Inspection on 12/09/07 for Park House

This inspection was carried out on 12th September 2007.

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

The inspector 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

Park House 14/12/06

Park House 13/03/06

Park House 09/08/05

Park House 23/02/05

Park House 06/09/04

Park House 17/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Park House Park House 7 Manor Road St Marychurch Torquay Devon TQ1 3JX Lead Inspector Rachel Proctor Unannounced Inspection 12th September 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Park House DS0000018407.V346073.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. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Park House Address Park House 7 Manor Road St Marychurch Torquay Devon TQ1 3JX 01803 314897 01803 323784 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) Mr Christopher Norman Bennett Mrs Diane Winifred Bennett Lorraine Barbour Care Home 21 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (21), of places Physical disability over 65 years of age (21) Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate up to 2 Service Users over 60 years. Date of last inspection 14.12.06 Brief Description of the Service: Park House is a large detached property with pleasant gardens situated in a quiet residential area on the outskirts of Torquay. The home is close to local amenities. It is registered to provide care for older people including those with physical disabilities and/or dementia, and up to two people aged over 60 years. At the time of this inspection, 20 people were living at the home. Two were sharing a room and the remainder were in single rooms. Fifteen of the rooms have en-suite facilities. There are two spacious lounges and a separate dining room. Part of one lounge is used as the office. A shaft lift provides access to the upper floor. At the time of this inspection fees ranged between £331 and £400 per week Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took placed on the 12th of September 2007. Three people had their care followed during the inspection. A selection of documents relating to management and care provision were reviewed during the inspection. A tour of the home was completed, this included communal areas and individual peoples rooms. Four people living at home and two members of staff were spoken to during the inspection. Staff were also observed whilst providing care for people. Following the inspection survey forms were received from four people living at the home, four relatives and one health professional. Information from the visit to the home and some comments contained in the survey forms have been included in this inspection report. What the service does well: What has improved since the last inspection? Medication practices have improved since the last inspection. Records show that staff are recording the use of medication properly, this has reduced the risk to people living at the home. People who use shared rooms had given their consent to do so. Two people said they had chosen the home because they were able to share a room. The homes policy regarding protection of people from abuse had been updated and reflected the local guidance. Contact numbers were easily available for staff to use. The cleanliness of toilets had improved and hand towels had been provided. Skin creams being used were labelled for individual people’s use. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 6 Training record shows that sufficient staff had received training in first aid to ensure that a qualified first aider and was available for each shift. 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 House DS0000018407.V346073.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, 1,2,3,6 This judgement has been made using available evidence including a visit to this service. People are given sufficient information about Parkhouse and it’s services to make an informed choice as to whether the home can meet their needs. The way individual peoples care needs are assessed and recorded should ensure that people receive the care they need. EVIDENCE: The statement of purpose had been up dated since the last inspection to reflect the recommendation made in the last report. This now contains information about the room sizes and staffing numbers. The manager advised that this is provided for new people admitted to the home and is available on request. Four people had their care followed as part of this inspection, their individual plans of care had a copy of the terms and conditions of occupancy, which included the room number. One person who had changed the room they were Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 9 in had a copy of a letter on file advising the person and their representative of the change. An assessment template is used to record the individual needs of people accessing the service. This broadly covers what is needed to allow assessment of individual needs and plan their care. The Four people whose care was followed also had copies of other agencies assessment, which had been completed prior to their admission to the home. People spoken to during the inspection said staff had talked to them about their care needs and what was important to them. One person said they preferred to stay in their own room and staff had enabled them to do this. They went on to say that they did join in the activities provided if it was something they enjoyed. Park House does not provide intermediate care. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, 7,8,9,10 This judgement has been made using available evidence including a visit to this service. People health and person care needs are generally well met. However some medication records lack detail which may put people at risk of not receiving the medication as the prescriber had intended. EVIDENCE: Individual peoples care plans were stored in a locked filing cabinet in the quiet lounge. Each person in the home had a plan of care stored in this cabinet. In addition to this the manager had introduced a care plan sheet which was kept in individual bedrooms. These contained information about the basic care needs for the individual, and space for staff to sign this when the care task had been completed. One person who required a cream to be applied to their skin also had this recorded on their care plan sheet. Four people had their care followed, this involved looking at their plans of care, the room they used and where possible these people were spoken to during the inspection. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 11 Risk assessments appeared to be an integral part of the care planning process. These risk assessment included manual handling, nutrition, pressure sore risk and risk of falls. Each person whose care was followed had completed risk assessments, which had been up dated when changes had occurred. The people whose care was followed had a monthly record of care plan reviews. The manager confirmed that all the people living at Park House have their care plan reviewed monthly or sooner if their care needs change. The care planning system uses a template, which lists possible care needs. The person completing the template identifies the care need for the individual by ticking the relevant section. These templates cover health; personal, emotional and social care needs for the individual. The four plans of care viewed had all the sections in the care plan completed and up dated with a review date. One person had a copy of a review undertaken with the person and their representative. Medication was being stored in a locked cupboard, separate storage had been provided for controlled drugs. However the manager advised that none of the people living at Park House at the time required controlled drugs. The controlled drug record was available for inspection. This had been completed to show the name and dose of the drug and the person prescribed for. Two staff members had signed this record when the medication was given. Two of the medication records for people indicated that the prescribed medication should be taken as directed/required. The manager was able to clearly state when the medication should be given to the person. However no record had been made regarding when the medication should be given on the medication record sheet. The manager advised that she had spoken to the GP and the pharmacist about clarifying the reason when medication should be given on the medication record. The manager was able to state why skin treatment creams were being used for individuals. However prescribed skin treatment creams did not always have their purpose recorded in that persons care plan folder or medication record. Prescribed creams seen in individual peoples rooms had been prescribed for that person. People who were spoken to during the inspection said staff were very helpful and friendly and understood what they needed. Staff observed providing care for people were doing so in a friendly supportive way that valued the person as an individual. Staff were seen to knock on individuals room doors before entering their room. People were being addressed by their preferred name, which had been recorded in their plan of care. Portable screening had been provided in the shared rooms. Two people spoken to who were sharing a room said they had chosen to share a room and had chosen the home because they were able to have a shared room. They said staff were respectful and kind to them. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 12 The manager explained how peoples personal laundry is managed in the home. She confirmed that no individual staff member is responsible for laundry. She advised that each member of staff puts washing in the washing machine or drier during their shifts. Staff are also responsible for ensuring peoples clothes are returned to them. Two relatives comment cards received indicated that although their relative always had clean clothes to wear they did not always have their own clothes returned to them. The laundry system should be improved so that people always receive their own clothes back after washing. Park House DS0000018407.V346073.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. 12,13,14,15 This judgement has been made using available evidence including a visit to this service. People who live at Park House are given the opportunity and encouragement to make choices about their day to day lives. EVIDENCE: The manager advised that lists of activities are kept for people to see. This showed that people have access to a variety of activities. During the afternoon of the inspection a member of staff was conducting a quiz about well know proverbs. Those people in the lounge appeared to be enjoying taking part in this activity. Pictures of people living at Park House taking part in activities were shown. Three people spoken to in their own rooms said they preferred to stay in their rooms and did not wish to take part in the activities provided. Individual rooms doors had a twist locking system. Those people in their own rooms said they preferred the door to be locked as some people living there sometimes came into their room if it isn’t locked. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 14 The lunchtime meal was attractively presented and nutritionally balanced. The manager advised that if a person did not like what was on offer an alternative would be made for them. This mealtime appeared unhurried with people eating their meals at their own pace. The manager advised that those people that needed assistance to eat had their meals at the second lunchtime sitting. Staff observed assisting people were doing so in a friendly supportive way. The manager advised that staff are aware of individual peoples likes and dislikes for food. Where preferences or dislikes were known these were recorded in the persons plan of care. Examples of this were seen. Some people spoken to said they preferred to eat their meals in their own rooms. The manager provided a copy of the environmental health officer’s report from 02.03.07. This indicated that there were some actions that needed to be taken. The kitchen and food storage areas were clean at the time of this inspection. The manager advised that there are cleaning schedules that the staff follow to maintain cleanliness and monitor fridge and freezer temperatures. The Better food safer business information was available for staff and the managers use. Records had been completed using these templates. Park House DS0000018407.V346073.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. People who live at Park House can feel confident that their concerns will be treated seriously. There are sufficiently robust systems in place to protect people from abuse. EVIDENCE: The people asked said they knew who to speak to if they had any concerns. The complaints policy was available with the Statement of Purpose and Service Users Guide. The manager provided the record of concerns/complaints, which showed the actions taken to address the issues raised. The manager advised that no complaints had been received since the last inspection. She further commented that if a concern was raised this was dealt with as it occurred. Feedback from relatives indicated that staff are mostly friendly and approachable. All indicated they knew who to speak to if they had any concerns. Since the last inspection the Policy concerning the Protection of vulnerable adults from abuse had been up dated to reflect current local and national practice guidance. The Registered Manager confirmed that staff had received training regarding protection of vulnerable people. Examples of training received were contained in the staff files seen during the inspection. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24,26 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People who live at Park House generally have a comfortable and attractive home to live in. However some people’s bedrooms would benefit from better furnishings and having the décor refreshed. This would ensure all the people living at the home have access to the same standards of accommodation. EVIDENCE: The ground floor accommodation comprises a kitchen, dining room, and two lounges, one of which contains care records in locked cabinets. There are also six bedrooms on the ground floor. Laundry and food stores are sited in a small outbuilding. Opposite the kitchen there is a bathroom with an assisted bath. A toilet on the ground floor is reserved for staff and visitor use. A tour of the home was completed as part of the inspection. All communal areas and bathrooms and toilets were seen. A selection of people’s private bedrooms were seen; these were personalised with items of that person’s choice. Stairs and a shaft lift provide access to the first floor, this was seen in Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 17 use during the inspection. A further eleven bedrooms are sited on the first floor. There is also a bathroom with an assisted bath and shower and an additional toilet. Fifteen of the