Inspection on 26/07/07 for Pineapple Road (9-9a)

This inspection was carried out on 26th July 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pineapple Road (9-9a) 30/09/06

Pineapple Road (9-9a) 22/02/06

Pineapple Road (9-9a) 28/11/05

Pineapple Road (9-9a) 04/11/04

Pineapple Road (9-9a) 01/07/04

Pineapple Road (9-9a) 13/01/04

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

CARE HOME ADULTS 18-65 Pineapple Road (9-9a) Amersham Bucks HP7 9JN Lead Inspector Chris Sidwell Unannounced Inspection 26th July 2007 11:00 Pineapple Road (9-9a) DS0000023051.V342269.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 Pineapple Road (9-9a) DS0000023051.V342269.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. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Pineapple Road (9-9a) Address Amersham Bucks HP7 9JN 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) 01494 765079 h3001@mencap.org.uk www.mencap.org.uk Royal Mencap Society Miss Joanna Watson Care Home 6 Category(ies) of Learning disability (6), Physical disability (1) registration, with number of places Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th September 2006 Brief Description of the Service: Pineapple Road is a home for adults with a learning disability and is managed by Mencap. The home is situated in a quiet part of Amersham not far from local shops and a walk to the town centre. There are good transport links with buses running past the end of the road and the town has a train station with main line trains and tube trains into London. The home is registered for six people, being accommodated on two floors. There are four bedrooms on the first floor and two on the ground floor. One room has an en-suite. The home has an attractive garden, which is accessible to residents, to the rear of the property. The current fees for this home are £63.95 per week. These reflect the fees paid by the resident to Mencap. Additional fees may be payable to the housing association in respect of living accommodation. Additional costs are also incurred for some travel and personal items. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three days and included an unannounced visit to the home. Prior to the visit the manager was asked to complete an annual quality assurance self-assessment, which she did and returned on time. Surveys were sent to the residents in a format appropriate to their needs and to families and healthcare professionals. Two family members returned the surveys. All six residents completed the questionnaires with some help. Information received by the Commission for Social Care Inspection since the last inspection was considered in the planning of this inspection. The residents, manager, staff and visitors were spoken to on the day of the unannounced visit. Records were examined and a tour of the building undertaken. The way in which the organisation promotes equality and diversity was considered throughout. What the service does well: There is a thorough assessment procedure and residents have the opportunity to stay at the home prior to moving to help them, and those who are supporting them, to assess whether the home can meet their needs. The diverse needs and cultural background of potential residents are considered as part of the initial assessment. Residents have a varied and active lifestyle, which reflects their interests and abilities. Residents are encouraged to visit day centres and an evening club, which helps them develop their skills and brings interest and diversion to the day. Meals are varied and residents have the opportunity to choose meals for the menus at the weekly menu-planning meeting. Residents are encouraged and supported to remain in contact with their families, which they enjoy. The staff are supportive in accompanying residents if their families live at a distance from the home. The health and personal care needs of people living at the home are met, promoting health and well being and ensuring that they receive medication in a safe and consistent manner. Complaints and adult protection are effectively managed. The views of people who live at the home are listened to reducing the risk of harm to them. The home is safe and reasonably well decorated and residents are encouraged to personalise their rooms. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 6 There are sufficient staff, who have had basic training, to meet residents’ needs in a supportive way. Recruitment procedures are thorough ensuring that residents are protected form unsuitable carers. There is a low turnover of staff and where there are vacancies, bank staff who are known to residents are used. Bank staff have the same training opportunities as permanent staff. 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. Pineapple Road (9-9a) DS0000023051.V342269.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 Pineapple Road (9-9a) DS0000023051.V342269.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There is a thorough assessment procedure and residents have the opportunity to stay at the home, prior to moving, to help them and those who are supporting them to assess whether the home can meet their needs. EVIDENCE: No new residents have moved to the home since the last inspection. The organisation has comprehensive policies and procedures in place to guide managers on the steps that they should take should a vacancy arise at the home. The manager explained this process, which would entail an initial assessment and frequent visits to the home, progressing to longer stays. During this period the home, the potential resident, their family and appropriate care managers would make an assessment as to whether the home could meet the potential residents needs. There was documentation in resident’s files to verify that this process had been undertaken for the existing residents. The documentation used for the assessment has cues, which prompt staff to consider potential residents diverse needs and cultural backgrounds. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are detailed care plans in place, which document service users’ needs and how these are to be met, within a risk assessment framework. Residents and their families have been involved in developing these care plans which reflect their wishes. EVIDENCE: The care plans are comprehensive and updated regularly. The organisation is currently implementing a more ‘person centred’ approach and has amended the care planning documentation to reflect this. The manager is gradually implementing the new documentation and has a plan to complete the transfer of the remaining care plans to the new documentation over the next three months. Two plans were looked at in detail. They contained evidence that residents’ choices are taken into account and that residents’ days are structured to help them achieve their goals. Care plans are reviewed regularly. There was evidence in the files that residents and families are involved in the reviews. The atmosphere in the home was relaxed and caring. Residents were welcomed back in the late afternoon from their day centres and were able to choose how to spend their evening. The residents who returned the Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 10 questionnaires indicated that they had a choice as to how they spend their day. The home manages service users’ money with individual bank accounts in place and individual wallets kept at the home for everyday expenses. A sample of wallets and transaction records was examined and found to be in good order, with receipts in place to explain expenditure and balances matched the records. Risk assessments are in place. The organisation has also revised the risk assessment documentation to make clear that risk is sometimes a part of everyday life and that risk assessments are a way of doing things safely and sensibly rather than only doing those things that are totally safe. The manager is introducing the new risk assessments in conjunction with the resident, their family and relevant professional supporters. There is a missing person policy in place. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents have a varied and active lifestyle, which reflects their interests and abilities. Meals are varied and residents have the opportunity to choose meals for the menus. Residents are encouraged and supported to remain in contact with their families, which they enjoy. EVIDENCE: Some of the residents were attending day services and two people were at home on the day of the unannounced visit. From care plans, daily notes and discussion with service users, there was evidence that service users attend local day services and make use of clubs in the evening. The residents spoken to said that they enjoyed the day centre and the evening club which brought interest and diversion to the day. All residents had a holiday planned and one was being supported to go abroad to stay with her father. Residents who wish to can make use of churches in the area and their spiritual needs are noted in care plans. Receipts of expenditure showed that service users use the local shops for clothes shopping, leisure activities and buying items such as toiletries and magazines. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 12 Residents are supported to take responsibility for keeping their rooms clean and tidy and participating in the general tidiness of the home. There is a choice of entertainment in the home and residents have their own hobbies. One resident said that she enjoyed her jigsaws. Another enjoys the garden and visits the local pub on occasions. Residents are encouraged to keep in contact with families. Only one family member returned the questionnaire and he said that he was happy with the care that his son received, stating that ‘residents are well looked after, in a comfortable environment, where they are reasonably free to do as they wish’. One resident is taken to London regularly to visit her family. There is a varied menu and residents contribute to the weekly menu planning. The manager is developing a picture book approach to assist those residents who cannot verbalise their wishes. There was Pizza and salad on the menu on the day of the unannounced visit. Fresh fruit is available in the dining room for residents to help themselves when they wish. There was no one requiring special meals on cultural grounds at the time of the inspection although the manager said that these could be arranged if necessary. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The health and personal care needs of people living at the home are met, promoting their health and well being and ensuring that they receive medication in a safe and consistent manner. EVIDENCE: There was evidence in the care files that resident’s healthcare needs are met. All residents are registered with a local general practitioner and visit when necessary. The local consultant specialist and learning disability team monitors their overall care. There was evidence in the files that residents have regular dental check ups and optician visits. One resident has epilepsy and there are protocols in place for summoning aid when necessary. The home does not administer rectal diazepam. One resident has had a speech therapy assessment to improve his swallowing and ensure that he receives the correct textured food. Personal support is given in resident’s rooms. There are medication management policies and procedures in place. Records showed that all staff who administer medication have received training. The home uses a dosette system with is overseen by the pharmacist. Medication entering and leaving the home is recorded. The medication administration charts were completed accurately. The home does not hold any stocks of Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 14 controlled drugs. No residents self medicate although there are policies and procedures in place should any one wish and be able to do so. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Complaints and adult protection are effectively managed. The views of people who live at the home are listened to reducing the risk of harm to them. EVIDENCE: There is a complaints procedure in place, which contains the contact details of the Commission for Social Care Inspection. The family member who returned the questionnaire said that he was aware of how to make a complaint although he had not had to do so. He felt that the home was responsive should he have to raise anything with the manager. The Commission for Social Care Inspection has not been notified about nor received any complaints since the last inspection. The home has policies in place to respond to safeguarding allegations and staff have received Protection of Vulnerable Adults training. The Commission for Social Care Inspection has not been notified of any allegations, which are being investigated by the local authority. Service user-friendly versions of the complaints procedure and what abuse is and what to do about it are in the service users guide. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is safe and reasonably well maintained although the communal areas and some rooms would benefit from redecoration, if residents are to live in a cheerful and well-decorated environment. EVIDENCE: The home is situated in a residential street and is in keeping with the local environment. It stands out slightly as the waste bins, including the yellow clinical waste bin, and recycling bins are situated at the front of the building, drawing attention to the clinical needs of the residents and giving the home an institutional look. A tour of the building was undertaken. The home was clean and tidy on the day of the inspection and there were no offensive odours. A new bathroom has been installed since the last inspection. The hallways and the carpets were dull and dingy and in need of redecoration. Window restrictors are in place and radiators have low temperature surfaces. All rooms are single and residents have personalised their rooms with their own belongings and pictures. There is an attractive garden, which is accessible to residents. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 17 There are control of infection policies and procedures in place. There were no offensive odours in the home. The laundry was clean and tidy on the day of the unannounced inspection. The kitchen was clean although the work surface was in poor condition and worn and permeable in places, posing a food hygiene risk. This must be addressed. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient staff, who have had basic training, to meet residents’ needs in a supportive way. Recruitment procedures are thorough ensuring that residents are protected form unsuitable carers. Care staff should be supported to gain National Vocational Qualifications in Care to raise the standard of training within the home and give carers greater knowledge and skills to support residents to achieve their goals. EVIDENCE: The level of training has improved since the last inspection. Mandatory training has been improved and all staff have had basic mandatory training in safe working practices and medication administration. Sufficient staff have had first aid training to have a first aider on duty on each shift. Thirty percent of staff hold the National Vocational Qualifications in Care at level 2 or above. The manager said that she had been told that there was insufficient funding for more staff to undertake this training at present. The home does not meet the standard that fifty percent of staff hold this qualification and neither is there a plan at present to move towards meeting this. This should be addressed. The staffing levels have improved since the last inspection. There is now a carer on duty at all times, which gives greater flexibility to residents. There Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 19 are two people on duty when residents are at home which gives some residents the opportunity to go out, while others may wish to stay at home. The need for agency staff has reduced and the home uses the organisation’s own bank staff, who have the same training opportunities and supervision as permanent staff. The staff team reflect the gender composition of the residents and residents or their families can choose same gender carers if they wish. There was evidence that regular staff meetings are held and the staff spoken to said that they felt involved in the home and that their views were respected. The files of two recently recruited members of staff were examined. They contained documentation to verify that staff had completed an application form, which showed their work history. All staff had been interviewed and interview records had been kept. Two references and a Criminal Records Bureau disclosure had been sought before the staff member had started work. Staff had commenced a ‘Skills for Care’ accredited induction programme. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management arrangements are satisfactory and there is a good quality assurance system in place to ensure that the service continuously improves and is responsive to residents and families needs. EVIDENCE: The registered manager is on secondment to the organisation’s training team and has been replaced by an acting manager. She has experience of caring for people with learning difficulties and is in the process of registering with The Commission for Social Care Inspection. She holds the National Vocational Qualifications (NVQ) in Care at level 3 and is considering starting the Registered Managers Award (NVQ at Level 4). She has a job description and the lines of accountability are clear within the home and within the organisation. There are quality assurance systems in place to regularly review the quality of care. The organisation has developed a family charter in partnership with Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 21 residents and their families, which aims to involve families and residents in the quality of care offered. The family charter is available in an accessible format for residents. A satisfaction survey has been sent to all families. The results are awaited and the manager said that when they are received they will be collated and an action plan developed. There is also an ongoing computerised quality-monitoring programme, which is monitored by the operational managers on a regular basis. An operational manager visits the home on a monthly basis and reports of these visits are kept on file. Action has been taken to address the requirement of previous inspection reports in a timely manner. There are health and safety policies and procedures in place. Fire safety records are maintained with evidence of regular checks being undertaken and a satisfactory fire officer’s report in 2006. Staff were up-to-date with health and safety related training such as moving and handling, first aid and food handling. The accident records showed a very low incidence of injury at the home. Records were in place to show that equipment is routinely serviced and certificates verified gas and electrical safety at the home. Staff were routinely checking fridge and freezer temperatures and hot water temperature. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 2 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Pineapple Road (9-9a) DS0000023051.V342269.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. 1 Standard YA30 Regulation 13(3) Requirement The permeable surface of the kitchen worktops should be replaced to minimise the risk of infection to residents. Timescale for action 31/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA24 YA24 YA32 Good Practice Recommendations An ongoing programme of redecoration should be undertaken to improve the communal areas of the home. The waste bins should be stored discretely to reduce the institutionalised appearance of the home externally. Care staff should be supported to gain the National Vocational Qualifications in Care at level 2 or above. Pineapple Road (9-9a) DS0000023051.V342269.R01.S.doc Version 5.2 Page 24 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 Pineapple Road (9-9a) DS0000023051.V342269.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. 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