Inspection on 14/04/05 for Pinebeach

This inspection was carried out on 14th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Pinebeach 30/07/07

Pinebeach 07/11/06

Pinebeach 08/05/06

Pinebeach 21/11/05

Pinebeach 02/12/04

Pinebeach 02/07/04

Pinebeach 03/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Pinebeach 53 Southcliffe Road Friars Cliff Christchurch BH23 4EW Lead Inspector Jo Palmer Announced 14 April 2005 10:00 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 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. Pinebeach Version 1.10 Page 3 SERVICE INFORMATION Name of service Pinebeach Address 53 Southcliffe Road, Friars Cliff, Christchurch, Dorset, BH23 4EW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01425 273122 01425 277876 Lifecaring Holdings Ltd Mrs Mary Ann Price Care Home with Nursing (N) 36 Category(ies) of OP - 36 registration, with number of places Pinebeach Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 02 December 2004 Brief Description of the Service: Pinebeach is located opposite the sea and beach at Friars Cliff near Mudeford. The lounge, library and some of the rooms have sea views. The building has a lower ground floor. The laundry, kitchen, boiler room, registered person’s office and staff facilities are located on this floor. The ground floor comprises of dining area and annexe, lounge, library, managers office, service user bedrooms, sluice room, communal bathrooms and toilets. The first floor comprises of service user bedrooms, a sluice room and communal toilets and bathrooms/shower rooms. There is level access throughout the floors and access by passenger lift to all floors. The outside area has two large wooden benches facing the sea, in the summer months additional garden furniture is put out that includes tables, chairs and parasol. The garden attracts wildlife, particularly birds. There is off road parking for staff and visitors. Pinebeach Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection on 14th April lasted for five hours. Mary Price, the registered manager and Mr Dedman, Responsible Individual for Lifecaring Holdings Ltd were present. The last inspection of Pinebeach identified a number of requirements; the purpose of this inspection visit was to monitor progress in addressing those requirements and to review practices in relation to some of the National Minimum Standards. Where requirements have not been addressed, these are repeated but this inspection concentrated on the outcomes of care and services for residents, measuring against some of the standards. The inspector spoke with five residents, one relative, a care assistant, one trained nurse, the manager and Mr Dedman, took a tour of the home and examined relevant records. Although registered to accommodate 36 people, there were 21 residents living at the home. What the service does well: The Service User Guide provides sufficient information about the home to enable people to make a choice as to whether the home may suit them. Choice is also supported by the opportunity for people to visit the home before agreeing to move in. Resident’s physical wellbeing is maintained by regular contact with their doctors and other health professionals they may need to see. Options for recreational and leisure activities depend on individual choice and the person’s capabilities, support is given for people to remain in contact with their friends and family. A good choice of menu provides residents with options for their meals, which they are able to take in the home’s dining area or in their own rooms if they choose. Residents are able to voice their concerns or complaints which staff agree to manage with sensitivity until the resident is satisfied the problem has been resolved. Pinebeach is a comfortable, clean home where people living there have sufficient space in their rooms for some of their personal belongings and any equipment they may need such as a wheelchair or hoist. Pinebeach Version 1.10 Page 6 Currently there are less residents living at the home than it has room for, the number of staff is therefore adequate to meet resident’s needs and Mr Dedman and Ms Price make certain that staff are only employed following proper selection. What has improved since the last inspection? What they could do better: Before people agree to move to the home, their care and welfare needs must be carefully assessed so that both they, and staff at the home can be sure that their needs can be met. Where able, they must play a part in the assessment to make sure that they agree with the decisions made about what they need from the home. New residents must have their care and welfare needs written into a plan of care that gives staff instructions on how those needs are to be met. These plans of care must be continuously reviewed to make sure they keep pace with the changing needs of residents. Care plans and records of care must show how the resident has been able to make decisions about their own lives in the home and how they want to maintain contact with family, friends and the local community. Resident’s safety in relation to any risks posed by unguarded radiators must be assessed. Safety needs must continue to be incorporated into care plans to detail how any risks can be reduced. To ensure the safety of residents is maintained, the registered persons need to address the recommendations made by the occupational therapist in her report on the home. Training must be provided to staff (eg. Induction, Foundation and NVQ level 2) to make certain that they are knowledgeable, and capable and can provide high quality care for all residents. The registered persons must set up a quality monitoring system that makes sure the views of people living at the home are taken into consideration when planning changes or improvements. The