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Inspection on 12/06/07 for Swallows Residential Home

Also see our care home review for Swallows Residential Home for more information

This inspection was carried out on 12th June 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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 service offers homely and attractive accommodation to a small number of residents. Residents spoken with spoke highly of the food and the meals served on the day of the inspection looked appetizing and nutritious. Over 50% of staff have undertaken NVQ2 in care.

What has improved since the last inspection?

Medication practice has improved at the home and the records were being better maintained. The home is seeking clarification from the GP where it is unclear about what is being prescribed. Pre admission assessments of prospective residents needs are being undertaken, ensuring that staff are clearer about the residents needs prior to their admission. Updating training has been organised for care staff. There is better monitoring of water temperatures and an engineer`s advice is being sought.

What the care home could do better:

The manager works at the home on two days each week and while she may be available by telephone, this does not replace onsite management. There is a deputy manager in post however a number of the requirements, which have been made at this inspection, have been outstanding from previous inspections. The homes management have been required to review the day-today management of the service as the home has been assessed as operating as adequate. Care plans should be up to date and clearly outline how care should be delivered to meet resident`s needs. Daily records should be more comprehensive and detailed. While there have been improvements to medication practices, issues still remain and further training should be provided to senior staff to ensure greater oversight of practice. The home`s policy on the protection of vulnerable adults should be expanded, as staff should be clear as to the steps that they should take should they become aware of an issue. Staff who are recruited must be the subject of robust checks and have a POVA First check in place before they start work at the home. It is of concern that a member of staff does not have a criminal record bureau check in place as required under the legislation. The home must provide evidence to the Commission of the servicing of bath hoist and the electric hoist. The home organises some activities for residents but this could be expanded and a wider range of activities offered.