individual rooms have en-suite facilities. Locks to individual rooms, toilets and bathrooms were all capable of being opened from the outside with a coin or key. People asked about these locks on their room doors said they were easy to use and prevented other people entering their room accidentally. The manager advised that several of the people living at the home were inclined to wander and go into other people’s rooms without their permission because of their condition. Locking individual room doors prevented this happening. One person’s room entered on the ground floor had a cable draped across the floor leading into a cupboard. The manager advised that this was the connection for the homes telephone/fax machine. The way the phone cable was draped across the floor could pose a trip hazard for the person using that room. One relatives survey form indicated that some of the private bedrooms could do with refreshing as the carpets; curtains and furnishing were starting to look “tatty”. The manager confirmed that the owner ‘s were in the process of redecorating some rooms and new carpets and furnishing had been provided for some individual rooms prior to the last inspection. Communal and some en-suite toilets were fitted with frames or booster seats. These were in good condition and outwardly clean. The undersides of these seats and the toilet bowls had been cleaned. The Manager advised that they had ensured that all the aids fitted in toilets and bathroom were properly cleaned. Since the last inspection the manager has obtained a copy of the department of health infection control guidance for her and the staff to use. Staff were observed using gloves and aprons when attending to peoples personal care. Fresh aprons were used when staff helped to serve meals for people in the home at lunchtime. The home’s kitchen was clean. Food in fridges and freezers was appropriately stored. The laundry had cleanable walls and an impermeable floor. A copy of the last environmental health report was provided at the inspection. The manager confirmed that the recommendations made and been completed. The cleaning schedules provided in the safer food better business folder were being used to ensure cleaning was monitored in the kitchen area. The home has a spacious and attractive garden. From the garden there is open access to the car park and a busy main road. The facility is not, therefore, suitable for people with dementia. Two relatives survey forms received indicated that they would like the garden to have a secure area that would be accessible to their relative, particularly in the hot weather. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. There is an adequate number of trained or experienced staff at most times. People’s safety at night has improved by ensuring night staff have access to a first aider. EVIDENCE: A duty rota was being kept, which shows the staff on duty each shift and in what capacity they are employed. The manager advised that more staff are on duty at peak times or if the needs of the people living at the home increase significantly. One staff member spoken to confirmed this. In addition to the care staff the home employs ancillary staff, which include cleaner and a cook. The survey forms received from staff and the comments made during the inspection indicated that staff feel supported to do their work and have access to appropriate training. The pre inspection information contained in the annual quality audit showed that the home has 50 of staff trained to NVQ level 2 or above. An example of the induction information used for staff was provided. Four staff files were seen as part of this inspection. These contained the information required by law for staff files, this included reference checks, application form and police checks. The staff files seen also contained a signed copy of the contract of employment. The manager provided the homes policies and procedures for inspection, the homes code of conduct expected for staff employed was included. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The management practices in the home should protect people who live at Park House and ensure the home is run in their best interest. EVIDENCE: Diane Bennett, the Registered Provider and Lorraine Barbour, the Registered Manager, both hold relevant qualifications, which include the Registered Managers Award. They have many years experience in the care of older people. Management tasks are shared between the Registered Provider and Manager. Both also undertake care work in the home. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 20 There are systems in place to monitor the quality of the service provided. Records were available of regular “walk through” environmental checks. These were discussed with the manager. The annual development plan for the home was not seen. However the manager was clear about the year on year improvements that should take place. The Annual Quality audit provided prior to this inspection showed that the quality assurance programme would be used to draw up a development plan for the home. The manager advised that the home staff do not manage the finances of any of the people living at the home. The person’s family or representative does this. Maintenance records were seen, these showed satisfactory routine maintenance of the home’s equipment and systems and included lift servicing and electrical appliance testing. The risk assessments produced for the home’s environment were available for the inspection. The management of health and safety has improved since the last inspection. First aider’s are available on night duty and staff have received information about good practice for infection control. A copy of the infection control manual provided by the health authority was available for staff use. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 21 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 2 X X X 2 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 2 X 3 X X 3 Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 1 2. 3. 5. Refer to Standard OP10 OP19 OP20 OP24 OP7 Good Practice Recommendations The manager should review the laundry systems used for individual peoples clothes to ensure that they have their own clothes returned to them after washing. Refurbishment of the environment and decoration of individual peoples rooms should continue. The garden should be made more secure to meet the needs of the service users with dementia. The management should review the type of locks in use and the practice of locking doors to communal facilities The Registered Manager should consider ways in which the care plan can be made accessible to all day and night staff as a working document The prescribing GP should be asked for specific directions, DS0000018407.V346073.R01.S.doc Version 5.2 Page 23 6. OP9 Park House preferably in writing, for medicines labelled as directed. Where directions are taken by phone, these should be written down, double checked, and signed. 7. OP9 Specific directions for staff should be produced for any medicine prescribed as required, in consultation with the prescriber. Such directions should include the reason for the medication, the circumstances under which it is to be administered and the maximum dosage to be given in a defined period. Park House DS0000018407.V346073.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 House DS0000018407.V346073.R01.S.doc Version 5.2 Page 25 - 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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