management of the home must be more accountable, in Mr Dedman’s absence, Ms Price must have access to all the home’s records as required by regulation. Pinebeach Version 1.10 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pinebeach Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Pinebeach Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 5 The home’s Statement of Purpose and Service User Guide provide detailed information about the care and services provided at Pinebeach. The admissions process is inconsistent and does not always enable the home to thoroughly assess a persons needs or establish whether those needs can be met at Pinebeach although where able, residents can visit the home prior to moving in on a trial basis. EVIDENCE: Residents spoken with who were newly admitted to the home, confirmed they had sufficient information about the services to enable them to make an informed choice about moving to Pinebeach. A copy of the home’s Service User Guide, which contains a summary of the Statement of Purpose was available to residents in their rooms. Examination of resident care files showed that usually a senior member of staff carries out a pre-admission assessment. Where persons are assisted with moving to the home by social services, a summary of the social services care assessment is usually received. In one instance however, it was noted that the Pinebeach Version 1.10 Page 10 resident was admitted to the home on the day before the care assessment was carried out. This resulted in the person moving to Pinebeach with no assessment of care and welfare needs and no knowledge of whether the home was able to meet them. Ms Price confirmed that on admission, the resident goes through a period of on-going assessment for up to four weeks prior to a care plan being established. Of those assessments that were carried out, they were noted to detail all the person’s health and welfare needs. Three residents who had recently moved to the home confirmed that they were able to visit prior to making arrangement to move in, one stated that he was ‘on probation’ referring to a trial period before agreeing to a permanent contract. Pinebeach Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 & 10 Systems for resident consultation and participation in the assessment and care planning process are inconsistent. Resident’s health and welfare needs are acknowledged in individual plans of care where the resident has lived at the home for an assessment period. Care delivery is unplanned where residents are new to the home. Resident’s health needs are met through visits to doctors and other health professionals as required. There are satisfactory arrangements for managing medication in the interests of residents. Residents are respected and their right to privacy is supported. EVIDENCE: Of those assessments seen, there was no evidence of resident consultation and no record of where the information had been obtained. Similarly, care plans did not evidence the resident’s agreement with the outcome or method of planned care delivery. For those residents who had recently been admitted to the care home, there were no plans of care. Ms Price confirmed that the care plan Pinebeach Version 1.10 Page 12 would be written following approximately a four-week period of assessment from the admission date. Whilst it is acknowledged that an extended assessment period is often necessary to determine specific aspects of care need in relation to living in the home, a basic plan of care is essential to safeguard the interests of the resident. A resident who is wheelchair dependent for instance would have specific, immediate needs in relation to moving and handling and to pressure relief which must be planned for in care schedules. Five comment cards were returned from residents on which they had indicated their satisfaction with the care received, one relative also returned a card stating ‘we are very pleased with the care (our relative) receives’. Records seen demonstrated each resident’s contact with other health care professionals as required such as GPs, chiropodist, optician and dentist. Examination of stocks and records relating to medication management demonstrate that correct procedures are used. Residents spoken with confirmed that they are treated respectfully, one stating that it ‘couldn’t be better’, referring to the quality of his private life in the home. This resident also confirmed that he is able to make choices with regard to his everyday routine and activities. One resident raised some concerns about a member of staff who she felt was intrusive although said her concerns were not sufficient to raise a formal complaint. One comment card returned from a relative stated that two members of staff ‘tease the patients and don’t know when to stop’. These matters were discussed with Mr Dedman and Ms Price who confirmed that appropriate action would be taken and have, since the inspection, confirmed that the staff member concerned has been dismissed from employment. Pinebeach Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Social, cultural, and recreational activities are dependent on individual preferences and the resident’s capacity for involvement. Residents are supported in maintaining contact with their friends, family and the local community and in making decisions about their lives in the home; this is not however, always documented. A good, wholesome, varied diet is provided offering a choice of menu. EVIDENCE: Daily care records established the extent to which each resident participates in activities, whether independently or arranged and supported by staff. Records also show frequent visits by friends and families; one returned comment card from a relative stated ‘I can visit at any time’. Care records do not indicate the resident’s involvement