Inspection on 23/05/07 for Pengarth

This inspection was carried out on 23rd May 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 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pengarth 18/09/08

Pengarth 22/05/08

Pengarth 03/05/06

Pengarth 21/09/05

Pengarth 25/04/05

Pengarth 25/10/04

Pengarth 02/06/04

Pengarth 05/12/03

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Pengarth Windmill Hill Ellington Morpeth Northumberland NE61 5HU Lead Inspector Anne Urwin Brown Key Unannounced Inspection 23rd May 2007 09:30 Pengarth DS0000000545.V338249.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 Pengarth DS0000000545.V338249.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. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pengarth Address Windmill Hill Ellington Morpeth Northumberland NE61 5HU 01670 - 860475 F/P01670 - 860475 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) www.flexiblesupportoptions.co.uk Flexible Support Options (UK North East) Limited Mrs Margaret Danielson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 4 persons may also have a physical disability Date of last inspection 3rd May 2006 Brief Description of the Service: Pengarth is a detached bungalow situated in the small village of Ellington and is home to five residents with severe learning and physical disabilities. A post office, shop and public house are situated nearby and a bus service is available to a nearby town centre. Off-street car parking is available at the front of the premises and there is a large garden to the rear. Disabled access is provided at both the front and rear of the building. The home is not registered to provide nursing care. The Statement of Purpose and User guide is available at the home together with a copy of the last inspection report. A fee of £769.79 per week is charged at Pengarth. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit on 3rd May 2006. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on date(s). During the visit we: • • • • • • Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit We told the manager/provider what we found. What the service does well: The needs of each person living at Pengarth had been properly assessed before they moved into the Home. This means that staff knew about the needs of each person and what care and support they required. Appropriate plans of care had been completed for each person. This means staff had all information they needed to support each person and keep them safe. The way people are supported to make decisions about their daily lives and choices were satisfactory. Residents are well supported to use local community resources and attend social events that they prefer. They are also supported by staff to stay in touch with their friends and family. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 6 The relationships between staff and residents were good. Residents living at the home are treated with respect and dignity when staff help them and talk to them. There is a lot of choice at mealtimes and staff help to make sure that residents have a nutritious diet. Support plans were in place and show staff how to help people. Staff had a good understanding of each person’s support needs. The arrangements for checking and meeting the health care needs of residents were good. This means that people get the care and support they needed. 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. Pengarth DS0000000545.V338249.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 Pengarth DS0000000545.V338249.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): Standards 1 and 2 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Detailed information is available to help people make choices about the service before moving in. Comprehensive assessments are carried out before and after admission to ensure the peoples’ needs can be planned and properly met. EVIDENCE: Residents are not able to communicate verbally and staff are reliant on using facial expressions or body language to seek their opinions. Two relatives responded to questionnaires sent out and they said that there was enough information provided before admission to help them make a decision about the placement. Records show that relatives and care managers are actively involved in arranging admissions to the home. Records show that each person’s needs have been fully assessed by the staff at Pengarth. Information from the assessments is used to draw up individual care plans taking account of specialist needs and risks. In addition care management assessments are available for each individual. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 were inspected. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Adequate care plans are in place for individuals. Reviews of individual plans are not always comprehensive and this means staff sometimes do not record when a treatment or intervention is completed. Staff enable and support residents well so that they can be as independent as possible. Risk management procedures are in place to protect people using the service, but not all records contain sufficient information about how risks are minimised for individuals EVIDENCE: Each individual has a care plan, but sometimes the reviews of plans do not reflect work going on or the outcome of work staff are undertaking. For example a plan relating to skin integrity did not show if treatment was Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 10 continuing or was completed. Some plans did not reflect the care being delivered. Staff on duty demonstrated a good understanding of individuals’ needs. Evidence was available that relatives are involved in the care planning process. Staff support people using the service with information, assistance and communication to make day-to-day decisions. Staff demonstrated how individual choices are made and records showed where relatives have been consulted when a person using the service was unable to make decisions affecting their lives. Risk assessments are in place for individuals. However there is at times insufficient detail about how moving and handling risks are minimised in peoples’ records. Staff were aware of risk assessments and gave examples of how individual risks are minimised. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Pengarth have good opportunities to use facilities in the area to help them to maintain links with the local community. Good opportunities to take part in social activities are available for people living at Pengarth to provide stimulation and interest. Contact with family and friends is well supported and encouraged by staff to ensure that links are kept. Mealtimes are flexible to suit individual preferences. Meals are carefully planned to provide a balanced and nutritious diet that suits each individual’s taste and needs. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 12 EVIDENCE: Records show that people living at Pengarth have opportunities to access a range of activities that are valued and fulfilling. These show that walks, trips out for shopping, to the local pub, cinema/theatre, swimming and bar meals regularly form part of peoples’ routines. Holidays are planned and information in individual records showed that people attend local events in the community. On the day of the inspection only two staff were on duty, which meant that there were no outings, as staff were responsible for care tasks as well general housekeeping and preparation of meals. This meant that the time spent with residents was limited during the morning of the inspection. Staff support individuals to keep in touch with relatives and friends who are important to them. Records show that relatives are consulted about what happens in people’s lives. There are opportunities to mix with people outside Pengarth through the use of what the local community has to offer. Contact with relatives is recorded and shows that staff kept them up to date about issues affecting individuals. There is clear written guidance for staff regarding how they should respect and safeguard the residents’ right to privacy. Staff were observed to follow this guidance during the inspection. Menus showed that meals are varied and nutritious. The records of meals provided indicated that they were varied, well balanced and nutritious. Special diets were catered for. Alternatives were available and peoples’ individual preferences were catered for. Healthy eating was encouraged. The staff had all received training in food hygiene. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good arrangements are in place to provide people with the personal support they need so that they can be as independent as possible. Health care needs are well met by using a multi-agency approach. Comprehensive medication systems are in place to make sure that residents are not put at risk. EVIDENCE: Personal healthcare needs are recorded to show that specialist requirements are identified and met. The delivery of personal care is individual and flexible. Staff respect privacy and dignity and respond to changing needs. Records show that daily routines are flexible and are organised to suit individual requirements. People were well dressed and clothes are chosen carefully to maintain their dignity. Staff were well informed about the individual needs of residents. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 14 The health care records show that there are regular visits by the General Practitioner, District Nurses and other health care professionals involved in supporting people living at Pengarth. A separate health care plan is not in place, but elements of a health care plan are available within the individual care plan to show health care needs are identified and met. Residents are supported to access health care services such as dentist, optician, and chiropodist and, where appropriate, specialist services such as a dietician. Residents have the aids and equipment they need and these are well maintained to keep them and staff safe. The aims and objectives of the home reinforce the importance of treating individuals with respect and dignity. Guidance on administration of medicines is clear and staff have training in the safe handling and use of medicines. None of the residents self-administer medicines. Records of administration were generally in good order, but two staff had not signed to confirm a handwritten entry in the medication record or the completion of a course of antibiotics. A lockable storage facility was available for the safe storage of medication. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were inspected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a satisfactory complaints procedure in place to ensure that complaints are dealt with effectively and to the satisfaction of the complainant. Clear protection policies and procedures are in place to safeguard people living at Pengarth from abuse. EVIDENCE: There is a clear procedure that sets out how complaints will be dealt with. This is available to residents, their relatives and carers. Records showed that there have been no complaints made since the last inspection. One relative confirmed in the questionnaire that they were aware of the complaints procedures. Staff had received basic training in the protection of vulnerable adults. Policies and procedures for the protection of vulnerable adults were in place. Staff were aware of the procedure to be followed in the event of an allegation being made. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 27, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The design and layout of the home provides people with a well-maintained and comfortable environment to live in that encourages independence. The standard of the accommodation, décor and furniture and fittings was good. Arrangements for keeping the home clean and tidy protect people living there. Sufficient toilets and bathrooms are available and work was in progress to improve the facilities available so that residents’ needs are more effectively met. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 17 EVIDENCE: The home was clean, tidy and homely in appearance. The premises are accessible to all of the residents. The furniture and fittings are of a good standard. Maintenance and redecoration is carried out at regular intervals. All accommodation is on the ground floor and residents’ rooms are personalised and attractive. Equipment including bed rails, air mattresses and hoists are available in bedrooms to suit the identified needs of residents. Records show that equipment is regularly checked and serviced. A programme of redecoration of bedrooms is in place. Work was in progress to fit a new Parker bath that is height adjustable to meet the needs of the residents. One bathroom is not regularly used and there are storage lockers and other items being stored in it. Plans have been prepared for this bathroom to be converted into a wet room, as the bath is too large and very low, which makes it difficult to transfer residents. The manager said it is also impractical as it uses so much water. Plans have been drawn up to create a “wet” room in half of this area and the other half will form part of a new office/sleep in room. This will be an improvement on the current use of the conservatory as a sleep in area. No odours were evident during the inspection. Cleaning materials and other potentially hazardous substances were safely stored. Policies and procedures were in place relating to the Control of Hazardous Substances and Infection Control and other Health and Safety matters. Training is provided in Health and Safety and Food Hygiene. Appropriate laundry facilities are provided to meet the needs of the residents. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 18 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): Standards 32, 33, 34 and 35 were inspected. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There is a competent team of staff who have access to a range of training opportunities. This meant that people were being cared for by staff who were experienced and are working towards achieving national qualifications. Staffing numbers during the night are insufficient to safely evacuate residents in the event of a fire, although daytime staffing levels are generally adequate to meet individual residents’ needs. Robust recruitment practices are in place to ensure that residents are kept safe. EVIDENCE: Rotas showed that staffing levels vary between five staff and two staff on duty during the daytime. On the day of the inspection only two staff were on duty. This level of staffing limits the availability of activities and outings as staff said they are unable to take people out when only two staff are on duty. At weekends there are regularly only two staff on duty. On the day of the Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 19 inspection staff on duty were responsible for all care tasks, domestic work and preparing meals on the day of the inspection. This limited the time they had to spend with individual residents. At night there is one person sleeping in at the home. A recent fire inspection report highlighted concerns about one person being able to safely evacuate residents in the event of a fire and management of home are reviewing this arrangement. A sample of staff personnel files was examined and these showed that appropriate recruitment policies and procedures were followed. Criminal Record Bureau (CRB) checks had been carried out on all the staff. Two written references were available in each of the four files checked. Staff • • • • • received regular mandatory training such as: First Aid, Food Hygiene, Moving and Handling, Health and Safety and, Fire Safety. Training programmes were in place and these were linked to staff appraisals and supervision sessions. Training provided included: • Mental Capacity Act, • Falls Awareness and, • Safe Handling of Medicines. New staff completed the Learning Disability Award Framework (LDAF) as part of their induction. Only one of the care staff has a relevant qualification in care and five staff are working towards this. Future training includes: • Safe Handling of Medicines, • Epilepsy, • Report writing, • Person Centred Planning and, • Protection of Vulnerable Adults. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 20 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): Standards 37, 39 and 42 were inspected. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager is suitably qualified and experienced and demonstrated a commitment to provide good quality care and support for the people living at the home. Quality monitoring systems are in place, which ensure that the service is being run in the best interests of the people living at the home. Adequate systems and practices are in place for health and safety that help to ensure residents and staff are safe from risk of harm, although not all entries in fire records were appropriately recorded. EVIDENCE: The manager is qualified and has the necessary experience to run the home. There was evidence that she understands the need to keep up to date with practice and develop her management skills. She has regularly updated her Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 21 training and reviewed the care practices within the home. The manager has personal performance targets and an action plan that are monitored and regularly discussed with her line manager. There is a quality assurance system in place that uses questionnaires, review of performance targets and quarterly monitoring of health and safety. Audits of records are carried out. The questionnaires are used to seek the views of relatives/carers, professionals working with residents and advocates about the operation of the service. Staff took part in regular training that covered moving and handling, health and safety, first aid and basic food hygiene. Risk assessments were in place covering safe working practices. The manager said that regular ‘in house’ checks of the Home’s fire equipment were being done, but some of these checks were not recorded in the fire log. Records indicated that staff had regular fire prevention training and took part in regular fire drills. Accident records are kept in an appropriate form. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 26 X 27 2 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 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 3 X 3 X X 2 X Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3 Standard YA6 YA9 YA33 Regulation 15 13 18 Requirement The content of each residents care plan must be regularly reviewed. More information is needed in Risk Assessments to clarify how risks are minimised. A review of staffing levels must be carried out to ensure that adequate numbers of staff are available to meet residents’ needs during the day and night. Fire records must be kept up to date. Suitable provision must be made for storage. This requirement is outstanding from 01/12/05. Timescale for action 31/07/07 31/07/07 31/07/07 4 5 YA42 YA39 23 24 31/07/07 31/10/07 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. Pengarth Refer to Standard YA32 Good Practice Recommendations Continue with staff development to achieve 50 of the DS0000000545.V338249.R01.S.doc Version 5.2 Page 24 staff team with NVQ level 2 or above in care. Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Pengarth DS0000000545.V338249.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!