CARE HOMES FOR OLDER PEOPLE Swallows Residential Home Helions Bumpstead Road Haverhill Suffolk CB9 7AA Lead Inspector Cecilia McKillop Unannounced Inspection 12th June 2007 11:00 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 Swallows Residential Home DS0000063929.V343370.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. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swallows Residential Home Address Helions Bumpstead Road Haverhill Suffolk CB9 7AA 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) 01440 714745 01440 761315 Burrows Care Homes Miss Annmarie Burrows, Mr Harold Burrows, Mrs Donna Burrows Mrs Megeita Barrett Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th October 2006 Brief Description of the Service: The Swallows Residential Home offers care and accommodation for up to sixteen older people, in single storey accommodation situated on the outskirts of the town of Haverhill in a rural position. The home was first registered in 1995 and the building adapted to provide appropriate accommodation for seven residents. In February 2000 an extension was completed, providing good quality and pleasant additional communal and bedroom accommodation and increasing the registration of the home to fifteen. In November 2000 a previous office was converted into an additional resident bedroom and the total increased to sixteen residents. All resident bedrooms are for single occupancy with one room having an en-suite toilet facility. The home came under new ownership and management in June 2005 and the new owners have already made changes to improve and upgrade the environment. The fees range between £331.00 and £375.00 per week. The cost of newspapers, chiropody, hairdressing and some transport is not included in the fees. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced inspection of the Swallows Residential Home. The inspector spent a day at the home speaking with residents and examining records. A sample of bedrooms were viewed and medication examined. The manager was unavailable on the day of the inspection and a senior member of staff assisted the inspector to access the required documentation. What the service does well: What has improved since the last inspection? What they could do better: The manager works at the home on two days each week and while she may be available by telephone, this does not replace onsite management. There is a deputy manager in post however a number of the requirements, which have been made at this inspection, have been outstanding from previous inspections. The homes management have been required to review the day-toSwallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 6 day management of the service as the home has been assessed as operating as adequate. Care plans should be up to date and clearly outline how care should be delivered to meet resident’s needs. Daily records should be more comprehensive and detailed. While there have been improvements to medication practices, issues still remain and further training should be provided to senior staff to ensure greater oversight of practice. The home’s policy on the protection of vulnerable adults should be expanded, as staff should be clear as to the steps that they should take should they become aware of an issue. Staff who are recruited must be the subject of robust checks and have a POVA First check in place before they start work at the home. It is of concern that a member of staff does not have a criminal record bureau check in place as required under the legislation. The home must provide evidence to the Commission of the servicing of bath hoist and the electric hoist. The home organises some activities for residents but this could be expanded and a wider range of activities offered. 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. Swallows Residential Home DS0000063929.V343370.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 Swallows Residential Home DS0000063929.V343370.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): 3,6 Quality in this outcome area is adequate. People who use this service can expect to receive some assessment of their needs prior to their admission to the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Two newly admitted resident’s files were seen. Both contained a pre-admission assessment completed by the service. The assessments, which were undertaken, were generally satisfactory although were not very specific. The assessments had been completed in conjunction with the family but there was no evidence of consultation with other professionals such as GPs. One resident had a hospital discharge summary. One resident who was interviewed said that she didn’t personally visit the home but a relative did on her behalf. The senior member of staff told the inspector that one relative had visited the home and had taken photographs of key areas to show to the prospective resident prior to their admission. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 9 The home does not offer immediate care. Swallows Residential Home DS0000063929.V343370.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 adequate. People who use this service can expect to have a care plan in place, but cannot be assured that it will be up to date or that care will be consistently delivered. Medication practices are improving. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The care plans for two new residents were seen and covered areas of care such as personal hygiene, continence, communication, night needs, diet and mobility. In addition there were risk assessments in place for tissue viability, nutrition and moving and handling. One of the two plans was generally satisfactory and contained all the required information. The second plan did not contain key information about the involvement of the district nurse and a pressure sore, which had been identified following admission. In discussion with the deputy manager it was clear that the home had taken steps to address the issue once they had become aware of it but they had not recorded their findings or their actions. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 11 Daily records were insufficiently detailed and focused mainly on the visitors that the resident received rather on residents needs and care delivered. One-of comments were noted such, as ‘feeling sick’, but there was no subsequent follow up. Residents interviewed confirmed that the home made arrangements for them to seek the GP if this was required. One resident described how staff washed their legs and put on ointment each day. They said there had been a marked improvement in their skin as a result. The home uses a monitored dosage system and as part of the inspection a sample of medication administration charts (MAR sheets) and the medication storage arrangements were examined. The MAR sheets showed an improved level of recording and there was only a small number of empty signature boxes. The codes had been correctly applied if the medication was not given for any reason. Staff were recording the numbers of tablets being given and the stock was being better managed. However one newly admitted resident had been without medication for several days the week prior to the inspection because the home was out of stock. The deputy manager said that the problem had arisen because the resident was moving from one GP practice to another and some records had been mislaid by the practice. The storage and administration system for the controlled drugs were examined as part of the inspection. The numbers of tablets and the recording tallied in the sample examined. The inspector was informed that all staff receive basic medication training from the medication provider. The deputy manager has not undertaken any supplementary training. Care practice was observed and staff were noted to treat residents patiently and were observed knocking on doors prior to entering. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. People who use this service can expect to be provided with a limited range of activities and freshly prepared meals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Resident’s files contained details of family contacts and their relationship to the resident. Daily records had entries about visits from family and friends. Residents said that staff welcome visitors to the home and there was a telephone, which they use if they wished. A number of residents had their own telephone in their room. The home is located in a rural position and the inspector was informed that residents can order a taxi if they wish to travel to nearby Haverhill. There is a trolley located in the dining area, which contains items such as cards, sweets and toiletries, which residents can purchase. A table was laid out with items for the forthcoming summer fete. On the day of the inspection residents were observed watching television and talking together. A number spent the afternoon in their rooms. There were no formal activities but the residents interviewed were generally satisfied and did Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 13 not identify boredom as an issue. The inspector was informed that there are fortnightly craft sessions, bingo games and sing-along organised. A trip to Felixstowe had been organised the previous month and another trip was being planned. At previous inspections the food provided has been identified as good. On the day of the unannounced there was a menu board on display setting out what was on offer. A freshly cooked quiche had been prepared with vegetables and a choice of potatoes. The food looked appetising and the cook came out and spoke to each of the residents to check that they were happy with everything. The tables were nicely laid and residents were offered a good range of condiments. Residents reported that they were provided with a fresh jug of water every day in their rooms and spoke positively about the quality and choice of food available. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is adequate. People who use this service can expect to have complaints taken seriously but they cannot be assured that staff are clear about what to do in the event of abuse. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The complaints policy was on display in the entrance to the home. The Home has copies of the protection of vulnerable adults guidance issued by the interagency committee of Suffolk. The home has an inhouse policy but this was very brief and referred all matters to the manager. The policy does not address issues such as when to make a referral, what to record and to whom a referral should be made. In the pre inspection information sent to the Commission there is reference to staff completing a booklet entitled vulnerable adults at risk of abuse. Staff interviewed reported that they had seen a booklet but had not undertaken recent training. In addition to the vulnerable adults procedure there is a whistle blowing procedure. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. People who use this service can expect to find accommodation that is comfortable, generally clean and homely. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A tour of the home was undertaken as part of the inspection. The home was tidy and looked well maintained, although some areas would have benefited from further cleaning. There were no unpleasant odours or hazards noted during the inspection. In the AQAA completed by the home prior to the inspection, the manager outlined a number of items that have been purchased and areas that have been redecorated over the last year. A sample of residents bedrooms were visited as part of the inspection and these were very comfortable and had been personalised by residents. Resident’s names were on the doors and keys were available. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 16 The inspector noted liquid soap, gloves and aprons at key locations around the home. One member of staff was observed with an individual hand wash. There was a display for staff on a “guide to hand washing”. The laundry was visited as part of the inspection and this was clean, tidy and well maintained. A new tumble dryer has recently been purchased and the washing machine has a sluice cycle. Water temperatures were tested as part of the inspection and were within the recommended levels. There was evidence that the home was monitoring the water temperatures and the inspector was informed that the home had arranged a visit from an engineer, in the days following the inspection. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28,29,30 Quality in this outcome area is poor. People who use this service can expect to be cared for by adequate numbers of staff who have been given training for their role. However the recruitment of those staff does not offer protection to residents. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home works to a two-week rota. The rota provided to the inspector was however inaccurate as it did not reflect the position on the day as a number of the staff who were due to be on duty were off sick. Cover was provided from within the staff team and by a member of bank staff. On the morning of the inspection, the deputy manager was on duty along with two other carers. Levels of staffing were adequate on the day of the inspection. One member of care staff provides night cover with a second carer on sleep in duties. In the AQAA competed by the home prior to the inspection the manager stated that over 50 of the current staff have achieved NVQ2 and 75 of senior staff have achieved Level3. The inspector was informed by staff who were interviewed as part of the inspection that they were provided with updating training. A number of staff have started health and safety and food hygiene courses. Three staff are due to undertake first aid training and a fire training session has been booked for the 28th of June 2007. Staff confirmed that they had received training in manual handling and infection control. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 18 The inspector was informed that newly appointed staff shadow more experienced staff as part of their induction. The recruitment records for three newly appointed staff were examined as part of the inspection. The files contained an application form/ CV, copies of certificates, checks on identification and records of interview. One of the CVs however did not contain dates of employment and therefore it was not possible to tell whether there were any gaps in employment. There were references but one reference from a previous care home was addressed to another member of staff at their home address rather then the manager of the home. One member of staff did not have a POVA First check or CRB clearance in place. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is adequate. People who use this service can expect that the homes manager has systems in place to ensure that the home is adequately managed but may not always be available on site. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The manager works at the home two shifts each week and is assisted by a deputy manager and senior carers. Staff reported that the manager was approachable and they were generally able to contact her by telephone should they need to do so. Previous reports document issues in the past with regard to the management of the home and whilst these were not resurrected during the inspection, it is not ideal that the manager has such a minimal presence at the home. The manager has stated in the AQAA completed prior to the inspection that staff receive supervision and regular senior staff meetings are held. The staff Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 20 meetings are minuted and staff interviewed confirmed that they receive supervision. The deputy manager informed the inspector that the home had recently sent out quality assurance questionnaires to interested parties and it was planning to display the results once these have been returned. Reports under Regulation 26 have been forwarded to the Commission. There was evidence in resident’s files that they are consulted about their needs at reviews and the home have stated that they have started to hold residents meetings to ascertain residents views. The systems in place for managing resident’s personal moneys were examined as part of the inspection. Receipts were in place for some items, which were bought on resident’s behalf by staff. The deputy manager said that there were not receipts for everything as some items had been purchased with the homes main shopping. There was not a clear audit trail, as staff, relatives or residents do not sign to withdraw or put money in. A certificate of public liability was on display. A fire risk assessment was in place and had recently been reviewed. The home’s management provided the Commission with the dates of the testing of the portable electrical equipment and fire detection equipment. The deputy manager was unable to locate certificates with regard to hoist servicing and it was agreed that this would be forwarded to the Commission. There was an accident book in place for residents and staff and the deputy manager was able to outline the steps taken by the homes management to minimise further risks following accidents which had taken place. Contact had been made for example with the falls assessor. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 All people using the service must have an up to date detailed care plan, which includes details of any pressure sores. This will ensure that they receive person centred support that meets their needs. The registered persons must ensure that there are adequate supplies of prescribed medication so that residents do not miss doses. Staff who are responsible for the ordering of medication receive additional training to ensure that there is oversight of medication practice and residents do not miss doses. The registered persons must compile a safeguarding policy for staff guidance based on the guidelines set out in the Suffolk interagency procedures. This is a repeat requirement. Further failure to comply may result in enforcement action. Staff must not start work at the home until all the required recruitment checks have been DS0000063929.V343370.R01.S.doc Timescale for action 01/09/07 2. OP9 13 (2) 01/08/07 3. OP9 13 01/09/07 4. OP18 13 (6) 01/08/07 5 OP29 19 01/08/07 Swallows Residential Home Version 5.2 Page 23 6. OP29 19 (1) (b) (i) Sch 2 7 OP38 23 8 OP31 24 undertaken. The registered persons must 10/07/07 undertake, and retain evidence of, all the recruitment checks required in Schedule 2 of the Care Standards Act 2001. This is a repeat requirement. Further failure to comply may result in enforcement action. The registered person must 01/08/07 provide the Commission with evidence that the bath hoist and the electric hoist are being serviced and properly maintained to ensure that residents are protected. The management arrangements 01/09/07 at the home must be reviewed to ensure that the home is managed in a way that best meets the needs of the residents living at the home 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 OP8 OP12 Good Practice Recommendations More detailed information is recorded on individual records to ensure better monitoring of health and welfare The range of social activities offered to residents could be expanded. Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Swallows Residential Home DS0000063929.V343370.R01.S.doc Version 5.2 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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