Inspection on 16/09/05 for North View (21)

This inspection was carried out on 16th September 2005.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

North View (21) 13/07/09

North View (21) 14/07/08

North View (21) 28/06/07

North View (21) 11/07/06

North View (21) 24/02/06

North View (21) 02/09/04

North View (21) 21/05/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 North View (21) Jarrow Tyne And Wear NE32 5JQ Lead Inspector Lesley Scriven Unannounced Inspection 16th September 2005 11:00 North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service North View (21) Address Jarrow Tyne And Wear NE32 5JQ 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) 0191 420 0125 0191 483 8857 United Response Mrs Pauline Gallagher Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection September 2nd, 2005 Brief Description of the Service: 21 North View is a registered care home owned by United Response. It provides accommodation with personal care and support for up to six men and women aged between eighteen and sixty-five who have learning difficulties. Some service users may also be physically disabled or have a sensory impairment. Nursing care cannot be provided. The property is a detached purpose built two-storey house, which stands in its own grounds. It has an accessible garden and patio, and blends in well with neighbouring houses. It has six single bedrooms, all located on the ground floor, a shared living room and a separate dining room and newly refitted kitchen. Staff accommodation is on the first floor. Within walking distance of Jarrow town centre, the home is close to local shops, Churches, pubs and a range of leisure facilities. It enjoys very good public transport links. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five and a half hours on one day. Time was spent with three of the people living at the home, although two had limited spoken communication skills, so the inspector was also dependent upon observations made of the relationships between service users and staff and of the support provided. As part of a case-tracking exercise one service user file was read. The home’s statement of purpose, service user guide, service user contract and some staff personnel records and complaints records were also checked, along with the home’s fire logs. A sample audit of the home’s system for receiving, storing, administering and disposing of medication was carried out. A partial tour of the premises and grounds looked at the standard of accommodation and facilities on offer and arrangements for maintaining safe living and working conditions. The manager and two staff were asked about the running of the home and the support and training they receive to enable them to do their jobs. What the service does well: What has improved since the last inspection? What they could do better: Service user’s contracts with the home need to be more detailed to include information about what people can expect in return for their fees. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 6 Support-plans too, although very nicely detailed, need to be written in a more accessible format, using pictures for example to aid understanding for those who have difficulty reading the written word. Records also need to be kept to explain how staff and users come to decisions about how well plans are going, and why levels of assistance need to be altered. Unsafe practices are still being followed by staff who assist people with medication and the manager is not doing sufficient to address this. Additionally, the home’s measures for ensuring fire safety are inadequate. The manager was given an ‘Immediate Requirement Notice’ to resolve both of these issues within a twenty-four hour timescale. 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. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 5, because some related requirements from these are still outstanding from the last inspection. 21 North View does not have an accessible service user guide or statement of purpose. Individual contracts are designed in a more easily understandable format, but they do not clearly set out service user’s rights. EVIDENCE: The home’s statement of purpose and service user guide do not include all of the information required by regulation and have needed to be improved since May 2004. This type of information is important as it explains what people can expect from the service and should help those looking for a place to live make an informed choice. The service user guide in its present format may be difficult to understand for people who cannot easily read the written word, so pictorial or audio versions should be supplied to everyone living at the home. People who move to 21 North View are given a copy of their contract with the home. A new style contract has been introduced, which is much easier to understand and uses pictures to explain the written word. However, not enough detailed information is provided about what United Response offers in return for its fees, so for example, service users may be unclear about what kind of holidays, outings or bedroom furnishings they are entitled to. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 9 Some contracts have not been signed by service users to show they agree to the terms and conditions of their placement, others have been signed by the home’s ‘key workers’. Where a person is not able to sign for themselves, the contract should be signed by a suitable family or professional representative. This cannot be a member of United Response staff, who clearly represents the company’s interests and not the service users. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Individual plans are not written in an accessible format, but they do cover all aspects of support required by service users. There is no written evidence to show how plans are evaluated. Wherever possible people are encouraged to make decisions about their lives and be as independent as possible, but this can sometimes be limited in an agreed way to minimise risk of emotional or physical harm. Service users are consulted about the day-to-day running of the home and participate in this as far as they are each able. EVIDENCE: Everyone who lives at the home has a support-plan, which is created by a named ‘key worker’. The plans look at all aspects of service user’s lives, both within and outside the home. They set out step-by-step instructions for staff about the type and level of emotional and physical support each person requires to achieve their personal goals whilst remaining as safe as possible. They also include nice details about personal preferences, such as favourite food and drinks, leisure pursuits, clothes and cosmetics. However, the plans are not written in an easy to understand language with pictures or symbols North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 11 and so are not accessible to all service users. Nor is there any written evidence to show how