Inspection on 31/07/06 for The Old Vicarage

This inspection was carried out on 31st July 2006.

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

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

Other inspections for this house

The Old Vicarage 11/07/07

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

CARE HOMES FOR OLDER PEOPLE The Old Vicarage Vicarage Gardens Featherstone Wakefield W Yorks WF7 6AH Lead Inspector Susan Vardaxi Key Unannounced Inspection 31st July 2006 08:50 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 Old Vicarage DS0000067007.V306177.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 Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Old Vicarage Address Vicarage Gardens Featherstone Wakefield W Yorks WF7 6AH 01977 708368 01977 708083 theoldvicarage@f2s.com 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) Calsa Care Limited Mrs Jean Chilton Care Home 30 Category(ies) of Dementia - over 65 years of age (30), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (30), Old age, not falling within any other category (30), Physical disability over 65 years of age (30) The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19/01/06 Brief Description of the Service: The Old Vicarage is a detached a four-storey building, situated in Featherstone near Pontefract. The home was refurbished to provide accommodation for 30 people over the age of 65 years who may have dementia and mental health needs, physical disabilities and requiring personal care needs. The building with a newer extension is set in its own large grounds and is in close proximity to local amenities including post office public house and shops. Public transport is easily accessible with bus stops located a short walk from the home. The service users’ accommodation is set on three levels with two lifts for access. Twenty-four of the thirty places provided are single accommodation only one of these has a toilet facility. The three-shared rooms have toilet facilities. Toilet and bathing facilities are located on all floors. The manager occupies the fourth floor of the building. The fees charged in July 2006 were £359. Hairdressing and chiropody are charged in addition to the fees. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There has been a change to the ownership of The Old Vicarage since the last inspection. The home is currently owned by Mr Jagjit and Mr Gurdip Singh and registered under Calsa Care Limited; the name of the home is unchanged. This was an unannounced key inspection, which was completed on two days over a period of 15 hours. Both visits included talking with service users, relatives, staff and the new providers and manager. Some records were inspected; a tour of the building completed and lunch was taken with the service users. At the inspection “Have Your Say” comment cards were left at the home for service users to record their views of the service. None have been received. Five comment cards returned by relatives/visitors were generally positive; some comments were discussed further with those who participated. Two GPs and two social care coordinators had also taken part in the Commission’s survey, the outcomes were positive. Eleven staff have NVQ levels 2 & 3 qualifications. The inspectors would like to thank the service users/relatives and all who participated with the overall inspection process for their co-operation. What the service does well: Information provided on completed survey questionnaires and discussions at the home show that they are satisfied with the service provided. All service users have contracts, which are being revised under the new ownership. Health care arrangements are satisfactory. A visiting district nurse said they did not have any concerns about the care provided. A notice in a local newspaper from a relative thanking staff for “their first class care” and “love of their relative” during their illness was seen at the home. The service users were joined for lunch on the first day of the inspection, those spoken with said they had enjoyed the meal, wastage was minimal. Adult protection referrals had been made appropriately. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The arrangements for storing, recording and administering medications need to be reviewed to ensure safe practice and procedures are in place and followed and a requirement has been made in respect of this. The staffing arrangements must be improved. There must be sufficient staff on duty at the peak times of the day to ensure that they are able to meet service users’ personal hygiene needs and assist them to eat their meal adequately. Care plans need to include the action staff must take to meet service users needs i.e. preventive action for pressure area care and promoting continence. Mental health and training to care for people who have disabilities must be provided to ensure service users’ needs are met. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 7 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 Old Vicarage DS0000067007.V306177.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 Old Vicarage DS0000067007.V306177.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): 1,2,3,4 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. Service users are provided with adequate information about the service they will receive. The arrangements for assessing service users’ needs prior to their admission are satisfactory. Intermediate care is not provided. EVIDENCE: The statement of purpose and service user guide were revised when the home was registered under the new ownership of Calsa Care Limited in June 2006 and were satisfactory. Copies of service users’ contracts held on file were checked; the providers said they are currently being reviewed. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 10 Records seen showed pre admission assessments had been completed and service users had been informed in writing that the home could meet their assessed needs. The Old Vicarage DS0000067007.V306177.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): 7,8,9,10,11 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the visit to this service. Risk assessments and care plans need to be developed further to ensure service users’ needs are identified and met. The arrangements for referring to health care professionals are satisfactory. The arrangements for storing, recording and administering medications need to be reviewed to ensure safe practice and procedures are in place and followed. EVIDENCE: Some care plans seen had been reviewed monthly. The care plans seen for service users admitted since the last inspection had been generated from the assessed needs. However, some risk assessments had not been completed for the preventative action to be taken where service users are unable to mobilise without staff’s assistance. Some care plans did not include specific action staff should take to ensure needs are met particularly for pressure area care and continence control. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 12 Risk assessments had been completed for manual handling, falls and nutrition on records seen. Records seen showed the GP, district nurse, chiropodist and opticians’ visits are arranged when required. A visiting district nurse said they did not have any concerns about the care provided. Nutritional assessments and records of weights had been completed. The manager said she had completed full audits of medications the most recent on 3rd August 2006. A record of the outcome was seen which showed some discrepancies regarding staff signature omissions and some analgesics in stock had not balanced with the records. She had completed an action plan to rectify this. The manager said the medication trolley is not used when transporting medications to service users sitting in a small lounge due to a slope between the two lounges. She said tablets are put into individual pots with service users names inside and then carried through to the lounge on a tray. The risks when using this practice of transporting medications was discussed with the manager who said this practice would stop immediately. Two medication trolleys were said to be in use, one trolley for storage of blister packs for daytime medication administration, the other for blistered medication administered at other times of the day. The manager said this was because of the volume of medications. All boxes of medications had been put into a plastic storage basket, which is then transferred between two trolleys as required throughout the day. It was recommended at the inspection that the manager contact the local pharmacist for advice in respect of safe storage arrangements. The manager said the GPs review service users’ medication annually or at the time needs change. The home has a complex medication policy, which is stored in the office; the policy does not give details of the arrangements for transporting medications throughout the home. On arriving at the home at 8:50am on the first day of the inspection, 23 service users were up, dressed, some were having their breakfast. It was seen that a service user was being shaved. It was seen that some service users’ personal hygiene needs had not been attended to. A substantial improvement in the standard of personal care given was seen on the second inspection visit four days later. The manager and providers said training in respect of death and dying was planned for some staff. The inspector was shown a notice put in local The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 13 newspaper by relatives thanking staff for the “first class care the home had given their relative” and of “the love given by staff” during a service user’s illness. The Old Vicarage DS0000067007.V306177.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 adequate. This judgement has been made from evidence gathered during the visit to this service. The records indicate that service users’ choices in respect of times to get up are respected, however their dignity will be compromised where there are not enough staff on duty to meet service users’ personal needs appropriately. Service users and relatives are satisfied with the meals and overall service provided. EVIDENCE: On arrival at the home on the first day of the inspection twenty-three service users were up, dressed and were having their breakfast. Some service users had not had all their personal care needs met. A member of staff spoken with said there were seven service users who needed assistance to get up when she had started work at 8am. This showed that night staff had got most of the service users up on the day of the inspection; there are only two staff on duty at night. There was a substantial improvement seen at the second inspection visit. Service users looked well groomed, comfortable and relaxed. The times that service users preferred to get up were seen recorded in their care plans. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 15 Prior to the inspection the providers and manager had arranged a garden party to be held in the grounds of the home, the event had been recorded on a DVD and many photographs had been taken. A visitor was seen playing dominos with their relative; they said they were satisfied with the care. There were a number of relatives visiting the home on the two days of the visit, those spoken with said they can visit at anytime, they made positive comments and said they were satisfied with the care provided. A service user unable to verbally communicate showed “thumbs up” when they were asked if they had enjoyed their lunch. A service user said the new providers were “lovely, very good” and they had bought everyone a box of chocolates and a card when the home had changed ownership. The providers said they are planning to introduce more internal and external activities and social opportunities for service users and a discussion took place about introducing reminiscence activities. Some service users’ personal allowance records seen recorded that advocacy has been arranged for them. However, the arrangements for some service users need to be confirmed to ensure that their money is always available for them. At the first visit the food items for service users breakfast were seen placed on a trolley, which was unattended, in a small lounge adjacent to the dining room and consisted of a pan of porridge, a large box of cereals. The presentation of breakfast was substantially improved on the second visit. The inspector joined some service users for the meal served at lunchtime on the first visit. The meal consisted of corned beef hash, and vegetables, and a pudding, the cook said service users had requested the meal. The service users said they had enjoyed the meal and there was little wastage seen. Some service users appeared to be having some problems keeping the meal on their plate. The Old Vicarage DS0000067007.V306177.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): 16,17,18 Quality in this outcome area is good. This judgement has been made from evidence gathered during the visit to this service. The home has systems in place that ensure that complaints are dealt with appropriately. Service users’ right to vote are respected. EVIDENCE: A complaint had been made to the Commission prior to the inspection, which is currently being investigated by the providers. The complaints procedure seen had been changed to include the names and contact details of the new providers. Some comment cards received from relatives after the inspection showed that they were not aware of the home’s complaints procedure. The providers have introduced a suggestion box, which is located in the entrance to the home. The manager said all service users are registered on the electoral register and most use the postal voting method. She said a service user always went to the polling station. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 17 An incident had occurred at the home between service users, and the manager made a referral for investigation under Wakefield Metropolitan District Council Adult Procedures. The incident, which was progressed through care management procedures, had been dealt with appropriately. Staff spoken with said they had not had adult protection training. The manager said this had been arranged. The Old Vicarage DS0000067007.V306177.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): 19,22,23,24,26 Quality in this outcome area is adequate. This judgement has been made from evidence gathered during the visit to this service. The general maintenance of the overall environment and replacement of fabrics and furnishings are generally satisfactory. EVIDENCE: A walk round the environment showed that the home is generally well maintained. The providers said they are planning to introduce a maintenance programme and a five year development plan for the replacement of fabrics and furnishing will be introduced and be available for inspection if needed. The providers said they had requested the fire officer to visit the home for advice when the home changed ownership. They said there were no concerns raised and the fire officer had been satisfied with the locking devices on the doors leading onto hallways. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 19 The laundry room was seen to be clean and tidy, no risks of cross infection were observed. All service users’ bedrooms seen were generally clean and comfortable and had been personalised by furnishings taken in on admission. The providers had purchased a mobile air conditioning unit, which had been put in the large lounge during the very hot weather. On the day of the inspection it was observed that staff were still unable to identify the source of the emergency call when it is operated on the first floor and in the basement. However since the inspection the new providers have informed the Commission that a complete new system has been installed. At the time of the first visit there was an odour of urine noted throughout the home. At the second visit a substantial improvement was noted, the providers and manager said carpets and upholstery had been cleaned. The Old Vicarage DS0000067007.V306177.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 adequate. This judgement has been made from evidence gathered during the visit to this service. The current staffing arrangements do not ensure service users’ needs are met on rising and retiring. Staff recruitment procedures appear to be adequate to ensure service users would be protected. Training opportunities are provided. However training in respect of dementia and mental health illnesses and disabilities is needed to ensure service users’ needs are adequately met. EVIDENCE: Some staff rosters seen showed that staffing levels had been reduced on occasions. The manager’s hours are included on the roster. On arrival at the home on the first day of the inspection it was seen that service users’ personal hygiene needs had not been met appropriately, three staff were on duty, one responsible for administering medications, a carer spoken with said there were 8 service users up when she and other day staff started work at 8am. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 21 Staff files seen showed that application forms are completed, staff applicants attend interviews at the home and CRB checks are completed, the providers said they are currently undertaking recruitment checks for an application recently made. They said there are recruiting an applicant was able to use “sign” which is the method of communicating with people who are deaf. Staff training records seen showed training including NVQ training has been provided on a regular basis. A record of staff training provided to date show eleven staff have NVQ qualifications levels 2 & 3 and seven staff are currently working towards completion. However, not all staff have had dementia or mental health training and this was discussed with the manager at the inspection. The Old Vicarage DS0000067007.V306177.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 good. This judgement has been made from evidence gathered during the visit to this service. The manager has the appropriate experience and qualifications to manage the home. The arrangements for enabling service users, relatives and staff to be involved in the running of the home are satisfactory. The arrangements for ensuring the safe handling of service users personal allowances are not satisfactory particularly where service users lack mental capacity and are unable to make informed choices. EVIDENCE: The manager has more than two years management experience and NVQ management qualifications. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 23 The providers work in the home most days, copies of letters sent out to service users, staff and relatives inviting them to attend a meeting to introduce themselves were seen prior to the inspection. A large garden party had been held at the home prior to the inspection, relatives had been invited. The providers have installed a suggestion box in the entrance area to the home to encourage all visitors, relatives, staff and service users to given their view on the service provided. Records seen and staff spoken with confirmed that formal supervision is held regularly. The providers have introduced a new system for recording and storing pocket monies for hairdressing, chiropody etc. Some records and cash balances were checked and no discrepancies were seen. Receipts for purchases had been obtained records and receipts obtained. The records showed that some service users personal allowances were not always in credit, the providers said they would always ensure service users were able to access the hairdresser and chiropody. The arrangements for handling some service users’ finances need to be confirmed to ensure that their personal allowance is always available for them. Throughout the inspection no environmental risks were seen. However, medication storage arrangements were not satisfactory, this has been addressed fully in standard 9. Mandatory training has been provided; the manager said updates were being arranged. The system check records were not seen on this visit, these records will be fully examined at the next inspection. The Old Vicarage DS0000067007.V306177.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 3 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 1 9 1 10 1 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 3 18 3 3 x x 3 3 3 X 3 STAFFING Standard No Score 27 1 28 3 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 2 3 X 3 The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15(1) 13(4)(c) Requirement The registered person must ensure that the service user’s plan sets out the action that needs to be taken by staff to ensure all aspect of their needs are met. The registered person must ensure that risk assessments are completed and action required included in the care plan for the prevention of pressure sores. The registered person must ensure that medication is administered and stored safely and accurate records are kept. Previous timescale of 28/2/06 not met. • The medication policy must be revised and stored where it is accessible to staff at all times. The pharmacist must be contacted for advice regarding the safe storage of medications. Medications must be transported throughout the home to service users safely. Version 5.2 Page 26 Timescale for action 31/08/06 2 OP8 12(1) 31/08/06 3 OP9 13(2) 31/08/06 • • The Old Vicarage DS0000067007.V306177.R01.S.doc 4 OP10 OP15 12(4)(a) 5 OP27 18(1)(a) The registered person must ensure that service users are assisted in a manner that protects their dignity. The registered person must ensure that an adequate number of care staff are rostered at all times of the day and night to meet service users needs. Previous timescale of 31/2/06 not met. The registered person must ensure that all staff receive ongoing training appropriate to the work they are about to perform. 31/08/06 31/08/06 6 OP30 18(1)(i) 31/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard OP15 OP16 OP35 Good Practice Recommendations Adapted cutlery and crockery should be provided for service users who are observed to have difficulty eating their meal independently. The revised complaints procedure should be distributed to service users and their representatives. The registered person should ensure that advocacy arrangements are made to ensure the safe handling of service users monies particularly when they lack mental DS0000067007.V306177.R01.S.doc Version 5.2 Page 27 The Old Vicarage capacity and are unable to make informed choices. The Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Old Vicarage DS0000067007.V306177.R01.S.doc Version 5.2 Page 29 - 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!