Inspection on 17/10/07 for Pensall House Resource Centre

This inspection was carried out on 17th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Pensall House Resource Centre 25/04/06

Pensall House Resource Centre 15/11/05

Pensall House Resource Centre 21/04/05

Pensall House Resource Centre 08/12/04

Pensall House Resource Centre 26/08/04

Pensall House Resource Centre 09/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Pensall House Resource Centre Fairview Way Pensby Wirral CH61 6XL Lead Inspector Inger Moynihan Key Unannounced Inspection 17th October 2007 90:00 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 Pensall House Resource Centre DS0000035958.V331086.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. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pensall House Resource Centre Address Fairview Way Pensby Wirral CH61 6XL 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) 0151 666 4648 Metropolitan Borough of Wirral Mrs Susan Teresa White Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two (2) beds to accommodate persons under 65 years of age in an overall total of 25 25th April 2006 Date of last inspection Brief Description of the Service: Pensall House is a two storey, purpose built unit owned and operated by the Metropolitan Borough of Wirral. It is easily accessible to the local facilities and amenities of Pensby and Heswall. Bus routes are close by. The unit is located in a residential part of the Wirral. There are good parking facilities at the front of the unit and wheelchair access is available at the front entrance. Bedrooms are located on two floors with a lift being provided to access these rooms. All rooms are single occupancy with ensuite facilities comprising of a toilet and wash basin. There is sufficient communal space for the number of service users accommodated at the unit, which includes a large dining room and a number of lounges. A separate smoking room is provided. Pensall House is furnished and decorated to a high standard, which provides a pleasant and comfortable environment for the residents. A range of equipment is provided to assist residents with their bathing and mobility. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information about Pensall House was obtained through a Pre Inspection Questionnaire (PIQ) and examination of residents case files and supporting documentation. A tour of the building took place and discussions were held with residents and staff about the standard of care and the management of the unit. A part of the inspection process includes sending questionnaires to residents, staff and health care professionals in order to obtain their views on the standard of the service provided. Comments made in these questionnaires are included in the report and contribute to the basis of any judgments made. Fees: short term care - £94.48p per week respite care - £66.85p per week What the service does well: Residents care needs are assessed before a service is offered to ensure their ongoing needs are met. One of the residents spoken to during the visit said the staff are excellent, they are very helpful and very efficient. Another resident said the staff are very kind and Im being looked after very well. I have no complaints to make. The friend of one resident said she found the staff to be very professional and polite. This was further reinforced in the residents questionnaires returned to the CSCI which noted positive comments about the staff and standard of care provided. Some of the comments made in the questionnaires included my mum has always benefited health wise when she has been in Pensall House, she always comes home much fitter ..... Another commented very good atmosphere, staff really create a very happy home.... Three health care professional questionnaires were returned to the CSCI. Overall the comments were very positive although some points were made about how the service could improve by tailoring it more to residents individual needs. When asked what the service does well one questionnaire noted supports patients to remain independent and rehabilitate to return to own home, One health care professional spoken to during the visit reported Pensall House provides an excellent service. She stated the units management is well organised and the staff are professional and very experienced in the care of older people. Residents are clear on who they should speak to about making a complaint and the staff are clear on the action they should take in the event of them receiving a complaint. Systems are in place to ensure residents are protected Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 6 from abuse and harm. All of the residents spoken to during the visit said they were very happy with the standard of care they receive and had no complaints to make. One resident said all of the staff are wonderful. The standard of the decor throughout the unit remains very high and provides a comfortable and pleasant environment for residents to stay. The kitchen was clean and tidy and it was reported that a recent Environmental Health inspection raised no concerns. The cook has recently been nominated as staff member of the year, which was acknowledged by the director of the organisation. This recognises the high quality of staff employed at the unit. Staff are competent and trained to know how to look after the residents properly. Staff questionnaires returned to the CSCI indicated staff are happy and well supported in their role. They noted the unit was well managed. The service is run by a person who is fit to be in charge and who ensures the residents are well cared for. The staff are always looking at ways of improving the service provision. What has improved since the last inspection? What they could do better: Improvements need to be made to the care plans, supporting risk assessments and medication administration procedures. Please contact the provider for advice of actions taken in response to this Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 7 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. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Some improvements need to be made to the assessment documentation to ensure staff know how to keep the residents safe from harm. EVIDENCE: Records showed that an assessment of a residents care needs and any risk factors affecting their wellbeing is carried out before a resident moves into the unit. This assessment gives staff the information they need on how to look after the person properly and keep them safe from harm. Some improvements need to be made to the way risk assessments are completed to ensure staff have all the information they need on how to keep the residents safe from harm. Intermediate care is provided at Pensall House to help service users maximise their independence and return to their own home. This service is provided as Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 10 a part of the overall service of respite care but has the additional support of a team of health care professionals. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Some improvements need to be made to the care plan documentation to ensure residents holistic care needs are met. EVIDENCE: Records showed that a documented plan of care is drawn up when a resident moves into the unit. The care plan provides information about residents care needs and gives staff guidance on how to look after the person in accordance with these needs. Documentation is in place to demonstrate that residents physical and mental welfare is regularly monitored and they have access to a range of relevant health care professionals. Some improvements need to be made to the care plan documentation, as the information did not always reflect the residents identified care needs and in one instance a care plan had not been completed. This will ensure staff can accurately monitor and review each persons well being and ensure their current care needs are met. One resident spoken to during the visit said the staff are very kind and Im being looked after very well..... Another residents said I couldnt fault the staff, they Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 12 treat you like a person, they are lovely. The friend of one resident said she found the staff to be very professional and polite. Systems are in place for the safekeeping, handling and administration of residents’ medication and only trained staff are allowed to administer medication. The following issues arose in relation to the medication administration record sheets: • • • A risk assessment had not been completed for one resident who administers a part of their own medication. A large amount of unused medication was held in stock, a record of this medication had not been kept Out of date medication was possibly being given to one resident The homes medication procedures must be effectively managed to ensure residents receive the medication they need and are kept safe and well. Five residents questionnaires were returned to the CSCI. They all recorded they receive the care and support they need and that staff act and listen to what they say. Four questionnaires indicated staff are always available when needed, one questionnaire indicated this was usually the case. Four questionnaires indicated they always receive the medical support they need, one questionnaire indicated this was usually the case. Some of the comments made in the questionnaires included my mum has always benefited health wise when she has been in Pensall House, she always comes home much fitter ..... Another commented very good atmosphere, staff really create a very happy home.... Three health care professional questionnaires were returned to the CSCI. All of the questionnaires indicated the service always seeks advice and acts upon it to improve individuals heath care needs. Two questionnaires indicated the service always respects residents privacy and dignity, one questionnaire indicated this sometimes happens and suggested ways staff could improve on this. One questionnaire indicated residents are always supported to live the life they choose, two questionnaires indicated this usually happens. The questionnaires indicated the staff always have the right skills and experience to support individuals social and health care needs, although one indicated this was usually the case. When asked what the service does well, one questionnaire noted supports patients to remain independent and rehabilitate to return to own home, One questionnaire made comments about how the service could improve which were discussed with the manager at the time of the visit. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 13 One health care professional spoken to during the visit reported Pensall House provides an excellent service. She stated the units management is well organised and the staff are professional and very experienced in the care of older people. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 14 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): 12 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The homes routines are flexible and varied, which suit residents preferences and choices. A varied and nutritious diet is provided to ensure residents interest and good health. EVIDENCE: The units routines are flexible which means residents can exercise choice in relation to their social activities and daily routines. A range of social activities takes place during the week to ensure residents do not become bored and to provide them with social interaction. The residents spoken to confirmed they enjoy the activities and acknowledged the staff respect their decision not to join in. All of the residents spoken to during the visit confirmed they were happy with the units routines. The residents confirmed their family and friends can visit at any time, which means they can maintain personal relationships. Residents said they enjoy their meals and always have plenty to eat and drink, they confirmed they are always offered a choice at meal times. One resident said the food is excellent. This was further supported in the residents Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 15 questionnaires returned to the CSCI. Mealtimes are relaxed and informal and staff are on hand to help when necessary. Staff are aware of residents dietary care needs and ensure their individual preferences are catered for. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 16 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): 16 and 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A complaint procedure is in place to ensure residents know their complaints will be listened to, taken seriously and acted upon. Systems are in place to ensure residents are protected from abuse and harm. EVIDENCE: Residents know who to speak to if they wish to make a complaint about the care they receive and the staff are aware of the procedure they should follow in the event of them receiving a complaint. This was further confirmed in the staff and residents questionnaires returned to the CSCI. The units complaint procedure is displayed. All staff have completed training in relation to the protection of vulnerable adults from abuse and a copy of the Wirral Adult Protection procedure is in place to ensure allegations of abuse are managed correctly. All of the residents spoken to during the visit said they are very happy with the standard of care they receive and they had no complaints to make. One resident said the staff are wonderful, all of them. The PIQ indicated that 3 complaints have been received by the unit all of which have been investigated. The CSCI has not received any complaints about this service. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The standard of the decor throughout the unit remains very high and provides a comfortable and pleasant environment for resident to stay. EVIDENCE: The standard of furnishing throughout the unit remains very high and the grounds are well kept. A programme of routine maintenance is in place to ensure the unit is well maintained. The standard of hygiene remains very high and there are sufficient laundry facilities to cater for the number of residents staying at the unit. The manager must ensure the laundry door is kept locked at all times as this is a high risk area, this also applies to all store cupboards. Systems are in place to control the spread of infection along with supporting policies and procedures, which staff can refer to when necessary. The domestic staff have completed training Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 18 in relation to health, hygiene and infection control to ensure residents and staff safety and welfare. The kitchen was clean and tidy. It was reported that an Environmental Health inspection took place earlier this year with no concerns being raised. The cook was recently nominated as staff member of the year. This was acknowledged by the director of the organisation and recognises the high quality of staff employed at the unit. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are competent and trained to know how to look after the residents properly. EVIDENCE: There are sufficient staff on duty to look after the residents in accordance with their particular needs with additional staff being on duty at busy times of the day. There are also sufficient domestic/catering staff employed to ensure the unit is kept clean and tidy and good food is provided. The manager reported that more than 50 of staff are qualified to National Vocational Qualification level 2 or above. This exceeds the National Minimum Standards recommendation for 50 of staff to be qualified to this level by 2008 and ensures staff are up to date with current good practice. As indicated earlier in the report, residents have only positive comments to make about the staff team so it is clear the units recruitment procedure is effective for the purpose of employing good quality staff. Examination of staff files indicated the necessary security checks had been carried out to ensure staff are suitable to work with vulnerable adults. The information held on file would benefit from being streamlined with some additional information being collated. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 20 Staff are provided with a range of appropriate training to ensure they are kept up to date with current good practices. A copy of the training certificate and date of completion of training must be kept. The registered manager was advised to carry out a training need analysis, which may form the basis of the units training plan for the forthcoming year. A rolling programme of training on equality and diversity is currently being provided to all staff. This will ensure staff have an understanding of issues relating to residents age, disability, gender, race, religion or faith and sexuality. Staff are provided with induction training when first employed to ensure they know what is expected of them within their role. This induction training programme is comprehensive and covers both departmental issues and issues relating to the care of the residents and the running of the unit. The registered manager must look to developing the in-house training programme in order to demonstrate that issues relating to the care and support of the residents and the units own policies and procedures have been addressed. Five staff questionnaires were returned to the CSCI. The questionnaires indicated the staff are always given up to date information about the needs of the people they support and the ways information is passed between staff always works well. They questionnaires indicated their induction training covered everything they needed to know to do their job when they started and confirmed they receive training which is relevant to their roles, helps them understand and meet the individual needs of service users and keep up to date with new ways of working. The questionnaires indicated they meet regularly with their manager for support. Four questionnaires indicated there are always enough staff to meet the residents individual needs, one questionnaire indicated this was usually the case. Two questionnaires stated they find Pensall House a very happy place to work with a good staff team. Another questionnaire indicated the service is excellent with good support from the manager and senior staff and good training. Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service is run by a person who is fit to be in charge and who ensures the residents are well cared for. EVIDENCE: The registered manager is qualified and competent to run the unit for the residents best interests. Staff spoke well of the registered manager saying she is always available for advice and support. Quality assurance systems are in place to ensure the ongoing efficient and effective running of the service. This includes monitoring and supporting staff, reviewing administrative systems and consulting with residents about the care they receive. The manager and staff are always looking at ways of improving the service which includes making occasions of seasonal events, currently Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 22 Halloween, setting up a small shop and arranging for a therapeutic dog to visit the unit each week. During the summer the staff built a lovely garden area, which residents can use and plans are being made to provide a small garden and seating area at the back of the home. The registered manager does not handle residents weekly payments; the Social Service finance department do this. However she will hold residents money for safekeeping if asked to. The records for one person were checked and were in good order Staff meet regularly with their manager to discuss their training needs and development within their role. Staff confirmed they found this meeting useful and they felt well supported in their role. All of the staff spoken to during the visit said they enjoyed their work and enjoyed working with the residents. The PIQ indicated that regular health and safety checks are carried out on equipment around the building and supporting policies and procedures are available for staff to refer to. Staff have completed training in relation to this aspect of care and the owners health and safety department has recently carried out a health and safety inspection. This is in line with good practice and ensures residents and staff safety. Pensall House Resource Centre DS0000035958.V331086.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 2 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 4 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 4 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 4 x 3 x 3 x x 4 Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP3 Regulation 14 Requirement Timescale for action 17/11/07 2. OP7 15 3 OP9 17 Detailed risk assessments must be in place to ensure staff have all the information they need on how to keep the residents safe from harm. An up to date plan of the care 17/11/07 provided to residents must be in place to ensure staff have all the information they need on how to look after each person in accordance with their particular care needs. The medication administration 17/11/07 procedures must be reviewed and changed to ensure residents medication is managed more efficiently and to ensure they receive the medication they need and are kept safe and well. Particular attention must be paid to the following: • • Risk assessments for residents who self medicate. The amount of unused medication held on the premises. Version 5.2 Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Page 25 • Out of date medication being given. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Merseyside Area Office Burlington House Crosby Road North Waterloo, Liverpool L22 0LG 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 Pensall House Resource Centre DS0000035958.V331086.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!