Inspection on 23/03/06 for Outreach Community & Residential Services 1 Newtown Mews

This inspection was carried out on 23rd March 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Outreach Community & Residential... 04/08/09

Outreach Community & Residential... 19/09/08

Outreach Community & Residential... 06/11/07

Outreach Community & Residential... 09/11/06

Outreach Community & Residential... 22/11/05

Outreach Community & Residential... 24/03/05

Outreach Community & Residential... 20/07/04

Outreach Community & Residential... 10/02/04

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

CARE HOME ADULTS 18-65 Outreach Community & Residential Services 1 Newtown Mews 1 Newtown Mews Prestwich Manchester M25 1HE Lead Inspector Sue Evans Unannounced Inspection 23rd March 2006 09:45 Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Outreach Community & Residential Services 1 Newtown Mews 1 Newtown Mews Prestwich Manchester M25 1HE 0161 773 1062 0161 740 5678 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) Outreach Community & Residential Services Mrs Esther Weinstock Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 4 service users, to include: up to 4 service users in the category of MD (Mental Disorder under 65 years of age). The service should employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection. 22nd November 2005 Date of last inspection Brief Description of the Service: 1 Newtown Mews is one of a group of homes managed by Outreach Community and Residential Services. Outreach is a charity that provides care and support predominantly to Jewish people with learning disabilities or mental health needs. This home is registered to provide care and accommodation for up to 4 people who have mental health needs. The house is situated in a residential area of Prestwich, close to bus and tram routes, local shops, synagogues, and other local amenities. The house is similar to other houses in the area and it is not distinguishable as a care home. It has a lounge, and a lounge/dining room. All bedrooms are single. Outside, there is car parking space at the front, and an enclosed garden at the back. The philosophy of care, as described in the Statement of Purpose, promotes values such as independence, dignity, rights, fulfilment, and choice. Cultural needs are supported. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took 5¾ hours. Most of this time was spent watching what went on in the home, talking to 2 of the residents, and interviewing 2 staff members and the manager. The inspector also looked round some parts of the house, and examined some key records. This inspection was the second to take place in the current inspection year. In order to gain a fuller picture of the home, this report needs to be read in conjunction with the report of the previous inspection of November 2005. What the service does well: What has improved since the last inspection? The shower room has been improved in an effort to make it more pleasant for residents. Safety has also been improved by providing fire safety training, paper towels for hand drying, and by ensuring that all portable electric appliances are tested. Some records, for example medication records, now contain more detail. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 6 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. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None None of the above standards were assessed this time. EVIDENCE: Standards 1 and 2 were assessed in November 2005. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 and 10 Residents know about their individual plans, and they are involved in reviewing their needs and updating their goals. Residents are able to make choices about their lifestyles, with help from staff if needed, to exercise their right to autonomy and individuality. The home encourages residents to be as independent as possible, helping them to keep any risks to their health and welfare to a minimum. Residents trust staff to maintain confidentiality. EVIDENCE: Standards 6 and 9 were assessed in November 2005. The manager and staff were aware of the assessed needs of the residents. Their descriptions of how they assisted residents matched with the information given by the residents themselves, and the information held in personal files. The personal files for 2 of the residents were looked at. They included assessments, health plans, individual personal plans, review notes and risk assessments. They also contained a brief summary of the resident’s key support needs providing staff members with a quick reference point. The manager was asked to make sure that all information held on files was dated. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 10 Records showed that needs and goals were reviewed every 6 months. There were also reports of monthly informal meetings between the resident and their key worker to review needs and goals. Residents confirmed that they were involved in reviewing their needs and goals. Residents said that they had choice about how they spent their time. Records and discussions showed that residents were encouraged to make appropriate choices in areas such as leisure, employment and education, or choosing menus. Residents took part in their own chosen activities, and they had individual menus. They were also involved in choosing furnishings and colour schemes for the home. Most residents managed their own finances, and two looked after their own medication. The manager said that residents generally spoke for themselves but that sometimes families might act as advocates. She gave an example of how the home also tried to help people to find independent advocates if they wanted this. Records and discussions showed that risks were assessed, and balanced against the resident’s right to choice and independence. Examples were given. As required at the time of the November inspection, the risk assessment in respect of the identified resident had been updated. Staff members understood confidentiality procedures, including their duty to share otherwise confidential information with an appropriate person, for example if a service user was thought to be at risk. Residents said that they had not heard staff members discussing the personal information of others, and they trusted staff to maintain confidentiality. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, and 15 Residents have choice about their lifestyles, taking part in activities that they enjoy doing. They participate in the community, with staff support if needed, enabling them to lead fulfilling lifestyles. Cultural needs are supported. Contact with families and friends is supported and encouraged. EVIDENCE: Standards 12, 13, 14, 16 and 17 were assessed in November 2005. Most residents could take part in community activities without staff support. However, staff members did spend time on community activities with residents. This was observed during the inspection. Residents described some of the community activities that they were involved in. These included work, college, social groups, meals out, and shopping. All residents had the opportunity to go on an annual holiday. During the inspection, one resident went to work in the morning, two went shopping with a staff member for food for Passover, and another was accompanied to the library by a staff member. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 12 At home, residents enjoyed pastimes such as watching television and DVDs, playing keyboard, and reading. Cultural and religious needs were respected. Shabbas and Jewish festivals were observed. Records and discussions indicated that staff members were offered training in Judaism. It was also expected that only kosher food would be brought into the house. Residents described how they kept in contact with family and friends. Some regularly spent days or weekends with family members. Residents’ personal plans contained a section covering “relationships, sexuality and partnerships”. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Residents are independent and attend to most of their own personal needs, with prompt and encouragement from staff if needed. Medication storage and procedures promote good health and safety but there is a need to ensure that the identified staff member undertakes medication training. EVIDENCE: Standards 19 and 20 were assessed in November 2005. In respect of personal and physical care, residents were generally self-caring, and any assistance from staff members took the form of encouragement and reminders. All residents were able to express their wishes about the way they were supported. From discussions with them, it was evident that they had choice over their daily routines, for example what time they got up or went to bed. Indeed, when the inspector arrived at the home at 9.45 am, two residents were having a lie-in. It was observed that residents and staff spoke with each other in a friendly, natural manner. Residents said that they were happy with the way that the manager and staff members treated them, and the way they spoke with them. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 14 They confirmed that staff members were polite. One said, “Staff are very good, it’s easy to talk to them”. They described their key worker as “smashing”. Residents were satisfied that their privacy was respected, for example they had keys to their bedrooms, and they said that nobody entered their bedrooms without invitation. The home had medication policies and procedures. As advised previously, it is recommended that a paragraph about non-prescribed medicines be included in the policy. Medicines that were kept in the home were securely stored. Two of the residents looked after their own medication. Since the last inspection, the manager had expanded the risk assessments to include details of the quantity supplied, for example 1 week’s supply, and how often the arrangements were reviewed. However the manager is still advised to include how the medication is supplied (for example in bottles, or in a dosette box), and whether the resident knows what to do if a dose is lost or missing, There were records of medication received, administered, and disposed of. The medication administration records (MAR) that were looked at were fully completed. The manager had asked residents or relatives to sign a “Consent to Medication” form. There was a need for one of the staff to undertake training in the safe handling of medicines. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Residents know who to complain to and feel that any concerns are usually listened to and dealt with. Protection policies and procedures, and staff understanding of adult protection, ensure that the home has the means to be able to respond properly to any suspicion or allegation of abuse. EVIDENCE: Standards 22 and 23 were also assessed in November 2005. The written complaints procedure included a statement about peoples’ rights to make complaints directly to the CSCI. Residents’ personal files contained signed confirmation that they had received a copy of the procedure. Residents said that they would speak to the manager or staff if they had any concerns. They felt that action would usually be taken to look into their concerns, although one person wasn’t sure if anything had been done about a recent concern they had raised. As requested during the last inspection, the manager needs to make sure that complainants are kept informed of the action being taken to resolve complaints and concerns. The informal complaints book needs to be more fully completed to show what action has been taken, the outcome of the investigation, and how and when the complainant was notified of the outcome. Staff members were aware of the written procedures covering adult protection and whistle blowing. They understood their responsibilities in reporting any suspicions of abuse. One staff member said that this had been discussed during 1 to 1 supervision meetings. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 16 The manager had been on a training course in adult protection but staff This is strongly members had not yet had the opportunity to do so. recommended. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 In order to provide a pleasant, comfortable home for residents, the home needs to make some improvements to the environment. EVIDENCE: Standards 24, 26, 27, 28 and 30 were assessed in November 2005. The home is situated in a residential area of Prestwich, close to bus and tram routes, local shops, synagogues, and other local amenities. The house is similar to other properties in the area. It is not identifiable as a care home. During the last inspection, a number of requirements were made in respect of improving the environment. Since then, the shower room had been improved, and a new lounge suite had been ordered. The manager said that plans were in hand for redecoration throughout the house. She said that the work should be completed by the end of May. Other work, for example the painting of the outside of the house, and attention to the worn doors and drawer fronts in the kitchen, had not yet been completed. Discussion took place about the need for an ongoing schedule of maintenance and renewal. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 18 Standards of cleanliness in most areas of the home were better than last time but there was still room for improvement, for example wiping spillages from door frames, walls and cupboards. As required last time, paper towels were now being provided for hand drying. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 36 The Service needs to encourage and support staff members towards achieving a target of having at least 50 of care staff trained to NVQ level 2. Staff members are appropriately supported and supervised to help them to develop professionally and provide a good service to residents. EVIDENCE: Standards 34 and 35 were assessed in November 2005. During the inspection, it was observed that residents had no hesitation in approaching staff members if they needed them. Residents said that said that they would go and see the manager or a staff member if they needed to talk about anything. One said, “Staff are very nice, they help you when you need it”. None of the current support workers had done NVQ training (one staff member who had achieved the award had recently moved to another post). The manager said that one support worker was due to begin the training in June. The Service needs to continue to encourage and support staff members with NVQ training with a view to having at least 50 of workers with the qualification. Staff members said that they felt well supported by the manager. They said that she was approachable and they could see her at any time if they wished Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 20 to discuss anything. She was described as “understanding” and “a very good leader”. Staff members said that formal 1to1 meetings took place monthly, with minutes recorded. They also said that monthly staff meetings took place. They said that there was always someone on call in case they needed help or advice. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 Service users and others are asked for their views on the quality of the service. The health and safety of service users and staff are promoted by means of regular maintenance and safety checks. EVIDENCE: Standards 37, 39 and 42 were assessed in November 2005. The home had a number of ways to monitor the quality of the service including regular residents’ meetings, the recording of any concerns, and the recording of outcomes from monthly visits to the home by a nominated manager within Outreach. Outreach had also undertaken an in-depth quality audit of the service provided by the home. This included asking residents, relatives, staff and others about their views of the service. A very detailed document had been produced which highlighted areas of good practice and areas identified for improvement. These areas had been summarised into several pages at the back of the document. Discussion took place about the need to make sure that the summary included full details and timescales for addressing the areas for Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 22 improvement. A copy of the summary needs to be made available to residents, and others, so that they know that their views have been noted and, where applicable, acted upon. A copy of the summary also needs to be sent to the CSCI (Commission for Social Care Inspection). Standard 42 was assessed last time and requirements were made in respect of fire safety training and portable electric appliance testing. These had been addressed. It was also noted that the home had valid certificates for the soundness of the gas and electrical installation systems. The manager had produced a fire risk assessment. Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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 X 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000008443.V265421.R01.S.doc 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 X Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 2 X X X 3 X X 3 X Version 5.1 Page 24 Outreach Community & Residential Services 1 Newtown Mews 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 YA20 Regulation 13(2) Timescale for action The registered person needs to 30/06/06 ensure that the identified staff member undertakes training in the safe handling of medicines. The registered person needs to 23/03/06 make sure that in future the complaints and concerns book includes details to show what action has been taken, the outcome of the investigation, and how and when the complainant was notified of the outcome. (Timescale of 22/11/05 not met) The registered person needs to 30/06/06 continue with the plans to redecorate the identified areas inside the home. The registered person needs to 30/06/06 arrange for the outside of the house to be repainted. The registered person needs to 30/06/06 arrange for the upgrading of the worn doors and drawer fronts in the kitchen. DS0000008443.V265421.R01.S.doc Version 5.1 Page 25 Requirement 2. YA22 22 3. YA24 16, 23 4. YA24 23 5. YA24 16, 23 Outreach Community & Residential Services 1 Newtown Mews 6. YA30 23(2)(d) The registered person must 30/11/05 ensure that the standards of cleanliness in the home are maintained. The summary section of the 30/04/06 quality audit document, showing how and when the areas identified for improvement will be addressed, must be made available to residents so that they know their views are being acted upon. A copy must also be sent to the CSCI. 7. YA39 21, 24 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 YA20 Good Practice Recommendations The registered person is advised to include management of non-prescribed medicines in medication policy. the the 2. YA20 The medication self administration assessments should be expanded to include details of how the medication is supplied (for example in bottles or a dosette box) and whether the resident knows what to do if a dose is lost or missing. The registered person is advised to provide staff members with opportunities to undertake adult protection training. The registered person needs to continue to encourage and support staff members with NVQ training with a view to having at least 50 of workers with the qualification. 3. 4. YA23 YA32 Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Outreach Community & Residential Services 1 Newtown Mews DS0000008443.V265421.R01.S.doc Version 5.1 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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