Inspection on 17/07/06 for Sandsground

This inspection was carried out on 17th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Sandsground 10/07/07

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Sandsground Swindon Road Highworth Swindon Wilts SN6 7SJ Lead Inspector Bernard McDonald Unannounced Inspection 17th July 2006 09:15 DS0000064694.V303153.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 DS0000064694.V303153.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. DS0000064694.V303153.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sandsground Address Swindon Road Highworth Swindon Wilts SN6 7SJ 01793 764948 01793 765181 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) Choice Limited Ms Janet Rosemary Paginton Care Home 3 Category(ies) of Learning disability (3) registration, with number of places DS0000064694.V303153.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection First Inspection Brief Description of the Service: Sandsground is a large renovated three-bedroom bungalow on the edge of Highworth. The home is on one level allowing service users access to all areas. In addition day care facilities are held in a large outbuilding in the garden. Communal living space includes a large living room and separate dining room. In addition there is a small quite room at the front of the property and a small dining area adjacent to the kitchen. To the rear of the property there is a large enclosed garden and to the front a large stoned driveway and parking area sufficient for the needs of the home. The home is providing care and accommodation to three adults with challenging and complex needs and associated behavioural problems. The home will be staffed by a minimum of three staff on duty on all shifts. There is two waking night staff. DS0000064694.V303153.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 over a total of eight hours. The inspector had opportunity to meet with all service users but was unable to fully obtain their views on the care they receive. In addition seven members of staff were interviewed. The inspector examined the care plans of three service users. As part of the case tracking, comment cards were sent to service users, their relatives, care managers and relevant stakeholders to obtain their views on the service provided. The inspector viewed all communal living areas and service users bedrooms. A number of records were examined including three staff recruitment files, health and safety documents and a sample of risk assessments. The fee charged for the service at Sandsground is £3111 per week. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the service does well: What has improved since the last inspection? This is the first inspection of the home since it was registered in October 2005 DS0000064694.V303153.R01.S.doc Version 5.2 Page 6 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. DS0000064694.V303153.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 DS0000064694.V303153.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, 5. The transition of service user moving into the home is safely managed but the home is failing to ensure they are fully aware of the terms and conditions of their stay. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Discussion with staff confirmed each service user has had a gradual introduction to the home. Service users have a transition team to support them through the move to the home. The purpose of the team is to develop a transitional assessment package to ensure the move is managed in the best interest of the service user. Two service users have now successfully moved into the home. One service user continues to be gradually introduced and was having an introductory visit on the day of the inspection. The inspector was unable to communicate effectively with service users to obtain their views on their transition to the home. Examination of service users care records showed each service user had a plan of care and a contract. However the contract details had not been completed and did not specify the fees payable or demonstrate how the terms and conditions had been explained to the service user or their representative. In addition no service users had a copy of the service user guide. When brought to the attention of the manager the guide was later emailed to the home and a copy was printed off for each service user before the end of the inspection. DS0000064694.V303153.R01.S.doc Version 5.2 Page 9 Two service users had a comprehensive community care assessment completed prior to moving to the home. One service users records did not contain a copy of their assessment and it is a requirement that this is obtained to ensure the home is fully aware of the needs of the service user and they can safely meet their needs. DS0000064694.V303153.R01.S.doc Version 5.2 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, 7, 9. Although service users do have a plan of care these do not accurately reflect their needs and although risks associated with their care have been identified these need to be fully incorporated into the care plan. The home is making every effort to involve service users to make informed decisions. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The inspector examined the records of all service users. Each service user has a plan of care. This is a new service and as part of the transition, service user care plans are reviewed at six weeks and again at twelve weeks. As part of the case tracking process the views of care managers have been obtained. Comments received included confirmation that all service users have a plan of care, which is being followed and reviewed regularly. Care plans demonstrated care plans had been reviewed. However, the outcome of the review had not been incorporated into the working document. As a result it did not represent what support each service user required from staff to meet their needs. For example where a care plan states dependent on staff it does not specify the action required. In discussion with staff the inspector was informed of various tools used to communicate with a service DS0000064694.V303153.R01.S.doc Version 5.2 Page 11 user. This was not reflected in the service user care plan, which had no reference to what is an effective communication method that enables the service user to make choices about their life. Discussion with staff did demonstrate a good awareness of the needs of service users and were positive in their ability to safely meet their needs. The home does however continue to use agency staff and the home must ensure care plans fully reflect the needs of service user. Risk assessments and specialist interventions have been completed in consultation with the psychologist. The assessments were clearly written and staff had signed to confirm they had read and understood the contents. However care plans do not lead the reader to the risk assessments or interventions, which is an integral part of how the home safely meets the needs of service users living there. Discussion with the manager confirmed service users are able to attend staff meetings. The use of the communication passports and communication boards enable service users to direct staff to what they want to do. Observations made during the inspection found staff positively interacting with service users and responding to gestures and sounds as service users made their needs known. DS0000064694.V303153.R01.S.doc Version 5.2 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): 12, 13, 15, 16, 17. The home is making every effort to ensure service users are provided with opportunities to take part in community activities and provides support to enable service users to maintain contact with people who are important to them. Meal times are relaxed and a varied diet is provided. