Inspection on 05/02/07 for Newnton House

This inspection was carried out on 5th February 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newnton House 11/01/06

Newnton House 26/09/05

Newnton House 25/01/05

Newnton House 14/10/04

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

CARE HOME ADULTS 18-65 Newnton House 4 Newnton Close Stamford Hill Hackney London N4 2RQ Lead Inspector Yemi Adegbite Unannounced Inspection 5th February 2007 10:00 Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 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 Newnton House DS0000010277.V329621.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 Adults 18-65. 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. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Newnton House Address 4 Newnton Close Stamford Hill Hackney London N4 2RQ 0207 690 5182 0207 690 5182 newnton.house@hotmail.co.uk 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) Mrs Dymphna Caulfield Mr & Mrs Despo & Jim Gopalla Manuel Joaquim Martins Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: Newnton House is a residential care home offering accommodation, support and guidance to a maximum of nine service users who have mental health support needs. Most service users are ex-offenders and have been referred to the home via the Home Office and mental health specialists. Many have previously been detained under Mental Health legislation. The home is located in a residential area of Manor House within the London Borough of Hackney. Bus and train links are good and the home is close to local shops and amenities. The home’s premises are a spacious two-storey building, which is very well maintained both internally and externally. Service users have access to a garden in the rear of the house. There is private parking in the front driveway. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unnanounced inspection conducted by one inspector over the course of a day. The overall objective of the inspection is to ensure service users are receiving the best possible care and their welfare is safeguarded and promoted. In addition to checking the home’s compliance with the legal requirements made at the last inspection. The inspector met with a support worker on the day of the inspection. One service user also met privately with the inspector. Service users files, medication and medication administration records, all health and safety records, policies and procedures and other relevant documentation were also examined. A tour of the premises was also undertaken. Verbal feedback was given to the registered manager at the end of the inspection. The Inspector would like to thank the service users and staff members of their assistance with this inspection. What the service does well: The home provides a friendly atmosphere with homely and comfortable surroundings. Some refurbishment works have been undertaken around the home. There is a very stable staff team and they work hard to build up positive relationships with service users and have good understanding of service users support needs. The home develop with service users a support plan that details their mental, social and healthcare needs. Service suers are supported to be independent with their finances where appropriate. Service users are consulted and vonolbed in the day to thday running of the home and are supported to by staff to participate fully in all apsects of community life. Service users spoken with by the inspector fed back that they liked living at the home and that staff were friendly and helpful. The home obtains relevant information from other professionals as part of the referral process. It also carries out its own assessments on potential service users. Service users moving into the home sign a statement of expectations and role with the home. Staff receive appropriate training which is relevant to the needs of the service users admitted into the home. Staff receive monthly supervision sesions with their manager, which is exceeding the National Minimum Standard. Over 50 of staff have obtained or are currently studying for an NVQ award at Level 3. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Newnton House has the necessary documentation, policies and procedures, which assist prospective service users in deciding if the home can meet their needs. However it is required that the service users guide and tstatement of purpose be amended to reflect current changes within the home. All Service users are issued with a Statement of Expectation and Rules upon their admission. EVIDENCE: The Inspector was notified that four service users have been admitted into the home since the last inspection. Cross tracking of two of these files evidenced that the service users are admitted into the home only after a full assessment has been undertaken. The home obtains appropraite referral information including reports and assessments from other professionals. It was further evidenced that the home has carried out its own assessment and developed an individual plan for each of the service users sampled. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 9 The home has eligibility criteria and service users are only admitted into the home, if their needs can be fully met. The home does not accept emergency admissions. Both the service users guide and the statement of purpose were available. These documents have been comprehensively written and contained all the information required in line with National Minimum Standards. However it is required that these documents are amended to accurately reflect the recent changes to the home in respect of the management change and some facilities changes; i.e. increase of room numbers. Each of the files sampled had a signed statement of expectation and rules with the home that had been completed upon admission. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are given the support they require to meet their personal needs, however in order to fully meet the above standards, comprehensive risk assessments are in place for all identifiable risks highlighted on the individual care plan. EVIDENCE: The inspector sampled the personal files of two service users. Cross tracking of these files evidence that the integrated Care Programme Approach (CPA) for people with mental health needs forms the basis of the single care plan. The care plans developed by the home were comprehensively reviewed and identify the service users individual needs including areas such as health, personal and social care needs. Caer plans were being evaluated and regularly reviewed by the home and multi-disciplinary professionals and updated accordingly to reflect changing Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 11 needs. Care plans seen were signed by the service users to indicate their involvement. Service users are allocated key workers who are expected to provide guidance, support