Inspection on 02/05/06 for The Fairway

This inspection was carried out on 2nd May 2006.

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

The inspector 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 Fairway 20/04/07

The Fairway 27/01/06

The Fairway 10/10/05

The Fairway 31/01/05

The Fairway 15/07/04

The Fairway 04/03/04

The Fairway 19/08/02

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

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

CARE HOMES FOR OLDER PEOPLE The Fairway Green Lane Highlands Oxhey Hertfordshire WD19 4LX Lead Inspector Yoke-Lan Jackson Key Unannounced Inspection 10:00 2nd May and 7th June 2006 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 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 Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Fairway Address Green Lane Highlands Oxhey Hertfordshire WD19 4LX 01923 221345 01923 209997 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) www.quantumcare.co.uk Quantum Care Limited James Antwi Care Home 45 Category(ies) of Dementia - over 65 years of age (45), Old age, registration, with number not falling within any other category (45), of places Physical disability over 65 years of age (45) The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 2006 Brief Description of the Service: The Fairway is operated by Quantum Care Limited and is a purpose - built residential care home for service users in the Old Age and Dementia category. It is owned by Hertfordshire County Council. The home is situated in Oxhey, close to Watford town centre. There is parking space in the front of the building. The surrounding grounds are mainly laid to lawn. Accommodation is provided on all the floors arranged as four separate units. Each unit has a small kitchenette, where service users and their relatives can make drinks and snacks. Quantum Care Limited operates a non-smoking policy in all its care homes. The Fairway charges £400-£505 per week. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on 02/05/06 (and completed on 07/06/06). The registered manager was present. There were 34 service users in the home. The majority of the service users were in the Dementia category. The inspection began with a tour of the premises. All 4 units were visited. Time was spent observing how the staff care for and interact with the service users. Staff and service users were interviewed. There was general discussion with the registered manager. Documents were examined. (See below for details of the inspection findings). What the service does well: What has improved since the last inspection? The surrounding grounds have been cleared of debris and hazards to safety. The patio area in Batchworth Unit has been rebuilt and the flooring in Prestwick Unit has been replaced. The home is organising a support group for relatives called ‘Friends of Fairway’. The registered manager hopes to put in place a ‘Comments Book’ so that any issues or concerns raised can be dealt with immediately. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 6 What they could do better: The handling of falls in recent weeks raises serious concern. Medical assessment and hospital admission were delayed in a number of cases, where fractures were confirmed. The home’s Policy and Procedure in the event of a fall accident was not being followed. In a recent CSCI survey, one comment received was “A recent fall resulted in a fractured wrist, which initially was stated by staff to be bad bruising – the necessary hospital visit for X-ray was therefore delayed by 10 days”. It is recommended that the registered manager review the procedure on falls management in the home to ensure that there is an effective monitoring system in place to prevent service users being subjected to undue delay in getting the correct medical treatment, including hospital admission. Members of staff in attendance at a fall incident should have further training on ‘Emergency First Aid’ and ‘Falls Management’. There are a few annual activities and group activities but on a daily basis there is a lack of stimulating activities. All staff should be involved in ensuring that service users have meaningful, stimulating activities as part of the caring aspect. Care plan files were not kept secured in accordance with the Data Protection Act 1998. (See Statutory Requirements and Recommendations). The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 7 The results of the recent survey are given below. Questions & Responses Q1 Q2 Have you received a contract? Yes 5 No 0 No Response 0 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 - Did you receive enough information about this home before you moved in so you could decide if it was the right place for you? Yes 3 No 2 No Response 0 Do you receive the care and support you need? Always 1 Usually 4 Sometimes 0 Never 0 No Response 0 Do the staff listen and act on what you say? Yes 4 No 1 No Response 0 Are the staff available when you need them? Always 1 Usually 3 Sometimes Do you receive the medical support you need? Always 3 Usually 2 Sometimes 1 0 Never Never 0 0 No Response No Response No Response No Response No Response 0 0 0 0 0 Are there activities arranged by the home that you can take part in? Always 3 Usually 1 Sometimes 1 Never 0 Do you like the meals at the home? Always 2 Usually 3 Sometimes 0 Never Never 0 0 Do you know who to speak to if you are not happy? Always 3 Usually 2 Sometimes 0 Do you know how to make a complaint? Yes 5 No 0 No Response Is the home fresh and clean? Always 3 Usually 2 Are you male or female? Male 1 Female 4 0 0 0 Sometimes No Response Never 0 No Response 0 Did you fill in this form yourself or did someone support you to do it? Myself 0 With Support 5 No Response 0 Would you like to speak to an inspector? Yes 0 No 2 No Response 3 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 Fairway DS0000019568.V293752.R01.S.doc Version 5.1 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 Fairway DS0000019568.V293752.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3. (6 is not applicable) A pre-admission assessment is carried out before a prospective service user is admitted. The recent CSCI survey indicated that not every service user (or their relative) were given the information they needed to make an informed choice. Each service user is given a copy of the contract. (Quality in this outcome area is Adequate. This judgement has been made using available evidence). EVIDENCE: The pre-admission assessment was documented and kept in the service user’s file. The home will only admit a service user whose needs can be met. A copy of the contract was given to each service user on admission. The registered manager confirmed that each service user is given a Service User Guide on admission and that information is provided to all prospective service users. