Inspection on 11/12/07 for The Chestnuts

This inspection was carried out on 11th December 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

The Chestnuts 18/12/08

The Chestnuts 22/08/06

The Chestnuts 21/03/06

The Chestnuts 24/10/05

The Chestnuts 01/03/05

The Chestnuts 24/08/04

The Chestnuts 04/03/04

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE The Chestnuts 57 Bargate Grimsby North East Lincs DN34 5AD Lead Inspector Mrs Kate Emmerson Key Unannounced Inspection 11th December 2007 09:30 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 The Chestnuts DS0000034324.V356606.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. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Chestnuts Address 57 Bargate Grimsby North East Lincs DN34 5AD 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) 01472 345513 Cleethorpes Care and Nursing Ltd Marie Rose Land Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26) of places The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the occupant of the room must have no significant mobility problems 22nd August 2006 Date of last inspection Brief Description of the Service: The Chestnuts is a well established home situated in a pleasant central location of Grimsby. It has access to local amenities and public transport. The building is Victorian in style with a modern extension providing care for up to 26 residents. The home caters for the needs of residents with the problems of old age and mild to moderate dementia. The home consists of three storeys serviced by stairs and a passenger lift. There are twenty single rooms, of which nine have en-suite facilities and three shared rooms. The home has registered a room on the first floor which has conditions applied due to configuration limitations. There are bathroom and WC facilities located on each floor. There is one lounge, a conservatory and dining room, all of which are located on the ground floor. The home has pleasant front and rear gardens with ample parking to the side of the property. The current scale of fees are £329- £367 per week. Additional charges include activities, chiropody, hairdressing, newspapers and toiletries. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection and the visit to the home was unannounced, taking place over a period of seven and a half hours. Questionnaires were sent out prior to the site visit to a range of people who have an experience of the service. The inspector received comments back from two members of staff and three visitors. This information as well as information received from the manager provide a focus for inspection and will be reflected in this report. On arrival at the home the building was looked around and a number of records and policies were inspected. The owner, manager and five members of staff were spoken to. Three service users and a visitor to the home were also spoken to on a one to one basis and the majority of people who lived in the home were spoken to as they went about their daily activities. What the service does well: A number of positive comments were received from people who use the service. They said that staff are kind and look after them well. The people who lived in the home said that the food was very good and there was lots of choice. The meals provided were balanced and a choice was offered at every mealtime. There were a variety of activities available and the staff were observed to positively encourage and assist people to take up activities of their choice. The home is well decorated, clean, tidy and homely. The owners make sure that the good standards are maintained. All the people who spoke to the inspector said that they were happy with everything and have no concerns about how the home is run. Staff spoken to were knowledgeable about how to protect vulnerable people and people said that they feel safe when being offered personal care and helped around the home by staff. The training made available to staff is appropriate for the work that they perform and takes place on a regular basis. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 6 Combined with the home’s regular audits, there is a system for consulting people who live in or visit the home about the quality of care provided. This information is used to monitor and improve standards in the home. The people who want to live in the home have their needs assessed and a detailed care plan developed to inform staff what care is required to meet the person’s needs. All the care given is recorded and the care plans had been regularly reviewed to ensure that they were up to date. What has improved since the last inspection? What they could do better: The home was generally well managed and safety checks had been completed in most areas. However they must ensure that hot water temperatures in bathrooms are not so high that it puts people at risk of accidental burns. They must also ensure that the fire alarm is tested at least weekly to ensure that it is in full working order. The home was very clean and tidy but there was room that was very odorous so they must ensure that all rooms are kept free from odours to ensure a comfortable environment. The staff received a wide variety of training but training records were not always kept up to date to evidence that staff had received all the required training. They must provide evidence that all the staff have received moving and handling training in the last twelve months. They must ensure that staff receive formal supervision at least six times per year. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 7 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. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 8 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 The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 9 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 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is able to meet the needs of service users owing to a thorough assessment on admission. EVIDENCE: There was evidence in files examined that the home had undertaken a thorough assessment of peoples needs. The assessments were not always dated or signed by the person completing them to evidence that the information was gathered prior to the person being admitted to the home. The assessments were well-presented and linked clearly to individuals care plans. The assessments included information from people who used the services and their representatives and health professionals. This evidenced The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 10 that the home worked in partnership to ensure full information about people’s lives and care needs was recorded. The home does not provide intermediate care. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 11 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 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health and personal care needs were met and people felt they were treated with respect. EVIDENCE: The home had detailed plans of care in place that described the needs of individuals clearly and demonstrated to staff how these needs were to be met. The care plans reflected the content of the assessment. Staff demonstrated, when asked, that they had a good working knowledge of people’s needs. Three care records were looked at during the visit to the home. These indicated that people’s health care needs were met. People said that they could see a GP when they wished and the home organised this for them. A chiropodist regularly visited the home and records showed assistance was The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 12 given to attend other health care appointments such as the optician and dentist when required. There was good management of risks where people’s mobility was reduced and the records detailed the care to be provided in such cases. There was evidence that peoples weight was measured on a regular basis in order for the home to monitor nutritional needs. The home had developed links with the dietetics department at the local hospital and staff had attended training. A screening tool had been implemented to ensure any issues with nutrition could be identified quickly and the home was able to refer directly to the department for advice. Where one person had been identified as at risk their weight and dietary intake had been monitored and a referral made to the dietician. Not all the care plans or risk assessments were signed by the individual or their representative to show that these had been discussed and agreed. One person would be able to self medicate but preferred the home to do this for them. The home did not actively promote self-medication and this policy should be reviewed. The home demonstrated that it administered medication appropriately by keeping comprehensive and fully completed records. This included controlled drugs. Medication was stored appropriately and the temperature of the room and cabinets were monitored. Records and discussions with staff confirmed that those who administered medication had been trained to do so. The medication policy and procedure did not include procedures for disposal of medication or the action to take in the event of a medication error and this should be further developed. People spoken with said that staff treated them with respect and were polite. Positive and lively interactions were observed between individuals and staff. A number of people said that the staff were nice and kind to them. Staff were observed to speak to people appropriately on the day of inspection. In discussion with staff about respecting people’s privacy, staff were able to demonstrate that they understood the need for sensitivity when carrying out personal care tasks. Staff were observed to knock on people’s doors prior to entering and people said that their privacy was respected. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 13 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 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Good facilities were provided for people to experience activities and community and religious involvement of their choosing and maintain contact with their relatives and friends. Meals were nutritious and balanced, offering a healthy and varied diet. EVIDENCE: Although social needs and preferences were not always identified on assessment people’s lifestyle in the home satisfied their social, cultural religious and recreational needs. This was evidenced in care plans and in talking to people and staff. A range of weekly activities was offered in the home including bingo, reminiscence, board games, baking and arts and craft. Staff were observed to positively encourage and assist people with activities. Religious services were regularly held in the home and people were able to attend church services in the community if they wished. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 14 Staff were all involved in assisting people to participate in the activities. A charge of £5 per week was charged for activities. This had been agreed by people using the service or by their representative but there was no evidence to show that the additional charges had been made known to the Local Authority where they were funding people’s care. It is recommended that this is discussed and agreement sought with the Local Authority. Contact with family and friends was promoted by the home. People were positive about being able to see their friends and family when they wished. Visitors to the home say that they were made to feel comfortable and that the atmosphere was welcoming. One visitor says that she was invited to stay for dinner. A number of people in the home commented about the food and how good it was. One person said that the food was “good and there is plenty of choice”; another said, “ the food is very good and there is plenty of it”. Menus were balanced and varied. It was observed that staff offered choice at meal times and the menus indicated that a choice was available at every meal. Meals were well presented and organised. One staff member stated that having a kitchen assistant now at teatime had made a big difference to the care offered at this busy time. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 15 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The arrangements for complaints and protection were handled well. EVIDENCE: The home has a clear complaints procedure in place and this was displayed in the home. People spoken to said that they had no complaints about the home and feel confident to raise issues of concern if they arise. The relationships between staff and people who live in the home were observed to be open and inclusive. Complaints were recorded in a complaints log and addressed by the manager. There had been no complaints since the last visit to the home. The home had a policy in place to protect people form abuse. Staff spoken with were clear about reporting procedures should anyone make an allegation of abuse. All staff had received training in this area via the local council. This subject was also covered in supervision sessions and questionnaires were also used. The manager was advised to review records to ensure all staff had received refresher training in last twelve months, as the supervision sessions had been infrequent and these sessions were not recorded in training records. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 16 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, 21, 25 and 26 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home was clean, hygienic and well maintained but excessively hot water temperatures in a bathroom may put people at risk. EVIDENCE: The facilities that the home provides for people were of a high standard. The home was regularly decorated and a planned programme of maintenance was in place. The toilet and bathing facilities for service users were maintained to a high standard and were sited suitably. Locks missing from toilet and shower room doors at the last inspection had been replaced so that service users privacy was protected. The hot water temperature in one bathroom was too high at The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 17 48°C. The water temperature must be maintained close to and not exceeding 43°C to prevent accidental burns. The bedrooms were personalised and well decorated. Picture signs were provided to help people identify the bathrooms and toilet facilities. The home was very clean and tidy throughout although one bedroom was very odorous. Staff were observed to practice appropriately to avoid the risk of cross contamination. Staff are aware of the need to wear protective clothing when undertaking certain tasks. The home had a laundry, which was suitable to meet the needs of service users. People were satisfied with the laundry service that the home provided. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 18 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 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Well-trained staff looked after people in the home although records were not always up to date. Recruitment had improved and offered protection to people living in the home. EVIDENCE: The home was staffed appropriately. Three staff were on duty throughout the day, which included a senior member of staff. The manager was supernumerary to the rota. A further member of staff was provided at weekends on the early shift and a teatime assistant was provided from 4pm to 7 pm, 7 days a week. Two members of staff were on duty from 8pm to 8am with a staff member on call. Of the seventeen care staff employed eleven had achieved NVQ level 2 and three are working towards this qualification. The recruitment of staff had improved and all checks with regard to references and POVA first check (Protection of Vulnerable Adults) had been obtained prior to employment. The home held records of interview but had not recorded The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 19 meetings and decision-making processes re recruitment where CRB (Criminal Record Bureau) checks had identified convictions. This is recommended to evidence that levels of risk were considered prior to employment. A training plan was in place and a record of training received by staff in the home was available for inspection. The training was varied and appropriate for the work that staff undertake. The staff confirmed that they reci3ved a wide variety of training in the home which was relevant to their role. The manager stated that moving and handling training had been completed on the 4 December 2007 but she had not received the certificates to evidence this. She was requested to provide evidence to the Commission that this training had been completed. Training in working with people with dementia was provided and ongoing for all staff. Throughout the inspection the staff showed that they were very skilled in working with people with dementia. Staff said that the course was excellent and they had changed and improved practice as a result. Staff had received an induction to skills for care standards once employed by the home. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 20 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, 36 and 38 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. A lack of consistent fire alarm checks may put staff and people living in the home at risk in an otherwise well managed home. Staff supervision had not been provided at the required frequency to ensure support and future development for staff. EVIDENCE: The manager has been in post for 4 years and has achieved the registered manager’s award and NVQ level 4 in care. Staff and people living in the home say that the manager is approachable and supportive. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 21 The home operates an effective quality assurance system that seeks the views of people living in the home and staff on a regular basis. This has been further developed to seek the views of health professionals and other stakeholders. There is a monthly audit system in place that looks at key areas aimed at improving standards. People are protected by the financial procedures of the home. The home does not act as appointee for any residents and looks after monies for individuals appropriately. Written records of all transactions were accurately maintained. The home had a residents’ fund that was contributed to by fund raising events and donations. The records had been reviewed to ensure that these clearly showed all the transactions. The home had recently been charging people who live in the home £5 per month as a contribution towards activities. Whilst there was agreement to this from people or their representative, they had not informed the Local Authority about the additional charges and this is recommended where the Local Authority are funding people. Formal one to one supervision had been provided but not at the frequency to achieve at least six sessions per year. The manager was advised to review how this could be achieved and to ensure that a supervision plan is implemented. The appropriate safety checks were carried out within the specified time frame and policies were in place for safe working practice, which means that the environment is a safe place. However the fire alarm had not been tested consistently on a weekly basis dating back to April 2007. In April and July the alarm was only tested once, only twice in June and three times in other months up to November when it had been tested weekly. This means that the system is not being frequently checked to ensure that it is in full working order and there may be a risk of people not being alerted in the event of a fire if there is a system failure. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 22 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 2 X X X 2 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 X 2 The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP25 Regulation 13(4) Requirement The registered person must ensure that hot water temperatures in bathrooms is maintained close to and not exceeding 43°C to prevent accidental burns. The registered person must ensure that rooms are kept free from odours to ensure a comfortable environment. The registered person must ensure that training records are kept up to date to evidence that staff have received all the required training to ensure safe practise. The registered person must provide evidence to the Commission that all the staff have received moving and handling training in the last twelve months. This is to evidence that staff have received all the required training to ensure safe practise. The registered person must ensure that staff receive formal supervision at least six times per year. DS0000034324.V356606.R01.S.doc Timescale for action 14/02/08 2 OP26 16(2)(k) 01/03/08 3 OP30 17(2) 01/04/08 4 OP30 13(5) 01/03/08 5 OP36 18(2) 01/04/08 The Chestnuts Version 5.2 Page 24 6 OP38 23(4) The registered person must ensure that the fire alarm is tested at least weekly to ensure that it is in full working order. 14/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 6 7 Refer to Standard OP1 OP7 OP9 OP12 OP12 OP18 OP29 Good Practice Recommendations The registered person should ensure that assessments are signed and dated on completion. The registered person should ensure that the care plans and risk assessments are discussed and signed by the person using the service or their representative. The registered person should ensure people are offered the opportunity to self medicate where they are able. The registered person should ensure that people’s preferences in regards to social activities are recorded. The registered person should seek agreement from the placing Authority to make additional charges for activities. The registered person should review records to ensure that all staff have received safeguarding training in the last twelve months. The registered person should ensure that records of meetings and decision-making processes re recruitment where CRB (Criminal Record Bureau) checks have identified convictions. This is to evidence that levels of risk were considered prior to employment. The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 The Chestnuts DS0000034324.V356606.R01.S.doc Version 5.2 Page 26 - 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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