Inspection on 13/01/06 for St Quentin

This inspection was carried out on 13th January 2006.

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

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

Other inspections for this house

St Quentin 14/05/08

St Quentin 14/05/07

St Quentin 19/07/05

St Quentin 29/09/04

St Quentin 13/07/04

St Quentin 17/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE St Quentin Sandy Lane Newcastle Staffordshire ST5 0LZ Lead Inspector Mrs Sue Mullin Announced Inspection 13th January 2006 12:10p 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 Quentin DS0000005004.V277069.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 Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Quentin Address Sandy Lane Newcastle Staffordshire ST5 0LZ 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) 01782 617056 01782 620255 st.q@virgin.net St Quentin Residential Homes Limited Ms Christine Joan Rushton Care Home 20 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (7), Old age, of places not falling within any other category (20), Physical disability over 65 years of age (1) St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: St Quentin is a care home, registered to provide personal care for up to 20 residents in the above categories. The home is very gracious and maintains many old features, which are evident throughout the home. There are 18 single bedrooms, 7 with en suite and one double room, well appointed spacious lounges and very pleasant dining room. There is also a small-designated smoking area. The home is located in a residential area on the outskirts of Newcastle and close to a range of shops and community services and situated on a public transport route. The home also has use of their own mini bus. The home was first established in 1988 and is owned and managed by the family business. There is a sister home next door, which provides nursing care 24 hours a day. The home is set back from the road with mature front gardens and ample car parking space. The home also accepts up to three people in the above categories for day care. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory announced inspection took place on 13th January 2006 Discussions took place with the care manager and the staff on duty. Several residents were spoken to and staff were observed interacting and undertaking duties with residents. A range of documentation relating to both the care of the residents and environmental issues was examined. A sample of medication records were inspected. There were at full occupancy with 20 residents but two of those were in hospital at the time of the visit. The home can also accept three residents on a day care basis. The care manager Mrs Christine Rushton has worked in the home for many years and has some supernumerary time, where required for training and management duties and spends some of the time undertaking care duties in the home. This allows her to witness care practices performed by others and take part in the provision of care herself. From these two separate roles she is able to form the basis of good sound practice and then deploys and supports her staff accordingly. The home provided the number and quality of staff needed to meet the identified needs of the residents. Staff received the training required to undertake their duties and appeared well motivated and were promoting residents’ choice, privacy and individuality. The home had undertaken assessments of all prospective residents and was able to meet the current residents’ assessed needs. External health professionals visiting residents provided a seamless service. The home responded appropriately to the health care needs of the residents. During the inspection it was determined that every effort is maintained by care staff to ensure all identified needs are met. The care staff described great progress with a resident who was admitted to the home unable to walk properly or remain continent. Much effort and care was provided so that eventually this resident became almost fully independent again. This resident was spoken to at length and could not praise the home and staff enough. She stated that ‘ If I had not come here to receive such good care and kindness, I would surely be dead by now. I cant thank them enough’. Such is the care delivered at St Quentin’s residential home. A happy friendly atmosphere was felt throughout. During discussion one resident informed the inspector ‘ it is lovely to waited on hand and foot’. Happy banter was exchanged during the inspection and was recognised as a natural daily event. The home had received no complaints since the last inspection and none had been submitted directly to the CSCI. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 6 Two residents use Oxygen in their rooms and these cylinders need to be chained to the wall or kept in a wheeled trolley especially designed for the transport and safety of the cylinder. Otherwise these could pose a hazard to people should the cylinders fall. This was discussed with the care manager who is actively seeking to resolve this matter. This will be checked on the next inspection. Although not all radiators and pipe work throughout the home were guarded or have low temperature surfaces, only a few under the windowsills remain. As these will need to be removed for remedial action, it was agreed that this would be carried out in the warmer weather when the radiators are not required produce heat. These will be checked on the next inspection. What the service does well: What has improved since the last inspection? St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 7 The corridor at the rear of the home has been decorated and several radiators and pipe work have had ornate covers installed. New vinyl flooring has been fitted around a washbasin in one of the bedrooms. A new bath has been fitted into the upstairs ‘ blue bathroom’. A new washing machine has been provided in the laundry. New curtains hung in some rooms. 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 Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5 The home provided an admissions procedure that enabled residents and their representatives to retain choice and control over their lives. The home’s quality of staffing and the involvement of a range of health care professionals enabled residents to have the confidence that the home was able to meet their needs. EVIDENCE: Following discussions with several members of care staff it was clear that they all possessed a good sound knowledge of the residents in their care. They were able to inform the inspector about individual requirements such as who liked bed rest in the afternoons and who required wheelchair/transfer assistance. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 10 Further information was provided in detail, regarding incontinence management and residents suffering from any form of confusion. There were no service users from the Ethnic minority in the home at the time of the inspection. The admissions procedure included an assessment by the home completed before admission and provided the opportunity for the prospective residents and/ or their relatives to visit the home. Staff spoken to confirmed that residents or their relatives could visit the home to look round before they committed themselves to residency. Records showed that assessments had been completed and this provided the necessary information for the home to be able to provide the care needed. Staff spoken to were aware of individual resident’s needs as well as their likes and dislikes and were aware of good practice principles. Records showed that the home involved the necessary health care professionals to respond to the health care needs of the residents including CPN, and the District nurse. Records and discussions with staff confirmed that they had received the training required to meet the residents’ needs. Files showed each resident had a plan of care for daily living. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 The home was actively identifying the health needs of the residents and residents could expect that all aspects of their care requirements were fully met. The medication at this home is well managed promoting good health. Resident’s could be assured that they are treated with respect and their privacy and dignity were promoted enhancing their wellbeing and self esteem. EVIDENCE: The care planning system used in the home was good. Clear entries are made with the date and signature clearly identifiable. All activities of daily living had been assessed and care plans put into place where required. Long-term care plans were reviewed monthly and short-term care plans reviewed weekly or more frequently if necessary. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 12 All service users had a key worker involved in the main planning of their care. The home took time and effort to ensure members of the families were given the opportunity to be involved in the care planning process. There was evidence that health care services were accessed promptly to meet assessed needs. Care staff explained the personal hygiene care practices within the home and how they ensure service users receive a bath at least once a week, more often if required. There is a system in place that records/identifies when any form of personal hygiene is required. Care staff maintain these records and handover clearly to the oncoming shift if there have been any changes made to the programme. This standard was discussed at length and it was determined that every effort is maintained by care staff to ensure all identified needs are met. The care staff described great progress with a resident who was admitted to the home unable to walk properly or remain continent. Much effort and care was provided so that eventually this resident became almost fully independent again. This resident was spoken to at length and could not praise the home and staff enough. She stated that ‘ If I had not come here to receive such good care and kindness, I would surely be dead by now. I cant thank them enough’. Such is the care delivered at St Quentin’s home. Nutritional assessments were referred to and there was an individual assessment sheets completed in the care plan records. All service users are weighed monthly. There were no poorly residents in the home on the day of the inspection. One resident was receiving district-nursing services for a leg ulcer and working relationships with external professionals was described as very good. No diabetics in the home required Insulin. It was very pleasing to see that all care staff/resident interaction was undertaken in a polite, sensitive and caring manner. It was obvious to see that the care staff were well thought of by the residents, as camaraderie was evident throughout the inspection. Staff maintained eye contact when addressing residents and took time in waiting for responses. Doors were knocked before entry to any rooms and privacy and dignity was respected at all times. Residents wore their own clothes and they looked very smart and presentable, obviously time and attention had been made in assisting residents to dress for the day. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 13 Medication is administered by levels of care staff, who have all received drug administration training from the dispensing pharmacist. All MAR sheets seen were completed correctly and have a photograph of the resident. There are specimen signatures of staff in the front of the file, to identify those signing for drugs given. The pharmacy delivers weekly, there were no controlled drugs in the home but Temazepam was kept in the controlled drug cabinet for extra safety. Some residents self medicate with Lactulose or eye drops otherwise all medication is administered by trained staff. Two residents use Oxygen in their rooms and these cylinders need to be chained to the wall or kept in a wheeled trolley especially designed for the transport and safety of the cylinder. This could pose a hazard to people if the cylinders were to fall. This was discussed with the care manager who is actively seeking to resolve this matter. This will be checked on the next inspection. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 14 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, 14,15 The flexible routines, the social activities provided the residents with a lifestyle that respected their individuality and provided them with choice and variation. Catering aspects were excellent providing residents with a comprehensive choice of homemade, nutritious meals. EVIDENCE: Residents stated that they were very happy living in the home, which had activities in place. Visitors could visit at any reasonable time and they were made to feel welcome. Spiritual guidance is sought where requested and the home currently has a regular church service. One resident receives frequent visits from a Nun. Activities are provided by all disciplines of staff in the home and outside agencies are also used. There is an art and crafts session once a week and monthly keep fit classes. Reminiscence groups are held and discussions undertaken regarding local and national events in the news. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 15 The home provided flexible routines whereby residents could get up and go to bed when they wished, could spend time in the communal rooms or in their bedrooms and could choose where to have meals and snacks. Every part of the kitchen was spotless, all environmental health requirements well met. The cook and her team knew every like and dislike of the residents and generally indulged their every wish. Menus were well thought out with good quality choices on offer. All ingredients used in the kitchen were of very good quality and stored appropriately. All residents spoken to said that nothing was too much trouble for the catering staff to provide for them. They were extremely complementary about all catering aspects. One of the choices on offer during the visit was fresh salmon, with fresh parsley sauce, fresh vegetables followed by home made chocolate cake and custard. This was enjoyed very much by the vast majority of residents, two who indicated that this menu was a common occurrence. The dining room was laid up carefully prior to each meal and the care staff even took the trouble and made the effort to fold the cloth napkins in an alternating decorative way, at the main meal times. When laid the tables looked very pleasant and appealing. The dining room is a lovely environment to enjoy meals in, especially with the ever-attentive staff, providing assistance in a discreet and professional manner. The mealtime observed was as an opportunity to socialise with each other and much laughter and merriment was evident. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 16 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 Complaints were responded to appropriately ensuring that residents and relatives concerns were addressed. All care staff had received training in adult protection and were confident that to any concerns were appropriately addressed. EVIDENCE: The home has a comprehensive complaints policy/procedure on display in the home. This is also incorporated in the Statement of Purpose and Service Users Guide. The commission have not received any formal complaints since the last announced inspection. The home has not received any complaints at any level since the last inspection. The home has robust procedures for responding to or dealing with any concerns relating to abuse of a resident. The staff in the home displayed knowledge of how to deal with verbal/physical outbursts of aggression and they confirmed that any incidents of this nature would be clearly documented and reviews undertaken to establish the best way forward in meeting the resident’s needs. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 17 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): 19,20,21,24,25,26 All accommodation provided a homely and domestic environment for the residents that respected their privacy and choice. The home had suitable procedures in place to minimise the risk of infection. The home’s communal areas were spacious and bright and the whole environment was spotlessly clean. EVIDENCE: A tour of the home took place and it was noted that there were sufficient toilets/bathing facilities and this meet the assessed needs of the residents The heating and lighting available in the home was found to be fully satisfactory and all lounges have a good level of natural light. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 18 Staff reported that the hot water supply was within safe limits. Emergency lighting is available throughout the home and the records demonstrated regular testing of the luminaries. Although not all radiators and pipe work throughout the home were guarded or have low temperature surfaces, only a few under the windowsills remain. As these will need to be removed for remedial action, it was agreed that this would be carried out in the warmer weather when the radiators are not required to produce heat. These will be checked on the next inspection. There were no malodours evident. Domestic and laundry staff are employed in the home over a seven-day period. The level of cleanliness throughout the home was very high; every part of the home seen by the inspector was very clean. COSHH requirements were met and the collection of waste was appropriate. The gardens are well maintained. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 19 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): 27,28,30 The level of staffing and the quality of the staff was providing the residents with a good standard of care. All training aspects had been met and all staff ensured resident’s safety was a priority. EVIDENCE: The home provides personal care only, all nursing care is provided by district nursing services. There is a care manager who has been employed in the home for 14 years. The staffing matrix is made up of: • • • Early shift there are three care assistants Late shift there are two care assistants Night shift there are two care assistants There is adequate domestic and catering staff in the home The care assistants in the home provide laundry cover. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 20 Staffing levels are based on the dependency levels of residents in the home and these are reviewed on a regular basis. On the day of the inspection staffing levels and skill mix were found to be acceptable. The home prefer not to use agency cover and staff the home with familiar staff where required. Training issues were discussed and it was determined that all mandatory training had been met and this was recorded. Several members of staff spoken to confirmed that they had received appropriate training in: • • • Manual handling Fire safety and drills Food hygiene The home had organised a training session together with some of the care staff from the adjacent sister home for First Aid training later on in the month. NVQ is progressing very well in the home and forms the basis of good sound practices throughout the home. Catering and care staff have received Basic food hygiene training. The home had procedures in place and staff had received training to maintain a safe environment. Fire testing and fire training had taken place. Fire drills were up to date for day and night staff. Procedures were in place to ensure water was at a safe temperature, and the necessary testing of mobile equipment had taken place. Supervision of care staff was well met with records maintained. Staff were engaged in conversation and were keen to inform the inspector about the best things concerning the home. They stated ‘ The food is fantastic, we eat here sometimes and we know how good it is’. ‘The atmosphere in the home is great, the residents and relatives are lovely’ ‘ we feel really supported and valued’. ‘ We all like coming to work and see how the residents are’. None of the staff spoken to good think of negative point about the home. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 21 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): 31,32,33,36,37,38 The home is well managed providing residents with continuity in standards of care. The systems for residents/relatives/staff views to be taken into consideration and acted upon are robust and residents can be assured that the management of the home will maximise their quality of life. EVIDENCE: The home is well managed. The manager has the necessary experience, knowledge to run the home in accordance with statutory requirements. The home had some methods of reviewing the service through informal discussions with residents and relatives as well as a formal method of reviewing the environment. Residents and relatives views were sought and they were made aware of announced inspections. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 22 Following discussions with the care manager and one on the owners who undertakes maintenance duties, it was determined that: Emergency lighting and fire testing was in order Fire training is up to date Fire extinguishers had been serviced COSHH data sheets were current Risks assessments are reviewed regularly Manual handling training was up to date. Infection control measures are all in order Controlled waste is collected in line with infection control guidelines The lift is serviced regularly and documentation was seen. The home’s maintained the required records and those seen were very well organised and in order, and all were kept safe and secure in line with national requirements. Procedures were in place to ensure water was at a safe temperature and the necessary testing of mobile equipment had taken place. The home was fully insured and there were no concerns as to the home’s financial viability. St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 23 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 X 3 4 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 3 3 X X 3 3 4 STAFFING Standard No Score 27 3 28 3 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X X 3 3 3 St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Quentin DS0000005004.V277069.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Quentin DS0000005004.V277069.R01.S.doc Version 5.1 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!