Inspection on 13/11/07 for Ocean House

This inspection was carried out on 13th November 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

CARE HOME ADULTS 18-65 Ocean House 15 Alder Hills Parkstone Poole Dorset BH12 4AJ Lead Inspector Tracey Cockburn Key Unannounced Inspection 13th November 2007 10:00 Ocean House DS0000069856.V354469.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 Ocean House DS0000069856.V354469.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. Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ocean House Address 15 Alder Hills Parkstone Poole Dorset BH12 4AJ 01202 706160 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) ocean.house@harbourcare.co.uk Mrs Eve Mary Went t/a Harbour Care Mrs Eve Mary Went Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 4. Date of last inspection New service Brief Description of the Service: Ocean House is registered to provide care and support to 4 people with a learning disability. The service is for respite care. It is a detached house, in a semi residential no thru road, situated close to the amenities of Wallisdown. Accommodation is well laid out and comprises a lounge with patio door leading to a large well maintained garden. Separate kitchen and dining area and 4 bedrooms all on the ground floor. All bedrooms are single occupancy and have either a wet room or hand basin in the room. The front of the property provides car parking on a tarmac driveway. The garden is enclosed and there is a wooden veranda. The home is wheelchair accessible. Harbour Care own the home. Fees are individually assessed with the funding authority. For further information on fees details can be found on the Office of Fair Trading website: www.oft.org.uk Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection the first since the service registered with the commission in July 2007. The site visit was started without warning; unfortunately there was no one home. An expert by experience had been arranged to be part of the site visit and this had to be cancelled. Another date was arranged with the provider. On the second day there were no people using the service available as they were all at day activities. The manager and a senior member of staff were present throughout the inspection and able to answer any questions. The manager has not been in post long and was able to demosntrate areas which are being developed such as a person centred approach. Part of the methodology used was to send out survey forms to people who use the service as well as staff and care managers. A tour of the premises took place and 1 member of staff on duty was spoken to. Before the site visit, documentation received such as the annual quality assurance assessment were reviewed. What the service does well: People using the service only do so following an assessment of their needs. This means that the service is clear about how they can support an individual. People using the service are encouraged to make decisions about their daily lives. People using the service are supported to take risks as part of their life. People are able to participate in activities which interest them in the home and the wider community. People are able to maintain relationships which are important to them and keep the routines of their daily life. People are able to eat the food they like as part of a healthy diet. People who use the service are supported the way the like and have their physical and emotional needs met. Staff receive the training they need to safeguard the people using the service. The home is warm, welcoming, comfortable and clean. People are supported by competent staff who have been through a robust recruitment procedure. People who use the service benefit from a home which is improving all the time. Ocean House DS0000069856.V354469.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. Ocean House DS0000069856.V354469.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 Ocean House DS0000069856.V354469.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who are considering this service have the information they need, however further work is needed to make some of the information less confusing and more accessible so people can make an informed choice. People have their care needs assessed through the care management process before care is provided, which means the service is able to decide if they can meet individual care needs. EVIDENCE: The service has a statement of purpose and service user guide; this sets out the aims and objectives of the service and the facilities provided. The format could be developed to be more accessible for people who find pictures and symbols more useful to understand. There is some use of pictures in the guide however there is some confusion in the guide about which service it is referring to. The picture is of Ocean House but the words name another home. People who use the service at present are only admitted through a care management assessment as the service has a block booking arrangement with funding authorities. Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 9 On 2 files seen both contained a copy of the care management assessment and care plan. The home did not have its own care plan (see standard 6). Ocean House DS0000069856.V354469.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, 9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People have individual care plans however they are not the services own, which means they are not as up to date as they should be to reflect changing needs. Records reflect the choices made by people who are using the service. There are individual risk assessments in place for people using the service, which reflect individual needs. Staff handle information sensitively. EVIDENCE: The home had not fully developed their own care plan based on the care management assessment and care plan. There was some evidence in both files seen that the service were beginning to look at information about individuals in a person centred way. However this was not fully developed. On 1 file there was evidence that the service were aware of a change in someone’s health needs however the care plan provided by the funding authority was not up to Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 11 date. Several survey forms returned by relatives and carers suggested that a carers needs are taken into account. Care plans provided by funding authorities for individual’s receiving care are very detailed and cover all aspects of a persons health and welfare. 1 of the files seen did not contain an up to date care plan from the funding authority. The annual quality assurance assessment (AQAA) submitted by the home states that the service notes individual needs through the care plans and in pre admission visits. In 1 file it was noted that an individual had a changed medical condition since the last period of respite, however this information was not in the care plan supplied by the funding authority, as it had not been reviewed since the last period of respite. The manager of the service was aware and commented on the need for good communication with care managers to ensure the staff have the information they need to meet individual care needs. The manager said that they are developing good links with care managers. 1 member of staff who returned a survey form stated “plans are detailed but that sometimes behaviours which are in plans do not manifest themselves during a period of respite”. 