Inspection on 10/08/06 for Swan Lodge

This inspection was carried out on 10th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

Other inspections for this house

Swan Lodge 01/08/07

Swan Lodge 13/12/05

Swan Lodge 05/05/05

Swan Lodge 11/10/04

Swan Lodge 29/04/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Swan Lodge Kent Avenue Wallsend Tyne & Wear NE28 0JE Lead Inspector Suzanne McKean Key Unannounced Inspection 09:30 10th August 2006 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 Swan Lodge DS0000028821.V289854.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. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Swan Lodge Address Kent Avenue Wallsend Tyne & Wear NE28 0JE 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) 0191 263 9434 0191 2621413 swan.lodge@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Care Home 46 Category(ies) of Old age, not falling within any other category registration, with number (46) of places Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual is below pensionable age. Should this resident leave the home CSCI must be notified. 13th December 2005 Date of last inspection Brief Description of the Service: Swan Lodge is a purpose built care home situated on the same site as another care home owned by the same company. The home provides nursing and social care for up to 46 older persons. There is also a contract with the NHS to provide 6 beds for the local GPs. The home has lounges, dining rooms and separate smoking rooms on each floor. All of the bedrooms are single and have en-suite facilities. There are a range of specialist bathrooms, showers and toilet facilities throughout the home. The first floor is accessible by stairs and a passenger lift and the grounds are readily accessible. There is ample car parking to the front of the home. The home shares the kitchen and laundry services with the adjacent home. Swan Lodge is well positioned for local transport and all local amenities. The fees charged by the home range between £361 and £420 depending upon the resident’s needs and service they receive. Additional fees are paid to the home via the nursing care element (free nursing care payment). There is information about the service through the service user guide containing the statement of purpose. A copy of the last inspection report from Commission for Social Care Inspection is available in the entrance to the home. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over 10 hours during two visits. It covered all of the core standards. Eight residents, and three relatives were spoken to directly although more were chatted to briefly. Three staff were spoken to and asked for their views. Four care plans, training records and the records for medication, staff files training, and health and safety records were examined. Ten resident and ten relative questionnaires were sent out. Three relative and three residents questionnaires were returned and the contents of these have been including in this report. There were sixteen requirements identified during the last inspection and one recommendation. Thirteen of the requirements have been met. In total seven requirements have been identified as a result of this inspection. The recommendation remains in place and one additional one has been made. What the service does well: What has improved since the last inspection? A number of improvements have been made since the last inspection. Complaints are recorded more effectively and generally the recording of individual records maintained in the home has been improved. The manager has worked with the company to improve the decoration and maintenance undertaken in the home. Medication disposal is now appropriate and the contract is in place. The sluice rooms are now tidy and well organised and control of infection policies are now being followed in the cleaning and care practices. Emergency call cords were all to floor level allowing them to be Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 6 used even in the event of a resident having fallen. The home has reached the 50 target for carers to have NVQ level 2 qualifications. Staff are now receiving specialist training to match the needs of the residents in the home. This is being recorded in their personal files. The Manager is devising a way of recording all staff training in a way the training needs analysis can be undertaken. 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. Swan Lodge DS0000028821.V289854.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 Swan Lodge DS0000028821.V289854.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. No resident is admitted into the home until there is a comprehensive assessment undertaken by the staff. This assessment then forms the basis for the development of the care plan. The home does not offer intermediate care. EVIDENCE: Five care plans were examined. Each had a pre-admission assessment. Either the Manager or the senior staff had carried them out. The records seen were well documented and detailed enough to form the basis of the care planning. Three care plans also contained a care management assessment, which is provided to the home on admission, and from these documents an individual care plan is developed. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The residents are having their needs met and the individual care planning is identified in the care plans which are up to date and detailed. The residents are treated with respect and their privacy is being maintained. The residents receive their prescribed medication in line with safe working practices. The medicines in the home are well managed and safely disposed of as necessary. EVIDENCE: The residents all have individual plans, which identify their care needs and how they are to be met. These are based on an admission assessment, which is then added to during the placement. Five care plans were looked at. They all contained enough information regarding the needs of the resident to allow staff to give the necessary care. There are relevant risk assessments available for nutrition, wound care, moving and assisting, and continence promotion. The plans are regularly reviewed and updated to make sure that they contain up to date and accurate information. The care plans show that the residents have Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 10 access to all NHS services and facilities. There was a good range of pressure relieving mattresses in use for the prevention of pressure sores. Only two residents currently have wounds. The records showed how the wounds were being cared for which was appropriate. External advice was being sought from NHS advisors for specific care needs for one resident. The systems for managing medicines in the home is appropriate. The staff record the medicines being ordered. The prescriptions are then checked on receipt from the General Practitioners and are then sent to the Chemist for dispensing. The medicines are checked again when received into the home so that any errors can be picked up. The home has a contract with a Pharmacist, which included giving advice as necessary. No residents are currently managing their own medication. There is a contract in place for the disposal of those medicines no longer needed by residents. The contract is part of the pharmacy agreement. The Manager, nursing and care staff, and support staff provided information to show that they aware of the needs of the residents. The Commission for Social Care Inspection questionnaires returned from both residents and relatives were complementary about the way the care is being delivered. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents are generally satisfied with the flexibility of their daily routines, which address their cultural, and religious needs. There are not enough opportunities for residents to be involved in varied and individualised social activities. The food being served offers a nutritious and balanced diet and gives choice and variety. Catering staff work to accommodate residents needs within the restrictions of multi-occupancy living. Arrangements for residents to maintain contact with family, friends and local community are suited to individual’s needs and vary accordingly. EVIDENCE: There are social care assessments in the care plans. There is currently no activities co-ordinator although at present one of the carers is doing some work including organising weekly trips out (accompanied). She is organising carpet bowls, scrabble, and videos. There has been a recent trip out for some resdients and a summer fair has been organised for two weeks after the inspection date. Due to the dependency level of some of the residents a Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 12 number of the activities offered are less active and provided on a more one to one basis. This is not sufficiently developed to offer individualised activities for the residents in line with their social assessment. The records of the activities provided are not detailed enough, and it is necessary that this be developed further to show the full extent of what is going on in the home. There is a relatives and residents meeting organised for the week after the inspection. The notes from the last are to be completed and made available to the relatives and relatives. The residents described the ways they are encouraged to take control of their daily routines in simple but important ways including the time they get up, what and when they eat and how they spend their time. Staff confirmed that they assist residents to make choices about how they spend their day. Residents have visitors at any time and are able to use their own rooms, the small lounges or the larger, busier lounges to receive them. Relatives are given information within the residents’ guide about visiting arrangements. Residents said they were satisfied with the arrangements for visitors and that staff welcome them. The food served on the day that these standards were being looked was sausage and hash browns or soup and sandwiches then fruit scones or ice cream. All residents seemed to enjoy the food served. The scones were tasted and found to be tasty and were nutritious. The mealtime was well organised and the food being served was well received by the residents. An example of this was one who said, “this is nice” and “ the food is lovely”. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. There is a complaints policy in place that is known to residents, relatives and staff. This describes the system for managing and dealing with complaints, which is being followed. The residents are protected from abuse by staff training, recruitment and selection and effective documentation. EVIDENCE: The complaints procedure is available in the service users guide and a copy is available at the front entrance and is displayed in the home. The records of the complaints were examined. There has been one complaint recorded since the last inspection. This was recorded satisfactorily and dated with details of the concerns. A written response was in place which upheld the majority of the issues and an action plan identiifed. A new method for recording complaints was discussed and the Manager is to implement a log book and seperapte file containing the details of the complaint. This had been put in place by the second visit. Two of the residents who were interviewed during the visit understood how to make a complaint, and could identify the way this would be dealt with. The returned questionnaires confirmed that both relatives and residents are informed about the complaints procedure and all but one had not needed to use it. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 & 26 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The bedrooms are all single occupancy and are decorated and equipped in a homely and personalised way. The home is generally well decorated, and there is an ongoing programme of redecoration. However additional cleaning / domestic staff time are needed to ensure that it is maintained to an adequate standard. The bathing facilities are currently not adequate as there are only two assisted baths for resident use. EVIDENCE: A tour of the premises was conducted with the Manager and alone and it was noted that the communal rooms are clean and well decorated. Bedrooms are personalised and are organised in line with the wishes and choices of the resident. There are a few bedrooms which require replacement of the carpet, Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 15 and the manager has a list of these with priority given to those in greatest need. The Manager has plans to further improve the environment generally as part of the redecoration programme. The home was generally clean and odour free on both of the visits. However there are times when there are no domestic staff on duty. This includes after 2pm Monday to Friday and weekends. This results in a poorer level of cleaning than necessary. Feedback from the questionnaires returned suggested that the bedroom areas are not always deep cleaned to the necessary standard. There is not enough domestic cover to allow them to undertake more than the routine programme of cleaning. (see staffing requirement) This was discussed with senior members of the company team and it was agreed that this would be addressed. There is liquid soap and disposable paper in the en-suites and appropriate waste bins have been purchased so staff are able to dispose of the paper without leaving the room. Appropriately coloured aprons were available to allow staff to follow control of infection policies, and staff were seen to be using them correctly. Red dissolvable laundry bags are available and staff were therefore not handling soiled linen prior to it being washed. There are five bathing facilities in the home. However, out of the five there are only two assisted baths being used. The shower room has been out of service for some time and the other baths are not assisted facilities. The Jacuzzi bathroom was being used for storage of equipment including a commode chair and unused bed rails. This is not satisfactory, as staff would need to remove them prior to bathing. Other communal rooms contained some clutter and should be tidied to make them more suitable for resident use. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The home is adequately staffed the majority of the day however there is a period between 14.00 and 20.00 when an additional care is needed. Domestic staff are not provided in sufficient numbers to ensure that the home is cleaned effectively. The home has an effective recruitment and selection system including Criminal Record Bureau checks and use of the Protection of Vulnerable Adults List which ensures that residents are cared for by competent staff and are in safe hands. The training programme is up to date for all staff and a significant amount of training is being given to the staff in health and safety, statutory and clinical areas of practice. EVIDENCE: Two staff records were examined and were complete including application forms, two references and a completed interview form. The requirement to have a CRB and POVA check in place is applied to all of the staff in the home. Where necessary a work permit was in place. Health certificates/information were on in file and proof of quallifications where necessary. Induction information was included in the records and quality assessments had been documented. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 17 The manager confirmed that she has ensured that the staff are up to date with moving and handling, first aid, and food handling and hygiene training. However the records for fire training suggest that some staff are not up to date with their fire training updates. The staff are offered a number of other training opportunities including pressure area care and continence training. The care staff are encouraged to undertake National Vocational Qualifications (NVQ 2) and there is more than 50 of the staff have achieved this. The NVQ training is commenced once staff have completed their induction training. Two out of the three of the returned relative questionnaires suggested that there were insufficient staff. On examination the staffing rota does support this, in that there needs to be another carer on duty between 2 pm and 8 pm to bring the home in line with the company staffing policy. Also there are no domestic staff after 2pm from Monday to Friday and none at weekends. This results in staff having to undertake domestic duties if they arise during these periods. The staffing levels were discussed with the senior managers of the company and it was agreed that this would be resolved. Additional staffing hours had been organised by the second visit. Supervision has been provided to the staff however the last on record was carried out in March 2006 and the previous ones before that were in November 2005. The staff must be provided with supervision six times per year and although it is acknowledged that the Manager has planned for this to be undertaken it is not up to date. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The manager for the home is not yet registered with the Commission for Social Care Inspection. However the company has policies and procedures in place to ensure that the home is managed effectively and the regional manager is supporting her. Resident’s personal allowances are being managed effectively. The Manager is ensuring that the residents are protected through good health and safety practices and staff training. Only fire training updates are not fully up to date. EVIDENCE: The manager in the home is not yet registered with Commission for Social Care Inspection as she has been working temporarily in the post and has only recently been made the permanent manager. She has not yet submitted her Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 19 application and must do so as soon as possible. However recent changes she has made have been positive and she is working towards making the necessary improvements as identified in this report. The records of the arrangements to ensure that persons working at the care home receive suitable training in fire prevention, and by means of fire drills and training in the procedures to be followed in the case of fire were examined and were adequate. However the updates for all staff are not up to date. There is a system in place to review health and safety in the home involving the staff, for which records are available. During the tour of the premises it was noted that there were no obvious risks and the Manager confirmed that she undertakes daily tours herself to ensure that it remains so. Records were examined of the staff meetings, and the contents of these suggest that there is a broad spectrum of relevant issues discussed. These are posted in the staff room for those staff who were unable to attend. The Manager has also had one to one meetings with the relatives and residents as appropriate. As she is new into her post she is considering the best way to ensure that the residents and relatives are consulted and communicated with. There have been no resident/relative questionnaires recently and no formal attempts to elicit their views. These must be carried out to ensure that they can contribute to the homes quality assurance process. The personal records kept in the home for residents who are receiving assistance to manage their finances were examined and are detailed, logical and appropriate. Receipts were in place for purchases made on behalf of residents and signatures of either two staff or one and the service user were in place. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 20 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X 2 X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 21 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 OP12 Regulation 16 (2) (m) (n) Requirement Social activities must be offered to residents according to their expectations and preferences and in line with their abilities and needs. Bathing facilities must be available in sufficient numbers and suitable to the needs of the residents. Staffing for care and domestic staff must be reviewed and additional staff provided as necessary. The manager must submit her application for registration to the CSCI for consideration. All care staff must receive formal supervision six times a year. There must be a formal system based on seeking the views of residents and all other stakeholders to assess and develop the quality of care in the home. Fire training must be provided at the necessary intervals. Fire training must be provided at the necessary intervals. Timescale for action 01/12/06 2. OP21 23 (2) (j) 01/12/06 3. OP27 18 01/10/06 4. 5. 6. OP31 OP36 OP33 8, 9 18 24 01/12/06 01/12/06 01/12/06 7. 7. OP30 OP37 23 (4) (d) 23 (4) (d) 01/10/06 01/10/06 Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 22 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 OP19 Good Practice Recommendations It is recommended that the care plan audits are carried out as planned The manager should audit the communal space in the home and de-clutter them to ensure that they can be used effectively. Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Swan Lodge DS0000028821.V289854.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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