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Inspection on 30/10/06 for Station Court

Also see our care home review for Station Court for more information

This inspection was carried out on 30th October 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff team have a good understanding of the service users support needs. This was evident from the positive relationships which have been formed between the staff and the service users. Links with the community are good, and staff support each service users social and recreational needs. The service employs an activities support worker. Some of the creative work she has done with the service users is displayed around the home. The service users spoken to were pleased with the variety and choice of activities. The service regularly reviews the homes performance through a good programme of self-review and consultations with service users, relatives and professionals. The service users spoken to said they liked living in the home and that staff listened to them, and took what they said seriously and were there for them when needed. The meals are varied and well balanced offering a good choice and variety. The service users spoken to said the meals were generally very good.

What has improved since the last inspection?

The home is about to commence a pilot scheme with the Specialist Behaviour Team based at St Georges Hospital. They will provide staff training, support and advice, and implement specific care strategies for individual service users. A sensory garden has recently been created in the grounds. New holistic care plan formats have been introduced.

What the care home could do better:

They should provide staff with a greater knowledge and awareness of equality and diversity issues. It is recommended that training be arranged within the next six months. This will enhance their awareness relating to: race, gender, age, ethnicity, sexuality, disability, and belief. Arrangements should be made to complete care plan evaluations in more detail. This will enable staff to monitor and record the on-going needs of each service user. To improve service users healthcare needs, a system should be introduced to record when each service user receives an annual health care and medication review. Arrangements should be made to ensure that all prescribed external creams are correctly labelled. This will promote the safe handling of medications.

