Inspection on 04/09/07 for The Conifers

This inspection was carried out on 4th September 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Conifers 15/05/06

The Conifers 05/10/05

The Conifers 20/06/05

The Conifers 20/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 The Conifers 1a Lodge Road Rushden Northants NN10 9HA Lead Inspector Mrs Carole Burgess Key Unannounced Inspection 4 September 2007 10.00 TH The Conifers DS0000012751.V337613.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 The Conifers DS0000012751.V337613.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. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Conifers Address 1a Lodge Road Rushden Northants NN10 9HA 01933 395522 01933 395511 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) Mrs Marie Jeanette Judith Mather-Franks Mrs Claudia Atkins Care Home 12 Category(ies) of Learning disability (12), Physical disability (4) registration, with number of places The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of service users must not exceed 12 All service users have a Learning Disability No service users with a physical disability may be admitted to the home when there are already 4 such service users within the home 3rd August 2006 Date of last inspection Brief Description of the Service: The Conifers is a care home providing personal care for 12 service users. It is one of three homes in Rushden, owned by Mrs Mather Franks; all providing personal care to adults with a learning disability. The home was first registered by the local authority in 1990 and is a twostorey detached house. There are six single and three shared bedrooms. There are bathing facilities on both floors, which include a bath and three showers. There are a range of communal areas and a patio garden. All areas of the ground floor and gardens are accessible to persons who use wheelchairs. The home is situated in a quiet residential area of Rushden with access to local facilities and amenities. The Statement of Purpose, Service Users’ Guide & Inspection Report are available on request (these provide information on how the agency is organised and what services they provide). The Statement of Purpose and Service Users’ Guide are provided for new residents and include pictorial information. Monthly Fees at the time of inspection were: £526 - £900 per week. Additional costs paid by service users include hairdressing, chiropody and some travel (individual taxis for example). The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours. An opportunity was taken to look around the home, view records, policies and care plans and to talk to staff. The primary method of inspection used was ‘case tracking’ which involved selecting two residents and tracking the care they receive through a review of their records, discussion with care staff and observation of care practices. One resident was seen during the inspection. The remaining residents were at Day Care. The resident appeared happy and well cared for. Due to his disability he was unable to give the Inspector meaningful feedback regarding his life at The Conifers What the service does well: The Conifers provides a good standard of care based on normal living principles and community integration, for people who have significant learning and physical disabilities. Prioritises residents’ needs ensuring that, although some residents have limited verbal communication, their wishes and feelings are respected. Provides individualised care planning documents and risk assessments for each resident, demonstrating a commitment to enabling residents to have some control over their lives. The home is bright and stimulating and bedrooms are decorated in a modern youthful manner, reflecting the residents’ need and interests. Residents enjoy age appropriate activities whenever possible and are well supported by staff. Have a stable staff team who provide a homely and caring environment for the residents. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Following this inspection two requirements and six recommendations were made. It is the expectation of the CSCI that the Registered Provider (owner) and the Registered Manager will implement these as soon as possible to improve their service to the residents. Requirements: The Registered Provider (owner) and the Registered Manager must ensure that all staff files contain all of the necessary information, including references and proof of CRB checks which must be available for inspection in the home. A written record of money or property deposited in the home or returned to the service user must be maintained. Recommendations: The Statement of Purpose and Service Users Guide require updating to provide current information for prospective and current residents. Misleading information regarding the categories of residents who can be admitted to the home should be removed. The Service Users Plan (care plan) should identify the needs and aspirations of the resident and demonstrate how the home will help the resident to achieve personal goals. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 7 The home’s risk management strategies and risk assessment should identify specific risk to individual residents (such as going swimming) and identify action to be taken to minimise risks without limiting the residents preferred activity. The complaints policy requires updating to include timescales. National Minimum Standards (NMS) 22, ‘all complaints should be responded to within 28 days’. The safeguarding policy (protecting vulnerable adults) requires updating to include current local guidance. The room identified to the Registered Manger during the inspection is kept free from unpleasant odours. 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 Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 & 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with information about the home, and have their health, welfare and social care needs assessed, so that they can be met once they move into the home. EVIDENCE: The home provides prospective residents and their relatives with a Statement of Purpose and Service Users Guide (both give information about the home) to help them decide if the home is the right one for them. This included information in a pictorial format for the prospective residents who have a learning disability. However, the information provided required updating. Information regarding registration categories and contact details for the CSCI were incorrect and could be misleading. The pre-assessment process and documentation was satisfactory ensuring that the residents’ health, welfare and social needs can be met. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 10 Residents’ files contained a needs assessment, and admissions review. The admission review was completed on the day that a resident moved into the home and was attended by the resident, their representative, the home owner (provider), Registered Manager and deputy manager. This and regular reviews ensure that the residents’ needs continue to be met. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 11 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 & 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are looked after in respect of their personal and social requirements, but in some cases care plans do not show how residents will be enabled to make choices, take acceptable risks, and to have their needs met within their capacity to do so. EVIDENCE: Care plans and daily records contained information about the support residents required in their daily lives. Some residents have limited verbal communication skills. Individual methods of communication had not been fully explored, or recorded, in the residents’ care plans. Whilst it is recognised that the staff group is stable and know the The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 12 residents well there should be clear guidelines for staff about each individual resident’s communication system, possibly with pictorial representations, of how residents’ express their needs and feelings: however, interaction observed between the staff and resident was supportive and positive, enabling the resident to express himself within his capacity to do so. However, One resident, during the admission assessment had expressed a wish to be able to go into town on his own. This had been neither followed up within the care plan to assess if this were possible nor a plan provide that would help the resident to achieve this. General risk assessments such as ‘Moving & Handling’ had been completed in the residents’ care plans but more detailed risk assessment for specific, individual activities, such as shopping, should show what support each resident needs to enable them to take risks within their capacity to do so. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff ensure that residents experience a safe and homely life style which is appropriate to their age and ability. EVIDENCE: Residents’ files contained details about their daily activities and interests, which include visiting the Day Centre, shopping, holidays etc. Residents are enabled to take holidays in the UK and abroad, accompanied by staff. Appropriate risk assessments are undertaken to ensure, as far as is possible, the safety and well-being of the resident is maintained. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 14 All of the residents spend part or all of the day at the Day Centre during the week. During the evening and at weekend residents choose how to spend their time supported by the care staff. Most Saturdays many of the residents go swimming and/or shopping. Residents go on holiday once a year, sometimes to Blackpool, sometimes abroad. These activities ensure that they interact with the local community and have a fulfilling lifestyle. Residents’ religious needs are recorded and supported. A number of residents and care staff went on a pilgrimage to Lourdes in May of this year. Residents’ rooms were highly personalised and indicative of their personal tastes and lifestyles, which are encouraged and supported by staff. Family and friends are encouraged to maintain contact and staff support residents to visits their family, if necessary. However, the Registered Manger said that some of the residents have little contact with their families and look upon The Conifers as their home and other residents (and staff) as their family. Menus are rotated four weekly and include a healthy variety of food. Menus are very flexible to meet the individual needs and preferences of the residents. Individual choices were recorded on the menu sheet. Residents choose what they would like for a packed lunch to take to Day Care each day. Special requirements are provided for individual residents such as diabetic diets and residents are encouraged to eat healthily and maintain a healthy weight. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 15 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 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are well looked after in respect of their health and personal care. EVIDENCE: Residents’ care plans contained details about individual healthcare needs. There are regular reviews and a range of health and social care professionals provide specialist support to ensure that the residents’ needs are fully met. Medication policies and procedures were sound and residents receive their medication as prescribed. Medication is stored safely in a locked cupboard and staff receive medication training, which is regularly updated. The Conifers DS0000012751.V337613.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 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements for receiving and responding to complaints are satisfactory resulting in protection of residents’ rights. EVIDENCE: The CSCI has not received any complaints regarding the home. The home has not received any complaints from residents or their relatives since the last inspection. Staff were aware of Adult Protection procedures, and how to manage allegations and complaints. Training sessions are provided and staff received ‘in house’ training in July 2007 to ensure that residents are protected from abuse. However, the home’s complaints and safeguarding policies and procedures require updating to reflects the current local Multi Agency Policy & Procedure For The Protection of Vulnerable Adults from Abuse, No Secrets’ publication to ensure that staff have access to current guidance on safeguarding vulnerable adults. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 17 The complaints policy should include timescales for responding to complaints so that residents and their representatives have all of the relevant information should they wish to make a complaint. A pictorial complaints process for residents, and choices of whom they wish to speak with if they have concerns, or a complaint, would ensure that residents remain fully protected. The Conifers DS0000012751.V337613.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comfortable, clean, homely and safe standard of accommodation is provided for the residents. EVIDENCE: The home is safe and well maintained with adaptations to suit residents’ specific needs. It is decorated and furnished to a good standard that creates a comfortable and homely environment and was fresh and clean on the day of the site visit. There are sufficient bathing and toilet facilities on both floors of the home and residents’ rooms have a hand washbasin. Individual bedrooms were colourfully The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 19 decorated to reflect the gender and youthful personalities of the residents who live there. One room did not have a lampshade. The Registered Manager said that this was at the request of the resident. This should be recorded in the residents file to show that it is the resident’s personal preference. A number of bedrooms have been recently redecorated and all of the bathrooms have had new flooring. One resident’s room, as identified to the Registered Manager, had a slight odour. The Registered Manager said that the carpet had been shampooed but this had not completely eliminated the problem. This problem should be attended to so that the resident’s dignity is maintained. One toilet was without a toilet seat as it had been broken. The Registered Manager said that a special, soft seat had been ordered and it should be replaced within the next few days. The Conifers DS0000012751.V337613.