in decision-making processes with regard to social care assessments. Residents spoken with confirmed that they occupy their time in a manner that suits them, some choosing to stay in their rooms for meals and during the day with books, television/radio for company whilst others choose to spend time in the home’s communal areas with other residents for company. Some residents retain a high degree of independence and are able to come and go as they please. Pinebeach Version 1.10 Page 14 Residents spoken with confirmed that the provision of meals was good and that there was a choice of menu although several confirmed that they often forget the choices they have made. Each resident spoken with however stated that the food is always appetising and well presented. Pinebeach Version 1.10 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 A written complaints procedure leaves residents in no doubt that steps will be taken to deal with any complaint or concern they may have. EVIDENCE: Five comment cards were returned from relatives, all indicating that they were aware of the home’s complaints procedure. Of six comment cards returned from residents five stated that they would know who to talk to if they had any concerns. Ms Price confirmed that no complaints had been received. One resident raised some concerns about a member of staff; this resident stated that she was sure her concerns would be listened to although did not want to raise it as a complaint with the manager but agreed to the issue being discussed during the inspection. Ms Price gave assurances that the concerns would be dealt with sensitively and the resident would be kept informed and included, where appropriate in resolving the issues. Pinebeach Version 1.10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 21, 22, 23, 24, 25 On-going investment in the interior décor has improved the appearance of the home creating a better environment for those living there and visiting. Residents live in a comfortable, clean environment with their own belongings around them although risks posed by unguarded radiators compromise their safety. Bedrooms, bathrooms and communal areas provide sufficient room for residents. EVIDENCE: There was evidence of continued improvements to the interior décor of the home, the hallways and corridors have been decorated and re-carpeted and resident rooms are decorated as they become vacant. Much of the furnishings in resident’s bedrooms have been replaced, rooms now provide clean, modern wardrobe and cupboard units with lockable storage space. Residents are able however, if they wish, to bring in items of their own furnishings subject to suitability. Pinebeach Version 1.10 Page 17 Exposed pipe-work and radiators are not all guarded. Mr Dedman confirmed that four radiators have been guarded and the remainder will be done as rooms become vacant and are decorated. Some resident care files held risk assessments and identified corrective action necessary to prevent the risks of accidental scalding; some care files did not have such assessments. An assessment of the premises by an occupational therapist has been carried out to assess the need for aids and adaptations. Several recommendations were made as a result of this assessment; Mr Dedman and Ms Price confirmed that they were being acted upon as part of the on-going decoration and refurbishment of the home. A relative stated on a returned comment card that ‘the laundering of clothes could be better’. The laundry service was not inspected although residents spoken with confirmed that they had not experienced any difficulties with having clothing taken for, or returned from, the laundry. Pinebeach Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 & 30 The deployment and number of available staff is sufficient to meet the needs of the residents. Procedures for the recruitment of staff are robust. Limited progress has been made in ensuring that staff are equipped with the skills necessary to meet assessed need. EVIDENCE: For the current number of residents living at the home, there were sufficient numbers of staff on duty. Six comment cards were returned from resident’s relatives, of these four stated that they thought there were sufficient numbers of staff on duty, two did not. Three cards returned from health care professionals and a social worker confirmed that there is always a senior member of staff on duty to confer with. One comment card returned from a relative stated that ‘at times there appears to be too many agency staff on duty, insufficiently trained’. Ms Price confirmed that with the numbers of residents accommodated currently reduced to 21, no agency staff have been used. Mr Dedman confirmed that he is actively recruiting staff although has been disappointed by the small numbers of applicants. Employment records seen for staff show that recruitment procedures are in place that include appropriate screening to ensure the employee’s suitability. Pinebeach Version 1.10 Page 19 Four care staff (23 ) have attained level 2 NVQ, one of these is currently undertaking level 3. A further three staff are undertaking the level 2 NVQ qualification which will give a total of 41 of care staff trained to National Occupational Standards. The registered persons are advised to look at the Skills for Care (formerly TOPSS) web site at www.skillsforcare.org.uk for information on available training and funding opportunities* Mr Dedman has engaged the services of a local training provider who has confirmed that courses run are done so in accordance with the requirements of the National Training Organisation occupational standards for moving and handling, food hygiene, infection control, emergency aid and health and safety. These courses are available to all staff and a training matrix examined evidenced that most