Inspection on 26/02/07 for Oaklands Leonard Cheshire Foundation

This inspection was carried out on 26th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Oaklands Leonard Cheshire... 28/10/08

Oaklands Leonard Cheshire... 13/12/05

Oaklands Leonard Cheshire... 19/07/05

Oaklands Leonard Cheshire... 06/01/05

Oaklands Leonard Cheshire... 01/09/04

Oaklands Leonard Cheshire... 27/08/02

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

CARE HOME ADULTS 18-65 Oaklands Leonard Cheshire Foundation Oaklands Dimples Lane Garstang Preston Lancashire PR3 1UA Lead Inspector Mrs Ruth Edgington Unannounced Inspection 26th February 2007 9.30 Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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 Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Oaklands Leonard Cheshire Foundation Address 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) Oaklands Dimples Lane Garstang Preston Lancashire PR3 1UA 01995 602290 01995 600026 www.leonard-cheshire.org.uk Leonard Cheshire Deborah Jane Holmes Care Home 27 Category(ies) of Physical disability (27) registration, with number of places Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home will at all times employ a suitably experienced and qualified manager, at all times, who is registered with the NCSC 13th December 2005 Date of last inspection Brief Description of the Service: Oaklands is a Leonard Cheshire Foundation home providing care and support for physically disabled adults from the age of 18 to 65 years. The home is an adapted property situated on the outskirts of Garstang and is registered to accommodate a maximum of 27 persons of either sex needing nursing or residential care. Day care is also available on the premises. The home offers a range of activities and support to meet the individual needs of residents. The home has a number of lounge areas and a large dining room. There are sufficient toilet and bathing facilities to meet the needs of the residents accommodated. A passenger lift provides access between the ground and first floor and a variety of aids are available around the home to promote independence. Residents are encouraged and enabled to maintain links in the community and a bungalow is available in the grounds where relatives and friends may stay. Written information is given to prospective residents and on admission a copy of the Service User Guide is placed in their bedroom. The written information explains the care service that is offered, the home’s aims and objectives and all relevant information that residents need to assist them in making an informed decision about life in Oaklands. Information received on 6th October 2006, prior to the visit, showed that the fees generated were dependent on the assessed needs of the individual resident. Further information gained during the visit indicated that these could range anywhere from £594 to £817 and above in some cases, per week. Additional charges paid for by the residents included hairdressing, chiropody and personal requirements of choice. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken as part of the home’s Key Inspection. The site visit commenced at 9.30 am and took place over four hours. Prior to the visit the registered manager completed a pre-inspection questionnaire, which provided information about the residents, staff and other information, which assisted in assessing how the home was meeting the National Minimum Standards. Comment cards were sent out prior to the visit to gain the views about the service provided. In total, two relatives and one doctor completed and returned the comment cards. Comments received from the Leonard Cheshire Foundation following their monthly visits to the home were also useful in assessing the standard of care and facilities provided for the residents. A random selection of residents, staff and administrative records were looked at and discussions took place with the registered manager. During the visit a number of residents and members of staff were spoken to individually. A tour of the home took place, during which general discussions took place with residents and staff. From observations made, comments received and written documentation examined, the information has been put together to produce this report. What the service does well: This is a home where the residents are well cared for. The care is very much dictated by the needs and wishes of the individual residents. The staff team work well together and show a good understanding of the needs of the residents. A key worker system (designated member of staff who is responsible for individual residents) is in operation and ensures consistency of care. The staff are well trained and supported by a manager who leads by example ensuring that residents are cared for by a competent, reliable staff group who are able to meet their needs. From observations and discussions during the visit evidence was gained confirming that the manager and staff have a good understanding of equality and the diverse needs if the residents, which ensures that the individual needs of each resident are met. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 6 Residents continue to have their say about the service provided through their involvement with the Disability Forum, which holds meetings at the home on a regular basis. One resident said, “I love it here, its a wonderful place, its better than sliced bread.” Another resident said, “ If it was no good I would have left long ago, I can get out and about no problems”. 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. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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 Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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): 2 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The home’s admission and assessment procedures are clear to ensure that the resident’s individual needs and aspirations are met. EVIDENCE: The care records of four residents were looked at in detail and were found to contain full assessment information that had been obtained prior to admission. Evidence was seen confirming that the assessment process involved the prospective resident, their representatives and families, therefore ensuring that the home could meet the residents’ individual needs. Staff were able to demonstrate that they were well aware of the care needs of the individual residents and this was confirmed during the inspection through observations of the care practices being carried out. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 9 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 & 9. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. There is a clear and consistent care planning system in place, which ensures that the service users’ needs, aspirations and goals are met. EVIDENCE: Examination of the care plans of the four residents case tracked were very comprehensive and covered every aspect of the individual resident’s care needs, social, emotional, spiritual and recreational needs and the action needed to be taken by staff to ensure that these needs are met. Residents’ information also contained a detailed life, a record of significant events and risk assessments. Daily entries were made setting out the care given. All care plans were signed by the resident, or their supporters and any constraints discussed and agreed. Care files also showed that residents or their supporters had signed the record of information held and had been made aware of their right of access to their records. Residents spoken to said that they received the right levels of support from staff and were enabled to reach their own goals. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 10 Throughout the visit observation were made of the caring approach of the staff towards the residents and the practices in the home ensured that residents were treated with respect and their right to privacy was upheld. Residents spoken to during the confirmed that they were satisfied with the care being provided and said that the staff were very good and caring. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 11 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): 12,13,15,16 & 17. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. Opportunities for development and community participation are addressed in the care plans, ensuring that people have a lifestyle that meets their individual needs and expectations. EVIDENCE: Residents spoken to confirmed that they were encouraged and enabled to take part in a variety of activities. Their interests were recorded in their assessments and provided a basis for planning individual activities, outings and holidays. These include activities in house, snooker, computers and Internet, reflexology, music sessions, creative writing, art classes, beautician, massage, college, library, swimming and cinema. An activities organiser was employed to facilitate leisure activities and evidence was seen of the information on varied venues available to meet individual choices. One resident spoken to was preparing to go to Mexico and arrangements had been made for them to swim with the Dolphin, which was one of their goals. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 12 Comments had been raised previously by residents in regard to going out more frequently, especially in an evening. This issue had been looked into and arrangements made for staff hours, in particular those of the drivers, to be more flexible in order that individual needs can be met. On the day of the visit two residents had gone out for a pub lunch, which had been arranged to meet their wishes. One resident spoken to stated that before coming into the home they had repaired electrical equipment and that they had been provided with the space at the home to continue to do this. The resident also said that in order to comply with requirement under health and safety there had been some constraints placed on what they could store, however they understood the reasons for this. The Disabled Peoples Forum holds regular meetings at the home. This involves and supports residents in living with disability. There are a number of volunteer staff from other countries and they share their cultures with the residents who are interested. There was a very relaxed atmosphere in the home with a lot of affectionate banter between the residents and staff and residents commented that the staff were very kind and they could not do enough for them. Examination of the menus indicated that the meals were nutritious, well balanced and provided an excellent choice. Special diets were provided for those resident who required them. Evidence was seen that confirmed that meals were not hurried and assistance was given to meet individual needs. Comments received from residents spoken to confirmed that they enjoyed their meals and had their likes and dislikes catered for. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 13 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): 18,19 & 20. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The health and personal care that residents receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Observations were made during the visit of the support that was given to the residents by staff to maximize their privacy, dignity and independence. Discussion during the visit confirmed that staff were fully aware of the healthcare needs of residents and that these were monitored and the care plans kept up to date. Entries made on care plans showed good communication between the home and healthcare professionals. Residents spoke highly of the levels of support provided and said that they were happy with the care they received. Evidence was seen that previous concerns in regard to medication had been discussed with the staff and the correct procedures were now in place. The medication in operation ensure that the residents are protected and their Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 14 needs met. Only staff trained to do so administer the medication. The administration records and storage of medication were seen to be safe and complied with the requirements. Residents are consulted on admission regarding whether they wish to self medicate and they sign a form to this effect. A lockable facility was provided for each resident in their bedroom should they wish to keep their own medication. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 15 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 & 23 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The arrangements in place for handling complaints ensure that people feel confident that their complaints will be listened to and taken seriously. Procedures for dealing with and reporting abuse were in place to ensure that people are adequately protected. EVIDENCE: The home has a detailed complaints procedure, which includes access to external agencies. All residents are given access to the complaints procedure and receive a copy of it in the service users guide. Residents said that they felt any concerns they have are dealt with and that they were confident in approaching the manager of the home. There were no complaints made to the Commission for Social Care Inspection (CSCI) since the last report, however the manager did inform CSCI of an allegation that had been made and examination of the complaints records in the home confirmed that this had been dealt with appropriately and outcomes recorded. From discussion with the manager and staff evidence was gained to confirm that they had a good understanding of the procedures to be followed in the event of any allegation or suspicion of abuse or neglect. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 16 Evidence was seen of training by staff in relation to complaints procedure, Whistle Blowing and Safeguarding Adults. Staff spoken to also confirmed that these subjects are covered during their NVQ (National Vocational Qualification) training. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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 & 30. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The standard of the environment in this home provides residents with a comfortable and homely place to live. Further deteriation of the outside of the building could pose a possible risk to the residents’ health and safety. EVIDENCE: The home is a very large adapted property set in a rural environment with an excellent view of surrounding areas. A tour of the home confirmed that residents’ bedrooms were very individualised, containing their personal items and had been decorated according to their wishes. The residents spoken to said that they were happy with the accommodation provided. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 18 The home was found to be warm, clean and free from any offensive odours and there was a welcoming, pleasant and homely environment throughout. Since the last inspection the upstairs corridor has been redecorated. New flooring has been laid to the first and ground floor corridors and bedroom have been redecorated as required. In consultation with the fire department it has been identified that the sliding bedroom doors need replacing and an action plan and quotes have been received in order that this work can be carried out to ensure the safety of the residents. The outside of the building was showing signs of deteriation especially in relation to the condition of the windows, however there was no indication that the health and safety of the residents was affected in any way at this time. Discussions in regard to the future of the home were still taking place and until a firm decision was made the manager confirmed that work identified in their five-year maintenance plan would continue to be undertake to ensure that the residents continued to live in a safe and homely environment. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The deployment of staff throughout the day is sufficient to meet the needs of residents. The homes recruitment procedures are robust and these provide safeguards for the protection of the residents. EVIDENCE: The policies and procedures for the recruitment of the staff are robust and provided safeguards for the protection of the residents. There is a very large staff group, the majority of whom have worked in the home for a long time. Comments had been received in regard to the number of staff available at particular times of the day. This issue had been looked into and some difficulty had been experienced due to the number of staff requesting flexible working hours, from examination of the rota’s provided and observations made, the staffing levels were found to be sufficient to meet the needs of the residents accommodated at that time. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 20 The training records examined showed that all staff undertake a formal induction process that includes the subjects required by mandatory training. Training also includes disability equality training, diversity training, risk assessments and issues relating to health and safety. Evidence was seen to confirm that the majority of staff have obtained a minimum of level 2 NVQ (National Vocational Qualification). This ensures that staff employed by the home are competent and well trained to meet the needs of the residents. Staff spoken to had a clear understanding of their role and what is expected of them during their shift. They said that this was a settled staff group and that they felt well supported. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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): 37,39 & 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents. The home has policies and procedures in place to ensure the health and safety of residents and staff are promoted and protected. EVIDENCE: The registered manager is a very competent and experienced in caring for the needs of the residents accommodated in the home. She is a qualified nurse and also holds the required management qualification. This level of experience and qualification ensures that the residents and staff benefit from competent and effective leadership. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 22 There are good systems in place to gather staff, residents and relative’s views as part of the monitoring of quality. One member of staff who had worked at the home for a long time said that this was a good place to work, all staff worked well together and the manager was very supportive. Information provided in the pre-inspection questionnaire stated that all safety equipment was regularly serviced. The policies and procedures in the home ensure that the health, safety and welfare of the residents and staff were promoted and protected. Polices and procedures in the home, covered matters relating to equality and diversity. The manager confirmed that staff received training and observations and discussions with staff and residents showed that there was an understanding of this area. The manager confirmed that she had recently completed a self audit document produced by Leonard Cheshire Foundation, which she found very helpful in assessing how the needs of the residents were being met by the service provided. A representative of the Responsible Individual visits the home on a regular basis and completes a report. A copy of their report is retained in the home, and a copy is sent to the Commission for Social Care Inspection (CSCI) providing useful information in relation to the quality of the service being provided. External audit are also carried out by other organisations such as the Multiple Sclerosis Society and the manager confirmed that they had just received their report which was positive and confirmed that the home would remain on the Society’s list of preferred providers. Oaklands Leonard Cheshire Foundation DS0000006067.V311972.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 x 2 3 3 x 4 x 5 x 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 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 x x 3 x Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 24 NA 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. Standard Regulation Requirement Timescale for action 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 The exterior of the building should continue to be closely monitored in order that should there be any further deteriation appropriate steps are taken to ensure the safety and well being of the residents Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Oaklands Leonard Cheshire Foundation DS0000006067.V311972.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!