Inspection on 27/02/07 for Taunton House

This inspection was carried out on 27th February 2007.

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

The inspector 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

Taunton House 13/11/08

Taunton House 04/10/05

Taunton House 08/06/05

Taunton House 07/12/04

Taunton House 15/06/04

Taunton House 17/02/04

Taunton House 03/06/03

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

CARE HOME ADULTS 18-65 Taunton House 26 Marlborough Road Ryde Isle Of Wight PO33 1AB Lead Inspector Janet Ktomi Key Unannounced Inspection 27th February 2007 14.30 Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Taunton House Address 26 Marlborough Road Ryde Isle Of Wight PO33 1AB 01983 611250 01983 611250 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) Mr David John Knowles Mrs J Knowles Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person who is over 65 years of age may be accommodated in the home in the category (MD/E) 4th October 2005 Date of last inspection Brief Description of the Service: Taunton House is a family run care home registered to provide care and accommodation to up to five adults who have mental health difficulties. The house is a detached period building in Ryde and has been converted to provide single bedroom accommodation for the residents and separate accommodation for the owners. There is parking space at the front of the building and a large garden to the rear of the property. The home is close to public transport or residents can walk to the nearby shops or town centre. The home is owned by Mr and Mrs Knowles and managed by Mrs Jackie Knowles. Weekly fees are based on social services care band 2 rates of £344.75. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first ‘Key Inspection’ for Taunton House, a ‘Key Inspection’ being part of the new inspection programme, which measures the service against the key National Minimum Standards. The visit to the home, was conducted by one inspector over one day lasting a total of four hours, where in addition to any paperwork that required reviewing the inspector met with all the people who live at the service and undertook a tour of the premises. The inspection process also involved pre fieldwork visit activity, with the inspector gathering information from a variety of sources, the Commission’s database, pre-inspection information provided by the service and linking with previous inspectors who have visited the home. Comment cards were completed by all service users and one relative comment card was also received. Taunton House provides a homely environment on a domestic scale for up to five younger adults who have experienced difficulties with their mental health. All current service users have lived at the home for several years. The home currently has one vacancy. What the service does well: The home provides informal support and encouragement for the residents to be as independent as possible within a small family based home environment. All of the residents are physically mobile and able to make decisions about their daily living activities. The residents do voluntary work or take part in organised recreational and social activities offered locally. Residents stated they were very happy and there was nothing they wanted to change. The comment card received from one relative stated that he was happy with the overall care provided for his relative and had no concerns or complaints. The manager provides the majority of care and is supported by her husband, and by a part time domestic and one part time carer who works flexibly as the service requires. The service has a live-in Japanese student who assists the manager with some domestic and care activities. The staffing arrangements ensures a high level of continuity for the residents. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager would ensure that new residents are only admitted whose needs the home could meet and who are compatible with the people who already live at the home. New residents would have the opportunity to visit the home on a number of occasions prior to making a decision to move into the home. EVIDENCE: At the time of the inspection the home had one vacancy, with the existing residents having lived at the home for at least two years or more. The inspector discussed with the manager the actions she would take should a new resident be referred to the home. The manager was clear about the need to ensure that she obtained full information from as may sources as possible about any prospective resident. Prospective admissions would be discussed with existing service users and if it was felt that their needs could be met then they would be invited to visit the home on a number of occasions prior to making a decision about moving in. The manager was clear that existing residents views, and reactions/interactions with the prospective resident during visits, would be taken fully into consideration when a final decision is made Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 9 about a new admission. The manager was aware about the homes registration categories and the level of needs the home could meet. All new admissions are initially for a one month trial period. The home has comprehensive preadmission assessment tools available for use as part of the pre-assessment process. There have been no previous concerns about the statement of purpose, service users guide or contracts. Therefore these documents were not viewed and the relevant standards not assessed. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents have agreed individual care plans that are reviewed and updated as needs change. Residents make decisions about their lives with assistance as needed. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: The inspector viewed two of the four residents individual weekly plans, care plans and risk assessments. Risk assessments and care plans are written in appropriate language and clearly state the care required by individual residents and management plans for identified risks. Appropriate records were seen detailing specific information relevant to each resident within individual record books. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 11 Where the resident is on the Care Programme Approach (CPA), the care plan is reviewed with the resident, the home manager and all others involved in the residents care, at agreed intervals (either six months or one year). Residents are encouraged to take individual responsibility for their own rooms and stated they have to take their laundry to the utility room to be washed. Discussions with residents indicated that they were happy with the arrangements to keep their own rooms clean and that they get help as required (such as with duvet covers). The homes domestic cleans the en-suite facilities. Discusion’s with residents about their money indicated that they are able to spend their money as they wish. The manager is not appointee for any residents however she supports two residents to manage their personal allowance. The records and storage facilities seen are appropriate. As a small family run home, the daily routines are informally agreed and usually residents get together each day for their evening meal, this provides an opportunity for the residents to socialise and discuss day-to-day issues that may arise. Ad hoc residents meetings are organised should the manager wish to discuss specific issues with all residents. Residents are encouraged to take responsible risks and have all agreed to the homes policy on the use of alcohol, smoking and consideration of others living at the home. As previously mentioned risk assessments are undertaken and were seen with care plans. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All residents spoken to were happy with their own routines and lifestyles. Residents were very happy with the food provided at the home. EVIDENCE: Individual weekly routines were seen within resident’s files. These indicated that residents were encouraged to undertake a range of planned and ad hoc activities. Residents are supported and encouraged to develop their own daily routines that include voluntary work, social and leisure activities, and maintaining contact with family and friends. The manager works closely with the community mental health team to ensure that residents have information and choice about work and leisure opportunities. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 13 Privacy and choice are respected in the home and residents said that they liked having their own rooms to spend time in when they want to, and also enjoyed those activities they take part in outside of the home. Residents stated that the manager will provide transport if required or they use local public transport, bus or train depending on where they are going. It was evident that the atmosphere in the home is relaxed and informal with residents having independence and freedom of movement within the home, and as agreed on their individual care plans. Residents discussed contact with relatives and friends and their individual routines and other social activities. It was clear that residents were able to lead the lifestyles they preferred. The inspector met all four people who live at the home. All stated that they are happy with the meals provided. Residents get their own breakfasts and can make themselves drinks at any time having free access to their kitchen. Residents stated they have free access to snacks such as fruit, toast, cakes and biscuits whenever they wish. Supplies of these were seen in the communal rooms. Residents can have lunch in the home or take packed lunch with them to their day-time activities. The manager cooks the main evening meal. Service users can choice to eat this in either the lounge/dining room or the residents kitchen. Menus tend to be informally agreed and alternatives are offered to the main meal where the manager is aware of individual preferences and needs. Residents confirmed that the manager asks them what they would like if they are home when the meal is being prepared. If residents are out at the time of the evening meal one can be saved for later or a snack organised for the resident when they return. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents physical and emotional healthcare needs are met by the home. Medication is appropriated stored and administered within the home. EVIDENCE: The manager has many years experience working with people who are experiencing difficulties with their mental health. The manager works closely with the community mental health team with a CPN visiting every two weeks, and health issues are immediately identified and a referral arranged with the residents GP. Residents confirmed that the manager is available to support them and provide transport for medical appointments. Residents are registered with a GP of their choice in the local area and confirmed that they are supported to attend dental and optician appointments. The manager has frequent daily contact with all service users so is able to detect signs that may indicate health care needs. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 15 The residents are all independent in personal care and there have been no changes since the previous inspection. The residents are able to make decisions about the way they receive care and support from the manager and it is evident that support is offered in a way that maintains personal privacy and independence. At the time of the inspector’s visit two residents required regular medication and had been assessed as unable to self medicate. The storage arrangements and medication administration records were viewed and found to be appropriate. Medication is administered either by the manager, her husband or the overseas live in student/carer who has been trained by the manager. The home uses nomad dosset boxes prepared weekly by the local pharmacist. Some residents are prescribed additional medication that can be taken only when required as opposed to a regular prescription. The manager stated that only she administers this medication and would record this on the Medication Administration Records and in daily care notes. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel their views are listened to and acted on, residents are protected from abuse, neglect and self harm. EVIDENCE: Information about the homes complaints procedure is included in the service users guide. Residents spoken with stated that they were happy living at the home and did not have any complaints, when asked what they would do if they had complaints they confirmed that they would say something to the manager. As a small family run home the manager has daily contact with the residents and deals with any complaints that may arise. The manager stated in the preinspection questionnaire that no complaints had been received since the previous inspection. Service users confirmed this to the inspector. Residents attend a variety of local day services and a care manager/CPN visits the home every two weeks, residents could also make complaints or raise concerns to him. The manager is aware of the local adult protection policy and procedures and is kept informed of updates and changes via her involvement in the local Care Homes Association. The manager has attended adult protection training and is due to attend an update day in March. The manager has also attended challenging behaviour training. Some residents are at risk of self harming, and Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 17 this has been identified on individual risk assessments and management plans are in place. All residents are able to make their own decisions and all have access to additional support from their community care co-ordinator if required. The manager demonstrates a good knowledge and awareness of the residents’ needs and abilities and is able to access specialist services to support residents whenever needed. