Inspection on 18/12/06 for Mill House

This inspection was carried out on 18th December 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mill House 14/01/09

Mill House 12/01/06

Mill House 05/10/05

Mill House 14/12/04

Mill House 16/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Mill House 102 Mill Road Mile End Colchester, Essex C04 5LJ Lead Inspector Pauline Dean Key Unannounced Inspection 18th December 2006 11:30 Mill House DS0000017887.V322872.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 Mill House DS0000017887.V322872.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. Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mill House Address 102 Mill Road Mile End Colchester, Essex C04 5LJ 01206 845378 01206 843367 broadhzn@aol.com 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) Broad Horizons Limited Miss Sarah Walsh-McKechnie Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 3 persons) 12th January 2006 Date of last inspection Brief Description of the Service: Mill House is an established, small care home for three younger adults with learning disabilities. The registered provider is Broad Horizons Ltd. The responsible person is Mrs Jean Revelle. The registered manager is Miss Sarah Walsh-McKechnie. Mill House is one of a group of three small care homes located in Mill Road, Colchester. The three homes work in close co-operation with each other. The home is found in a residential area of Colchester, located close to Colchester General Hospital. There are local shops and facilities nearby, with the main town centre offering shopping and leisure facilities a short bus ride away. Accommodation for the three service users is on the ground and first floor; each having a single room with a wash hand basin. There is a bathroom with bathing and shower facilities, and a toilet. An office/staff bedroom is also found on the first floor. On the ground floor there is a lounge/dining room and kitchen. The property is semi-detached and has gardens to the front and rear. There is some off the road parking. The rear garden is enclosed with a decking patio area, flowerbeds and lawns. Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection, covering the key National Minimum Standards, took into consideration all recent records relating to the service, including information sent to the Commission by the Providers. A record of inspection was collated prior and during the inspection process. It also included a site visit to the home on 18/12/06, which lasted approximately 8 hours over the three Broad Horizon Care Homes. At this visit, the inspector was able to speak with two of service users as they went about the home and care staff on duty. The registered provider was present during this inspection. A tour of premises was completed and there was observation of care practice and the sampling of records. Where possible, the site visits focussed on the experience of a sample of two service users, a process known as case tracking. Of the twenty-three National Minimum Standards inspected on this occasion, fourteen were met and nine nearly met. One of which was a repeat requirement. Whilst it is recognised that there has been an increase in requirements, from three to nine, it should be noted that more Standards were inspected at this inspection. At the time of this inspection there were three service users living at Mill House. Current fees are £550 - £575 per week. Hairdressing, papers, magazines, clothing, personal activities and college fees are not covered by the fees and are charged at cost. What the service does well: What has improved since the last inspection? Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 6 Disappointedly there has been little improvement since the last inspection. Five of the judgement outcomes were found to be good, with the remaining three judged as adequate. One requirement relating to quality assurance has been completed since the last inspection and survey work has been conducted. Mrs Revelle said this work had been considered and used to inform working practices in the home. 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. Mill House DS0000017887.V322872.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 Mill House DS0000017887.V322872.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 good. This judgement has been made using available evidence including a visit to this service. Documentation ensures that service users move into the home knowing that their needs will be met. EVIDENCE: There have been no new admissions since the last inspection. One service user left the home to go into an independent living accommodation and a third service user transferred over from another Broad Horizons care home. Mill House has full occupancy of three service users. Admission paperwork sampled and inspected in one of the three Broad Horizons Care Homes had a detailed admission assessment with supporting paperwork and assessments from the placing authority. This admission was completed September 2006. Mill House DS0000017887.V322872.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. Care planning documents detailed health, personal and social care needs and records evidenced all aspects of care required. Service users are enabled to a degree to make decisions through risk assessments and risk management. EVIDENCE: A plan of care had been developed for all three of the service users living at Mill House. The care plan for one of the service users was sampled and inspected and was found to be detailed in it’s format. Nine care plan objectives had been considered and these were found to be reviewed monthly Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 10 with a full review of needs held six monthly. This had taken place on 24th June 2006 and was therefore due by the end of December 2006. It was not possible to evidence through discussion with the service user as to whether they made decisions about their lives. It was however possible to evidence that choices had been made through the record keeping held in the care plan, both the daily record and the six monthly review documents. In addition care staff spoke of service users making decisions and whilst they may have limited language they were able to communicate their feelings and wishes through non-verbal language and gestures. A risk assessment was found on the care plan file of the sampled service user. From inspecting the care plan it was seen that this required reviewing to ensure that it is relevant with risk assessment strategies in place. Mill House DS0000017887.V322872.