Inspection on 09/02/06 for Primrose House

This inspection was carried out on 9th February 2006.

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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Primrose House 18/06/08

Primrose House 03/07/07

Primrose House 27/06/06

Primrose House 28/06/05

Primrose House 25/11/04

Primrose House 20/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Primrose House 2 Moor View Western Road Ivybridge Devon PL21 9AW Lead Inspector Wendy Baines Unannounced Inspection 9th February 2006 9.30 Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Primrose House Address 2 Moor View Western Road Ivybridge Devon PL21 9AW 01752 894222 NONE 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) Mrs C A Nurse Mrs C A Nurse Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2005 Brief Description of the Service: Primrose House is a small care home registered for five younger adults with a learning disability. The home provides a service primarily for people with autism and Aspergers syndrome. The emphasis is on a homely atmosphere where service users can be as independent as possible while being supported within a safe and caring environment. Service users are included in the daily domestic routine of the home and are encouraged and supported to voice and express their views and concerns. Primrose House is a large terraced house in the centre of Ivybridge village, which is located ten miles to the east of central Plymouth. Service users accommodation is spread over two floors. The home does not have appropriate facilities for potential service users with significant physical disabilities. The house has a large garden to the rear. The location of the home allows service users to walk to local shops and amenities and enjoy a lifestyle that minimises restrictions but provides support and guidance as necessary. The registered provider, Mrs Cheryl Nurse, has owned and managed the home for the past eight years. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place on the 9th February 2006, between 9.30am and 2.30pm. The Inspector was able to meet with the Registered Manager, Mrs Cheryl Nurse, the staff and four of the service users who currently live in the home. Much of the day was spent talking to service users about their life in the home and the local community, and observing staff who provide the support and care. A tour of the premises took place and a sample of records relating to service users and the home were inspected. The atmosphere of the home was warm and welcoming. Discussion took place with the Registered Manager and owner of the home for the need to ensure that Records, Policies and Procedures in the home are reviewed and developed as required in previous inspections. These records and systems will ensure the safety of service users and further improve the quality of the service provided. What the service does well: Primrose House is a small care home situated within the close-knit community of Ivybridge in the South Hams. The location of the home allows service users who wish to develop their skills and independence to access facilities in the community with minimal support from staff. Some service users attend day services, which are within walking distance of the home and all service users use local shops and leisure facilities. Service users are all of a similar age and are encouraged and supported to lead and enjoy an active and fulfilled lifestyle. Staff have a good awareness of service users rights and work hard to support and encourage them to make choices about their daily routines. Due to the small size of the home the staff are able to monitor any changes in service users health and make relevant referrals and contact with specialist health services when required. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 6 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. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Information regarding the home is available to current and prospective service users, however this information has not been produced in a format accessible to all those currently receiving a service. EVIDENCE: A Statement of Purpose and service user guide have been combined into one document. This is available to existing and prospective service users. The information does not include all the points as listed in standard 1 (Care Homes Standards 2000) and needs to include; Age range of service users, details of specific facilities/services provided and details of the staff working in the home. This information should also be made available in a format appropriate to each service user, using signs, symbols and photographs where necessary. The home has had no new admissions since the last inspection. The Registered Manager confirmed that in the event of a new admission a Pre-admission assessment would be completed with arrangements for visits to the home when possible. Local Authority contracts were available on service users files and a contract of Terms and Conditions had been completed between the home and service user. This information should be agreed and signed by the service user and/or their representative. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10. The staff in the home encourage and support service users to make choices and decisions about their lifestyle and care. Although service users have care plans, there is no clear or consistent system in place to ensure that this information is regularly reviewed. EVIDENCE: A sample of service users records and care plans were seen during the inspection. Since the last inspection the home has started to develop service user plans to include; medium and long- term goals and guidelines for staff on how to support service users with these identified areas of need. The care plans did not cover all aspects of Personal, social support and healthcare needs as set out in standard 2 (Care homes standards) and did not evidence a clear process for reviewing this information. Observation throughout the inspection confirmed that service users are encouraged and supported to make choices and decisions about their day-to day life and staff offer guidance and support where necessary. Discussion with service users and staff confirmed that some restrictions are in place regarding service users choice to partake in certain activities. It was Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 10 evident that the reasons for these restrictions had been discussed and agreed between the home and service user. However, this information was not documented and did not show that other agencies/representatives had been consulted or that these restrictions would be reviewed. Service user files contained some risk assessments specific to individuals and activities. However, risk assessments had not been completed for all areas of care inside and outside the home and there was not a clear process for reviewing this information. Service users are encouraged to manage their finances as much as is possible. All service users have a bank account and a record is kept by the home of all expenditure. The proprietor is the Appointee for one service user. Service users files are kept locked away. The Registered Manager said that plans were in place for an extension to the home, which would include a staff office. This arrangement would be beneficial to the home and would improve the confidentiality and privacy of service users information. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17. Service users are encouraged and supported to develop their skills and independence. They can enjoy a range of stimulating activities inside and outside the home. EVIDENCE: Primrose House is located within easy access to the shops and facilities in the small community of Ivybridge. Most of the service users currently living in the home are able to access opportunities outside the home with minimal support. During the inspection service users were observed organising themselves for the day and were reassured by staff regarding these arrangements when necessary. Some service users attend local day centres and colleges, and all use the local shops and leisure facilities. Each service user has their own interests and things that they like to do. These include; shopping, swimming, cycling and visiting family and friends. Staff spoken to said that there were no restrictions regarding visitors although everyone would be expected to consider the rights of everyone in the home when making these arrangements. Service users spoke to the inspector about visits home to see family, and staff recognised the importance of supporting and maintaining these contacts. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 12 The Registered Manager and staff are very aware of the rights of service users and promote their decision- making skills with regard to financial and other personal matters. Service users bedrooms have locks and individuals are able to choose whether they want to spend time alone or in the company of others. One service user spoken to said that he was ‘ able to be private but could go out and use the local shops whenever he wanted’. Service users participate in activities individually and are also able to choose an outing with the other service users at the weekend. Service users are encouraged to develop their daily living and social skills. During the inspection service users were observed using the kitchen area to prepare snacks and drinks for themselves and others. Main meals are provided by staff with flexibility in the times and choice of meals. Service user records confirmed that the home monitors closely any specific dietary needs and makes relevant referrals if there are concerns about a service users diet or weight. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,21. Service users are provided with personal and healthcare support appropriate to their needs. EVIDENCE: Service users are independent in their personal care, although they may need prompts and guidance regarding personal hygiene. Service users choose their own daily routine, shop for their own clothing and make their own decisions regarding their appearance. Staff will give advice and assistance when asked. Daily records confirmed that service users are supported and encouraged to attend routine health checks such as the opticians and dentist. Health needs are documented in individual files, however the Registered Manager should ensure that this information is well organised and clear to ensure that it is easily accessible to those providing care and can be regularly reviewed. Health needs are monitored and referrals made to specialist health services when necessary. It was evident that the Registered manager and staff have Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 14 worked tirelessly over the past 18 months to access support for a service user who’s health had deteriorated and they believed required specialist health input. The home has continued to liaise with GPs, Social Services and the specialist Learning Disability/Mental Health services to ensure the best outcome for this individual. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. The home does not have sufficient policies and procedures in place relating to behaviour/aggression by a service user to ensure the safety of the individual or staff. EVIDENCE: Staff spoken to were aware of different forms of abuse but had not received sufficient training in this area of care. It is recommended that the Proprietor and care staff attend the multi-agency adult protection training. Discussion and observation confirmed that some service users behaviour could be unpredictable and at times aggressive towards themselves or others. Service user files contained limited information relating to these behaviours and staff spoken to were not aware of any agreed guidelines for managing these situations. The home had written policies and procedures relating to service users money and all financial records were found to be in good order and kept safe. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30. Service users live in a safe, comfortable and well- furnished home. EVIDENCE: The house is bright and spacious, and room sizes are adequate for the number of service users accommodated. There is an attractive garden and patio area at the rear, which is used during the summer for BBQs. All service users rooms were seen and these were decorated to reflect individual taste and personality. Locks were provided on bedroom doors. The main bathroom and toilet were found to be clean and in good order. These had been fitted with locks to ensure privacy, but the locks are of a type that cannot be overridden from the outside in the event of an emergency. Staff use the lounge area for ‘sleeping-in’ duty, which could restrict service users use of this room during the night. The Registered Manager said that building work has started to extend the kitchen area and create an office/ sleeping-in room for staff. The communal parts of the house were found to be clean and hygienic. Staff said that some of the service users choose to clean their own rooms independently. The Registered provider should ensure that service users have the skills to complete these tasks and that standards of hygiene in service users bedrooms are safe and appropriate. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 17 Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,35,36. Although staff have a good understanding of service users needs, staffing are not always sufficient in number to ensure the safety of everyone in the home if a serious incident should arise. EVIDENCE: The staff team consists of the Proprietor and five support workers. There is usually one member of staff on duty at any one time, with two on duty on Saturdays when service users go out on outings or are at home. The staff spoken to had a good understanding of service users needs and were very aware of their daily routines. Staff had a good rapport with service users and were observed treating them with respect and dignity at all times. The staff spoken to demonstrated some uncertainty about dealing with difficult situations when working alone. On the day of the inspection there was one staff member on duty with three service users at home during the day. Discussion with staff members, observation and incidents recorded in records suggested that one staff member is not always sufficient to meet service users needs, particularly if a difficult incident should arise. Although the Registered Manager lives close by and is on-call there are no written procedures for lone working. The Registered Manager said that there are training records detailing the training that staff have undertaken. This was not available in the home. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 19 Two support staff are qualified to NVQ Level 2. Only one member of staff holds a current first aid certificate. Staff spoken to said that they have had some opportunities to attend one- day training courses such as ‘ Autism and Aspergers awareness’. It was not evident if the home had a rolling programme for training or if training needs are updated to ensure that staff have the skills to meet the needs of new service users moving into the home. The Registered Provider monitors staff practice on a day-to-day basis. Staff have a handover between shifts when any issues arising are discussed. There is no formal, recorded individual supervision between the Registered provider and individual staff members. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,40,41,42. Service users and staff have open access to the Proprietor who provides and informal style of management. Service users live in an environment where most health and safety standards are satisfactory, but safe- working practices must be maintained by adequate risk assessments, policies/procedures, record keeping and staff training. EVIDENCE: Primrose House is a small care home, which is owned and managed by Mrs Cheryl Nurse. Mrs Nurse has a nursing qualification and has had many years experience of working with people with a Learning Disability, particularly Autistic Spectrum Disorders. Mrs Nurse does not as yet hold the Registered Managers award, or an equivalent management qualification. Throughout the inspection service users were observed as being comfortable and relaxed within their home and were able to go about their daily routines independently or with help from staff when requested. The staff members spoken to were aware of each individuals needs and were keen to discuss ways of improving practice and ensuring the best lifestyle for service users. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 21 The Registered Manager and staff have demonstrated that they are prepared to go to great lengths to ensure that the service users in their care receive the correct services particularly relating to health issues. Since the last inspection the home have started to develop the care plan process. The Registered Provider should review all of the homes records, policies and procedures to ensure that the information available can be easily accessed and understood by those providing care. There should also be policies and procedures for Lone Working and agreed guidelines for staff to manage episodes of difficult/aggressive behaviour. As staff are lone workers, it is essential that all staff receive training in first aid. There must be a staff member qualified in first aid on the premises at all times. There are no covers on radiators, no restrictors on hot water outlets or restriction of first floor window openings. Risk assessments were not available regarding these areas of Health and Safety. Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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 2 2 3 3 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 2 29 x 30 2 STAFFING Standard No Score 31 x 32 2 33 2 34 x 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 3 2 3 LIFESTYLES Standard No Score 11 3 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 x 3 2 3 x 2 2 2 x Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 23 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 YA9 Regulation 13 Requirement Timescale for action 21/05/06 2. YA22 13/37 The Registered Provider must evidence a clear systematic process for reviewing risk assessments. 21/05/06 The Registered provider must ensure that staff are aware of any agreed guidelines to manage episodes of difficult behaviour that may be displayed by a service user. The Registered provider must ensure that all staff have the necessary training and support to ensure that they understand the behaviours and understand the guidelines that have been agreed. The Registered provider must report to CSCI any incident which; involves an injury or which adversely affects the well being of a service user in the home. The Registered Provider must review the staffing levels in the home. There must be a sufficient number of staff to meet the DS0000003780.V262496.R01.S.doc 3. YA33 12 21/05/06 Primrose House Version 5.1 Page 24 assessed care needs and ensure the safety of all those living in the home. The Registered Provider must ensure that there are adequate staffing levels in the morning and evening and on occasions when all service users are in the home. 4. YA35 18 The Registered Provider must 21/06/06 ensure that staff working in the home have the skills required to meet service users needs at all times. The home must have a written training and development plan for the staff team. This information must be kept in the home and made available for inspection. 21/05/06 The Registered Manager must review the homes record keeping procedures to ensure that the information can be accessed and understood by those providing care. The homes Policies and Procedures must be reviewed to ensure they are appropriate to the home and should include; Procedures for Lone working Dealing with Aggression by a Service user. There must always be a member 21/06/06 of staff with First training on each shift. The Registered Provider must complete risk assessments for the need for Window restrictors, Water temperature valves and radiator covers. 5. YA40 17 6. YA42 13 Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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. 1. Refer to Standard YA1 Good Practice Recommendations The Statement of Purpose should be extended to include more details information about the services provided, Age range of service users and details of staff. This information should be provided in a format accessible to current and prospective service users. The Statement of Terms and conditions between the home and the service user should be signed by both parties and/or the service users representative. Service user plans should be extended to include all areas of Personal, social and healthcare needs as listed in Standard 1(Care Homes Standards) There should also be a clear process for regularly reviewing this information. Toilets and bathrooms should be fitted with locks that can be overridden from the outside to allow access in the event of an emergency. The home should explore options to provide sleeping in staff with a facility that is separate from the service users communal space. The Registered Provider should ensure that service users who wish to clean their bedrooms independently have the skills to do so, and that standards of hygiene and cleanliness are monitored to ensure they are safe and acceptable. A system of regular, recorded, one to one, staff supervision meetings should be developed and implemented. The proprietor should obtain the registered managers award. The proprietor and staff should attend the Multi-agency adult protection training. 2. 3. YA2 YA6 4. 5. 6. YA27 YA28 YA30 7. 8. 9. YA36 YA37 YA23 Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Primrose House DS0000003780.V262496.R01.S.doc Version 5.1 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. 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