CARE HOMES FOR OLDER PEOPLE
Mulberry Court Care Home Clifton Park Shipton Road York North Yorkshire YO30 5PD Lead Inspector
Denise Rouse Key Unannounced Inspection 30th May 2007 09:55a X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address DS0000069337.V335078.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000069337.V335078.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Mulberry Court Care Home Address Clifton Park Shipton Road York North Yorkshire YO30 5PD 01904 671122 01904 671144 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) Barchester Healthcare Homes Ltd Mrs Donna Louise Batty Care Home 64 Category(ies) of Old age, not falling within any other category registration, with number (64) of places DS0000069337.V335078.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Age range 50 years plus Date of last inspection New service, due to being registered as a limited company. Brief Description of the Service: Mulberry Court provides nursing care for up to sixty-four residents. The home is purpose built and has accommodation and communal areas on all three floors, which can be accessed by a lift. All the private rooms have en-suite facilities and whilst most are for single use there are four rooms suitable for double occupancy. The home is located on the northern outskirts of York, with good transport links, to local facilities and the city. It is situated in its own grounds with parking facilities. Information completed by the registered manager on the 4th of April 2007 indicated that the fees ranged from £478.58 to £1000 per week. Extra include items like hairdressing, newspapers, chiropody services, aromatherapy and dental services. Information about the home including previous Commission for Social Care Inspection reports, and service user guide are available from the home. DS0000069337.V335078.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • A review of the information held on the home’s file since it was re-registered in February. • Information submitted by the registered provider in the pre inspection questionnaire. • Surveys received from five service users, four relatives, two general practitioners and two care managers. • An unannounced visit to the home by two inspectors, which lasted six hours, thirty-five minutes and which included a full tour of the premises. Evidence gained by direct observation, talking with service users, staff and visitors. Inspection of records, including care profiles, medication administration records, staff files and some of the homes policies and procedures. What the service does well:
“Meals are exceptionally good.” The home has achieved an internal Barchester award. This is awarded to those homes whose all round catering services reach ‘hotel standard’. The dining rooms each have a large bowl of fruit for people who live there to help themselves and fresh coffee available for all. There is a ‘food comment book’ in each of the dining areas, where residents or staff can comment on the meals. This means that people have a voice in the meal service. The staff are provided with comprehensive training to improve their knowledge and skills. This makes sure that people receive care from a well-informed staff team whose practice is up to date. The manager is enthusiastic about her work and encourages and welcomes comments from others as a way of developing the service. She sees getting feedback as an important way of making sure they are ‘getting things right’. There is a varied activities programme, and a full time organiser who is receptive to people’s requests. With the planned provision of raised garden beds there is now a gardening group who have been involved in the planning of these beds. Some one to one work is done with people who are bedfast or DS0000069337.V335078.R01.S.doc Version 5.2 Page 6 more disabled though this could be developed more. The lack of this type of activity was commented on in one of the surveys. All trained staff and carers have had extra training to provide more up to date care and support to people who are dying, and their families. This should allow high quality care to be provided to these individuals by knowledgeable and skilled staff. What has improved since the last inspection?
This is classed as a new service because Barchester Healthcare has reregistered all their homes earlier this year. However there have been no fundamental changes in the way the home operates as a result of this new registration. It is therefore reasonable to comment on improvements made since the last inspection in December 2006. The home now has shared access to a minibus, which was previously solely used by another ‘Barchester home’ in York. This means that social activities requiring transport are now more easily organised. The medication records are now completed properly and there are no gaps where signatures should be. These records show that people receive their drugs according to their prescription. The manager has introduced annual training and assessment for trained nurses to make sure this good standard is maintained. All care records now state whether people would prefer to receive help with their personal care from someone of the same sex. This provides people with more choice and control of their lives, and is respected by the home as far as possible. Care staff, whose first language isn’t English, are now given the option and support to attend ‘English speaking classes’ in York. This new learning, when fairly new in a new country, should enable them to understand and support people better. Recruitment files are now put together in a different way. This makes it much easier to check that the recruitment process has been carried out properly so that people living in the home are protected from others who may be not suitable to work in a caring environment. The manager has created a feedback form, which is given to new residents and their families shortly after they move to the home for the first time. This provides the manager with the resident’s views about how the pre-admission process was for them. This information can guide senior staff, who carry out future assessments, to make sure the process is done in a sensitive and professional manner.
