Inspection on 15/11/06 for Overton House

This inspection was carried out on 15th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Overton House 14/11/07

Overton House 03/03/06

Overton House 08/06/05

Overton House 24/02/05

Overton House 19/08/04

Overton House 16/02/04

Similar services:

Dystlegh Grange

Thornton Lodge

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

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

CARE HOMES FOR OLDER PEOPLE Overton House 2 Newton Avenue Longsight Manchester M12 4EW Lead Inspector John Oliver Unannounced Inspection 15th November 2006 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 Overton House DS0000021573.V299012.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. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Overton House Address 2 Newton Avenue Longsight Manchester M12 4EW 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) 0161 273 2555 Mrs Angela Asomaning Mrs Angela Asomaning Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 18 service users who require personal care only by reason of old age (OP) and one named service user who is out of category by reason of age (PD). Should the above named service user no longer require the accommodation offered by Overton House then the conditions of registration will revert to old age (OP) only. Date of last inspection 3rd March 2006 Brief Description of the Service: Overton House is a privately owned residential care home providing personal care and accommodation for 19 older people. The home is located in the Longsight district of Manchester. Longsight is a multicultural residential area, which is close to the city centre and is within reach of good transport links to Stockport and surrounding areas. The home is a large Victoria style property. It is located on a corner plot by a busy junction of the A6.Bedroom accommodation is on the ground and first floors. There are 3 single and 8 shared bedrooms. All rooms have a wash hand basin and basic furnishings are provided. None of the rooms have en-suite facilities. There is a passenger lift. Accessible toilets and bathrooms are located on both floors near to bedrooms and living rooms. There are two lounge facilities on the ground floor, one of which is the designated smoking area. A separate dining room is available. Parking is limited to the roadway in front of the home. Fee charged by the home range from £353: 74 to £500: 00. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection site visit took place as part of the inspection process on 15 November 2006. The site visit was carried out over a six-hour period. The following report is based on information gathered by the Commission for Social Care Inspection (CSCI) since the last inspection of the home, which, was conducted in March 2006, and information provided by the registered provider/manager in the pre-inspection questionnaire returned to CSCI. Time was also spent gathering information by talking with the registered owner/manager, staff of the home who were on duty at the time and a number of residents who wanted to say how they found living in the Overton House. Some time was also spent looking at files, records, the home’s policies and procedures and a tour of parts of the home. At the last inspection, a number of improvements were identified that needed to be carried out. These had been completed when they were checked during this visit to the home. During discussion with the registered manager/owner about the home she was able to show that she had a lot of good ideas and plans for further improving the service provided at Overton House. A copy of the Business Plan – ‘Changes are ahead’ was also provided. This document gave information about the short, medium and long term plans for the home and the service. What the service does well: Staffing levels in the home was good and plenty of staff were available to make sure that supporting residents in meeting their identified needs was given priority. A lot of time had been spent in making sure that individual residents get support in the way that is most important to them. Information in care plans was very clear and had been reviewed on a monthly basis. This meant that residents’ changing needs could be identified quickly and care plans updated to make sure all staff were aware of those changes. Watching staff interacting with residents gave a good indication of their commitment to supporting residents in meeting their needs and also showed that staff were respecting the privacy and dignity of individuals whilst providing that support. A good example was of a resident being escorted discreetly to their room in order to get changed and of the member of staff gently Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 6 encouraging the resident to do this without other residents being made aware of the situation. Information in individual resident’s files clearly showed that other healthcare professionals such as Community Psychiatric Nurses (CPN), District Nurses, and Psycho geriatricians were all involved in supporting people to maintain a healthy life. Residents spoken to during the visit said some things about the home including: “I go out to the shops – on my own”, “Staff are good” and, “Staff help me when I need it”. Staff spoken to said that the management of the home was “excellent” and that there was “always enough staff – we never struggle”. What has improved since the last inspection? What they could do better: A number of old glazed window frames were in the front garden awaiting disposal by the firm fitting the new windows. These could, potentially, be a risk to a resident or member of staff should they go into the front garden area. It would be better if the home made sure that the removal of such ‘debris’ is done at the time the work were being carried out. It would be good if a regular check of the premises were carried out by staff to make sure that any risks to the residents or to the staff and visitors (e.g. nails in parquet flooring) are identified and dealt with to reduce risks sooner rather than later. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 7 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. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 8 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 Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents were assessed prior to admission. EVIDENCE: Since the last inspection there had only been one new admission into the home. The file of Mr ‘A’ was examined and was found to contain all relevant paperwork including Care Management assessments and the pre-admission assessment carried out by the manager of Overton House. The Care Manager had made sure that the home had received all relevant details to support the residents’ admission into the home. Evidence was seen that arrangements had been made for an older person currently in hospital to visit the home later in the week. The manager had previously been to the hospital to carry out an assessment of need and the visit had been arranged in order for the person to have a look around the home and to take some lunch. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 10 Overton House did not offer the service of intermediate care and the manager confirmed this. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents identified health and social care needs were being met. Medication policies and procedures were being adhered to and appropriately met. EVIDENCE: Care plans and risk assessments had been completed for each resident living in the home. These were comprehensive in content and gave clear guidelines to staff in how to support the person to meet their identified needs and goals. Three care plans were selected, one of which belonged to Mr ‘A’ who was the last resident to be admitted into Overton House. These plans had been reviewed on a monthly basis and had been updated where required. Wherever possible they had been signed by the resident and/or their representative. One member of the care staff team said: “I am involved in care planning, plans are reviewed once a month including risk assessments”. “All information is shared to ensure all staff know – especially information about culture and other things that could be important to that person”, and, “Care managers Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 12 carry out reviews as well and when this happens the manager keeps us (staff) informed”. Information seen included confirmation of other health care professionals involvement in meeting care needs such as: “seen by optician” and “seen by chiropodist”. Nutrition was being monitored more intensely for one particular person due to fluctuations in weight gain/loss and the personal hygiene of another was being encouraged in order to maintain better personal health and independence. During the visit a Speech Therapist came to see a particular resident and, from the conversation with the manager, it was very clear that the staff in the home were closely following any advice that had been given by the Speech Therapist and that she had a good relationship with the staff in the home. Discussion with a number of residents confirmed that staff upheld their privacy and dignity. Comments included: “Staff always knock on your door”, “Most staff talk to you like an adult – which is good” and, “You can always talk with the boss in the private – if you want to – but she’s always around anyhow”. Since the inspection conducted in March 2006 there had been a significant improvement in the way in which medication and medication procedures were handled. The home now used the services of Boots Pharmacy who had provided relevant training to those staff with the responsibility for administering medication. Medication Administration Records (MAR) were examined and appeared to be appropriately recorded and signed. Records were held of all medication received from and returned to the pharmacy and all prescriptions were received by the home before being sent to the pharmacy for dispensing. Discussion with the manager indicated that when the monthly medications are due to be delivered to the home, an extra member of staff would be put on duty to ensure that medication can be accurately checked with no distractions. Examination of staffing rotas and discussion with staff confirmed this. This was seen as good practice. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had choice and support to meet their expectations and preferences regarding their daily lifestyle. EVIDENCE: On the day of the visit to the home the atmosphere was relaxed and informal. Staff were seen to be around the lounge and dining areas discreetly assisting residents. Various activities were available for people to participate in. One of the most popular being ‘art class’. Various paintings done by the resident’s were displayed throughout the home. One care plan examined indicated that the individual enjoyed ‘interacting in activities’ including household activities and that staff were “trying to encourage ‘B’ to dry dishes and washing to enable ‘B’ to feel involved with other service users”. Residents were helped to maintain contact with people they wished to keep in touch with and visitors were welcomed into the home. Discussion with a number of residents confirmed that visitors came regularly into the home and signatures of visitors in the ‘visitors book’ confirmed this. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 14 Meals were planned over a 4 week period and included various choices as an alternative to the main meal of the day. All food stocks were freshly purchased from the local community stores and, on the day of the visit, the manager had been shopping for ‘specialities’ ready to celebrate a residents birthday that day. Ample stocks of tinned and fresh food were available and menus included culturally appropriate types of food that were available to all residents. The kitchen had recently had some refurbishment which, included a new ‘double range’ gas cooker, large stainless steel extractor hood, new refrigerator and, new stainless steel cladding to the walls. One resident spoken to said: “Meals are really good – you can have what you want – had ribs for dinner – really good”. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had the relevant policies, procedures and systems in place to enable concerns to be raised and to protect residents from neglect and/or abuse. EVIDENCE: A clear complaints procedure was in place and a record of complaints was kept. An examination of these records indicated that one complaint had been received from a resident since the last inspection. Full details of the complaint were recorded along with the details of the investigation process and the outcome for the resident. The manager and the resident had signed the documents. The home had a comprehensive policy for dealing with abuse including the Department of Health guidance “No Secrets”. Since the last inspection the home had dealt with one allegation made by a resident against a member of staff. Policies and procedures had been adhered to and referrals had been made to the appropriate agencies. Discussion with staff confirmed that training had been received in Abuse Awareness and that a clear understanding of the procedure to follow in the event of an allegation being made was understood. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 16 The home had a policy regarding dealing with resident’s money and financial affairs. This gave clear directions to those staff with responsibility for dealing with these matters. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Overall, the general environment of the home was clean, tidy and comfortable with systems in place to protect the safety of residents. EVIDENCE: During discussion with the manager and a tour of the premises evidence was seen that a number of requirements made at the last inspection visit had been addressed and that further work was ongoing. Bedrooms viewed during the inspection confirmed that a programme of redecoration was taking place and that a number of new carpets had been purchased. Those bedrooms seen were clean, comfortable and personalised to varying degrees reflecting the character of the resident. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 18 The business plan for the home identified many areas of planned improvements for the home both internally and externally over the next 6 – 12 months. Following an assessment by the manager/owner of the home new UPVC double glazed windows had been fitted to various parts of the premises and this was on going at the time of this visit. Some new seating had been provided to the lounge areas, including two new settees and new carpeting had been laid on the stairs leading to the first floor. However, in the main lounge, a number of ‘nail heads’ were protruding from the parquet flooring. These could be a potential tripping hazard and must be removed. It was also seen that a number of the ‘old glazed window frames’ were in the front garden awaiting disposal. These could place residents and staff at risk should they enter the front garden and must be removed. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment and training policies and procedures now in place provided sufficient competent and well trained staff whose performance was regularly monitored. EVIDENCE: The staff team in the home consisted of the registered manager, 2 assistant managers, care staff and ancillary staff. Working rotas were available for inspection and confirmed that staffing levels in the home were sufficient to meet the needs of the residents in the home. Discussion with two members of staff offered the following comments: “Always enough staff – never use agency” and, “Enough staff - never struggle – don’t use agency staff”. Each member of staff had an individual training record that identified training courses attended. Most training with staff was carried out by a professional training organisation. Comments made by staff regarding training included the following: “Been on a lot of courses including Moving and Handling, First Aid, Health & Safety and Abuse Awareness”. “Get training – just finished NVQ level 2, have also done Moving and Handling, First Aid and Basic Food Hygiene”. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 20 Since the last visit in March 2006 three new members of staff had been employed in the home. Files were examined for these members of staff and all relevant paperwork appeared to be in place. However, application forms did not require a full work history to be listed. This could result in any gaps in the individuals employment history not being further explored. This could place residents and other staff at risk from unsuitable people being employed to work in the home. Discussion with the manager confirmed that all staff in the home had an enhanced Criminal Record Bureau check on file. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 21 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ living in the home benefited from having the support of a manager with skills to provide and develop a good quality service and had procedures in place to promote and protect their interests. EVIDENCE: The manager had completed various training courses and holds both the Certificate and Diploma in Management Studies. The latest copy of the business plan (September 2006) for the home was provided and this identified many new proposed developments for the home during the next twelve months. A chartered accountant maintained the business account to ensure financial viability of the home. Appropriate insurance cover was in place and the certificate was displayed. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 22 Discussions with the manager about the management of the home indicated that she was very aware of the needs of people with varying degrees of disabilities including dementias. The manager had developed good relationships with other healthcare professionals such as the Community Psychiatric Nurses and used their knowledge and skills to support the staff team in meeting some specific needs of some residents living in the home. The manager had confirmed dates for the maintenance and servicing of equipment used in the home within the pre-inspection questionnaire returned to the Commission for Social Care Inspection and a random selection taken from these documents during the visit indicated that all servicing was up to date. A fire drill had been carried out with the staff team on 3 September 2006 and the fire register indicated that the fire alarm system was tested on a weekly basis. Where the home managed the personal allowance for any resident individual records were kept and were available for examination on the day of the inspection. All records were found to be appropriately kept and up to date. In order to measure the quality of the service being provided by Overton House, regular ‘survey questionnaires’ were sent to both residents/relatives and visitors. Two questionnaires received from visitors to the home were randomly selected and these offered the following information in relation to questions being asked: * How do you rate the quality of care offered to your relative? 1 stated good, the other, excellent. * How do you rate friendliness of the staff? Both stated excellent. * How do you rate the cleanliness of the home? 1 stated good, the other, excellent. * How do you rate our response to your phone calls? Both stated excellent. * How do you rate the décor and homes Ambience? Both stated excellent. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 23 * How do you rate our response to any complaints or comments you may have had cause to make? Both stated that no complaints had been made. * How do you rate our laundry service? 1 stated good, the other, excellent. * How do you rate the meals in the home? Both stated good. * What are you overall impressions of the home? Both stated excellent. One questionnaire randomly selected from residents ranged the service from good to excellent on the questions being asked and also offered the following comment: “The staff do a very good job considering the difficulties imposed on them”. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 24 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 3 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 X 18 3 2 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 X X 3 Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 25 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 OP19 Regulation 13 (4) (a) (b) & (c) Timescale for action a) The protruding ‘nail heads’ 30/11/06 must be removed from parquet flooring in the main lounge. The ‘old’ glazed window frames 15/12/06 stood in the front garden must be removed and be appropriately disposed of. Requirement 2 OP19 13 (4) (a) (b) & (c) 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 OP29 Good Practice Recommendations It is recommended that job application forms request a full work history from potential employees in order that any ‘gaps’ in employment could be further explored. Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Overton House DS0000021573.V299012.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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. 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