Inspection on 20/12/06 for Penn House

This inspection was carried out on 20th December 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Penn House 02/12/09

Penn House 11/12/08

Penn House 19/12/07

Penn House 11/01/06

Penn House 19/10/05

Penn House 09/11/04

Penn House 01/03/04

Penn House 01/03/04

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

CARE HOME ADULTS 18-65 Penn House The National Society For Epilepsy Chesham Lane Chalfont St Peter Gerrards Cross Bucks SL9 ORJ Lead Inspector Gill Gentles Unannounced Inspection 20th December 2006 09:30 Penn House DS0000023006.V322264.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 Penn House DS0000023006.V322264.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. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Penn House 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) The National Society For Epilepsy Chesham Lane Chalfont St Peter Gerrards Cross Bucks SL9 ORJ 01494 601435 Penn@epilepsynse.org.uk martineau@epilepsynse.org.uk The National Society for Epilepsy Mrs Kaye Bailey Care Home 22 Category(ies) of Physical disability (22) registration, with number of places Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Provision of respite care for service users. Date of last inspection 11th January 2006 Brief Description of the Service: The National Society for Epilepsy is an independent registered charity that is administered by a Board of Governors who oversee the running of the Chalfont Society. The centre is located on a large rural site on the edge of the village of Chalfont St Peter. It consists of residential houses, a supported living project, a number of workshops and sites for daytime activities, an assessment unit which is an NHS provision, and additional services including a chapel, a restaurant, central kitchens and laundry, a small shop run by service users, administrative buildings and staff accommodation. Penn House is one of the residential houses and provides 24 hour residential care for up to 22 adults. The home is divided into five ‘flats’ and is situated centrally on the site. Attractive, open, grassy areas surround the house. It has no private garden of its own but there is a small area at the front with benches and tubs of flowers. There is access to public transport and this is used by service users living in the home. The current fees for this home are approximately £902.00 per week. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place on the 19th December 2006. Policies, procedures, home records and care records were examined. The home manager, service users and staff were spoken to. Interactions between service users and staff were observed. Approximately nine service users were spoken with throughout the course of the inspection. The care of four service users was case tracked and care practices were observed. Documentation pertinent to the health and welfare of service users and health and safety around the home were viewed. A tour of the environment pertinent to the four service users being case tracked was carried out. This included bedrooms, bathing and toileting facilities as well as the communal areas. The Commission received comment cards from service users and a health care professional. The evidence seen and comments received indicate that this service meets the diverse needs (eg religious, racial, cultural, disability) of individuals. What the service does well: Risk Assessments are in place to ensure service users are safe. The home/organisation offers a range of activities in the community, which provide opportunities for stimulation and involvement. Service users are supported to maintain contact with family and friends, and to keep important social contacts. The home ensures that they cater for all service users’ specialist needs, offering balanced and nutritious meals. Medication is managed well, ensuring that service users receive the medicines they require to keep them healthy and well. Effective complaints procedures are in place to ensure that issues raised by service users and their representatives are listened to. Adult protection is appropriately managed to ensure that service users are not placed at risk of harm. In general the environment creates a homely, comfortable and safe home for service users. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 6 The home’s recruitment policy and practices support and protect service users from potential harm. Staff records identify that staff have the competencies, qualities and training required to meet service users’ needs. Service users receive the appropriate support from well-supported and supervised staff. The home appears to be managed well by the manager, giving clear leadership to the team and promoting continuity of care to service users and improving standards all round. 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. Penn House DS0000023006.V322264.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 Penn House DS0000023006.V322264.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 adequate. This judgement has been made using available evidence including a visit to this service. The home has a current Statement of Purpose and Service Users Guide in place that reflects the service provided. Each resident has his or her individual needs and aspirations assessed. However, there are shortfalls in documentation being available in the home. EVIDENCE: The manager has recently updated the Statement of Purpose and Service Users Guide to reflect the service as it is today. Care records of four service users were examined, one of which was of a new service user admitted to the home since the previous inspection. Information was limited in relation to pre-admission assessment of need. Three of the service users have lived in the home for several years and the initial assessment carried out had been archived. The newest service user’s file did not evidence an assessment having been carried out. The manager and staff team confirmed that this service user had been admitted into the respite bed and then became permanent, without a full assessment of needs being completed for long term care. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 9 There was no evidence that this service user was or is compatible with the existing service users living in the home. However, from observation and discussion with the staff members it was clear that the placement has worked out. The Service Users’ Guide states that, “If you would like to come and stay for a trial period we can arrange for a short stay for one month, which will give you a good idea about what Penn House and the NSE are about”. It is recommended that documentation to support the month’s trial is in place for all new service users. Penn House DS0000023006.V322264.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, 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Personal care needs of the service users are identified through the care plans. However, there are still a number of shortfalls that need addressing to ensure that service users’ holistic needs are being met. Risk Assessments are in place to ensure service users are safe. EVIDENCE: Four-service users care was tracked as part of the inspection process. Each service user had a care plan in place, which is written by the keyworker in conjunction with the team leaders. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 11 All documentation included: • • • • • • • • • • • • • • • • • • Who the Keyworker is A photograph of the service user Epilepsy management Nocturnal care Psychiatric care Medication competence Identified behaviour Eating and drinking Finances Social skills Personal care Domestic skills Communication Mobility Cultural and religious needs Daily activity programme Hobbies and interests Medication The care plan files contain an abundance of information pertinent to providing the appropriate care to individuals. However, there are still areas that need to be addressed and improved on. There was no evidence to support that service users have been involved in making decisions about their chosen lifestyle or whether personal goals have been selected and incorporated. Discussions took place with the manager and deputy about developing the plans further to ensure that service users are involved, and guaranteeing that all their wishes, needs and preferences are reflected, that they are signed and dated and that personal profiles/pen pictures are included as there was a lack of personal information maintained. Discussions took place with staff members around the layout of the plans, as it was felt that they focussed on the negative first, eg problems/issues rather than ‘this is me I need support to…’ etc. . Comprehensive risk assessments are in place for each service user whose care was tracked. A number had been reviewed during the last sixmonths. However, there were several that hadn’t been since June 2005. Penn House DS0000023006.V322264.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, 17 Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. The home/organisation offers a range of activities in the community, which provides opportunities for stimulation and involvement. Service users are supported to maintain contact with family and friends, and to keep important social contacts. The home ensures that they cater for all service users’ specialist needs, offering balanced and nutritious meals. EVIDENCE: There are opportunities for service users living in Penn House to access a variety of on-site work experiences such as Chalfont Assembling and Packaging (CAPS), recycling and gardening, etc. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 13 The centre also has links with the local colleges and a number of service users in Penn House access them. The NSE has their own college advisor based at the centre who supports service users to choose and access educational base classes or learning new hobbies. Service users spoken with confirmed that they had either been to work or to the day centre facility that offers a selection of activities such as sports, sensory, arts and therapy, etc. Service users whose care was tracked attend the on-site activities, but very few off-site. Care plans identify individual’s hobbies and interests which service users confirmed were generally accessed. One service user’s care plan identifies that, “Refuses to take part in any daily activities provided by the centre” - there was no evidence to suggest that alternatives off-site had been offered. Off site work experience (shelf stacking) is being looked into for one service user in the New Year. During the course of the visit one service user whose care was being tracked went out Christmas present shopping and out for lunch. The service user confirmed that this had been planned and that he/she was looking forward to it. Care plans reflect the importance of family and friends and the staff and service users spoken with confirmed that relationships are supported and encouraged. Service users spoken with confirmed that they are encouraged to be independent and make individual decisions about their daily lives. All service users have been offered keys to their bedroom doors. All service users have access to all the communal areas in the home. Staff were observed interacting well with service users in a respectful way. Staff were also observed knocking on service users’ doors and waiting for a response before entering, unless in an emergency. All meals are received from the central kitchen on site between Monday and Friday. At weekends the staff are responsible for providing all meals. Service users are encouraged to become involved in preparing food in the lovely new kitchen recently installed. In general meals are partaken in the dining room. However, service users are able to eat in their flats or their rooms, which was observed during the visit. Penn House DS0000023006.V322264.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, 20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users are offered personal, physical and emotional support as and when required. However, records are maintained with GP records and not accessible so as to ensure needs are being met. Medication is managed well, ensuring that service users receive the medicines they require to keep them healthy and well. EVIDENCE: The staff and service users spoken with throughout the course of the inspection confirmed that they are appropriately supported by accessing all the healthcare provisions they need, either on site or in the local community. However, care plan documentation failed to support this. The home does maintain health care records which belong to the GP and consultant who are either based or hold clinics on site and in the home. As part of the inspection these records were not viewed, as they do not belong to the service but to the medical professionals. It is required that all healthcare needs are incorporated within the care plan documentation. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 15 The Service Users Guide and Statement of Purpose clearly state that the service users have access to a wide variety of healthcare professionals. Two GPs hold clinics on site twice a week, for which service users are able to make their own appointments if they wish. This is supported with a GP out of hours service or the emergency 999 number. The NSE has a psychiatrist who is accessible by the home’s staff making appointments for the service users. The neurologist is based in the medical centre and holds clinics on a Tuesday and house visits on Wednesdays. Chiropodists, dentists and opticians also visit the NSE and hold their own clinics in the medical centre at approximately six-week intervals. Service users are also supported to access community providers if they so wish. All medication at the time of the inspection is stored in lockable wall cabinets in the office. Service users were observed coming to the office at lunchtime and requesting their own medication. Ten out of 19 service users are partially self-medicating and two are completely self-medicating. The manager confirmed that she has recently ordered small lockable cupboards to go in all the service users’ bedrooms. Unfortunately when they first arrived they were the wrong size and had to be returned. Medication Administration Records sheets were found to be completed adequately and there were no errors detected. Medicines were found to be in date and stored appropriately. Staff administering medication had been trained and completed a period of observation before being signed off as competent. There were some items being stored in the medicines cabinet that should not be and these need to be removed. Penn House DS0000023006.V322264.