Inspection on 10/08/07 for The Hall

This inspection was carried out on 10th August 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 Hall 15/05/06

The Hall 09/01/06

The Hall 27/06/05

The Hall 25/02/05

The Hall 20/09/04

The Hall 01/02/04

The Hall 24/06/03

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

CARE HOME ADULTS 18-65 The Hall The Hall Ashford Road Hamstreet Ashford Kent TN26 2EW Lead Inspector Brenda Pears Unannounced Inspection 10 August 2007 10:30 th The Hall DS0000023574.V346815.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 Hall DS0000023574.V346815.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 Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Hall Address 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) The Hall Ashford Road Hamstreet Ashford Kent TN26 2EW 01233 732036 Mr Michael John Rogers Mrs Sylvia Margaret Rogers, Mrs Sharon Ann Colton, Ms Joanne Clare Rogers, Mr Alan Edward Rogers Mr Robert Andrew Mycroft Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Provide residential care to not more than nine (9) people with Learning disabilities. Not more than three (3) people with physical disabilities The residents shall be sixteen (16) years and over The three (3) residents with physical disabilities must also have a learning disability 15th May 2006 Date of last inspection Brief Description of the Service: The Hall is situated in the village of Hamstreet, Kent and is placed a short distance from the railway station and is on a public bus route. Access to local amenities, shop and recreation facilities can be easily reached on foot. The home is registered to provide care and accommodation for a maximum of 9 people aged between 16 and 65. The target age range of people using the service is 16 to 25 years who have a learning disability. The service is set up to be of benefit to young people who wish to move into greater independence, and therefore the aims of the service are to provide a great deal of opportunities for responsibility taking and personal development. The home is a spacious building with lots of character. Bedrooms are situated on the ground and first floor and are all single occupancy. A large lounge has been split in two to provide a greater range of communal space. The kitchen / diner has a small computer area off the dining room end. There are two bathrooms (one ground, the other first floor), both with toilets and one separate toilet in a central, ground floor location. The home maintains a smoke free environment within the home, but supplies separate covered areas in the garden for smoking by staff and service users. The garden area is secluded and is mainly patio and bark covered, enabling it to be used all year round. As a rough guide, fees may range from £200.00 to around £400.00 per day. Fees are assessed by the amount of support provided and on the staffing levels needs for the individual. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken from 10.30am with a focus on the well being, safety and quality of life for service users living in the home. The methods of inspecting the home included speaking to service users, the registered manager, Mr Robert Mycroft and members of staff. The inspection process also consisted of information collected before and during the visit to the home. A tour of the building and observations of both staff and service users at this time are reflected in this report and in the outcomes. The term ‘service user’ was used by members of staff and by those living in the home, this term is therefore used in the body of this report. What the service does well: What has improved since the last inspection? The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 6 Formal training has now been undertaken to inform staff about adult abuse and how to recognise various forms of abuse. Choices are given at all times with each day being spent as the individual wishes. Planned outings/activities are only undertaken if the service user chooses to participate. The daily activities are on display on the office door to inform service users who is to support each activity. Medication has improved and is now supplied in an appropriate monitored dosage system. The local pharmacist has been into the home and provided guidance on the appropriate use of this new system. Service users are now fully involved in menu planning and alternative routines have been tested until everyone is satisfied with the methods of deciding on meals. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of a new service user are assessed before a move into the home, ensuring a full awareness of individual needs. The statement of purpose and service user guide clearly says what services will be offered. EVIDENCE: The current service users have lived in the home for some years and there are seven people living in the home. A review of information on file, and previous inspections, has shown that pre admission assessments are undertaken. Assessments include information about behaviours and guidelines for staff and how to provide support with specific targets to work towards. The service user guide has now been developed into picture (Widget) format and can also be put onto tape, to support and inform service users. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 9 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 good. This judgement has been made using available evidence including a visit to this service. Individual plans are in place to fully support service users, but attention must be paid to ensure information is clearly dated and easily understood. EVIDENCE: Each day is started with the service user choosing what they wish to do and one person regularly undertakes the planning of a main meal. This choice is made with appropriate assistance to ensure nutritional awareness, then a shopping trip and cooking this meal is planned. Each service user undertakes this activity, developing and enabling daily living skills. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 10 Staff were seen to be ensuring service users had choices and that choice was then respected. At this inspection service users were given time and appropriate consideration by staff. While care plans have been reviewed, the dates on some documents were not accurate and some did not contain a date. Attention must be paid to the documentation of all records, to ensure information is current and easily understood by everyone. Risk assessments support all activities and all manageable risks are undertaken as part of the development process. The manager explained that restraint is only used in situations where no other alternative is available. The staff use alternative methods of making an area safe and ensuring all other service users are in a safe area. The manager stated that containment was used and all other distractions that may help the situation. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 11 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. Service users enjoy their chosen activities, many of which are undertaken in the community, providing both choice and independence. EVIDENCE: Service users spoke to the inspector about their activities and in particular, attending the local football ground and playing in the football team when possible. Routines in the home ensure the chosen activities are supported and that staff are available to take the person to their destination. Clear programmes of events are available each day, providing information for service users and to inform them exactly who is due to provide support. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 12 Events in the home are undertaken with the full involvement of service users. Choices are supported and encouraged, with daily routines being developed to ensure the wishes of the individual are met. Discussions at this time and previous sampling of records confirm that activities and outings are regularly undertaken in the community. Service users are being supported towards becoming independent and moving into supported living. This has been accomplished with previous service users and staff continue to work hard to achieve independent outcomes. Advocates support service users where possible and others enjoy regular contact with families. One service user is currently planning an engagement party later this year and this event was discussed at this time. Relationships are supported within individual risk guidance. Service users have previously confirmed that staff do help them maintain contact with their friends and family. College and work placements are enjoyed. Trips out are undertaken several times a week and shopping, college and work in the local community are also undertaken. A holiday is booked for the month of August to attend the Colchester festival. This is an event full of activities that include water sports and disco and service users discussed their excitement at the prospect of this holiday. For those who do not wish to take this break, an alternative option has been planned to a holiday park. Service users previously said that they want more to do with the menu planning. They want more say as to what goes on it and did not want a rolling menu planner. Since the previous inspection, various formats have been tried for meal planning. Service users gave their opinions and various changes have been put into place. Following these trials and discussions with service users, the menu now reflects individual choices. The weekly planner shows who is undertaking an individual meal that requires a shopping list, shopping trip and then cooking the meal for everyone to enjoy. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 13 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. Staff do ensure healthcare needs are met, consider the dignity of service users and treat individuals with respect. EVIDENCE: All service users have access to appropriate healthcare professionals and this is evidenced in care plans and notes of all healthcare visits. Discussions with staff showed they have a good knowledge of the health needs of each service user. Care plans show the individual personal support assessed for each service user and how independence is promoted. The manager explained that service users have discussed sexual orientation, how people dress and what impression different people create. The attention that is generating by certain behaviours, the type of attention and the attitude of others is discussed to ensure the outcomes of actions are fully understood. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 14 Medication has improved and is now supplied in an appropriate monitored dosage system. The local pharmacist has been into the home and provided guidance on the appropriate use of this new system. Controlled drugs are stored and recorded appropriately. Spot checks are undertaken by the manager and records show when these have taken place. Medical administration records (MAR) sheets were seen to be up to date and clearly completed. Healthcare needs are maintained through regular contact with the Tizzard centre, local mental health team, and cognitive behaviour therapist. learning disability team, community psychiatric nurse, GP consultant psychiatrist, who reviews medication on a regular basis. Regular checks are also undertaken every 6-8 weeks with the chiropodist, as are regular sight and hearing checks. Clear directions were seen on care plans to change medication regarding one person with diabetes. However, these directions did not have dates and this could cause confusion and does not ensure that current needs are easily identified. Since the last inspection, the number of reportable incidents has decreased. The manager explained that staff now carry out alternative methods if a serious challenge is presented. More emphasis is put on making an area safe, taking other service users out of the immediate area and to attempt to defuse situations or quickly identify an escalating situation. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 15 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. Service users are listened to and routines and practices in the home do support and protect service users. EVIDENCE: There is a complaints procedure in place that is also available to service users in a format that supports them. The manager explained that there is a good relationship with family and service users are encouraged to openly discuss any concerns at all times. This was confirmed later when speaking to service users who confirmed they are able to discuss any matters with staff and also have meetings. Work has also been undertaken around people who feel depressed and what this means and how people act. The manager showed the inspector some diagrams that have been used to explain what being depressed and feeling low actually means. Pictures show this clearly and simply and service users have found these pictures do help them to understand. Since the last inspection, training on the awareness of abuse has been undertaken. This is now due to be refreshed and is to be booked through the organisation, new staff will also undertake this training. Additional information The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 16 and booklets are available to ensure staff recognise any form of abuse. This is also part of the staff induction programme and is TOPPS approved. Service users stated they know who to complain to and are confident that the staff and manager will listen and act on any matters. Those spoken to did confirm they have no worries about speaking up and saying if they are not happy. All money handled on behalf of service users has restricted access and only three people have keys. While recording is thorough and up to date, there are not always two signatures recorded. This was discussed with the manager, who confirmed that two signatures would be recorded at all transactions. This is good practice and also ensures protection is maximised. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 17 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): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. While the home was found to be clean and hygienic, there are areas that require attention, particularly carpeting and the access to the laundry area. EVIDENCE: In the main, the home is clean and hygienic with a very relaxed and welcoming atmosphere. However, regular maintenance has not been undertaken and some areas are in need of attention. Lighting on the stairs has been improved as a previous health and safety audit identified a risk due to low level lighting. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 18 Some redecoration has been undertaken in the hall, some painting and minor repairs have also been undertaken. There are pictures of outings and activities that have been enjoyed, these are on display in the large lounge and also in the smaller lounge area that is used for visitors and quiet discussion. The home is rather shabby in places and some carpet does need replacing, particularly by the office in the front lobby, as this could present a safety risk where the carpet is frayed and wearing very thin. Service user rooms are individual and independent housekeeping is encouraged and supported. The laundry room is accessed via a very steep slope. Bad weather could present a problem and if a person is carrying laundry, this would present a dangerous walkway. A covered seating area in the small rear garden does provide an external area for those wising to smoke and also for discussion and a good open area for relaxation. The inspector spoke to service users in this area and everyone appeared relaxed and comfortable. Much laughter and jokes, as well as informative discussions were enjoyed. Those taking part were very honest and practical when discussing their future hopes and plans. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 19 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. Service users are supported and protected by staff training, recruitment and the supervision process. EVIDENCE: All recruitment checks and references are undertaken by the organisation and when these are complete, the home is directed to start the new member of staff. The manager explained that service users take part in the selection of new staff, with visits to the home being undertaken. These are followed by feedback from service users and also from members of staff to say how the person dealt with questions and interacted with those living in the home. There is an induction process undertaken by all new staff that includes information on types of abuse and is only signed off when fully understood. Time is given for staff to read care plans, talk to service users and get to know the routines in the home. New staff have three days in which they attend the The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 20 home from 9am to 5pm in which to get to know those they are supporting and also allow service users to get to know the new member of staff. Training that has been undertaken includes first aid, health & safety, fire, medication. All core training is undertaken by new staff and refresher courses are also currently being booked for all staff who need this. Training is undertaken and booked by the Supervisory Manager of the home who was undertaking a review of the service in line with regulation 26 at this time. Quality assurance is undertaken and is being further developed with a new format and to also extend the scope of feedback. The new forms being developed were seen at this time. The manager explained that discussions and meetings are regularly undertaken with those living in the home. However, these have not been fully recorded in the past and the home must ensure all discussions are fully supported with records of items discussed and what action is taken following these meetings. Two staff folders were seen and did contain copies of the appropriate paperwork and new staff do not start work without CRB and POVA checks being in place, which ensures the full safety of service users at all times. The home has also recently started a mentoring process for new staff to provide support during and after the induction process. Staff changes have adjusted the numbers of staff in the home who have achieved qualifications regarding NVQ levels. Currently there are four staff who have NVQ levels 2 and level 3. The manager has NVQ level 4 and the registered manager award. One person is to start NVQ level four in September and another member of staff is to start NVQ level two at this time. All new members of staff are also being booked onto NVQ level two. Staff spoken to at this time confirmed they are supported by the management style and by other members of staff. There was a good knowledge of the needs of service users and a comprehensive understanding of recording systems and where information was to be found. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 21 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The current acting manager is a suitable and competent person to be running the home and staff work hard to ensure the safety, health and welfare of service users. EVIDENCE: The home is managed in an inclusive way that ensures everyone, both service users and staff, are aware of what is happening at any time. Observations and discussions confirm that service users are comfortable and included in all discussions and plans that are made. This gives ownership to service users and makes it very much their own home. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 22 The well being and safety of service users is ensured through recruitment and training. Health and well being is ensured through support from appropriate professionals and up to date training being undertaken. Life skills and goals are supported by staff and the routines in the home are dictated by service users needs and wishes. Risk assessments also support safety and the undertaking of manageable risks. Regular audits are carried out and the servicing of the electrical equipment, the boiler and fire extinguishers were all up to date and the home insurance was also in date. Regular checks on fire alerts and fire practices are regularly undertaken and recorded. There were not COSHH items in evidence, ensuring the complete safety of service users in the home. Discussions, observations and records do clearly show that those living in the home are at the centre of activities and routines. Service users spoke confidently and openly at this time, appearing to be confident and comfortable with voicing their opinions. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 23 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 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 X 3 x The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23 Requirement That an ongoing maintenance and refurbishment programme is in place to ensure the environment meets with required standards. That the access to the laundry area is risk assessed and safety maintained. Timescale for action 17/08/07 2. YA24 23 17/08/07 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 YA6 Good Practice Recommendations That regular audit checks are undertaken to ensure all records are correctly dated. Providing adequate audit trails and correct information to support service users, particularly with regard to medication and care plans. The Hall DS0000023574.V346815.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Hall DS0000023574.V346815.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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