Inspection on 05/10/06 for Shandford

This inspection was carried out on 5th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Shandford 22/07/08

Shandford 23/11/05

Shandford 21/06/05

Shandford 02/02/05

Shandford 12/10/04

Shandford 26/01/04

Similar services:

Fairfields Country Rest Home

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Shandford 31 Station Road Budleigh Salterton Devon EX9 6RS Lead Inspector Teresa Anderson Key Unannounced 09:00 5 October 2006 th 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 Shandford DS0000022028.V310705.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. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shandford Address 31 Station Road Budleigh Salterton Devon EX9 6RS 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) 01395 443326 becky@shandford.wanadoo.co.uk www.shandford.com Shandford Residential Care Home Limited Miss Susan Marie Bissett Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Shandford Care Home is a large detached property in the coastal town of Budleigh Salterton. It is owned by a not-for-profit organisation and is overseen by a voluntary committee. Personal care and accommodation is provided for up to 25 residents who have needs relating to old age. The home is situated within pleasant and level gardens a short walk from the sea front and town centre. There are some local shops and a large public green nearby. There are two lounges, one on each floor and a dedicated dining room. There is a 6-person passenger lift and parking is available. Shandford has been extensively modernised and extended since it was first acquired in 1958. It has recently undergone further improvements to extend the lounge and dining room and to add a treatment room, an assisted bathroom and a sluice. 18 of the 25 bedrooms now have ensuite facilities. Current fees range from £287.00 to £387. These fees do not include items such as toiletries, newspapers and hairdressing. Information about this home, including reports, is available direct from the home and from their website www.shandford.com Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place as part of the normal programme of inspection. It started at 09.00am and finished at 3.00pm. During that time the inspector spoke with the manager and office manager, with 4 members of care staff and with the cook and cleaner. She was introduced to residents and explained her role at a residents meeting that was being held. She then spoke with approximately 10 residents, 3 in depth. The care and accommodation offered to 3 residents were case tracked (this helps us to understand the experiences of people using the service). The inspector also observed the care and attention given to residents by staff. She saw all the communal and service areas of the home and some of the resident’s bedrooms. Before the site visit the home provided information in a pre-inspection questionnaire. Surveys forms were sent to 11 residents and 7 were returned; to 9 members of staff and 7 were returned and to health and social care staff who visit the home and 4 were received. Records in relation to assessment, care planning, medication, staffing, training, recruitment and residents monies were also inspected. What the service does well: Information relating to Shandford is excellent. The written guide to the home is kept up to date and the website offers a wealth of information and photographs. All residents are assessed prior to admission and it is ensured that staff have enough information about residents needs and can help each new resident to settle in. Comments from residents include ‘I’m glad I came here’ and ‘I am completely content here’. Each resident has a plan of care that includes information on his or her preferred routine and likes and dislikes. Residents say they get the care they need and that staff always listen and act upon what they say. One resident said ‘I couldn’t be better cared for’. Activities are offered which include outings, an entertainment man and bingo. Residents say that they never get bored and are happy with these arrangements. Food is described as ‘good’ and ‘lovely’. It is based on a two-week menu and is cooked on the premises by a very experienced cook. Fresh foods are used where possible. Residents are treated with respect and dignity. They say they feel safe and secure and clearly have excellent relationships with carers who they describe as ‘lovely’ and ‘caring’. Residents are relaxed, confident and at ease. One resident said the best thing about the home is ‘the freedom to be me’. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 6 The home is always kept clean and fresh and residents report that this was the case even during the ‘worst’ of the recent building work. Staff and residents are well supported by an experienced manager and excellent management systems. The home has demonstrated consistent improvement and innovation since the employment of the current manager in 2004. The current staff team should be commended for their commitment and hard work. 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 Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 8 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 Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 3. This home does not provide intermediate care. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Excellent information is available to residents about the home to help them to make a choice about where to live. Assessments of residents prior to admission ensure that staff have enough information in order to know and meet their needs and to help them deal with a potentially traumatic transition. EVIDENCE: In surveys all residents said that they had received a contract and that they had had enough information about the home before moving in. The office manager ensures that the guide to the home is updated. This includes updated the extremely comprehensive and informative website. Staff Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 10 spoken with said that they read the guide so that they know what residents are told they can expect and so that they can deliver this. Each prospective resident is assessed prior to moving in and additional information is collected from health and social care staff where appropriate. This ensures that the assessment is comprehensive and provides a broad basis for the initial plan of care to be delivered. Staff report that they have enough information about each resident before they move in including information on moving and handling. All those who responded in surveys say that they know about the particular needs of residents, understand the care plan and know what name the resident likes to be known by before they begin working with that resident. Staff spoken with demonstrate a good understanding of how moving into a care home can be a traumatic life experience for new residents and say they try to make the transition easier. One way of doing this is by having an allocated ‘minder’ for each new resident. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The arrangements in place for planning resident’s care ensure that residents get the care they need in a way that suits them. The healthcare needs of residents are well met with evidence of multidisciplinary involvement. The systems for the management and administration of medications are good and largely ensure that residents’ medication needs are met safely. Personal support is offered in such a way as to protect and promote residents’ rights to privacy and dignity. EVIDENCE: Each resident has a written plan of care and three were looked at in depth. Each one generally provides good information for staff on how to deliver care to a high standard and in a consistent way. This includes information on the residents risk of developing pressure sores and what staff should do to prevent Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 12 this, and information on how the resident should be moved and handled. The residents preferred daily routine is documented for staff to follow and include information about the residents past and likes and dislikes. The system is easy to read and use. There is good evidence of the involvement of health and social care staff where appropriate. This includes GP’s, Community Psychiatric Nurse (CPN), district nurse, chiropodists and opticians. In surveys all residents say that they always or usually receive the care and attention they need. All said that staff always listen and act on what they say and that staff ensure that medical support is available when needed. Health and social care surveys returned said that they are happy with the care provided. The care plan of one resident who is currently challenging the service could improve. This relates to the lack of recording of observations made of this resident’s behaviour and of what should be done by staff to manage this. Some staff demonstrate a good understanding of this type of behaviour but management strategies should be agreed and recorded and their success or failure discussed and recorded in order to ensure consistency and good practice. This was discussed with the manager. Daily entries in care plans are not always being linked to the objectives set in the care plan. This means that monthly reviews of the care plans are not always as meaningful as they might be. The manager described how medication within the home is managed. The system used should ensure that there is a clear audit trail and that the margin for error is reduced. However, during inspection of the Medication Administration Records a number of gaps in record keeping were noted meaning that the system in place is not being followed and the margin for error is increased. During the inspection it was seen that residents are treated by staff with immense respect and that their privacy is promoted. For example, staff ensured that residents were taken somewhere private to speak with the inspector. Residents say that staff knock on their bedroom doors and that they receive their care in private. All residents wear their own clothes at all times and are helped to maintain their dignity by ensuring that these are kept clean and tidy, without compromising the residents choice. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Links with the community and visitors are very good and residents have their social care needs met. Support is offered in a way that promotes choice and flexibility. The meals offered provide choice, variety and meet nutritional needs although meals offered to those with specialist needs could be improved. EVIDENCE: In surveys the majority of residents said that there are always activities arranged by the home that they can join in with. During the inspection residents said how much they enjoy singalongs (organised by the ladies committee) and the entertainment man who comes in twice a week. Other activities include bingo and one to one activities such as jigsaws. Some residents are able to go out on their own and others go out when staff have time to accompany them. Outings are arranged to local amenities that residents say they really enjoy. Recent visits have included the Exmouth Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 14 Pavilion, Bicton Gardens and a local garden centre. Volunteers help out on these occasions as well as providing other support to residents such as doing shopping for them. Volunteers also helped those residents who needed help to complete the survey forms. Residents say that visitors are always made welcome and offered refreshments. In surveys 7 residents said they always enjoy the meals and 1 said they usually do. One resident said ‘I can find no fault at all’. Lunch is served in the dining room where tables are laid and decorated. Specialist equipment is available for those who need it to help them remain independent. Those who need assistance to eat are given this. There is a two week menu and meals are cooked on the premises and where possible fresh ingredients are used. An alternative meal is not routinely offered but if residents request something different they can have this. Some staff thought that those residents who are diabetic could have a more varied diet. One diabetic resident said that they miss sugar but that they understand they can’t have it and that they always get a substitute. This person also said that they like some meals liquidised (as does another resident) and the cook does this. The inspector noted that foods making up the meal are not liquidised separately but as one bolus. This is not good practice. Staff demonstrate a good understanding of choice and autonomy and gave the inspector good examples of how they achieve this. One resident for example has a favourite colour and staff ensure this is available for them to wear all the time if this is their choice. Preferred routines e.g getting up times and going to bed times are recorded in care plans and residents say that staff follow these. One resident said that they are slow to wake and described how staff wake them in a gentle and accommodating way. One resident said they like to spend time alone and that staff make sure they get this. Staff were observed interacting with residents. They clearly understand their idiosyncrasies and what they like and dislike and work hard to make residents happy. One resident said that their teddy bears are important to them and that staff respect this and the bears. Bedrooms are personalised for each resident. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The home has a complaints system that residents feel confident in using if they need to. Residents feel safe and well cared for and staff’s knowledge of adult protection ensures that residents live in an environment where they are protected from abuse. EVIDENCE: The home has a complaints policy. Residents say they never have a need to use this because if they are unhappy about anything they just say and something is done. All residents who sent in surveys say that they always know who to speak with if they are not happy, that they know how to make a complaint and that staff listen and act on what they say. All staff working at the home have received or are due to receive training in the protection of vulnerable adults. This includes the housekeeping staff and the entertainment person. All those who work in the home, on a paid or voluntary basis, undergo enhanced police checks and excellent recruitment procedures are in place. Staff demonstrate a very good understanding of abuse and of what to do if they suspect abuse or if an allegation is made. Residents say that staff are respectful, kind, thoughtful and caring. They say they feel safe and secure. Shandford DS0000022028.V310705.