Inspection on 14/05/07 for Smithy Forge

This inspection was carried out on 14th May 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Smithy Forge 15/12/05

Smithy Forge 10/06/05

Smithy Forge 24/02/05

Smithy Forge 19/08/04

Smithy Forge 22/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Smithy Forge 3a Norton Village Runcorn Cheshire WA7 6PZ Lead Inspector Sue Dolley Unannounced Inspection 14th May 2007 09:00 Smithy Forge DS0000005199.V327883.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 Smithy Forge DS0000005199.V327883.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. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Smithy Forge Address 3a Norton Village Runcorn Cheshire WA7 6PZ 01928 790986 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) Mr Denis Price Mrs Lynn Price Mrs Lynn Price Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of six places within the category of learning disability. 15th December 2005 Date of last inspection Brief Description of the Service: Smithy Forge is a large modern detached house in a quiet residential area near Norton Priory and within easy reach of the routes to local towns. The home is registered to provide care for six adults who have learning disabilities. There are six single bedrooms in the home. Three on the ground floor and three on the first floor. There is a large comfortable lounge with colour television and video. The dining room/conservatory opens onto a patio, which gives access to a large and private rear garden. Smithy Forge is well presented, well maintained and furnished to a high standard. The current scale of charges is £324.00 to £690.00 per week. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on 14th May 2007 and lasted 4 hours. One inspector carried out the visit. This visit was just one part of the inspection. Before the visit, the owner of the home was asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for people who use the service, families and health and social care professionals to find out their views. Other information received since the last key inspection was also reviewed. During the visit various records and the premises were looked at. Four people living within the home were also spoken with and they gave their views about the service. What the service does well: What has improved since the last inspection? What they could do better: The next of kin details, weekly activities sheet and the ‘circle of friends’ information needs to be checked regularly to ensure the information is up to date and reflects recent changes. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 6 Smithy Forge should have clear contact information and a procedure in place to ensure that the home can be staffed and ready to provide care, when people who use the service need to return home from day care or elsewhere at short notice. 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. Smithy Forge DS0000005199.V327883.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 Smithy Forge DS0000005199.V327883.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): 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care is taken to gather assessment information from a number of different sources to complete dependency assessments. This ensures all needs are identified and that individual needs can be met. EVIDENCE: The group of people living within the home has remained unchanged for a considerable period of time. When considering a placement at Smithy Forge, people had been gradually introduced to the home, the staff and existing people living within the service. The care folders, dependency assessments, health action plans and daily records of two people who use the service were checked. The care plans and assessment documentation were thorough. They were read, along with the essential lifestyle plans, and identified and addressed all care and support needs. The care plans accurately reflected the individualised support needed and provided. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 9 Examples of diary sheets were read and accurately described the daily events for each person. The level and quality of information provided, indicated ongoing and attentive monitoring and support to people living within the home. Within each care file there were advisory notes to staff regarding individual care planning and review to ensure all care needs were fully addressed. Key workers were identified and a circle of friends map had been drawn for each person to identify people important to them. Advice was given at feedback to the inspection as the circle of friends, next of kin details and activity sheet needed updating for one person. Essential lifestyle plans provided positive descriptions of people. They included details about their personality and character and identified interests, achievements and independence skills. Likes, dislikes, preferences and the hopes, dreams and fears of each individual were recorded. Copies of assessments and reports written by health care professionals were available to view on file. This information along with risk assessments and review notes, combined to give a good overall picture of care and support needs and emerging skills. Staff members were knowledgeable about the people in their care and this level of understanding encourages a sensitive and caring environment within the home. Smithy Forge DS0000005199.V327883.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 good. This judgement has been made using available evidence including a visit to this service. Care needs are thoroughly assessed and people living at Smithy Forge are involved in decisions about their lives. People who use the service are encouraged to play an active role in planning the care and support they receive and are assisted towards independence. EVIDENCE: The assessment and care planning processes within the home focus on achieving positive outcomes for people and ensures the diverse needs of residents are met. The overall aim of each care plan was fully explained and individuals’ personal goals had been recorded. People living at Smithy Forge had been involved in the assessment process and had agreed and signed their care plans. Each care folder contained a photograph of the person cared for, to aid identification. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 11 Care information included clinical, personal and occupational profiles and weekly activity sheets. Staff members had guidelines for behaviour management to refer to, to help raise awareness and to enable them to provide appropriate support at times of challenge. There was evidence of people living within the home making choices and of them being involved in decision –making. The minutes of house meetings were read and had been agreed and signed by the people taking part. Decisions taken at meetings had been recorded in the actual words used by people who use the service. Discussion had been held about an opportunity to go on a trip out organised by The Princes Trust. Two people had accepted, one declined because they thought the weather was to cold, one declined because they would be on leave and another because they did not wish to miss their supported employment placement. The people living within the home had been involved in selecting new carpets, in choosing places to visit for trips out and in compiling fortnightly menus. In discussion with people who live at Smithy Forge, they confirmed that they choose times of retiring and rising, are involved in selecting meals and choose who they receive support from. They confirmed that each person was included in a household rota which involved them in completing housekeeping tasks for example setting the table, washing dishes, cleaning and helping to prepare snacks and meals. Each person receiving a service is encouraged to experience a number of structured activities designed to help develop daily living skills and to increase independence. An effective risk assessment process is in place to ensure any risks involved are minimised for example in relation to drink and meal preparation, bathing, smoking and independent travel. During the inspection a group of four people who live at Smithy Forge were engaged in conversation about the home, about their interests, experiences and abilities and all demonstrated that they had choices and individualised support to enable their aspirations to be met. One resident expressed immense satisfaction in maintaining a paid supported employment placement. Each resident spoken with, regarded Smithy Forge as their home and confirmed in actions and words that they enjoyed the friendship of residents and staff alike. A relative provided a number of positive comments in a survey questionnaire issued prior to the inspection. They felt that their relative regarded Smithy Forge as ‘home’, they were happy that their relatives’ independence was nurtured. They said they were able to visit the home without the need for an appointment and regarded it as an excellent place. Smithy Forge DS0000005199.V327883.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): 12,13,15,16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Smithy Forge are encouraged to engage in social, educational, and occupational activities to meet their expectations and to develop their life skills. EVIDENCE: The care folders provided evidence of people using the service, having opportunities to learn and use practical life skills inside and outside the home and to maximise their independence. Individuals confirmed that they had been enabled to get involved in various leisure activities and that staff members supported them to pursue their own interests and hobbies. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 13 The people living at Smithy Forge attend day care services within the community. One person has a long- term supported employment placement at a local day nursery. Residents spoke of their hobbies, of their interests in television and music and talked about going to various music concerts with staff. There are, regular one to one and small group activities organised and people at Smithy Forge are regularly involved in birthday celebrations, shopping trips, and trips to the cinema. Occasionally the people at Smithy Forge have meals out and take -a -ways delivered. Staff members have a wide knowledge of the local community and involve individuals in shopping trips and various other activities within the local community. People receiving a service are encouraged to participate in all aspects of life within the home and are consulted individually and as a group about how the home is run. They have gained in confidence and abilities as a result. Several people had been involved in staff selection and had enjoyed and gained from the experience. In response to a survey questionnaire one person said, ‘The staff are so kind, I like this place, the house is always clean and we have a nice new carpet’. Smithy Forge DS0000005199.V327883.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 excellent. This judgement has been made using available evidence including a visit to this service. The people who receive a service have effective personal and healthcare support to maintain their health and wellbeing. Personal support is flexible, consistent and is able to meet the changing needs of people cared for. EVIDENCE: Detailed health action plans were in place for each person and everyone receives annual health screening and is promptly referred to specialist health services when the need arises. Records of care provided evidence that staff members were alert and aware to changes. They had been quick to notice changes in health and had quickly obtained the necessary healthcare support for people with deteriorating health. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 15 Two health action plans were checked and provided extremely detailed information. They recorded all health issues, and the necessary action to meet needs. The health action plans contained for example, photographs of General Practitioners involved, Opticians and Chiropodists including photographs of the Health Centre and some medical equipment regularly used there. The role of each individual health care professional was explained to aid peoples’ understanding and to help prepare people for health appointments with particular professionals. All health care visits and contacts were carefully recorded with outcomes and action to be taken. Details of recent health investigations were available to staff members and information had been provided to encourage healthy diets to help prevent strokes and to reduce cholesterol. Mediation storage and record keeping was checked. The medication records were carefully and accurately maintained. Staff members had been supplied with descriptions of each medicine prescribed to explain the function and purpose and any possible side effects. The records of medicines sent to day care and on leave were also carefully kept. Omission codes were used appropriately and discontinuation dates were carefully recorded. Five of the staff members have been trained to administer medication. Risk assessments for the self -administration of medicines were available on file to help identify and minimise risks. The medication file also contained photographs of residents to aid identification. Smithy Forge DS0000005199.V327883.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. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure in place and has an open culture that enables people receiving care and their supporters to express their views and concerns in a safe and understanding environment. EVIDENCE: There is a clear and accessible complaints policy and procedure through which people receiving a service and relatives can address any issues important to them. The pre- inspection questionnaire stated that there had been no complaints during the last twelve months. The home is committed to ensuring that people are consulted about matters, which are significant in the running of the home, which might affect their well being, or quality of life. The manager and staff are always available to listen and respond to the views of the people living at Smithy Forge and to provide advice and support. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 17 The manager ensures that People receiving care are safeguarded and staff members have received appropriate training to inform the work that they do. Future training to be planned included Protection of Vulnerable Adults training and No Secrets training. There are robust procedures in place for responding to suspicion or evidence of abuse or neglect, including whistle blowing. Care staff have access to the Department of Health guidance entitled, ‘No Secrets’. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Smithy Forge is well maintained clean and pleasant. It is decorated and furnished to a good standard providing a comfortable and homely environment for people living there. EVIDENCE: Care and attention is given to maintenance and renewal to ensure the environment is welcoming, comfortable clean and hygienic. The entrance hall and lounge have recently been re-carpeted and there are plans to replace the bathroom window. The reports of monthly monitoring visits undertaken by the owner provided evidence of the premises being regularly checked and of maintenance issues being addressed promptly. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 19 The lounge, hallway, office, kitchen and communal bathroom were checked along with two bedrooms. All areas were well maintained, well decorated, fresh and clean. Some people have chosen their own furniture and have also chosen not to have particular items of furniture in their rooms. Their choices were indicated within their plans of care. The outdoor space was well maintained. The large rear garden is fenced and private and is well used by residents in the summer months. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 20 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): 31,33,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team support each other and share their skills and knowledge. They know the people they care for well and ensure the smooth running of the service. EVIDENCE: The registered manager ensures that staff members have clearly defined job descriptions and understand their own and others’ roles and responsibilities. Staff members know and support the main aims and values of the home and demonstrate a commitment to providing individualised care and support. The registered manager is a co-owner of Smithy Forge and has more than 15 years experience of working with adults with learning disabilities and has completed NVQ level 4. Staff members are experienced, have the necessary experience to undertake the work that they do and undertake training to enhance their skills and learning. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 21 One new member of staff has commenced employment since the last inspection and is NVQ qualified. The existing staff team have continued to advance their NVQ training and qualification. Staff members work well together as a team and support each other. The manager and staff cover any temporary staff shortages. On the day of the inspection the inspector arrived at 9:40 am to find that the member of staff was due to go off duty and all residents were away from the home either on leave or at day care. The inspection commenced later at 15.40 when a member of staff was on duty and the residents had begun to return home. As the manager and home owners, were on holiday and the home was not staffed earlier in the day it was unclear how day care providers would have been able to contact the home and staff should a person had needed to return there unexpectedly to be cared for. Informal arrangements may exist and day care providers may be able to contact staff via staff at a sister home in Runcorn. The arrangements for this type of event however need to be formalised and made known to all parties, so that the home can be staffed at short notice and receive and care for people wishing to return at any time. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 22 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): 37,38,39 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People at the home benefit from a management approach which is open, inclusive and positive. Effective quality assurance systems ensure a consistently high standard of record keeping and assessment to help maintain the health and safety of people within the home. EVIDENCE: People receiving the service benefit from the management and leadership within the home and people know that they will be listened to and consulted. The management approach to the home creates an open, positive and inclusive atmosphere in which the individuals cared for can develop to their full potential. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 23 The people living at Smithy Forge and staff are involved in decision- making processes and are consulted and well informed. Staff members are well informed about the circumstances of the people they provide care for. They know people well and are able to provide appropriate and individual care and support. People cared for know that they can have access to their records and can have help to maintain them. The individual and home records are consistently well maintained to a good standard and are securely kept. During the inspection three examples of peoples’ personal money held for safekeeping were checked against the records kept. The balances and records were accurate with receipts provided for expenditure. The fire precautions record book was checked and was well maintained. Reports from the Environmental Health Department and Fire Service were read and the issues identified, had been addressed and met to ensure that the health safety and welfare of residents was promoted and protected. The results of the homes’ own survey responses are published and made available to people who use the service. There is a system of continuous selfmonitoring and quality assurance in place. The owner completes monthly monitoring checks and also makes additional visits to the home to check that the home is running smoothly. The reports of the monitoring visits, conducted by the home -owner provided evidence of maintenance issues being discussed and of action agreed to make improvements. The reports also provided evidence of issues being discussed with people who live at Smithy Forge and of their views being taken into account. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 24 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 X 2 3 3 3 4 X 5 X 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 X 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 4 3 X X 3 X Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard YA33 Good Practice Recommendations The arrangements for contacting staff at the home need to formalised and made known to all parties to enable people to return to the home unexpectedly at any time and be provided with the necessary care. Smithy Forge DS0000005199.V327883.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 Smithy Forge DS0000005199.V327883.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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