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support and assist service users to participate in educational, training and community activities, as they are able. Staff support service users to maintain family links & friendships. Service users rights are respected and responsibilities are recognised. EVIDENCE: None of the service users living at Mill House have employment or attend college. The registered provider and a care staff member said that they would not be able to take part in these activities. Service users within the home completed surveys produced by the Commission for Social Care Inspection (CSCI). All three service users had responded, Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 12 being assisted by the registered manger. They spoke of being able to make choices in what they could do and being able to make decisions. All three service users are encouraged to access the local community. Pub meals, walks and the Gateway Club disco are enjoyed and within the three Broad Horizon homes all service users meet and socialise together. All three service users maintain family links and friendships. They are supported to visit their relatives and one service user was absent from the home as they had gone to their parent’s home for Christmas. At this site visit, the two service users were seen coming and going from their bedrooms. They were encouraged to listen to music of their own choice in their rooms and could be alone or with company. Records were seen of meals planned and eaten. Service users are encouraged to make choices and during the site visit, the two service users settled down to eat the meal of their choice. Both chose to eat at the dining table in the lounge/dining room and obviously enjoyed their meal. Both drinks and fresh fruit were offered as snacks throughout the day. Mill House DS0000017887.V322872.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. The home’s arrangements for supporting the healthcare of service users was satisfactory, with the record keeping and medication administration well managed. EVIDENCE: Throughout the site visit, the inspector noticed that service users were able to come and go to their rooms as they pleased. The two service users at home on the day of the site visit, were not able to tell the inspector how their personal support was managed, but from inspection of a care plan it was possible to see how service users’ choices had been taken into account. All service users are registered at a local GP surgery. They have access to local healthcare facilities such as the dentist and opticians. Links with a consultant psychiatrist and the outreach team are encouraged and service Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 14 users are supported by the home and their relatives to attend regular review appointments. Medication administration was not sampled and inspected in detail at this inspection. It was sampled in detail at another of the three Broad Horizons care homes. Previous issues around self medication storage and management no longer apply as this service user no longer lives at Mill House. The medication for all three service users is held by the care home with appropriate record keeping and storage in place. Mill House DS0000017887.V322872.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 adequate. This judgement has been made using available evidence including a visit to this service. Overall, service users were well treated and listened to, with complaints and adult protection procedures in place. EVIDENCE: Mill House has a complaints procedure, which has been devised using a care home consultancy company. This was found in the home’s policies and procedure file and in a service user’s file. This procedure made reference to raising complaints with the Commission and states that complaints should be raised with “registered director of our Inspectorate.” Mrs Revelle, the registered manager was advised of the need to review this procedure for there are inaccuracies. In addition, clarification is required as to the role of Commission for Social Care Inspection (CSCI). It should be noted that the Commission is not a ‘complaints agency’ and does not have statutory powers to investigate complaints. The Commission will use their powers of inspection to undertake Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 16 enquiry so that we can make a judgement as to whether the provider is complying with the regulations. An adult protection procedure was found in the home’s policies and procedures file. This had a variety of documents entitled ‘Preventing Abuse of a Person in our Care’, ‘Signs of Abuse’ and ‘Suspicion of Abuse.’ Whilst these documents had reference to the Essex County Council Protection of Vulnerable Adults (POVA) referral and the Department of Health document – ‘No Secrets’, the need to review and revise these documents was evident for reference was found to the previous Commission –National Care Standards Commission (NCSC) in the latter document. Mrs Revelle was advised of the need to review these documents making the changes as required. The inspector was informed that the home has the Essex CD training package on abuse and Mrs Revelle said that she plans to use this as a training tool. Mill House DS0000017887.V322872.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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Overall, the home provides a safe, well-maintained environment that is accessible to service users, homely and meets individual needs. EVIDENCE: Overall, Mill House continues to offer a bright, clean and a homely environment. The premises are of a domestic type and are in keeping with the local community in a residential area. This home as with the other two homes managed by Broad Horizons Limited is having a loft extension offering additional bedroom accommodation. This was ongoing at the time of the site visit and as would have been expected this had caused some disruption in the care home. Some damage had been caused by Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 18 the building work in two of the service user’s bedrooms and these along with the hall, staircase and landing which had been prepared for decoration will require decoration of completion of the building works. Issues around privacy for one service user had been considered and opaque Perspex added to the bedroom window. Whilst it is recognised that this action had been taken whilst the building work was ongoing, the care home is advised of the need to reconsider the action taken and look to more appropriate window dressings to ensure privacy. At the last inspection, new kitchen worktops and kitchen cupboard kickboards were being fitted. This room as the lounge/dining room was in good decorative order with furnishings and furniture of good quality. Laundry facilities comprise of a washer and dryer, which are domestic in character. The washer is sited in the kitchen, with the dryer in the garden shed. Consideration is given to the management of laundry to ensure that soiled items do not come in contact with food preparation and eating. Mill House DS0000017887.V322872.