Inspection on 01/06/05 for Stonecroft

This inspection was carried out on 1st June 2005.

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.

Other inspections for this house

Stonecroft 30/10/08

Stonecroft 29/05/07

Stonecroft 08/12/05

Stonecroft 26/02/05

Stonecroft 29/07/04

Stonecroft 29/01/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Stonecroft Kibblesworth Gateshead Tyne & Wear NE11 0YJ Lead Inspector Nic Shaw Unannounced Wednesday, 1 June : 11:00 st The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Stonecroft Address Kibblesworth, Gateshead NE11 0YJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0191 410 3323 0191 410 3323 Northgate & Prudhoe NHS Trust Mrs Sue Lawrence (in process of being registered). PC Care home only 5 Category(ies) of 5 x LD, 1 x PD, 1 x SI registration, with number of places Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26th January 2005 Brief Description of the Service: Stonecroft was first opened in 1997 as part of Northgate and Prudhoe NHS Trust’s, “The Trust”, resettlement programme. It provides ordinary housing for people with learning disabilities who were formerly resident in “long stay” hospitals. Stonecroft can provide personal care for 5 people who have a learning disability. The service cannot provide nursing care. The home is a large detached bungalow set in its own grounds. The house is spacious with a large living room, dining room, kitchen, sun lounge, breakfast area and six bedrooms. The home has wide passageways and is accessible for people who use wheelchairs. There is a separate laundry and storage facilities. There are pleasant gardens to all sides of the home that service users can reach safely. The home is situated in the village of Kibblesworth a few miles from the town centre of Birtley and the Team Valley Trading Estate. The village itself has a number of local amenities including shops, public house and community centre. There are bus stops nearby which link with the main regional centres and the home has its own transport which has been adapted to make it accessible to service users who use a wheelchair. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours in June 2005 and was a scheduled unannounced inspection. The inspection process involved observing interactions between the staff and the people who live in the home as well as talking to the service users, staff, and a visiting “enabler”, (person employed by the Trust specifically to facilitate activities for service users), and aromatherapist. The manager was on annual leave, however, the designated person in charge, the sleep-in member of staff, assisted with the inspection. A sample of records were examined including care plans, rotas, accident book and fire logbook. A tour of the building took place, which included all communal areas and a sample of service users bedrooms. The judgements made are based on the evidence available on the day of the inspection. What the service does well: The staff work hard to meet the personal and health care needs of the service users, whilst promoting their independence, ensuring that regular contact is maintained with their GP’s and other health professionals. Good systems are in place to monitor any changes made to the service user’s medication. The organisation provides staff with on-going training in order to provide them with the skills and knowledge to help them to support the people living in the home. The staff provide the service users with a range of activities both within the house and in the community. They also strive to look for alternative activities which would be of benefit to those people with a physical disability, such as aromatherapy sessions. The service users are supported by the staff to take reasonable risks as part of independent living. For one service user this means that she is able to regularly go horse riding, an activity which staff said she very much enjoys. The home is clean warm, and well maintained. Bedrooms are spacious and reflect the likes and personality of each service user. The service users have Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 6 access to a spacious garden with a garden swing, which is popular with some of the service user’s during summer. An aroma therapist who regularly visits the home commented positively on the friendly welcoming atmosphere. What has improved since the last inspection? What they could do better: Some of the information contained within the care plans needs to be developed to tell staff what they should do should a service user choose not to follow their care plan. Communication diaries should also continue to be developed in order to help staff to understand each person’s method of communication. The views of the service users have been sought by use of questionnaires. However, the service users have communication needs and would not be able to complete these independently. As such, in order for this process to be of value, details of how this information was collated needs to be recorded. It would be beneficial for service users to have access to an independent advocate particularly in relation to this process. Please contact the provider for advice of actions taken in response to this Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 8 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 Standards Statutory Requirements Identified During the Inspection Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5 Service users are provided with a contract which assists their relative’s to know that their rights as residents are protected. EVIDENCE: A new contract has been developed since the last inspection and a copy of this has been provided to each of the service users and is held in their personal file. This is now available in a picture format in an attempt to assist those service users with communication needs to understand the terms and conditions of residency. Discussion with the staff confirmed that the service user’s family members have also had access to this document. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6&9 The health and personal care needs recorded in the care plans generally reflect the service users care needs. However, these need to be further developed to ensure that the service users welfare is not placed at risk. Systems are in place to enable service users to take reasonable risks. As such they can enjoy a range of activities as part of living an independent lifestyle. EVIDENCE: Of the care plans examined information was available to advise staff of the interventions needed of them to meet the service users personal care needs. Much of this information was detailed and up-to-date and included all aspects of the person’s life. However, observations made of practises during the inspection indicated that some of the care plans needed to be developed to clearly advise staff of action they should take, particularly in those situations where a service user communicates that they do not wish to follow their care plan. In addition to this where aspects of a service users rights are limited as a result of risks identified, this needs to be clearly recorded in the care plan. These developments will ensure consistency and continuity of care and safeguard the service users well being. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 11 It was positive to note that there is some information contained within the care plan advising staff of the service users method of communication, for example, key words which may be used and level of understanding. However, some of the communication observed during the inspection, although staff spoken to knew what this meant, was not documented in the care plan. It was also positive to note that since the last inspection a notice board with photographs of those staff on duty each day has been implemented as an alternative method of communicating the rota to service users. Staff spoken to confirmed that currently they were in the process of carrying out a risk assessment in order to enable two of the service users to go swimming. This has involved the staff visiting the swimming pool in order to assess its accessibility. Records examined confirmed that a risk assessment had been carried out in order that one service user could go horse riding. Discussion with the staff confirmed that following a recent accident involving the service user falling from a horse, this risk assessment is to be reviewed and up-dated in order that the service user can continue to enjoy this activity. Records examined confirmed that a six month review meeting has recently been held for each of the service users. The service user’s family and other professionals, such as the occupational therapist, physiotherapist and GP were invited and issues from the last care plan review, health care and medication were discussed. Any issue raised during the review meeting is incorporated in the care plan and monitored to ensure that the service users health and personal care needs continue to be met. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14&16 Service users are provided with a range of activities within the home and in the local community. Consequently service users lead valued active fulfilled lives. The daily routines encourage service users to lead independent lifestyles. EVIDENCE: On the morning of the inspection two of the service users were supported by a member of staff and the enabler to go for a trip out to Harperley prisoner of war camp. On their return another service users was accompanied on a trip out to a local garden centre. The home has its own transport and therefore service users can benefit from trips to places further afield. Discussion with the staff confirmed that they were in the process of preparing for two service users forthcoming holiday to Ayr. The service user spoken to confirmed this to be the case and they are soon to go shopping, with staff support, to buy clothing for this. Staff spoken to also confirmed that the service users regularly access community facilities such as hairdressers, local pubs for pub lunches and trips to the Metro Centre. On the day of the inspection an aroma therapist visited the home and provided three of the service users with an aroma therapy session, an activity which they all very much appeared to enjoy. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 13 Some of the activities documented in the service users daily care plan, for example, line dancing, no longer take place and as such these records need to be up-dated. Observations confirmed that the staff refer to the service users preferred mode of address. Service users are encouraged to take part in light domestic tasks in the home. This was observed in practice and also supported by information recorded in the care plans. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19&20 Services users are assisted by staff to remain in good health. EVIDENCE: The level of support each service user requires was recorded in their care plans. Observations confirmed that staff provide service users with support in relation to their intimate personal care in a sensitive, discreet manner, carrying care tasks in the privacy of the person’s bedroom. Continuity of care is provided through a keyworker system. Staff spoken to were clear about their role as a keyworker, which involves preparing information for the service users review as well supporting the service users with shopping for clothing and arranging hairdressing appointments. Care plans examined confirmed that the service users have regular access to their GP and other medical professionals such as physiotherapists and occupational therapists. Discussion with the visiting aromatherapist confirmed that she is currently liaising with a service user’s physiotherapist with a view to providing additional aromatherapy sessions in order to promote her health care needs. Minutes of the recent review meeting held for each of the service users confirmed that their health care needs are closely monitored. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 15 Medication records examined confirmed that medication is regularly reviewed with the service user’s GP and is administered to them appropriately. Where there have been changes to a service user’s medication, records confirmed that this is closely monitored by staff. This was particularly evident for one service user for whom medication is being gradually reduced. There were also clear guidelines in place instructing staff of when they should administer “as and when required” medication. Staff spoken to confirmed that they are all soon to attend training in the safe handling of medication. Since the last inspection the manager has introduced a front sheet to the medication administration record which includes the names of those staff authorised to administer medication together with the training they have received in this area. It is advised that a specimen signature also be obtained from the staff authorised to administer medication, in accordance with guidance provided from the Royal Pharmaceutical Society. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 There are satisfactory procedures in place which protect the service users from abuse. EVIDENCE: Since the last inspection the home’s adult protection policy and procedure has been reviewed and amended to take account of the Local Authority Adult Protection Procedure. This provides staff with clear information and guidance on action they should take if they have any concerns in this area. Staff spoken to confirmed that they have received training in relation to the protection of vulnerable adults. It was also good to note that they said that as a team, although they work very well together they would have no hesitation in challenging one another if they felt that care practices were inappropriate. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The environment provides service users with a homely, comfortable place in which to live. EVIDENCE: The home was found to be clean, warm and well maintained. Since the last inspection there have been some improvements to the décor. This has included the re-decoration of the dining room ceiling and on the day of the inspection the front door was to be painted. Staff spoken to confirmed that new bedroom furniture has been purchased for two of the services users. The staff also confirmed that the service users were fully consulted on the design and colour. Each service user has their own bedroom and those seen were spacious and personalised to reflect their likes and tastes. A new specialist bathing facility has been installed and this includes a “whirlpool” feature, which staff reported the service users very much enjoy. Other specialist equipment provided to meet the needs of the service users includes overhead hoist tracking in addition to a mobile hoist. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 34 The service users are in safe hands with their personal care needs being met by a trained staff team. Staff recruitment records are not held within the home as such it was not possible to make a judgement in relation to this. EVIDENCE: Staff spoken to confirmed that they have received a range of training provided by the Trust. This has included a twelve week equality and diversity course, a twelve week infection control course as well as NVQ level 2. Of the twelve care staff 2 staff have achieved the NVQ level 2 qualification in care, 2 staff are about to commence this, whilst 3 staff are in the process of completing this qualification. When those staff currently completing the NVQ level 2 qualification in care have achieved this, the 50 target will be met. Discussion with the staff confirmed that the manager is an NVQ assessor, which has been of benefit to them. There are no staff recruitment records available to inspect in the home as required by the Care Home Regulations but these are available at the Trust’s main office. As such it was not possible to fully assess the staff recruitment procedures in order to ensure that they are robust and as such protect the residents. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 19 There have been no new staff recruited since the last inspection and there has been little turnover in staff. This has provided continuity of care for the service users. There is one part time staff vacancy and staff spoken to confirmed that these hours are being covered by existing staff. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39&42 The health and safety of service users is generally promoted and protected. However, matters in relation to bath water temperatures need to be established. Systems are in place to obtain the views of service users and used to influence the development of the service. However, further work is needed in the area of quality assurance to ensure the aims of the service and positive outcomes for service users are achieved. EVIDENCE: On the day of the inspection the home was found to be free from noticeable hazards. Staff spoken to confirmed that they carry out regular environmental checks to ensure that the health and safety of the service users is protected. Checks include ensuring that all light bulbs are working, and that bathwater temperatures are maintained at 43 degrees centigrade. However, records of the bathwater temperature indicated that this had fallen below the recommended temperature and at times was recorded as 39.7 degrees centigrade. Staff spoken to said that the temperature they record is the Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 21 temperature of the water in the bath when full. Other staff may check the temperature as the water is running from the tap. It is advised that clarity be sought in respect of this procedure in order that should the bathwater temperature need to be adjusted this can be addressed. Staff confirmed that they have received training in relation to health and safety issues such as moving and handling, food hygiene and fire safety. All staff have received training in relation to emergency first aid whilst a further 2 staff have completed a full first aid training course. Appropriate records are held in relation to accidents. The fire log book examined confirmed that fire alarms are tested regularly and fire equipment and emergency lighting checks are carried out as recommended by the fire authority. All staff have recently received fire instruction, 12th May 2005, and staff spoke to confirmed that they receive a fire instruction every 3 months. Systems are in place to obtain the views of service users. Recently all service users have completed a questionnaire in relation to the quality of the service. The completed questionnaire was available in the service user’s personal file, however, as all of the service users have needs in relation to their ability to communicate it was not clear as to how this process had been completed. Staff spoken to said that the keyworkers had completed it with each of the service users. It would be beneficial to record responses from service users and methods of communication used to support this process. Staff spoken to said that none of the service users have an independent advocate, which would of benefit in such a process. The Trust has a quality assurance system in place entitled “Total Quality Management”. This involves the staff team selecting a particular standard and monitoring whether this has been achieved over a month. Staff spoken to, however, confirmed that this process had not been implemented since February 2005 and is an area for future development. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 22 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 3 Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x 2 x 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stonecroft Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 23 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 6 Regulation 15 Requirement Care plans must be in sufficient detail to guide staff on action they should take in relation to the service users care needs. Risk assessments must aslo be completed and risk management plans developed to minimise the identified risks. 50 of the care staff must have a care NVQ level 2 qualification. Records of staff recruitment must be available for inspection. (Previous timesacle 1st June 2005). Timescale for action 30th August 2005.1 2. 3. 32 34 18(1)( c ) 19 31st December 2005. 31st December 2005. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 6 39 39 Good Practice Recommendations The development of the communication dictionaries. The continued development of the quality assurance system. The use of indepndant advocates should be considered. Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne South Shields NE34 9PT 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 Stonecroft B52-B02 S7418 Stonecroft V219774 1 Jun 05 Stage 4.doc Version 1.30 Page 25 - 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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