Inspection on 18/01/07 for Peppard House

This inspection was carried out on 18th January 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Peppard House 23/01/06

Peppard House 16/08/05

Peppard House 31/01/05

Peppard House 15/06/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Pinta

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Peppard House 45 Woodcote Road Caversham Reading Berkshire RG4 7BB Lead Inspector Sally Newman Unannounced Inspection 18th January 2007 09:40 Peppard House DS0000011090.V327255.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 Peppard House DS0000011090.V327255.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. Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Peppard House Address 45 Woodcote Road Caversham Reading Berkshire RG4 7BB 0118 947 2067 0118 946 4014 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) Choice Limited Mrs Jennifer Mary Thwaite Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7) of places Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users not to be admitted over 65 years of age. Date of last inspection 23rd January 2006 Brief Description of the Service: Peppard House provides residential care to seven adults, of both sexes who have learning and associated behavioural disabilities. The house is owned by and the care provided by C.H.O.I.C.E Limited. It is situated in a residential suburb approximately two miles from the town centre. It has its own transport and is on a public transport route. The house is a large three storied building, with bedrooms on the first floor, there is ample communal space and an adequate, well-used rear garden. Fees range from £796.55 to £2134.52 per week. Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection that was conducted over the course of 3 days and included a visit to the service of 5½ hours duration. Evidence for the report was gained from records held by the commission, information provided by the service and a range of surveys which were sent to relatives and visiting professionals. Two service users were supported by staff to complete surveys and a sampling of a range of records within the service was carried out. In addition, discussions were held with the manager and care staff, two of which were in private, and a visiting advocate. Two relatives and four professional surveys were returned and have been incorporated into the findings of the report. Due to the communication difficulties of service users the inspector obtained additional evidence from observations of interactions taking place in the home throughout the course of the visit. The manager was appointed in April 2005 and there was ample evidence to suggest that she had settled well into the role and had provided a positive influence on the service. She was well regarded by staff and professionals who had a direct input to the wellbeing of service users. It was acknowledged by the manager that she needed to delegate tasks more effectively to senior staff. This would enable her to maintain an overview of recording and monitoring systems and ensure that any omissions are addressed without delay. The provider has a range of polices and procedures relating to equality and diversity. All staff attend a diversity training course at the commencement of employment. Care plans have been designed to take account of individual needs and cultural and religious choices. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service that meets the needs of individuals of various religious, racial or cultural needs. This service provides a high quality of care by a well managed, dedicated and committed staff team. The outcomes for service users are good and in some areas excellent. There is a culture of continuing improvement and on this occasion no requirements or recommendations have been made. What the service does well: The range of opportunities for service users to participate in activities is of a high standard. The overall standard of care is very good. The service is run in the best interests of service users. Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 6 Quality of life for service users is good. Maintains a consistent and dedicated staff team. Transitions plans for service users moving in and out of the home are excellent. 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. Peppard House DS0000011090.V327255.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 Peppard House DS0000011090.V327255.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): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The needs of prospective service users are assessed to a high standard and ensure that an appropriate service is provided. EVIDENCE: Evidence was provided from a range of records, survey results and discussion with the manager. Brief observation of a discussion between the manager of the home and the manager of the home to which a service user was in the process of moving was also undertaken. The transition plans for two service users moving into the home were seen. One of these service users had moved to the home on a planned temporary basis. The standard of information was excellent. The paperwork was detailed, comprehensive and individually tailored and included a gradual programme of familiarisation. The care manager of one service user who had moved to the home recently provided positive feedback and was very impressed with the service and its ability to meet the needs of this individual. This service user had settled well and previous troublesome behaviours had almost disappeared. Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 9 Although only a temporary stay was planned for one service user who was in the process of moving out of the home the standard of information and the care and consideration applied was equal to the service user who had moved to the home on a permanent basis. A brief observation of a discussion between the managers for the current and the new placement was undertaken. The discussion focussed upon progress in relation to the service user’s gradual move to the new placement and suggestions for further enhancing a calm transition were considered. Discussion with the manager regarding a service user who left the home last summer demonstrated that the move had been handled sensitively and delicately. This had been of particular importance as this individual had shared the home with other established service users for in excess of 10 years. Peppard House DS0000011090.V327255.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. Individual plans are detailed and contain comprehensive information. Service users are encouraged to make decisions for themselves and are supported by staff in doing so. Risks are identified and comprehensive management plans are implemented to minimise risks to service users. EVIDENCE: Evidence was provided from discussion with the manager and staff, from perusal of records, observations and from feedback from a range of surveys. Care plans were sampled and confirmed that a consistent and comprehensive range of information is maintained on service user files. The manager was aware that some care plans need to be cleared of excess and unnecessary paperwork. The manager is in the process of introducing ‘key worker’ files that contain essential information and measurable action plans to achieve goals. Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 11 There was evidence of service users being encouraged to make decisions for themselves through discussion with staff. Examples provided included food and activities. The manager wants to continue to involve service users more in the running of the home by actively seeking their views through communication tools specific to each individual. In discussion staff confirmed that in the last year there had been greater involvement of service users who are actively encouraged to participate as fully as possible. Risk assessment and management plans seen were excellent. The detailed information benefited from input from the psychology team and provided clear procedures and guidance to staff in specific situations with individual service users. Minimal intervention is undertaken with three service users where identified triggers for challenging behaviour are clearly documented in guidelines for staff. These are regularly reviewed and updated and identify appropriate training for staff. Staff spoken to demonstrated a clear understanding of the risks associated with certain service users and provided examples of where management plans are actively implemented in order to reduce the risk of harm to service users. The manager in discussion demonstrated a sound understanding of the need to be sensitive to the balance of service users’ desires and preferences and their safety. Peppard House DS0000011090.V327255.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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Activities are wide-ranging and individually focussed. Service users are encouraged to be part of the community and are supported to have appropriate personal relationships. Service users’ rights and responsibilities are supported and they enjoy a healthy and varied diet. EVIDENCE: Evidence was obtained from discussion with staff, from perusal of records, observation and from feedback from surveys. There was overwhelming evidence from discussion with members of the staff team and the manager that activities and participation in the community are considered to be a particular strength of the home. The day care organiser provided an overview of the range of activities on offer and how these were Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 13 focussed upon individual interests and preferences. She confirmed that the team as a whole are vigilant at identifying new opportunities both occupational and leisure based. Some activities included ice-skating (also for wheelchair users), pub/restaurant trips, social clubs, day centres and further educational colleges. There are other activities that are brought into the home such as reflexology. A private discussion with a visiting advocate confirmed that upon arrival at the home he is always welcomed and service users are observed leaving the home, returning from activities and engaging in activities within the home. Observations following arrival at the home confirmed that service users were anticipating a range of activities that morning and some sought reassurance from staff of the location and timings of their individual programme. Positive feedback was received from questionnaires with one service user indicating that he liked it at Peppard House and would like to go on a train trip. Menus confirmed that meals are varied and nutritious. The manager intends to introduce a weekly opportunity for all service users to individually choose and cook the main meal on a specified day. Fridges were well organised and temperature checks are undertaken on a regular basis and are recorded. Food is ordered on the Internet as the time taken to manually undertake the shopping was not considered to be a good use of staff time. However, service users have the opportunity to shop for small amounts of food as the need arises. Preferences are not written down but the manager confirmed they are well known by the staff team. Peppard House DS0000011090.V327255.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 good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support to a high standard and their physical, emotional and health care needs are well met. The arrangements for medication are robust and protect service users. EVIDENCE: Evidence was provided from discussion with staff, from a range of records maintained in the home, from observations during the visit and from the results of surveys. Personal support continues to be of a high standard. The manager and staff spoken to demonstrated a sound knowledge of service users’ personal and health care needs. Wherever possible male staff are deployed to support personal care with male service users and there is always at least one female member of staff on duty. Key worker responsibilities are monitored by the manager to ensure that action plans are reviewed on a regular basis. All service user files have health action plans that clearly identify individual health Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 15 care needs and the action undertaken and that planned for the future. One relative indicated on a survey form that she would like to see greater dental hygiene. The manager took note of this feedback and will investigate and take action as appropriate. Care plans indicated appropriate input from a variety of health care professionals and positive feedback was received from a G.P. and a Consultant Psychiatrist. There are clear policies and procedures in respect of the arrangements for medication. The inspector briefly observed the administration of lunchtime medicines and staff were able to explain the processes clearly. All administration includes an administrator and a witness and all entries are double signed. Only those staff trained to do so administer medication. This training includes observed practice and the ongoing assessment of competence. The home does have periodic visits from a pharmacist who reviews the procedures within the home. The last pharmacy visit was in July 06 when no issues were raised. Peppard House DS0000011090.V327255.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. Service users’ views are taken seriously and acted upon. They are protected from abuse, neglect and self-harm by the procedures operating in the home. EVIDENCE: Perusal of a range of records, together with discussion with the manager and staff provided the evidence for these outcomes. There are clear procedures for making and responding to complaints, which are provided by the organisation. There were two complaints entered into the complaints record. Although one related to a staff issue both were dealt with appropriately. The manager wants to simplify the complaints procedure for service users, which is currently provided in pictorial form but is lengthy and complicated for them to understand. All staff receive protection of vulnerable adults training at the commencement of employment and regular updates are provided. Staff spoken to demonstrated a clear understanding of the principles and potential for abuse and were clear about the action to take should an allegation or suspicion arise. Peppard House DS0000011090.V327255.