and monitor their progress. Records of these sessions were seen as evidence of proactive working with service users to address their individual needs and goals. Service users are supported to take risks as part of an independent lifestyle. Care plans sampled contained risk assessments for a variety of activities, which includes managing finance, cooking and accessingthe local community. However it was disappointing to note that some risks highlighted in the individual care plan had not been comprehensively assessed. A care plan had identified the issue of drug abuse but there was no risk assessment in place or guidance for staff as to the appropriate action to take. The registered manager must ensure that all identified risks are comprehensively assessed and reflected in the individual care plan. This was a requirement issued in the previous inspection report, which will be re-issued in this report with a new timescale. The Commission may consider enforcement action for failure to comply within this extended timescale. The home organises monthly meetings for service users to participate in the running of the home. The inspector sampled recent minutes for these meeings and evidenced that matters such as maintenance, activities and the organisation of a shopping rota had been discussed. Discussion with service users and further sampling of individual plans evidenced that service users are supported to make their own decisions, for example, activities they would like to be involved with and their daily routines. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for social, leisure and personal development are actively promoted and supported by staff. The home demonstrates that it engages service users in participating in the wider community. EVIDENCE: Service users have opportunities for personal development within the home. Independent living skills are more actively promoted. Service users stated and staff confirmed they were more involved in daily living tasks. These included domestic skills such as: cleaning, cooking and doing their own shopping with help and support from staff when required. Service users have opportunities to fulfil their spiritual needs and are part of the local community. They are engaged in a range of activities in the community, which included accessing local amenities, adult education courses, Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 13 shopping and undertaking voluntary work. A service user stated that with the help and support of the home, he has been able to achieve an NVQ Level 2 award in catering and greatly enjoys cooking for himself and other service users at the home. He is hoping to achieve higher qualifications and securing employmen within the catering industry. The home demonstrated that service users’ rights are respected and responsibilities recognised in their daily lives. They are supported to maintain family links and friendships outside of the home. Service users were observed during the inspection exercising their individual choice and participating in their own daily routines. Documentation and observation evidenced that service users choose when to get up, get dressed, be alone or in company, and when not to join an activity. Staff were also observed talking to and interact with service users. Service users are offered a key to their individual bedrooms and a key to the main door unless there are specific mental health issues. Staff do not enter service users bedrooms without permission. Service users are given £20.00 per week to purchase their own food shopping in addition to their own monies. Service users plan their own meals and are encouraged to shop wisely and maintain a balanced diet. The service user spoken with during the inspection stated that this amount was sufficient and promotes greater independence and budgeting skills. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users physical and emotional wellbeing are closely monitored and the home demonstrates effective management of medication administration systems. EVIDENCE: The registered manager stated that all the service users living at the home are self-caring although some may require prompting at times. The home ensure consisitency and continuity of support for service users by allocation of a designated key worker with regular sessions taking place once a week to discuss; among other things, any concerns or worries service users may have. All service users are registered with a local GP. It was also evident from the daily entry available in the individual care plans that service users have the involvement of other professionals such as opticians, dentist and out-patient appointments. It was positively noted that the care plan of a diabetic service Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 15 user containted evidence that their health needs are closely monitoreed by the home, for example visit to the diabetic clinic and the recording of daily blood glucose chart was seen on file. There are policies and procedures in place for safe management and administration of medication. Medications are dispensed by the local pharmacy in blister packs and are securely stored in a locked cabinet in the staf office. Medication received by the home is appropriately signed for. The inspector found evidence that medication held correspondeded with that listed in records. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Members of staff working in the home have received trainin in Adult Protection/Safeguarding and this ensures that there is a proper reponse to any suspicion or allegation of abuse. EVIDENCE: The home actively encourages service users to express their views and to be involved in the day to day running of the home. Service users spoken to during the inspection stated that they felt free to raise any concerns they might have with members of staff or the manager and are sure it would be dealt with appropriately. The inspector viewed the home’s complaints log and noted that there had been no complaints recorded since the last inspection. There is a written policy and procedure for dealing with allegations of abuse and whistle policy and procedure for dealing with allegations of abuse and whistle blowing. All staff working in the home have received training in Adult Protection / Abuse awareness. A member of staff spoken with was aware of the action to be taken if there wer concerns about the welfare and safety of service suers. The registered manager advised the inspection that no adult protection concerns had been reported since previous inspection. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The décor, furnishings and fittings in the home are of a good standard and provide a comfortable and homely environment that meets the needs of the people living there. EVIDENCE: Newnton House is a large two-storey building located in the London Borough of Hackney an is close to shops, transport networks and other local amedities. The property blends easily into the neighbourhood and presents as a large family home. The home has recently undergone some re-decoration and extension work which provides service users with a higher standard of accommodation. The home now has nine single bedrooms, six of which offer ensuite facilities, a larger lounge and kitchen and additional office space. The home is well Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 18 decorated, comfortable, clean and free from offensive odours. The home has sufficient and suitable heating. Communal areas consist of a sitting room, dining room/kitchen and a garden to the rear of the premises. Service users were observed to move freely around the communal areas. There were sufficient bathroom and toilet facilities for the numbers accommodated. Each service user has their own bedroom which they can arrange as they wish, bringing personal items with them when they move in to create their own personal space. Those rooms seen by the inspector evidence personalisation and reflected their individuality. Bedrooms have adequate natural light and ventilation. Carpets, curtains and bedding were well maintained. There was a separate laundry facility which was clean and tidy at the time of inspection. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels are satisfactory to meet the individual needs, and recruitment of staff is sufficiently robust to safeguard those living at the service. EVIDENCE: Service users benefit from a small consistent permanent staff team, with low staff turnover. In addition to the manager, the employs four senior support workers, two support workers and a domestic staff who works twice a week. The registered manager stated that staffing levels are additionally increased to meet service users needs when required. This ensures that service users are able to follow their individual activity programmes and have one to one time with staff. Staffing rotas were examined. Staffing levels were found to meet the individual and collective needs of service users. Two members of staff are on duy at all times with one member of staff covering night duties. There is an on-call Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 20 emergency procedure in place. It was the inspectors view that the staffing level was appropriate at the time of inspection. Staff spoken with demonstrated an awareness of their roles, responsbilities and service users individual needs. Service users spoken to were consistent in their praise for the home and had no complaints abouts staff. The home benefits from a well supported and supervised staff team. Staff receive monthly supervision from the home manager, which exceeds National Minimum Standards. Records are maintained of supervision, these evidenced discussions such as service users issues, training and development. The inspector sampled files for two of the most recently employed members of staff. Files examined indicated that the home is undertaking all the necessary recruitment checks to ensure the protection of service users; including taking up two written references, proofs of identification and an enhanced Criminal Records Bureau (CRB) check had been obtained before staff commenced employment. The home has a training and development plan and the manager is proactive in identifying training needs for staff. Photocopies of certificates awarded for successfully completed training courses were found on each of the sampled files and staff had also evidently received a comprehensive induction. Most staff had participated in training towards NVQ awards. Staff spoken with stated that the new manager is approachable and supportive. Evidence was seen that staff supervision is undertaken at the frequencies described, staff also confirmed that they received regular one-toone supervision and welcomed the opportunity for regular training to expose them to new, best practice. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and residents benefit as the home is run in their best interests. EVIDENCE: Standards 37 and 39 were not specifically tested at this inspection as there were no outstanding requirements in relation to these standards. At the time of the previous inspection all of the outcome standards were assessed as met. These standards will be assessed at future inspections. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 22 The manager has been in post for over a year and has completed the process to become Registered with the Commission for Social Care Inspection. He is a qualified mental health nurse with many years of management experience. Record keeping in the home was generally of a good standard. Records were stored securely and staff and service users could access their records as appropriate. The home had a comprehensive set of policies and procedures in line with National Minimum Standards. Daily reports are completed and recording promoted service users’ individuality. Regular staff and service user meetings contribute quality assurance within the home. Evidence showed relevant issues were discussed and service users continue to take an active role in the discussions. However, this should be further developed by ensuring that the views of relatives and professionals are sought on how the home is achieving goals for service users. The results of the survey should be published and made available to all invovled and other interested parties. Fridge and freezer temperatures are monitored and recorded daily. The registered persons also check the quality of care within the home through monthly visits in accordance with Regulation 26, reports of which are comprehensive and available for inspection. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X X X X X X 3 X Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 24 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 5(1) Requirement Timescale for action 10/08/07 2. YA9 13.4(c ) 3. YA39 35 The registered person must ensure that the service user guide is updated to reflect recent changes in the home. The registered person must 10/08/07 ensure that all identified risks are comprehensively assessed with clear strategies and guidance to staff as necessary. (Previous timescale of 28/02/06 not met). The home must develop its 10/08/07 quality assurance process to include the views of service users, their families and other stakeholders. The outcomes of this process should be made available to all interested parties. Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 25 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 Newnton House DS0000010277.V329621.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford London 1G1 4PU 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 Newnton House DS0000010277.V329621.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. 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