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, homely and safe environment, sharing a domestic residence with the registered owners. EVIDENCE: The house is a detached period building in Ryde and has been converted to provide single bedroom accommodation for the residents and separate accommodation for the owners. There is parking space at the front of the building and a large garden to the rear of the property. The home is close to public transport or residents can walk to the nearby shops, town centre or beach. The manager showed the inspector round the home and residents showed the inspector their private accommodation (bedrooms). Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 19 Residents have their own front and bedroom door keys and can come and go as they wish although they are asked to let the manager know if they are going to be out for meals or returning late. All bedrooms are for single occupancy, four located on the first floor and one on the ground floor. All bedrooms on the first floor have en-suite facilities and the ground floor room has a bathroom located very close by, which has a walk in shower, wash basin and WC. The pre-inspection questionnaire stated that all bedrooms on the first floor have been redecorated since the previous inspection. Residents showed the inspector their bedrooms that were all pleasant with the necessary furniture and fixtures. Residents have personalised their rooms. Residents are expected to keep their bedrooms tidy with the majority of general household tasks being done by the manager and part-time staff. A bathroom is also provided on the first floor. Residents have a large communal lounge/dining room and separate residents kitchen with dining table are provided. Residents also have access to a large well maintained garden which they confirmed they use in the warmer months. Residents have free access to all parts of the house and garden with the exception of the manager’s private accommodation. The inspector spoke with one service user who smokes who confirmed that he was aware of where he could smoke and happy with the arrangements. The home was found to be clean and tidy. All residents are fully mobile and there is no need for disability aids or adaptations. The home has held fire drills and residents are aware of the action they should take in the event of a fire. The inspector viewed the certificates to confirm that gas and electrical services are regularly checked and maintained by an appropriately qualified person. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users individual and joint needs are met. EVIDENCE: The owners employ some part-time staff to be in the home on those occasions when the manager is not there or the owners are on holiday. The people employed on a casual and part-time basis are known to the manager and residents and have worked at the home for a number of years. Previous reports state that all the necessary pre-employment checks including references and Criminal Records Bureau checks had been undertaken and that staff are supervised and had an induction training programme with the manager. The manager also offers work experience placements to Japanese students via a programme co-odinated by the Isle of Wight College. The students live in and work in the home and have been checked by the programme before they Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 21 start work. There is currently a Japanese student working at the home. Residents stated that they get on well with the students and that someone is always available if they need support or assistance. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home, their individual needs and wishes are fully considered and their health, safety and welfare is promoted and protected. EVIDENCE: The home is owned and managed by the proprietors who live on the premises with the residents. One of the owners is the registered manager with day-today responsibility for the home. The registered manager has many years of experience working in care and has completed the Registered Managers Award and NVQ level 4 in Care. Whenever Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 23 the opportunity arises, the manager likes to update her professional knowledge and has attended training in respect of challenging behaviour, the Mental Capacity Act, medication and fire risk assessment. The manager is due to attend adult protection update training in March. The manager is a member of, and attends meetings for, the Isle of Wight care homes association and is able to access information and support from this association. From observations of the interaction between the manager and the residents it is evident that he manager has an open and friendly approach and is accessible for the residents to seek advice and support. The inspector spoke with all four people who live at the home. Discussions indicated that they are all able to make choices and decisions in respect of their daily lives. Most evenings all residents eat their evening meal together and this provides an opportunity to socialise and discuss any issues. The inspector viewed minutes of the occasional residents meetings that are held ‘ad hoc’ if the manager feels there is a specific issue or issues to discuss, however most issues are discussed informally which is appropriate for the size of home and service user group. A copy of relevant information and policies and procedures is kept in the residents lounge. Formal systems of quality assurance or customer satisfaction are not appropriate in this family run home but it is evident that the residents are consulted on a daily basis. The manager ensures that residents have a regular review of their care needs with members of the community team. The residents are aware of fire safety and respect the house rules for smoking only in designated ground floor areas. The manager has completed a fire risk assessment and fire detection systems are checked at regular intervals. The manager considers potential risks new service users may pose to existing service users as part of the pre-admission assessment process. There were no concerns noted by the inspector in relation to health and safety during the visit to the home. Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 25 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Taunton House DS0000012544.V327194.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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