CARE HOMES FOR OLDER PEOPLE Station Court Station Road Ashington Northumberland NE63 8HE Lead Inspector Jim Lamb Unannounced Inspection 30th October 2006 09:30 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 Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Station Court Address Station Road Ashington Northumberland NE63 8HE 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) 01670 817 222 01670 817 555 stationcourt@barchester.com www.barchester.com/oulton Barchester Healthcare Homes Limited Mrs Vivienne Morris Care Home 63 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (31), Old age, not falling within any other of places category (30) Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two service users under 65 years of age are to be accommodated in the DE category. No further admissions can take place in this category without the agreement of CSCI. One named service user category MD, can be accommodated for respite care. CSCI must be notified when the named service user leaves the home. 17th October 2005 2. Date of last inspection Brief Description of the Service: Station Court is a residential care home providing personal care and accommodation for 63 older people. The home is in a residential area of Ashington with good access to public services and amenities. All bedrooms are single with en-suite facilities. The home is very well decorated throughout. There are a number of lounges, dining rooms, Assisted bathrooms, a large conservatory and an activities room. The gardens are attractively landscaped, and there is also an enclosed sensory garden. Copies of inspection reports and information about the service are available in the home. Fees for the home range from £378 to £442. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection visit. The inspection took place during the morning and early afternoon. Time was spent talking to the manager, three staff, two relatives and fourteen service users. Service users care records were inspected together with other records relating to the management of the service. A tour of the premises also took place. Five service users feedback cards were received. All indicated that they were generally happy with most aspects of the care that they receive. All said, they were happy with the care and support they received, and that staff listened and acted on what they said. They said that they would know how to make a complaint. One service user said, “Sometimes staff talk to each other when they are assisting me, and it makes me feel like they are not concentrating. I want their full attention when they are dealing with me”. Another said, “Sometimes my bedroom drawers are dusty”. Another said, “Sometimes the food is not cooked the way I like it”. What the service does well: The staff team have a good understanding of the service users support needs. This was evident from the positive relationships which have been formed between the staff and the service users. Links with the community are good, and staff support each service users social and recreational needs. The service employs an activities support worker. Some of the creative work she has done with the service users is displayed around the home. The service users spoken to were pleased with the variety and choice of activities. The service regularly reviews the homes performance through a good programme of self-review and consultations with service users, relatives and professionals. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 6 The service users spoken to said they liked living in the home and that staff listened to them, and took what they said seriously and were there for them when needed. The meals are varied and well balanced offering a good choice and variety. The service users spoken to said the meals were generally very good. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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 Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 2 3 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are provided with enough information about the service to enable them to make a choice about where they want to live. All service users are appropriately assessed prior to admission into the home, which means that staff know they can meet their needs. All are provided with a written contract explaining their terms and conditions with the home. EVIDENCE: Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 9 Details of the extra charges, and what these are for, are in the contract given to service users and are agreed prior to their admission. The home’s Statement of Purpose and the Service Users Guide both contained the full range of information required. The service users guide is precise in what prospective service users can expect and gives a good detailed account of the accommodation, skills and experience of the staff, and how to make a complaint. All service users are given a copy of the guide. Four service users’ files were checked and each included a full up to date needs assessment. They contained a range of appropriate information. The service users are involved in drawing up both these initial assessments and the home’s subsequent service user plans. For those self-funding and without a Care Managers assessment, a skilled member of staff always undertakes the assessment. The assessment also involves the family or a representative of the service user. The service users said their needs were met and they were happy with the care offered to them. The care plans were checked and staff interviewed, which confirmed that a range of specialist services was provided to service users. Staff interviewed had had a range of relevant training and experience. The home does not provide intermediate care. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning system is not quite clear enough to ensure that staff have the information they need to meet the assessed needs of the service users, as the evaluations lack enough information. Service users are supported to make decisions about their lives, and take risks to promote their independence. The health care needs of the service users are appropriately met. EVIDENCE: There is a comprehensive assessment in the service users’ care plans. There is also a comprehensive risk assessment of service users. The management of risk takes into account the needs for independence and choice. There are advocacy arrangements, as well as family input to represent service users. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 11 Each service user has an allocated key worker. Staff were observed providing personal care to service users in a kind, considerate and helpful manner. Service users spoken to confirmed that staff respect their privacy and treated them in a dignified manner. The new care plan format introduced is still in its early stages. The evaluations need to be developed further to fully explain the progress of each individuals assessed needs. The care plan is a working tool and is understood by service users, by staff, and service users representatives. There are systems in place to ensure the care plan are reviewed and up-dated. The service arranges additional reviews when changes take place. Staff spend time with service users to communicate their views to the on-going development of the care plan and the annual review process. Service users, care managers and their representatives attend annual reviews. The Reviewing Officer visiting the home at the time of the inspection said, “The staff are excellent at keeping me informed of each service users needs, and this assists me greatly with the reviewing process”. There was a range of comprehensive assessments in the service users’ care records. These included; moving and handling, dependency needs, skin care and nutritional assessments. One service user has a superficial pressure sore. There was a care plan in place to provide staff with the information they need to treat and promote skin viability. There is a medication policy which is accessible to staff. Medication records were well completed for ordering, receiving, administrating and disposal. Controlled drugs are well managed. To promote the safety and wellbeing of service users, all prescribed external creams, must have labels that specify the frequency for use, and avoid using, as directed. All staff involved in the management of medication have undertaken accredited medication training. The service users all receive regular health care checks and medication reviews. Currently these checks are not recorded in the individuals care records. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 12 Self-advocacy is promoted and service users can access a range of external agencies that promote independence. Any rights that are restricted are linked to risk assessments. Service users’ all said that they are able to make decisions for themselves. One service user said, “ The staff are very good, they always have time for me and always listen properly”. Another said, “I am able to do as I please, there are no restrictions”. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The meals in the home are generally good, offering both choice and variety. The service users have opportunities for personal development and leisure activities. They are supported to maintain very good links with the community and their relatives and friends. EVIDENCE: Service users are supported to live a normal life in the community. They are supported and encouraged to be in control of their own lives and to enjoy their own interests and hobbies. The home has access to transport, and regular outings are arranged to local places of interest. All service users are supported to maintain very close links with their families. They can choose who they want to see and when. Two visiting relatives said, “I am very pleased with the care provided, we visit often and are always made to feel welcome”. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 14 Daily routines promote independence, choice and freedom of movement. At least two hot meals are provided each day. The meals are varied and well balanced. The service users said that the meals were generally good. Special diets are provided as and when needed. Full fat milk, butter and cheese are always used. The cook said, “I meet with the service users often to discuss the menus, it can be difficult at times to please everyone. I always make sure there are alternative additions to the menu choices, soup, eggs, beans on toast, salad, and cold meats are always available”. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a good, clear, user-friendly complaints system and service user’s views are listened to and acted upon. Procedures are in place to protect service users from harm, and these are followed. EVIDENCE: There is a complaints procedure. The procedure is written in a way that ensures service users fully understand its contents. All complaints are investigated within 28 days. Service users said that they had been given copies of the procedure and that staff listened to their complaints and dealt with them fairly. There is an appropriate complaints recording system in place. During the last twelve months there have been fourteen complaints received. The service clearly takes all complaints seriously. Several involved various care issues; others were about untidy rooms and a bedroom carpet that needed to be cleaned. All complaints were fully investigated and resolved. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 16 The service has a Whistle Blowing policy and a copy of the Local Authorities Vulnerable Adults procedures. Training of staff in the area of protection is regularly arranged. The service ensures, through training, supervision, review and quality monitoring, that care staff fully comply with policy and procedures in relation to protecting and safeguarding the rights of the service users. The staff spoken to confirmed that they were fully aware of these procedures and that they had received training. They were able to satisfactorily describe the action that they would take to deal with allegations of abuse. The service also has a copy of the Department of Health’s document, “NO SECRETS”. The service keeps detailed financial records on behalf of the service users. Service users are encouraged to take responsibility for their own financial affairs and to use their money as they wish. Staff will support those who need help in financial matters. There is a clear robust policy that protects service users from financial abuse. No staff act as an appointee for any of the service users. Receipts of personal spending are kept. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 20 22 24 25 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service provides a comfortable and safe environment for those living there. The standard and decoration is very good. Communal areas and bedrooms are large, and meet the service users needs. All areas within the home are well maintained, clean, tidy and free from offensive odours. EVIDENCE: The home was clean, well decorated and well maintained. The grounds were tidy, safe, attractive and accessible. The service users have access to a newly created and enclosed sensory garden area. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 18 The home meets the requirements of the Disability Discrimination Act and the layout and design is suitable to meet the specific needs of the people who live there. All staff are trained in the safe use of aids and equipment. There is an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. Service users can see visitors in private in their own rooms. All bedrooms have privacy locks. There are several smoke-free sitting rooms, and there is one smoker’s lounge. Furnishings and fittings were domestic in design and in good condition. Bedroom sizes exceed the minimum required. There is space on either side of beds when necessary, to enable access for carers and specialist equipment. The bedrooms are nicely decorated and highly personalised. All rooms have en-suite facilities. The rooms are centrally heated and the heating level can be controlled within each bedroom. All areas are well lit, clean and tidy and smell fresh. There is a proactive infection control policy and they work closely with external specialists, e.g. infection control, environmental health, and staff ensure that infections are minimised. Clinical waste is properly managed and stored. The kitchen was found to be clean and well organised and stock levels were good. Appropriate checks are carried out including food and fridge temperatures. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. One bathroom on the first floor requires a new seal around the bath. The laundry facilities are well organised, and the washing machine has a disinfection control cycle. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 29 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a good match of well-qualified staff offering consistency of care within the home. There are robust procedures in place for the recruitment and selection of new staff, which helps to protect service users. The staff receive supervision and this provides them with a good understanding of the service users support needs. EVIDENCE: Samples of 4 weeks’ rotas showed the required numbers of staff were on duty: nine staff between 8am and 9pm, and four staff between 9pm and 8am. All the staff were over 18 years of age and those left in charge were at least 21. Training needs of staff are identified in supervision and appraisal sessions. The training programme meets The National Training Organisation requirements for the first six months. All staff receive paid training. The service provides a good training and development programme for all employees. The management prioritise training and facilitate staff to undertake external Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 20 qualifications beyond the basic requirements. Currently 65 of the staff team have achieved NVQ level 2/3. The service continues to operate a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. The service sees induction and any probationary period as being an extension of recruitment. There is little use of agency or temporary staff. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32 33 35 38 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager is supported by the organisation in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The systems for service users’ consultation are good, and service user’s views are both sought and acted upon. The health and safety of the service users is promoted. The service is not fully aware of equality and diversity and its implications. Staff training will improve awareness and promote their knowledge. EVIDENCE: Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 22 The manager has the required qualification and experience, and is competent to run the home and meet its stated aims and objectives. The staff interviewed were clear about their responsibilities. They had good knowledge of the service users assessed needs. Staff and service users spoke positively about the manager saying she had encouraged them to contribute to the development of the service. There is a strong ethos of being open and transparent in all areas of running the home. Service users are told when inspections take place and they are shown inspection reports. These are also summarised and discussed in service user meetings. Copies are available for relatives and others to see. The service has sound policies and procedures, which the manager and the organisation effectively reviews and updates, in line with current thinking and practice. Systems are in place to monitor staff adherence to policies and procedures during their practice. The service is not fully aware of equality and diversity and its implications, and is not currently able to promote the diversity agenda within the service. They need to make plans to seek improvements through research and training and keeping up to date with best practice in this area, and by obtaining new legislation and guidance, and implementing specific policies and procedures, in the areas of race, ethnicity, age, sexuality, gender, disability, and belief. These will enable staff to translate their understanding into positive outcomes for service users. The service continues to operate a good quality assurance system. Service users views are sought and acted upon. Relatives and professionals are also consulted. The service has a good record of meeting relevant health and safety requirements and legislation. The records inspected were found to be appropriately completed. There are appropriate maintenance contracts for the home. Water storage tanks, gas and electrics are checked annually. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X 3 3 X 3 X X 3 Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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. 1. Standard OP7 Regulation 15 Requirement Care plan evaluations must include sufficient information to enable staff to meet the ongoing assessed needs of each service user. All service users annual health care and medication reviews must be recorded. Timescale for action 01/12/06 2. OP9 13 01/12/06 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 2 Refer to Standard OP30 OP9 Good Practice Recommendations Provide staff with equality and diversity training and implement specific policies and procedures. All prescribed external creams must have labels that specify frequency of use. Station Court DS0000055020.V302868.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Station Court DS0000055020.V302868.R01.S.doc Version 5.2 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. 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