Inspection on 09/06/05 for The Heathers

This inspection was carried out on 9th June 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Heathers 10/03/10

The Heathers 08/12/09

The Heathers 11/12/08

The Heathers 13/06/08

The Heathers 13/06/07

The Heathers 16/06/06

The Heathers 15/11/05

The Heathers 08/03/05

The Heathers 21/09/04

The Heathers 19/03/04

Similar services:

Oakmount Hostel

Ark House

St Anne`s Alcohol Services - Leeds

Lynwode Park

Parkfield Rest Home

Priory Road

Elmhurst

Linwood Court

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

CARE HOMES FOR OLDER PEOPLE The Heathers 1 St Pauls Road Manningham Bradford BD8 7LU Lead Inspector Susan Knox Unannounced 9 June 2005 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 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 Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Heathers Address 1 St Pauls Road, Manningham, Bradford, West Yorkshrie BD8 7LU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01274 541040 01274 541040 Yorkshire Regency Health Care Ltd Care home only 27 Category(ies) of Old age (17), Dementia over 65 (4), Physical registration, with number disability (5), Alcohol dependent over 65 (1), of places Alcohol dependent past/present (1), Physical disability (2) The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The category of A be used for the specified service user only. The category of PD be used for the specific named service users. Date of last inspection 8 March 2005 Brief Description of the Service: The Heathers is a detached adapted property located within walking distance of the city centre. It is close to local shops, a bus route and Lister Park. To the front of the building is a garden with a small car park. Accommodation is provided for 27 service users on the ground and first floor. The second floor is unused although renovation of this area is underway. A passenger lift provides access to all areas. The majority of those accommodated are elderly. A small number may have mental health and/or physical needs; are younger than retirement age; have alcohol dependency. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Susan Knox lead inspector and Gill Sangster carried out this unannounced inspection. Also present was Rod Hamilton Business Relationship Manager CSCI who was shadowing the inspectors. Mirage Bibi acting manager was working on shift throughout the visit. Also present were Denise Smith operations manager and Stuart and Sue Crabtree providers, for part of the visit. Inspectors reviewed some documentation, inspected the building, sat with service users for the main meal of the day and had discussions with service users and staff. This home provides accommodation for a small number of younger adults and therefore should be inspected to the dual standards of older people and younger adults. Due to the category and age of the younger people a decision has been made to inspect to the older people’s standards. The building work to renovate the second floor first stage is near completion. Before this can be registered a variation of registration relating to younger adults and an amended statement of purpose needs to be submitted to the CSCI. At the time of this visit one service user was missing for the second time. Door locks were being fitted to the main doors. Feedback on some issues was given to Stuart Crabtree provider who left before the end of the inspection due to a previous appointment. Detailed feedback was given to acting manager Mirage Bibi and Denise Smith. What the service does well: The service users enjoy the meals that are prepared for them. The majority of service users said they were content and settled in the home, they were happy with the carers and felt safe. Service users are encouraged to speak out about any concerns. The home has a nice atmosphere and staff are friendly and caring. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 8 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 standard(s) 2, 3, 5. Assessments are carried out before admission in order to ascertain if individual needs can be met. Care records are legal documents and must be signed and dated. The providers and managers must clearly identify how the needs of the two diverse groups of service users they are proposing to accommodate will be met. EVIDENCE: Relatives confirmed that a family member had made a visit to the home before admission. Pre admission assessments were available in care documentation. These had sufficient information for decisions to be made on whether the home could meet the service users need. As discussed during the visit all documentation must be dated and signed. A contract was seen for someone purchasing care privately. Local authority contracts were also available. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 9 The inspectors expressed their concern about proposals to increase the numbers of younger adults and the affect this may have on the older people accommodated, particularly their safety. The managers and provider were advised to submit detailed proposals about meeting the needs of these client groups. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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 standard(s) 7, 8. Service user and/or relatives are not actively involved in care planning including risk assessments. Care planning has improved but could further improve if staff took more responsibility and considered the outcomes for service users. Care plans need to be updated and signed. The inadequate risk assessments do not provide sufficient information for staff to monitor service user’s safety. Service users were happy with the care provided by staff. EVIDENCE: Six care plans were reviewed in total. This documentation showed a significant improvement since the last inspection. Some evidence was available of attempts to include service users in care planning. In the care planning for two of the younger residents, one was very detailed with clear evidence of review and evaluation. The other had three care plans dating from 2001 to 2004 covering only some of the individual’s needs. Significant gaps in daily records The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 11 were seen such as no record of the reason a service user was admitted to hospital. For one, a care plan relating to diet had suddenly stopped without a written explanation. Regular assessment of weights was carried out but staff need reminding to focus on the outcomes by comparing previous weights. On one occasion there had been a weight gain and loss of seven pounds in one week. This was obviously a mistake but had not been dealt with by staff. Many of the care records needed signing so that the person making the record could be held accountable. A number of risks were identified but the management of these had not been discussed or agreed with the individuals and risk assessments were poor. Concerns were raised with managers about those who persist in smoking in their rooms. This puts the home and occupants at risk. This needs to be assessed prior to admission when discussions are held and the ‘house rules’ can be outlined. Risk management strategies can be agreed and recorded, then regularly reviewed. Action needs to be taken to minimise identified risks and hazards and to consider training for service users at risk. As discussed, the local fire officer needs to be contacted for advice. Discussions with staff showed a good understanding of resident’s needs. Residents said they liked living at the home and described staff as “very good”, “nice” and “ a good bunch”. During discussions with service users and relatives it was felt that health needs were being met. In addition, the inspector discussed with managers a conversation held with a visiting professional where an opinion was expressed that the standard of health care in the home had improved. Medication was not reviewed at this inspection other than the medicine trolley is kept in the dining room but is not secured to the wall. This was identified at the last inspection and needs to be addressed. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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 standard(s) 12-15 Activities are regularly organised and enjoyed by service users although some work is required to address the developmental needs of younger adults. Service users are given independence but the need to minimise risks for the more vulnerable service users may impact on this. Mealtime procedures ensure that the independence of service users is encouraged. EVIDENCE: During discussions with service users they were satisfied with the activities arranged within the home. They described the recent trip out to Blackpool and even found some enjoyment in the break down of the transport. Relatives present on the day said they were welcomed into the home. Evidence was available in the activities file relating to receipts for the hiring of transport and in house entertainment. Service users expressed their satisfaction about the degree of choice and control they had within the day-to-day routines of the home. This included bedtimes and leaving the home independently of staff. At the time of the visit digital locks were being fitted to the external doors. This was due to the needs of a few service users. Management needs to consider the impact this will have on those able to leave the home independently. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 13 Lunch was taken with the residents. The food looked appetising and was well presented. There were no tablecloths or napkins but the manager said that these were usually provided. Residents said that they enjoyed the food and staff were seen to be attentive to individual needs but unobtrusive, allowing people to eat their meals in their own time. Each table was provided with their own teapot, milk jug and sugar so that resident could help themselves to tea. Lunch was a sociable time with residents and staff chatting with each other. As stated earlier, the home has a small number of younger residents with different needs from the older client group. Currently all the residents share the same communal space which can present difficulties at times. The younger residents spoken with during the visit expressed satisfaction with their care and praised the staff. However there is currently little opportunity for these residents to develop and progress their lives through participation in meaningful activities both in the home and the community. Staff need training and guidance in these areas and knowledge about how to access the appropriate services to support these residents in achieving fulfilment in their lives. In expressing concerns about an apparent lack of opportunity for personal development for the younger adult, it is acknowledged this was not a concern expressed by a service user. However, it needs to be part of the aims and objectives of the home if the dual registration is granted. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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 standard(s) 16, 18 Service users displayed confidence with the staff group that any concerns would be acted on. Adult protection and abuse issues should be regularly discussed with staff in order to ensure that all are aware of correct procedures. EVIDENCE: The complaint procedure is displayed prominently. In addition this information is available in the Statement of Purpose. Service users clearly described how they were encouraged to speak out about any concerns. The acting manager advised that no complaints have been made to the home. The last complaint received by the CSCI was October 2004. In house abuse awareness training has been held for staff. The operations manager has attended the local authority adult protection training and staff are booked to attend the same training. This information was available in the training file and confirmed during discussions. During discussions about the procedure to follow in the event of a disclosure about abuse staff would not follow the recommended route. The acting manager was advised to discuss this at staff meetings. Adult protection and abuse should regularly be part of the agenda for staff meetings. Discussions with staff identified that further training is required to ensure that all of the senior staff are aware of the adult protection procedures including how and when to implement them. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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 standard(s) 19-21, 23-26 The rooms and other areas that have been renovated are to a good standard. Other areas are very poor with many rooms requiring repair, refurbishment and redecoration to ensure that residents have a comfortable, homely and safe place to live. The standard of cleanliness is poor which makes the home unhygienic and less pleasant for the residents. EVIDENCE: The provider is converting the top floor of the home to provide five additional bedrooms, three single and two double, and a communal bathroom This work when registered, will allow the three bedrooms with three beds to be reduced to doubles. A new staircase has been installed with a new carpet and the lift will service this floor. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 16 All parts of the home were inspected. Some bedrooms were personalised and homely but the majority of rooms need redecorating and refurbishing. Some areas of the home are in a poor state of repair and require urgent attention. Many items of furniture were shabby and worn and need replacing. Radiators were not adequately guarded and would not protect the service users from injury if accidents occurred. Several bedrooms have no door locks fitted or lockable facilities for residents to keep things safe and private. Toilets and bathrooms were poor quality and need upgrading. At the last inspection it was required that the chair on the fixed hoist in the first floor bathroom was replaced. The manager said that this had not been done because a replacement chair could not be sourced due to the age of the equipment. Therefore the whole hoist must now be replaced. The smoking lounge was particularly poor in relation to décor and furnishings with a heavy pall of smoke in the room despite the window being fully open. The provider advised that a new carpet has been ordered but the whole room needs refurbishing and redecorating. Additional ventilation should also be provided. The laundry is located in the basement and has separate areas for washing and drying. A number of commode pots were being disinfected in the laundry room where a sluice sink is located. It is required that as part of the developmental works being undertaken a separate sluice room is provided at a more central location in the home. This room should include a wash hand basin, sluice disinfector machine and clinical waste bin. A number of maintenance works requiring urgent attention were identified to the provider and manager. The standard of cleanliness was poor with malodours in two bedrooms and some furniture stained or ingrained with food debris. The provider advised that two keypad locks, with the agreement of the fire authority, were being fitted to two of the external doors. This was to safeguard two of the residents who would be at risk if they left the home without staff. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27-30 Staffing levels were appropriate and care was provided by a group of staff who receive regular training. The number of supervision sessions needs to be improved in order to monitor and support the care staff employed. Recruitment procedures are poor and put service users at risk. EVIDENCE: Copies of the rota were made available for inspection and staff on duty were the acting manager, 5 carers, the cook and the domestic. Staffing levels complied with former agreements and met the needs and numbers of service users. The staff group is a mix of newly recruited carers and long standing staff. Two sets of recruitment files were reviewed for the latest recruits. Application forms had been completed. Copies of training certificates were available for one but apart from one did not relate to the care of the elderly. This was due to the previous home not allowing training documentation to be removed from the home. One file showed evidence that identity had been checked. Both had no references and CRB checks were not done although the manager advised that these had been applied for. The manager was advised that no staff should be employed before adequate safeguards had been undertaken such as obtaining references and CRB checks. The training file contained details of courses attended and those planned. Staff confirmed attendance at Safety Compliance, Oral health, Dementia care The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 18 Studies and Palliative care. Preventing Malnutrition in Older people was booked for 15 June. Staff training is on going. Staff praised the training opportunities that were available to them and described recent training they had undertaken. Staff said that they received supervision but there was some variation in how frequently this occurred. Supervision needs to be carried out six times a year. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 38 The records of service user’s financial transactions need to provide clearer evidence that personal monies are being protected. The safety of service users and staff relating to fire is regularly assessed. The record for drills needs to be more robust. The provider needs to take action in relation to other safety checks and procedures. EVIDENCE: Records were available for personal allowances retained for safekeeping. The manager was asked to clearly record the amounts and transactions when transferring from one safe to another, as records were confusing. In addition, clarification was required about one recent admission and an agreement for a specific amount of monies to be paid monthly. Fire safety records were available for inspection. Weekly tests are carried out for fire alarms and emergency lighting. Staff fire drills are recorded with staff signing names as having attended. The manager was advised to record these The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 20 drills other than on scraps of paper. A fire safety audit was available. An up to date certificate was available relating to extinguishers. Building audits are carried out weekly and recorded. An electrical report is available for the majority of the building. Part of the first floor is not included therefore the provider was advised that this must be completed. There was no of the maintenance of the fire alarm system, nurse call alarm and Portable Appliance Testing (PAT). The inspector’s concern about the number of service users who smoke and the few who persist in smoking in their rooms was discussed. This area of safety needs urgent attention. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 2 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION 1 1 1 x 1 1 1 1 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 2 x x x 2 x x x 2 The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 22 yes 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 4 Regulation 6 Requirement Submit proposals in writing including a review of the statement of purpose detailing how the needs of the older and younger mix os service user will be met. (Referred to for the last two inspections) Care plans need to be updated for all service users. Ensure documents are signed and dated. Involve service users and/or relatives in care planning including risk assessments. Ensure that the medicine trolley is securely stored. (Referred to at the last inspection) Ensure that the inpact of locked doors does not affect those able to leave the home independently. Review the opportunities personal development for younger adults The three triple bedrooms in use are not acceptable, reduce to two people sharing as soon as possible. (Referred to since 2001) Ensure that all staff are aware of the correct procedures in dealing with adult protection and abuse. Renovate existing bathrooms J52 S1162 The Heathers V227931 090605 Stage 4.doc Timescale for action 30 June 2005 2. 7 15 10 July 2005 3. 4. 9 14 13 12 30 June 2005 30 June 2005 5. 13 13 30 July 2005 6. 7. 18 21 13 23 30 June 2005 30 August Page 23 The Heathers Version 1.30 and WC 8. 24 23 Replace poor quality furniture. improve the quality of the environment in the smoking room. Provide an expel air device. (Referred to for a number of inspections) Safe guard hot radiators. (Referred to for a number of inspections) Review the present method of guarding this heating. Ensure that an additional sluice is provided centrally within the home. Ensure that cleaning schedules include armchairs and tables. Replace the chair to the ambilift first floor bathroom. (Referred to for a number of inspections) Address the malodours in the two bedrooms identified. Improve procedures for staff recruitment. Ensure that all financial transactions are clearly recorded. Ensure that an electrical wire safety check is carried out for the remainder of the first floor. Submit evidence of the maintenace of the fire alarm system, nurse call alarm and PAT. Review the present smoking policies for service users and involve the fire authority in assessment of risk. 2005 30 August 2005 9. 25 13 30 August 2005 30 August 2005 10. 26 16 11. 12. 13. 29 34 38 19 25 13, 23 30 June 2005 30 June 2005 30 June 2005 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 19 Good Practice Recommendations Ensure that the regular accumulation of building debris is J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 24 The Heathers regularly removed from the side of the buiding. The Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Heathers J52 S1162 The Heathers V227931 090605 Stage 4.doc Version 1.30 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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