Inspection on 01/05/07 for Quince House

This inspection was carried out on 1st May 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Quince House 13/05/10

Quince House 03/02/10

Quince House 01/12/09

Quince House 08/04/09

Quince House 01/06/06

Quince House 12/10/05

Quince House 06/07/05

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Quince House 77 Adeyfield Road Hemel Hempstead Herts HP2 5DZ Lead Inspector Mrs Alison Butler Unannounced Inspection 1st May 2007 10:00 Quince House DS0000061600.V338547.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 Quince House DS0000061600.V338547.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. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Quince House Address 77 Adeyfield Road Hemel Hempstead Herts HP2 5DZ 01442 248316 01582 840023 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) Complete Care Services Limited Angela Rankin Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th December 2006 Brief Description of the Service: Quince House is a care home providing personal care and accommodation for six younger adults with learning disabilities. It provides a specialist environment for people with ASD (autistic spectrum disorder) and associated challenging behaviour. The home was opened in September 2004. It is owned by Complete Care Services Limited. The home is located in a residential area of Hemel Hempstead. It is a two storey detached family house, indistinguishable from the neighbouring properties. All the community services are within easy reach. The home has its own vehicle and it is close to the town centre. All the home’s bedrooms are single, and five have en-suite facilities. One bedroom is on the ground floor, and would be accessible for any service user with mobility difficulties. The home has an enclosed garden, a patio area, lawn and flowerbeds. There is off street parking at the front of the house. The Statement of Purpose and Service Users Guide provide information about the home for referring social workers and prospective clients. The current charge is £1800.00per week. This is correct as of 01/05/07. For up to date information on fees contact should be made direct to the home. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted with the manager and staff on duty. Time was spent talking with the people who live at Quince House, examining records and a tour of the home was carried out. This report has been written from the information already known to the Commission and a visit to the service. Where information has remained the same this has been carried forward into this report. What the service does well: What has improved since the last inspection? Since the last inspection and the additional visit made in December, care plans have been reorganised with a format that is easier to follow. They provide good details of the action required by staff to meet the individual’s needs. Cross-referencing is also taking place to guide staff to behaviour plans risk assessments etc. The recording of incidents is now presented in a more detailed way and the manager carries out regular audits to ensure there is a robust trail of evidence. Medication procedures have been updated to reflect the supply of blister packs, and the procedures are clearly written. Recording of the medication storage is carried out and this ensures that it remains within safe limits to prevent deterioration of the medicines. A washing machine has been purchased to provide the home with a sluice cycle this prevents staff from handling soiled linen and clothing. There are red alginate bags available for washing soiled linen and clothing. (The bags disintegrate in the washing machine). Staff files contained all the required information before they commenced employment. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 6 The manager continues to look at ways to put policies; procedures and questionnaires into user-friendly formats to ensure all individuals are able contribute to the running of the home. 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. Quince House DS0000061600.V338547.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 Quince House DS0000061600.V338547.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): 1&2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is available to prospective people who would like to make an informed decision about whether the service is appropriate to meet their needs. All people who use the service have their needs fully assessed prior to admission to ensure they can be met. EVIDENCE: The Statement Of Purpose has been reviewed and contains all relevant information. The Service User Guide has been put into a pictorial format. This provides the people who use the service information that is easier to understand about Quince House. As part of the admission process assessments are carried out by a skilled and experienced member of staff, (normally be the manager and another). They would also receive a copy of an assessment from the referring social worker. Where applicable, the person requiring a place at Quince House would visit the service and meet the people already living in the home. A visit to the home would take place if this were appropriate. All people who receive a service are provided with terms and conditions, as well as their rights and responsibilities. Quince House DS0000061600.V338547.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 & 8 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs reflected within their care plans. They are consulted and take part in all aspects of the home. EVIDENCE: The staff involve the people who use the service whenever a task is being carried out. They also encouraged them to take on responsibility for household chores. The care plans examined were detailed in providing the action required by staff to meet the individual’s assessed needs and any personal goals. These included plans on dealing with behaviour, communication and epilepsy. Care plans provide cross-reference information to guidelines and risk assessments, (which had been highlighted to action at a previous visit to the home in December 2006). Daily records give clear information of what has been happening during each shift during the day. The manager continues to monitor these to ensure Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 10 sufficient details are recorded especially if there have been specific incidents which have happened. This should provide a trail of evidence if later required to provide additional support that may be needed. The manager has produced a questionnaire to find out the views from the people who use the service to ensure they are meeting their expectations and look at ways to improve the service. Each person is allocated a key worker who reviews the plans with the individual and makes any changes as necessary. One of the care plans examined looked as if it had not been reviewed, but discussions with a member of staff showed that they had sat and discussed with the individual and a few notes had been made. They had yet to make changes to the plans and assured the inspector that not only would this happen as soon as possible, but it would also be signed and dated. Risk assessments have been reviewed although one needs to be more realistic in the action taken to lower the risk in regard to the paddling pool in the garden. A discussion took place and the manger stated that this will be actioned and they understood what was being asked of them. Quince House DS0000061600.V338547.