Inspection on 02/02/06 for St Angelas Convent

This inspection was carried out on 2nd February 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Angelas Convent 09/01/08

St Angelas Convent 10/05/07

St Angelas Convent 11/05/06

St Angelas Convent 14/06/05

St Angelas Convent 05/12/04

St Angelas Convent 06/07/04

St Angelas Convent 10/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

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 St Angelas Clifton Down Convent St Angelas Clifton Down Convent 5 Litfield Place Clifton Bristol BS8 3LU Lead Inspector Sandra Gibson Unannounced Inspection 2nd February 2006 10:30 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 St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 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. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service St Angelas Clifton Down Convent Address St Angelas Clifton Down Convent 5 Litfield Place Clifton Bristol BS8 3LU 0117 9735436 0117 9706844 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) Sisters Of The Temple Sister Marie Louise Levern Care Home 23 Category(ies) of Dementia (3), Old age, not falling within any registration, with number other category (20) of places St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate 3 persons with DE, certificate will revert to 23 OP when these persons leave. 14th and 15th June 2005 Date of last inspection Brief Description of the Service: St Angelas Clifton Down Convent is operated by The Sisters of The Temple, a Roman Catholic religious order. The senior care staff are sisters within the order. Additional lay staff are employed to fulfil care and ancillary responsibilities. It is registered by the Commission for Social Care Inspection to provide accommodation and personal care to 23 persons aged 65 years and over. St Angelas is a large detached building in a suburb of North Bristol close to the countryside. Shops and community facilities are within 1/4 mile of the home. Accommodation is provided over three of four floors, in single rooms, all of which have en-suite facilities. There is a communal dining room on the ground floor, which is only used on special occasions by residents. There are no communal lounge facilities in the home. St Angelas home offers respite care when places are available. A shaft lift is in place to all floors. The top floor offers accommodation to independent guests of the Sisters of the Temple. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place midweek between the hours of 10:30am and 5:45 pm. Evidence was gathered from: talking to/observing residents, talking to the manager/talking to the administrator/talking to and observing staff, talking to one visitor, talking to four residents, examining records, policies and procedures. What the service does well: What has improved since the last inspection? The information provided to residents in the contract / statement of terms and conditions has improved since the last inspection with the result that residents and their representatives are better informed. Residents are benefiting from increased opportunities to experience a more stimulating and varied life where various informal activities are regularly made available by experienced staff to reduce isolation and increase wellbeing. There have been improvements to the complaints procedure since the last inspection with a result that there are now satisfactory arrangements in place to ensure that residents and their representatives are fully aware of how to make a complaint. There have been improvements to the staffing levels at night since the last inspection with a result that residents are better protected. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 6 There have been improvements in the supervision system, which ensures that residents benefit from staff that are appropriately supervised. The system for accessing records has improved since the last inspection which ensures that resident’ rights and best interests are safeguarded at all times. Health and safety checks have improved since the last inspection, which ensures that the health, safety and welfare of residents and staff is promoted and protected. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3, The information provided to residents in the contract / statement of terms and conditions has improved since the last inspection with the result that residents and their representatives are better informed. The admission procedure is not wholly satisfactory as it does not ensure that a person’s needs have been fully assessed prior to moving into the home. Without this information there is no assurance that an individual’s needs can be met. EVIDENCE: A sample of residents contracts / statement of terms and conditions were examined. These documents have recently been updated with the address and details of The Commission for Social Care Inspection. It was noted that the long stay contracts and short stay contracts in place contain all the relevant information. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 9 Following an additional follow up visit to the home by the inspector on the 6th December 2006. The manager of St Angela’s’ formally wrote to The Commission For Social Care Inspection to request the removal of the condition that three residents may be accommodated at St Angela’s when the primary focus of their care is as a result of dementia. During this inspection the manager informed the inspector that there were no residents accommodated at St Angela’s whose primary focus of their care was as a result of dementia. As discussed at the previous inspection the needs assessment documentation does not contain all the information required to carry out a full assessment. The format is a tick box style and does not encourage the person who carries out the assessment to obtain more details. This documentation was discussed with the manager and another member of staff during the inspection. There was evidence to confirm that there are plans in place to improve the needs assessment documentation. Examples of other formats were provided to the manager. However it was explained that CSCI can only advise on this documentation and not recommend any particular format. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 There have been no improvements in the care planing system since the last inspection.It is currently not satisfactory with the result that some residents’ individual needs may not be met. The physical healthcare needs of residents continue to be well met with evidence of good multidisciplinary working taking place on a regular basis. However,a large percentage of the staff team may not have the experience and training to meet residents’ mental health needs. There have been considerable improvements since the last inspection in the medication administration system. However further imrovements are needed to ensure that there are safeguards in place to protect residents and staff at all times. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 11 EVIDENCE: As discussed at the last inspection a sample of care plans seen did not include information on resident’s emotional and mental health needs. It was also noted that some care plans in place are not detailed enough for staff to safely follow. There was evidence of long gaps found in the daily running records. As discussed above this documentation was discussed with the manager and another member of staff during the inspection. There was evidence to confirm that there are plans in place to improve the care planning documentation. Records confirmed that health professionals such as General Practitioners, District Nurse and chiropodists are contacted at the appropriate time. Equipment was observed to be in place to prevent pressure sores in residents who were at risk. It was observed by the inspector that one resident seen during the inspection was very anxious at times and needed a lot of reassurance from staff. Staff were copying reasonably well with this residents challenging behaviour but it was noted that they would possibly benefit from the support of the “In reach” Mental Health Team who provide support to staff working with older residents with mental health needs including severe anxiety. It was noted that the majority of staff have received training in dementia care but not working with older people with mental health needs. One visitor seen during the inspection confirmed that she/he is always contacted if their friend has an accident in the home or is admitted to hospital. The medication administration system was examined. It was observed that the quantity and amount of prescribed medication received into the home is now accurately recorded. A sample check of medication administered was checked and noted to be up to date and accurate. A number of residents continue to be supported to self-administer medication. It was noted that there is now a risk assessment in place to protect these residents. Lockable storage facilities are available in all residents’ rooms. Details of medication prescribed to an individual are recorded on the assessment documentation prior to a person being admitted to the home. It was noted that the exact date of this record of medication is not always recorded. It was also observed that the security arrangements for the storage of controlled medication or medication that needs to be stored like controlled medication are not wholly satisfactory. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 Residents are benefiting from increased opportunities to experience a more stimulating and varied life where various informal activities are regularly made available by experienced staff to reduce isolation and increase wellbeing. Visitors and members of the local community continue to be made very welcome, which provides interest and stimulation to residents. EVIDENCE: On the whole St Angela’s provides a quiet lifestyle for residents where very few communal activities take place. This is noted to be satisfactory for the majority of residents who are fully informed about the lifestyle prior to admission and this is their preference. Many residents are visited frequently by friends and family and may be taken out for the day. However during the last inspection two visitors told the inspector that they felt that there was a lack of social activities provided in the home. They told the inspector that their relative may have chosen that lifestyle when she/he was first admitted to the home, but when she/he became more frail she / he also became more isolated .It was their opinion that there was no choice available for residents to join in with activities in the home. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 13 The manager explained during the last inspection that she had recently allocated one member of staff each day to spend more time engaged in social activities with residents. The duties of this member of staff were to talk to residents about their interests, escort residents to the garden and read to them. It was noted during this inspection that further progress had been made with developing social activities for residents. One member of staff has now been delegated this role. A job description was in place to confirm this information. It was pleasing to see that the above activities take place and that the communal dining room is now being used more frequently for residents to meet. There was written evidence to confirm that seven residents now participate in regular coffee mornings or tea parties. The manager said that following mass families and priests often join in with these events. Written evidence to confirm these social activities are taking place was available. One visitor confirmed that they were always made very welcome in the home and that the manager and staff were very helpful. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 There have been improvements to the complaints procedure since the last inspection with a result that there are now satisfactory arrangements in place to ensure that residents and their represenattives are fully aware of how to make a complaint. Systems in place to ensure that residents are protected from abuse have improved since the last inspection. However, further work is required to ensure that residents are protected from risk of harm. EVIDENCE: There have been no new complaints since the last inspection. Three residents consulted confirmed that they were aware of the complaints procedure and that they knew who to speak to if they had any concerns. One visitor told the inspector that if they had any concerns then they would speak to the manager. Following a recommendation made at the last inspection. Information about how to make a complaint is now available for visitors where they sign in the visitor’s book at the entrance to the home. The information is also available on each floor of the home. One resident spoken to said “We are well looked after here. Staff are very nice and we have nothing to complain about”. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 15 Following the last unannounced inspection conducted on 14th and 15th June 2005 advice has been sought from Bristol City Council Safeguarding Adults Coordinator in respect of St Angela’s Adult Protection policy and procedure to ensure that it was in line with the Local Authority Adult Protection Procedure (No Secrets in Bristol) and to review the physical restraint policy. These documents have now been up dated following advice and are available for staff to use. It was noted that fifteen members of staff including the manager attended Protection of Vulnerable Adult training by an external organisation in November 2004. Refresher training course took place in March 2005. However neither the manager nor any of the staff team have attended Protection of Vulnerable adult training provided by Bristol Social Services and Health which highlights the Local authority policy and procedure No Secrets in Bristol. It was pleasing to note that The Commission for Social Care Inspection continue to receive regular notifications about residents’ welfare and health. This practice has improved greatly since the last two inspections. It was observed that there were gaps in the recruitment process, which will be discussed in detail in the section on staffing. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 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): These standards were not inspected during this inspection. They were all met at the last unannounced inspection conducted on 14th and 15th June 2005. EVIDENCE: St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 17 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): 27,28,29,30 There have been improvements to the staffing levels at night since the last inspection with a result that residents are better protected. The procedures for the recruitment of staff are not safe and place residents at risk of harm. The staff training programme is satisfactory with the result that residents benefit from a more competent, trained staff team. EVIDENCE: It was noted during this inspection that the staffing levels during the day met the dependency levels of the residents. And it was found at the additional follow up visit held on 6th December 2005 that the staffing levels at night have increased to two staff following the requirements of the last unannounced inspection. The manager explained that one member of staff carries out waking duties and the second member of staff carries out waking duties from 8.30pm until 11.30am, then sleep in duties until 5.30am and finally waking duties until 7.30am. The manager who lives in the Convent, which is part of the home, is also available in an emergency. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 18 During this unannounced inspection the manager explained that since the new staffing arrangements at night commenced in September 2005 she had not been called once in an emergency and that in her opinion the new staffing levels at night were a positive development in the home. There is a night staff rota in place and all night staff have been provided with a new contact outlining their duties. The manager informed the inspector that a formal review of night staff would be carried out every three months. During the inspection it came to the attention of the inspector after examining six staff files that there were staff working in the home who had initially been supplied by a care agency but had recently started working for St Angela’s, staff who were still employed by the care agency and also staff who in the past had worked for the agency but now worked for St Angela’s It was noted that one member of staff who had recently been employed by St Angela’s had a criminal records bureau check (CRB) and protection of vulnerable adults (POVA) check in place completed not by the home or the agency but by another organisation they had previously worked for. Another member of staff had been supplied by the agency, but had no CRB or POVA check in place. A third member of staff who had been employed by St Angela’s but had initially been employed by the agency had completed an application. However the application did not provide information about whether a person was medically fit to work, nor did it provide a criminal declaration It was noted that there was only one reference in place which had not been from her previous employer but from a colleague working at St Angela’s. The CRB/POVA check had also been completed by a previous agency. Following further discussions with the manager it was noted that there were outstanding CRB /POVA checks on four care staff that had been sent to the St Angela’s “CRB umbrella organisation” the previous week. It was also noted that none of the cleaners or volunteers had CRB / POVA checks in place. Serious concerns about the lack of this information were raised with the manager particularly as a requirement had been made at the last inspection for these checks to be completed by 31st July 2005. An immediate requirement was made and the agency member of staff who had no CRB/POVA check in place was requested to stop working by the manager and was sent home. The sample of staff personnel files seen confirmed that staff receive induction training on appointment. They also receive regular training in the home on statutory subjects such as fire safety training, first aid, basic food hygiene and manual handling, and specialist training such as dementia care. From the information seen the staff team are progressing well with NVQ 2 training and two members of staff have NVQ3. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 19 Two staff consulted during the inspection were very positive about working at St Angela’s. They confirmed that they had been given the opportunity to do NVQ3 but had declined although conformed that they had reached NVQ2. They both said that they had in their opinion “a lot of training provided”. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 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): 36,37,38 There have been improvements in the supervision system, which ensures that residents benefit from staff that are appropriately supervised. The system for accessing records has improved since the last inspection which ensures that resident’ rights and best interests are safeguarded at all times. Health and safety checks have improved since the last inspection, which ensures that the health, safety and welfare of residents and staff is promoted and protected. EVIDENCE: There was written evidence in place to confirm that supervision of staff is starting to take place on a regular basis. The fire log was examined; it was noted that all fire safety checks and training were up to date. A fire risk assessment was also available for inspection. St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 21 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 X 3 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 1 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 3 3 St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 22 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. Standard OP3 Regulation 14(1)(a) Requirement No person should be admitted to the home unless a full needs assessment is obtained by a suitably trained person The needs assessment documentation in place in the home must be improved to assist in the collection of this information Timescale for action 31/05/06 2. OP7 15 This is an ongoing requirement from the last un inspection conducted on14th 15th June 2006 31/05/06 A written care plan which includes residents emotional and mental health needs must be drawn up following consultation with the resident or representative where appropriate The care plan documentation must be improved to assist in the collection of this information This is an ongoing requirement from the last inspection conducted on the14thand 15th June 2006 St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 23 3. OP9 13(2) The manager must improve the arrangements for the recording of the details of the medicines prescribed on a new residents admission. This information must be dated. The storage arrangements for controlled medication and medication to be stored as controlled medication must be improved as highlighted in National Minimum Standards 9 The manager and another member of senior staff must attend Adult protection training for managers provided by Bristol Social Services and Health. All staff must also attend adult protection training provided by Bristol Social Services and Health Before a person is employed to work in the care home the manager must ensure that there are the following documentation in place: two written references (including one from previous employer), evidence that the person is physically and mentally fit for the job, declaration of any criminal offences, a CRB/POVA check conducted by St Angela’s’ CRB Umbrella organisation. Any member of staff supplied by an agency must have a satisfactory up to date CRB/POVA check completed by the agency they commence working in the home. 31/05/06 4. OP18 13(6) 31/12/06 5. OP29 19 02/02/06 St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 St Angelas Clifton Down Convent DS0000026518.V256926.R01.S.doc Version 5.0 Page 26 - 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!