staff have undertaken this statutory training. However, these courses make up only part of the standards expected of induction and foundation training which must be provided by the home, induction in the first six weeks of employment and foundation in the first six months. *The registered persons are reminded that from February 1st 2005, National Occupational Standards and content and structure of NVQ training have changed. Pinebeach Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 37 & 38 The management arrangements of the home support good care practices for residents. Organisation of some administrative tasks and quality monitoring systems need to be better defined to ensure residents benefit from an efficient administration. Fire precautions and fire training for staff promotes resident safety. EVIDENCE: Mr Dedman and Ms Price manage the home. Mr Dedman deals with most of the home’s management and administrative duties whilst Ms Price manages resident care issues and staff supervision. When Ms Price has days off duty, a reliable senior is on duty who takes responsibility for the home. When Mr Dedman takes days off, there is no administrative support or back up and Ms Price does not have access to all the home’s records and paper-work that are kept in Mr Dedman’s office. Pinebeach Version 1.10 Page 21 Questionnaires are contained in the Service User Guide for residents to complete, Mr Dedman confirmed that only a few have been returned which he has not yet audited. There are no other methods of auditing or monitoring care practice and services at Pinebeach to ensure they are in line with the home’s expressed Statement of Purpose and there is no development plan. Ms Price carries out an audit of accidents in the home in order to recognise any patterns or recurrences. The last inspection reported that Ms Price said she was also due to undertake an audit of medication usage in the home, this has not been done. Ms Price confirmed that the home does not take responsibility for any resident’s personal allowances, money or valuables; each resident has representation if needed in this respect by a family member or appointed person. Records required by regulation are up to date and accurate although attention is required to ensure care assessments and care plans are up to date and reflect the changing needs of residents. Access by residents to their personal records and information was not assessed. Procedures for maintaining the fire precautions in the home are satisfactory and other policies are in place ensuring staff awareness of infection control, accident reporting, health and safety and food hygiene procedures. The health and welfare of residents must be protected in relation to the risk of accidental scalding from unguarded radiators in the home. Pinebeach Version 1.10 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 1 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 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 3 x 3 3 3 3 1 x STAFFING Standard No Score 27 3 28 1 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 2 1 x 3 x 2 3 Pinebeach Version 1.10 Page 23 yes 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 3 Regulation 14 Requirement Accommodation must not be provided to persons at the care home until their needs have been assessed; assessments must be comprehensive and provide sufficient detail to enable staff at the home to understand the needs that are to be met. All service users must have an individual plan of care, based on assessed need that must be followed in order that care needs can be met and risks reduced or eliminated. Service users must be consulted with regard to decsion making prosesses of assessment and care planning. All service users must have an assessment in relation to the risks of accidental scalding posed by unguarded pipe-work and radiators. In the absence of risk assessments all pipe-work and radiators must be guarded or have guaranteed low surface temperatures. A minimum of 50 of care staff must be trained to NVQ level 2 with evidence of core and optional National Occupational Standards being attained Version 1.10 Timescale for action 30 June 2005 2. 7 15 30 June 2005 3. 25 13 30 June 2005 4. 28 18 31 December 2005 Pinebeach Page 24 5. 30 18 6. 33 24 7. 33 26 The registered person must ensure and be able to evidence that the training provided for all staff meets NTO specification. All members of staff must receive induction training to NTO specification within six weeks of appointment to their posts, and Foundation training within the first six months of appointment, which equips them to meet the assessed needs of the service users accommodated as defined in their individual plan of care. Effective quality assurance and quality monitoring systems, based on seeking views of serviceusers, must be in place to measure the success in meeting the aims, objectives and statement of purpose of the home. The responsible individual for Lifecaring Holdings Ltd, Mr Dedman, must visit the home each month specifically for the purpose of reporting on the conduct of the home, a copy of the report of this visit must be made available to other of the directors, the registered manager and to the Commission. In the absence of the responsible individual, management accountability must rest with the registered manager who must have access to all records required by regulation in order to effectivley manage home. 30 June 2005 31 August 2005 30 June 2005 Pinebeach Version 1.10 Page 25 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 Pinebeach Version 1.10 Page 26 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 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 Pinebeach Version 1.10 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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