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The environment of this home provides residents with a homely, clean and place to live. EVIDENCE: Shandford was first used as a care home in 1958. Since that time it has been extensively modernised. 18 of the 25 bedrooms now have ensuite facilities, bathrooms have been upgraded to better suit those people with disabilities or with mobility problems and a sluice, to help promote infection control, has been added. On the day of inspection one resident had chosen and was being helped to move bedrooms so that they could have ensuite facilities. The resident was both excited and scared at the prospect of change. Staff were working hard to get the bedroom looking like ‘home’ to help this person cope with the move. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 17 Residents say that the home is always clean and fresh and that the cleaner works hard to keep it this way. Staff were observed adhering to infection control procedures to ensure good hygiene practice. Shandford DS0000022028.V310705.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. The quality outcome in this area is good. This judgement has been made using available evidence including a site visit. Staff receive appropriate training and are employed in sufficient numbers to provide residents with the support and care they need. The recruitment procedures designed to protect residents are closely followed, ensuring residents’ safety. EVIDENCE: Residents, in surveys, say that they always get the help they need. Some say that at times they have to wait ‘a little while’ but that this does not cause problems. Staff are described as ‘lovely’, ‘the best’ and many residents said ‘we are privileged’ and ‘we are blessed’. There are usually 5 carers on in the morning, 3–4 carers in the afternoon and 2 at night. The home does not tend to use agency staff. The majority of staff say that they are not usually asked to care for people outside their area of expertise, that they get the support they need and that the care plan allows enough time to give the care required. Some thought that the care to be given could be better explained to them. Training for staff (apart from mandatory training) includes communication skills, diabetes and handling medication. Approximately 44 of staff are Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 19 trained to NVQ level 2 or above (the national standard to be achieved is set at 50 ). A number of residents are developing symptoms of dementia. Whilst these residents do not need to be cared for in specialist facilities, they and staff would benefit if staff received training in dementia and person centred care. There is an excellent system in place for managing recruitment. All the necessary checks are made including obtaining references and police checks. The manager follows up or puts in place extra checks if there are any reasons for doubt. Three staff recruitment files were checked and were in order and all those police checks carried out since the last inspection were also checked by the inspector. The office manager organises this to comply with Data Protection. This is commendable. Shandford DS0000022028.V310705.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a site visit. The management systems in place help to ensure residents live in a wellmanaged, safe environment where they are protected. The management style and ethos of the home ensure that the quality of residents’ lives are enhanced. EVIDENCE: There has been consistent improvement in the standards of care practices in this home since the current manager was employed in 2004. She has identified priorities and worked hard with staff to achieve good outcomes for residents. The home has a relaxed atmosphere where residents and staff feel able to speak up and be heard. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 21 The manager has consistently demonstrated a sound knowledge base and competency. She has good experience of working with the physically disabled and with the elderly. She also has a positive attitude towards learning, and to gaining and passing on new information for the benefit of residents. The manager is well supported by the office manager who provides administrative support and ensures that management systems are efficient and effective. In addition the vice-chairperson of the management committee carries out unannounced inspections when for example she speaks with residents to get their views on the services offered and checks on the number offalls sustained by residents (the rate is low). On the day of this unannounced inspection a residents meeting had been arranged. The inspector was invited to attend this to explain her role. Residents said that the home is ‘marvellous’ and that the staff are ‘the best’. Residents were confident and clearly comfortable enough to speak out if they wanted to. Residents say the home ‘feels like home’ and they feel ‘important’. Regular satisfaction surveys are undertaken, the results collated and published (on paper and on the web site) and action is taken to meet any identified shortfalls. The home manages small amounts of monies for some residents. Access to this is limited. Receipts and records of all transactions made are kept. Three were checked and found to be in order. All staff receive mandatory training including infection control, food hygiene and fire training. The manager reports in the pre-inspection questionnaire that maintenance contracts are in place and that policies and procedures are kept up to date. The placement of the staff notice board is very innovative. Staff report it is very useful, that they read the information on it and that they take notice of what is placed there. Shandford DS0000022028.V310705.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 4 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 4 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 4 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 x 3 x x 3 Shandford DS0000022028.V310705.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 OP7 Regulation 15 (1) Requirement You must ensure that the care plan of the one resident identified is updated to include how their needs in relation to their health and welfare (dementia and communication) are to be met. Timescale for action 30/11/06 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 4 Refer to Standard OP7 OP9 OP15 OP27 Good Practice Recommendations You should ensure that care staff update care plans in relation to the objectives identified and to reflect changing needs. You should ensure that there are not gaps in the records relating to the administration of medication. You should ensure that meals that are liquidised are not done so as one bolus but that each food making up the meal is liquidised and presented separately. You should ensure that staff receive training in dementia (person centred) care. Shandford DS0000022028.V310705.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 Shandford DS0000022028.V310705.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!