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Examination of records show one service user is being supported to attend daytime activities that they were previously involved in. Discussion with staff confirmed two service users who are permanent residents have staff support to enable them to attend specialist day care. The home has transport to enable service user access the community. Records examined show service users have been supported on trips out, swimming, hydrotherapy, walks and general shopping. The home also has day care facitilites and has recently appointed a day care coordinator. During the inspection staff were observed taking service users out into the community, which they clearly see as part of the role of support worker. However the record of these activities do not allow staff to record whether the service user enjoyed the experience and it is recommended DS0000064694.V303153.R01.S.doc Version 5.2 Page 13 this document be reviewed. However comments received from the relatives of one service user highlighted that on occasions the minimum agreed staffing levels have not always been maintained resulting in service users not being able to access daytime and leisure activities. This was brought to the attention of the manager who confirmed there had been occasions when staffing levels were compromised mainly at change over times when service users have returned earlier than expected. There is now a full compliment of staff and this should not occur in the future. This is a service where there is a high level of input from service users families and regular meetings with the home and social services continue to take place. At the time of the inspection one service user continues to be gradually introduced to the home and a communication book is used between relatives and the home. There are restrictions on service users accessing the grounds unaccompanied and the kitchen area. This is supported by a risk assessment to ensure the safety of service users. Examination of the record of meals served at the home demonstrates a varied diet is being offered. The main meal is served in the evening and discussion with the cook confirmed they were aware of service users likes and dislikes and will normally cook anything that service users want. Nutritional advice has been obtained due to the specific dietary needs of the service users. Records of the main meals are being kept. However more detailed records of the meals served to one service user should be kept to demonstrate the service user is having a balanced diet. DS0000064694.V303153.R01.S.doc Version 5.2 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): 18, 19, 20. The home is making every effort to ensure service users receive support in the way they prefer and that their health needs are safely met. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Discussion with staff confirmed there is a flexible approach to routines at the home. Times for getting up and going to bed are at the instigation of service users and staff gave examples of indicators to look for when service users are getting tired. Further more staff were able to give examples of offering service users a choice of what to wear and what sign or gesture to demonstrate which article of clothing they wanted to wear. There is a multi cultural staff team though service users themselves have no specific cultural requirements. Records examined confirmed service users have access to specialist services such as psychologist and psychiatrist as determined by their care plan. In addition service users are registered with the local health practice. One service user has chosen to remain with their existing G.P. Comments received from the relative of one service user raised concern over the medication practice and in particular that they had “run out” of their medication. DS0000064694.V303153.R01.S.doc Version 5.2 Page 15 Discussion with the manager confirmed there had been communication problems during the transition period between home and Sandsground. The manager has since changed the supplier to improve the system. Examination of the medication records show clear records were being kept of medication administered and received at the home. Staff confirmed they have been trained in the safe handling of medication. DS0000064694.V303153.R01.S.doc Version 5.2 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): 22, 23. The home is striving to ensure service users views are listened to and they are protected from abuse but the recording of complaints and training for staff in abuse awareness needs to be improved. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Records show the home has received two complaints since it was first registered. The records show the complaints were investigated. The action taken in response to the complaint was not recorded. The home was keeping a complaints book and both complaints were recorded on one page. It is recommended that each complaint be recorded separately to ensure confidentiality is maintained. The home has developed a complaints procedure that is in a format suited to the needs of service users using large text, symbols and pictures. The home had a copy of the local vulnerable adults procedure and copies of Wiltshire and Swindon “no secrets” guidance was available. Discussion with staff confirmed they would report any concerns affecting the welfare of service users directly to the manager. However only a small percentage of staff have received any formal abuse awareness training. When brought to the attention of the manager the inspector was informed that staff have been put forward for the next training day in December. However not all staff will be able to access this training. The home was holding money on behalf of service users and records show it is being accurately and safely managed. DS0000064694.V303153.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 29, 30. Service users live in a home that is clean, comfortable and well maintained, though bathing facilities are not entirely suited to the needs of service users. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The inspector viewed all communal living areas and all service users bedrooms. Having recently opened the home is well maintained and was found to be clean and tidy. Service users have single bedroom accommodation two of which have en suite showers. Comments received highlighted the fen suite shower room in one service users room is not entirely suitable. Discussion with the manager confirmed an occupational therapist assessment has been completed and there are plans to improve the bathroom to meet the more specialised needs of service users. It is recommend that CHOICE provides the Commission with the timescale for the work to be completed. One bedroom has no en suite facilities as determined by assessment. Service users have unrestricted access to all parts of the home, however access to the garden and front courtyard is restricted to ensure the safety of service users following a risk assessment. The rear garden is enclosed and there are plans to have a keypad lock on the garden gate, which would be DS0000064694.V303153.R01.S.doc Version 5.2 Page 18 incorporated in the fire alarm system. The manager stated the garden has still to be landscaped and wheelchair access to the new conservatory. As an interim measure the home should risk assess the step down from the conservatory into the garden as the present drop could pose a risk to service users. One service user has CCTV installed in their bedroom. The protocol for its use is clearly recorded. At the time of the inspection the system had not been used, as the service user has not spent an overnight stay. It is part of the protocol that the use of CCTV is reviewed every month to ensure it remains appropriate and does not unnecessarily impact on the service users rights to privacy. The laundry room is situated well away from food preparation areas. Facilities include a commercial washer and dryer and discussion with staff confirmed they were sufficient for the needs of the home. It was an extremely hot day when the inspection took place and no fans or other cooling systems were in place at the home. When raised with the manager the inspector was informed the use of fans could be a risk to service users. It is recommend that due to the extreme temperatures the home should explore other options in an effort to cool the building and to ensure service users can live in a comfortable and reasonable temperature. DS0000064694.V303153.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 36. The home is ensuring service users benefit from a competent and trained staff team. Safe recruitment practices are being followed but improvements are needed to ensure staff are adequately supported. The Quality rating in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The inspector met with six support workers in private. Staff were very positive about their skills and abilities to meet the needs of service users. Training records show that each member of staff has a training and development plan. For staff new to learning disability services the Learning Disability Award Framework training (LDAF) is provided as part of the induction programme. As a new service National Vocational Qualification Training (NVQ) is in its infancy, though there are plans to register staff on the award over the coming months. In addition there is a formal induction programme that is “skills for care” accredited and induction booklets were available for inspection. However no staff had received any training in equal opportunities and it is recommended that this is provided. The inspector examined the recruitment records of three members of the care team. Records show staff did not commence work until the necessary recruitment checks had been completed. All staff had a satisfactory Criminal Records Bureau check (CRB). DS0000064694.V303153.R01.S.doc Version 5.2 Page 20 There has been a recent management change at the home and this has led to the formal supervision of staff being neglected. One member of staff said they had no supervision since commencing work and another member of staff had only one formal supervision meeting. The manager stated she was aware of this deficit and a new supervision plan was being implemented. DS0000064694.V303153.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. The home is run by a competent manager who is making every effort to improve the service it delivers and ensure service users are able to live in a safe environment. The Quality rating in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The manager has been in post for over four months and has recently been registered by the Commission as the manager of the home. The manager has recently commenced the registered managers award that she hopes to complete over the next twelve months. As part of the homes quality review questionnaires have been sent to the relatives of service users to obtain their views on the service provided. The manager stated she plans to develop the quality plan over the coming months. The manager has yet to seek the views of the service users, which needs to be given as much priority as seeking the views of relatives. DS0000064694.V303153.R01.S.doc Version 5.2 Page 22 Examination of the fire safety book demonstrates staff are receiving fire safety training. In addition there has been three fire safety drills since the home was opened. Staff training records show health and safety training is provided. All radiators are guarded or have low surface temperatures and hot water is regulated close to 43c to reduce the risk of injury to service users. Safety certificates are in place. DS0000064694.V303153.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 2 3 X 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 2 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X DS0000064694.V303153.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 Standard YA2 Regulation 14(a)(b) Requirement Timescale for action 01/09/06 2 YA6 3. 4. 5. YA17 YA29 YA36 6. YA39 The registered person must ensure all service user have an assessment of need completed by a competent person and ensure a copy is kept at the home. 15(1)(2)(b) The registered person must ensure the service users care plan is updated as part of the care review. The plan must clearly specify how the needs of service users are to be met. 17(2) The registered person must ensure an accurate record is kept on all meals served. 13(4)(a) The registered person must risk assess the access to the garden through the conservatory. 18(2) The registered person must ensure staff receive formal supervision from a competent and trained person. 24(1) The registered person must ensure it seeks the views of service users as part of the quality review. 01/09/06 01/08/06 01/08/06 01/10/06 01/12/06 DS0000064694.V303153.R01.S.doc Version 5.2 Page 25 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. Refer to Standard YA5 YA6 Good Practice Recommendations The registered person should ensure service user are fully informed of the terms and conditions of their stay and the amount of fees payable. The registered person should ensure the service user care plan contains information on the risk associated with their care. The registered person should ensure any records kept of service users involvement in daytime or leisure activities includes details on whether the service user enjoyed the experience. The registered person should ensure that a record is kept at the home on the outcome of any complaint. The registered person should ensure each complaint is recorded in the complaints book on a separate page. The registered manager should ensure that all staff are made aware of the local vulnerable adult procedures. The registered person should provide the Commission with details of the expected timescales for completing the improvements to the bathroom. The registered person should ensure there is a safe system for keeping the building cool in hot weather. The registered person should ensure staff receive equal opportunity training. YA13 4. 5. 6. 7. 8. 9 YA22 YA22 YA23 YA27 YA29 YA35 DS0000064694.V303153.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 DS0000064694.V303153.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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