham Alamein Andover Hampshire SP11 6JA Lead Inspector Peter J McNeillie Unannounced Inspection 10th April 2007 09:00 Michael House DS0000012058.V332515.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 Michael House DS0000012058.V332515.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. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Michael House Address MacCallum Road Enham Alamein Andover Hampshire SP11 6JA 01264 345800 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) Enham Mrs Karen Mary Sawyer Care Home 23 Category(ies) of Physical disability (23), Physical disability over registration, with number 65 years of age (2) of places Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Agreement has been given for one named person over 65 years of age to be accommodated at the home (date of birth is 31.07.35) 9th January 2006 Date of last inspection Brief Description of the Service: Michael House is part of The Enham Organisation, a charitable trust which is situated in the North Hampshire village of Enham Alamein close to the towns of Andover and Newbury in Berkshire. The establishment is one of three similar registered residential facilities all of which are sited close to each other in large extensive grounds. The home is registered to provide care and support for up to 23 service users with a physical disability, the majority of whom participate in work of their own choosing at the at the resource and development centre which is also on the same site. Michael House is a modern, purpose-built two-storey building fitted with a range of electrical and mechanical aids and equipment designed to assist residents maintain as independent life as possible. The establishment also incorporates an assessment suite, where prospective residents are invited to stay prior to a permanent admission. During their stay, potential residents are able to experience what living at Michael House is like and what care / support as well as work and social opportunities are available both in the home, nearby community and throughout the Enham Organisation. These assessment stays are also designed to allow staff to assess the needs of a potential resident and ensure the home can meet these needs. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report was written after taking into consideration a number of sources of information /evidence including a site visit to the premises, previous reports examining residents /staff records, personal observations, talks with residents, staff, management, reading reports produced by the registered person as required by the regulations, responses to an internal annual satisfaction survey results from an in house quality survey responses to a pre inspection user survey by C.S.C.I. and responses by the manager to a pre inspection questionnaire. Following the last two inspections during which the key standards for younger adults were last inspected no requirements or recommendations were made. This key unannounced visit, which took place on 10/04/07 between the hours of 09.00am and 01.30pm, was the first inspection for the year 2006/07 and covered all of the designated key standards for younger adults. During the inspection the inspector who was assisted by the senior carer on duty and the manager from a sister home had the opportunity to discuss living and working in the home with a number of staff and residents both individually and in groups. The results and findings contained in this report will determine the frequency and type of future inspections. Current residential fees range from £574 to £596 per week. Three-week assessment: from £2598. What the service does well: The home provides care in a well maintained pleasant welcoming environment by a well managed, motivated, trained staff team who work in a manner that acknowledges all residents as individuals and recognises their Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 6 rights needs and aspirations including the desire for independence. Areas of particular note are the assessment, care planning, activities, and the environment within the home all of which were assessed as excellent. 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. Michael House DS0000012058.V332515.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 Michael House DS0000012058.V332515.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): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a system of assessing and identifying re needs in which the resident participates and ensures residents safety and that their assessed needs can be met. EVIDENCE: A sample of three residents files chosen at random by the inspector were viewed. All of the records seen confirmed that residents are only admitted following a detailed assessment of needs, risk and benefits being carried out. As part of the pre admission procedure following a referral from a care manager, which would include a care, management assessment prospective Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 9 residents would be invited to stay at the home where a very comprehensive assessment of need over a period of approximately three weeks takes place. Prior to the commencement of the assessment, a pre-assessment meeting is held with the prospective resident. This allows all parties to identify any special requirements the person might have during the assessment as well as answering any worries and concerns. Other areas covered at this meeting would normally include a brief history of the individual and details of any identified risks, medication needs and personal and family contacts. During the three-week period the prospective residents who would live in an assessment flat is also invited to visit and stay in any of the two sister homes to allow a comparison between the various facilities on site. At the end of the three-week period assessment and development reports are produced. The assessment report which includes information on social skills communication, personal care, emotional needs and physical health equipment /aids required also concludes whether or not the home can meet the person’s needs. The development report includes suggestions for personal development plans and activities, for example work experience, art, drama, life skills, numeric and literacy study. A report is also made by the Occupational Therapist. If needs can be met and the prospective resident agrees plans are then made to admit, initially for a probationary period. The home arranges a three-monthly review for each new resident following their initial probationary period. This is also seen as a settling-in period, during which the home continues to work with residents to establish their aims, strengths, needs and aspirations A care plan is formulated from all the information collected and signed by all parties. Michael House DS0000012058.V332515.