Inspection on 17/07/07 for Ottley House

This inspection was carried out on 17th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Ottley House 09/07/08

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Ottley House Corporation Lane Coton Hill Shrewsbury Shropshire SY1 2PA Lead Inspector Rosalind Dennis Draft Unannounced Inspection 17th July 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ottley House Address Corporation Lane Coton Hill Shrewsbury Shropshire SY1 2PA 01743 364863 01743 244651 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) Barchester Healthcare Homes Ltd Elizabeth Jane Sagar Care Home 36 Category(ies) of Dementia (36), Old age, not falling within any registration, with number other category (26), Physical disability (10) of places Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide personal care (with nursing) and accommodation for service users of both sexes whose primary care needs on admmission to the home are within the following categories:dementia, DE, 36; old age not falling within any other category, OP, 26; physical disability, PD, 10. The maximum number of service users to be accommodated is 36. 2. Date of last inspection 13th July 2006 Brief Description of the Service: Ottley House is a care home registered to provide nursing care to 72 service users offering care to people in the categories of old age, physical disability and dementia. It is a purpose built home situated in a residential area on the edge of Shrewsbury town. The accommodation comprises 64 single rooms, 60 of which have en-suite facilities and 4 double rooms with en-suite facilities. There is easy access to pleasant gardens. The range of fees charged by the home varies according to the nursing needs of the individual and whether the individual is cared for in a single or shared room-weekly fees currently range from £419 to £700 (high dependency). Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was conducted mostly by one inspector over a period of around seven hours, another inspector spent a shorter period of time at the home focussing on how the home provides recreational and social activities. . All ‘key’ standards were assessed during the day- that is those areas of service delivery that are considered essential to the running of a care home. Time was spent speaking with people living at the home, their significant others, speaking with staff and management, observing staff working and looking at range of documentation. Twenty one surveys were sent from CSCI to people living at the home and eleven surveys returned-a range of positive and negative responses were received and some of these comments are included in this report. Some weeks prior to this inspection the manager had submitted an Annual Quality Assurance (AQAA) document to CSCI-this document assists CSCI to assess the home’s performance. What is positive is that the manager has recognised weaknesses within the service and identified how the home intends to improve. What the service does well: What has improved since the last inspection? Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 6 The home has improved its recruitment processes and this protects people living at the home from the employment of inappropriate staff. ‘Key’ members of staff have received training in the safe fitting of bed rails and medication is now stored securely. 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. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this home. Quality in this outcome area is good. Comprehensive pre-admission assessments ensure that individuals admitted to the home have their care planned and their needs met by a skilled staff group This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation of a random selection of care files from the general nursing and dementia care units demonstrate that people’s care needs are comprehensively assessed prior to and on admission to the home. The assessment process shows that the home seeks detailed information about the individual’s care needs and any other matters that are important to them, such as their significant others, hobbies, cultural and religious needs –observation of care plans shows that this information is then used to plan the person’s care. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 9 A ‘residents terms and conditions’ information booklet provides detailed information in respect of overall care and services covered by the home’s fees, including an admission agreement and third party agreement as appropriate. Eight out of eleven people who responded via questionnaire to CSCI confirmed that they had received a contract; seven people said that they had received enough information about the home before moving in with one person commenting that they had not. Two people spoken with during the inspection confirmed their satisfaction with the admission process. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. There is clear and consistent care planning in place, which provides staff with the information they require to meet individual needs. Evidence of regular review and good multidisciplinary working ensures that health and personal needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People on the Ann Carter Unit (general nursing) unit who were spoken with appeared generally very happy with their care-comments made by people included ‘carers very good’ ‘I’m happy-no complaints’ ‘happy with careeverything’ and one relative commented ‘ I can go home each day, knowing that my relative is well looked after’. People cared for on the Charles Darwin unit were dressed appropriately and hygiene needs were attended to promptly. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 11 Four care files were seen and this shows that staff plan and review care using an effective care planning and risk assessment process. Care plans were comprehensive on both units and took into account short and long term care problems. Moving and handling risk assessments contained detailed information to provide staff with the information they need to safely move individuals and all other risk assessments seen were complete and regularly reviewed-although the frequency of these reviews were not as consistent on Charles Darwin Unit. Observation of records for a person with a wound shows that the home has good systems in place to monitor and treat wounds-there is a range of pressure relieving aids within the home and these were found to be used appropriately. Of the eleven questionnaires received by CSCI, seven people commented that they always receive the care and support they need, two people responded ‘usually’ and another two people responded ‘sometimes’. A question to determine whether people feel that they receive the medical support they need resulted in nine people responding ‘always’ one ‘sometimes’ and one person responded ‘never’-care files that were checked showed that staff regularly contact healthcare professionals for advice and/or to request that visits are made to the home. Information received by CSCI prior to the inspection confirms that the home plans to improve how it offers support before and after admission to the home and to listen to people’s preferences - this should help to ensure that people’s needs and preferences are consistently met. The medication storage rooms were found to be organised well and Medication Administration Record (MAR) sheets were observed to be complete-both medication storage rooms were kept locked when not in use. Regular audits are undertaken of the medication systems as part of the home’s quality assurance processes-however records of the temperature of the medication fridges show that staff are not clear on the required temperature ranges for these fridges as staff have been recording temperatures which are consistently excessive but with no evidence of action being taken to address this. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. The home provides a range of activities and the meals at the home are good, offering variety and catering for different nutritional needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home currently has one person designated for the provision of activities and throughout the inspection this staff member was seen speaking with people living at the home on a one-one basis and assisting people with activities such as drawing- at the time of inspection relatives and people living at home spoke positively about the contributions made by this member of staff. Factors which need to be taken into consideration when planning activities such as a person’s mobility, sight and spiritual needs are now forming part of an assessment –and this should help to ensure that activities and social events are individually relevant. The home produces information on planned activities for the month ahead, which shows that a range of events take place-it was discussed that it may be beneficial to produce both this document and the menu’s in different formats, such as large print. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 13 Ten responses were received to a question on the CSCI survey regarding activities; four people responded that there are ‘usually’ activities arranged by the home that they can take part in, six people had responded ‘sometimes’ and written comments included activities are ‘sometimes rubbish’ and that the ‘range of activities is very different from those of her lifestyle before being admitted’. Information provided by the manager prior to the inspection shows that the manager has already identified that the standard of activities could be improved. Documentary evidence was also available to show that the home is looking to implement training using a Barchester training package called ‘Memory Lane’ as well as appointing a second activities person and it was agreed that this should help to ensure that people are provided with activities based on current good practice guidance as currently people on both units are provided with the same range of activities. Each unit has a kitchenette area, which enables people to make drinks when they are visiting the home and information on the provision of meals for visitors is included in the statement of purpose/service user guide. Leaflets detailing information on advocacy services are readily available throughout the home. A range of responses were received to a question on the CSCI survey ‘Do you like the meals at the home’- 3 people responded ‘always’, 5 responded ‘usually’, 1 ‘sometimes’ and one person responded ‘never’. Written comments included ‘the meals are very good’, ‘more chips’ and ‘vegetables too tough’. The meals served during the inspection looked appetising and well-presented, and most people living at the home commented that meals are always good, one person described how the food choices are better on some days than others and another person spoke of how some vegetables might not be easy to swallow for some people with swallowing difficulties- this was brought to the attention of the manager. Suitable assessments and monitoring processes are in place to ensure that people at risk from poor nutrition receive adequate interventions. The home has recently won an award from Barchester for its catering services and menu’s show that the home offers a good choice of meals-which had been changed following the results of the last survey undertaken by the home. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. The service has a complaints procedure that is up to date and accessible to enable anyone associated with the service to complain or make suggestions for improvement. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ottley House has a formal complaints procedure and copies of this procedure were observed to be available within the “Residents Guide” and in the reception, the procedure is also available in Welsh. Out of nine people who responded to a question regarding complaints on the CSCI survey, eight people confirmed that they knew how to make a complaint- one person responded that they did not know, comments received included ‘would talk to a senior nurse’ ‘usually speak to the most senior member of the nursing staff I can find but have been unable to take matters to a higher level’. Observation of the complaints file shows that 4 complaints have been made direct to the home in the past twelve months and the process used to record and respond to complaints confirms that the home responds promptly and robustly to any complaints that are made. On the day of the inspection the regional manager was at the home to meet with people who had recently made a complaint. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 15 Procedures are in place for the protection of vulnerable adults, the local multi agency guidelines are available for staff reference if required. The manager has a good knowledge of adult protection processes and procedures and records show that staff receive ongoing training and updates in adult protection/abuse awareness. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. The standard of the environment is good providing people with an attractive, clean and homely place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All parts of the home that were seen were decorated to a good standard. Furniture in use appeared appropriate and of good quality and the selection of moving and handling aids within the home provides staff with safe ways to move people. The home has a five year plan in place to upgrade the home –two bathrooms have recently been refurbished and one lounge is to be refurbished this year. People spoken with were happy with their rooms and communal areas such as dining areas and lounges. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 17 Charles Darwin unit has wall coverings of different textures and some signage on bathrooms and toilets, although further consideration to enhance sensory stimulation in accordance with current good practice guidance would be a positive development. The manager discussed that a shortage of cleaning staff had recently resulted in a less efficient cleaning service-which did give rise to a complaint being made. On the day of this inspection all parts of the home were clean and staff were observed steam-cleaning carpets on Charles Darwin Unit. Infection control management within the home is assessed using Department of Health Guidance and records confirm that staff receive training and updates in infection control. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. Training opportunities within the home are good which ensures that staff are appropriately skilled and competent to carry out the duties for which they are employed. The home has improved its recruitment processes and this protects people living at the home from the employment of inappropriate staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living on Ann Carter unit commented that they consider sufficient staff are usually on duty to meet their needs-staff on this unit also stated that they believe staffing numbers are adequate to provide and meet care needs. The home has recently had a high number of staff leave, with most leaving from the Charles Darwin unit and this has created some instability within the home-one relative commented on the impact of staffing changes on Charles Darwin unit which they believed has led to some inconsistencies with attending to care needs, another visitor spoke positively about the care their relative receives. One person spoke of how the lounge area on this unit is not always supervised, this had been noted at the start of the inspection when it was seen Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 19 that 15 people were seated in this area without any staff present-this was brought to the attention of the manager. It was confirmed that one member of staff was absent at short notice and a member of staff from the other unit came to assist later in the day. Observation of staffing rotas show that the home does appear to be maintaining staffing levels at sufficient numbers and the manager is aware that staffing levels need to be calculated according to the dependency and needs of the people living at the home. A question on the CSCI survey ‘Are the staff available when you need them?’ resulted in 3 people responding ‘always’, 5 responded ‘usually’ and 1 person responded ‘sometimes’-comments received included ‘often no staff in lounge’ ‘manager at the home won’t bring in bank staff or employ more staff’, ‘often no member of staff is available when help is needed’ ‘level of care sometimes affected by staff shortages’ and ‘the staff on the EMI unit ...are wonderful, they give X great care and always get time to support the family’. A discussion with the manager and observation of documentation shows that home is actively recruiting new staff-and examination of two staff personnel files shows that the home now ensures all pre-employment checks are undertaken prior to the person starting work. Since the last inspection a new home trainer for staff has been appointed and at the time of inspection training was in progress. Staff confirmed good training opportunities are available and observation of a training matrix shows that the home is organised in its approach to training to ensure that people are kept up to date. The manager confirmed that training in new mental health legislation is to be incorporated into planned dementia care training. Changes within the staff group has led to a reduction in those with NVQ Level 2 in care, however over half of the care staff have either attained or in the process of attaining this qualification. Discussions with staff confirmed access to regular formal supervision. Staff appraisals are also undertaken and personal development plans completed. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38. Quality in this outcome area is good. The home is continually monitoring and reviewing processes to ensure that people receive a good range of quality services. The home is well maintained and the staff group appropriately skilled to ensure that the health, safety and welfare of residents is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager, Jane Sagar is a registered nurse with a good range of supporting qualifications, skills and experience. An Annual Quality Assurance Assessment (AQAA) completed by the manager and submitted to CSCI shows that Jane Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 21 Sagar is able to recognise where the home could improve and the steps needed to achieve those improvements to benefit people living at the home. The home continues to operate a comprehensive process of auditing quality and practice, which includes auditing of catering services, health and safety, medication, activities and infection control. Questionnaires are sent out to people living at the home and their significant others to gain feedback on the services provided-however few people provided responses to the last survey’s undertaken. The results are then collated and published along with an action plan detailing how the home will act on negative feedback-this easy to read document is readily available. The manager is currently looking at different ways to consult with and involve relatives and advocates in how the home is run. The regional manager conducts regular unannounced visits to the home and copies of the findings of these visits are sent through to CSCI. The home does not safe keep any money on behalf of residents. If ‘sundry’ expenditure is required payment is made through the petty cash system and an invoice raised for the person or their representative. Observations during the inspection confirmed a safe environment and equipment appeared well maintained. One set of bed rails on the Charles Darwin Unit appeared not to be of sufficient height to reduce the risk of the person falling out of bed and this was brought to the attention of the manager and the maintenance person attended to this promptly. Individual risk assessments for the use of bed rails were in place on the care files seen, training for key staff to ensure safe use has been provided and the manager confirmed that induction training now incorporates bed rail training. Training records show that staff are provided with training in all safe working practice topics. An independent company has recently undertaken a comprehensive health and safety audit and documentary evidence was available to show that maintenance and servicing of equipment is undertaken. Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 OP9 Regulation 13 (2) Requirement The temperature of the drugs fridge must be maintained at between 2 and 8°C and the registered person must ensure that staff are aware of the required temperature range and of the procedure to follow should the temperature fall outside this range. (Previous timescale of 01/09/06 not achieved) Timescale for action 01/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations The home is advised to consider ways to reduce the boredom and feelings of isolation for residents that are confined to bed as a result of their illness. (17/07/07-assessed as in progress) 2 OP12 It is advisable to produce the activity and menu plans in other formats. This should enhance information sharing with people who have communication difficulties. DS0000069245.V337952.R01.S.doc Version 5.2 Page 24 Ottley House 3 OP19 The home is advised to consider changes to enhance the environment on Charles Darwin Unit. This may promote well-being and enhance sensory awareness for people living at the home Ottley House DS0000069245.V337952.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Ottley House DS0000069245.V337952.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. 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