Inspection on 18/12/06 for Nether Hall

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 Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Nether Hall 01/12/08

Nether Hall 10/02/06

Nether Hall 02/10/05

Nether Hall 25/01/05

Nether Hall 30/09/04

Nether Hall 09/09/02

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Nether Hall Nether Hall Road Hartshorne Swadlincote, Derby Derbyshire DE11 7AA Lead Inspector Claire Williams Key Unannounced Inspection 18th December 2006 08:30 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 Nether Hall DS0000002122.V323774.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. Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nether Hall Address Nether Hall Road Hartshorne Swadlincote, Derby Derbyshire DE11 7AA 01283 550133 01283 819262 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) www.southerncrosshealthcare.co.uk Ashbourne (Eton) Limited Mrs Sheila Elizabeth Smith Care Home 50 Category(ies) of Old age, not falling within any other category registration, with number (47), Physical disability (3) of places Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Nether Hall care home is registered to provide nursing and personal care to service users whose primary care needs fall within the following categories:- Old age, not falling within any other category (OP) 47 Physical disability (PD) persons aged 44 years and over (3). Adults with physical disabilities (PD) to be accommodated in Bedroom Nos. 1,3 and 8. The maximum number of persons to be accommodated is 50. 2. 3. Date of last inspection 10th February 2006 Brief Description of the Service: Nether Hall Nursing Home provides personal care with nursing, and can accommodate 50 people, all of whom must be over 65 years of age. However, the Home can also provide places for 3 people with disabilities, aged 44 years and over, within the total of the 50 places. The Home is in a rural setting, near to the village of Hartshorne. The property was originally a private dwelling that has been extensively converted and extended into a care home. Accommodation is provided to a good standard across two floors. The upper floor is accessible via a passenger lift, a chair lift or via staircases. Bedrooms are attractively decorated and have been personalised by the current occupants. All except two bedrooms have ensuite facilities. Communal areas are bright and decorated to a good standard. The Home provides a number of lounges and dining areas, as well as a separate smoking area. Information about the service is provided in the Statement of Purpose and Service User Guide; both of these documents are made available to residents. Information included on the pre-inspection questionnaire received on 12/06/06 stated that the fees for the home commenced from £328.20 to £750.00 per week. Items not covered in the fees include hairdressing, chiropody, toiletries, and transport. Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection, carried out by one inspector, which lasted 10 hours. A review of the evidence available prior to the site visit was undertaken, for example, the pre inspection questionnaire, resident surveys (2 surveys received) and notification of incidents, are used to identify areas to be examined during the site visit. Records such as care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents) were examined during this inspection. Time was spent talking with 12 residents and 7 staff members who were on duty and observing the daily routine. The inspector also had the opportunity to speak with 2 relatives. Some bedrooms were viewed during this visit and a brief tour of the building was undertaken. Other records such as medication records, and staff files were also examined. An assessment was also made of the progress by the registered persons to address the requirements made at previous inspections. The registered manager was on duty and assisted the inspector with the inspection. Following consultation with these people, it was agreed that they would be referred to as ‘residents’ for the purpose of this report. What the service does well: What has improved since the last inspection? The Registered manager has continually demonstrated her commitment to developing the home and its service provision. Since the previous inspection all residents have been given copies of the Service user guide, and Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 6 improvements have been made to the medication practices in the home to ensure residents health care needs are adequately met. Training has also been provided for majority of the staff team in First aid to enable them to respond to any medical issues that may occur. 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. Nether Hall DS0000002122.V323774.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 Nether Hall DS0000002122.V323774.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, and 3 (Standard 6 is not applicable in this home) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with information about the home in suitable formats and do not move into the home without having their individual needs assessed and being assured that these would be met. EVIDENCE: Discussions were held with residents’ case tracked about the arrangements for their admissions to the home and information provided to them and/or their representatives. Majority of the residents stated that their representative’s had the opportunity to visit Nether Hall, and from this visit and the discussions held, a decision was made for them to move in. One of the relatives spoken with stated that he moved his parent into this home due to “the positive reputation it has in the local community”. There was evidence in the resident’s bedrooms to support that they had been given copies of the Service user guide. The Statement of purpose is accessible in the reception area and a copy is available upon request. The Registered Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 9 manager confirmed that both of these documents have been updated to reflect the change to the registered provider. The recorded needs assessment information for each resident case tracked was examined. This information has been transferred onto the new documentation implemented by the new provider and was comprehensive and up to date. Confirmation was received from the head of Care that assessments are undertaken before anyone is admitted and a judgement is made to support that Nether Hall can meet their needs and a letter is sent detailing this. Feedback from residents and their representatives was generally positive about the care provided and about the Registered manager who was described as “supportive” during the admission process. Nether Hall DS0000002122.V323774.