Inspection on 22/05/07 for Stiperstones

This inspection was carried out on 22nd May 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Stiperstones 10/07/09

Stiperstones 15/04/09

Stiperstones 05/01/09

Stiperstones 23/10/08

Stiperstones 21/04/08

Stiperstones 10/01/06

Stiperstones 11/08/04

Stiperstones 26/04/04

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Stiperstone Stiperstone Clappers Lane Chobham Surrey GU24 8DD Lead Inspector Pauline Long Unannounced Inspection 22nd May 2007 09:30 Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 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 Stiperstone DS0000013802.V336665.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 Adults 18-65. 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. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stiperstone Address Stiperstone Clappers Lane Chobham Surrey GU24 8DD 01276 858440 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) Welmede Housing Association Ltd Mr Alistair Ian Ogilvy Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Within the category `LD` (learning disabilities), 1 (one) service user may be within the category `LD` and `PD` (learning disabilities/physical disability) The age/age range of the persons to be accommodated will be: 35-64 YEARS 10th January 2006 Date of last inspection Brief Description of the Service: Stiperstones is a care home for eight adults with learning disabilities and provides personal care only. The property is located in Clappers Lane, Chobham, Surrey and accommodation is provided on two floors accessed by stairs. The home has eight single bedrooms and facilities include a kitchen, lounge, dining area, office, laundry, bathrooms and toilets. The property has a private drive and a large garden which is secure and easily accessible. Private parking is available. The fees at the home are £1395.00 per week. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.30 and was in the service for 4 hours. It was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s owner or manager, and any information that CSCI has received about the service since the last inspection. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. Communication with the service users was limited due to their communication difficulties. However their apperance and body language evidenced a sence of wellbeing. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The CSCI would like to thank the residents, the home manager, staff and visitors for their hospitality, assistance and co-operation during the site visit. What the service does well: The home manager and staff demonstrated an open and inclusive approach to the service users care. The home benefits from a long standing stable staff team, who have worked in the home for several years, and this was reflected in the level of knowledge and understanding of the needs and preferences of the service users. The home promotes and encourages contact with family/friends and the local community. Relatives were complimentary about the care and services provided by the home and commented that, the service responds to the different needs of their relatives and all service users are treated as individuals. Relatives also commented, that the home has a family atmosphere and that care staff treat the services users as one of the family and that the staff are wonderful caring people and are very professional. From the evidence seen by the inspector and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 6 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. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents are only admitted to the home following an assessment of their needs. EVIDENCE: All of the service users have been residing at the home for some years and their care needs assessments were developed whilst in the care of the previous care service provider. No new service users have been admitted to the home since the previous inspection. Discussions were had with the manager in respect of the care needs assessment process. He stated that any admission to the home would only be carried out following an in-depth assessment of the service users needs and with the involvement of significant others, for example relatives and other professionals. Three service users care needs assessments were sampled. All were found to be comprehensive and provided the reader a good overview of the service users needs. The assessments included activities in respect of all daily living and diversity issues, for example all daily living activities and their preferences in respect of their names, health and social care needs, spiritual needs and their likes and dislikes around activities. Due to verbal communication difficulties, service users were unable to confirm they were involved in this Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 9 process. One relative commented that the home responds to the different and complex needs of his son. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s health and social care needs are well met. They are treated with respect and their privacy and dignity is promoted. Improvements are required in respect of some risk assessments. EVIDENCE: Care plans were sampled, and were found to be comprehensive and well written. The care plans gave clear instructions and guidelines to the reader about a service users care needs and choices. All care plans had been regularly reviewed. The staff on duty had a good understanding of the service users personal care needs and choices, staff commented that they had worked with the service users for several years and knew them well, this was evidenced from the positive interactions and relationships observed. Staff were observed supporting the service users in respect of decision making and choices for example: going to the local shops, spending time outside or spending time in their rooms listening to music. It was noted that one service user was enjoying listening to music in his bedroom. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 11 Risk assessments around all daily living activities were clearly documented and guidelines in place to minimise the identified risks. It was noted that one of the service users tends to put non food objects into his mouth, whilst there were some risk assessments in this respect there were no risk assessments in respect of the potential hazards to a service users health and safety where liquid soaps and hand wash were concerned. A requirement has been made in respect of these standards. Please refer to pages 26 and 27of this report. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 People who use the service experience good quality outcomes in this area. The residents are encouraged and enabled to maintain fulfilling lifestyles in the home and promotes contact with family, friends and the local community. Residents are encouraged and enabled to makes choices in their lives and meal times are a positive experience for them. EVIDENCE: The routines in the home were determined only by the timings of the visits to and from the shops or other activities. Due to the level of their learning disability none of the service users undertake employment or further education. It was noted that the service users were encouraged to clear their dishes away following their meal. One service users attends a regular music activity class. One relative commented that I feel that my brother and other clients are treated as individuals, the home has a family atmosphere and the staff treat all of the service users like family. The manager stated that the home has its own transport in order to take the service users out and about. A holiday to Ireland has been arranged for three of the service and discussions Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 13 are underway in respect of a holiday in Scotland or Wales for the other service users. The manager commented that the home is committed to ensuring that the service users maintain their relationships with their family and friends and that families visit regularly. The manager discussed various activities for example: visits to the shops and to the local pub and to the cinema. Those residents who wish to practice their faith are encouraged to do so. The home has a four weekly menu in place in place and it looked appetizing and nutritious. It was only provided in written format and it was difficult to see how services users would choose their meals. Discussions were had with the staff in this respect, staff commented that they knew the resident’s likes and dislikes around food and that the service users would push the food away if they did not like it. They also commented that the home was in the process of buying a digital camera in order to provide pictorial menus. It was noted that all of the residents were eating the same meal. It was observed that during meal times some of the service users were wearing plastic aprons, this practice did not promote a service users dignity, and was discussed with the staff. Some of the service users required support with eating their meal and this support was offered in a sensitive manner. It was noted that the service users were encouraged to clear their dishes away following their meal. A recommendation has been made in respect of these standards. Please refer to pages 26 and 27 of this report. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The staff have a good understanding of the residents physical, emotional and health support needs, this was evident from the positive interactions and relationships observed. Residents are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Staff, were observed providing various aspects of personal care support for the service users, this support was offered in a manner that promoted the service users dignity and privacy. As discussed earlier in this report care plans included clear guidelines on any support each service user required with personal, emotional and health care needs. One relative commented that “I have always found that the home meets the needs of my brother”. Daily records evidenced visits to the doctor, various health related appointments and reviews of care. Health care professionals commented that the staff at the home communicate well with them and that they have a good professional relationship with the home. Medication procedures and storage were sampled. None of the service users are responsible for their own medication. The storage of medication was good Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 15 and records were well kept, with no gaps in signatures noted. The staff discussed the medication training they undertaken. This was evidenced in the homes training records. The manager stated that staff would only be permitted to administer medication following training and being assessed as competent. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents are protected by the homes policies, procedures and practices around concerns, complaints and protection. EVIDENCE: No complainant has contacted the Commission with information concerning a complaint made to the service since the last inspection. The manager stated that no complaints had been received at the home since the last inspection. The manager also commented that service users relatives or representatives could speak directly to him if they had concerns. The majority of the relatives commented that they were aware of the complaints procedure, but had, never had to use it. One relative was unsure as to the complaints procedure. The staff commented that if the service users were unhappy with anything they would communicate this to the staff. No referrals have been made under the local authority multi agency Safeguarding Adults procedures. Discussions were had with the staff on duty and scenarios put to them in respect of the home’s safeguarding adults procedures. Discussions were had with the staff in this respect and the staff interviewed, demonstrated a good understanding of the policies and procedures. All of the staff at the home have undertaken the local authority multi agency training in respect of safeguarding adults and are due to undertake a refresher course. This was evidenced in the homes training records. A recommendation has been made in respect of these standards. Please refer to pages 26 and 27 of this report. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Improvements are required to ensure that the environment is kept clean, well decorated and provide the service users with a pleasant place to live. EVIDENCE: It was noted that many areas of the home required attention in respect of cleaning. The carpets in the dining room area were very soiled. The walls in the communal areas were also soiled with food spillages. Staff had attempted to clean them, but because the paint was not washable some of it had been removed by the cleaning process and was unsightly. The carpets in the hall were also soiled and required cleaning. The carpets in two of the service users bedrooms, were soiled and worn in places and require urgent attention. They need to be replaced. The manager stated that there was a cleaning regime at the home and that the care workers do try to keep it clean. This should be reviewed and an audit process put in place to ensure the regime is being adhered to. He also commented that all of the carpets would be steam cleaned every 3 months. This should also be reviewed, to ensure that the home is Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 18 appropriately cleaned. The bathrooms and kitchen were clean and hygienic with good infection control measures in place. A requirement has been made in respect of these areas. Please refer to pages 26 and 27 of this report. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. EVIDENCE: Staff files sampled and direct observations evidenced that the home employs a diverse staff group. On the day the staffing levels were adequate for the dependency levels of the residents. There were 4 care staff and the manager on duty. Staff commented that the home was very seldom short staffed and that there was no agency usage. Relatives commented, that the staff always communicate well and are good at their jobs. The homes recruitment practices were sampled, and were found to be good. Three staff files were sampled and all had the required documentation, with evidence of CRB ( Criminal records) or POVA (Protection of Vulnerable Adults) checks in place. Discussions were had with staff, who, talked about their job roles and responsibilities. Work based observations evidenced competent staff carrying out their various tasks. Staff discussed some of the training they had undertaken. Training records demonstrated that various training courses had Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 20 been undertaken, for example, Basic life support, Manual handling, Food hygiene, Fire training, Medication and Safeguarding Adults training. There was no evidence of any good practice training for example, Dementia Care or Management of continence which if implemented would be of benefit to service users and staff. Discussions were had with the manager in this respect. The home is proactive in promoting NVQ (National Vocation Qualifications), 2 staff have achieved NVQ 3, 2 staff have achieved NVQ 2 and a further five are undertaking an NVQ qualification. Whilst there are no training courses related directly to Equality and Diversity, the manager stated that equality and diversity issues are discussed during the staff induction training and in the NVQ modules. Care staff discussed various diversity issues in respect of the service users, for example service users faith needs being addressed. A recommendation has been made in respect of these standards. Please refer to pages 26 and 27 of this report. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The resident’s benefit from an open and inclusive management approach to the running of the home. Improvements must be made in respect of actively seeking service users views. EVIDENCE: The manager has worked in the service for some years and has recently achieved the Registered Manager Award. He demonstrated an open and inclusive approach and management style. From observation of his interactions with the service users and staff and staff it was clear that there was an atmosphere of openness, understanding and respect. The homes quality assurance process was discussed. Whilst there was evidence to indicate that some quality audits were carried out, it was unclear as to how the home seeks the views of service users and other stakeholders. The manager stated that in the past they had held service users meetings, but Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 22 they felt the service users did not gain anything from them and they have not had one for some time. He also discussed developing pictorial service user surveys. Service users surveys are not sent out to relatives, representatives or health care professionals. The organisation carries out monthly visits to the home and produces a report in this respect. The most recent report did not identify the areas of concern around the general cleaning and decoration at the home. Health and safety checks are routinely carried out at the home. The manager stated that all of the equipment in the home had been properly maintained and serviced, but was unable to produce the most recent service certificate in respect of the assisted bath. Records evidenced that water temperatures, fire drills, fire bells and kitchen records in respect of fridge, freezer and food temperatures were well kept. A requirement has been made in respect of these standards. Please refer to pages 26 and 27 of this report. Stiperstone DS0000013802.V336665.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 Adults 18-65 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 2 X X 3 X Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 24 No 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. Standard YA9 Regulation 12(1)(a) 13(4)( c) Requirement Timescale for action 22/06/07 2. YA30 23(2)(d) 3. YA39 24(2)(b) Unnecessary risks to the health and safety of service users must be identified and so far as possible eliminated. (a) Risk assessments must be carried out on all of the liquid soaps and hand wash which service users have access too. (b) The risk assessments must documented. All parts of the care home must 22/07/07 be kept clean and reasonably decorated. Attention must be paid to: (a) The carpets in the home must be kept clean. (b) The carpets in two of the bedrooms must be replaced. (c) A review must be undertaken in respect of the decoration in the communal rooms. The quality assurance process in 22/07/07 the home must be reviewed and updated to ensure that the views of service user and other stakeholders are actively sought. DS0000013802.V336665.R01.S.doc Version 5.2 Stiperstone Page 25 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. 3. Refer to Standard YA32 YA35 YA18 YA22 Good Practice Recommendations The service could consider reviewing the homes training programme in order to ensure that the staff have the skills to meet the changing needs and ages of the service users. The service could consider reviewing the practice of the use of plastic aprons for service users at meal times in order to further promote their dignity. The service could consider how best to ensure that all stakeholders are aware of the homes complaints procedure. Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Stiperstone DS0000013802.V336665.R01.S.doc Version 5.2 Page 27 - 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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