Inspection on 26/06/07 for Sea View Lodge

This inspection was carried out on 26th June 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sea View Lodge 04/08/09

Sea View Lodge 18/05/09

Sea View Lodge 19/06/08

Sea View Lodge 22/11/06

Sea View Lodge 23/06/06

Sea View Lodge 02/03/06

Sea View Lodge 31/05/05

Sea View Lodge 14/12/04

Sea View Lodge 30/03/04

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

CARE HOME ADULTS 18-65 Sea View Lodge 116 Central Parade Herne Bay Kent CT6 5JN Lead Inspector Joseph Harris Key Unannounced Inspection 26th June 2007 10:00 Sea View Lodge DS0000023424.V338996.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 Sea View Lodge DS0000023424.V338996.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. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Sea View Lodge Address 116 Central Parade Herne Bay Kent CT6 5JN 01227 375253 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) seaviewlodge@aol.com Mr Shahid Sheikh Mrs Nelofar Sheikh Mr Shahid Majeed Sheikh Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2006 Brief Description of the Service: Sea View Lodge is a 10-bedded home for people with learning disabilities in the town of Herne Bay. The house is located on the seafront close to the pier and a short distance from the centre of town with a good range of amenities and facilities. There are reasonable public transport from the town including bus routes and a train station. The home is set out over two floors. The ground floor mainly comprising of communal space with two bedrooms and the first floor consisting of bedrooms and toilets/bathing facilities. There is adequate communal space throughout the home with more space available following refurbishment. There is a small, enclosed courtyard to the rear of the home and a larger paved area with parking space to the front of the home. The current fees for the service at the time of the visit range from £398 to £560. Information on the home services and the CSCI reports for prospective service users will be detailed in the statement of purpose and service user guide. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit on 26th June 2007. During the course of the visit the inspector spoke to all service users present in the home and staff members. A tour of the premises was undertaken and a range of documents were examined relating to service users, staff, health and safety, medication and other records relating to the running of the home. The registered manager was not present during the visit and, as a result, some documentation was unavailable for inspection including staff personnel files and some health and safety documentation. What the service does well: What has improved since the last inspection? What they could do better: 3 requirements and 7 recommendations have been made as a result of this inspection process. It is required that the home provides safe and appropriate storage for medications that require refrigeration. Additionally, it was not possible to fully inspect the homes recruitment procedures and health and safety certificates due to the fact that the manager was not present at the time of the visit. These documents need to be available for inspection at all times. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 6 Amongst the recommendations were issues covering the level of activities provided in the home for some of the residents who find it more difficult to go out in particular. There are also steps leading into and out of the kitchen, which should be reviewed due to the decreased mobility of some service users. Further work is advised to update care plans providing clear and unambiguous guidance for staff to meet needs. Contracts of residency should include room numbers and fees. The registered manager needs to reinstitute staff meetings and separate resident meetings on a regular basis. The staff rota also needs to be kept up to date providing an accurate reference for all staff on duty throughout the week with particular regard to the registered manager’s hours. Improvements have been made to the quality monitoring processes and this now would benefit from being further developed. 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. Sea View Lodge DS0000023424.V338996.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 Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5. Quality in this outcome area is adequate. Service users have access to adequate information about the home and their needs are assessed prior to moving in. A written contract is in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has developed a statement of purpose and service users guide. These documents were reviewed and updated in August 2006. The required information is contained within these documents, however it may be beneficial for the registered manager to improve the service user guide, by including pictures, symbols and increasing the size of the lettering to aid understanding and accessibility for some service users who receive it when choosing whether to move into the home. Pre-admission assessment information was examined for two service users who have relatively recently moved into the home. Both service user files contained adequate information including care management joint assessments and the most recent care plans and risk assessments. The registered manager has developed an in-house pre-admission assessment form for use with prospective service users who do not have a care manager. These forms were not completed for the service user files examined. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 9 A contract covering the terms and conditions of residency is in place. This document has recently been updated and provides clear information regarding the services and expectations of all parties. It is advised, however, that the registered manager includes the room number occupied and completes the schedule of fees. Refer to recommendation 1. A signed copy of the contract was on file for all service users. Sea View Lodge DS0000023424.V338996.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. Service users needs are assessed and perceived risks managed. Residents are able to make decisions about their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home develops a plan of care for each service user and throughout the course of the visit three resident files were examined. A care management care plan was on file for each service user covering assessed needs. However, it was noted that the plans developed by the home provided little additional guidance for staff to be able to consistently meet individual needs. Some aspects of care needs should provide additional guidance especially with regard to issues such as diabetes, epilepsy. Refer to recommendation 2. Plans showed evidence of 6 monthly review and the registered manager has developed pen portraits providing a summary of needs and likes as well as a brief history. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 11 Residents are enabled to make decisions affecting their lives and restrictions are documented following liaison with care managers and service users. Residents reported that they have access to their finances as they wish and they are supported to manage their monies appropriately. The home has developed risk assessments for all service users addressing a range of perceived risks. The level of guidance is adequate. It was noted that a number of issues raised within Care Management joint assessments for some service users were not fully addressed through the risk management process, which is an area that would benefit from review. In one circumstance this related to identification of hot surfaces and water, which should be appropriately risk assessed by the home. Sea View Lodge DS0000023424.V338996.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is adequate. Service users have a lifestyle that suits their needs, although further work can be done to expand the level of activities within the home. Residents have a healthy and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities and leisure pursuits available for service users varies dependent on the ability of each individual to access outside resources. A number of service users attend clubs and day services throughout the week from 2-5 days. There was also evidence that some residents regularly go out with staff. However, some of the older service users, who expressed no desire to go out, have limited resources at their disposal in the home. All residents have activities that they like to participate in independently including colouring, jigsaws, cross-stitch and watching television. One resident stated that they Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 13 used to have a lady come to the home to do arts and crafts and it was also stated that the manager considered booking an outside entertainer. The home needs to provide some structured activities for those residents who wish to participate. Activities are arranged with staff each afternoon, but the records maintained for these demonstrated a similar range of pastimes as those engaged in independently. It is advised that an activities programme is developed, which staff can facilitate to include sessions such as arts and crafts, music and movement, sing-a-longs and baking amongst other things. Refer to recommendation 3. Residents confirmed that their friends and relatives are welcomed into the home at all reasonable times. Where appropriate the registered manager liaises with significant others where there is an issue of care. Service users are able to follow their daily routines in a flexible manner choosing when to get up and go to bed. Residents said of the staff that “they are very nice and caring” and that they “do all they can to help”. Some residents take part in household chores and are involved in the day to day running of the home on differing levels. All residents’ room have the facility to be locked. The home provides a healthy and balanced diet and residents stated that the food in the home is nice. “We can choose what we want most of the time if we don’t like what’s on the menu”. One resident said, “Mr Sheikh (the registered manager) involves us much more in the planning of menus and the staff are good cooks.” There was a reasonable range of food available in the home both fresh goods and frozen products. Residents with special dietary needs are catered for. It is suggested that the home provides fresh milk in addition to the long life variety to cater for individual tastes. Sea View Lodge DS0000023424.V338996.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. Service users receive personal support in the way they prefer and their healthcare needs are met. Medication issues are appropriately managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users confirmed that staff provide thoughtful and sensitive support for their personal needs. Staff spoken to had a good awareness of individual needs and considerations, although service users particular personal care needs and how to address them could be more thoroughly addressed through the care planning process, as well as methods for promoting each residents independence in this area of care. The home monitors the healthcare issues of residents and there was evidence of file to demonstrate that service users have attended appointments with healthcare professionals and any health related concerns are appropriately referred. It is advised that the home monitors some healthcare issues more closely and that this monitoring is clearly stated within care plans, such as monitoring epilepsy and diabetes issues and ensuring that all professional Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 15 advice is clearly recorded. All residents are registered with a local GP and have access to complimentary healthcare such as chiropodists, dentists and opticians, etc. Medication records were examined, which were complete and up to date and all medication issues were seen to be well managed, however the home has recently required some medications to be stored in a fridge and a dedicated, lockable medication fridge needs to be provided for this purpose. Refer to requirement 1. Sea View Lodge DS0000023424.V338996.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Service user’s views are listened to and they are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an adequate complaints process in place covering all relevant topics. A copy of this is provided in the service user’s guide and is on display within the home. It was reported that there have been no complaints since the last inspection. A complaints book is in place to record issues of note and demonstrate the actions taken. Service users stated that they felt comfortable in raising concerns with the registered manager and staff. The home has adequate policies and procedures in place addressing issues of abuse and adult protection, which include a whistle-blowing policy. Issues of abuse are addressed through the induction process. All staff have attended courses covering adult protection issues and abuse awareness. In discussion with staff there was a reasonable awareness of what action would be required should they witness or suspect abuse. Policies and practices with regard to the handling of service users money and valuables, safe storage and access to records are adequate. There have been no adult protection alerts raised since the last inspection. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 and 30. Quality in this outcome area is adequate. Service users live in a homely environment that may benefit from some minor modifications. The home is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has continued to update the general environment including the refurbishment of a number bedrooms and the provision of radiator guards amongst other things. The home is set over three floors with bedroom accommodation on each floor. The main lounge and kitchen area are also located on the ground floor. There is a bathroom and toilet on each of the top two floors. The home has a small patio area at the rear and an area at the front where residents can sit out with a sea view. There is a domestic laundry area situated in the conservatory just off the kitchen and a risk assessment is in place to ensure laundry is not carried through the kitchen when food is being prepared. There are two additional rooms to the rear of the building that Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 18 currently provide space for private meetings and as a storage area. The registered manager has previously stated plans to refurbish these areas. There are two steps down from the lounge into the kitchen and from the kitchen into the rear corridor. Due to the mobility needs of some service users it is advised that these steps are provided with ramps to improve access. Refer to recommendation 4. On inspection the home was clean and hygienic. All hazardous substances were safely stored with the exception of refrigerated medications. Policies and procedures are in place with regard to the control of infection. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 35. Quality in this outcome area is adequate There are adequate numbers of staff on duty who receive adequate training and support to meet service users needs. Staff personnel files were not available for inspection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager was not present at the inspection therefore it was not possible to gain access to the staff personnel files and, as a result, standard 34 could not be assessed. There are 2 staff on duty at all times within the home. At night time one member of staff sleeps-in and it is reported that the registered manager stays at the home at night time also. The home has a staff team of 4 full-time employees who have been recruited through an overseas agency, from China. The registered manager also works full-time in the home, although the rota stated that he was due to be on duty on the day of the inspection, but was not Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 20 present. It is important that the staff rota is maintained and up to date at all times. Refer to recommendation 5. Staff reported that they have received training in all the mandatory training topics and some certificates demonstrating this are displayed on the wall in the hallway of the home. However, due to not being able to access staff files, it was not possible to determine the current induction programme and evidence of any additional training for some staff. The registered manager needs to make satisfactory arrangements to ensure that staff personnel files are available for inspection at all times. Refer to requirement 2. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is adequate. All of these standards were only partially assessed due to the registered manager not being present at the time of the inspection. The registered manager is appropriately qualified and experienced and has introduced improved quality assurance mechanisms. The health and safety of service users is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has owned the home and been in post for a number of years. He has attained the necessary qualifications and has demonstrated a willingness and drive to improve the service over the past few years. The staff Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 22 stated that he supports them in their works and service users commented that they get on well with him and acknowledge some of the improvements that have been made. The registered manager has produced a questionnaire for residents regarding the quality of care that they receive addressing a number of different areas. Some service users recalled completing the questionnaire. This is a positive step in ensuring the quality of the service and this should now be completed for staff and professionals to feedback about the service. Once all responses have been received the results should be collated into a quality report showing areas of satisfaction and areas of proposed improvement with an action plan to demonstrate how these improvements will be managed. Refer to recommendation 6. According to records of staff meeting and resident meetings these have not occurred for approximately 6 months and need to be reintroduced at intervals of no less than every 2 months. Refer to recommendation 7. Some health and safety records were available for inspection including the accident book and fire safety log, all of which were maintained and up to date. However, it was noted that some accidents had occurred, which had not been included for notification to the Commission for Social Care Inspection. There was access to some invoices, which demonstrated that some service checks have been completed, but there was no access to a number of health and safety certificates and staff were not aware of where they were kept. It is required that all health and safety service maintenance and certificates are available for inspection at all times. Refer to requirement 3. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 X 35 2 36 X 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 2 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 2 X X 2 X Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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. 3. Standard YA20 YA35 YA34 YA42 Regulation 13(2) 19, schedule 2 13(4), schedule 4 Requirement To provide a lockable drugs fridge for the sole purpose of storing medications. To ensure staff personnel files are available for inspection at all times. To ensure all health and safety related information, service certificates and fire and environmental risk assessments are available for inspection at all times. Timescale for action 01/08/07 01/08/07 01/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA5 YA6 YA12 Good Practice Recommendations To ensure all required information including fees and rooms occupied is in the contract of residency. To develop care plans providing more detailed guidance to enable staff to meet assessed needs. To provide a structured programme activities, with particular consideration for those residents who are less able to go out. DS0000023424.V338996.R01.S.doc Version 5.2 Page 25 Sea View Lodge 4. 5. 6. 7. YA29 YA33 YA39 YA39 To improve accessibility into the kitchen by introducing a movable ramp for both steps. To ensure that the staff rota is kept up to date at all times. To continue to develop quality monitoring processes. To ensure staff meetings and separate resident meetings are held at regular intervals. Sea View Lodge DS0000023424.V338996.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Sea View Lodge DS0000023424.V338996.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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