Inspection on 14/02/06 for The Old Dairy

This inspection was carried out on 14th February 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 found no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Dairy 27/10/08

The Old Dairy 14/11/06

The Old Dairy 22/07/05

The Old Dairy 25/02/05

The Old Dairy 22/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Old Dairy (The) 11 High Street West Lavington Devizes Wiltshire SN10 4HQ Lead Inspector Malcolm Kippax Announced Inspection 14th February 2006 10:00 Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 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 Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Old Dairy (The) Address 11 High Street West Lavington Devizes Wiltshire SN10 4HQ 01672 562755 01672 569477 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) Cornerstones (UK) Ltd Miss Lisa Driscoll Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Any placement for short-term care or for an emergency placement must be agreed with the Commission before the placement commences. For the purpose of this condition, short-term is defined as a placement that is expected to last not longer than 3 months. An emergency admission is defined as an admission whereby someone is likely to be placed at short notice without an up-to-date assessment of needs having been carried out and the person has not had the opportunity to visit the home prior to placement. 22nd July 2005 Date of last inspection Brief Description of the Service: The Old Dairy is one of a number of care homes in Wiltshire that are run by Cornerstones (UK) Ltd. The Old Dairy is an old property in the village of West Lavington. Each service user has their own room and there are two communal rooms. There is a garden and a parking area to the front. A house vehicle is available for trips out. The Old Dairy is the service users permanent home for as long as this remains appropriate to their needs and wishes. Service users receive support from the home’s manager and a permanent staff team. Service users attend a range of activities in the community. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged at short notice at a time when the manager could be present. It took place from 10 am until 4 pm. The inspection focussed on a number of key standards that were not looked at during the previous inspection in July 2005. Service users were spoken with at different times during the inspection to fit around their day activities. Two service users were met with in the nearby village hall where they were attending an art and crafts session. One staff member was met with in the home. Another staff member was out for most of the day providing one to one support for a service user. The home’s manager, Lisa Driscoll, was available throughout the inspection. Pascale Orban, the Area manager from Cornerstones (UK), was also present for much of the time. Some changes have been made to the accommodation since the last inspection. Records were examined, including care and assessment, health & safety, staff training, medication and quality assurance. What the service does well: What has improved since the last inspection? There have been good developments in several areas, which show a better management overview and a better focus on improving the home. New and detailed care plans have been introduced, which give good information about the service users’ needs and preferences. Other guidance about health and personal needs has been produced in summary form for different occasions. During the inspection, two service users were enjoying a new art and crafts session that was taking place in the village hall. The home environment is improving through redecoration and refurbishment. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 6 Quality assurance has now been set up and Cornerstones (UK) is being more pro-active in assessing and improving standards in the home and the outcome for service users. A comprehensive staff training plan has been produced. 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. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 Prospective service users are helped to get to know the home before moving in. (Standard 2 did not apply at this time as no new service users have moved into the home). EVIDENCE: Shortly before this inspection, the manager had informed the Commission of plans that were being made for the admission of a new service user from another Cornerstones (UK) home. This person was visiting The Old Dairy at the time of the inspection. A file had been set up that contained personal information and copies of letters that had been sent confirming the preadmission arrangements, including an overnight stay. The manager said that the visits were an opportunity to see and assess the suitability of the home for this person. The staff team had started to complete an assessment of needs record. Information was being collected for inclusion in a personal Service User’s guide. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 A new style of care plan is providing better information about the service users and their needs. Some further developments will be beneficial. Service users receive support in making decisions about their lives and with being safe in what they do. (Standard 6 was looked at and almost met at the last inspection). EVIDENCE: Care plans were seen at the last inspection and were looked at again as a new style of care plan has since been introduced. Three examples of the care plans were looked at. These included sections covering ‘Personal details’, ‘Strengths and needs’ and ‘Likes and dislikes’. There was no contents sheet to help locate the different sections, or a date confirming when the plan was originally written. The main section described a service user’s daily routines and their need for support in good detail. Within this section there were references to risk assessments that had been undertaken. This is good practice, although the assessment records were not directly cross-referenced. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 10 The service users’ goals were recorded in another section within the care plan. One service user’s goals were specific and measurable. Goals recorded in the other two plans were of a more general nature, e.g. ‘to remain as independent as possible’ and ‘to continue interacting socially’. The ‘Goals’ part of the care plan did not include a section for the recording of progress and relevant dates, such as when the goals has been met. The overall care plan did not include a review section. The manager said that the care plans would be reviewed six-monthly and at regular staff team meetings. There was no written guidance about implementing the new care plan system. The manager said that the system had been discussed at a team meeting. The risk assessments were kept in a separate file. The majority of assessments seen had been written or reviewed in the last three months. The assessments referred to the benefits of a particular activity, as well as identifying the hazards. This is good practice. Some of the risk ‘scores’ sections had not been completed. Safety measures were identified although the forms did not always include a concluding statement about the outcome of the assessment and whether any further safety measures are needed. A ‘Vineland’s assessment has been undertaken with some service users since the last inspection. This appears to have been useful in giving further information about the service users’ needs and their likely progress in developing skills. The manager said that service users were encouraged to make decisions, although house meetings were not a good forum, as some service users found these difficult to manage. Instead, a ‘Comments book’ had been set up, as an alternative to meetings and which staff use to record relevant information that service users have mentioned. This appears to be a good means by which the service users’ views can be heard and recorded on an informal basis. Recent entries included comments made by service users about things that they would like to do, such as going on a train. The entries included an ‘Action’ section, where some information was recorded about how this would be followed up, but not always whether it had been achieved. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Service users are encouraged to be independent within their capabilities. Service users have meals that they enjoy and can help with their preparation. (Standards 12, 13 and 15 were looked at and met at the last inspection). EVIDENCE: As reported under standard 9, risk assessments are being undertaken which help to ensure that service users can participate safely in activities that may involve a degree of risk. The care plans include some clear statements about some restrictions that have been agreed about what the service users can and cant do, in areas that could be seen to affect their individual rights. These were mainly in place for safety reasons, such as the need for staff support when in the community, or because of personal circumstances and family relationships, in which case a care manager had been involved. An individual approach was evident in some separate guidance that had been produced about each service users’ likes and dislikes and what is important to Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 12 them. This was designed for staff and others who may not know the service users so well. Using the headings, ‘Red, Amber and Green’, information was prioritised according to its importance. Details of the service users’ planned activities are recorded on their personal files. These reflect the their different interests and how they wish to spend their time. On one day a week the village hall is hired by Cornerstones (UK) and an arts & crafts session is held with service users. Two service users showed their work and liked this activity, which is within walking distance of the home. During the inspection service users were using the kitchen for making drinks. Service users make breakfast with varying degrees of supervision. Particular preferences and some health related matters are recorded in the care plans. The manager said that there were no special diets needed although an appointment had been made for a service user to see their GP because of an increase in weight. It was hoped that a referral would be made to a dietician. Menus are decided on each week with service users and a record kept of the meals served. The record showed that sometimes service users have an alternative meal to the one planned. Details of some meals were sketchy and lacked detail. The sweet course was not shown. The manager said that fruit was available. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 20 Service users receive the support that they need with their health care and medication. (Standard 18 was looked at and almost met at the last inspection). EVIDENCE: Each service user had a health file, of which three were looked at. These included forms for the recording of visits to GPs, dentists and other healthcare professionals. Service users had each had appointments within the last four months. One service user had recently attended a specialist unit for an annual check up. The service users’ daily records include a checklist for personal care, such as ‘teeth’. Boxes had been ticked, rather than including a comment about what had actually been done or needed to be done. Since the last inspection, a booklet, ‘My Health’ has been produced to give relevant information should a service user need to leave the home or be admitted to hospital, etc. These looked very useful. A monitored dosage system is used for medication. None of the service users manage their own medication. Staff members administer the medication from Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 14 cassettes that are kept in a locked facility. The pharmacist had visited the home in October 2005 and approved the arrangements. The records of administration were up to date. A change in the way that medication is recorded coming into the home was discussed with the manager. The manager confirmed that no medication was being prescribed on a PRN (as needed) basis. The GP had signed and approved a list of homely remedies. This covered all the service users except one and the manager said that approval would be followed up for this person. Staff members receive training through ‘Protocol’. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Staff members listen to the service users’ concerns although it is not always clear how these have been followed up. Staff members receive guidance about the protection of vulnerable adults, although some information is no longer relevant. Service users will be better protected by the development of an appropriate policy and procedure. EVIDENCE: The service user’s guides include a complaints procedure in pictorial version. The manager said that service users vary in their understanding of how to make a complaint. Some service users would find it difficult to act independently. A ‘Complaints log’ book is being maintained. This included details of a complaint that had been made by a neighbour in connection with recent work in the garden. Most entries concerned complaints that had been made by service users. These varied in significance. The concerns had been logged and some included a comment about what had been done at the time to help the situation. There was a lack of information, for example about the outcome of the complaint and the action being taken to resolve the matter in a systematic way. The use of a complaint form with sections would help ensure that all details are recorded. The manager said that some complaints concerned matters that were being resolved through the use of behavioural guidelines and strategies. Staff members have received the ‘No Secrets’ booklet on the protection of vulnerable adults. The staff team received training through the vulnerable adults unit in 2005. The home’s policies and procedures file contained some Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 16 other documents relating to abuse and POVA. One of these referred to the procedures under the Registered Homes Act 1984. Other information had not been updated to reflect current arrangements. The manager said that there was no organisational policy about abuse and the protection of vulnerable adults. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not looked at on this occasion, other than to follow up the requirements that were made at the previous inspection. (Standards 24, 26, 27, 28 and 30 were looked at during the previous inspection. Standard 28 was met and standards 24, 26, 27 and 30 were almost met). EVIDENCE: There have been a number of improvements in the accommodation and facilities since the last inspection. These include new floor tiles in the hall and the refurbishment of the lounge, where the décor has been updated. There is a new toilet and a new shower. The condition of the garden has improved and new fencing erected. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Over 50 of the staff team are well qualified. Service users will benefit from the home’s new staff training plan. Its implementation will need to be planned on an individual basis. (Standard 34 did not apply at this time as no new staff members have been employed. Standard 33 was looked at and met at the previous inspection). EVIDENCE: The staff team of six includes four support workers who have achieved NVQ level 3. The manager said that staff members are currently being ‘re-inducted’ and that L.D.A.F. accredited training is available to new staff members. Some new induction booklets have been produced. A staff member spoke about the training she had received although her records were not available in the home. Another staff member training record was looked at. This showed that during 2005, the subjects of physical intervention, bereavement, medication, communication, autism and Asperger’s had been covered in training events. The records prior to 2005 showed that the staff team have received training in first aid, food hygiene and fire safety. The manager said that Cornerstones (UK) has a training manager who is based in another of the care homes. A training policy had recently been produced. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 19 This sets out the training that staff will receive, under the headings of ‘Essential’, ‘Desirable’, ‘Specialist’ and ‘Mandatory’. Priorities are identified for the training events that a staff member needs to attend during their first year. The training plan looks very comprehensive. Individual training needs assessments and plans for staff will help to ensure that each staff member receives the training that they need, as set out in the training policy. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Service users benefit from an experienced manager who is undertaking a relevant qualification. Quality assurance has received good attention during the last year and further developments will be beneficial. Systems are in place for maintaining health & safety, although there is a lack of clarity about responsibilities in this area. EVIDENCE: Miss Driscoll has managed the home for a number of years and has overseen a number of positive developments during this time. Miss Driscoll is currently undertaking the registered managers award. Quality assurance has been developed during the last year. There was documentation relating to an internal audit of the standards. A number of standards have been looked at to date, with action plans recorded. The audit Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 21 is due to be completed by the end of May. The manager said that in 2005, questionnaires were also given out to service users, families and community teams. Further information about this was not available in the home. There was no policy on quality assurance to provide an overview of the arrangements and show how the questionnaires and the audit are linked. The home’s fire log book was up to date, other than for fire instruction to a part-time member of staff. The manager said that she would be seeing this person later in the day and would give instruction at that time. Electrical checks (PAT and installation) had taken place in 2005. A C.O.S.H.H. file is being maintained. A monthly maintenance check had been recorded up to November 2005. The manager said that changes had taken place in health & safety responsibilities and it had not yet been decided who would be undertaking specific tasks. Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 N/A 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 N/A 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X 3 X 3 X X 2 X Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA22 Regulation 22 Requirement The registered person must ensure that all complaints are fully investigated and the outcome recorded. The registered person must ensure that a policy and procedure are produced for the protection of vulnerable adults. The registered person must ensure that guidance for staff about abuse and the protection of vulnerable adults is up to date and accurate. The registered person must ensure that all members of staff receive instruction in fire precautions at least once in every period of three months. That the names of people who have health & safety responsibilities are clearly identified. Timescale for action 15/02/06 2. YA23 23 31/03/06 3. YA23 23 31/03/06 4. YA42 4 15/02/06 5. YA42 13(4) 31/03/06 Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 24 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. 2. Refer to Standard YA6 YA6 Good Practice Recommendations That a contents sheet and dates are added to the care plans. That written guidance is produced about the use of the new system of care plans. This would include, for example, how the service users and others contribute to the plans and how the plans are to be reviewed. That the service users’ goals are more specific and records kept of the service users’ progress with meeting these. That an ‘outcome’ section is added to the entries in the Comment book That the risk assessments are numbered and more closely linked to the service users’ care plans. That the outcome of the risk assessments is more clearly recorded. That the menus contain greater detail of the meals that are prepared. That a comment, rather than a tick, is recorded on the service users’ daily care records. That complaint forms are used in preference to the complaints log book. That each staff member has an individual training needs assessment and plan which will show their progress with attending the relevant courses in accordance with the home’s training policy. That a policy on quality assurance is produced which shows the overall arrangements, with timescales identified. 3. 4. 5. 6. 7. 8. 9. 10. YA6 YA7 YA9 YA9 YA17 YA19 YA22 YA35 11. YA39 Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Old Dairy (The) DS0000060333.V283275.R01.S.doc Version 5.1 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. 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!