1 relative who returned a survey form said that there needs to be “better lines of internal communication regarding clients requirements”. Another relative who returned a survey form said, “Should read information sent in with person and act on it”. This could be done by updating the homes care plan and discussing with staff. There was evidence in the 2 files seen that people who use the service are supported to make decisions and care plans provided cover how people make choices. A record is kept of daily choices about getting up, activities, and meals. As people are in the service for respite there is no management of finances for individuals, however a clear record is kept of any monies brought into the home by an individual for the duration of their stay. A record is kept with receipts of how the money is spent. These records are audited daily and weekly. There are risk assessments in place for people who use the service, the manager says they are continuing to develop these as they get to know people better. Files contained risk assessments around being out in the community, evacuating the building if there was a fire. There was a risk assessment in place for 1 person who was at risk of choking but this information was not in the care plan. Information on individual’s who use the service is stored securely. All records of incidents and accidents are stored collectively. The provider explained that they are kept together for the purpose of auditing and once the audit is completed the individual incident records are stored in the personal files of each individual. Ocean House DS0000069856.V354469.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, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are able to participate in activities, which interest them in the local community. People who use the service have their rights respected. People are supported to have a healthy diet. EVIDENCE: People who use this service are already participating in activities such as going to college and day activities either in a day service or in the community. While in respite these activities continue. The manager is in the process of ensuring that they capture information about the social and leisure activities which people want to do while on respite, this includes having information available on activities in the community while people are with them, arranging trips at the weekend and booking bowling alleys or getting cinema tickets if they know the person who is coming likes to Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 13 do these things. The AQAA states that the service has a variety of indoor games and videos for people to use while they are on respite if they wish. The manager pointed out that the service is still in the process of getting to know the people who use the service and tailoring the activities to individual wishes. 1 person who uses the service returned a survey form, which said, “They are able to do what they want at the weekend and in the evening” 1 relative who returned a survey form said when asked how could the care service improve: “arrange more outings/activities during client stay”. The daily routines for each person staying are detailed in the care plan provided by the funding authority. As there was no one in the home at the time of the site visit it was not possible to observed staff interacting with people using the service, however from survey forms returned there were only positive comments about the staff and the care and support they provide. The fridge and freezer were well stocked with food. There was fresh fruit and vegetables in the kitchen. There is a menu plan, a member of staff explained that this is flexible depending on what people feel like. The member of staff also said that they would buy specific food items if they know that someone coming in for respite really likes a particular item. As part of the introductory visit people who are considering using the service come for visits at teatime and have participated in the preparation of the meal. Ocean House DS0000069856.V354469.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): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive the support in the way they need and prefer and their physical and emotional needs are met. The home has a policy on dealing with medicines and staff have the training they need to ensure that people using the service are protected. EVIDENCE: As previously stated the service receive detailed care plans from care managers, which contain information on the way people prefer to be supported. The manager also explained that they are developing a more person centred approach to updating information as they get to know people better, doing this during stays. 4 survey forms returned by relatives were all positive about the way staff support the people receiving the service. Staff are aware of health care needs and check with parents and social workers before someone is admitted on their current health. The service tries to ensure that routines are maintained while someone is in respite. The manager explained the priority given to information about health. Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 15 The home has a medication policy and the annual quality assurance assessment (AQAA) says that when someone comes into the service the medication is checked and this is repeated at the end of his or her stay. The service also has information on the individuals own GP and they can register temporarily with a local GP for the duration of their stay. Staff have received training in the safe handling of medication. At the time of the inspection the records seen were accurate. Ocean House DS0000069856.V354469.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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service feel listened to. Staff receive the training they need to ensure people are protected. EVIDENCE: The service has a complaints procedure and make it available to people using the service. 3 of the 4 survey forms returned by relatives were happy with the information about complaints and how the service responded. The complaints leaflet is also in an accessible format. The service is considering revising this leaflet, as symbols used are a little confusing. There had bee no formal complaints at the time of the inspection. The service has a policy and procedure on safeguarding adults and staff receiving training. At the time of the inspection there had been 1 safeguarding adults concern raised. This allegation was not substantiated but the service and local authority to ensure better communication had agreed several actions. The service has also arranged for staff to complete total communication training. This will enable staff to enhance communication with those people who use the service and are not able to communicate verbally. Ocean House DS0000069856.V354469.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 excellent. This judgement has been made using available evidence including a visit to this service. People who use the service live in a homely, comfortable and safe place. The home is clean and hygienic. EVIDENCE: The service can accommodate a maximum of 4 people in single en-suite rooms. There is a large lounge with patio doors leading onto a wooden veranda. All the rooms are well presented. 