Inspection on 29/06/07 for Neilston

This inspection was carried out on 29th June 2007.

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 but made no statutory requirements on the home.

Other inspections for this house

Neilston 30/04/09

Neilston 02/04/08

Neilston 11/10/07

Neilston 20/06/06

Neilston 17/01/06

Neilston 22/09/04

Neilston 05/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Neilston 47 Woodway Road Teignmouth Devon TQ14 8QB Lead Inspector Margaret Crowley Unannounced Inspection 12:00p 29th June 2007 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 DS0000003759.V335806.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. DS0000003759.V335806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Neilston Address 47 Woodway Road Teignmouth Devon TQ14 8QB 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) 01626 774221 01626 879395 Joy@neilston.info Mr John Bryant Wescott Mrs Joy Wescott Mrs Joy Wescott Care Home 22 Category(ies) of Dementia (22), Old age, not falling within any registration, with number other category (22) of places DS0000003759.V335806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2006 Brief Description of the Service: Neilston is registered to provide care for a maximum of twenty-two older people who may also have dementia. The proprietors and registered providers are Mrs Joy Wescott and Mr John Wescott who live on the premises. Mrs Wescott manages the home on a day-to-day basis and Mr Westcott takes responsibility for the upkeep of the house and garden. Neilston is situated on a hill in a quiet residential area of Teignmouth, and is approximately one mile from the town centre. It is a detached house with a substantial garden.Car parking is available on the road outside. There are 18 bedrooms registered as single rooms and two registered as double bedrooms. All have en-suite facilities. Accommodation is situated on the ground and first floors and there is a stair lift to the first floor. There is a large lounge and a separate dining room with an adjoining sun lounge, which leads to the rear garden. Fees currently range from £299-372. Written information is provided for people considering going to live at Neilston and those who are resident. A copy of the most recent CSCI inspection report is available. DS0000003759.V335806.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 12 hours on 29th June and 2nd July 2007 by Margaret Crowley, regulation inspector. Mrs Wescott, one of the proprietors who manages the home, was present on each day. There were 20 people resident in the home during the inspection. Many were spoken with, including 2 in more depth regarding the lifestyle in the home and the care services they receive. A tour of the premises was made. Records were inspected, including care, medication and staff records. Staff were observed and spoken with in the course of their daily duties. Three visitors to the home were spoken with. A pre-inspection questionnaire was received from the proprietors and surveys were received from 8 people who live at the home, 8 relatives and 7 staff. What the service does well: What has improved since the last inspection? What they could do better: DS0000003759.V335806.R01.S.doc Version 5.2 Page 6 New people going to stay at Neilston do not always have a comprehensive assessment of their care needs undertaken and recorded. This does not ensure that care staff are aware of and have planned for their needs prior to their admission. Although some progress has made in producing care plans since the last inspection, each person did not have a detailed care plan, which reflected their current needs and choices, nor were they or their representative involved in regular reviews of their care. Despite concerns at previous inspections, the system for administering medication was not safe because records were not always completed accurately at the time that medicine was administered. The number of staff on duty did not ensure that there was sufficient staff available to meet people’s needs in a safe and unhurried manner. Domestic staff were not employed. Mrs Wescott and the care staff prepare meals and undertake cleaning duties. The garden did not provide a safe environment because garden tools, garden chemicals, maintenance equipment and building materials were accessible to people using the garden. Fire and accident records seen during the inspection were not always maintained up to date. The fire door at the entrance of a bedroom was wedged open on both days of the inspection. The proprietor was informed that an approved hold-open device must be fitted if the person occupying the room wished to have the door held open, in order to prevent the risk of fire. 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. DS0000003759.V335806.R01.S.doc Version 5.2 Page 7 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 DS0000003759.V335806.R01.S.doc Version 5.2 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1,3,6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People receive information to assist them in choosing to live at Neilston, but there is limited assessment information to assist staff in providing care for new people. EVIDENCE: A person who had come to live at Neilston recently and their relative were spoken with and they said that staff were kind and friendly. A statement of purpose and service user guide was available. These not been reviewed recently or state the services for which the home is registered. Since the last inspection the proprietor has introduced new forms to record the assessment of people’s needs and plans of care. The new format contains several sections. Those inspected had only been partially