Inspection on 23/01/07 for Newhaven

This inspection was carried out on 23rd January 2007.

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

Newhaven 15/05/06

Newhaven 22/11/05

Newhaven 21/06/05

Newhaven 10/02/05

Newhaven 02/09/04

Newhaven 14/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Newhaven Drakes Drive Stevenage Hertfordshire SG2 OEY Lead Inspector Mrs Sheila Knopp Unannounced Inspection 23rd January 2007 09:50 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 Newhaven DS0000019481.V324616.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. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newhaven Address Drakes Drive Stevenage Hertfordshire SG2 OEY 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) 01438 354811 014 38 758223 www.quantumcare.co.uk Quantum Care Limited Kerry Ann Stevenson Care Home 42 Category(ies) of Dementia - over 65 years of age (42), Old age, registration, with number not falling within any other category (42), of places Physical disability over 65 years of age (42) Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October 2006 Brief Description of the Service: Newhaven was purpose built about 30 years ago in a residential area of Stevenage and provides accommodation on three floors for up to forty-two service users over sixty-five years of age who may also have dementia or a physical disability. Service users occupy single rooms in group living units. Each unit has an open plan lounge/dining area and kitchenette. Bathrooms and toilets are conveniently situated throughout the home and are fitted with appropriate aids. There is a large activities room on the ground floor, where the kitchen, laundry and administration areas are also located. The garden to the rear of the home is not overlooked and provides outdoor space where service users can spend their time. Inspection reports can be obtained on request from the manager of the home. The current fees range from £400- £490 per week based on an assessment of need and contractual arrangements with funding authorities (correct on 23.1.07). Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on an unannounced visit to the home by two inspectors. The report includes information provided by residents (8) and staff (5) on the day of the inspection. Relevant care, management and health & safety records were reviewed. Questionnaires were sent directly to residents and General Practitioners (GPs) who visit the home. The views of 18 residents and 6 GPs who returned completed questionnaires have been taken into consideration when writing this report. Information received by the Commission since the key inspection on 15th May 2006, including an additional inspection, which took place on 20th October 2006, has been reviewed. A copy of the inspection report dated 20th October 2006 is available on request from the Commission. What the service does well: What has improved since the last inspection? Both the manager and company have taken steps to address the concerns raised by the Commission following the inspection on 15th May 2006, which identified a high number of requirements mainly due to gaps in the staff and management team at the time. A stable management and staff team are now Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 6 in place, which will enable the service to move forward. The majority of requirements were met when the home was re-inspected on 20th October and any outstanding requirements have now been met. The company have taken the positive step of providing a new medication room, which will enable staff to manage and store the medicines for residents in a safer and more organised environment. Staff are recording drug refrigerator temperatures and have been shown how to use the maximum/minimum thermometers to ensure medicines are stored safely. Staff are now ensuring that accurate records of fluid intake are being kept for residents who need assistance. There is now more focus on providing a stimulating environment for residents, which staff can take forward and develop further. Staff have started a newsletter to involve residents and their relatives more in the life of Newhaven. Liquid soap and hand towel dispensers have now been installed in resident rooms and key areas to reduce the risk of cross infection and comply with current practice. Various issues related to the management of equipment raised at the last inspection have been addressed and no concerns regarding the safety of equipment were identified as a result of this inspection. Quantum Care have continued to upgrade the decoration and furnishings within the home to maintain standards. The home is now fully staffed. Agency staff are not being used which provides reassurance to residents that they will be supported by staff they know. What they could do better: The building does not meet the standards required of newly registered homes. This is recognised by Quantum Care who are in the process of building a new home in Stevenage to replace Newhaven. Residents and staff will be kept informed of the progress and plans being made. There needs to be a more detailed account of the reasons why staff are given discretionary medication, associated with changing behaviour, to demonstrate the rights of individual residents are maintained at all times and other options are considered. Staff need to look at the meal time experiences for all residents to ensure it is a pleasurable and enjoyable part of the day rather than a task for staff to get through. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 7 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. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 (standard 6 does not apply to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A member of the management team meets with prospective residents and gathers information from health & social care professionals before an offer of accommodation is made to make sure staff can meet their needs. EVIDENCE: The care records examined provided details of the preadmission assessments carried out and information obtained from key people in the individual’s life including hospital and social worker reports. The family of a resident, unable to communicate their own needs , who was staying for a short break had provided detailed information about how they needed to be supported. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 10 Where possible prospective residents are invited to spend time in the home, have a meal and meet residents and staff. Seventy two percent of residents who completed questionnaires confirmed that they had received enough information to decide if it was the right place for them before moving in. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards &, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive a good standard of personal care and attention from staff, which supports their physical, mental and social well being. Requirements from the last inspection regarding ensuring a good fluid intake and the dignity of residents during transfers from chair to hoist were met on this occasion. Residents have access to the community medical, health & social care professionals they require to maintain their health. The policies and procedures in place support good practice in relation to administering medication. Information is available to alert staff to the reasons why some medication is given on a discretionary basis (PRN). However this needed to be more detailed for one resident to demonstrate staff are acting in the interest of the individual rather than for the benefit of other residents. EVIDENCE: Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 12 Residents appeared to be well supported and in good health. They are able to retain their own GP when they come to Newhaven if they are from the local area. No concerns regarding health care standards in the home were raised by the six GPs who returned questionnaires. As an indicator of good standards of care the manager reported that no residents had pressure sores. Where required specialist equipment is obtained as a preventative measure. Generally the care plans detailed the action required by staff to support the individual needs and preferences of service users. The unit managers need to check the information recorded to ensure a consistent approach. For example on one care record for an individual on a respite stay there was a very detailed assessment and daily record providing information on their dementia care needs. However their risk assessments, which would alert staff to potential problems had not been filled in. Where residents are receiving PRN medication for behavioural issues there needs to be a more detailed plan of care describing the symptoms, actions which can be taken to prevent matters getting worse and a clear description of why the medication was given if this is required. Staff in fact were working to this model but it was not recorded. On one of the days medication was given the daily record reported there were no concerns. Where issues of this nature arise the manager is seeking advice and putting multidisciplinary agreements in place in relation to the use of medication and equipment such as bed rails Staff were knowledgeable about the needs of individuals and are able to verbally fill in gaps on the care plan. There appears to be good communication and an active key worker role, which supports residents as their needs change. A relative said ‘the communication between staff on shifts is very good’. Staff receive training at varying levels from one day to one year certificated courses to understand and support residents with dementia. Requirements from the last inspection regarding ensuring a good fluid intake and the dignity of residents during transfers from chair to hoist were met on this occasion. Staff had identified and were closely monitoring residents who needed assistance to maintain an adequate fluid intake. The medication room has now been moved to a larger area, which will assist staff in maintaining safe systems of work. Quantum Care have their own pharmacist who audits standards within its homes. A review of medication systems was carried out at Newhaven the day before the Commission’s unannounced inspection. A copy of the report has been provided which satisfies the Commission on this occasion that all necessary steps are being Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 13 taken to maintain good standards. The manager agreed to provide confirmation that the action required by the company pharmacist has been completed. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The availability of staff and use of resources to provide residents with a range of stimulating and interesting activities and events has greatly improved since the inspection in May 2006. Residents are able to receive visitors at any time, either in their own room or one of the public areas subject to their agreement. Residents are encouraged to maintain their individuality by adding personal possessions and belongings to their rooms. Residents are able to make choices from a varied and nutritious menu. However, on this occasion the lack of organisation in one area led to a poor experience for residents at lunchtime. EVIDENCE: Since the last inspection additional staff have been identified to develop the social life of residents within the home and local community. The range of activities has increased. Events are more widely advertised and staff have Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 15 started a newsletter to keep residents and relatives involved and informed. Activities such as a regular tea dance are arranged outside the home. There are local shops nearby. Residents unable to get out can purchase items for themselves from a shop at Newhaven. The questionnaires completed by residents confirmed activities were arranged that they could take part in but also recognises that some individuals prefer to organise their own time. Residents were bright and alert indicating there is a good level of social interaction. Interaction between staff and residents was positive with lots of good humoured but sensitive encouragement. Some residents reported that the companionship of other residents was important to them. Initiatives are being developed which focus on the sense of well being and purpose for residents with dementia. Overall the residents were positive about the choice and standard of meals served. Residents are provided with a regularly changing menu, which has been nutritionally assessed to meet the needs of older people. The catering staff are able to respond to dietary and cultural requirements. A member of staff has put together a pictorial version of the menu to assist residents in their choices. Staff need to be aware of the effect that poor management of meal times can have on residents. Residents requiring wheelchairs were brought into the dining room on one unit 20 minutes before lunch was due to be served. There was no stimulation such as music during this time in which one service user sat facing the wall. When lunch was served the residents who had arrived first in the dining room were served last having waited a full 40 minutes. The meals were served on to cold plates and by that time the food was barely warm. The staffing implications of this need to be reviewed to ensure adequate numbers are available at key times. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives can be confident that any suggestions and concerns they have will be listened to an acted upon in an open and constructive manner. Staff are aware of the need to protect and support residents in their care and receive training to ensure they remain alert to issues that may arise. EVIDENCE: There is a clear and accessible complaints procedure, which provides information on the action to take and expected timescales for a response at each stage of the process. The record of complaints held within the home demonstrated that this process is working. The recorded information did not give rise to concerns regarding the frequency and type of complaints being received by the manager. At the time of this inspection no complaints had been received directly by the Commission since the inspection in May 2006. A relative said ‘ All the staff are very approachable and helpful. If any staff member cannot deal with the request or questions, they know who to refer it to’. Sixteen out of 18 residents who completed questionnaires agreed that staff listened to them and acted on what they said. Residents said they would talk Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 17 to carers, their key worker or the manager if they were unhappy, which demonstrated they felt able to approach staff. No concerns have been raised under the Hertfordshire Safe Guarding Adult procedure between inspections. Notifications of incidents sent to the Commission by the manager under Regulation 37 demonstrate staff have taken action to support and protect residents in situations arising outside the home where they have been felt to be vulnerable. This demonstrates staff are working in the interests of residents and acting as their advocate. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although the accommodation does not meet the standards required of new homes in terms of each bedroom having an en-suite toilet and wash hand basin, residents are provided with accommodation that is well maintained and kept clean and fresh. The provision of suitable hand washing facilities for staff and residents has improved infection control standards within the home. EVIDENCE: Quantum Care have reviewed the fabric and decoration of the building to ensure standards are maintained until new accommodation is provided. The kitchen and dining areas have been upgraded and new lounge seating provided. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 19 Systems for maintaining the safety of residents are in place. This includes regulated hot water temperatures, low surface temperature radiators and window restrictors above ground level. The fire safety systems have been recently reviewed following a visit by the Hertfordshire Fire safety service. The manager agreed to ask the maintenance contractors to adjust the door closures into the stairwell to ensure they shut completely as the mechanism had become sluggish. A good standard of housekeeping is maintained. Fourteen (77 ) out of 18 residents who completed questionnaires said the home was always fresh and clean. No concerns were raised with regard to housekeeping standards. The laundry has suitable equipment to management the laundry for the residents. A requirement made in a previous inspection report to provide liquid soap and hand towels in resident rooms and high risk areas to reduce the risk of cross infection has been met. Staff were observed using aprons appropriately at meal times to maintain good hygiene. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff work hard to achieve good standards within the numbers working on each shift given the number of residents who have dementia and the layout of the building on three floors. The recruitment procedures ensure staff are checked for their suitability to work with vulnerable people. There is a staff training programme in place, which supports new staff through their induction and continues to develop their skills and competence through NVQ and statutory training courses. EVIDENCE: Staffing levels have increased since the last key inspection during the day and at night. However there are times when the supervision and support of residents such as at meal times are stretched indicating the deployment of staff at peak times needs to be kept under review. A relative said staff ‘work hard to make Newhaven a happy and cheerful home for the residents and their families’. The home is now fully staffed and agency staff are not being used which provides continuity and reassurance to residents. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 21 Four personnel files were checked confirming that references and criminal records checks are obtained as required to ensure suitable people are employed. The training programme has been brought up to date and staff are receiving the required levels of training when they start work and through a programme, which supports their continued development. Quantum Care have a programme of dementia care training which staff are able to move through at varying levels to provide a range of skills and expertise across the staff team. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and staff are supported by a Registered Manager who has the required experience and qualifications to carry out their role competently. Quantum Care has a quality assurance system in place, which includes seeking the views of service users, relatives and stakeholders to improve the service provided. Service users are able to deposit money for safekeeping. Staff are aware of the need to protect the financial interests of service users by ensuring they get the personal allowances they are entitled to receive. There are health & safety policies and procedures and auditing systems in place to protect residents and staff. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 23 EVIDENCE: Quantum Care senior managers are regular visitors to the home. Monthly health & safety visits and audits are completed and the required report to the Directors under Regulation 26 are completed and made available to the Commission on request. The views of service users and their relatives are obtained and the findings of surveys are reported back at an annual forum. Policies and procedures are regularly reviewed in line with changing legislation and good practice advice. A recent example of this has been the introduction of new guidance on pressure area care. A record of accidents is maintained and audited to identify any underlying trends. Accidents and incidents are reported to the Commission as required. There is a system in place to enable service users to have access to money deposited on their behalf. The records seen include signatures and receipts for money deposited and withdrawn which enables individual accounts to be tracked. There is a company wide training programme in place and staff receive regular updates in the required statutory training to ensure safe working practices. The records of annual safety checks and fire safety checks were found to be in order. Regular checks are carried out on moving and handling equipment and no problems were seen during this inspection related to the maintenance of hoists or wheelchairs. Staff supervision records demonstrate that practice in relation to health & safety is monitored and challenged to ensure the safety of residents and staff. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 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 x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12(1) Requirement Ensure there is a behaviour management plan in place for each resident receiving medication on a PRN basis to modify their behaviour. Timescale for action 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations Review deployment of staff and management of meal times so residents are not having to wait and meals are served at an appropriate temperature. Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Newhaven DS0000019481.V324616.R01.S.doc Version 5.2 Page 27 - 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. 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