1 bedroom has a wash hand basin which is neatly hidden behind doors as part of the built in cupboard area. The rooms have either single or double beds according to individual preference. Bathroom is well designed with 2 flaps in the side of the bath so the hoist can be used over the bath. At present there is a step down from the veranda to the garden, the service is planning to replace the step with a ramp. There is access to the garden for a wheelchair user through a bedroom, which has a patio door and ramp into the garden. Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 18 All bedrooms are on the ground floor. The home is in keeping with others in the street and is accessible. The furnishings are comfortable and of good quality. The home is clean and free from odours. At the time of registration the home met the environmental standards and the local fire service. Ocean House DS0000069856.V354469.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. People who use the service are supported by staff that receive the training they need to do the job well. The home has a thorough recruitment policy and practice. Further work is need to ensure that all staff have up to date training for specific medical conditions to fully support people who receive a service. EVIDENCE: At the time of the inspection the service employs 6 staff and at the time their annual quality assurance assessment (AQAA) was completed 40 had or were working towards NVQ 2 or above. The AQAA also states that the service employs people who have the skills and experience needed to work with people who have physical and learning disabilities. 2 survey forms were returned from staff both were very positive about induction and training. 1 survey returned by staff stated that they felt they had the right support and experience to support people with different needs. Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 20 Recruitment procedures are robust, people are interviewed face to face, interview records are kept with decisions reached and why, references are sought and Criminal Records Bureau checks are completed before someone starts work with the service. Any concerns are picked up at an early stage and monitored through supervision. People who use the service have not been involved in the staff selection process at this point but the manager is considering how this could be achieved. 2 files for staff were seen and contained the correct information. All staff receive an induction process, both surveys returned by staff were positive about this. Staff receive training in mandatory subjects such as moving and handling as well as infection control and food hygiene. There were some gaps in training, which had already been identified by the manager, and training was being arranged. There is a staff rota, which is clear on who is working on each shift; it was not clear on the rota who was on duty at night. Ocean House DS0000069856.V354469.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 good. This judgement has been made using available evidence including a visit to this service. As a new service improvements continue to be made to work towards it being a well run home. Quality Assurance is developing to ensure that people who use the service have their opinions listened to and acted upon. The manager is aware of the need to ensure every member of staff as mandatory training in place to ensure that the staff and people who use the service have their health, welfare and safety protected. EVIDENCE: At the time of the inspection the manager for the service had not yet registered with the commission. The manager is in the process of completing her National Vocational Qualification (NVQ) at level 4. During the inspection Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 22 the manager was clear on aspects of the service, which were still developing such as a person, centred approach. As the service is still quite new the manager is also in the process of developing communication systems and getting to know what people want from the respite service. The manager is considering using pictures of staff so that people know to look at the board to see who will be on duty when they return from activities. As staff are becoming involved in total communication the manager is considering the use of symbols around the home. The quality assurance process being developed by the home includes sending out questionnaires after every period of respite. Information is also asked of other people such as relatives and care managers. The manager is very aware of fire safety and this was demonstrated at the start of the site visit when she demonstrated the fire exits to the inspector. Hazardous substances were stored in a locked cupboard in the kitchen. Water temperatures are regulated and the environment is maintained safely. Gas and electricity equipment is maintained appropriately. Insurance was also up to date and the certificate displayed. A fire risk assessment had been completed in June 2007 with the fire officer. All fire records seen were up to date and staff were in the process of receiving fire training. Fire evacuations had been completed and the weekly checks done. All accidents and incidents are recorded and reported. Safety procedures are posted in the kitchen. Not all mandatory training for all staff was up to date. Since the inspection information has been supplied to the commission detailing the mandatory training which has been put in place. Ocean House DS0000069856.V354469.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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 2 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 2 X 3 X 3 X X 2 X Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 (1) Requirement The registered provider must develop with each person who uses the service an individual plan based on the care management assessment and care plan. The registered provider must make sure that staff have the training they need to fully understand the needs of the people using the service. The registered provider must ensure that all staff are up to date in fire, moving and handling, food hygiene, first aid and infection control training. Timescale for action 31/03/08 2 YA35 18 (1) (c) (i) 31/03/08 3 YA42 18(1) (c)(i) 31/03/08 Ocean House DS0000069856.V354469.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. 1 Refer to Standard YA1 Good Practice Recommendations The registered provider should make the service user guide available in formats suitable for the people for whom the home is intended. Individual care plans should be made available in a language and format the person can understand. The registered provider should consider storing information for each person using the service individually rather than collectively. The registered provider should seek advice on the use of covert medication before someone comes into the home for respite so the information and action are clearly documented and agreed by all professionals involved. The registered provider should simplify the complaints procedure, which uses widget. 2 3 YA6 YA10 4 YA20 5 YA22 Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF 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 Ocean House DS0000069856.V354469.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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