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): 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Mill House’s recruitment policy did not meet requirements and therefore does not support and protect service users. There was not sufficient evidence to demonstrate that staff were adequately supervised, trained or supported in their roles. EVIDENCE: Staffing levels and staff rotas were sampled and inspected on the site visit. A rota for the month of December 2006 had been developed and it was noted that there was on omission, no staff were detailed for 20th December 2006. This was raised with Mrs Revelle, who agreed to clarify this with the registered manager on their return. During the month of December, two to three care staff were roistered in the home. Whilst it is recognised that one of the service user was away for three weeks of this month, clearer accurate records need to Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 20 be kept to clearly detail that there are sufficient numbers of staff to support service users’ assessed needs at all times. The file of one staff member was sampled and inspected at this site visit. A completed application form and three references were found in place, but care staff were unable to locate the current Criminal Record Bureau (CRB) disclosure and Protection of Vulnerable Adults (POVA) check. This was raised with Mrs Revelle, the registered provider and it was acknowledged that there is a need to improved staff recruitment practices and record keeping in the home. A thorough overall of all staff records is recommended. Within the staff file inspected there was some evidence of an in-house induction training, but there was no evidence of individual training and development assessments and profiles. These clearly need to be developed to ensure that there is a staff training and development programme, which meets Sector Skills Council workforce training targets. Whilst there was some evidence in the past of a structured record supervision sessions, this had decreased and there is therefore a need for a through review of this practice to ensure that regular recorded supervision sessions are held in the home. Mill House DS0000017887.V322872.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. The home has a qualified, competent and experienced manager to run the home. The home has to review and develop a quality assurance and quality monitoring system to help ensure that the home is run in the best interests of the service users. Safe working practices are promoted through ongoing training. Health and safety certification promotes a safe working environment. Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 22 EVIDENCE: Miss Walsh-McKechnie, the registered manager has completed a National Vocational Qualification (NVQ) level 4 in Management and has a NVQ equivalent in care through her nursing qualifications. Since the last inspection service users, relatives and staff have completed quality assurance survey work. An analysis of the outcome of the survey work has been completed and these have been circulated and used to improve practice within the home. Copies of completed survey forms were found on service user’s files. Safe working practices are ensured through basic training courses and some evidence of this was seen on staff files and from discussion with staff and management. Mrs Revelle said that basic training courses in food hygiene and health and safety are planned in 2007. Safety certification relating to electrical installations was inspected and was current until September 2007. Gas service and safety records were found for 2005, but 2006 certification was not found. Emergency policies and procedures for fire, missing persons, accident procedure and monthly Fire and Emergency Evacuation Records were sampled and inspected. These were found to be in good order. Mill House DS0000017887.V322872.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 X 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 2 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 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 2 X Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 24 Yes 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. 1. Standard YA9 Regulation 13 (4)(b)(c) 14(2) Requirement Timescale for action 20/02/07 3. YA22 22 3. YA23 13(6) 21 4. YA24 23 The registered person must ensure that staff enable service users to take responsible risks, ensuring that they have good information on which to base decisions within the individual service users’ care plan, risk assessment and risk management strategies. The registered person must 20/02/07 ensure that there is a clear and effective complaints procedure, which includes the stages of, and time scales, for the process, and that service users know how to complain. The registered person must 20/02/07 ensure that service users are protected from abuse, neglect and self-harm. This is with regard to the adult protection policy and procedure. The registered person must 20/02/07 ensure that the home has a planned maintenance and renewal programme for the fabric and decoration of the premises with records kept. This is with regard to maintenance and decoration following DS0000017887.V322872.R01.S.doc Version 5.2 Mill House Page 25 5. YA33 18 (1)(a) 6. YA34 19, Schedule 2 18(1)(c) 7. YA35 8. YA36 12 (5), 18 (2) completion of the loft conversion. The registered person must ensure that service users are supported by an effective staff team. Consideration should be given to the assessed needs of service users in accordance to the Residential Forum Guidance. The registered person must ensure that there is a thorough recruitment procedure in place to support and protect service users. The registered person must ensure that there is a staff training and development programme, which meets Sector Skills Council workforce training targets. The registered person must ensure that staff receive support and supervision to carry out the job as detailed in the National Minimum Standards for Care Homes for Adults (18 - 65). (This is a repeat requirement. Previous timescale of 03/02/06 was not met.) 20/02/07 20/02/07 20/02/07 20/02/07 9. YA42 13, 16, 23(2)(p) The registered person must ensure that so far as is reasonably practicable the health, safety and welfare of service users and staff is safeguarded through the promotion of safe working practices, ensuring basic training opportunities are offered and there is compliance with health and safety legislation. 20/02/07 Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 26 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 Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mill House DS0000017887.V322872.R01.S.doc Version 5.2 Page 28 - 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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