DS0000069337.V335078.R01.S.doc Version 5.2 Page 7 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. DS0000069337.V335078.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000069337.V335078.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3. (6 not applicable) People who use the service experience good outcomes in this area. People have their needs assessed before moving into the home, to ensure their needs can be met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Records show that people are assessed by senior nurses, with regard to their physical, social and emotional needs before moving into the home. This means peoples needs are recognised and can be met. Before moving in they are invited to look around the home with their relatives and to stay for a few weeks on a trial basis. One person said, “I received enough information, and decided from the brochure”. Another commented “I tested the service before becoming a resident”. This allowed them to experience the services available in the home and to make an informed decision about whether the home could meet their needs, before deciding to stay as a permanent resident. Intermediate Care is not provided at Mulberry Court.
DS0000069337.V335078.R01.S.doc Version 5.2 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9, 10. People who use the service experience good outcomes in this area. Service users personal and health care needs were generally well met, however some shortfalls were identified, which may have placed some service users at risk. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Barchester have changed their documentation and staff spoken with felt that information was now easier to read. Care plans now recorded whether people preferred male or female carers to help them with personal care, which provides people who use the service with more choice. Four care plans were looked at to see if the records clearly described how the care needs of those people were to be met. They had their care plans and risk assessments reviewed monthly. However the needs of two people changed
DS0000069337.V335078.R01.S.doc Version 5.2 Page 11 between these monthly reviews. These changes were not reflected in their records to show that their new needs had been acknowledged and re-assessed. One person had moved to the home recently. Their records showed that there had been a fundamental shortfall, in that staff failed to recognise and respond to their significant weight loss. When this was discussed with senior staff however, prompt and appropriate action was taken. Medication systems within the home were inspected, and were found to be generally correct. Some peoples’ photographs, which are in place to confirm identification, were missing from their medication charts. Staff, however were aware of this and were sorting it out. People said they were generally happy living at the home. They looked clean and well cared for. Staff were seen addressing individuals by their preferred names and knocking on bedroom doors before they entered, to respect their privacy and dignity. One person on the first floor though, was calling out, but the carer did not go to them to check on their wellbeing. This was discussed with the head of the unit and the manager. DS0000069337.V335078.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15. People who use the service experience excellent outcomes in this area. The preferred social needs of people at the home were known and were well met. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People choose how to spend their time and were well supported by staff. The activities programme is varied and a weekly programme is given to all the residents as well as being displayed at various places in the home, so that people know what’s going on. The home has a licensed bar. Daily newspapers are available for people to read. Trips are available the last one was to Castle Howard and a fish and chip restaurant afterwards. A mini bus is available. Cake making is offered, which the chef organises and this is very popular. A gardening group has just been set up. Various seeds have been sown ready to plant out in the raised beds, planned for the new garden, which is being constructed in the days following the visit. These beds will enable people interested in gardening to keep an
DS0000069337.V335078.R01.S.doc Version 5.2 Page 13 active role. People had requested a poetry group so this had been set up. One person said. “Even if I don’t participate, I watch what’s going on and feel involved”. Themed activities for example “Ladies Day at Ascot”, Chinese New Year, Burns Night and the American Independence Day celebrations have taken place in the last year. One-to-one activities take place however one person said that “there were not enough social activities for bed ridden residents”. This comment was discussed with the manager. Residents meetings were held, which were well attended. Minutes were available to ensure all parties were kept fully informed and the manager presented an action plan of how she planned to address any issues raised. The dining areas looked inviting and menus were available on the tables. Comments received included “Meals are exceptionally good”, and “there is plenty of choice with meals”. However one person said “there needs to be more English food”. The meals looked appetising and lunch was a social occasion, with hospitality staff being available in an unobtrusive way. The meals were unhurried and people requiring help were assisted in a respectful manner. Kitchen records looked at were satisfactory. DS0000069337.V335078.R01.S.doc Version 5.2 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16, 18. People who use the service experience good outcomes in this area. Service users feel their complaints would be taken seriously, and acted upon. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The complaints policy was displayed along with advocacy details in the reception area. People spoken with stated that they felt safe in the home. Staff, residents and visitors knew who to complain to and all were confident that issues would be sorted out. One person said. “I go to management if I have a complaint, to make sure they get the right information”. There was a ‘Concerns book,’ which appeared to contain concerns and complaints. Brief handwritten notes had been made by the manager to record how these issues had been dealt with, but there was no evidence of any formal letters written, which would outline what action had been taken. A record of this evidence should be kept. Staff spoken with had received training relating to safeguarding adults. Two staff members were spoken with about their responsibilities should they see something they were concerned about. One was clear about their role but the other was not. The manager needs to be sure that all staff know what to do in
DS0000069337.V335078.R01.S.doc Version 5.2 Page 15 that situation so that people who live at the home can be protected from harm. New staff, who start working at the home before their Criminal Record Bureau check is available, have a PoVAfirst check (Protection of Vulnerable Adults) undertaken to make sure that they are suitable to work within the care sector. This vetting system protects people from harm. DS0000069337.V335078.R01.S.doc Version 5.2 Page 16 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 26. People who use the service experience good outcomes in this area. Service users live in a clean and well-maintained home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: A tour of the building was undertaken. The home was attractively decorated with soft lighting and furnishings throughout. There was a secure door entry system to ensure that vulnerable people were protected from unauthorized guests. Spacious lounge areas were well decorated and furnished. Some ground floor bedrooms had patio doors suitable for wheelchair use. These areas were kept beautifully clean and tidy. One comment received was “the home creates a very good impression for visitor. The building, furnishings, communal areas and grounds are lovely”.
DS0000069337.V335078.R01.S.doc Version 5.2 Page 17 There was a payphone on each floor for people to use if they did not have a private line in their bedroom. Many people choose to spend time in their own rooms, which are personalised with photographs and other effects. Wheelchair access to the garden could be gained, and this area was due to be landscaped with raised beds to improve the outside environment. A decking area was also available at the front of the building, for people to enjoy. The kitchen had been completely revamped earlier this year and now was better designed for food preparation. The flooring and the ceiling fans in the dry store and freezer room though, needed cleaning properly to maintain health and safety. Laundry systems were satisfactory except that the laundry door should be kept locked when no staff are present to protect people who live in the home from the cleaning chemicals stored there. Whilst most people were very satisfied with the laundry two people commented less positively in their survey form. Comments include “my clothes are well looked after” and “they could be more careful with laundry” and “they need to improve the system of marking clothing”. There were plastic aprons and gloves available throughout the home for staff to use. Care staff were observed using this protective clothing. This helped to ensure that infection control measures were in place to protect people from harm. One office door was held open by a fire extinguisher. This poor practice was discussed with the manager. DS0000069337.V335078.R01.S.doc Version 5.2 Page 18 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29, 30. People who use the service experience good outcomes in this area. People who live in the home are cared for by adequate numbers of staff who are well trained, and have a good understanding of their role We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: People receive assistance from staff who usually work in that area, as each of the three units was staffed separately. Generally staff do not move from one area to the other, unless due to staff sickness. This helps to ensure good continuity of care. Staffing levels were altered as the dependency and numbers or residents increased, so that people did not have to wait for attention. One person said, “there’s a lot of nice girls here”, and “the staff are attentive and kind”. Care staff were encouraged, helped and supported to undertake their National Vocational Qualification in Care at Level 2 or 3; the home had 47 of care staff that held this qualification. This means that there are more staff on duty at any one time, who have had relevant training in the work that they do. Residents are more likely to be cared for by staff, who are more knowledgeable, and can provide safe, consistent care.