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 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are competent and sufficient in numbers to meet the residents’ needs but staff files did not contain all of the relevant documentation required for inspection. EVIDENCE: Staff rotas demonstrated that there were sufficient staff to meet the needs of the residents. Two staff files were checked. References were not seen in either of the files and one file did not contained proof that a Criminal Records Bureau (CRB) check had been carried out. The Registered Manager said that the provider had this information, that references had been obtained and CRB checks had been completed, and that this information would be provided within the week. This information must be retained within the home for inspection and be available at all times. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 21 (This information was provided for the Inspector before completion of the draft report). There is a satisfactory induction and training programme available to staff. Two staff files demonstrated that staff receive regular and relevant training, including mandatory training/updates i.e. adult protection, first aid, food hygiene and moving and handling. Certificates of attendance were seen. This year staff have undertaken training in the Mental Capacity Act 2005, First Aid, Food Hygiene, Challenging Behaviour and Safeguarding Adults. The Registered Manager said that four staff have achieved National Vocational Qualification (NVQ) in Care Level 2/3 and four other staff are currently doing or completing NVQ’s to ensure that staff have the necessary skill to care for the residents. The Conifers DS0000012751.V337613.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, 41 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Registered Manager provides supportive leadership to staff, ensuring that residents receive a good standard of care but accurate records of residents’ personal allowances must be maintained. EVIDENCE: The home has a Registered Manager who has many years of experience in care. The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 23 There is an ethos of warmth and openness in the home and staff deliver a good standard of care and appear well organised. Health and Safety Policies and Procedures, such as regular gas boiler checks and wheelchair maintenance are completed, to ensure the health and safety of the residents and staff. Quality assurance of the service is monitored through regular review of residents’ files and annual questionnaires completed by residents (who are able) and sent to relatives to obtain their views about the care provided for residents – although the Registered Manger said that these were rarely returned and that relatives generally kept in touch by phone. It was suggested that stakeholder questionnaire for such people as GP’s District Nurses, Chiropodists may provide useful feedback which could be collated and presented with the Statement of Purpose to demonstrate the home’s commitment to improving the service for the residents. Some residents have limited communicate skills but are consulted through their personal communication systems, and there are regular residents meetings to discuss activities and menus so that residents are involved in the day to day running of the home. The residents’ personal allowances were checked. Each resident has a bankbook. A number of residents control their own money. Personal allowance money is kept in separate envelopes for each resident that are locked in a cupboard. However, no records of transaction were maintained to show the amount deposits and withdrawals. The home must maintain satisfactory records for the protection of both residents and staff. (This was addressed and evidence provided for the Inspector before completion of the draft report). The Conifers DS0000012751.V337613.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 3 2 3 3 X 4 X 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 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 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 2 3 X The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 25 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 YA34 Regulation 19 Requirement The Registered Provider (owner) and the Registered Manager must ensure that all staff files contain all of the necessary information, as described in the Care Homes Regulations 2001, Regulation 19, Schedule 2 & Schedule 4.6, including references and proof of CRB checks which are available for inspection. A written record of money or property deposited in the home or returned to the service user must be maintained, as described in the Care Homes Regulations 2001, Regulation 17 & Schedule 4.9(b). Timescale for action 10/09/07 2. YA41 16 (2)(l) 10/09/07 The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 26 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. Refer to Standard YA1 Good Practice Recommendations The Statement of Purpose and Service Users Guide Update requires updating to include all of the information contained in Care Homes Regulations 2001 4(1) & Schedule 1, and remove any misleading information regarding the categories of service users who can be admitted to the home. The Service User Plan (care plan) should identify the needs and aspirations of the service user and demonstrate how the home will help the service user to achieve those goals. The home’s risk management strategies and risk assessment should identify specific risk to individual service users (such as going swimming) and identify action to be taken to minimise risks without limiting the service users preferred activity. The complaints policy requires updating to include timescales - NMS 22, ‘all complaints are responded to within 28 days’. The safeguarding policy requires updating to include current local guidance. The identified room is kept free from offensive odour. 2 3 YA6 YA9 4 5 6 YA22 YA23 YA30 The Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Conifers DS0000012751.V337613.R01.S.doc Version 5.2 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!