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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Effective complaints procedures are in place to ensure that issues raised by service users and their representatives are listened to. Adult protection is appropriately managed to ensure that service users are not placed at risk of harm. EVIDENCE: The home has appropriate policies and procedures in place to ensure that service users’ views are listened to. The home has received no complaints since the last inspection. Documents are set up for the recording of any complaints and outcomes. The Commission has received no information concerning complaints made to the service by service users or their representatives. Service users are protected from abuse by the home’s policies and procedures. Nine out of ten members of staff have received Protection of Vulnerable Adults training. Penn House DS0000023006.V322264.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. In general the environment creates a homely, comfortable and safe home for service users. EVIDENCE: Penn House is a home situated in Chalfont St Peter on the site of the National Society for Epilepsy. The home is an old detached house with an extension offering accommodation to 20 service users in five separate flats with single bedrooms. The flats and bedrooms of the service users who were case-tracked were viewed. In general they were found to be homely, personalised to a domestic nature with natural and electric lighting and heating. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 18 Service users spoken with were happy with their individual rooms and had chosen where furniture was placed. One service user does however, have concerns over major cracks appearing in the walls. The manager confirmed that the building works department is looking at them. The service user in question did express concerns that he/she had not been informed of what is happening. The manager must ensure that the cause of the cracks is identified and appropriate action taken to ensure that the service user is not placed at risk by subsidence, etc and keep the service user informed at all times. Each of the five flats has a small kitchenette, toilet and shower facilities. The shower/bathrooms are in need of some maintenance as they still display the concrete floors, which are dangerous if somebody should fall, placing service users at risk and are in need of replacing with non-slip softer flooring. Appropriate infection control systems are in place and nine out of ten staff have received training. There were no odours detected in the home. Penn House DS0000023006.V322264.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, 35 Quality in this outcome area is good; This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and practices support and protect service users from potential harm. Staff records identify that staff have the competencies, qualities and training required to meet service users’ needs. Service users receive appropriate support from well-supported and supervised staff. EVIDENCE: The manager explained that she feels the staffing structure implemented since the previous inspection has greatly improved the management arrangement within the home. There is now the manager, deputy and two team leaders. The manager has delegated responsibilities to the three seniors giving them greater ownership. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 20 The senior staff spoken with confirmed that they feel the staff in place have the appropriate skill base to carry out their roles and provide support to service users competently. However, there are seven staff vacancies which were being filled by NSE bank staff at the time of the visit. Personnel files were viewed of new employees and linkworkers to the service users whose care was tracked. All files contained the appropriate information required to ensure that service users are protected from harm. All new staff receive an in-house and corporate induction which links in to the NVQ training in Care. Four staff have completed NVQ Level 2 and above and three new staff have commenced NVQ Level 2. An abundance of training is available and accessed by the staff team such as challenging behaviour, protection of vulnerable adults and mandatory. Out of ten permanent staff there are staff trained in:• • • • • • Food Hygiene - 8 Fire Awareness - 9 First Aid - 0 Manual Handling - 7 Infection Control – 9 Medication – 5 It is required that staff are trained in basic first aid. The responsibility for supervising staff has been split between the manager and senior team and records and staff spoken with confirmed that regular formal supervision is taking place. Penn House DS0000023006.V322264.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): 32, 34, 35 Quality in this outcome area is adequate; This judgement has been made using available evidence including a visit to this service. The home appears to be managed well by the manager giving clear leadership to the team and promoting continuity of care to service users and improving standards all round. In general, health and safety procedures are carried out, although there are a few shortfalls that could potentially place residents at risk from harm. EVIDENCE: The manager has worked at the NSE for approximately 11 years and has been the manager of Penn House for six years. She has completed her Registered Managers and Assessors Award. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 22 The manager has overall responsibility for the day-to-day operation of the home with the assistance of a deputy. Regular unannounced proprietors’ visits are carried out monthly and reports are maintained in the home and were viewed during the course of the inspection. It was unclear as to whether the NSE has carried out an annual quality audit on the home during the past 12 months. A selection of health and safety certificates was perused such as fire, gas and portable appliances and hoist servicing. It was noted that the home had no evidence to confirm whether a Legionella test had taken place since September 2005. As previously reported the home does not have staff working on any shift who have a current first aid certificate in place. Penn House DS0000023006.V322264.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 2 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 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 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 2 3 X 3 X 3 X X 2 X Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 24 No 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 YA19 Regulation 15 Requirement That the healthcare needs of all service users are maintained in the service users’ care plan or personal file. It is required that staff are trained in basic first aid. Timescale for action 30/03/07 2 YA19 YA42 18(1) 30/03/07 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 2 Refer to Standard YA2 YA6 Good Practice Recommendations It is recommended that documentation to support the month’s trial is in place for all new service users. That the manager continues to develop the care plans as discussed during the inspection and identified in the report. Penn House DS0000023006.V322264.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Penn House DS0000023006.V322264.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. 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