completed. The assessment of a person admitted recently was not signed and did not provide a comprehensive assessment of the person’s needs or give sufficient guidance to staff in providing care. Although, for example, a history of falls had been DS0000003759.V335806.R01.S.doc Version 5.2 Page 9 “ticked” in one section of the assessment, there was no risk assessment and risk management strategy for the person. Comments made were general, such as “ needs full care- dependent” rather than giving specific information. The “personal profile” section was only partially completed and there was little information regarding the person’s background, interests, and social needs to enable person- centred care to be provided. The proprietor indicated that people may sometimes be admitted in an emergency without full information being provided, but the records did not show when or if their needs had been re-assessed. The proprietor does not send a letter to prospective residents confirming that they are able to meet the person’s assessed needs, but an examination of the contract showed that it is covered in this. Neilston does not provide intermediate care. DS0000003759.V335806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards7,8,9,10.Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although improvements have been made in the care planning processes, care plans do not yet contain sufficient information to ensure that people receive consistent care. The administration of medication is not always recorded accurately, which could place people at risk. EVIDENCE: Comments made by people living in the home and their relatives were generally positive regarding the care provided. Relatives praised proprietor and staff for their attention to people’s care needs and for keeping them informed of any health concerns. They value Mrs Wescott’s active involvement in managing the day-to-day care of people living in the home. Many people living in the home have dementia and some are significantly confused and during the inspection were unable to express their views clearly . Those who could said that the staff were kind, helpful and available when they needed them. Some people said that staff were “busy”. A relative felt staff did not have sufficient time to ensure a person received sufficient exercise to improve her poor circulation. Another relative raised concerns about clothing, DS0000003759.V335806.R01.S.doc Version 5.2 Page 11 but during the inspection people living in the home looked well presented and their clothing well laundered. The inspector observed staff speaking to people in an appropriate and friendly manner, and being considerate when they were assisting them within the home. The care records of four people were inspected. Since the last inspection a separate folder has been introduced each person’s records. On advice from the inspector the records were moved from open shelving to a locked cupboard in the office. The proprietor and the senior staff have been working hard to transfer people’s information into the new care planning and recording format. Some progress has been made, but those seen had not yet been fully completed or lacked sufficient information to provide guidance for care staff to ensure that people’s needs are met. There was some evidence of reviews, but these did not show that the person and/or their representative had been involved in the process. Risk assessments were not detailed or linked to a risk management plan to alert and provide guidance for staff. Staff would benefit from training in assessment and care planning, and how to record the information. The system of daily/night time records was not yet co-ordinated with the new record system. This could result in important information being overlooked. Day time and night time records were recorded in two books, rather than separate recordings made for each person which could be transferred to their individual file. The proprietor said she intended to address this. The home’s system for the administration of medicines was inspected. A monitored dosage system was in use. There was no photograph was attached to the medication record to identify the person concerned. However, photographs for most people had been provided by the second day of the inspection. An examination of medication records showed that these were not being completed accurately. Despite previous requirements, blank spaces were seen in some records with no information recorded to account for what had happened to the medicines. One person’s medicine was signed in advance. The administration practice is unsafe as it leaves tablets unaccounted for and it was unclear whether or not the people concerned had received their medication. The dosage of one medicine had been increased since the current prescription had been received. Although this was recorded in the care records, it was not recorded on the medication administration record to ensure that staff gave the person the correct dosage. There was no controlled drugs register available for inspection. The proprietor said that staff within the home have not administered controlled drugs. One person was currently having a controlled drug administered in patch form by the district nurses who record the administration separately. These are stored in the home’s drugs cabinet There was no report available of last inspection by the community pharmacist. DS0000003759.V335806.