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Inspection on 03/11/06 for The Links

Also see our care home review for The Links for more information

This inspection was carried out on 3rd November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home manages its enquiry and pre-admission assessments well. Staff are dedicated and loyal and whose prime concern is that of meeting the residents needs. Staff manage to personalise care to meet each individuals needs and pay attention to the small details which improve residents lives. The home provides a loop system for those residents who are hard of hearing. This is primarily used during meetings but which is available at all times should the residents wish to use it. Residents opinions are valued, independence encouraged and account made of their privacy and dignity. The home is managed well and there are very good staff training opportunities.

What has improved since the last inspection?

At the last inspection four requirements and two recommendations were made. The requirements related to installation and/or servicing of three pieces of equipment in the home and a requirement was made in relation to resident medication management. All these requirements have been met. The recommendations were in relation to resident care planning and risk assessment processes. Both recommendations have been acted on.

CARE HOMES FOR OLDER PEOPLE The Links 7 Uphill Road North Weston Super Mare North Somerset BS23 4NE Lead Inspector Judith McGregor-Harper Unannounced Inspection 3rd November 2006 10:00 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 Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Links Address 7 Uphill Road North Weston Super Mare North Somerset BS23 4NE 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) 01934 625869 01934 419244 general-manager@abbeycarehomes.org.uk WSM Free Church Housing Association Mrs Mair Wynne James Care Home 13 Category(ies) of Old age, not falling within any other category registration, with number (13) of places The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2005 Brief Description of the Service: The Links is owned by Abbeycare, the Weston-super-Mare Free Church Housing Association and is situated on the seafront road. The home is in a converted older property and offers accommodation on two floors. A chair lift and staircase provides access to the upper floor although a few steps still need to be negotiated on the ground floor and first floor. The large lounge overlooks the well-maintained landscaped gardens and the dining room has a view of the local golf course. A well-stocked library is available in the reception area. Daily prayers and a church service every two weeks are held in the lounge. Although optional, the majority of residents choose to attend these services. The town centre with shops and recreational activities is close by and transport would be required to access this. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection was carried out by one inspector and took place over one day for a total of five hours. Ten residents were at the home on the day of the inspection. All residents who responded to a CSCI survey described themselves as White/British. There is currently one vacancy at the home. The inspector was able to see and spend time interacting with the residents. Staff on duty were able to give time to speak with the inspectors. The registered manager Mrs. James was on duty and assisted the inspector throughout the inspection visit. The inspector would like to thank Mrs James and her staff for their time and hospitality shown to the inspector during her visit. The atmosphere at the home was relaxed and friendly. Staff carried out their duties in a professional and attentive manner. The CSCI has forwarded service user surveys to the home and has received eight completed returns. Professional surveys about the home were sent out to associate community health care professionals and one was completed and returned. The responses were all positive indicating satisfaction with the care and management of the home. One respondent wrote. “I am very well looked after, everyone is helpful to my needs.” Another respondent stated. “Staff are very helpful and friendly. They have become my second family.” Records examined during the inspection were a selection of care plans, written quality assurance processes, medication records, staff training records and staff recruitment records, staffing rosters, service user menus, equipment servicing records, fire safety records, information provided by the home to prospective and new admissions, activity posters, a selection of service use contracts and resident cash financial records. Prior to the inspection the home completed and forwarded to the CSCI on request a pre-inspection questionnaire. This inspection examined key National Minimum Standards for Older People and any Standards where a requirement or recommendation were made at the last inspection. The aim of this inspection visit was to inspect outcomes for service users against key National Minimum Standards as part of the Commission’s ‘Inspecting for Better Lives’ strategy. Inspectors measure the quality of the service against four general judgements. These are - excellent, good, adequate and poor. The judgement descriptors for the seven chapter outcome groups are given in this report. What the service does well: The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 6 The home manages its enquiry and pre-admission assessments well. Staff are dedicated and loyal and whose prime concern is that of meeting the residents needs. Staff manage to personalise care to meet each individuals needs and pay attention to the small details which improve residents lives. The home provides a loop system for those residents who are hard of hearing. This is primarily used during meetings but which is available at all times should the residents wish to use it. Residents opinions are valued, independence encouraged and account made of their privacy and dignity. The home is managed well and there are very good staff training opportunities. What has improved since the last inspection? What they could do better: This was a positive inspection demonstrating that the home is managed well. Two recommendations are made. Firstly, medication management for residents who are supported to selfmedicate could be further improved by more detailed risk assessments. The home would benefit from arranging for G.Ps to review the ‘as required’ basis for some resident medications and a more current medicines reference book should be purchased along with a bound and numbered book for recording controlled medicines. In order to demonstrate good practice in managing the risk of cross infection the home should provide liquid soap, paper hand towels and foot operated pedal bins in toilets and bathrooms on the first floor to enable staff attending to personal care to wash their hands when working upstairs. Please contact the provider for advice of actions taken in response to this The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 7 