Inspection on 10/10/05 for Overbrook

This inspection was carried out on 10th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Overbrook 22/01/07

Overbrook 06/06/05

Overbrook 08/03/05

Overbrook 21/10/04

Overbrook 19/03/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Overbrook 92 High Street Wootton Isle Of Wight PO33 4PR Lead Inspector Liz Normanton Unannounced Inspection 10th October 2005 08:30 Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Overbrook Address 92 High Street Wootton Isle Of Wight PO33 4PR 01983 883390 01983 883390 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) Islecare `97 Limited Dianne Yvonne Mills Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th June 2005 Brief Description of the Service: Overbrook is a small group home providing care for four adults with learning disabilities. The home is a domestic residence situated in Wootton High Street and is close to local shops and amenities. The property is a two-storey building with a staircase to the first floor. There is level access to the front and rear of the property and a handrail around the garden to assist residents with sight impairments. There is off road parking to the front. The home is managed by Dianne Mills. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the second in the inspection year. The inspection took place on Monday 10th October and began at 8.30 am. Three staff were on duty throughout the morning and the manager arrived at approximately 12.00 noon. The senior member of staff assisted the inspector during the morning. In discussion with staff the inspector was made aware that there had been some staffing difficulties during the summer holidays. This led to a small number of staff having to provide cover and they felt under pressure. The matter has now been resolved. The inspector observed care staff interacting with the residents throughout the day and found that they understood the residents needs’ and treated them with dignity and respect. The inspector gathered information from examining staff files, having discussions with the staff and manager, and observations. The residents were not able to consult with the inspector about their care, however the overall outcome was that the residents are being well cared for. What the service does well: What has improved since the last inspection? The manager has made amendments to the statement of purpose, which now has information about CSCI. The fire inspector has visited the home and fire doors have been made safer by the Islecare maintenance team. New flooring as been laid in the dining area. The manager is now spending half a day at the home five days a week. The manager has completed the National Vocational Qualification NVQ level 4 and the Residential managers award and 50 of the staff team have completed NVQ level 2 in care. The senior carer has begun to implement formal supervision. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 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. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 5 Three residents at the home have been placed there for many years with the most recent resident having now been there for well over a year. The individual needs of the residents are being met by the home. The home has not provided the residents with an individual written contract detailing the terms and conditions of there placement. EVIDENCE: The care needs of prospective residents are gathered by way of assessment prior to admission to ensure that the home can meet the individual’s needs. The needs and aspirations of the residents are written into their individual care plans and care staff support them to meet these needs. The residents have high care needs and are dependent on the staff for all aspects of their care. The staff team are experienced/trained in working with people with learning disabilities. The inspector observed the care staff interacting with residents during the course of the morning and found that the care provided was consistent with the individual’s needs. One resident at the home has an independent advocate. All four residents’ individual files were viewed and none were found to contain a written contract or terms and conditions of the home. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 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): 8, 9 and 10 In the context of the standard the residents are not able to participate in all aspects of life in the home and do not have the cognitive/verbal skills to engage in consultation as to how the home should be run. The registered manager has undertaken comprehensive risk assessments for each resident allowing them to take risks on a daily basis. Residents may not have an understanding of the word confidentiality however care staff endeavour to maintain confidentiality of each individual. EVIDENCE: Only one of the four residents at the home has verbal communication and this is very limited. Three of the residents are registered blind. The residents were observed to need maximum care from the staff team. One resident is able to undertake minor household tasks and is encouraged to do so. Three residents rely on staff for external stimulation and motivation as they are not able to always express their wants. There are risk assessments in place for each resident. One resident has difficulty climbing the stairs to their bedroom however they are assisted by staff to access the staircase. The home has two pet rabbits and the risk of Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 10 harm to the residents has been assessed when they are petting them. One resident likes to knit and she is encouraged to do so. A risk assessment is in place re: the danger of the knitting needles. Three residents attend day centre services. All four residents go outside into the community with the assistance of staff. The home has a confidentiality policy and procedure provided by Islecare ‘97 Ltd. The registered manager stated that these were available to family members on request. Individual records are accurate and kept in separate files. Care staff are aware of the confidentiality policies and procedures. The registered manager also stated that prospective staff are asked about their understanding of the word confidentiality and are also informed of the need for confidentiality at interview. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 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): 11, 12, 14 and 16 Residents are encouraged to maintain life-skills, which they have previously learned. Opportunities to learn new life-skills are limited due to the residents’ abilities. Three residents attend day centre services where they take part in age, peer and culturally appropriate activities. The residents have access to leisure activities and are supported by staff to engage in activities within the home. Care staff respect the rights of the residents. EVIDENCE: One resident is on the Autistic spectrum and does not communicate verbally. The home has asked for support from the speech therapist to enable them to improve communication. The speech therapist has introduced some Makaton symbols, which are displayed on the wall. Care staff undertake baking and one resident likes to join in with this activity. Two residents are offered support from the Blind Society and the learning disability nurse supports one. Three residents attend day-centre services on a part time basis. Care staff are responsible for transporting them to and from this service. The inspector observed two residents leaving the home to be taken to the day centre. The home has a weekly activity chart on display on the staff notice board. Care Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 12 staff are responsible for the handling of residents’ personal allowance, as they do not have the capacity to understand money management. One resident likes to knit and although she was not observed in this hobby evidence of the wool and knitting needles was seen. One resident was observed using paper and colouring pens. An aroma-therapist visits the home every Monday night to give massage. Staff confirmed that the home had some outdoor equipment, which included a swing-ball and basket-ball net. The home is equipped with a television, digi-box and radio. The residents go out on a group trip every Sunday for tea at various public houses around the island. One resident goes to swimming club on a Saturday. Care staff stated that holidays had been planned this summer however they had to be cancelled due to the house vehicle breaking down and subsequent staff sickness. Residents are able to exercise choice as to when they get up in a morning. On the inspector’s arrival at the home one resident was already up and having breakfast. The other residents came down between 8.30 am and 10.30 am. The senior member of staff stated that care staff always knock on bedroom or bathroom doors before entering. All bedrooms are fitted with locks however residents do not have responsibility for holding keys. One resident opens their own post whilst the others require total assistance. Care staff were heard to call residents by other names other then the name stated in their care plans. The inspector raised this matter with the senior member of staff. The care staff were observed engaging verbally with the residents throughout the time of the inspection. Residents have the opportunity to be alone if they wish but were seen to prefer to stay in the close proximity of the care staff. Access to the garden is through the patio door leading from the living room. The patio door was open and residents could move freely in and out of the home if they so wished. Residents are not responsible for any household tasks. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 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): 19 and 20 The residents’ healthcare is a priority and staff endeavour to meet their physical, emotional and health needs. Residents are unable to administer their own medication. They are protected by the home’s medication policies and procedures. EVIDENCE: The residents are totally dependent on the care staff to meet their health care needs. All residents are registered with the local surgery, which is next door to the home. The learning disability nurse visits one resident on a monthly basis. Psychiatric support is provided to two residents by way of yearly appointments. Two residents are supported by the continence service. One resident’s health is monitored yearly by the hospital. Letters offering hospital appointments were seen. Routine dental, optical and hearing tests are done annually. Specialist diets are provided for residents with diabetes. All four residents were seen to look well. Residents are not able to self-administer their medication. The home has a medication policy and procedure. All medication was safely secured and records of medicines coming into the home were recorded. Medication administration was recorded on to MAR sheets. There was also a medication guidance sheet, which gave staff information of why the medication was Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 14 prescribed, and its possible side effects. The senior member of staff stated that all staff have been given in-house training on the policy and procedures and administration of medication. Residents are not able to give written consent. If they refuse to take it this is respected and recorded accordingly. There are no controlled drugs kept at the home. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 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): The above standards were assessed at the previous inspection and were almost met. A requirement for the adult protection policy and procedures to be amended is still outstanding. EVIDENCE: Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 16 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): 29 The home has equipment to maximise the residents’ independence. EVIDENCE: The home is equipped with two hand-rails on the staircase. There is also a hand-rail in the garden. There is a portable hydraulic bath seat, which was purchased at the end of last year. The bathroom is fitted with a grab rails. Two residents have been provided wheelchairs from the National Health Service. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 17 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): 31, 34 and 35 The care staff working at the home are experienced in caring for adults with learning disabilities and residents benefit from their knowledge. Residents are protected by the home’s recruitment policy and procedures. Care staff are appropriately trained in the primary disability of the residents and have some training in the area of how to support people with visual impairment. EVIDENCE: All employees are provided with a job description from Islecare ‘97 Ltd. Two job descriptions viewed. Islecare 97 ’Ltd are not registered with the General Social Care Council and therefore provide staff with an Islecare code of conduct. The inspector observed the care staff interacting in a positive way with the residents throughout the inspection. It was noted that the care staff had developed good relationships with the residents and were aware of their care needs. Care staff are aware of their own knowledge limitations and will liaise with the learning disability nurse for advice. The inspector spoke with staff about the recruitment process and found that Islecare ‘97 Ltd is an equal opportunities employer. The inspector viewed three staff files and found them to contain job application forms, two references and identification. There was also evidence that Crimina Recordl Bureau (CRB) checks have been undertaken. All new employees receive a sixweek induction period and a six-week probationary period. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 18 The residents’ primary care needs are well understood by the staff who have completed Learning Disability Award Framework (LADF). There has been some training with regard to understanding visual impairments, which has been provided by the Blind Society. Staff have not had training with regards to Autism. Islecare ‘97 Ltd have a training budget and all new employees receive mandatory training in the following areas: moving and handling, health and safety, health and hygiene, food hygiene, appointed persons (First Aid). Certificates of training were seen in staff files. Four members of the staff team have completed National Vocational Training NVQ at level 2 and the senior member of staff is undertaking NVQ level 3. The manager has produced a training calendar and staff files contain individual training records. There are opportunities for staff to discuss training needs in their yearly appraisals and supervision sessions. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40 and 42 The manager is experienced in the caring field and is qualified and competent to manage the home. The home has a warm, friendly atmosphere in which residents feel relaxed and well cared for. Islecare ‘97 Ltd monitor quality assurance however only one resident at the home would be able to engage in this process. Residents’ rights and best interests are safeguarded by the home’s policies and procedures. The home is kept clean and tidy and free from hazards and offensive odours. Residents’ welfare and that of the staff is promoted by the home’s health and safety policies and procedures. EVIDENCE: The registered manager, Dianne Mills, has over twenty-six years’ experience of working in the caring field, predominantly with the older persons and more recently with people with learning disabilities. Dianne has now managed Overbrook since 17th November 2003 she also has the responsibility of managing Rose Cottage. Dianne works at Overbrook for half a day Monday to Friday. Prior to managing Overbrook Dianne had five years’ experience in Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 20 managing a residential home. Dianne has been provided with a job description. Dianne has now completed NVQ level 4 and the Registered Managers Award. The manager has overall responsibility for managing the home. In her absence the home is run by the senior member of staff who has responsibility for supervising the staff team. The staff team are responsible for the day–today running of the home. All care staff are accountable to the manager. Care staff are able to voice their opinions about the running of the home at staff meetings and in supervision. The home provides a warm friendly relaxed environment to residents. Islecare ‘97 Ltd are committed to equal opportunities. The residents of the home would have difficulty in expressing their views about the running of the home. Islecare ‘97 Ltd undertake an annual service user audit with the use of a questionnaire which has pictorial symbols. Islecare ‘97 Ltd undertake monthly visits and provide CSCI with Reg 26 forms giving details of how they found the service being run on a given day. CSCI provide the home with questionnaire leaflets, which are then available for residents’ families and stakeholders to complete and return if they so wish. Two letters sent to the home in 2004 thank the staff for all the care they have provided. Residents are no longer advised of CSCI inspections as the inspections are now unannounced. The home generally meets timescales for the implementation of requirements. The home has recently received an updated manual of policies and procedures, which has been purchased from Somerset Care. Islecare ‘97 Ltd adopt these policies and they are then implemented into the home. The policy and procedure for adult protection does not comply with the Isle of Wight Adult Protection policies and procedures. The manager has asked care staff to go through the manual, which is easily accessible. The registered manager has undertaken generic risk of potential hazards within the home. There is control of substances hazardous to health (COSHH) risk assessments. All COSHH materials are stored safely. Each individual resident also has a risk assessment on file. All staff members have received training in health and safety/hygiene and food hygiene. Foodstuffs are stored appropriately. Fridge and freezer temperatures are tested twice daily and temperatures are recorded. There are four fire zones in the home, which staff test weekly on a rotational basis. The fire inspector has visited since the previous inspection and fire doors have been fitted with an additional strip of wood to lengthen the doors. Sight Guard test fire equipment and systems . quarterly. The home has had a gas safety check in January 2005. Electrical appliances within the home are PAT tested by the landlord South Wight Housing and were done in September this year. The home has relevant health and safety policies and procedures in place. Care staff run the hot water taps for 10 mins every morning to protect against Legionella. All first floor windows are fitted with restrictors. The home have recently purchased a new drier and the washing machine was tested three weeks ago. The manager ensures Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 21 compliance by setting a good example, observation, and through the sharing of information in staff meetings and providing written guidance. The home is secured at night for residents’ safety. All accidents are recorded and details of serious incidents are sent to CSCI. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x 1 Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x 3 x LIFESTYLES Standard No Score 11 3 12 3 13 x 14 3 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score 3 x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Overbrook Score X 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x DS0000012520.V251405.R01.S.doc Version 5.0 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 5 (b) (e) Requirement Timescale for action 10/10/05 2 YA5 5 (c) 3 YA23 12 (a) 4 YA24 16 The service user guide requires information with respect to contract terms, fees and complaints procedure. (Previous timescale of 30th September not met) Each service user should have a 30/12/05 contract for the provision of services and facilities by the registered provider. The home’s adult protection 10/10/05 policy and procedure must incorporate the Isle of Wight adult protection policy and procedures. Islecare to follow up the refitting 30/12/05 of the kitchen with the Landlord South Wight Housing and to provide CSCI with a timescale for action. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 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 YA35 Good Practice Recommendations Islecare should consider providing additional training for staff in the areas of Autism and Visual Impairment to inform them of the secondary disabilities of the service users. Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Overbrook DS0000012520.V251405.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!