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13,14,15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although group activities provide interest for some people living in the home, people’s needs and preferences regarding daily routines and leisure activities are not always sought and recorded. EVIDENCE: The home has an activities programme that includes games, exercise and musical entertainment, with an activity taking place each morning and afternoon. A record is kept of the activity and those who took part. During the inspection a student on a work experience placement provided musical entertainment on the piano and the organ. Care plans inspected provided little information regarding people’s interests, and choices of leisure activities and daily routines. The more able people are able to make choices regarding their daily routines and two people like to go into Teignmouth unaccompanied. Two people attend church with the proprietor. A relative commented on the lack of stimulation and choice in the activities provided. Some people said they prefer not to participate in communal activities and like time spent talking to visitors or staff. The DS0000003759.V335806.R01.S.doc Version 5.2 Page 13 inspector observed that current staffing levels allow little time for staff to spend individually with people. Visitors to the home said that they are “made welcome at all times” and “always offered a cup of tea”. Many people have relatives living in the local area, with whom they have contact. People living in the home and their relatives praised the quality of the meals. The meals seen during the inspection were of a satisfactory standard. There was no choice of menu offered at lunchtime, but both the proprietor and the cook said that they know people’s likes and dislikes and an alternative is always available. A choice of menu is offered at teatime. DS0000003759.V335806.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16, 18 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People living at Neilston and their relatives can feel confident that their concerns will be dealt with and that people will be protected from abuse. EVIDENCE: The home has a written complaints procedure, which is contained in the statement of purpose and service users’ guide, and was on display. Surveys received from people living in the home and their relatives indicated that they knew how to complain, or a relative would raise concerns on their behalf. A relative commented that any concerns are addressed promptly. Since the last inspection a book to record complaints has been introduced. One complaint had been received regarding the temperature of a person’s room and has been addressed. The home has an adult protection policy and a copy of the local adult protection procedures. Staff have received training in the protection of vulnerable adults. DS0000003759.V335806.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards19, 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People live in a home that is comfortable, clean and satisfactorily maintained, but lack of safety in the garden could place people at risk. EVIDENCE: Neilston is decorated in a homely style and has pleasant communal areas and attractive gardens for people to enjoy. A tour of the premises took place and all bedrooms were seen. They were found to be well decorated, clean, comfortable and personalised to the person’s individual taste. Relatives and people living in the home commented on the pleasant surroundings and the cleanliness of the accommodation. Mr Wescott, one of the proprietors is responsible for the maintenance and decoration of the premises, assisted by a maintenance worker. Although routine maintenance matters are addressed, gardening tools and chemicals, DS0000003759.V335806.R01.S.doc Version 5.2 Page 16 building materials and sheds containing maintenance equipment were accessible to people using the garden. The premises were clean, hygienic and free from unpleasant odours other than in one room where this was being addressed. The proprietor said that she had already arranged for the carpet to be replaced. An upstairs corridor was poorly lit and the proprietor arranged for a new light socket to be fitted during the inspection. DS0000003759.V335806.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The number and skill mix of staff on duty does not ensure that there are always sufficient staff available to meet people’s needs in a safe and unhurried manner. EVIDENCE: Communication seen between staff and people living in the home during the inspection was friendly, caring and courteous. People said that staff were kind and helpful, and relatives confirmed this. However two relatives commented on the lack of staff available. The inspector observed that there was little visible presence of staff in the dining room during lunchtime and that a student on work experience was the only person present for part of the time during this period. This was a particularly hectic period when some residents were unsettled and attempting to leave the room. There was little evidence throughout the inspection that care staff have time to spend with people individually, other than undertaking personal care. Concerns have been raised at previous inspections regarding the staffing complement and particularly the lack of domestic staff and a designated cook which places additional pressure on care staff. On the days of the inspection care staff observed undertaking cooking and cleaning and laundry duties. The proprietor said she has been unable to recruit ancillary staff, but that care staff are offered additional hours to undertake domestic tasks. DS0000003759.V335806.R01.S.doc Version 5.2 Page 18 On the days of the inspection there were 20 people living at Neilston. The staff rota was examined and showed that some staff work excessive hours, which could impede their competence to carry out their work. These staff are