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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service are encouraged to make choices about activities. The menus offer a balanced, varied and nutritious diet. EVIDENCE: Four out of the six residents were at home during this inspection. The manager and the team are investigating day service provision for three people who use the service as their college course comes to an end at the end of this term. Each individual has a programme, which has been produced in pictorial format and is displayed in dining room on a large notice board. Observation showed that when an individual asks what is happening, they are referred to their plan and then staff confirm what they have said. Photographs of various days out and holidays are on display and the individuals were happy to tell the inspector about these activities. In the afternoon of the inspection, they were off to the bowling alley and were very much looking forward to this. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 12 There is involvement from families and individuals go and stay with them (but look forward to returning to their home at Quince House). One family member has purchased a trampoline and safety net for the garden a risk assessment has been completed. The individuals appear to enjoy using this when the weather is clement. Discussion took place with people who use the service and a decision has been taken for them to all go to Blackpool. Individuals are encouraged to save and pay for their holidays, as would we all. Whilst the individuals pay for the cost of the accommodation which includes the accommodation for staff. The food costs for both the individuals and staff are paid for by the home’s budget. Staffing costs are covered through the home’s budget. The transport costs are also covered by the home’s budget. The manager has a small budget to cover activities and outings. There have been some issues with the local authority and their interpretation of whether or not additional funding is required or should be included in the existing fees to cover additional day services. This should be dealt with through the legal department. Although I am sure the individuals will not loose out on the care and support they require from the dedicated and supportive team if referrals are not actioned. Quince House DS0000061600.V338547.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service receive support in meeting all their healthcare needs as appropriate. Safe procedures are in place for the safe administration of medicines. EVIDENCE: Examination of the care plans showed that health care needs are well documented and record where changes in health have occurred. These are also discussed with healthcare professionals as appropriate. Residents enjoy good support from the GP and district nurses as required. Staff are knowledgeable about the needs of the individuals and know their preferences and the support that is required. Medication records were well kept with the exception of any medication that has been left over from the previous month. There is no bring-forward system in place and this does not enable easy reconciliation if there has been a significant period when the medication has not been administered. Whilst some ‘given as required’ medication has details of when it is to be given, ‘Paracetamol’ requires the same treatment, as this may be different for each Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 14 individual. Some may be able to ask while others display discomfort etc. No individuals at the time of this inspection are able to manage the administration of their own medication. The temperature of the medication cupboard is monitored and recorded and records show that it has remained within safe limits. This has been better managed since they have changed storage arrangements. There has been a visit from the pharmacist in October 05. The home has to continually chase up the pharmacist’s reports and the latest was not available at this inspection. The manager stated that the supplying chemist keep changing the pharmacist which makes it difficult to receive the reports. They have no other issues relating to medication and it is received in advance to the previous month finishing. A number of residents suffer from epilepsy and support is received from visits to an epilepsy clinic, protocols are in place for the administration of rectal diazepam, staff all receive training before being able to administer it and this training is carried out yearly to ensure are continually updated. Quince House DS0000061600.V338547.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their views and concerns on a safe and understanding environment. EVIDENCE: The manager is looking at ways to put the complaints procedure into a more user-friendly format to enable it to be easier to understand for those living at Quince House. It was also suggested that they may want to consider introducing a pre-printed letter saying they have a concern and would like to talk to the someone about it. All the resident would then have to do is sign the letter and place it in a stamped addressed envelope. The person that is felt to be most appropriate would be in touch with them shortly. A police investigation has taken place into an allegation of abuse, since the last inspection and resulted in a member of staff being dismissed. The information recorded had been poor and therefore the police did not have enough evidence to proceed with a prosecution. The recording of information has improved and is monitored by the manager to provide a good trail of evidence. The Hertfordshire County Council Adult Protection Procedure is available to all staff and the in house policies and procedures also now refer directly to this. There had been no further complaints received by the home since the last visit to the home in December 2006. The home had received a compliment from the GP who praised the staff for the care they provide at Quince House. (See section on staffing for further information on safe procedures). Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 16 Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who use the use service live in a comfortable and reasonably wellmaintained environment. EVIDENCE: The people who use the service looked relaxed in their surroundings. A tour of the building and discussion with the manger took place. The lounge had been re-painted, although the flooring in the lounge should be replaced, as it has to be consistently cleaned due to the needs of the people living at Quince House. Alternative flooring should be considered that would provide a better and more hygienic surface. The dining room is to be redecorated in the near future and new curtains have been purchased. New blinds have been fitted in the kitchen. An individual’s en-suite bathroom flooring is carpeted and is not ideal for the individual as it regularly needs cleaning which is time consuming. It is also not hygienic; an alternative must be sought which would be more hygienic and easily cleaned. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 18 The bedroom that is accessed from the lounge had the door wedged open and this is not a safe practice. An alternative method for holding the door open must be introduced to protect the safety of all who live, work and visit the home. There is access to the garden through the dining room that has a large step to negotiate and could pose a risk to those living at the home. An additional step or ramp must be put in place to minimise the risk of trips and falls. A new washing machine has been installed that provides a sluice cycle. With the use of red disposal bags this eliminates the need to handle soiled laundry. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported and protected through the home’s recruitment policies and procedures. EVIDENCE: There is a minimum of four care staff on duty at any time during the day and a waking night staff plus a sleep-in person who is on call in case of emergencies covers the nights. This is felt adequate to meet the needs of the individuals at the time of this inspection. There is also a list of regular bank staff that can be called upon at short notice to cover shifts. People who use the service were encouraged by staff to take responsibility in the household chores. Good interaction was observed between them and the staff. The staff were knowledgeable about their needs of the individuals and how to manage difficult behaviours and healthcare needs. Staff are able to access the Hertfordshire Social Services training programme and they also use Business Link. Recent training has included moving and handling, safe techniques in managing challenging behaviour, epilepsy including administering rectal diazepam. Five of the seven permanent staff Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 20 hold an NVQ in care at level 2 or above. Bank staff are also offered training to ensure they are able to meet the needs of the individuals living at Quince House. Training would be better managed if the manager were allocated a budget at the beginning of the year. Examination of the newly recruited deputy showed that all the required information had been obtained prior to them commencing employment. A look at a further two files of staff that are due to start once all the information has been obtained. A discussion took place why the individuals felt that they did not require a work permit as they were from outside the EU. It is recommended that further information be sought to ensure that these are obtained if necessary prior to commencing at Quince House. The manager assured the inspector that this would be done. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a well run home. Health, safety and welfare is promoted and protected through a series of checks and monitoring processes, with the exception of a door being wedged open which could pose a fire safety risk. EVIDENCE: The manager is knowledgeable about the care home regulations and the national minimum standards; she has achieved an NVQ level 4 in care. It is hoped that by the end of December 2007 she will have gained her Registered Managers Award. She is working with the staff team to ensure all people who use the service are able to have their say, they have produced a questionnaire in WIDGET (Picture format), they are also looking at ways to produce the complaints procedure into a better and more user friendly format. See Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 22 complaints section for more details). The manager states that a report will be written from the results of the questionnaires and a copy will be forwarded to the Commission for Social Care Inspection There is a commitment to equal opportunities and people have their cultural needs addressed within the care plans. There is an open and inclusive atmosphere in the home and a dedicated staff team in ensuring individuals needs are met. Policies and procedures in the home are reviewed as necessary and are changed in line with current good practise and changes in legislation. There is a health and safety audit carried out at regular intervals, including regular fire safety tests and drills, water temperatures are tested and recorded. A door leading off the lounge had been wedged open and this could cause a potential fire risk an alternative opening device must be sought. All records were stored securely to maintain confidentiality. A check on the monies of people who live at Quince House was carried out and showed the records were well kept, receipts obtained and regular auditing is carried out. A policy and procedure is in place for the keeping of monies etc, but consideration should be given to introducing a procedure for managing the monies on a day-to-day basis. This was discussed with the manager on the day giving examples of how best this could be done. There is no formal supervision structure for the manager, as the proprietor has only a limited knowledge on care. A manager from another home carries out the regulation 26 visit and this is where support is sought for each other. The manager feels this works well and can access their colleague at any time for help and support. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 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 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X 3 2 X Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 24 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 2 Standard YA24 YA42 Regulation 16 (2)(c) 13 (4)(a) & (c) Requirement Appropriate flooring must be sought for rooms identified during the inspection An alternative door opener must be sought for the room adjacent to the lounge. Timescale for action 31/10/07 31/05/07 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 YA20 YA32 YA42 Good Practice Recommendations A carry forward system should be used for all medicines not blistered. The proprietor should consider allocating a set budget for the manager to use for training of staff. A door from the office to the home should be considered to provide easy access for staff and those living in the home. Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hertfordshire Area Team CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 Quince House DS0000061600.V338547.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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