Inspection on 29/08/07 for Philiphaugh

This inspection was carried out on 29th August 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

Philiphaugh 06/07/09

Philiphaugh 10/10/06

Philiphaugh 09/05/06

Philiphaugh 24/11/05

Philiphaugh 11/05/05

Philiphaugh 10/11/04

Philiphaugh 06/07/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

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

CARE HOMES FOR OLDER PEOPLE Philiphaugh Station Road St Columb Major Cornwall TR9 6BX Lead Inspector Elaine Bruce Unannounced Inspection 29th August 2007 09:00 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 Philiphaugh DS0000009249.V344067.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. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Philiphaugh Address Station Road St Columb Major Cornwall TR9 6BX 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) 01637 880520 01637 880520 Mr Stephen Michael Hendy Mrs Alice Margaret Taylor Care Home 32 Category(ies) of Dementia - over 65 years of age (19), Learning registration, with number disability over 65 years of age (6), Mental of places Disorder, excluding learning disability or dementia - over 65 years of age (19), Old age, not falling within any other category (12) Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. Service users to include up to 12 adults of old age (OP) Service users to include up to 6 adults aged over 65 with a learning disability (LD(E)) Service users to include up to 19 adults aged over 65 with a mental illness (MD(E)) Service users to include up to 19 adults aged over 65 with dementia (DE(E)) Total number of service users not to exceed a maximum of 32 Date of last inspection 10th October 2006 Brief Description of the Service: Philiphaugh provides care for up to thirty two service users in need of care by reason of old age, dementia, mental disorder and a learning disability. Respite care is available at the home in addition to long stay care (when a bed is available). The home also provides a day care service. The home is situated close to the town of St Columb Major enabling the more mobile service user to visit the shops and facilities independently. The home is set in attractive grounds and is a listed building. Car parking is available in the grounds of the home. The building has been extended with two wings. There are several communal rooms including an activities room and a smoking lounge. Access to the first floor in the main house is by a staircase, which is provided with a stair lift. Bedrooms are available on the ground and first floor of the home. Many of the bedrooms have en suite facilities. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection at Philiphaugh took place on the 29th August 2007 at 0900 until 1600. The manager was on duty on the day of the inspection and assisted the inspector during the course of the day. The home was very busy on the day of the inspection with a number of health care professionals attending the home and a number of people in the home requiring the assistance of the manager. The manager presented very well during the course of the day with the demands on her time. Case tracking of particular people took place as did conversations with them and other people in the home. Some of the people who were able to give an opinion on the home expressed very positive comments on the standard of care that they are receiving. Positive comments were also received in two surveys which were completed by people in the home prior to the inspection. One stated: “the care and attention taken at this home is second to none”. In addition to the inspection of care files and associated records staff files were inspected as were the policies and procedures, the medication arrangements, the standard of the meals and the premises. The home has recently had a very difficult time and it would appear that considerable improvements have been made to the running of the home with a number of outcomes in the report now assessed as good. This is a credit to the manager and her team. Prior to the inspection a completed Annual Quality Assurance Assessment was received at the CSCI as were seven staff surveys. The surveys indicated that the staff enjoy working at the home and feel very strongly that they are delivering a good standard of care. One person said: “We have a good group of staff and everyone gets on well with the residents, we deliver excellent care”. The home is able to offer short stays (respite care) as well as longer stays and the range of fees (per week) is from: £249 to £360. What the service does well: The registered manager has worked very hard to move the home forward. A number of outcomes in this inspection report are now assessed as “good”. The Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 6 manager is an experienced and competent manager who has gained the trust and respect of her staff team and the people in the home. The staff team works very hard to ensure that the people in the home enjoy their daily life. A considerable amount of effort by the staff is put into the daily activities that take place at the home. This again is a credit to the staff as a large number of people in the home have complicated care needs that require one to one assistance. The home has it’s own transport and this is not only used for weekly outings but the people in the home are taken (when required) to their medical and hospital appointments with an escort in the transport. The people in the home commented very positively on the good meals that they are receiving. This was also confirmed in two surveys and the staff survey forms also made reference to the good standard of meals that the home is providing. What has improved since the last inspection? What they could do better: The staff and management team are delivering a good standard of care to people in the home and some of the people have complicated care needs. Documentation must be fully in place in care planning and if necessary a risk assessment developed from that to ensure that all the information on care needs is made available to staff in writing. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 7 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. Philiphaugh DS0000009249.V344067.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 Philiphaugh DS0000009249.V344067.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): 1 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Procedures are in place prior to admission to ensure that the people being admitted to Philiphaugh (and their relatives) can be confident that their needs will be met. EVIDENCE: Philiphaugh has developed a combined statement of purpose and service user guide which sets out the aims and objectives of the home and provides information about the service. The guide has recently been fully updated and has been provided to the people in the home and or their representatives. The document is also on display in the entrance of the home along with the most recent inspection report for the home. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 10 Admissions to the home do not take place until a full needs assessment has been undertaken. The majority of the pre admission assessments are carried out by the registered manager and in her absence the deputy manager. Where the assessment has been carried out through the care management arrangements the registered manager accesses a summary of the assessment and a copy of the plan. A good practice admission policy and procedure is in place to guide staff in the absence of the manager. The home is able to provide a short stay facility as well as longer stays. It is recommended that the pre admission assessment document is expanded in information to ensure that all the care needs of the people coming to the home have been assessed fully. Prospective people and their family/representative always have the opportunity to visit and spend time in the home prior to agreeing admission. Philiphaugh DS0000009249.V344067.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): 7,8,9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people in the home can be confident that they will be treated with respect and that their personal and health care needs will be met. EVIDENCE: Each person at the home has a care plan in place which is supported by daily day and night recording. The care plans are developed over the first couple of months following admission to the home. It was noted that some information included in health care professional assessments was not made fully available in risk assessment information which should be addressed as there are a number of people at the home with complicated care needs. Evidence of reviewing the care plans and updating them where necessary is in place. The people in the home have access to health care services that meet their assessed needs both within the home and in the local community. All the Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 12 people in the home are registered with a general practitioner of their choice and all have access to dentists, opticians and other community services. Separate documentation/records are held on visits to the people by any health care professionals. The home appears to have good working relationships with the local health care professionals. On the day of the inspection two community psychiatric nurses were involved in two reviews of people at the home. There is evidence of weight monitoring in care planning and information on nutritional requirements. The home provides an escorted service to any hospital and medical appointments on the mini bus transport. The home has in place a medication policy and procedure which is fully accessible to the staff. Medication administration records were found to be completed appropriately on the day of the inspection including records for controlled medication. Storage of medication was also found to be satisfactory. All staff who have responsibility for medication administration have received training for these duties. The home has in place policies and procedures to guide staff on delivering care with respect and dignity. One person spoken to stated that all the staff are very kind and caring. One completed survey form said: “the care and attention at this home is second to none. Mum is well treated and looked after.” Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines in the home are arranged to meet the needs of the people living there. Visitors to the home can be confident that they will be welcomed and that social activities are arranged. The dietary needs of the people in the home are well catered for with a balanced and varied selection of food that meets peoples’ individual taste and choices EVIDENCE: The home has sought the views of the people living there and considered their varied interests and abilities when planning the routines of daily living and arranged activities. The daily records evidence that the people are involved in a number of activities to include for example bingo, skittles, board games, music and regular trips out. The home has it’s own transport. A fete has recently taken place with a large amount of money raised which is used as a “comfort fund” for the people in the home to be funded when going out on their activities or to buy presents when it is their birthday. On the afternoon Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 14 of the inspection bingo took place which appeared to be enjoyed by a large number of the people in the home. Some of the routines of the home are fixed to a specific time and day and have evolved over a considerable number of years, as a number of the people in the home have lived at Philiphaugh for a lot of years. One person who completed a survey wrote: “I enjoy bingo and the outings”. The home has developed a system for displaying information and bringing attention to community events and activities. The notice board provides information on planned activities and plans are already in hand for the Christmas pantomime which is to be held at the home. The people in the home are encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and all visitors are asked to sign the visitors’ book on arrival at the home. The daily records evidence when visitors have been to Philiphaugh. Some of the people in the home chose and are able to be independent and exercise this choice by going to the shops to collect a paper for example. The religious and cultural needs of the people in the home are considered. There are plans to organise a service at the home on a monthly or fortnightly basis. A full time cook is responsible for providing quality nutritional meals. He regularly meets with the people in the home to listen to their choices and suggestions for the menu. The cook explained that regular amendments to the menu do take place to make the food interesting and varied. The cook is familiar with the dietary needs/requirements of the people in the home and provides a diet that meets individual needs and choices. The meals for the day are displayed in the dining room of the home. The menu rotates over a four week period and is mainly traditional to include two roasts in the week and fish and chips on a Friday. The main meal of the day on the day of the inspection was roast pork, roast potatoes, apple sauce and vegetables followed by rice pudding with jam. The tea time meal was to be scrambled eggs on toast. The cook explained all meat is purchased locally at the butchers and fresh vegetables are delivered weekly. The people spoken to during the course of the day expressed very positive comments on the standard of the meals in the home. One person who completed a survey form said “If I don’t want what the meal is I always get offered another choice.” One completed staff survey form said: “the meals are fantastic for the service users”. The main meal of the day is eaten at 1200 hours and can therefore be finished at 1230. This has been discussed regularly with the home to try to encourage the home to provide more flexibility with these timings. It is though apparent that the people in the home are happy with the arrangements. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people at Philiphaugh can be confident that any complaints they have will be treated seriously and they will be protected from abuse. EVIDENCE: The home has a complaints policy and procedure that states clearly the procedure for making a complaint and who a complaint should be addressed to. This information is provided in the service user guide/statement of purpose and is also available to read in the entrance of the home. The adult protection policies and procedures have been regularly updated by the registered manager and have been read by the staff employed at the home. This documentation is now very detailed and the manager has worked hard in this area to improve the information in the policy and procedure. Staff have also received adult protection training from a member of the Cornwall County Council care management team. The manager discusses adult protection regularly in staff supervision. It is recommended with a number of new staff employed that external adult protection training commences again with a view to ensuring all staff are fully updated in this important area. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people at Philiphaugh are benefiting from the recent improvements to the environment. The home is warm, clean and comfortable. EVIDENCE: Philiphaugh is well placed for the people in the home to access St Columb Major and all it’s facilities. The grounds of the home are spacious and seating is provided in a number of areas. Car parking is available in the grounds of the home. Considerable improvements are noted to the environment since the inspection of the 10th October 2006. The main lounge of the home has been decorated Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 17 and new furniture purchased with new curtains on order. It is now a light pleasant room for the people in the home and any visitors to the home to enjoy. Corridors throughout the home have been painted and a number of bedrooms improved with painting and decoration. The dining room has also been painted and would benefit further from a new carpet. The rear lounge of the home is now provided with an extractor should any person at the home wish to smoke in that area. The home employs a maintenance person for all internal and external jobs. The majority of the bedrooms are on the ground floor of the home with en suite facilities. Toilets are well placed for the communal areas. There are plans to improve the bathing facilities at the home. The laundry is provided with industrial machines and equipment such as gloves are readily available. A staff member is employed daily for these duties. The home employs cleaning staff who undertake cleaning duties on every day of the week. The home was found to be clean on the day of the inspection. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people in the home are cared for by motivated, kind and caring staff in sufficient numbers to meet the needs of those currently living in the home. Good recruitment procedures protect the vulnerable people in the home EVIDENCE: The people in the home spoken to during the course of the day expressed positive comments about the staff who care for them. It was noted that good staff and people relationships have been formed. Two surveys from people in the home were received prior to the inspection. One said “the staff are always helpful, they always come if I ring my bell. I have no complaints what so ever”. Staffing rotas inspected indicated satisfactory staffing levels for the number of people in the home with particular additional staff employed for busy times of the day. Two waking night staff are employed by the home. In addition to the care staff, housekeeping, cleaning and maintenance staff are employed. The service recognises the importance of training and is regularly providing training to all of it’s staff. This has included mental health awareness training Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 19 to all staff and dementia training. A large number of the care staff have undertaken their NVQ (2) training (70 ) and plans are in hand to update the induction training provided to new staff. The deputy manager is enrolling for her NVQ 4 qualification later in the year. The service has satisfactory recruitment procedures in place which are being followed to include the taking up of two written references and a criminal records bureau check. Seven completed staff surveys were received at the CSCI (prior to the inspection) from staff employed at the home. They all indicated very positive comments around the way they feel that the home is being run and the standard of care being delivered. Comments included: “the care home is run in a very good way and everyone works together”. “It is a very nice home to work for”. “We care to the best of our ability for our clients, we do this really well”. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 20 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 good. This judgement has been made using available evidence including a visit to this service. The people at Philiphaugh live in a well managed home. The management and staff team strive to provide a stimulating, safe environment where people are respected and rights are upheld. EVIDENCE: The registered manager is an experienced manager who has obtained her registered managers award qualification. She has worked very hard to improve standards at the home and move the home on from what had been a very difficult time. All the staff and the people in the home spoke very positively at the inspection about the registered manager. The manager Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 21 regularly attends training and this has recently included a training day on the mental capacity act. The manager is supported in her duties by a deputy manager and the registered provider who attends the home daily on a Tuesday, Wednesday and Thursday. The manager has recently updated all the policies and procedures in the home with plans for further improvements to take place. She regularly involves the staff in the home in staff meetings and regular staff supervision and appraisals are taking place. A recent quality assurance/monitoring of the home has taken place to the people in the home and their relatives/representatives. The results of the questionnaires are to be analysed by the registered provider and the manager. The results on a first read indicate very positive comments. A number of people in the home are unable to manage their finances and are therefore helped with their finances where there are no relatives/representatives to do this. A number of people in the home have their financial arrangements handled by a solicitor. The home provides facilities to keep any valuables and money safe. An audit of associated records found this process to be satisfactory. Health and safety policies and procedures are in place and a staff member has been given responsibilities in this area and received training to allow him to undertake his duties. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP7 OP19 Good Practice Recommendations To expand the pre admission assessment document to ensure that all information is included to help with care planning. To ensure that all health care assessment information is included in care planning documentation and a risk assessment where necessary developed. To replace the carpet in the dining room. Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Philiphaugh DS0000009249.V344067.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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