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 Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents receive sufficient information to enable them to make a choice about moving into The Links. Informal pre-admission visits to the home are encouraged. Residents sign a contract with the organisation regarding their terms and conditions of stay at The Links. No resident moves into the home without having their needs assessed. EVIDENCE: The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 10 The homes Statement of Purpose is reviewed annually and an updated copy is forwarded to the Commission and held on file. A Service User Guide is provided in each resident bedroom. Robust procedures are in place to ensure that prospective residents receive sufficient information about the home prior to making a decision to live here. Residents are assessed prior to taking up accommodation at the home to ensure that their needs can be fully met. On the day of the inspection the manager was liaising with the family of a prospective resident regarding assessing their relative for suitability of moving into the home. Residents recalled visiting the home prior to moving in and appreciated the months trail period offered to enable them to ‘test drive’ the service. Two resident’s contracts with the home were inspected. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have general care plans and risk assessments in place, which would further safeguard the residents if they contained further detail. Residents are treated with respect with their privacy and dignity protected. Access to appropriate health care provision is maintained. Medication procedures are safe. Some residents are supported to manage their own medication. EVIDENCE: The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 12 Each resident has a care plan that is reviewed on a monthly basis. A ‘getting to know you’ questionnaire is also completed which gives details of the resident’s day-to-day routines, likes, dislikes and preferences. Two care plans were inspected in detail. The care plans contain general information about the care to be provided. Care plans demonstrated evidence of resident involvement in the drawing up of the individual plan of care and care pans were reviewed monthly. Care plans inspected demonstrated that residents receive appropriate health care support from community health care professionals. This was also confirmed in conversation with residents. Where residents self-medicate this was risk assessed. The current risk assessment format could benefit from being more detailed to reflect the risk to the particular resident rather than generic risks. Asking the resident to sign as acknowledgement that they have been handed their prescribed medicines for safekeeping would also demonstrate best practice in self-medication management by the home. The home management has worked hard to provide good staff training in medicines administration and is currently reviewing in-house medicines procedures and processes to further improve on good practices. This is to be commended. Medicine records and storage were inspected. The home manages medicines well. It is recommended that the home purchase a current reference book of prescribed medicines, as the one in the home is now two years old. The home should also purchase a bound page numbered book for recording controlled medicines in, rather than the current exercise book that is used. Some medicines prescribed did not have clear instructions from the pharmacy regarding ‘as required’ doses. It is recommended that the home arranges for such medicines to be reviewed by the prescribing G.P. Medicine administration records were maintained well but the Registered Manager was reminded to ensure that staff record the amount of variable does given for any laxatives administered to residents, in order to audit therapeutic effectiveness of the medication. Staff were observed interacting with the residents. They had developed with the residents who they have come to know better, appropriate humour and banter, whilst remaining polite and respectful. Residents spoke highly of staff personal qualities and professional care giving skills. There have been no deaths at the home for over 12 months. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident social, religious and recreational needs and preferences are respected and in-house planned activities strive to reflect resident tastes and interests. Families and friends are welcomed into the home. Meals reflect individual choices and the quality of meals are well thought of by residents. EVIDENCE: There are planned activities organised and advertised in the home. Some residents choose not to partake in the activities, as they prefer to attend to their own entertainment, such as visiting friends, attending to correspondence and relaxing with music or television. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 14 The home arranges a variety of events and activities, which include hairdressing, communion services, coffee mornings and craft events such as creating greeting cards. Outings are also arranged, mainly in summer months. A beautician visits monthly and the home arranges on a less regular basis visiting musical entertainment. One visitor was at the home on the day of the inspection. They spoke highly of the home’s management, staffing and care provision for their relative. The kitchen is clean, suitably equipped and spacious. The inspector took lunch in the dining room with residents. The atmosphere at lunch was pleasing with residents enjoying social conversations and the diners appreciated the meal. Residents also have the option of taking meals in their own rooms. There are choices available at each meal and specialist diets are catered for. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have confidence in the homes robust complaints procedures and systems are in place to ensure that there are clear avenues in which complaints and compliments can be received. The home holds appropriate policy documents in the protection of vulnerable adults and a good staff training programme is in place for training staff in abuse awareness. EVIDENCE: The complaints procedure is available in the service user guide and is posted in the reception hallway. Residents felt that they could approach any staff member should they need to complain and that it would be taken seriously and acted upon. The home has not received any complaints since the last inspection and no concerns or complaints about the service have been raised directly to the Commission during this time. The Links also have a ‘house visitor’ (who is a representative from the Free Church Association) who visits the home on a weekly basis generally. The role of the ‘house visitor’ amongst others is that of ensuring the residents are The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 16 satisfied with service they receive. The residents are able to discus any issues or concerns should they wish or need to do so with the ‘house visitor’ who can act as a liaison link between the resident and the home. Policies and procedures, including local multi-agency guidelines for the protection of vulnerable adults were held in the home. Staff training records indicated that staff receive updates in abuse awareness training. A staff Whistle Blowing policy is promoted in the home. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a pleasant, clean and comfortable home, which is adapted to meet the physical requirements of residents. EVIDENCE: The Links provides a pleasantly decorated comfortable home for its residents. There is a relaxed ambience and the home is clean and well presented. The accommodation is arranged over two floors with the communal areas on the ground floor. The lounge is to the front of the property overlooking the landscaped front garden. This large room is light and airy arranged with various lounge chairs. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 18 The separate dining room leads off the inner hallway and overlooks the front and side of the property. This houses dining room tables and chairs and a ‘hostess trolley’. Access to the first floor is via a stair chair lift. This is currently awaiting a service repair but residents are managing within the limitations of the chair lift not operating optimally. There are several steps, which residents need to be able to manage at the bottom of the stairs and at the top, which the stair lift does not cover. Two upper floor bedrooms have been knocked into one and an ensuite double room created. Two ground floor rooms have been knocked into one and an ensuite added. There are eight single rooms ensuite and two double rooms with en-suite facilities. The home provides two bathrooms and three toilets. One bathroom has a walk in bath and another has a bath hoist. The radiators have low temperature covers and can be individually controlled. There are call bells available in each room. The staff have two ‘sleep in rooms’. One is sited at the bottom of the stairs and the other at the rear of the property. The home is hygienic and staff have received infection control training. Currently liquid soap, paper hand towels and foot operated bins are not available in first floor communal toilets and bathrooms. This is recommended, as it will make cross infection control measures more robust for staff. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff are rostered on daily duties to meet the needs of residents. The home has robust recruitment and training for staff, safeguarding the interests of the residents. EVIDENCE: The company training manager leads the staff training program. Staff training records were inspected and the home’s training plans was discussed. The organisation is investing in providing a good range of both statutory and resident need led training for the staff group. The home currently has 50 of care staff holding and NVQ care qualification at a minimum of level 2. Other staff are working toward this NVQ award. The staff rota comprises of two General Assistants, one senior staff member and a cook in the mornings. A General Assistant and senior staff member form the afternoon staff with two night staff, which are sleeping staff. The rota The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 20 demonstrated that the home has at least two care staff members available at all times. The registered manager ensures that rota is completed and the home staffed by carers who can meet the needs of the residents safely. The staff turnover generally is low, allowing staff to offer consistent care to the residents. New staff have orientation into the homes day-to-day routines and an induction program that reflects best practice with Skills for Care induction standards. Staff recruitment practices and personnel files inspected were well ordered and demonstrated good practice. Volunteers to the home have had CRB checks completed. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well organised and managed to meet the best interests of the residents. Staff receive regular constructive supervision by managers. Quality assurance processes are in place to ensure that the home regularly seeks feedback from service users and interested parties regarding quality of service provision. Where the home handles resident’s cash, this is robustly audited to prevent financial abuse. Health and safety of staff and residents is appropriately maintained. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 22 EVIDENCE: Mrs Mair James is the Registered Manager and holds the Registered Managers Award. She has several years experience in the care sector. Her ‘open door’ approach enables staff and residents to discus any issues with her. She is liked and respected by residents, staff and visitors. Residents meetings are held on a regular basis used as an open forum to gather opinions and views on the homes services and facilities. The minutes of these meetings are available for all to see. Surveys of resident’s views in the form of a questionnaire were undertaken in July and the outcomes published within the home. Regulation 26 visits are undertaken on a monthly basis and records of these audits are forwarded to the Commission. Records relating to servicing of equipment in the home were inspected and were in order, including evidence of compliance with Requirements made at the previous inspection. Since the last inspection mixer valves have been fitted to baths and sinks to prevent the risk of scalding to residents. Residents manage their own financial affairs with either their families or representatives. A spot check was carried out for one resident’s cash geld by the home. Accurate records were maintained. The home has kept the Commission informed of notifiable events requiring reporting. Fire records inspected were in order. Residents are involved in regular staff fire evacuation drills at the home. This is good practice. The home is completing a building risk assessment review in line with recently published Fire Regulations. The Links DS0000008064.V315957.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 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 3 The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations Medication management for residents who are supported to self-medicate could be further improved by more detailed risk assessments. The home would benefit from arranging for G.Ps to review the ‘as required’ basis for some resident medications. A current medicines reference book should be purchased A bound and numbered book for recording controlled medicines should be purchased. Where a prescribed medicine has a variable dose the amount given should be recorded. 2. OP26 In order to demonstrate good practice in managing the risk of cross infection the home should provide liquid soap, DS0000008064.V315957.R01.S.doc Version 5.2 Page 25 The Links paper hand towels and foot operated pedal bins in toilets and bathrooms on the first floor to enable staff attending to personal care to wash their hands when working upstairs. The Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Links DS0000008064.V315957.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!