Inspection on 04/11/05 for Rosehedge

This inspection was carried out on 4th November 2005.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Rosehedge 28/09/07

Rosehedge 14/03/07

Rosehedge 09/03/06

Rosehedge 06/12/04

Rosehedge 28/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Rosehedge 42 Thingwall Lane Broadgreen Liverpool Merseyside L14 7NY Lead Inspector Mrs Janet Marshall Unannounced Inspection 4th November 2005 09:30 Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 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 Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 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. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rosehedge Address 42 Thingwall Lane Broadgreen Liverpool Merseyside L14 7NY 0151-220-5247 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) Brothers of Charity Mrs Cecilia Baines Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 4 LD Date of last inspection 6th December 2004 Brief Description of the Service: Rosehedge is a care home providing personal care and accommodation for a maximum of four adults with learning disabilities. It does not provide nursing care. The Registered Provider is Brothers of Charity (BOC), a charitable company that is a well-established organisation within this field. Margaret Curzon is the newly appointed Manager. The premises are of a domestic style, which was fully refurbished and adapted for registration purposes. The ground floor consists of one bedroom, two lounges, a dining room, kitchen, utility room and laundry. The first floor has three bedrooms and a staff office/sleeping-in room. Toileting and bathing facilities are distributed evenly throughout the premises and are equipped with appropriate aids. There is no lift. The home has a very pleasant garden area to the rear of the building. The home has a call system throughout the premises. Service users do not attend day care but are occupied by the staff team. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspection visits are required at the home each year, this was the first. There has been no cause for any visits to the home since the last routine inspection in December 2004. This was an unannounced inspection that took place over 6 hours. Neither the residents nor staff knew that the inspector was coming. A partial tour of the home was conducted. The home was clean and tidy and is generally in good condition although there is some minor repairs and improvement needed. During the inspection residents were encouraged to carry on with their routines and take part in the activities they had pre-arranged for that day. The nature of the disability of residents is such that it is not always possible to obtain direct views about their experiences, however, this was achieved through discussion, general observations and compliance with standards. At intervals throughout the inspection discussion with staff took place. Their comments and views about the home were obtained. A selection of care records and other required records were inspected. Records that were examined included residents care plans, daily diaries, medical notes, medication sheets, staff rotas and records of health and safety checks. Two residents were ‘case tracked’. Case tracking means that the inspector concentrates on the care given and experiences of one or more residents to ensure that the persons needs are recorded in their care plan and are being met. Margaret Curzon has recently been appointed as manager of the home. She has been advised of the process that she needs to follow to become registered manager. The registration certificate, which is displayed in the hallway, shows details of the previous manager. A new one will be issued following the approval of a registered manager. An up to date insurance certificate showing the appropriate cover was displayed in the office. The requirements and recommendations from the last inspection were discussed and examined. What the service does well: Residents needs are continuously assessed so that the home can be sure of meeting their needs. Care plans have been reviewed and updated with the involvement of others to ensure that changing needs are met. Independence is encouraged to allow residents to develop their daily living skills. Residents care plans reflect they are encouraged to take responsible risks in their lives, which are safe and effective. Information about residents was stored securely to ensure that their confidences are kept. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 6 Residents are given opportunities for personal development, which encourages independence. Residents take part in a variety of activities both at home and in the local community, which are appropriate to their needs and wishes. Relationships are encouraged so that residents maintain contact with family and friends. Residents are encouraged to eat food that is healthy and enjoyable which ensures their health and wellbeing. Personal support is carried out in a sensitive and flexible way to ensure the privacy and dignity of residents at all times. Residents health and personal care is well recorded ensuring that these needs are understood and met. Residents who are prescribed medication are protected by the home’s medication procedure. The home was clean, tidy and maintained to a very good standard providing a comfortable and safe environment for the people who live there, however the condition of some areas compromise the independence, comfort and dignity of residents. Cleaning routines were in place to ensure that a high standard of cleanliness and hygiene is maintained at all times. Staff are competent and qualified to carry out their jobs. They are sensitive, flexible and caring in their approach and have a good understanding of residents needs. Residents benefit from a staff team who are fully supervised and supported. The manager is positive and approachable which benefits residents and staff. The health and safety of staff and residents is fully protected by the home’s health and safety systems. What has improved since the last inspection? What they could do better: Residents activity logs need to be fully completed to show that Residents are given opportunities for personal development. The homes complaints procedure should show new information about the Commission so that people now who to complain to. The home was clean, tidy and maintained to a very good standard providing a comfortable and safe environment for the people who live there, however broken equipment and the condition of some areas compromise the independence, comfort and dignity of residents, these areas need attending to. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 8 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 Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 9 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): 2 Residents needs are assessed so that the home can be sure of meeting their needs. EVIDENCE: There have been no new residents admitted to the home since the last inspection. Four men who have lived at the home for a number of years occupy all rooms. All care files contained assessments, which were carried out prior to the residents being admitted to the home. The information shows that the home is able to meet their needs. Records showed that residents needs are being continuously assessed and met by the home. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 10 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, 8, 9 & 10 Care plans have been reviewed and updated with the involvement of others to ensure that changing needs are met. Residents take part in aspects of life in the home, which promotes their independence. Residents care plans reflect they are encouraged to take responsible risks in their lives, which are safe and effective. Information about residents was stored securely to ensure that their confidences are kept. EVIDENCE: A detailed Essential Lifestyle Plan (ELP) was available for each resident. They include good information about individuals abilities, routines, likes and dislikes, medical and personal care. They are well written and include a good amount of information, which enable staff to meet each persons needs. The plans show that regular reviews take place ensuring changing needs are identified and met. Records show the involvement of relatives, key workers and other professionals in the reviewing of residents plans of care. Case tracking showed residents needs are recorded in their care plan and are being met. Observation showed that residents at times do display challenging Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 11 behaviour. Staff were seen to manage this appropriately and in accordance with residents plan of care. The home continue to have good working relationships with specialists in the field of learning disabilities and access such help when required. Staff said they encourage and support residents to take part in aspects of live in the home. Residents level of involvement, and ability is recorded in their ELPs. Through discussion staff showed they respect residents rights to make decisions. Choices and decisions that are made for residents by others and why are recorded. One resident was seen being encouraged and supported to attend to his laundry. Risk assessments and support guidelines viewed for residents showed they have been reviewed and updated since the last inspection. They ensure that residents independence is encouraged and that they continue to take responsible risks in their every day lives. Care plans for all residents were kept securely in the office. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 12 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 & 17 Residents are given opportunities for personal development, which encourages independence although records don’t always show this. Residents take part in a variety of activities both at home and in the local community, which are appropriate to their needs and wishes. Relationships are encouraged so that residents maintain contact with family and friends. Residents are encouraged to eat food that is healthy and enjoyable which ensures their health and wellbeing. EVIDENCE: Although residents have limitations staff are consistent in involving them in aspects of live in the home. This was evident on observation as staff were seen encouraging their involvement in tasks such as cleaning and vacuuming. Recordings in the learning logs kept on each resident showed that they are also supported to tidy rooms, shop and make beds. Some of these records were incomplete. They should be completed in all areas to show that residents are given opportunities for personal development. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 13 Records, observation and discussion with staff showed that opportunities are provided for residents to also take part in activities in the local community. Learning logs and an activity record also supported this. During the visit residents continued with the activities that they had arranged for the day. With the support of staff two residents went horse riding and one resident went for a walk. Another resident had plans to go out later on in the afternoon Each ELP highlights the needs that residents have and include reference to any risks present or issues with respect to behavioural needs. Risks have been assessed and show how best to minimise them. Staff said residents are supported to shop for personal items as well as things for the home. The records seen also showed that residents are supported and encouraged to develop and maintain contact with family and friends. There was plenty of fresh, tinned and frozen foods kept at the home. Staff spoken with said they plan menus around residents preferences and involve them in shopping for food. Residents are not involved in preparing food because it is not safe for them to enter the kitchen because of their limitations. The lunchtime meal was sampled. It was hot and tasty, residents appeared to enjoy their lunch. Staff were relaxed and patient whilst assisting residents who needed help to eat. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 14 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): 19 & 20 Personal support is carried out in a sensitive and flexible way to ensure the privacy and dignity of residents at all times. Residents health and personal care is well recorded ensuring that these needs are understood and met. Residents who are prescribed medication are protected by the home’s medication procedure. EVIDENCE: Staff were observed supporting residents with personal care. Personal care was carried out in residents own bedrooms and the bathroom showing that staff are respectful of residents right to privacy. Two residents who were case tracked had available individual plans of care, which identify relevant aspects of health and personal care and plan accordingly. There is good information, which show that residents health care is monitored and that they access the appropriate health care facilities at the required intervals. Mobility needs are well assessed and planned for as well as nutritional requirements. Staff showed a good understanding of the medical, and personal care needs of residents. A district nurse attends to one resident at the home. Records of the visits are kept. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 15 A requirement was given following the last inspection for Medication record sheets to be fully completed. Medication sheets that were examined showed that they are now being completed to a good standard. Medication was stored safely in the home. A record of all medication that goes in and out of the home is kept. Medication training has been provided to all staff that administer medication. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 16 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 Residents are protected from abuse by the home’s policies and procedures. EVIDENCE: The home has robust procedures for responding to suspicion or evidence of abuse or neglect. They include a Whistle Blowing procedure and the Local Authorities Protection of Vulnerable Adult procedure (POVA). The homes complaints procedure gives details of the Commission as a contact for residents, their families and staff if they wish to raise any concerns or for advice. The information shows details of The National Care Standards Commission (NCSC), which no longer exists. It has been replaced with the Commission for Social Care Inspection (NCSC), contact details are still the same. The complaints procedure should be changed to show this information. No complaints or allegations of abuse have been made to the Commission. Physical and verbal aggression by one resident is understood and well documented. The necessary procedures are in place to ensure their safety. Records show that staff have undertaken training, which helps them understand and manage behavioural issues as well as protecting residents from abuse or neglect. One member of staff confirmed her understanding of the home complaints and POVA procedures. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 & 30 The home was clean, tidy and maintained to a very good standard providing a comfortable and safe environment for the people who live there, however the condition of some areas compromise the independence, comfort and dignity of residents. A shared room is being developed for the use of residents. Equipment, which is out of use, compromises one residents independence. Cleaning routines were in place to ensure that a high standard of cleanliness and hygiene is maintained at all times. EVIDENCE: The standard of décor in the home is good although bland in places. Residents would benefit from a more stimulating environment. For example colourful wall coverings and pictures that would create a more homely feel. Positive steps towards achieving this have already taken place by the introduction of a sensory room. Staff recognise that residents often get anxious and frustrated, which lead to behavioural problems, so have created a room for residents to ‘chill out’. A ground floor lounge has been equipped with lights and other equipment aimed at providing a relaxing and stimulating area for residents. A member of staff confirmed plans to improve it further with new easy chairs and Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 18 a tropical fish tank. A member of staff described the benefits already seen for one resident who uses the room. Bedrooms on the first floor are decorated and furnished to a good standard. A range of personal items including TVs, music centres and colourful lights are displayed around residents rooms. The following repairs are required around the home to ensure the safety, comfort and dignity of residents: • The décor in the ground floor bedroom needs attention as it is becoming tatty with wallpaper peeling off in parts and stains on the ceiling. • The radiator in the ground floor bathroom, which is badly rusted, needs replacing. • The hoist in the ground floor bathroom needs to be repaired or replaced so that all residents have the use of a bath. This was raised as a requirement at the last inspection. • A shower hose needs to be fitted to the shower over the bath. • The wall over the sink in the ground floor bathroom needs plastering. All parts of the home were clean and tidy. Whilst cleaning staff were seen encouraging the involvement of residents. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 35 & 36 Staff are competent and qualified to carry out their jobs. Residents benefit from a staff team who are fully supervised and supported. EVIDENCE: All staff were seen interacting very well with residents. They showed that they have good knowledge and understanding of each persons needs and were patient and caring in their approach. Staff dealt with residents demands in a sensitive and flexible manner. Residents were seen responding positively to the support and guidance offered by staff. A record of future training and training completed by staff was seen. It shows that are receiving the training that is required of them. During discussion a member of staff said that they are happy with the level of training provided. A member of staff said the manager is regularly supervising staff on a one to one basis. Supervision records were not seen as they were kept in a secure place and can only be accessed by the manager. A member of staff said that discussions between them also take place daily in addition to regular staff meeting. Supervision of staff ensures that they are appropriately supported and fully aware of their roles and responsibilities. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 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): 38 & 42 The manager is positive and approachable which benefits residents and staff. The health and safety of staff and residents is fully protected by the home’s health and safety systems. EVIDENCE: A manager has recently been appointed to the home following the resignation of the previous manager. The manager has been advised of the process that she needs to follow to become the registered manager of the home. Staff made positive comments about the manager describing her as open and positive in her approach. Fire records showed that alarms are tested weekly and fire drills take place at the required intervals involving residents and staff. A detailed health and safety manual is available for staff to refer to. It includes policies and procedures, which ensure the health and safety of residents and staff. Information on cleaning products and substances that are potentially hazardous to health were also seen. Radiators are fitted with thermostats, which minimise scalding. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 21 There was no evidence to show the gas and electricity systems are safe. A member of staff was sure that tests had been carried out but was unable to locate the certificates. An immediate requirement was given for these to be obtained and forwarded onto the Commission within five days following the visit. Copies of the certificates were forwarded onto the Commission within the time given. They showed that the systems have been tested and are safe. Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 X 2 3 2 3 LIFESTYLES Standard No Score 11 2 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rosehedge Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score X 2 X X X 3 X DS0000021465.V264812.R01.S.doc Version 5.0 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 2 Standard YA27 YA29 Regulation 23(2)(b) 23(2)© Requirement The rusted radiator cover in the ground floor bathroom must be replace. The hoist in the downstairs bathroom must be repaired or replaced. The Brothers of Charity must inform the Commission of the appointment of the new manager. The manager must ensure that she makes an application to the Commission for registered manager of the home. Timescale for action 04/01/06 04/01/06 3 YA38 9(1)(2) 04/12/05 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 YA11 YA25 YA27 Good Practice Recommendations Residents learning logs should be fully completed. The decoration in the ground floor bedroom should be repaired. The wall over the sink in the ground floor bathroom should be plastered. DS0000021465.V264812.R01.S.doc Version 5.0 Page 24 Rosehedge Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 Rosehedge DS0000021465.V264812.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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