Inspection on 01/11/07 for Roseville

This inspection was carried out on 1st November 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Roseville 23/08/06

Roseville 24/02/06

Roseville 30/11/05

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

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

CARE HOMES FOR OLDER PEOPLE Roseville Marine Gardens Preston Paignton Devon TQ3 2NT Lead Inspector Michelle Finniear Unannounced Inspection 1st November 2007 07:55a X10015.doc Version 1.40 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 Roseville DS0000065294.V349341.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Roseville Address Marine Gardens Preston Paignton Devon TQ3 2NT 01278 741279 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) dibradley@fsmail.net Underhill Care Ltd Mrs Dianne Bradley Care Home 22 Category(ies) of Dementia - over 65 years of age (22), Old age, registration, with number not falling within any other category (22), of places Physical disability over 65 years of age (22) Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2006 Brief Description of the Service: Roseville is a detached property situated in a level residential area, approximately 200 yards from the sea front and near to local shops. The home cares for up to 22 service users aged 65 or over, who may have varying levels of physical and/or mental frailty. The home benefits from having level access to the ground floor, where the communal rooms are situated, and the garden. There is a shaft passenger lift to the first floor. All bedrooms are single rooms, and all have en suite toilet and washbasin facilities. There is a car parking area at the front of the building. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report reflects a summary of a cycle of Inspection activity at Roseville since the last inspection visit to the home in August 2006. To help CSCI make decisions about the home the owner and manager gave us information in writing about how the home is run. Documents submitted since the last inspection were examined along with the records of what was found at the last inspection. Two site visits totalling 11 hours were carried out with no prior notice being given to the home as to the specific date and timing of the first visit. Discussions were held with the manager and staff on duty and various records were sampled, such as care plans and risk assessments. Questionnaires were sent to staff who work at the home. A tour was made of the home and garden; and time was spent with the people who live at the home both individually and in groups undertaking an activity session. The Inspection site visit was carried out by a regulation Inspector and a specialist pharmacy inspector from CSCI. In addition a sample group of people were selected and their experience of care was ‘tracked’ and followed through records and discussions with staff and management from the early days of their admission to the current date – looking at how well the home understands and meets their needs, and the opportunities and lifestyle they experience. This approach hopes to gather as much information about what the experience of living at the home is really like. What the service does well: Roseville has a comprehensive programme of activity for people who live there, which has been enhanced by the provision of an accessible vehicle for service user and home use. On the day of the inspection people had opportunities to participate in an exercise group and quiz in the morning, with games, a clothing party and then evening fireworks. The day after there was to be a cheese and wine party. This high level of organised activity is commendable, particularly with the levels of disability at the home. The home has enrolled all of their staff on NVQ programmes, and has a new induction programme for staff which is also commendable. An NVQ is a recognised award to demonstrate the level of skill and competency of the staff group. The home has developed comprehensive management systems and an audit system to ensure peoples care is of a high quality. Relatives and other stakeholders are involved in this process and there are regular residents Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 6 meetings, chaired buy a resident in the home, looking at gaining peoples views on any changes they would like to see. The home is a comfortable living environment. The majority of the rooms have en-suite facilities, many with showers and baths as well as toilets and wash hand basins. Staff interacted well with people living at the home, and have been putting together life history books for them, many in their own time. This information helps staff understand the whole person they are caring for and the life they have led. It also supports them to be able to communicate with people about events of significance in their lives. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5, 6. Quality in this outcome area is good. People are fully assessed before moving in to make sure the home can meet their needs. Good information about the home is available to help people judge if it is the right place for them or their families. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a service user guide and a statement of purpose available. These documents contain information about the home and the services available. A copy of the service user guide is given to people looking around the home for a placement, and a copy is in each persons room in a room pack for reference. This information helps people to make a choice about whether the home is the right place for them. It also contains copies of the homes contract, which tells people what they can expect to receive for the fees paid, what their rights are and any conditions of living at the home, for example periods of notice required. Copies of contracts that had been signed were seen in most of the files examined. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 9 Discussion was held with a team leader on the first visit, regarding a recent admission to the home and how this had been arranged. They were able to outline the assessment that had been undertaken when the person was in hospital to make sure that the home was able to meet their needs. Their relatives visited the home on the persons behalf to decide if the home was somewhere they would like. Copies of paperwork and assessments from other agencies were obtained which gave information about the support and any specialist equipment needed. The information was then discussed with the home manager to make sure the referral was appropriate before a place was offered. This approach helps to make sure people do not have to move again if it is found their care needs are different then originally stated. People are encouraged to visit the home wherever possible before a decision is made as this helps them learn more about the accommodation and facilities available. The home does not cater for intermediate care. This means that they do not provide specialist rehabilitation programmes for people with a view to returning them to their own homes. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10. Quality in this outcome area is good. Health and personal care is well planned and delivered appropriately to ensure peoples needs are met. Medication is managed safely and people are protected by the training and systems in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three peoples files were seen in detail and other records referred to. Discussions were held with staff on how care was being delivered to the people living at the home and how well the plans reflected this. Time was also spent with people living at the home observing care interactions and discussing their experiences of care at the home. