Inspection on 10/08/06 for The Mayfair

This inspection was carried out on 10th August 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.

Other inspections for this house

The Mayfair 19/01/06

The Mayfair 24/05/05

The Mayfair 15/10/04

The Mayfair 10/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE The Mayfair Marine Road East Morecambe Lancashire LA4 5AR Lead Inspector Mr Ajam Auckburally Unannounced Inspection 10th August 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 Mayfair DS0000009685.V286285.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 Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Mayfair Address Marine Road East Morecambe Lancashire LA4 5AR 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) 01524 411836 01524 411836 Mrs Kathleen Prada Mrs Licia Pickvance, Mr Antonio Giacomo Prada Mrs Moira Elizabeth Robertson Care Home 45 Category(ies) of Old age, not falling within any other category registration, with number (45) of places The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: The Mayfair is a care home situated on Marine Road in Morecambe and facing the promenade. The building is a multi storey building and a passenger lift is available to access all the floors. The home is close to all the amenities but unfortunately they are still too far for most of the residents to access due to physical or mental frailties. The home can accommodate a maximum of forty-five people of both sexes. Accommodation is provided in thirty-seven single and four double bedrooms. Many of the bedrooms have an ensuite facility. The home is registered to take older people of both sexes who are aged 65 and over. The home is staffed 24hrs a day and care is provided according to needs. An assessment is carried out to determine the level of needs of all the residents. There were thirty-four residents living at the home at the time of the inspection. They are encouraged to retain as much of their independence as possible and the staff said that one of their roles is to help them achieve this. For those residents who need assistance, a team of staff are there to provide it. Current weekly fees are between £320 and £385 and additional extras like hairdressing, TV rentals, outings and newspapers are paid for by the residents. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Under IBL (Inspecting for Better Lives) The Mayfair was assessed as requiring a statutory key visit (inspection) between April 2006 and March 2007. An unannounced key site visit was carried out on 10th August 2006 which lasted for 5.5 hours. The inspection was carried out against the National Minimum Standards for Older People. The inspection despite being an unannounced one was carried out in a friendly atmosphere and with the full cooperation of the owners, the staff and the residents. During the inspection, some records were looked at and several residents and staff were spoken to. The residents were very positive about the care they receive and the way the staff treat them. Evidence about the inspection was gathered firstly by sending out questionnaires to residents, the families and the staff. When they were analysed, they showed that everybody was happy with quality of care provided and the facilities at the home. During the inspection, case files of residents were looked at to check that records of needs and action taken were recorded and reviewed. Residents and staff were spoken to and their comments noted. There were 34 residents living at the home at the time of the inspection and there were 4 care staff, two managers, a cook and other ancillary staff on duty. The number of staff on duty was well within the minimum level recommended. The staff were observed to be polite and attentive when talking and dealing with the residents. What the service does well: The inspection was conducted in a very friendly and cooperative manner and all the residents were very happy to tell the inspector about their home. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 6 Those spoken to said how happy they were living at The Mayfair. The atmosphere was very relaxed and staff and residents got on well together. During the visit, the inspector spoke and observed a number of residents who all appeared to be very comfortable and relaxed in their surroundings. The residents who responded to the written survey and those consulted during the inspection were very complimentary about the quality and variety of meals provided at the home. Great satisfaction was expressed about the standard of meals and choices on offer during each mealtime. Cold drinks like orange juice and other juices are available in the lounges at all times. Fresh fruit are also available. Hot drinks are offered at regular times in the day but residents can ask for one at anytime. A written pre admission assessment is done to ensure that residents admitted to the home are provided with care to meet all their needs. The owners are aware of equality and diversity and said that they treat everyone as equals and respect people’s different ways and habits. The staff benefit from a good standard of training. It was also pleasing to note that the home continue to meet the national target in NVQ training, with 64 of carers holding the qualification at level 2 or above. Two of the owners work in the home and are involved in the daily activities and are available to talk to residents, staff and relatives. The staff were observed to be polite and respectful when talking and caring for the residents. What has improved since the last inspection? There is a continuous programme of decorating and carpet replacements. Several bedrooms have been redecorated since the last inspection. The procedures for investigating complaints by the providers have improved in that more attention is paid to the residents’ written records. The percentage of care staff who have completed their NVQ training has increased to 64 . The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 7 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 Mayfair DS0000009685.V286285.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 Mayfair DS0000009685.V286285.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are good practices to ensure that new residents have adequate information in choosing the home. EVIDENCE: The records of admission of the last resident admitted to the home were examined. The owner said that in this instance, information was obtained from the relatives who visited the home on behalf of the resident. The service user guide contains information about the home, the care provided, the charges, the staffing, the complaint procedure and other useful information. A copy of the last inspection report is available in the reception area for people to read or they can ask for a personal copy. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 10 A member of the management team always visit prospective residents who are unable to visit the home, either in their own home or in hospital. A written pre admission assessment is done at this stage to ensure that the staff of the home can meet the assessed needs. A form is used to record information under the heading of: personal care, vision, mobility, eating and several more areas relevant to the care of the resident. The staff said that they are given as much information about the new residents as possible so that they can provide tailor-made care. New residents are allocated a key worker. A key worker system is operated at the home. This means that a small group of residents is allocated to a member of staff. The staff has responsibility to ensure that the residents are well cared for and that if they have any problems they can talk to the staff. The key worker system does not exclude other staff from caring for the residents. The owners said that referrals from residents of an ethnic background would be welcomed. She said that research would be carried out, for example if the home were unsure how to meet cultural, religious and dietary needs of people from a different country or culture. The owners said that policies have been tightened up to ensure that only residents for whom a complete care package can be provided are admitted to the home. The residents said that they were very pleased with the home and that their families have chosen well for them. They said that the staff are very good and that nothing is too much trouble for them. Intermediate care is not provided at this home. The Mayfair DS0000009685.V286285.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are very good practices to meet residents’ health care needs. EVIDENCE: Two residents, one of whom being the last one admitted to the home were case tracked. This means that two residents were selected by the inspector and the care they receive examined closely. Their assessments and care plans were examined and they were spoken to. The records show that detailed written information about the residents has been recorded. These include an assessment to identify the needs of the residents and also a care plan, which shows how the needs were being met. One of the residents needed help with personal hygiene, and the records clearly show how the staff were involved in providing assistance with this task. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 12 The physical assessment covers; personal hygiene, mobility, hearing, vision and other areas. The care plans give details of how the assessed needs are met. For example, if someone needed help with personal hygiene, the record will show that this person needs staff to wash and dress her. The care plans are reviewed monthly to meet the changing needs of the residents. The residents are involved in this exercise. The two residents said that they are very well looked after by a team of very good staff. Other residents spoken were very positive about the staff and the management of the home. They described the home as being ‘marvellous’ and ‘excellent’. One resident on a short stay said that if he had to come into a home permanently then the Mayfair would be his first choice. Six survey cards were received back from the residents and they were all positive about the staff and the care they receive. The inspector observed a very relaxed and friendly atmosphere in the home. There were good interactions between the staff and the residents. To meet the needs of residents who need support when walking along the corridors, handrails have been fitted on the walls. Some of the toilets have been fitted with grab rails to help those residents with poor balance and mobility. Some of the baths and showers have easy access and facilities to help residents who are disabled. There is ramp at the front door to help with wheelchair access. All the residents are white British, but the owners said if a resident from a minority group was to be admitted to the home, they will make sure to have as much information as possible by researching this group to meet care and dietary needs. Resident’s health care needs are met by involving health care professionals. Two GP’s have returned their survey cards. They were both satisfied with the services at the home. One has commented “ excellent standards of care and communication.” District nurse and chiropodist visit when required. The medications of two residents were audit trailed and were found to be correct. Residents who are able and willing can keep and administer their own medications. The home is sensitive to the needs of all the residents and does everything to help them remain as independent as possible. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 13 The staff said that their job is to work with the residents and meet all their needs. They said that they have very good relationships with all the residents. They were observed talking and helping the residents with sensivity and respect. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12.13.14 & 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are good arrangements to meet the social and recreational needs of the residents EVIDENCE: At the start of the inspection at 10 am, a few residents were still having their breakfast. The owners said that residents do not have to get up at specific times and that they get up when they are ready. Several residents were in the lounges whilst others were in their rooms. They said that they can please themselves as to what they do. The staff said that they assist the residents to do what they like. One resident was going out and she appeared to well dressed and had make up on. Activities include Tai Chi, Bingo, board games etc. A Tai Chi session was held during the inspection. The owners said that some residents went to Blackpool recently and a trip is being organised to an East Lancashire shopping outlet. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 15 The staff said that they try and meet residents’ individual needs. They said that if residents wanted to go for a walk or do something, they would try to oblige. The residents said that they do what they want and that the staff are very helpful and would assist them when required. The residents said that the food is very good and that they are offered choices at all mealtimes. On the day of the inspection, the choices for lunch were Turkey and Ham Pie or Beef Bourguignon. A choice of potatoes and vegetables were also offered. The management of the home is fully involved in serving the meals to the residents. During lunch, a member of the management team also went round taking orders for next day’s lunch. Meals are served in the dining room, which is well furnished and decorated. Residents may eat in the lounges or in their rooms if they prefer. There is a good choice of food to choose from at breakfast and teatime. Most of the residents have their breakfast in their rooms when a continental breakfast is served. If residents want a cooked breakfast, then this is served in the dining room. Records of meal served examined show that a good variety of meals are offered to the residents. The chef said that within reasons, she will cater for every taste. She said that she is able to cook food to suit ethnic needs and if she did not know how, she will try and find out. The records of meals showed that residents have been offered curry, spaghetti, lasagne and moussaka in the past. Residents are offered hot drinks at regular intervals during the day. They can help themselves to cold drinks and fresh fruit, which are left in the lounges. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There are good policies and procedures to protect and keep residents safe. EVIDENCE: The home has a robust procedure for dealing with complaints. All complaints and incidents are recorded on a form as part of the quality monitoring system. Written information about how and who to complain to is given to residents or their families. The residents said that if they had any complaints, they would speak to the owners or the manager and had every confidence that their concerns would be dealt with. The owner said that the management team is always available to speak to the residents or their families. There are systems in place for staff to report any incident of abuse either by staff themselves or by families. All the residents appeared to be safe and free from harm, neglect and abuse. Staff were observed treating the residents with respect and dignity. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 17 The staff spoken to were aware of different types of abuse. One member of staff spoken to was able to describe abuse as being physical, emotional and financial. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The environment is safe and maintained to very high standard. Residents live in a clean and well kept home. EVIDENCE: During a tour of the building, the home was found to be well maintained and clean. Several residents were in their rooms during the tour and they said that they like to spend part of the day in their rooms either to rest or doing their own things. Several of them were watching television and said that they do not find it easy to do this in the main lounges. The residents said that staff brings them their afternoon tea and biscuits in their rooms. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 19 The owners said that there is a rolling a programme of maintenance and carpets are changed when necessary. The residents said that they feel safe living at the home and that their rooms are well maintained. There are policies and procedures regarding the handling of cleaning materials and infection control. Some staff have attended courses on the control of infections. The residents’ general comments were that the home is beautiful, clean and homely. The management of the home has made great effort in providing aids and adaptations to help residents with physical disabilities. Handrails have been fitted alongside the corridors to help residents with mobility. There are grab rails fitted to some of the toilets to help residents who are disabled. There are a selection of different baths and showers to enable residents to have a choice which one they want to use. The staff said that most residents prefer the shower in which they walk in and sit on a seat to be showered. A passenger lift, albeit on the small side is available for the residents to use independently if they wish. A motorised chair, which can move up the stairs, is used to help residents go upstairs if the passenger lift breaks down. A team of domestic staff is employed to do the cleaning and a handyman is also employed for maintenance. The home was found to be free from hazards and the residents said that they can get around the home safely. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 & 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The calibre and level of staff are very good. Residents are cared for by a team of trained staff. EVIDENCE: The number of staff on duty has been maintained to a good level to meet the needs of the residents. At the time of the inspection, there were 4 care staff, two managers, a cook and four ancillary staff on duty. Staff rotas checked showed that the staffing level is well above minimum recommended for the number of residents at the home The owner demonstrated a good understanding of the procedures to be followed when selecting and recruiting staff. The staff files examined show that appropriate checks had been carried out before offers of employment had been made. Such checks included CRB (Criminal Records Bureau) checks and a POVA (Protection Of Vulnerable Adults) check. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 21 Training records show that the staff at the Mayfair have attended several courses. These include: Abuse, Moving and Handling, First Aid, Medications, etc. Staff are also given basic training in Equality and Diversity as part of their skills for life training. Staff spoken to said that they treat all the residents with respect and accept any difference people may have. CSCI (Commission for Social Care Inspection) recommends that at least 50 of care staff achieved NVQ (National Vocational Qualification) level 2. The percentage of care staff at the Mayfair with this qualification is 64 and is commendable. The staff spoken to said that they enjoy working at the home very much. They said that the management is very supportive and listens to what they have to say. They said that the residents always come first and they work around what they want to do. The residents said that the staff are marvellous and will do any thing for them. There were good interactions between the residents and the staff. They all appeared to be happy and content The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A good management team runs the home for the benefit of the residents. EVIDENCE: The Mayfair is managed on a day-to-day basis by two of the registered owners Mrs Licia Pickvance and Mr Antonio Prada. The registered manager is Mrs Moira Robertson. The owners work in the home and are supported by the manager and a team of staff. The management of the home has made great improvements in the home both to the physical aspects of the home and the quality of care for the residents. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 23 There is an ongoing programme of maintenance and decorating. Several bedrooms have an ensuite facilities now. Baths and showers, which are easy for residents to access and use, have been installed. The owners said that the home has an open door policy and that residents and staff are always welcome to come and have a chat. The inspector had the full cooperation of the owners, the staff and the residents during the inspection. The inspection was carried out in a friendly environment and residents and staff said that the Mayfair is the best home. The inspector found that the management of the home is open to suggestions and will take on ideas to improve the services at the home. The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X X 4 X X 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 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 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 X 3 X 3 X X 3 The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 25 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. 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. Refer to Standard Good Practice Recommendations The Mayfair DS0000009685.V286285.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Mayfair DS0000009685.V286285.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!