Inspection on 10/05/05 for St Judes

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 Judes 17/04/08

St Judes 23/10/07

St Judes 01/05/07

St Judes 14/02/07

St Judes 18/05/06

St Judes 02/02/06

St Judes 29/09/05

St Judes 21/10/04

St Judes 17/06/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

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 Judes 89 Cardigan Road Bridlington East Yorkshire YO15 3JU Lead Inspector Diane Wilkinson Unannounced 10 May 2005 13:00 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 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 Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Judes Address 89 Cardigan Road Bridlington East Yorkshire YO15 3JU 01262 674129 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Patricia Elizabeth Lewis Patricia Elizabeth Lewis CRH 14 Category(ies) of OP Old age registration, with number DE(E) Dementia - over 65 of places St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st October 2004 Brief Description of the Service: St. Judes is a privately owned care home that is registered to provide care and accommodation for fourteen service users (male and female) who are over 65 years of age, including those with dementia. Accommodation at the home is provided in single and shared rooms, with ensuite facilities in three of the nine bedrooms. In addition to private accommodation, there is a lounge/dining room, a lounge and a small smokers lounge. There is a garden at the rear of the property, which is safe and secure. Most areas of the home are accessible via the provision of a passenger lift and ramps, but the second floor is only accessible via the use of stairs. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over eleven hours – an additional inspector was present for the inspection at the home. The inspection included a tour of the premises and a review of documentation, including examination of service user records. Inspectors met and talked to most of the service users, a staff member and the registered provider/manager. What the service does well: What has improved since the last inspection? What they could do better: Two written references and a satisfactory CRB check must be obtained before staff commence work at the home, including volunteers. There is no formal staff supervision system in place that allows staff the opportunity to meet with a manager. Additional training is needed to ensure that staff have the knowledge to care for service users living at the home, for example, moving and handling and fire training. There must be enough care staff on duty at all times and the staff rota must evidence this. Volunteers must not replace care staff on the rota. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 6 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 Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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 standard(s) 1, 2 and 4 Service users have access to a satisfactory statement of purpose and service user guide to enable them to decide if the home can meet their needs. A lack of recent training detracts from the ability of staff to ensure that appropriate care is provided. EVIDENCE: There is an appropriate statement of purpose and service user guide in place. There is a copy of the service user guide (including a sample contract/statement of terms and conditions and the complaints procedure) in each bedroom. No completed contracts/statement of terms and conditions were seen by the inspector, but the registered provider/manager assured the inspector that these are now in place. There have been no recent admissions to the home and the East Riding of Yorkshire Council has currently suspended any new placements. During St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 9 discussion, the registered provider/manager assured the inspector that she is aware of the need to assess each service user prior to admission. She was advised that each service user should be informed in writing that the home is able to meet their current assessed needs. Staff have now commenced dementia care training via York College and it is hoped that this will better equip them to care for service users with dementia. Inspectors observed moving and handling practices at the home on the day of the inspection and these did not meet current good practice guidelines, and may place service users at risk. It is recommended that all staff undertake or update moving and handling training. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 9 Care planning at the home has improved and care plans now reflect the actual care needed by/provided to service users. Health care needs are met by staff apart from nutritional screening and the recording of pressure care/tissue viability. The administration of medication is satisfactory but staff that administer medications must complete accredited training to ensure the wellbeing and safety of service users. EVIDENCE: There are now effective care plans in place. However, records show that monthly reviews of care plans ceased in November 2004. Daily recording has improved – records were available for every day apart from one – the registered provider/manager acknowledges that she forgot to complete daily diary sheets on that occasion. There is no evidence that service users are involved in the development of their individual care plan. There is more evidence in records about how a service user’s health needs are met. Records in the accident book coincide with entries in daily diary records. The recording of visits by GP’s, District Nurses and other health professionals is St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 11 present in some instances but is not consistent – some recording is in daily records and other recording is on a specific sheet. One service user had a change in medication but there was no record of a visit or contact with a GP to identify why this decision had been made. Discussion with the registered provider/manager evidences that pressure care is taking place, but this is not recorded in care plans, and there must be evidence of nutritional screening. Some improvements still need to be made to the medications policy and procedure to ensure that it is a comprehensive document covering all areas of practice, and to ensure the safety of service users. The records for the administration of medications were examined by the inspector and are satisfactory. None of the current service users are prescribed controlled drugs and none have chosen to self-medicate. There is a list of staff that administer medications and a sample of their signature to enable records to be checked. None of these staff members have completed accredited medications training – this has been arranged with Hull College but has not yet commenced. Requirements from the last inspection are still outstanding for Standards 10 and 11 – these standards will be checked at the next inspection and are therefore remain outstanding. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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 standard(s) 12, 14 and 15 Service users are supported to fulfil individual hobbies and interests wherever this is possible. Contact with family and friends is encouraged by staff at the home. Service users express satisfaction with the quality of meals provided. EVIDENCE: Some service users choose to spend all day in their bedroom – these service users are accommodated in single rooms. Other service users spend time in one of the two lounges. Service users’ interests and hobbies are recorded in care plans, and daily records evidence that these are fulfilled wherever possible. Contact with family and friends is encouraged by staff at the home. No visitors called at the home on the day of the inspection so it was not possible to speak to anyone directly. One service user visits the library to choose her own library books on a regular basis. Any activities on offer are arranged ‘on the day’, depending on the wishes of service users, but these tend to be watching videos and television films rather than activities that involve staff input (due to a lack of time). There is no evidence that service users are informed of how to contact advocacy services, although the registered provider/manager stated that solicitors are contacted on behalf of service users if this is felt to be necessary. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 13 Lunch had just been served at the start of the inspection. Some service users had fish for lunch and others had mince. Service users expressed satisfaction with the quality of the meals on offer. It was observed that drinks are provided on a regular basis. A menu book is kept that records all meals provided by the home but there is no daily menu on display. Some service users eat meals in their own room. Staff were seen to assist service users appropriately to eat their meal. A member of staff was observed asking every service user what they would like for tea – various choices were offered. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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 standard(s) 16, 17 and 18 Service users have access to a complaints system though few are able to use this without significant support. Inadequate recording of service users’ finances managed by the owner places them at risk of financial abuse. EVIDENCE: The complaint’s procedure is displayed in the hall and is included in the service user guide. All service users have a copy of the service user guide in their bedroom. There is no complaints log in use so the inspector was not able to check any entries. The registered provider/manager stated that there have been no complaints made to the home since the last inspection. The registered provider/manager stated that service users are supported to contact a solicitor if this is felt to be necessary, but there is no evidence that service users are informed about available advocacy services. There are appropriate policies and procedures in place that are intended to protect service users from all types of abuse. There is no evidence that staff understand and follow these procedures. The registered provider/manager has not undertaken manager’s awareness training on the protection of vulnerable adults from abuse. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 15 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 standard(s) 19, 22 and 24 The standard of décor at the home is satisfactory and provides service users with a comfortable and homely place to live. A specialist assessment of the premises is needed to identify if accommodation on the second floor is suitable for the needs of the current service users. Service users are not offered the provision of a lock on their bedroom door and a key to promote their privacy and independence. EVIDENCE: The dining room has recently been redecorated and new carpets are due to be fitted. There is no programme of routine maintenance and redecoration in place. The garden was safe, tidy and attractive on the day of the inspection. There are currently no service users living on the second floor of the building. A risk assessment must take place for any service user who may wish to live on this floor in the future, to ensure that it is safe for them to use the steep stairs. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 16 There has been no assessment of the premises by a suitably qualified person. This assessment would evidence the suitability of the second floor to be used as accommodation by current or prospective service users. There is a mobility hoist available but the inspector was informed that this is not currently in use. Forthcoming moving and handling training may identify that the hoist should be used to transfer some of the current service users. The passenger lift and the two bath hoists were serviced in March 2005. There is an accessible call system in every room. Bedrooms are personalised to meet the wishes of service users and furniture has been provided to meet the needs of individual service users. None of the bedroom doors are lockable and there is no evidence that service users have been asked if they would like a lock on their door and a key. One service user has a lockable storage facility in the bedroom and other service users are able to have this facility. All radiators are fitted with a guard to control the risk of burning. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 Current recruitment and selection practices do not protect service users from abuse. On occasions the home is not adequately staffed and volunteers are used in place of a member of staff. Training records have improved and some staff training is taking place, but a training and development programme needs to be developed to give a full picture of the skills and experience levels of staff. EVIDENCE: There is a staff rota in place and this evidences that there are periods during the day when there is only one member of care staff on duty. On occasions, a volunteer is used in place of a staff member resulting in one member of staff and one volunteer being on duty. The registered provider/manager has been informed previously that these practices must cease and it is unacceptable that they have continued. The staff rota should record the capacity in which staff are employed. One member of staff has achieved NVQ Level 3 in Care and most staff are now undertaking NVQ Level 2 or Level 3 in Care. Training should continue to ensure that 50 of care staff have achieved this award by the end of 2005. There are two volunteers working at the home and two written references have not been requested and obtained for them – an immediate requirement was left at the home in respect of this breach of regulation. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 18 Individual training records have improved – a record is held of the training undertaken by each member of staff. These records need to be incorporated into a training and development programme for the home. There needs to be evidence that there is a satisfactory induction programme in place. Some staff require an update on fire training – an immediate requirement was left in respect of this. There is no evidence that staff have been issued with the code of conduct and practice set by the General Social Care Council. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 36 & 38 The systems in place to measure the satisfaction of service users and other stakeholders about care provided by the home need to be improved. There is no formal staff supervision system in place. Working practices and associated records do not currently evidence that the health and safety of service users is assured. EVIDENCE: There is no quality assurance or quality monitoring system in place at the home, and there is no annual development plan. A survey is attached to each service user guide, and one of these is placed in every service user’s bedroom, but there is no evidence that service users are aware of their presence or their purpose. A questionnaire has been sent out to relatives, and this information has yet to be collated and published. There is no system in place to obtain the views of other stakeholders. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 20 There is no formal staff supervision system in place. This is an outstanding requirement from previous inspections. There is a fire risk assessment in place but this needs to be updated. A new fire alarm system was fitted and tested in September 2004, and fire extinguishers were tested at the same time. In-house weekly fire tests ceased in April 2005 and an immediate requirement was left in respect of this breach of regulation. The passenger lift and the bath hoists were serviced in March 2005. There is a mobility hoist in the home but the registered provider/manager informed the inspectors that this is not in use – it has not been serviced recently. This must be rectified. Recording in the accident book is satisfactory and entries coincide with entries made in the daily records for service users. There is no written statement of the policy, organisation and arrangements for maintaining safe working practices in place, including appropriate risk assessments. There is no evidence that there are systems in place to control the risk of Legionella. There are outstanding requirements for Standards 31, 32, 34, 35 and 37. These standards were not assessed during this inspection but will be assessed at the next inspection. They therefore remain outstanding. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x 2 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 2 15 3 COMPLAINTS AND PROTECTION 2 x x 2 x x 2 x STAFFING Standard No Score 27 2 28 2 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 2 1 x x 2 x x 2 x 1 St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 9 10 Regulation Requirement Timescale for action 30th September 2005 31st August 2005 13, 18, 19 Staff that administer medication must have accredited training. 12, 18, 19 There must be evidence that & 24 staff are instructed during induction on how to treat service users with respect at all times. If service users in shared rooms have chosen not to use a screen, this must be recorded in care plans. (Previous timescale of 31.1.05 not met) 12, 13, There must be evidence that 14, 17, 18 staff follow policies and & 37 procedures that are in place about death and dying. Areas of this standard concerned with terminal care and a families involvement in a persons care must be addressed in policies and procedures and staff training. (Previous timescale of 28.2.05 not met) 17, 22 & There must be a complaints log 37 in use at the home and this must be made available for inspection. (Previous timescale of 31.8.04 not met) 18 There must be evidence that staff understand policies and procedures that are in place to J53_s19726_St Judes_v224495_170505_Stage 4.doc 3. 11 31st August 2005 4. 16 30th June 2005 5. 18 31st July 2005 Page 23 St Judes Version 1.30 6. 29 7. 38 protect service users from abuse, and that staff training has taken place. (Previous timescale of 1.11.03 not met) 18 & 19 Two written references must be 31st May obtained before staff commence 2005 work at the home, including any volunteers used. (Previous timescale not met) 12, 16, 17 Weekly in-house fire tests must Immediate & 37 be maintained consistently. There must be evidence that there is a system in place to control the risk of Legionella. There must be a written statement of the policy, organisation and arrangements for maintaining safe working practices, including risk assessments. (Previous timescale of 1.9.03 not met) 31st August 2005 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 4 Good Practice Recommendations Training must be in place to ensure that staff are able to offer the care needed by service users. Service users must be informed in writing, following initial assessment, that the home is able to meet their needs. A monthly review of individual care plans must take place. Daily recording must be consistent. Service users must be involved in the development of their care plan. Information about a service users need for pressure care and arrangements in place to promote tissue viability must be recorded more specifically. Nutritional screening must take place. Visits from GPs and District Nurses must be recorded consistently. Improvements need to be made to medications policies to ensure that they meet the requirments of the National Minimum Standards There needs to be evidence that service users are J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 24 2. 3. 7 8 4. 5. St Judes 9 14 and 17 6. 7. 8. 9. 10. 15 19 22 25 27 11. 12. 13. 28 30 31 14. 15. 32 33 16. 34 17. 18. 19. 35 36 37 informed about available advocacy services. A daily menu should be displayed. There must be a programme of routine maintenance and redecoration in place. The registered person must demonstrate that an assessment of the premises has been carried by a suitably qualified person. There must be locks on bedrooms doors and service users must be offered a key, unless a risk assessment evidences otherwise. Staffing levels must ensure that the home is fully staffed at all times, and this must be recorded on the staff rota. Volunteers must not replace staff on the staff rota. The staff rota should record in what capacity staff are employed. Training should continue to ensure that 50 of care staff achieve NVQ Level 2 in Care by the end of 2005. There must be a training and development programme in place and there must be evidence that Induction training meets the required standards. There must be evidence that the registered provider/manager undertakes periodic training to ensure that practice is kept up to date. There must be a registered manager in post who has achieved NVQ Level 4 in Care and Management by the end of 2005. The registered person must ensure that the management practices at the home are organised, clear and give a clear sense of direction and leadership. Improvements should be made to the quality assurance and quality monitoring systems to ensure that requirements are met. There must be an annual development plan in place. The registered person must ensure that there is a business and financial plan for the establishment that is open to inspection and reviewed annually. Records of all transactions entered into by the registered person must be available for inspection at all times. Clear information should be held about how personal items are purchased for service users and how these are paid for. There must be a formal staff supervision system in place. The registered person must develop and implement a number of records required by the National Minimum Standards and the Care Homes Regulations 2001, in particular, those specified in Schedules 2, 3 and 4. St Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Judes J53_s19726_St Judes_v224495_170505_Stage 4.doc Version 1.30 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. 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