Inspection on 22/05/07 for Netherwood

This inspection was carried out on 22nd May 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

Netherwood 18/10/06

Netherwood 22/11/05

Netherwood 09/06/05

Netherwood 09/11/04

Netherwood 24/05/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Netherwood Haughton Village Shifnal Shropshire TF11 8DG Lead Inspector Joy Hoelzel Key Unannounced Inspection 22nd May 2007 09:45 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 Netherwood DS0000020718.V335293.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. Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Netherwood Address Haughton Village Shifnal Shropshire TF11 8DG 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) 01952 462192 01952 462494 annharrison@netherwoodhome.wanadoo.co.uk Mr David Harrison Mrs Ann Harrison Mrs Judith Marina Sturdy Care Home 31 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (31) of places Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Up to 31 older persons can be accommodated which can include a maximum of 6 over the age of 65 with dementia. 18th October 2006 Date of last inspection Brief Description of the Service: Netherwood is a Care Home Registered with the Commission for Social Care Inspection to provide accommodation and personal care for a total of 31 older people. The Home is in the village of Haughton, on the outskirts of Shifnal. Set back from the road, in its own grounds, the Home enjoys a peaceful location, where views of the surrounding countryside can be enjoyed from most aspects of the building. The accommodation comprises an original building, which has been adapted and extended, with the additional provision of a 10-bedded Unit in 2002. Bedrooms, of which 19 offers single accommodation and 6 shared double accommodation, are situated on two floors serviced by 2 passenger lifts. All areas are maintained and furnished to a high standard, providing welcoming and comfortable surroundings. The grounds are laid to lawn, with mature trees and shrubs flower borders and garden seating to enable people to enjoy them. Weekly fees range from £383 23 - £458.70. Information of the home and the provision of the service are available in the statement of purpose and service user guide, both documents have recently been revised and are readily available. Commission for Social Care Inspection Reports for this service are available from the provider or can be obtained from www.csci.org.uk Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection is the first of key inspections for 2007/08 and took place over six and a half hours on Tuesday 22nd May 2007. It was conducted by one Commission for Social Care Inspection regulation inspector. Twenty five of the thirty eight National Minimum Standards for Older People were inspected. Thirty one people are currently living at the home; and throughout the time of the inspection were observed to be accessing all areas of the home. The registered manager was on the premises and in charge of the building and was supported by three care staff with additional domestic and catering staff. The owner of the home was on the premises during the inspection. Five case files were selected for case tracking, relevant documents were inspected, discussions were held with people living, working and visiting the home. Observation was made of the various daily activities and a tour of the premises was conducted. The manager completed a pre inspection questionnaire, twelve survey and comment cards were completed by relatives/representatives and a letter has been received from a physiotherapist. The findings and comments of this additional information will be included in this report. What the service does well: What has improved since the last inspection? Improvements have been made to the safe storage of medications. The gardens have been improved with new paths being laid to ensure that people can walk in the grounds and enjoy the gardens in safety. Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 6 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. Netherwood DS0000020718.V335293.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 Netherwood DS0000020718.V335293.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): OP 1,3,6 Quality in this outcome area is good. The home provides a Statement of Purpose that is specific to the individual home, and the resident group they care for. It clearly sets out the objectives and philosophy of the service and is supported by a Service user Guide. An experienced member of staff always undertakes the pre admission assessment. The assessment is conducted professionally and sensitively and involves the individual, and their family or representative, where appropriate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statements of purpose and service user guide are included in the homes brochure package and have been updated with the current information including details of the weekly fees for the service from April 2007. The brochure is readily available on request. The case file of the person most recently moving into the home contains an assessment of care needs from which an initial basic plan of care has been Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 9 developed. Other case files inspected included pre admission information from the primary care trust, social workers and previous social care placements. One person confirmed that they visited the home with their relatives prior to making the decision to move in. Another person stated that they were willing to let their relatives make the decision as to the suitability of the home with another person stating that the home was ideal for them because of the close vicinity to their family and friends. The home does not provide an intermediate care service. Netherwood DS0000020718.V335293.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): OP 7,8,9,10 Quality in this outcome area is adequate. Each individual has a care plan but the practice of involving people who use the service in the development and review of the plan is variable. The plan includes basic information but is not in sufficient detail or information to ensure that all care needs are effectively met. The care plan does not appear to be used as a working document and does not consistently reflect the care being delivered. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Five case files were selected for inspection, with people being at the home for varying lengths of time. Each person has an individual file with basic personal details, risk assessments, care plans, records of visiting professionals. The daily report in which care staff record daily life is in a separate file. There was little evidence to suggest that the person and/or representative had been involved with the planning and review of their care. Only one plan Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 11 recorded that discussions had been held with the person and their family when a change of accommodation had been offered. Risk assessments had been carried out for pressure sores, moving and handling and nutrition, however the amount of information, review times and content varied greatly. Where a risk had been identified for maintaining tissue viability, personal safety and nutrition a specific plan of care had not been developed. Four of the five case files inspected evidenced that nutrition and weight losses and gains are not being monitored appropriately with no action taken when a high risk has been identified or when there is a significant loss of weight. The manager stated that the home has only stand on domestic type weighing scales and for people who experience difficulties with mobility or balance it was impossible to monitor their weight effectively. The manager confirmed that records are not made of a person’s daily dietary intake. Another case file indicated that a person has had several recent falls and had been prescribed analgesia for pain; a specific plan of care had not been developed for reducing the risk of further falls or for effective pain management. The content of the care plans were discussed with the manager, who confirmed that most staff had cared for residents over long periods of time and as such have become familiar with the care needs of the individuals. The blister type packaging is used for administering medication in addition to some bottles and boxes of tablets and liquid preparations. The lunchtime medication round was observed with the Medication Administration Record seen to be completed at the point of administration. The minimum/maximum temperatures of the medication fridge are recorded daily and appear to be within normal limits. There is a secure cabinet for the storage of any controlled drugs that may be prescribed. Some personal confidential information regarding the bathing routines of named individuals is openly displayed on the notice board in the corridor by the main office. This was discussed with the manager and action was taken to remove the document from general view. The care staff were observed to be assisting service users with personal care discreetly and in a manner which promotes service users’ dignity. Netherwood DS0000020718.V335293.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): OP 12,13,14,15 Quality in this outcome area is good. People who use services are involved in meaningful daytime activities of their own choice and according to their individual interests and capability The menu could offer more variety and choice to meet the dietary needs of people using the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A monthly activity sheet is produced and displayed on notice boards detailing the activities arranged on a daily basis. One person stated that presently the art and craft group are preparing for the local carnival and commented that it was ‘great fun’. In house religious services are arranged each month, one person described her wish to go to the local church and went on to say that staff are arranging this for her. One person discussed with the inspector the opportunity to play cards with friends on a regular basis something that has been enjoyed over many years. Other people stated that they joined in with some of the arranged activities but at times preferred their ‘own company’. Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 13 Many visitors were at the home during the morning and afternoon all appeared to be at ease. One visitor stated the home was ‘very friendly and comfortable’ and they were able to visit several times each week. During the tour of the premises many of the bedrooms were very highly personalised with a persons possessions. Information on the advocacy services available within the district are displayed on the notice boards. The dining rooms were prepared in advance, ensuring the meals are taken in a congenial setting. People are encouraged to sit at the table for the main meal, with only the minority of people having the meal served in their rooms. One person did not like the main course prepared for the day, a member of the catering staff discussed the options with this person. A visitor stated that the alternative is generally ham and vegetables and that this person generally has that for lunch. One person stated that they didn’t enjoy the lunch and was not given the option of an alternative, the meal was taken to them by a member of staff and no choice or alternative was offered. One person requested some orange juice but was given a glass of water; staff offered no explanation of why she couldn’t have orange. Other people stated that the food was good. The menu sample in the statement of purpose gave only one choice of fare for lunch and supper with the exception of Saturday lunch and Sunday tea, liver and onions or sausage or quiche or egg salad respectively. However a notice is displayed in the dining room that people should inform with the cook by 10:00 if an alternative meal is preferred. Netherwood DS0000020718.V335293.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): OP 16,18 Quality in this outcome area is good. The complaints procedure is supplied to everyone living at the home and is displayed in a number of areas within the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes complaints policy and procedure was reviewed in January 2007, a copy is placed on the notice board and is included in the statement of purpose. A compliments, concerns complaints book is placed by the visitors signing in book at the entrance to the home. The manager confirmed no complaints have been made since the last inspection. People living at the home stated that if they had any concerns then in the first instance they would contact their family who would ‘ sort it out’ for them. Ten out of the twelve relative surveys completed indicated that they knew how to make a complaint should the need arise. The policy on abuse awareness has been reviewed in April 2007. The home offers a facility for residents to deposit personal monies for safekeeping, it was not possible on this occasion to inspect the records, the person who deals with all financial matters was not on the premises and the office was locked. The manager described the procedure for sundry Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 15 expenditure and confirmed that receipts are given, with all transactions recorded. Netherwood DS0000020718.V335293.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): OP 19,24,26 Quality in this outcome area is good. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The well-maintained environment provides aids and equipment to meet the needs of the people who use the service. The home is a very pleasant place to live with the bedrooms and communal rooms being homely and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All areas, communal and private, were spotlessly clean and hygienic. The lounge and dining rooms are well furnished and homely. Bedrooms are highly personalised with the provided furniture of a good quality. A comment received in the relatives survey indicated, ‘excellent care in good surroundings’. Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 17 The wardrobes in the bedrooms are all free standing and not securely fixed to ensure they do not become unstable and topple over. One lady was having difficulty with opening the wardrobe door and had to pull hard on it to open it. Door guards had been fitted to bedroom doors for the people who prefer their door to be open. Hand wash facilities have been provided at the point of the delivery of care. The garden has benefited from some landscaping with new paths being laid, to ensure ease of access to the gardens; people were seen to be walking around the grounds. The fire safety officer visited in November 2006 confirming the fire risk assessment to be satisfactory. The environmental health officer visited in January 2007 and made one requirement and 9 recommendations following the inspection. The manager confirmed that discussions have been held with the officer and that the requirements and recommendations have been complied with. Netherwood DS0000020718.V335293.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): OP 27,28,29,30 Quality in this outcome area is good. There appear to be enough staff available to meet the needs of the people using the service, with more staff being available at peak times of activity. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing rotas maintained with the levels to indicate the numbers of staff on the premises at any given time. The manager stated that the usual levels maintained are three staff from 7am – 8pm with one additional care staff at peak times i.e. 7-9am and 4-8pm. With three care staff on duty at night. The manager stated that the permanent staff cover for annual leave and sickness of their colleagues, the use of agency staff to cover the shortfalls not being necessary. Many staff have been at the home for a number of years with the turnover of staff being very low. Additional comments received in the surveys completed by relatives are ‘‘impressed with the enthusiastic attitude and interest in the residents shown by the younger care staff under the guidance of the more experienced staff’, ‘I should like to take this opportunity to give the staff at Netherwood my thanks and support’. Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 19 Staff are encouraged to train at National Vocational Qualification Level 2 or above, the pre inspection questionnaire indicates that 74 of the current care staff have gained accreditation. Two staff personnel files were inspected and evidenced that references are obtained prior to them staring to work at the home. The manager confirmed that all staff have had criminal record bureau disclosures check, the records are kept in the locked administration office. Training and development needs of staff are being identified through the appraisal system, the manager confirming that courses are being arranged throughout the year. Netherwood DS0000020718.V335293.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): OP 31,33,35,38 Quality in this outcome area is adequate. The manager is developing systems that monitor practice and compliance with the plans, policies and procedures of the home and is aware of the need to keep up to date with practice and continuously develop management skills. Checks show that records relating to health and safety are generally up to date although some gaps are found in recording and documents not available on request. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager Judith Sturdy successfully completed the formal registration process in January 2007, and has a good understanding of the client group. Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 21 She has been employed at the home for over 12 years and now works in a supernumery capacity. People living, working and visiting the home offered positive comments about the management style. Two people however stated that they ‘didn’t very often see her’. Discussions with the manager demonstrated that further training in the conditions/ diseases of ageing and subsequent treatments would be highly beneficial to ensure satisfactory outcomes for the people living at the home. Satisfaction questionnaires have been distributed to people living at the home; many have been completed by relatives or staff on their behalf. The results have yet to be audited, the manager stated that general concerns have been raised with the laundry service and the availability of staff at certain times. Positive feedback has been received from the physiotherapist, ‘It has always been a very well run home with pleasant staff and happy residents. If anything there is an even better staff/resident relationship and a very good atmosphere with the new manager and deputy’. The home offers a facility for residents to deposit personal monies for safekeeping, it was not possible on this occasion to inspect the records, the person who deals with all financial matters was not on the premises and the office was locked. The manager described the procedure for sundry expenditure and confirmed that receipts are given with all transactions recorded. Routine checks are maintained of the fire alarm, emergency lighting etc. The temperature of the hot water is being tested to ensure a safe temperature is maintained; however the records do not indicate the site of the outlet that is being tested. The gas cooker and tumble dryer were last tested for safety in 2004, with the electrical safety certificate dated as 1996. The manager was unaware of the requirement (Regulation 37) for notifying the commission of any accidents or incidents that affect the health, safety and well being of people living at the home. She was advised to look at the requirement in The Care Homes Regulations 2001 and access the CSCI website for guidance. Netherwood DS0000020718.V335293.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 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 2 X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15(1) Requirement Timescale for action 30/06/07 2 OP8 12(1) The care plans must contain details of all identified care needs and reviewed at least monthly to ensure that a persons assessed needs are fully met. Previous requirement 30/11/06 not fully met. Risk assessments must be fully 30/06/07 completed, with the findings recorded and the action needed to be taken to reduce the risk of a person being placed at harm 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 2 Refer to Standard OP7 OP8 Good Practice Recommendations When ever possible care plans should be developed, agreed and reviewed with the individual person and/or representative Suitable and appropriate weighing scales should be available to ensure that a persons weight can be effectively monitored. DS0000020718.V335293.R01.S.doc Version 5.2 Page 24 Netherwood 3 4 5 OP15 OP24 OP31 6 OP38 7 OP38 The menu should offer a variety of meals to ensure that people have choice suited to their personal preferences. The wardrobes provided by the home should be securely fixed to ensure the safety of people living, working and visiting the home. The registered manager should undertake training to update her skills and knowledge relevant to the client group to ensure that the care needs of people can be fully met. A system to ensure untoward incidents are reported to the Commission should be implemented. This will ensure the Commission is informed of serious events relating to the health and well being of people living in the home. Systems should be adopted to check the safety of the equipment in use at the home on a regular basis, this will ensure that people have a safe place in which to live and work. Netherwood DS0000020718.V335293.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Netherwood DS0000020718.V335293.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!