DS0000069337.V335078.R01.S.doc Version 5.2 Page 19 The carers spoken with said they felt they worked well as a team with the nurses and they contributed to peoples’ care plans to ensure the care given was correctly recorded, and signed for. Care staff attended the afternoon handover to ensure that they were aware of issues relating to the people they’d cared for and could contribute in discussions about the care. There was a key worker system. The staff liked this and said their role was to keep drawers and wardrobes tidy, to check they had enough toiletries, and to develop a good relationship with the person and their family. This helped to enhance the quality of the service provided. Staff recruitment files had been improved since the last inspection to ensure that they were easier to audit. Staff recruitment was robust. For example three references had been obtained about one person to ensure that a thorough work history had been gained. This is good practice to protect people from potential harm. Staff did not start working at the home without police checks being carried out. A newly appointed carer confirmed that they had received three days induction, two days working closely with a ‘buddy’ who could introduce them to their new role. This person confirmed the manager’s system, where new staff whose first language is not English are not ‘buddied’ with someone from the same country of origin. The induction process for new staff included a three monthly review. One person though still had some learning needs identified at that review. One month later the records did not show whether those needs had been met or were still outstanding. There is a training coordinator who plans and facilitates training for all staff. The coordinator and the manager have attended ‘Train the Trainer’ courses to enable them to provide training at times that are convenient for the home and the staff. There is a training room with computer and Barchester support a distance learning e-system. Mandatory training takes place annually and nurses are supported in updating their clinical skills. The nurses and care staff have attended extra training to enable them to improve the care provided to dying people and their loved ones. All this training means that people are more likely to receive consistent care from skilled staff whose knowledge is up to date. DS0000069337.V335078.R01.S.doc Version 5.2 Page 20 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, 38. People who use the service experience good outcomes in this area. People benefit from a well managed home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There was a competent experienced, registered manager at Mulberry Court. She was well supported by an Administrator, Head of Care and Unit managers. People knew who she was. One carer stated that the manager walked round the home every morning, and addressed any issues quickly and efficiently. The manager had an open door policy encouraging anyone to speak with her. DS0000069337.V335078.R01.S.doc Version 5.2 Page 21 The manager has introduced feedback forms for how the pre admission assessment was carried out to ensure that staff get the admission process as good as possible. Residents and relatives meetings, to which the chef also attends, are held every three months. The manager should consider how to gain the views of other people who either choose not to come, or are not well enough to attend these meetings. Barchester Healthcare conduct an annual anonymous questionnaire, although the last one had a low response. The manager should look at how to encourage a higher return rate so that the results will be more representative of the views of those interested parties. Senior managers employed by the company make regular visits and carry out monthly checks on how the home is operating. The manager and staff have helped and supported people to attend a funeral or to celebrate the lives of past residents by holding a party at the home to toast someone who had recently died. This gives a real family feel to the home and recognises the needs of individuals to acknowledge the loss of their friends. The home has made proper provision to ensure that there are safe working practices providing staff training in first aid fire food hygiene infection control and moving and handling. Maintenance and safety checks are completed to protect the health and safety of everyone living and working in the home. Barchester has a comprehensive range of health and safety policies to protect everyone and a health and safety committee meets quarterly to discuss any issues. Whilst the home still manages some people’s personal allowances and those records were in order, Barchester Healthcare are changing this system and the facility will not be made available for new people who move to the home. Comments received from surveys included. “My relative feels like they belong to a big family” and “the manager and staff seem to care for relatives and make them welcome” and “from what I witness the home is well run”. Four surveys commented negatively though on the weekly fees. For example one said, “if this home was cheaper, I would not expect perfection, but for the price, they warrant 5 Star in all areas”. DS0000069337.V335078.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000069337.V335078.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12 (1) (a) 15 (1) (2) Requirement Base line observations must be recorded upon admission so that comparisons can be made in the future if necessary. The registered manager must make sure that care plans and risk assessments are created or updated to reflect a person’s current needs so the right support can be given. 2 OP8 13 (1) (b) 15 (1) (2) The registered manager must make sure that people assessed as having high nutritional needs should have their weight recorded as written in their care plan. Further advice from health care professionals must always be sought to make sure the best possible care is provided. 3 OP18 13 (6) Management must ensure that all staff are fully aware of the action to be taken if an allegation of abuse was to be raised so that people can be protected from harm.
DS0000069337.V335078.R01.S.doc Timescale for action 07/07/07 07/07/07 31/07/07 Version 5.2 Page 24 4 OP19 13 (4) (a) The laundry access must be 31/07/07 restricted if staff are not present. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard Good Practice Recommendations It would be good practice for the registered manager to improve her record keeping describing how she deals with concerns and complains. DS0000069337.V335078.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000069337.V335078.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!