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. The home provides a comfortable and safe environment for service users. The standards of cleanliness in the home are good. EVIDENCE: A tour of the premises, perusal of records and discussion with the manager and staff provided the evidence for the outcome of these standards. There is an ongoing programme of maintenance for the home and the manager reported that repair requests are responded to swiftly by the company. Areas redecorated since the last inspection, include the lounge, hallways and corridors, the relaxation room, middle floor bathroom and two bedrooms. All service users are encouraged to participate in the choosing of colour schemes and furnishings. Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 18 Throughout, the home was clean and tidy. A cleaner is employed during the week to support care staff in maintaining a clean environment. There are robust procedures in place concerning the control of infection and the facilities for laundry are sited outside of the main building. The washing machine is of an industrial type and includes a sluice wash programme. Peppard House DS0000011090.V327255.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. Staff are competent and qualified and support service users well. The home’s recruitment procedures protect service users. Staff are well supported and supervised. EVIDENCE: Evidence was obtained from discussion with the manager and staff, from sight of a range of records maintained within the home and by the Commission and from the results of surveys. The manager and those staff spoken to reported that the staff team was more cohesive, with increased morale and closer working relationships. The team has an established core of staff and the team as a whole are forward thinking, supportive, committed and dedicated. The home does not use agency staff and any shortfalls are addressed by the use of overtime. Observations conducted throughout the course of the visit demonstrated that interactions between staff and service users were warm, confident and appropriate. Staff Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 20 training is highly regarded by the company and was described by staff as of a high quality and readily available. Of the current staff team 55 have achieved a qualification at NVQ 2 or above with an additional 5 staff undertaking NVQ training. The service has a training plan with individual profiles evident on those records seen. Additional and specialist training includes Autism and Aspergers, Epilepsy, Values and Attitudes, Effective Communication and Learning Disability and Mental Health. Recruitment and staff records were seen for 3 members of staff. The manager undertook to ensure that there was a clear photograph for each staff member, to be kept on their record. Criminal Records Bureau checks and employment references are kept at head office with the agreement of the Commission. Staff supervisions are recorded in a bound book by each supervisor. The manager advised that all staff members can have a copy to retain if they wish. The manager was aware that the service is not achieving bi-monthly supervisions for all staff at present. This was mainly due to the long-term sick leave of a senior member of staff. The manager was due to provide supervision training for one senior carer who would undertake supervision of all night staff. This would significantly reduce the number of supervisions undertaken currently by the manager. Staff advised the inspector that they felt well supported in their roles and found the manager approachable and fair. Regular staff meetings are held and the aim is to have them on a monthly basis. These meetings are recorded and all staff not in attendance are expected to familiarise themselves with the minutes. The manager has just introduced seniors meetings, which were described as working well. Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run and service users’ views underpin all aspects of the operation of the home. The health and safety procedures within the home are robust and protect service users. EVIDENCE: Evidence was obtained from discussion with the manager and staff, from perusal of a sample of records, from information held by the Commission and from survey feedback. The manager is well regarded by staff and external professionals as confirmed by the results of surveys and discussions with staff. She was described as Peppard House DS0000011090.V327255.R01.S.doc Version 5.2 Page 22 organised and approachable and a manager who gets involved in the day to day running of the home. The manager was asked to consider greater delegation of tasks to senior staff and the implementation of a management audit tool to ensure that records are maintained to the highest standards. The manager is currently awaiting verification of completion of the NVQ 4 and is due to commence Registered Managers Award training in February 2007. Evidence gathered throughout the inspection process confirmed that the manager had made a positive impact on the home and that she possessed good leadership skills. The inspector was advised that new service user questionnaires were being introduced by the company to capture individual service user views and will focus on the communication needs of individuals. Currently formal and internal reviews are used to obtain service user views together with observation of individual responses to new experiences. Formal service user meetings are not held due to the communication difficulties for service users. In discussion with the manager and staff it was evident that the approach of the home is service user focussed and there is a commitment to run the service in the best interests of service users. A sample of health and safety records was seen. Fire safety records were in order. A health and safety inspection report provided by the Environmental Health Department was seen and the manager provided verbal evidence that the recommendations had been addressed. A food safety inspection report could not be located during the course of the visit to the service. The health and safety file contained servicing invoices for appliances and equipment and various regular safety checks undertaken by both staff and external specialists. However, this file could be more efficiently organised to enable easier accessing of information. There was a low number of accidents to both staff and service users recorded and the manager confirmed that these records are regularly reviewed at visits to the home by the proprietors’ representative. Peppard House DS0000011090.V327255.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 X 2 4 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 3 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X X 3 X Peppard House DS0000011090.V327255.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Peppard House DS0000011090.V327255.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 Peppard House DS0000011090.V327255.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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