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 11 The plans seen were comprehensive and included clear assessments of the personal and healthcare needs and how the person liked this care to be delivered. This information is especially important as for example at Roseville many of the people have a deteriorating mental capacity. Three staff speoken to were able to describe in detail the care being delivered to three individuals. These demonstrated that the plans were an accurate reflection of the care being delivered. Plans also showed evidence of input from district nurses, general practitioners and specialist community services such as community Psychiatric nurses. A tour of the home showed that suitable equipment for the needs of the people at the home was in evidence from profiling beds, to hoists and specialised bathing and showering equipment. Pressure relieving mattresses were in use for the more frail people in accordance with the directions of the district nurses. One person had purchased their own specialised bed. People at the home have received flu vaccinations if they wanted them and have access to chiropody and dental/optical services as needed. We found that all medicine was stored securely and according to the current regulations. We found that one of the keys was not stored securely although this was addressed during the inspection. We observed the member of staff administering the medicines and found that they were all administered safely and in accordance with good practice. We found that the receipt of most medicines into the home had been recorded with the exception of some medicines received for a person on discharge from hospital. The members of staff administering medicines have received appropriate training and a review session is planned for the 8th November when other staff will also receive training. We found that people wishing to look after their own medicines are appropriately supported, provided with secure storage and have appropriate risk assessments in place. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. Quality in this outcome area is excellent. People living at Roseville have access to a full programme of activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The site visit was times to see people getting up. Many people do rise quite early, and are then given a cup of tea until breakfast starts. Staff were unhurried and care tasks had been delegated to ensure that each person received the attention they needed. Staff spoken to confirmed that some people liked to ‘lie in’ and this was respected. Roseville has an excellent programme of activities and stimulation for people living at the home. Formal activities are provided by care staff twice a day, and other activities are provided by visiting organisers. On the day of the first visit people were having an exercise session followed by a quiz. On the second visit there was an external activities organisation providing a session, then the home was due to have a clothing party, and then an evening of fireworks. The next day was a cheese and wine party. Staff regularly dress up for themed days when people can experience for example a “Hawaiian day” with themed Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 13 food and activities. A member of care staff organises an activity schedule, which provides for activities twice a day. One person spoken to said they didn’t choose to participate in the activities and liked spending time in their room or out with friends. People have some ability to exercise choice and control in their lives. Choices are available for example in the daily mealtimes, where on the day of the first site visit people were offered a choice of lunch of either scampi and chips or chicken salad. Staff spoken to were clear about giving people options in their lives, some of which may be small dependant on the abilities of the person. These might be what to wear or where to spend time in the day. The home has a locked front door, but people had free access into the garden and on the first visit one lady regularly went outside to sit in the sunshine. The locked front door should be examined in the light of new legislation. People are encouraged to visit the home and their relatives and are invited to the social events regularly held. Some people have very regular visitors, at least one of whom also works at the home. People at the home eat a good diet, which is home cooked and freshly prepared. Supplementation and fresh fruit smoothies are available for people who have a poor appetite, and people have home made cakes available daily, as is fresh fruit. People living at the home also enjoy a sherry before lunch. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18. Quality in this outcome area is good. Policies for the handling of complaints and management of adult protection issues should help to protect people living at the home from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure, which is detailed in the service user guide which has been given to each person. The complaints procedure is written in plain English and contains information on people outside of the home to whom complaints may be addressed. This is to ensure that if people were concerned about raising issues directly with the home they would have information provided as to who they could go to. One complaint has been received in the last year about the homes laundry, and it is understood this has been resolved. The home has also undertaken to provide a laundry person 5 days a week to deal with all personal laundry, in a hope of making sure that any problems with items getting lost or shrunk are minimised. The home has a monthly residents meeting, chaired by a person living at the home, where people are encouraged to voice and concerns or dissatisfaction. One recent meetings minutes showed that people had said they didn’t like a vegetable tart that was on offer and so this was removed from the menu. The home also sends questionnaires to people living at the home and their relatives Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 15 for comments and action id also taken as a result. This helps people who live at the home to influence the way the home runs, and resolve any complaint at an early stage. Staff have received training in Safeguarding and Adult protection, which includes an understanding of abuse and abusive practice. This should help to protect service users from abuse. Staff spoken to showed a clear understanding of the rights of individuals. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25, 26. Quality in this outcome area is good. Roseville provides a comfortable environment for people to live and work in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour was made of the home, including bedrooms, the kitchen and the laundry. Discussion was also held on plans the home has for improving the environment with an extension. This is planned to provide for additional much needed lounge space, new bathrooms and additional bedrooms, a clinical room and new staff facilities. Roseville is situated close to local shops and the sea front at Paignton. The home has a full passenger lift to access the first floor, and there is some dedicated private parking with on street parking nearby. This helps people living at the home who are physically able to maintain contacts with the local community, and have access to both floors of the home. There is a level enclosed and safe garden to the side of the home which is attractive. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 17 Peoples rooms very in size and shape, with the majority having en suite facilities consisting of a bath or shower and a toilet. Rooms are generally quite small, and most people do not use the showers but prefer to use the main adapted baths with a hoist. All rooms are currently for single occupancy. All areas of the home seen on this inspection were clean, warm and comfortable, with peoples rooms personalised with items of their own furniture and pictures. Considering several people living at the home have problems with continence management the home was substantially odour free, even at the busiest time of the morning. In the last year a small number of rooms have had new non-absorbent floor coverings fitted, which are to be risk assessed. The front door of the home is kept locked, and there is a code number to exit. One person has their own exit door from their bedroom, which means that they are not disadvantaged by the door being kept closed. Staff ensure that this is locked at various times during the day to help make sure the building is reasonably secure. The manager confirmed that all windows above the ground floor have restricted window opening except for one room where the person concerned has refused to have the restrictors fitted. The person in this room has signed a disclaimer but being able to access the rooms could potentially leave other people at risk. Risk assessments have been provided and the person concerned has agreed to ensure their room is locked when they are out.. The home has a communal bathroom on the first floor, and a new wet room has been provided on the ground floor. This is accessed off the lounge area, but staff could outline who they ensure that peoples privacy and dignity are retained when going to and from this area. There is a lounge, with television, on the ground floor of the home for service user use, and a conservatory, which can be available for people to see their relatives in private if they wish. People’s bedroom doors have been fitted with locks, which can be secured from inside the room but can be opened from the outside in case of an emergency. This helps to retain people’s privacy if they wish. The homes laundry is to the rear of the home and has a washing machine capable of achieving a sluicing cycle for foul linen. This means people can be protected from any risk of cross infection and their clothes kept clean. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. Quality in this outcome area is good. The staffing arrangements mean that people are well supported. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the site visits time was spent talking to staff about their role working with people live at the home and observing interactions. Staff seen were kind and confident in the dealings observed and people living at the home related well to them. One person living at the home said that “You couldn’t find better staff anywhere”. The home has recently restructured the staff into two teams, led by senior staff, and some management duties have been allocated between these two people, such as staff supervision and management of medication systems. Opportunities are available during the day for the exchange of communication and the management have a weekly meeting to discuss care and staffing issues. The staffing files for three people were seen during the site visit and these showed that the home follows a full recruitment process when employing staff. This includes taking up references and criminal records bureau checks. These help to make sure that people working at the home are suitable to be working with vulnerable adults. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 19 All staff working at the home either have or are working towards National Vocational Qualifications, which are a national award based on assessing the competency of staff in their workplace. Training is being delivered to staff in core areas, such as first aid and infection control as well as in disorders of old age and care practice issues. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 38. Quality in this outcome area is good. The home is being well managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion was held with the manager about the management systems at the home, some documents were sampled and discussions were held with senior staff on some aspects of health and safety for example moving and handling and infection control. The manager is experienced and has worked at the home for several years. She has achieved the Registered managers award, which is a qualification specific to managing a care home and is a very experienced registered nurse. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 21 People spoken to on the visit said she sets high standards and is good at her job. There is a full quality assurance system in use which gives detailed responses that can be statistically analysed and used to build up a picture of what is working well at the home and what can be improved. Staff supervision systems are being provided at the standard set rate of six times per year. Staff supervision is a system combining performance management and staff development, and involves each member of staff taking time with their manager on a regular basis looking at any issues to do with their work or performance, and any training or support they need. It aims to ensure staff are working at their potential, and giving consistent care to people living at the home. Roseville has a health and safety policy, which was seen on the second visit. Fire precautions at the home are regularly tested and the system was last serviced on 24th March 2007, which was documented in the log book and servicing records. Regular servicing helps to ensure the system would work appropriately in an emergency. All water outlets are now stated to be regulated. This means that people are protected from any risks of scalding as the water cannot be delivered to the taps at more than 43 degrees centigrade. Service contracts were seen for gas safety, records of the servicing of the shaft lift and records of tests on electrical appliances, which are carried out annually. The home has risk assessments available in relation to the building and it’s maintenance, which help to identify and minimise any risks to people living and working at the home. Staff training files contained information on staff training in some health and safety issues such as moving and handling tasks, fire protection and infection control. The system for managing peoples finances was also seen. Floats are held for each person and receipt kept for any expenditure made o their behalf. This covers for example bills for hairdressing and chiropody. Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 4 x 3 Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP9 Regulation 13(2) Requirement To ensure there is an accurate record of the medicines in the home the receipt of all medicines into the home must be recorded Timescale for action 01/01/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Roseville DS0000065294.V349341.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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