Inspection on 06/02/06 for St Anne`s Rest Home

This inspection was carried out on 6th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Anne`s Rest Home 05/08/08

St Anne`s Rest Home 06/02/08

St Anne`s Rest Home 14/03/07

St Anne`s Rest Home 30/03/05

St Anne`s Rest Home 05/08/04

St Anne`s Rest Home 20/02/04

Similar services:

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Snydale Care Home

Larchfield Manor

Hawkhills

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The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE St Anne`s Rest Home Grange Lane Burghwallis Doncaster DN6 9JL Lead Inspector Mike Hamstead Unannounced Inspection 6th February 2006 07:30 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 Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 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 Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Anne`s Rest Home Address Grange Lane Burghwallis Doncaster DN6 9JL 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) 01302 700319 01302 708752 Hallam Diocesan Caring Service Post Vacant Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th September 2005 Brief Description of the Service: St Ann’s Rest Home is situated in the village of Burghwallis to the north of Doncaster, not far from the A1. The hall is a grade 2 listed building with parts dating back to the 11th century. Many original and interesting features remain throughout the building, although the internal layout is not altogether ideal for the provision of residential accommodation for older adults. Bedrooms vary in size and shape and accommodation is provided on a number of levels. The home is set in lovely grounds on the edge of a quiet hamlet. The nearest shops can be found in the next village. The home is owned and managed by the Diocese of Hallam Trust. The home has no specific admission criteria relating to faith of the service users, however a mass is said daily in the internal chapel and the residents have the option of attending. The home is registered to accommodate 30 residents in the category of old age. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection methodology consisted of interviews with the acting care manager, staff on duty and visiting relatives, an examination of the progress made since the last inspection and the homes records. It also included a tour of the building to observe the accommodation. Additional information of the overall situation had been gained from previous inspection visits. The inspection was commenced at 07:30 and finished at 14:30. What the service does well: What has improved since the last inspection? There has been an innovative approach to informing potential residents of the services the home provides via a pictorial display of activities/events carried out and involving residents. The home is to have its own vehicle that will be used to provide extra and varied external recreational trips out. Attention has been paid to certain health and safety issues in residents bedrooms, and this remains an ongoing task. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 6 Staff training in the protection of vulnerable adults has taken place. There are draft annual development and business and financial plans for the home. The health safety and welfare of residents has been promoted by attention to safe working practices. 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 Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 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 Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 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): 1. Potential residents/representatives are now provided with adequate information to enable them to choose whether the home is capable of meeting their needs. The acting manager has shown initiative in developing an alternative way of representing the views of many residents via a display of activities undertaken. EVIDENCE: There is a statement of purpose and service user guide, and both documents have now been produced in a large print format. Each resident has a copy of the service user guide in their room, but this still does not contain the views of residents because the acting manager is having problems getting the majority of residents to respond to the questionnaires issued to them. As an alternative, and in an effort to assist prospective residents in gaining an overall picture of how existing residents view their life in the home the acting manager is compiling a pictorial display of what residents do in the home, such as baking, crafts, and general activities, and this is to be displayed in the entrance hall close to the service user guide starting next week. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 9 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, 10 & 11. Residents health and personal care needs are being met, and the residents privacy and dignity was seen to be respected by observation of care practices and comments received from residents. Immediate attention needs to be paid to the care documentation system that is not up to date and does not reflect the needs of residents. EVIDENCE: It was disappointing to note that the improvement in reorganising the care management documentation onto a new system, acknowledged at the last inspection has not been continued, for a sample of residents files examined showed a deterioration in the quality of recording undertaken, and in some cases the complete absence of recording onto care plans and risk assessments, and their evaluation. In addition not all annual reviews of residents are being carried out, allegedly due to a resources problem in Social Services, and this must be pursued as a means of determining whether residents are still appropriately placed. Discussions with the acting care manager and deputy care manager revealed that possible reasons for this decline, include the fact that both of them are St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 10 spending more time working “hands on” to cover staff sickness, and in the acting care managers case she has also had an involvement in other activities, involving working on the transition from weekly to monthly pay for staff. In the deputy care managers case, there has been confusion caused by care staff in thinking that because she had implemented the new system, that she would be responsible for updating the system on her own! This matter has been put on the staff meeting agenda for the 8th February 2006, when it is hoped to resolve the matter. Staff promote and maintain residents healthcare needs and there is access to all the primary health care services including the district nursing service who are currently visiting at present to attend to the needs of 3 residents. The inspector sought the views of the district nurse that attended, who spoke highly of the staff’s attitude and approach to the care of residents. All of the residents spoken with stated that their health care needs were well met. There is a policy and procedure for the administration of medication, and there are no residents that are self-medicating. All staff administering medication have received accredited training and the administration of medication was observed, and this was carried out satisfactorily. The MAR sheets examined were recorded satisfactorily and the home deals with controlled drugs as per procedure with regard to their recording, witnessing, and separate storage. It was possible to see many examples of residents being treated with privacy and dignity throughout the day. Staff do not enter bedrooms without knocking and seeking permission, and the majority of residents have keys to their doors and routinely lock them. Residents see their visitors and health care professionals in private, and are asked for their preferred form of address upon admission. There is a policy and procedure on care of the dying, and information on resident’s wishes regarding funeral arrangements and terminal care has been sought and recorded. Staff are acutely aware of the need for them to be sensitive and tactful at this extremely distressing time. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 11 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. Staff enable residents to enjoy a lifestyle suited to their particular expectations and preferences, and the acquisition of its own vehicle should enable staff to arrange more external activities for residents. EVIDENCE: There is a positive approach to activities, and a part –time carer now has a joint responsibility for co-ordinating activities for residents. A monthly list of activities is on display, and a wide range of internal recreational activities are arranged, where the Lost Chord visit every month, and Brenda Castle a singing entertainer is very popular and makes regular visits. The inspector learned that the home is getting its own vehicle that should enable more external trips to be organised. The recent initiative introduced of a monthly “residents day” is continuing where a resident is asked to make his/her choice for a highlight event, and a ventriloquist has been hired at a residents request, and another event planned, is that children from a local school have adopted a grandparent from residents in the home, and will be writing to residents on a “pen pal” basis in the near future. A religious commitment is not a pre-requisite for prospective residents, and the home’s admission policy is non-denominational but is to fulfil the spiritual St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 12 needs of residents. A catholic service is held every day at 11:00am in the chapel where communion is given (except Tuesdays, when it is at 6:00pm), and an Anglican service is held on the first Wednesday of every month for other residents. The home has an open visiting policy, and contact with family and friends is encouraged. A number of visiting relatives were spoken to, and one said the home provided “absolutely brilliant care”, and another relative that had attended mass with her mother, spoke highly about the standards of care provided. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 13 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, 17, & 18. Staff are now recording complaints, and have a knowledge and an understanding of Adult Protection issues that promotes the protection of residents. Staff are now receiving updated training in abuse awareness. EVIDENCE: There is a complaints procedure in operation, and two complaints have been recorded since the last inspection and satisfactorily dealt with. Residents are supported to participate in the electoral process, and the majority of residents used postal votes at the recent local elections and one resident went to the local voting hall to cast her vote. There is a policy and procedure on Adult abuse and whistle blowing and all staff spoken to were aware of the policies and of what procedure to follow if required. Some staff have received updated training in Adult Protection, and others are planned to attend this training in the near future, to promote the interests of residents. There is a policy precluding staff from involvement in, and benefiting from resident’s wills, and staff sign to say they have read and understood it. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 14 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, 25, & 26. Continuing investment is necessary to ensure residents live in a safe and well maintained environment. Liaison with the Fire Service is necessary with regard to the wedging of doors, and a risk assessment must be implemented for all residents exposed to potential dangers in the home. The home was odour free on this inspection. EVIDENCE: The communal areas are comfortable and work has been undertaken since the last inspection to lag some old pipework in a residents bedroom. As was mentioned in the last inspection report, work has been carried out over the years to box in old piping and guard radiators to protect residents, but inevitably because of the age of the building there are still signs of exposed heating piping at different heights within different rooms that would be financially prohibitive to modify. The home should continue where possible to lag old pipework to protect resident’s safety especially where residents are in close proximity to the piping. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 15 In addition staff are aware of the dangers present to residents in the number of sash windows in bedrooms and other areas around the home that are propped open and which present a health and safety risk to residents and staff. Staff are vigilant at all times in educating residents to the dangers of trying to open/close the windows themselves. Another area mentioned at the last inspection that has not received attention is the number of bedroom/other doors that are wedged open, which is against Fire Service advice. If it is required that these doors be left open, then Dor-Guards, a branded alternative to the electro-magnetic system must be fitted to the relevant doors to comply with the Fire Service advice. One resident asked the inspector to visit her room to witness the excessive heat, and this appears to be as a result of a failure to regulate the radiator in this room, and this must receive immediate attention. There is only one resident accommodated on the second floor that leads out onto the fire escape in this area, and an immediate risk assessment must be completed to protect the residents health and safety, because of the potential danger. A review has been carried out on the many examples of electrical wall sockets that contain a variety of plugs incorporating double adaptors to enable a wide range of electrical equipment to be run from them, and where decided an alternative separate multi –socket arrangement has been considered and fitted. The home has an ongoing maintenance and redecoration programme to maintain the premises, and to restore the inevitable consequences of wear and tear resulting from a group living situation. The ground floor corridor carpet has been cleaned together with a number of bedroom carpets since the last inspection, and the cleaning regime has been contracted for 3 visits per year to maintain its cleanliness. Policies and procedures are in place for control of infection, and there were no malodours on this inspection that promotes the health and safety of residents. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 16 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. Care and ancillary staffing levels were satisfactory to meet the needs of residents and ensure their welfare is safeguarded, but statutory training needs to be undertaken a s a matter of urgency. EVIDENCE: All staff are provided with a job description and contract of employment including their terms and conditions. There are no vacancies at the present time, although there has been staff sickness, that has necessitated both the acting care manager and deputy care manager working “hands on” to the detriment of their other responsibilities. All staff including the acting care manager understand their duties and responsibilities and how each role interlinks to provide the best care for residents. On the day of the inspection staffing levels were met. In addition to the acting care manager there was a deputy care manager a principal carer and 2 other care staff for 22 residents. All staff were aged 18 or over, and there were no senior staff under 21 years of age. The home has a commitment to NVQ training and over 50 of care staff have achieved NVQ level 2 or above. Two other carers are undertaking a basic skills pre-NVQ course, to prepare themselves for undertaking the NVQ course later this year. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 17 There is a recruitment policy and procedure but there have been no staff employed since the last inspection. Training needs and development plans are in place for all staff and the acting manager has now obtained a new system that incorporates a training matrix. The registered provider and acting manager are still working towards achieving the Investors In People Award. Staff are receiving induction training to NTO specification, and statutory training, but certain elements of statutory training such as health and safety, food hygiene, first aid, and fire training are currently overdue. The acting care manager has a scheduled meeting with a managing training agency on the 22nd February 2006,to arrange dates for this training. The current induction and foundation standards are being replaced by new common induction standards from September 2006, that will incorporate the former requirement to complete foundation training, and it is planned that staff will have a period of 12 weeks to complete the course. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 18 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, 34, 36, & 38. Residents continue to benefit from a home run well and in their best interests where their health and safety is generally promoted, but this has been affected by the management resources becoming stretched on ancillary duties to the detriment of the overall care. Relationships between staff and the acting manager continue to be very good that promotes the interests of residents. Fire drills must be carried out on a 6 monthly basis to safeguard the interests of residents and staff. EVIDENCE: The acting care manager Gail Nelthorpe has virtually completed the registered managers award and the deputy care manager Karen Oates has just started the qualification. The principal carer is also due to start NVQ 4 in health and St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 19 social care demonstrating a collective management approach to the effective and efficient care of residents. In addition, the acting care manager continues to undertake periodic training and has been on a supervision and appraisal course and a fire training course since the last inspection Ms Nelthorpe will be undertaking a “fit person” interview with CSCI as soon as all references have been received. Discussion with the acting care manager and deputy care manager revealed that a combination of factors such as working on the new payroll system, and having to cover more shifts on the floor for staff sickness, together with the increased dependency of many residents, has meant that they have not been able to give the required attention to the management of care in the areas of the care documentation system, and also staff supervision. The quality of care in a home is strongly influenced by the calibre of its management, and it is important that senior staff in the home are not diverted from their main tasks of being in control of the day to day delivery of care to residents and are able to carry out their responsibilities without having to become involved in ancillary tasks. Once again staff confirmed that they were happy with the open approach of the acting care manager, and felt comfortable and at ease and able to raise any issue concerning the care of residents. Staff felt that they could raise issues informally, or formally at handovers and staff meetings, and that they would be listened to and supported. Staff supervision is still not up to date, but there is an annual development plan in draft that will be implemented for 2006/7, and the business and financial plan is to be done by the diocesan co-ordinator for 2006/7, and both should be open to inspection. An up to date certificate of public liability insurance cover was on display in the entrance hall. Appropriate servicing of equipment had taken place, the gas boiler was serviced on the 17/08/05 and fire records were in order with the exception that fire drills were not carried out 6 monthly in 2005, and must recommence immediately in 2006. Accident records were completed, and portable appliance testing was done in January 2006. There had been a “Thorough Examination” under LOLER of the homes hoist and stair lift in August 2005, but the acting manager had to telephone the company to get the date the shaft lift received a ”Thorough Examination” that was the 15th November 2005, and this certificate must always be available for inspection. The hard wiring test was carried out on the 7/10/04, and the test for Legionella was done in September 2005. St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 20 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 3 x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 x x x x x 2 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 4 3 3 3 2 3 2 St Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 21 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 OP7 Regulation 15 Requirement The registered person must ensure that plans of care are updated to maintain the health personal and social care needs of residents. The registered person must ensure that annual reviews of residents are carried out. The registered person must ensure that residents live in a safe environment, with regard to the number of wedged doors. The registered person must ensure that a risk assessment is made out for the resident living in close proximity to the second floor fire escape door. The registered person must ensure that the heating in resident’s bedrooms may be controlled in that room. The registered person must ensure that all statutory training is undertaken to the required frequency. The registered person must ensure that the manager is enabled to discharge her responsibilities to residents fully. DS0000007964.V279856.R01.S.doc Timescale for action 28/02/06 2. 3. OP7 OP19 15 23 28/02/06 28/02/06 4. OP19 23 28/02/06 5. OP25 23 28/02/06 6. OP30 18 31/03/06 7. OP31 9 28/02/06 St Anne`s Rest Home Version 5.1 Page 22 8. OP36 18 9. OP38 12 & 23 The registered person must 28/02/06 ensure that staff receive supervision at least 6 times per year. The registered person must 28/02/06 ensure that fire drills are carried out 6 monthly in accordance with Fire Service advice. 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 Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 Anne`s Rest Home DS0000007964.V279856.R01.S.doc Version 5.1 Page 24 - 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. 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