employed on a contractual basis from outside the United Kingdom. They live on the premises. There is one member of staff awake at night to provide care from 8pm to 8am. The proprietors and care staff who live on the premises are available on call at night. Staff records were inspected and showed that since the last inspection Criminal Records Bureau disclosures and references are being applied for in a timely way to protect people living in the home from potential abuse. The current staff group contains a mix of skills, training and experience. The five foreign nationals are trained nurses in their country of origin, but their qualifications are not currently valid in the United Kingdom. Two of the four U.K. care staff hold the National Vocational Qualification in Care at level 2 or above. Staff have received training in safe working practices including moving and handling, infection control and fire safety. Further training in first aid and caring for people with dementia is planned. Evidence was seen of a system of staff supervision, which is now recorded. Staff meetings do not take place on a regular basis. DS0000003759.V335806.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35,37,38 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The lack of attention to some health and safety matters and record keeping could place people at risk. EVIDENCE: Mr and Mrs Wescott have owned and managed the home for 18 years. Mrs Wescott is a nurse who was trained and qualified in the Philippines and she takes responsibility for the day-to-day running of the home. She holds the Registered Managers Award and is a qualified National Vocational Qualification training assessor. DS0000003759.V335806.R01.S.doc Version 5.2 Page 20 Since the last inspection some improvements have been made in quality insurance systems with the introduction on new satisfaction surveys for residents and visitors. There is minimal involvement with people’s finances, as either the person’s relative or a representative manages this. Where the proprietor makes payments to or on behalf of people, records and receipts were available for payments made. Fire safety records examined showed that the record of tests had not been completed for the previous month. The fire door at the entrance to a person’s room had been wedged open by a book on both days of the inspection. The proprietor was advised that this presented a fire risk and only approved hold open devices must be used. Accident records were examined and showed that for a period of three months prior to a new format being introduced, no accidents were recorded. An examination of a small sample of daily records during that period showed that falls were not recorded, which indicated that accidents may have been under reported. There was a lack of attention to safety matters within the garden. Gardening tools and chemicals, building materials and sheds containing maintenance equipment were accessible to people using the garden. DS0000003759.V335806.R01.S.doc Version 5.2 Page 21 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 2 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 1 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 1 DS0000003759.V335806.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP3 Regulation 14(1)(a) Requirement Timescale for action 02/09/07 2 OP7 15(1), 15(2)b,c All prospective residents must have a comprehensive assessment of their needs, which is recorded. This will ensure that care staff are aware of and have planned for the person’s needs prior to their admission to the home. 02/10/07 All residents’ care plans must set out in detail the actions that need to be taken by the staff to meet the residents’ individual health, personal and social care needs. The care plans must include a risk assessment with written guidance for the staff on how to reduce any risks identified. Previous requirements of 20/6/06 and 28/02/07 not met 2.The resident and /or his or her representative should be involved in the review of the plan of care, particularly when the resident’s needs change. Staff must sign the medicine administration record at the time that medication is given to a resident. When prescribed DS0000003759.V335806.R01.S.doc 3 OP9 13(2) 02/07/07 Version 5.2 Page 23 4 OP27 18(1)(a) medication has not been administered, the reason must be recorded on the medication administration record. Previous requirements of 20/06/06 and 08/11/06 not met Immediate requirement made The number of staff on duty must be reviewed to ensure that there is always sufficient skilled and experienced staff available to meet residents’ needs in a safe and unhurried manner. Accident records and fire safety records must be kept up to date and accurate to ensure the health and safety of residents and staff. Garden tools, garden chemicals, maintenance equipment and building materials must be stored securely to ensure that the garden is a safe environment. 02/09/07 5 OP38 17(2) Schedule 4 02/07/07 6 OP38 32(2)(o) 02/07/07 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 OP1 Good Practice Recommendations The statement of purpose and service user guide should be reviewed and state the services for which the home is registered Staff would benefit from training in undertaking and recording assessments of people’s needs and plans of care A choice of menu should be available at all times 2. 3 OP7 OP15 DS0000003759.V335806.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Devon Office Unit 1 Lnhay Business Park Ashborton Devon TQ13 7UP National Enquiry Line: 0845 015 0120 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 DS0000003759.V335806.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!