the plans are evaluated or why decisions are made to change them. Service users are encouraged to take as much control as possible over their own lives and be independent in those areas they are able: taking responsible risks in relation to making drinks and snacks independently or participating in social activities. Staff always carefully assess the level of risk involved and weigh up the benefits and pitfalls, and sometimes choices or freedom of access outside the home for example, might be limited to ensure a person’s safety. Where limitations are necessary, they will only be put in place after consultation with the service user and a supporter, such as a family member or social worker. Again though, record keeping requires improvement to show how risk management plans are kept current and continue to be applicable. Service users are consulted about life at the home and gather together every Sunday afternoon to discuss issues that are important to them. The outcome of discussions sometimes results in changes to the daily or weekly routine and people are able to choose what activities they’d like to take part in, what groceries they’d like to buy and where they’d prefer to holiday. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 15. All service users are supported to engage in the local community and make the most of the facilities on offer in the area. This enables them to maintain friendships and links with families. EVIDENCE: People who live at 21 North View are supported individually or in small groups to use local shops, pubs, cafes and leisure facilities. Personal preferences, abilities, support needs and risk management strategies in relation to this aspect of life are all carefully considered as part of the support-planning process. This means that people can engage safely in the local community, enjoying their favourite leisure activities with the right level of staff assistance to help them maintain independence and gain new skills. Everyone is registered with local health services too. All users attend day services in the area, where there are opportunities for further education and employment and to meet with friends. Inviting friends and family back to the home is encouraged too, and service users may entertain their guests in privacy. A new separate telephone line has also been North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 13 installed and a cordless handset purchased, so that people may take or make calls from their bedrooms. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20. Support with the tasks of daily living, including managing personal hygiene, dressing, eating and getting around in and outside the home is given in a way that does not undermine service user’s dignity or self esteem. There are continuing problems with the way people are assisted with medication and the manager has not taken sufficient action to make sure systems are safe. EVIDENCE: Warm relationships between staff and service users are evident and key workers have a good understanding of the needs and lifestyle preferences of people who live at the home. This enables them to offer the right kind of assistance in a very personalised way. Service users are supported with personal care tasks by workers of the same gender to protect their dignity, and are able to choose their own clothes, hairstyles and make-up so that their appearance reflects their personality. The last inspection highlighted some unsafe medication practices and the manager was instructed to carry out regular audits of staff practice and of the records kept in this regard and to take prompt action to address any new problems found. However, some mistakes are still being made and unsafe practices continue. In one case, changes to a service user’s medication regime North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 15 had been made on the basis of a discussion with a doctor, without first obtaining written advice or a new prescription and corresponding medication administration record sheet (MARs). The worker’s hand-written changes to the original administration record were also very misleading. This is dangerous and should not have happened, especially since the majority of staff have now completed training in ‘the safe handling of medications’. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. The views of service users and their supporters are taken seriously and appropriate action is taken to resolve concerns and complaints. The home’s ‘whistle-blowing’ policy needs to be reviewed to ensure that all staff are made aware of the procedure to follow if they have any concerns about service user’s well-being. EVIDENCE: The home has a clear and easy to understand complaints procedure which service users are able to access. No complaints have been made since the last inspection and people’s views about life at the home are regularly sought so that the service can be improved. The majority of staff have attended the ‘Protection of Vulnerable Adult’ (POVA) training offered by South Tyneside Council and the remainder have places booked between now and March 2006. They require this so that they are aware of the how to safeguard service users from abuse and know what to do if they have any concerns about the welfare of anyone living at the home. However, United Response’s ‘whistle-blowing’ policy still needs to be updated to inform staff that they must always report bad practice in line with their duty of care under the General Social Care Council (GSCC) code of conduct. Where an alert is made, this must be shared with the local authority adult protection co-ordinator and not just looked at internally, so that a full investigation can be carried out by all of the necessary agencies, including Health and Social Care, the Commission for Social Care Inspection and the Police if appropriate. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. People who live at the home benefit from an environment which is well maintained, safe, clean and comfortable, although some minor cleaning, repair and storage issues require attention. EVIDENCE: 21 North View is nicely decorated with good quality furniture and fittings in keeping with the age and lifestyle choices of the people who live there. Bedrooms reflect user’s individual interests and personalities and have been recently redecorated and refurbished. Staff keep the property clean and tidy and free from infection to the benefit of everyone’s health. A number of improvements have been made to the home since the last inspection, including the laying of new wooden flooring in communal areas, and more significantly, the fitting of new kitchen units and appliances. However, some minor repairs still require attention and the living room carpet needs to be deep-cleaned. Storage remains an issue too and as a result one of the bathrooms is cluttered with mobility equipment, which does not make for a relaxing atmosphere. The grounds are well maintained and provide pleasant additional space in the summer months. Where appropriate, environmental adaptations have been North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 18 fitted and equipment is used to maximise people’s independence. These are regularly checked to ensure they remain fit for purpose. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34. The home follows a sound recruitment policy to make sure service users are protected. The selection process takes into account the views of people living at the home. EVIDENCE: Before any new recruits are invited to take up a post at the home, two satisfactory written references are sought and enhanced Criminal Records Bureau (CRB) clearance and POVA register checks are required. This helps to ensure that only people of the required calibre can begin to work there. The recruitment process is carried out fairly and in line with equal opportunities good practice guidance. Following an interview with the company, candidates are also invited to visit the home so that service users may contribute to the selection process. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42. The manager works closely with the staff team to ensure the home is a pleasant place to live. She is working towards the necessary qualifications to meet the requirements of national minimum standard. Some major shortfalls were found in relation to health and safety issues, especially around handling of service user’s medications and fire safety. EVIDENCE: The home’s manager, Mrs Pauline Gallagher has worked with adults who have special needs for many years now. She has a Diploma in Management of Care Services and the Registered Manager’s Award, and will soon be studying towards completion of a National Vocational Qualification (NVQ) level IV award in ‘care’. She has developed warm and trusting relationships with the people who live at Number 21, and those who work there and this makes the home a pleasant and friendly place. However, there are some major shortfalls in relation to management of health and safety at the home. Unsafe practices were found in relation to the North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 21 handling of service user’s medicines and fire safety precautions have not been properly taken. Night duty staff must receive instruction in fire prevention and emergency procedures every three months, yet fire training is only provided by the company once every three years, and no drills or instruction sessions were carried out between December 2004 and June 2005. Less than a third of staff are familiar with the home’s written emergency fire procedure and there is no risk management tool in place to identify fire hazards in the home and determine how the risk of fire occurring might be reduced. As a result service users and staff cannot be adequately safeguarded. These issues should have been recognised and addressed through ‘Regulation 26 visits’ to 21 North View by the responsible individual or a person who works for the company but is not in charge of the day-to-day running of the home. Such visits are required by law to ensure that registered homes take responsibility for measuring the quality of the service they provide and for making sure the home is properly and safely run. The outcome of the visits must be reported to the Commission for Social Care Inspection. The last report however, was written by the home’s manager, who was not sufficiently objective in her appraisal and failed to spot the problems outlined above, describing the home as “well organised”. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 1 x x x 2 Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x x 3 x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 North View (21) Score 3 x 1 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 1 x DS0000000259.V250058.R01.S.doc Version 5.0 Page 23 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 4&5 Schedule 1 Requirement The statement of purpose and service user guide must be developed to include all of the information required by regulation. They must be made available to each person in a suitably accessible format TIMESCALE OF MAY 2004 NOT MET Service user contracts/statement of terms and conditions of placement must be revised to clearly show a breakdown of the home’s charges and what users can expect in return for their fees. Timescale for action 16/12/05 2 YA1 17(2) Schedule 4 16/12/05 3 YA6YA9 14(2) 15 (2(b,c) United Response staff may not represent service users for the purpose of entering into contracts with the company. TIMESCALE OF MAY 2004 NOT MET Written evidence must be kept to 16/12/05 show how each service users support-plan is evaluated and updated to reflect changing needs and circumstances. Risk management documents North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 24 4 YA20YA42 13(2) 17(1) Sch 3 must be evaluated in the same way. TIMESCALE OF MAY 2004 NOT MET. The registered person must ensure the safe receipt, storage, administration and disposal of medicines at the home. Accurate records must be kept and a full weekly audit of the system must be implemented by the manager to monitor staff competence. TIMESCALE OF MAY 2004 NOT MET. All staff must receive training in relation to the local authority adult protection policy and procedure. 16/09/05 5 YA23 13 (6 16/03/06 6 7 8 YA24 YA37 YA39 9 YA42 The home’s ‘whistle-blowing’ policy must be amended in line with GSCC code of conduct requirements. TIMESCALE OF FEBRUARY 2005 NOT MET. 23(2)(b) The lounge carpet requires deepcleaning and the thresh strip requires replacement. 9(2)(b)(1) The registered manager must complete the NVQ Level IV award in ‘care’. 26(4) Visits to 21 North View must be made in accordance with point 4 of this regulation by a member of the company who is not directly involved in the day-today running of the home. TIMESCALE OF JANUARY 2005 NOT MET. 13(4) The registered person must 23(4) make adequate arrangements for staff to receive suitable training in fire prevention and to ensure by means of fire drills and practices at prescribed intervals that everyone is aware DS0000000259.V250058.R01.S.doc 16/12/05 31/12/05 16/12/05 16/09/05 North View (21) Version 5.0 Page 25 of the procedure to be followed in the case of a fire, including the procedure for saving life. The home must have an up-todate fire risk management tool, which includes an analysis of fire hazards. TIMESCALE OF OCTOBER 2004 NOT MET 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 YA24 Good Practice Recommendations Consideration should be given to how and where mobility equipment might be stored so it does not impede use of bathrooms or other communal areas. North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 Page 26 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 North View (21) DS0000000259.V250058.R01.S.doc Version 5.0 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. 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!