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): 7, 8, 9, and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s philosophy of approach towards care successfully underpinned the promotion of residents’ rights to dignity, privacy and respect, and ensured that their personal and health care needs were being met. EVIDENCE: Discussions were held with residents’ case tracked about their care and comments were also received on the surveys. Positive comments were made and satisfaction was expressed about the arrangements for individuals personal, social and healthcare. Discussions were also held with staff regarding the arrangements for care delivery and the provision of individual equipment. The staff spoken to had a good knowledge of the resident’s needs and how these should be met and they confirmed access to all of the required equipment in order to support residents appropriately and safely. Four care plans of those residents case tracked were examined. All of the files contained a comprehensive care plan covering a varied range of areas dependent upon the individuals needs. However one file did not contain a plan of care that identified the support the resident needed Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 11 with personal care tasks. This was discussed with the Registered manager who confirmed that she would deal with this issue as a matter of urgency. The inspector received confirmation and evidence to support that a plan of care had been implemented for this resident on the following day. Each component of the care plan linked in with a risk assessment in relation to: moving and handling, falls, tissue viability, medication and nutrition. These assessments were completed and monitored in accordance with the guidance specified. There was evidence to support that the contents of the care files were reviewed on monthly basis and formal reviews undertaken. In response to the previous inspection the care files clearly indicated if a resident was unable to make daily decisions about their care, and it specified that staff undertake this task on their behalf in accordance with the residents known preferences. The arrangements for access to healthcare professionals was also discussed with residents and staff, including that relating to routine health care screening and records in respect of these were also examined and were properly maintained. A number of healthcare professionals visited named residents during the inspection, including GP, and a district nurse. The arrangements for the management and administration of medicines were also examined, with particular scrutiny placed on those residents case tracked. The inspector noted improvements in this area, and the requirements made previously had been addressed. All medication had been administered and signed for in accordance with the procedures in place. An inspection by Boots pharmacy has been undertaken in November 2006 and this reflected that medication was being administered and stored appropriately. A few recommendations were made and the Registered manager confirmed that these have been addressed. The arrangements for personal care and support were discussed with residents and also staff’s approaches with them. Generally comments received were positive and residents said that the care and support they received was “good” and ‘the staff are great”. All residents confirmed that they are treated with ‘dignity and respect’ and are “consulted at all times”. The relatives spoken with also spoke positively about the level of care provided and felt that their family member “was well looked after” and that the staff were ‘very good and caring’. Each resident has a letter box and a door knocker and those who spoke with the inspector confirmed that these are used and staff wait for a response before entering their rooms. Nether Hall DS0000002122.V323774.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): 12, 13, 14, and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements to enable residents to engage in occupational, social and recreational activities of their choice and in consultation with them, therefore providing a stimulating environment that meet resident’s preferences. EVIDENCE: Nether hall employs two part time activities co-ordinator. Discussions were held with residents and staff about the arrangements for residents to engage in occupational, social and recreational activities and to receive visitors. Feedback about these arrangements was also received via resident’s surveys. High levels of satisfaction were expressed in respect of these, and residents felt that the activities were well organised and in accordance with their individual choices. Records and details of activities displayed were reflective of this. On the day of the site visit for the inspection some friends of a resident came and sang carol songs with the residents which they said they had enjoyed. The activities co-ordinators ensure that all residents have some access to activities and provide both group activities and one to one sessions for those individuals who remain in their room. A newsletter is completed containing information Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 13 about previous or forthcoming events, and information about staff or residents for example about their birthdays. This is posted on the notice board for all to access. The Registered manager holds regular residents meetings and relative meetings, and these had been well received and the minutes of the meetings were recorded. The Registered manager also holds a surgery every month to enable residents or their representatives to have an informal chat with her about the running of the home. Relatives consulted stated that there is a welcoming and friendly atmosphere in the home, and good links were established with the local community. Residents confirmed that their cultural needs are supported and access to services promoted. The inspector was invited to have a lunchtime meal. The head cook informed the inspector that new menus had been devised following consultation with the residents, and these were due to be implemented soon. Majority of the residents spoke positively about the standard of food and meals provided, and confirmed that choices were “always available”. Residents commented that they particularly enjoyed the cooked breakfast, and that they did like the fact that all of the food was homemade. Observations confirmed that the mealtime was relaxed and the tables were set with napkins and condiments. Residents are given the choice of where to eat their meals and this was respected. Those residents that required support to eat their meal were provided with this in a dignified manner. Some residents require liquidised food and this was prepared individually, which is good practice. The use of moulds was discussed for the purpose of presenting food in a dignified manner. Nether Hall DS0000002122.V323774.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): 16, and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were confident that their complaints would be listened to, and there were suitable systems and procedures in place to promote the protection of residents from harm, and staff understood their responsibilities in relation to these. EVIDENCE: Details of complaints received by the home over the preceding 12 months were provided in the pre-inspection questionnaire as completed by the registered manager. There had been three in total. These were discussed with the Registered manager at the site visit for the inspection, including action taken and outcomes and records were examined in relation to these, which from the information provided were satisfactory. Effective information is provided for residents and their representatives as to how to complain by way of the home’s complaints procedure, which is openly displayed in the home and also provided in the service user guide and statement of purpose. Residents spoken with knew how to complain. Feedback from residents/representatives indicated that the Registered manager and staff listened to them and dealt with concerns raised promptly. Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 15 Staff spoken with was conversant with the appropriate procedures to follow in the event of any suspicion or witnessing of the abuse of any resident. The Registered manager informed the inspector that there have not been any safeguarding adults referrals since the last inspection. Residents spoken with said that they felt safe in the home and that staff treated them with kindness and respect. Nether Hall DS0000002122.V323774.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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe and well-maintained environment, which meets their needs and is homely and comfortable. EVIDENCE: The private and communal accommodation of resident’s case tracked was inspected and was found to be well furnished and decorated to a good standard and well maintained. Residents own rooms were well personalised and those spoken with expressed their satisfaction with these and the environmental standards throughout the home. All areas seen were clean, odour free and free from hazards. All areas were also well lit and ventilated and were furnished and decorated to a good standard. Equipment was provided in accordance with residents’ assessed needs. There are systems in place for the routine maintenance and renewal of the fabric and decoration of the home. There are suitably laundry facilities and Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 17 also separate sluicing facilities. Residents have lovely views of the surrounding areas and have access to a well tended garden and courtyard. Nether Hall DS0000002122.V323774.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): 27, 28, 29, and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although the staff meets residents’ care and support needs, the home’s record keeping in respect of staff recruitment does not ensure staff are vetted appropriately and residents fully protected. EVIDENCE: Details of staff employed, together with the arrangements for their deployment, recruitment, induction and training were discussed with the Registered manager and staff and records were requested and examined in respect of these. Information was also provided by way of the pre-inspection questionnaire completed by the registered manager with regard to staff employed and their recruitment and training. The discussions held with the staff members confirmed that they had a good knowledge of the residents and were motivated and committed to their roles. The staff felt that they were all working as a team and comments received included “we all work well together” “the staff morale is good”. It was evident from the staff discussions that they were committed to their roles, and “enjoyed their job” The residents and relatives consulted with spoke positively about the quality of the care received, and all made comments praising the staff for their hard work and commitment to ensuring the residents are “well cared for”. Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 19 The arrangements for staff recruitment and induction was discussed with the Registered manager and the personal files of three most recent staff employed were examined. The files contained majority of the required information but the inspector did note that only one of the three files contained two references, and only one file had a full employment history. Although one of the staff members had stated that they had completed a National Vocational Qualification at Level 2, there was no evidence in the file to support this. The Registered manager has only recently had administrational support as the previous staff member had left; therefore this has had a bearing on the files not containing all of the required documents. There was evidence to support that all new staff undertake an induction that meets the skills for care training specifications. Staff confirmed there had been a variety of training over the preceding 12 months, including moving and handling, Fire awareness, residents welfare, Palliative Care, Dementia, Health and safety, adult protection, safe handling of medicines and First Aid as detailed on the pre-inspection questionnaire It also stated that 18 care staff had achieved a National Vocational Qualification (NVQ) at Level 2 or equivalent, therefore achieving the required 50 target. Nether Hall DS0000002122.V323774.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): 31, 33, 35, and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from the home being managed by an experienced manager who provides clear leadership throughout the home. EVIDENCE: The registered manager has been employed at the home for many years. She is a Registered General Nurse and has completed the Registered Managers Award and NVQ level 4. Discussions were held with her about training and development undertaken and she confirmed that she continues to access training in order to keep up to date in all required areas. She is motivated and committed to ensuring that the home is managed in the best interests of the residents and that they are consulted about the day to day running of the home. Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 21 The residents, relatives and staff members consulted spoke positively about the management team and felt that they were supportive and approachable. There was evidence to support that a quality assurance survey had been completed previously in the year, and the results were analysed into a report. There was evidence to support that a representative of the registered provider visits the home on a monthly basis, and reports of these visits were provided. The arrangements for the management and handling of resident’s monies were discussed. The inspector was informed that a new electronic system will be implemented soon and all of the resident’s money will be put into individual banks accounts. Therefore at the time of this visit all of the finances were pooled together. Each resident did have an individual balance sheet and there were two signatures on each transaction. Following the recommendations made by the inspector the Registered manager confirmed on the following day that all of the residents money has now been separated into individual bags until the new system is finalised. Details of the required maintenance of equipment were provided within the pre-inspection questionnaire, which were up to date and satisfactory. Nether Hall DS0000002122.V323774.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 3 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP29 Regulation 17, S4 Requirement A copy of each reference (x2) must be obtained for each staff member recruited. A full employment history must be obtained for all new staff and written explanation of any identified gaps must be provided. Evidence must be obtained to support any previous training undertaken by new staff members. Timescale for action 01/02/07 Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 24 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 OP15 The head cook should considering using food moulds when presenting food that needs to be liquidised. Nether Hall DS0000002122.V323774.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Nether Hall DS0000002122.V323774.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. 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