Inspection on 29/04/08 for Park Croft

This inspection was carried out on 29th April 2008.

CSCI found this care home to be providing an Adequate service.

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

Park Croft 20/04/07

Park Croft 26/08/05

Park Croft 04/04/05

Park Croft 04/10/04

Park Croft 14/04/04

Park Croft 14/10/03

Park Croft 22/05/03

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Park Croft Park Place Winchester Road Wickham Fareham Hampshire PO17 5EZ Lead Inspector Kathryn Emmons Unannounced Inspection 29th April 2008 09:30 Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park Croft 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) Park Place Winchester Road Wickham Fareham Hampshire PO17 5EZ 01329 833994 None United Response ****Post Vacant**** Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th April 2007 Brief Description of the Service: Park Croft is a residential home for ten adults with learning disabilities, situated on the outskirts of Wickham Village near Fareham. The home is located within woodland, off the main road and ten minutes walking distance from the village. The premises include additional buildings that serve as a visitors lounge, craft and activity area, and office for the staff. Service users have their own rooms decorated and furnished to their individual preferences. The home encourages service users to be involved in day to day activities and routines, and individual choices are respected. The fees for the home range from £ 698.49 to £1519.77 per week. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. A visit to the service took place on 28th April 2008. This visit was unannounced and took place over 5.5 hours. The registered manager no longer works at the service and since June 2007 an acting manager has been in post, who was not present at the time of the visit. Care received by three service users was looked at in detail. This is a method called case tracking. This included looking at their personal records and a range of general home records. Staff were spoken with and the care they provided was observed. We sent comment cards to staff and service users but did not receive any back by the time of the site visit. During the visit we spoke with all of the service users who were present in the house and four members of staff. We also received a completed self-audit document completed by the provider to provide information before we did a site visit. This is called the AQAA (Annual Quality Assessment Audit). We also looked at how the provider makes information about their service, including CSCI reports available to prospective service users. What the service does well: There was evidence that information is given to service users about the service they can expect if they live at the home. A comprehensive activities and educational programme is in place. This means that service users have opportunities to engage in worthwhile activities and continue to be involved in hobbies and activities they enjoyed before they went to live at the service. The physical environment is of a good standard in most parts and service users have been able to personalise their rooms to give them a sense of ownership. Service users are consulted about meal choices. Staff receive training and are engaged in a National Vocational Qualification training programme. This means that they have more knowledge and skills to provide care for service users. Interactions between staff and service users are good and staff were clear on the needs of the service users and the importance of treating them as individuals. A key worker system is in place to support this. A quality assurance programme is in place, which includes monthly visits from a representative of the organisation. This means that the organisation is able Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 6 to identify those areas of the service, which require action to improve and develop the service to improve quality for the service users and staff. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have information available to them to assist them with making an informed decision to live at the service. Contracts are in place so service users can be clear on what service they can expect. EVIDENCE: The statement of purpose and service users guide are in place and were in symbol format so that service users had the ability to understand them more clearly. These need minor amendments to provide up to date information on staffing arrangements in the service. A business plan in place indicated that both of these documents were due to be reviewed by August. These two documents contain information about the service, staff and services offered. Service users and their relatives use this information to help them make decisions about living in the service. We could see from looking at care files that service users had contracts in place. Since the last inspection no new service users had been admitted to the service. At the previous inspection it was identified that a service user had Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 9 been admitted without a through assessment. The AQAA states that all prospective service users will visit the home before an offer is made and other service users will be involved in the decision making regarding who comes to live at the service. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Written records do not provide up to date care plans. Records show that some service users have agreed to their care plans. Lack of current risk assessments may place service users at potential risk. EVIDENCE: We saw care files for three residents both of these contained progress notes; heath care information and property lists and information regarding contacts such as relatives and heath care professionals. There was a brief summary of the service users abilities but no clear direction regarding how care should be delivered. In the front of both of the care plans was a printed page from the acting manager stating that all care plans and risk assessment were in the process of being renewed and up dated. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 11 This is a comprehensive piece of work and while this is being undertaken service users need to have their needs known by all staff and a system in place, which minimizes the potential risks they may encounter if they undertake activities, they are not safe to do without assistance. One risk assessment was located for one resident but this had been written 2 years previously. Staff said, “We know the care plans need updating but we have very little time”, another carer said “We know what help they need and what they are able to do without being in danger”. There was evidence that reviews had taken place for one of the resident’s case tracked and there were reports in place from relevant people such as the a day centre worker and care manager. We could see that service users had been involved in their reviews. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13 15 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to make choices and are supported to engage in appropriate activities and community inclusion. Service users have a varied and balanced diet and are able to have their choices catered for. EVIDENCE: All of the service users except one have lived together for many years and are of a similar age. We could see from weekly activity planners what activities service users took part in. We saw that holidays took place and many service users attended day centres. At the time of the visit 5 service users were at day centres or college. Two service users were having a home day. There is an activity room located across the courtyard and service users use this to do craft work and group activities. Service users are able to follow their religious beliefs and are supported to attend church. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 13 There is an emphasis on looking at the service users as someone who accepts support to lead a fulfilling and worthwhile life. The new care plan system aims to make goals for future experiences rather than focussing on meeting immediate care needs only. This is a system call PATH (Planning Alternatives Together with Hope). As mentioned earlier these documents had not been completed at the time of the visit. We observered two service users looking at books and engaging in conversations with staff and then assisting with preparing lunch. One service user chose to stay in their room and another service user was watching a video. The pre inspection information we received gave a list of all the activities residents had been able to participate in and information informing us how there was going to be more community inclusion for service users. In care plans were diagrams which service users had filled in with their activities choices and aspirations for the future. Staff we spoke with were aware of these and said they were always offering service users new opportunities. Life skills such as cleaning and cooking are part of the home day plan and key workers work with individual service users to support them in these tasks. An example of this is that one service user is going to be supported to cook a meal for their relative. Discussion with staff evidenced that staff felt that service users were able to be as independent as possible and participate in as much community inclusion as was possible as long as the service users were kept safe and it was the service users choice. During the visit we saw residents were able to spend their time how they chose and this included going to the shops for one service user and another helping in the kitchen. We saw one service user being supported to make a snack at lunchtime. Staff and service users take meals together. Three service users we spoke with indicated they liked the food at the service. We could see that service users were involved with meal choices and the menu maintained showed that a balanced diet was provided. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users personal and health care needs are met in their chosen way. Medication arrangements are satisfactory and access to health care professionals is good. EVIDENCE: Service users we spoke with indicated they were happy with how they received their care. One service user spends a lot of their day on bed rest and they indicated this was their choice. When help was requested we saw staff responded immediately and in a sensitive and dignified way. Duty rotas are produced so that there are male and female staff on duty so service users can chose who assists them with personal care. Interactions between staff and service users were observered during the visit. We could see that staff knew how to communicate with all of the service users present and that often this was not verbal communication. Staff have recently received training in Makaton, which is a form of signing which some service Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 15 users use to communicate their needs. One staff said “I found this training very useful and interesting and would like to learn more”. Each service user had an individual file with all of their health care needs identified. We could see that services users attended doctors, chiropodists, opticians and the dentist when needed. Information sheets were in place for service users to take to hospital with them so that hospital staff could see the choices, preferences and abilities of the service user. We looked at the medication arrangements for the service users. Staff who give out medication have been trained to do this and understood the importance of giving the right medication at the right time. Staff were able to tell us what the medications they gave were used to treat. There is a medication policy in place. Medication records we saw had been signed and completed correctly. We saw that the medication trolley was fixed to the wall and kept in a locked room. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users are confident their concerns will be listened to and acted upon. Staff are trained in safeguarding adults procedures and service users are protected from abuse. EVIDENCE: We saw from the complaints file that 2 service users had been supported to make complaints. Both of these we in respect of the behaviour of another service user towards them. We could see that the acting manager had responded to the service users concerns. The pre inspection information document identified that the complaint policy is not very easy for service users to understand and work is being carried out to make this easier for service users to use. We were also informed that the service had not been distinguishing between concerns and complaints and there for a record had not been maintained regarding concerns. This is planned to be put in place. Two staff were spoken with and given safeguarding adult scenarios, which they were able to answer appropriately. Staff spoken with said they were confident to challenge the manager if they thought a decision was not in the best interest of the service users. An up to date safeguarding adult policy was in place. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and tidy and provides residents with comfortable surroundings, which they are able to personalise. Specialised equipment is in place to support service users to be as independent as possible. EVIDENCE: We undertook a tour of the home with 2 of the service users. We were given permission by them and invited to go into their bedrooms. We saw that each room had been personalised by the service user living in it. One service user spends a lot of time in their room and requires the use of a hoist. The room was spacious and there was sufficient room for staff to use the hoist safely. The communal rooms were spacious and furniture was in a good state of repair. An ongoing redecoration programme is in place and plans are underway to provide a new kitchen, which will be more suitable for service users to use so they can be more involved in food preparation. The home was clean and Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 18 tidy and smelt fresh. Staff confirmed that service users are supported to carry out tasks to keep their bedrooms tidy and clean. The gardens were well maintained and service users were able to access these freely. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are cared for by enthusiastic and trained staff. Recruitment records need to be available at all times to demonstrate that the right people care for service suers. Supervision sessions enable development and training needs for staff to be identified. Inadequate staffing levels may place service users at risk. EVIDENCE: We were not able to look at the recruitment records for staff working on the day of the visit because they were not accessible to care staff. These need to be available at all times. Staff we spoke to say that they had received an induction programme and this included information regarding the fire safety systems, medication training and managing challenging behaviour. This induction programme also enables new staff to be aware of the polices and procedure of the service and how to care appropriately and safely for the service users. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 20 The staff we spoke with said they had a contract of employment and a job description. This enables them to be clear of their job role and what is expected of them. A training plan is in place for all staff and pre inspection information informed us what training took place such as health and safety, infection control and Mental Capacity Act. Since the last inspection the care hours have been reduced from 3 staff on each shift to 2 staff on most shifts. Additionally one of the service users is requiring more and more one to one support as they are displaying more challenging behaviour towards other service users and on occasion have been aggressive towards staff. This is further evidenced by an increase of incident reports being written by staff. All of the staff spoken to said they were “very concerned” about the current staffing level and one staff said that the situation was “waiting for an accident to happen”. We could see that the organisation had made requests for additional funding but in the meantime had not increased the staffing levels. One staff said that weekends were very busy as all service users needed assistance to get up, some went to church, staff had to cook lunch and one of the service users always required 2 staff to help with personal care. We discussed this situation with one of the organisations area managers at the time of the visit. Staff confirmed that staff meetings take place regularly. We saw minutes on this visit. Staff said they receive supervision sessions and these took place about every two months. We saw records of supervision for one member of staff. Staff interactions were noted throughout the visit. We could see that service users had positive relationships with the staff. Service users approached staff and would hug staff or hold their hands and would smile and nod their heads when they were asked how they got on with staff. This indicates a positive relationship between staff and service users. Staff were able to say what individual service users needs were and how they delivered care. Staff had a clear understanding of treating service users as individuals and encouraging them to be as independent as possible through giving them time to try and achieve tasks with guidance rather than staff taking over the task to save time. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37 39 and 42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. An acting manager manages the service. Lack of appropriate management of the behaviours of one service user may place other service users and staff at risk. Service users are able to express their opinions and the acting manager is working towards developing and improving the service. Checking of equipment and servicing of house systems keep residents and staff safe. EVIDENCE: An acting manager who has been in post since June 2007 manages the service. The commission is currently considering an application for registration as the registered manager. The acting manager participates in the organisations Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 22 manager training programme to ensure that the care practices are up to date and in the best interests of service users. Staff made generally positive comments regarding the manger and said that they were “approachable and “will listen to what I have to say most of the time” and “find him easy to get on with, really nice person”. Staff all said that they felt that the concerns they were raising regarding the behaviour of one of the service users was not being acted upon promptly enough and that they needed more support to manage the behaviours of the service user as their behaviours were causing distress to at least 2 of the other service users. This was discussed with one of the organisations area managers at the time of the visit who confirmed that the matter would be given urgent attention. We were told by staff that service users are able to go and sit in the acting managers office to spend time with him if they want to. Staff felt that service users had a good relationship with the acting manager and one said “He (manager) will always spend time with the person and try and make sure they are ok”. Since the acting manager has been in post more polices and procedures have been updated. Work is to commence on the whole care plan system which will provide more comprehensive information regarding service users needs. A quality assurance programme is in place and part of this consists of the monthly visits made to the service by one of the organisations representatives. During these visits the representative speaks to staff and service users and reports upon the conduct of the service. A report is then produced which is sent to the acting manager so they can continually assess the progress the service is making. From pre inspection information we received we could see that all testing of equipment had been carried out regularly to keep staff and residents and visitors to the service safe. Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 x 1 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 x 3 x x 3 x Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation 15(1) Requirement Risk assessments and care plans must contain sufficient detail so that the assessed needs of service users are known and they can receive effective support. Previous timescale not met 2. YA31 17 Schedule 2 18(1)(a) 12(3) Staff records must be available for inspection at all times. This is to ensure the right people have been recruited correctly to care for the service users. Sufficient staff must be on duty at all times to meet the assessed needs of all of the service users. A review needs to take place of the current systems of managing the behaviours of one of the service users. Current strategies are not working and staff and service users remain at risk of being harmed by the service user. 30/06/08 Timescale for action 16/06/08 3. 4 YA33 YA37 30/06/08 15/06/08 Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Park Croft DS0000012168.V361004.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Park Croft DS0000012168.V361004.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. 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!