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9. Medicines are administered in accordance with legislation. Each service user has a written care plan which is reviewed regularly. However, the healthcare needs of service users are not always met. There is no effective monitoring of service users at risk of falling and the monitoring of service users after a fall incident has deficiencies that resulted in delayed treatment for fractures. (Quality in this outcome area is Adequate. This judgement has been made using available evidence) The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 11 EVIDENCE: The home uses the Nomad system for each service user. The records examined were correctly filled and they were up to date. However, the storage of the weekly supply of medicines in the kitchenette cupboard may not be ideal as the temperature was over 25 degrees on the day of the inspection. In the storage room where the medicine trolley and controlled drugs were kept, the temperature was below 25 degrees centigrade. The registered manager agreed to review the situation immediately. One service user had her care needs reviewed on 06/06/06. The service user, her family and the local Social Services were involved in the annual review. The duty manager involved ensured that the reviewed care plan was properly documented, dated and signed by all the parties involved. There was evidence of fall incidents in recent weeks that had resulted in delayed medical assessments and delayed hospital admissions, resulting in Xrays being delayed. In these cases, fractures were confirmed. It was noted that the Quantum Care Policy and Procedures following a fall accident had not been followed as they should have been. Discussion with the registered manager, duty care managers and staff confirmed that the home does not have an effective falls prevention strategy. Although the home has a monthly audit on accidents, including falls, there is no effective monitoring system in place for some service users who are at risk of falling. Although risk assessments have been carried out, these were not followed up in practice. The registered manager should ensure that staff carry out the action planned so that further falls may be prevented and that, in the event of a fall, injury is minimised. All appropriate measures should be done to assist those service users who are at risk of falling. The registered manager should review the procedures for falls management. There should be an effective monitoring system so that service users who fall receive speedy treatment. Arrangements should be made for duty managers to have further training on ‘Emergency First Aid’ and ‘Falls Management’. All staff should have training on Falls Prevention. The registered manager has been advised to contact the Falls Team of the Primary Care Trust and the voluntary organisations that offer training or advice, including The Osteoporosis Society, Help the Aged and Age Concern. (Copies of research materials were given to the home). (See Statutory Requirements and Recommendations). The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15. The menu indicated that the meals provided are wholesome, nutritious and there is a selection of choices each day. However, feedback from some service user showed that the meals presented could improve. Service users have close links with their family and friends. The home lacks stimulating activities on a daily basis. (Quality in this outcome area is Adequate. This judgement has been made using available evidence) EVIDENCE: The home has a monthly menu with a selection of hot meals, vegetables and desserts. However, the CSCI survey included comments such as “some meals lack flavour, i.e. watery gravy and insipid food. On the first floor, the food sometimes arrives cold”. On the day of the inspection, service users were served sausages and mashed potatoes. The service users spoken to on the first floor said that they have no complaints about the food and that “it is usually good”. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 13 On the day of the inspection, the activity planned for the service users (hands massage) was not carried out in Sandy Lodge and Hartsbourne. The staffing level consisted of 1 carer in each of these 2 units. In Hartsbourne, 2 service users were bickering over a handbag and the member of staff had to intervene every few minutes to ensure their safety. In Sandy Lodge the service users were sitting in the lounge/kitchenette, watching television. One service user interviewed said: “I would like to go outside for walks but there is no one to take me. The staff are too busy”. There was no extra carer present to assist the service users in recreational activities or walking exercise. This seemed to be the daily routine. One written comment received by CSCI was “I feel my dad gets bored as he has always been very active minded and needs more to occupy his mind when he is in the home. He gets fed up with watching television all day”. It is recommended that more stimulating activities be planned and offered on a daily basis and that daily opportunity be given to the service users who wish to spend time outdoors in the surrounding grounds. The home is organising a support group for relatives called ‘Friends of Fairway’. The registered manager hopes to put in place a ‘Comments Book’ so that any issues or concerns raised can be dealt with immediately. (See Statutory Recommendations). The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17, 18. The home has a robust Complaints Policy and Procedure. Service users’ legal rights are protected. (Quality in this outcome area is Good. This judgement has been made using available evidence). EVIDENCE: Service users and their relatives are aware of the home’s Complaints Procedure. The home follows the Protection of Vulnerable Adult Procedures of Hertfordshire Social Services. Staff interviewed said that they have training on abuse and POVA issues and that they are aware of the Whistle-Blowing Policy. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24,25, 26. The home appeared generally tidy and comfortable. However, there is further redecoration to be done. Service users have the specialist equipment they require to maximise their independence. (Quality in this outcome area is Good. This judgement has been made using available evidence). EVIDENCE: The home has an ongoing maintenance programme. Refurbishment has been carried out in the Prestwick Unit. The lounge and corridor have been recarpeted. Laminated flooring has been fitted in the kitchenette and dining area. The flooring in the toilet has been replaced. The registered manager said that redecoration work to the interior walls is next on the agenda. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 16 The surrounding grounds have been cleared of debris and hazards to safety. The front entrance and the surrounding grounds have been improved considerably by the introduction of potted flowering plants. Seating is provided for the service users and visitors on the newly reconstructed patio in Batchworth Unit. Fresh potted flowering plants add to the attraction. One service user is provided with a light writer communication machine, since she is unable to communicate verbally. The home has a high number of wheelchair users and the wheelchairs are serviced regularly. The service users interviewed said that they are satisfied with their bedrooms, which are furnished with personal items on display. The bedrooms, community areas and toilet facilities are cleansed daily by domestic staff. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30. In general, staff have the training and the mix of skills to ensure that service users’ care needs are being met. However, staff require training on handling falls. The service users are supported and protected by the home’s recruitment policy and practices. However, the staffing level of 2 carers on the first floor is unsafe. (Quality in this outcome area is Adequate. This judgement has been made using available evidence) EVIDENCE: Staff have a thorough induction training programme in all the core skills including Health and Safety, Fire Safety, Moving and Handling, First Aid and Food and Hygiene. At least 45 per cent of staff are working towards achieving NVQ Level 2. However, there is need for further training on ‘Falls Prevention and Falls Management’ in the light of recent fall incidents. The home has vacant positions for carers. The manager felt that poor public transport may be a major factor in the home not being able to recruit staff. The provider is reviewing the transportation situation. Meantime, the home relies on bank and agency workers. The home arranges for the same agency workers to ensure continuity of care for the service users. The recruitment procedure is thorough and proper records are kept. The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 18 On the day of the inspection, there was 1 carer in Sandy Lodge to look after the personal care needs of 7 service users with restricted mobility. On the same floor, in Hartsbourne Unit, there was 1 carer to oversee 8 service users with dementia. Routinely, the 2 staff are expected to administer medication, write their daily reports, organise activities, serve lunch and assist the individual service users at mealtimes and attend to their personal needs. Each member of staff is also expected to relieve each other at break times and assist each other with moving and handling. This is unsafe practice as service users in the lounge are then left unattended. The staffing level must be increased to 3 carers per shift. (See Statutory Requirements). The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 36, 37, 38. Staff have regular appraisals and records were kept appropriately. However, service users’ personal records (the care plans files) were not securely kept in accordance with the Data Protection Act 1998. The standard of management could improve. The home’s policies and procedures have not always been followed. Management needs to arrange for better supervision of service users, especially those at risk of falling. (Quality in this outcome area is Adequate. This judgement has been made using available evidence). The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 20 EVIDENCE: There was evidence that staff appraisals had been conducted and the staff records were kept up to date and secure. However, it was noted that the service users’ personal care plan files were kept in the drawer in the lounge/ kitchenette in Sandy Lodge and Hartsbourne. The drawer has no locking device. In Batchworth, the files were kept in a lockable drawer that was not locked. The registered manager must ensure that all records for the protection of service users are secure and used in accordance with the Data Protection Act 1998. The management of the home could be more proactive. The carers would benefit from more support and encouragement from the managers in the daily routine of the home which in turn would benefit the service users. It is recommended that managers put into practice the knowledge and skills they have obtained in the course of their training and contribute towards learning and development of others and to minimise the risks of harm to service users. (See Statutory Requirements and Recommendations). The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 2 X X X 3 2 2 The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 22 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 OP8 Regulation 12 (1)(b) Requirement The registered manager shall ensure that the care home is conducted so as: (a) to promote and make proper provision for the supervision of service users at risk of falling. (b) So that service users receive the treatment, advice and other services from any healthcare professional without undue delay in the event of a fall incident. Timescale for action 07/06/06 2. OP27OP38 18 (1)(a) 3. OP37 17 (1)(b) The number of care staff must 07/06/06 be increased to 3 per shift on the first floor (between Sandy Lodge and Hartsbourne) as soon as possible. (The registered manager rectified the staffing level on 08/06/06) The registered manager must 07/06/06 DS0000019568.V293752.R01.S.doc Version 5.1 Page 23 The Fairway ensure that all records for the protection of service users, including care plan files are secure and used in accordance with the Data Protection Act 1998. 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 OP8 Good Practice Recommendations It is recommended that the registered manager review the procedure on falls management in the home to ensure that there is an effective monitoring system in place to prevent service users being subjected to undue delay in getting the correct medical treatment, including hospital admission. It is recommended that care managers have further training on ‘Emergency First Aid’ and ‘Falls Management’ (b) It is recommended that all staff have training on ‘Falls Prevention’. (Since the inspection, the registered manager has put in place in-house training sessions on falls prevention. The respective agencies have been contacted for further information.) It is recommended that more stimulating activities be planned and offered on a daily basis and that daily opportunity be given to the service users who so wish to have a short time outdoors in the surrounding grounds. It is recommended that the management team put into practice the knowledge and skills they have obtained in the course of their training and contribute towards learning and development of others and to minimise the risks of harm to service users. (a) 2. OP30 3. OP12 4. OP31OP32 The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Fairway DS0000019568.V293752.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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