Inspection on 31/01/06 for New Swinford Hall

This inspection was carried out on 31st January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

New Swinford Hall 04/09/07

New Swinford Hall 20/09/06

New Swinford Hall 06/09/05

New Swinford Hall 25/01/05

New Swinford Hall 21/09/04

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 New Swinford Hall Martley Drive Stourbridge West Midlands DY9 7DE Lead Inspector Mrs Cathy Moore Unannounced Inspection 31st January 2006 07:45 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 New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 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. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service New Swinford Hall Address Martley Drive Stourbridge West Midlands DY9 7DE 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) 01384 815975 01384 815978 N/K Dudley Metropolitan Borough Council Mrs Helen Janet Green Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. All requirements contained within the registration report of 25 and 26 November 2003 are met within the timescales contained within the action plan agreed between Dudley Metropolitan Borough Council and the National Care Standards Commission. Service users to include up to 18 OP ((PD(E) or MD(E) or both PD(E) and MD(E)), 2 MD and up to 2 PD, of which must be 50 years of age and over. By the 30 September 2003 water available from bedroom/bathroom taps together with any exposed pipe works shall not exceed 43 degrees Celsius. In the interim, following risk assessments, strategies are implemented to safeguard service users. 06/09/05 2. 3. Date of last inspection Brief Description of the Service: New Swinford Hall is owned and managed by Dudley MBC. The service it provides is fairly unique as it is short-term care only with an ethos of rehabilitation and re-ablement. A maximum of 18 residents’ at any one time can receive care from this service. The ultimate aim for residents’ accessing this service is for them to enhance or relearn skills lost by accident or illness, or to acquire new skills to enhance their independence in respect of daily living. Generally, the maximum length of stay at this home is five weeks. There is no charge to the resident for this service. The home is a traditional style property. It is located between Lye and Stourbridge in the borough of Dudley. The home is sited on a residential estate. Unfortunately few shops or facilities are available within the direct vicinity. The home has adequate outdoor space. There is limited car parking space at the front and side of the home. The home is divided into three units; these are called Romsley, Clent and Malvern units. Each unit has its own living, dining and kitchenette facilities. An assisted bath is situated on each floor. All of the bedrooms are single occupancy, each having en-suite facilities to include a walk in shower, hand washbasin and toilet. Two physiotherapists and two Occupational therapists work within the home producing rehabilitation and re-ablement programmes. Staff are trained to continue with these programmes on an on-going basis. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out by one inspector, on one day, between 07.45 and 14.40 hours. The inspection was carried out as the second of the homes’ two routine inspections for this inspection year. The inspection focussed on core National Minimum Standards for Older People that were not assessed during the previous inspection and previous requirements made. During the course of the inspection two residents’ files were examined. The premises were randomly assessed focussing on safety. Medication systems were also assessed. Five residents’ were spoken to during the inspection. The senior on duty was involved in the inspection process. Not all of the National Minimum Standards for Older People were assessed during this inspection .For a full overview of service delivery this report should be read together with the last inspection report dated 6 September 2005. What the service does well: The home is unique as it offers short term rehabilitation and re-ablement programmes. Staff within the unit are trained to work with each resident to enhance or relearn skills needed for every day living and independence. Physiotherapists and Occupational Therapists are on site to give professional input. The home in general is maintained to a good standard. It is clean, comfortable and fit for purpose. The home is divided into three units internally which creates a ‘ homely atmosphere’. All bedrooms are single occupancy with en-suite facilities provided -which include; a walk in shower, hand washbasin and toilet. Bedrooms are appointed to a good standard. The home offers a range of aids and adaptations to enhance mobility and individual potential example being; a passenger lift, grab rails, assisted bathing, a training kitchen and laundry. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 6 Records generally are produced and maintained to a good standard. The senior and staff team continue to be motivated and committed to providing a good standard of service to the residents’ in their care. As with previous inspections positive interactions were observed between staff and residents’. The majority of past requirements made have been addressed/met. Over 60 of the staff have attained N.V.Q level 2 or above in care. The home has since the last inspection received numerous thank you cards. Residents’ were very complimentary about the home comments received include; “ They spoil us here- couldn’t say a bad thing about the place”. “ Food very good, I have put on that much weight!”. “The staff are very nice, polite and kind”. “ I think it is wonderful here bright, cheerful and the carers are wonderful”. The senior in charge of the home during this unannounced inspection was totally calm and collected throughout even though the home was very busy at the time with a new admission and councillor visit. What has improved since the last inspection? Since the last inspection the manager has been formally approved as being a fit person to manage the home by the Commission for Social Care Inspection. The medication policy has been revised. Policies, procedures and service records have been better organised. The policy has been approved by the homes’ pharmacy provider. Checking systems have been introduced to ensure that required documents are used for residents’ on admission. Staff are being more diligent regarding infection control. No personal care items that should not have been were seen in communal bathrooms. Recordable handover systems for safe and medication keys have been established and implemented. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 7 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Nil No standards in this section were assessed during this inspection. EVIDENCE: No standards in this section were assessed during this inspection. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 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): 9. Medication systems require ‘fine tuning’ to ensure that they are safe and effective. EVIDENCE: Good practice was observed in respect of medications. The senior on duty has a good knowledge of medications she is responsible for. All staff who have a responsibility for medication have received accredited medication training. Photographs of each resident were available within their medication records. Medication key safety procedures are in operation. The staff example initial list for those staff who administer medication is current and up-to-date. The home has a contract with their pharmacy provider until the end of March 2006. Written documents were available to demonstrate that the pharmacy provider is undertaking regular audits of the homes’ medication and medication management. The last audit report dated 8 November 2006 did not highlight any shortfalls or problems. Controlled drugs prescribed were checked and found to be correct against balances. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 11 Unfortunately, a number of shortfalls were identified. For new residents’ being admitted to the home there was little evidence to demonstrate that their medication, dosage and frequency has been confirmed by a ‘reliable source’ examples being; their doctor or the hospital. Two staff at the present time are not verifying that information transferred from medication bottles and containers to medication records is correct. Although risk assessments are being carried out for residents’ who self administer prescribed oral medication, risk assessments are not in place for residents’ who are self administering prescribed topical or optical preparations. There were no clear instructions for medications that require weekly or alternative day administration. These were seen to be written; ’As directed’. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 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): 14,15. Residents’ are helped to exercise choice and control over their lives. Residents’ receive a wholesome appealing diet in pleasing surroundings at times convenient to them. EVIDENCE: The home only provides short term care- maximum stays are generally no longer that 5 weeks. Residents’ can take personal items into the home with them if they wish. It is positive that advocacy information was available within the home. Seniors on duty when asked about voting arrangements said;” It is usually the families that take residents to vote, this has been their choice in the past. We would arrange for residents’ to vote if they want to”. The home has a written 4 week menu in operation. The menu is varied and interesting. The menu does not however, detail supper options. The substantive cook has a good reputation in respect of her cooking. Residents can choose a cooked breakfast every day, there are alternatives available for each mealtime. The main meals options offered on the inspection day were beef stew or liver and crème caramel or eves pudding and custard. Tea was pilchards on toast or mince pie. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 13 Because of the rehabilitative and re-able ethos of the home where possible residents’ are encouraged to prepare and cook their own food. All residents’ spoken to were positive about the food. One said; “There is a choice of food-it is all good”. Another said; “ It is like a hotel here, the meals are wonderful”. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 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): 16,18. Residents’ are confident that their complaints will be listened to. Residents’ are protected from abuse. EVIDENCE: The home operates within the care sector of Dudley Councils’ corporate complaints procedure. Leaflets pertaining to this procedure were available within the home. They contain the address and telephone number of the Commission for Social Care Inspection as required. Information relating to complaints is available in the residents’ bedrooms. One resident when asked what she would do if she had a complaint responded; “ I would tell one of the staff. They have acted properly with everything else so I’m sure that they would deal with a complaint”. It is positive that the majority of staff have received abuse awareness training. Internal policies and procedures seen require a review. The home has available a copy of Dudley Council’s vulnerable adults protection procedures titled;’Safeguard and Protect”. It was noted however, that there was no evidence to suggest that the staff have read these procedures. The new leaflets to accompany the procedures- which contain useful contact numbers- were available within the home but not in a prominent place as they should be. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 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): 25. Attention must be paid to the homes’ heating system to ensure that it is effective and safe. EVIDENCE: Generally the home can be regarded as safe. Radiators’ are all guarded. Hot pipe work seen, was also guarded. Lighting generally is adequate (with the exception of corridors where it is dim in places) and domestic in style. The corridor lighting has been the subject for requirement for some considerable time. The home is experiencing problems with the heating system. Staff said; “ At times in some areas the home is cold. Sometimes it is too hot. Last week one room temperature was found to be 90oc. This concern was raised by two residents’ who said; “ The night before the heat was unbearable”. And; “ It was 90oc, we all felt ill”. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 16 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): 30. Further developments are needed to ensure that all staff are trained and competent to do their jobs. EVIDENCE: It is positive that the home has induction materials and processes for new staff. The home uses the ‘black Country Partnership for Care’ induction package. This evidenced by a new staff members induction materials being available on site. Whilst it is positive that the home has a training matrix it does not reflect all required training examples being; safe handling of medication or abuse awareness training. It is concerning that one staff member has not received all of the required mandatory training, for example she has not attended recent moving and handling training. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 17 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): 31,38. The manager is fit to be in charge of the home. She has however, yet to attain the required management training. EVIDENCE: The manager at the present time is on leave. She has been approved as a fit person to be in charge of the home by the Commission for Social Care Inspection. She has not however, to date, attained N.V.Q 4 in management which needs to be addressed on her return to work. Service certificates and evidence of routine maintenance work were examined. The fire alarm, fire fighting equipment and emergency lighting systems have all been serviced and are said to be in good working order. Portable hoisting and assisted bathing aids were serviced in December 05. Evidence was New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 18 available to demonstrate that fire fighting equipment and systems are checked in-house weekly and monthly. Recommendations were made by the homes’ insurance company following their assessment of the lift in September 2005 yet there was no evidence available to confirm that these recommendations have been addressed. Portable electrical appliances have not been tested since December 2004. Wherein they should be tested every 12 months. One senior has been delegated to deliver fire training to the staff. Concern was raised in that this staff members training is no longer valid as it expired in 2004. Accident records are being maintained. Accident analysis is not being undertaken as it should to identify patterns or trends. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 2 x x x x x x 2 x STAFFING Standard No Score 27 x 28 x 29 x 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x x x x x x 2 New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 20 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 OP9 Regulation 13(2) Requirement Timescale for action 15/02/06 2 OP9 13(2) 3 OP9 13(2) 4 OP9 13(2) The registered persons must seek written confirmation from a reliable source ( The doctor, hospital) of the prescribed medication ( dosage, frequency etc) for each resident being admitted into the homepreferably before they are admitted. The registered persons must 15/02/06 ensure that where medication records are produced by the home that the information transferred from containers to the medication records are verified by two staff. The registered persons must 15/02/06 ensure that a risk assessment is in place for all residents’ who self medicate – this to include all routes topical, optical etc. The registered persons must 15/02/06 ensure that all ‘over the counter’- homely remedies are ratified by the residents’ doctor. ( L’s Cod Liver Oil). New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 21 5 OP9 13(2) 6 OP15 17(2) Sched 4(13) The registered persons must ensure that clear instructions are detailed on all medication records – should not be written as – ‘As directed’. The registered persons must ensure that; Supper is detailed on all menus. 15/02/06 01/03/06 7 OP18 13(6) Supper is included on food intake charts/documentation. The registered persons must 01/04/06 ensure that; The homes policies and procedures aimed to protect vulnerable adults are reviewed. All staff read, sign and date Dudley MBC’s protection procedures ‘ Safeguard and protect’. The registered person and manager must ensure corridors in the home are redecorated. Timescale of 01/12/05 not met. The senior on duty informed that this work is due to be carried out in February 2006. The registered person and manager must ensure that the up-lighters- by assessing whether or not they meet the correct lux requirements/ meet the requirements of the home. Timescale of 01/02/06 not met on 31/01/06. 8 OP19 23(2)(d) 01/04/06 9 OP25 13(4)(a) 23(2)(p) 01/03/06 New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 22 10 OP25 13(4) 23(2)(p) The registered persons must ensure that; An engineer or other suitably qualified person fully assesses the heating system. The engineer or suitably qualified other must produce a report of their assessment. A copy of which must be forwarded to the CSCI. Approved room temperatures are maintained at all times. 28/02/06 11 12 OP30 OP30 13(4) 13(5) 18(1)(a) 18(1)c)(i) The registered persons must 01/04/06 ensure that all staff receive the required mandatory training. The registered persons must 01/03/06 ensure that the following training be detailed on the training matrix; Safe handling of medications. 13 OP31 9(2)(i) 14 OP33 24(1)(a) (b) Abuse awareness. The registered person and 01/07/06 manager must inform the CSCI of the confirmed start date for the manager to commence N.V.Q level 4 in management. The registered person and 01/05/06 manager must implement systems to ensure that the whole of standard 33 is being met. This standard/ requirement requires attention to ensure that all elements are being met. Timescales of 25/02/05 and 01/11/05 not fully met. New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 23 15 OP38 18(1)(a) The registered person and manager must ensure that staff receive health and safety training. Timescale of 01/12/05 not met. The registered persons must ensure that arrangements are made as soon as possible to have all portable electrical appliances tested. A date for this must be provided to the CSCI. An immediate requirement followed by a serious concern letter were issued to confirm this requirement. The registered persons must undertake a documented risk assessment relating to the lateness of the portable electrical appliance testing. A copy of which must be forwarded to the CSCI. An immediate requirement followed by a serious concern letter were issued to confirm this requirement. 01/04/06 16 OP38 13(4) 08/02/06 17 OP38 13(4) 08/02/06 18 OP38 13(4) 19 OP38 23(4) The registered persons must undertake a documented accident analysis on a monthly basis. The registered persons must ensure that the senior delegated to deliver fire training receives the required refresher fire training as her present certificate expired in 2004. 01/03/06 01/03/06 New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 24 20 OP38 23(4) 21 OP38 23(4) 22 OP38 13(4) 23(2)(c) The registered persons must consider if all staff need fire training immediately- as their last training was delivered by a trainer whose certificate had expired. The registered persons must ask West Midlands Fire Service to confirm in writing whether or not, once a year, external fire training is needed or if their 2 year course is adequate. A copy of the response to be sent to the CSCI. The registered persons must provide authentic written evidence to confirm that the work needing to be undertaken on the lift as highlighted in the insurance company lift assessment 9/9/05 has been carried out. 16/02/06 28/02/06 20/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 New Swinford Hall DS0000038656.V280502.R01.S.doc Version 5.1 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!