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 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has a well-developed system of planning and reviewing care which takes into account the wishes and aspirations of residents and ensures resident’s needs are met within a risk management policy. EVIDENCE: A sample of three residents records selected at random by the inspector were viewed. All of the residents spoken with expressed satisfaction at the care they were receiving and the manner in which staff treated them. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 11 Following a very detailed and comprehensive assessment process as described previously in this report, a care plan that gives full consideration to resident’s wishes and aspirations is produced. Three residents’ files chosen by the inspector were viewed. These files included written confirmation residents had been consulted about the plan. All residents talked with, also verbally confirmed they had been involved in and consulted about their care plan. Most of the files viewed included a photograph; in files where there was no photograph a statement to the effect that the resident did not wish to have their photograph taken had been included. Records indicated all plans are reviewed a minimum of three monthly and amended to reflect the changing high care needs of the residents. Residents rights to take risks is acknowledged and is seen as most important in assisting residents to achieve any independence. Any restrictions placed on individuals due to their high needs or physical abilities are clearly recorded in the care plans. Residents spoken with, in confirming they were encouraged to make their own decisions, and take responsibility for their own lives also acknowledged that all decisions should take into considerations all risks and if appropriate be made in consultation and support from staff. Michael House DS0000012058.V332515.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 good. This judgement has been made using available evidence including a visit to this service. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected service users interests and choices. EVIDENCE: Opportunities exist for residents to participate in structured programmes at the development resource centre and workshop, situated in close proximity to all the homes on the site. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 13 Residents’ taking part in the workshop are expected to show commitment such as working to deadlines. This expectation is intended to foster individual responsibility and help people develop skills for employment. Records viewed, comments from staff comments from residents and notices seen during the inspection confirmed a full programme of activities and social opportunities both in house and community based were available. Examples of activities on offer include, T.V.music, craft, I.T.holidays (£500 included in annual fees.), on site clubs, church, daily living skills classes, gardening. Residents management and staff confirmed participation in any activity was by choice and only undertaken following a risk assessment. Residents also confirmed they were encouraged and supported to participate and access the local community if they wished. Community facilities used include, included cinemas, pubs clubs, churches and shopping. A number of residents had their own transport. Many residents rely on transport provided by the home to visit local towns and places of interest and home as in many instances the use of public transport was not an option due to the absence of hoists/lifts to assist wheelchair users. Whilst support and assistance is available, residents are encouraged and supported to be proactive in seeking out local facilities, maintain family contact, establish friendships and if they wished, develop safe sexual relationships as part of them leading independent lives. Residents confirmed any limitations on them exercising unrestricted choice were discussed with them and agreement reached based on the need for personal safety and respect for others. All residents had access to in house public telephones. Many residents owned a mobile phone. All residents bedrooms are fitted with a lock under the student’s control, as is the main door, which is fitted with an entry phone, which allows residents to choose who they allow, enter. A menu based on healthy eating guidelines and residents likes and dislikes was displayed. Residents spoken to said they were satisfied with the food provided and Confirmed, if they did not like what was available an alternative they could choose was always provided. Staff and guidelines to assist residents who required assistance in eating was were also available Michael House DS0000012058.V332515.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. EVIDENCE: A sample of four residents records were viewed. Residents staff and managers confirmed residents were encouraged to exercise choice in all aspects of their lives including, the gender of staff who provides bedtimes, clothes, food, gender of carer, GP, dentist optician and key worker being quoted as examples. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 15 Following the assessment /care planning process any social or health care needs identified are resourced and provided, these might include consultations/input from include learning disability specialists, doctors, district nurses and care managers or access to the on site services of a physiotherapist or occupational therapist. Residents confirmed that they felt staff and management were fully aware of their individual needs and quick to respond should specialist external sources of support be indicated. All residents are encouraged to take responsibility for their own drugs and medicines if appropriate following a risk assessment. At the time of the inspection no residents had responsibility for their own drugs and medication and medication, which are all individually securely stored. Michael House DS0000012058.V332515.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): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse . EVIDENCE: A whistle blowing and Adult Protection Policy and Procedure have been implemented to work in tandem with the procedure produced by Hampshire County Council. The whistle blowing policy last reviewed in February 2006 is currently under review. All management staff spoken to demonstrate they were aware of the procedure to follow should they witness or suspect the abuse of a resident. The complaints procedure, which was also included in the service included information on how to contact The Commission for Social Care Inspection (C.S.C.I), was seen, as was record of complaints, which included time scales within which complaints must be dealt. The record and pre inspection documentation indicated that any complaints received had been dealt with promptly to the satisfaction of the complainant. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 17 Residents confirmed they felt confident and comfortable in discussing any concerns they had with the homes manager but staff did state they felt confident in discussing issues with management on behalf of any resident. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 18 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 excellent. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a purpose built environment which was clean, homely, free from adverse odours and equipped with a large number of specific aids and adaptations designed to maximise the independence, comfort and safety of the residents. EVIDENCE: A tour of the purpose built building indicated it was safe, well-maintained and met residents individual and collective needs. The building had been designed and built with the needs of persons with a disabilility including persons using a wheelchair in mind. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 19 Throughout the building there are large wide corridors, wide doors to bedrooms allowing the free movement of wheelchairs, personal fitted overhead hoists in bedrooms which were also equipped with special beds, baths or showers grab rails. Doors including the main door and lights operated automatically on being approached allowing the resident free use of their hands. All communal rooms were fully decorated, large windows ensured light airy rooms that were equipped with furniture designed to meet resident’s needs. Not only have the needs of the residents been taken into account, so have the needs of the staff enabling then to deliver a good service in a pleasant safe environment. Equipment in the homes kitchen could be raised and lowered to meet the needs of any user. During the tour of the building, which was tidy, clean and free from any adverse odours, no obvious hazards to health and safety were seen and fire safety arrangements were all being observed. An infection control policy and procedure is in place. All staff have access to aprons, gloves and antiseptic soap, which ensures resident safety and protection from cross infection. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 20 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 good. This judgement has been made using available evidence including a visit to this service. Resident’s needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. EVIDENCE: The rota provided with the pre inspection documentation indicated the planned deployment of staff would be a manager, 3 support/care staff and a housekeeper and a cook each shift. Residents spoken with said the staffing numbers were” O.K.” and they rarely had to wait for attention. Staff confirmed that staffing levels are closely monitored to reflect the assessed needs of residents and would be increased if required. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 21 The inspector was unable to view staff files as the manager was unexpectedly away from the home and the other key holder with access to the confidential information was not on site. Staff and management spoken to stated all staff are employed in accordance with a robust recruitment and selection procedure designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, satisfactory Criminal Record Bureau, Protection of Vulnerable Adults and reference checks followed by the satisfactory completion of an in house induction training and probationary period of employment. Confirmation of these procedures will be made at the next visit to the home. Staff training records and supervision were also not available; staff however did confirm that when they commenced employment they underwent very comprehensive induction training followed by National Vocational Qualification (N.V.Q.) and received regular supervision. The pre inspection questionnaire provided by the manager stated that 73 of staff had been trained to at least N.V.Q.level 2. And listed a number of other training initiatives that had taken place or were planned including, infection control, medication, epilepsy, health and safety, disability equality, diabetes awareness, protection of vulnerable adults food hygiene, lone working, I.T skills, and telephone aggression. All of the training records will be checked at the next visit to the home. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 22 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 management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought. EVIDENCE: The registered manager is RNMH qualified and is currently undertaking the NVQ level 4 Registered Manager Award (RMA). Mrs Karen Sawyer has previous care and management experience both with Enham and other organisations and has also done voluntary work. She is the senior care Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 23 manager at Enham and provides formal supervision to the other registered managers. Staff who confirmed they were fully aware of their responsibilities and towards residents confirmed management has an open door policy, and encourages them to share any concerns or ideas they have better the service. Resident’s views are sought through resident satisfaction surveys or at regular meetings. Residents at times are reluctant to complete forms, which are anonymous, and there fore the returns are sometimes low. In speaking to the manager on the phone the inspector was informed that the current system is being expanded to include residents relatives/representatives and visiting social and health care professionals. Progress will be evaluated at the next visit to the home. A health and safety policy and procedure was in place which protects staff and residents by ensuring the maintenance of a safe working environment including the regular maintenance and servicing of equipment/ machinery in use within the premises. During the visit no obvious hazards to health and safety were seen. Protective clothing, gloves, control of substances hazardous to health (COSHH) assessments, risk assessments, equipment servicing and accident records were available but training records to confirm all staff have receive training in the techniques of moving and handling first aid health and safety and the procedures to follow in the event of fire, including evacuation were not seen and have been referred to in the staffing section of this report. The home has a laundry procedure and a washing machine, which is capable of disinfecting soiled items. All of the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all radiators and hot pipes were covered. Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 24 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 X 2 4 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 4 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 15 16 17 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000012058.V332515.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Michael House Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 25 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 Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Michael House DS0000012058.V332515.R01.S.doc Version 5.2 Page 27 - 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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