Inspection on 04/05/05 for The Regency Nursing Home

This inspection was carried out on 4th May 2005.

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 Regency Nursing Home 19/01/10

The Regency Nursing Home 01/12/08

The Regency Nursing Home 01/12/06

The Regency Nursing Home 07/11/05

The Regency Nursing Home 24/01/05

The Regency Nursing Home 27/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Regency St Helens Parade Southsea, Portsmouth Hampshire PO4 0QJ Lead Inspector Mark Sims Unannounced 4th May 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Regency Version 1.10 Page 3 SERVICE INFORMATION Name of service The Regency Nursing and Residential Care Home Address St Helens Parade, Southsea, Portsmouth, Hampshire, PO4 0QJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 02392 820722 Mr Michael Raven and Julia Christine Raven Mrs Hazel Adeoye Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26), Terminally ill over 65 years of age (26) of places The Regency Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24/1/2005 Brief Description of the Service: The Regency Nursing Home is currently registered to accommodate 26 service users under the registration categories of Older Persons (OP) and Terminal Illness (TI), both categories registered in respect of 26 places. The Regency is situated along St Helens Parade, Southsea and is a short walk from the attractions of Southsea front and pier, although the amenities of the town are less readily accessible. Transportation links in and around the nursing home are good, with several local providers operating buses nearby and taxis can be accessed along the front. The property is a period town house, which has been adapted to accommodate patients, offering a passenger lift to all floors and ramped access where required. The bedrooms are a mix of single and shared accommodation and communal facilities include a dining room, lounge and sun-lounge. The Regency Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and formed the first visit of this year’s inspection programme. This was the inspector’s first visit to the home and the inspection lasted 6 hours, providing time for the inspector to familiarise himself with the environment, meet with key staff and generally spend time socialising with service users. What the service does well: What has improved since the last inspection? What they could do better: Some minor remedial works were identified during the tour of the premises, although these were not significant enough to warrant making them subject to either requirements or recommendations. The Regency Version 1.10 Page 6 The manager and proprietor have undertaken to address the issue prior to the next inspection. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Regency Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection The Regency Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 1, St 2, St 5. The home provides prospective service users and their representatives with access to both a statement of purpose and service users’ guide. In discussion with service users it was clear that they were supported in choosing/assessing the suitability of the home by relatives and representatives. EVIDENCE: In discussion with Mrs Raven (proprietor) it was established that no changes have been made to the home’s service users’ guide or statement of purpose documentation, which from a review of previous inspection reports and Commission data were noted to be acceptable documents that gave people a good insight into the services and facilities on offer at the home. It was also clear that it is the practice of the home to supply copies of the service users’ guide to all prospective service users on admission to the home and that this formed part of an information package, which also includes the contract, terms and conditions, a signed copy of which is maintained on the patient’s in-house file. The Regency Version 1.10 Page 9 During a tour of the premises the opportunity to stop and meet with several service users arose and led to lengthy conversations about the home, staff and general benefits of residing at The Regency. During one of these conversations the service user was very clear about how she came to live at the home and that she had been supported by relatives in selecting The Regency, her family visiting several homes in the area before deciding upon The Regency. The patient added that she thought her family had made a good choice and that she had enjoyed her time at the home. This kind of conversation was repeated on a number of occasions and was underpinned by the comments of a service user’s relative met in the lounge, who confirmed her involvement in scrutinising the home prior to her relative being admitted. The Regency Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 7, St 9, St 10. The matron/manager has introduced a comprehensive and individualised care planning package for service users. The home’s approach to the management and storage of service users’ medications was appropriately robust and secure. As part of the comprehensive care-planning programme details of people’s funeral wishes in the event of their deaths whilst resident at the home are gathered and documented. EVIDENCE: Five care plans were reviewed as part of the inspection process, each containing patient specific information such as photos for identification purposes, care plans, risk assessments, admissions sheets, running records, moving and handling assessments, details of funeral arrangements and wound charts, etc. The level of detail within each plan was felt generally to be good, and there was evidence that the plans were being regularly reviewed and updated, and that the service users or their representatives were involved in the review process. The Regency Version 1.10 Page 11 In conversation with some of the clients it was unclear how much they knew about the records the home maintained, regarding their care needs or how much involvement they felt they had in the review process, most people apparently happy to allow family or representatives to oversee such issues. The home’s medication system was audited as part of the inspection and found to be well organised and structured with clear systems for ordering and receiving medications into the home, appropriate storage facilities both within the individual’s bedrooms, or more commonly within the nursing office, a specific fridge for storing medications below room temperature and accompanying temperature checks, medications dispensed as part of a Monitored Dosage System (MDS), Medication Administration Records (MAR) sheets completed accordingly, copies of medication policies and procedures at the beginning of the MAR sheets files, a medications returns system operational, and a homely remedies programme agreed with a local General Practitioner, enabling some basic medications to be given, on a limited dosage arrangement, without an underpinning prescription being generated. As highlighted within the opening paragraph of this section the home seeks to establish if service users have any preferences or have made any funeral arrangements in the event of their death, any information collected is entered onto a specific chart and made available to staff, as part of the service user’s plan. In addition to the records kept by the home, staff also gain insight into issues around death and dying at induction and via National Vocational Qualification (NVQ) courses, where issues of respect, dignity and supporting people are amongst some of the core values considered, along with more specific optional units which consider specifics relating to death and care of the person following death. Eighteen of home’s care staff, according to their training records, have completed NVQ at level 2 or above. The Regency Version 1.10 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 12, St 13, St 15. The home employs an activities co-ordinator (part-time) to oversee the activities and entertainments for service users. Service users have the opportunity to maintain contact with families and friends both in person, as part of home’s approach to visiting and via telephone or correspondence. The catering arrangements within the home ensure service users receive a varied and appealing menu. The food prepared on the day of the inspection appeared appetising and nutritionally well balanced. EVIDENCE: During the tour of the premises a schedule of forthcoming entertainments was noted to be on display within the main reception area of the home, bringing to the attention of service users a number of varying events. The home also had on display a series of photographs from an in-house event in support of comic relief, the photos evidencing the involvement of both service users and staff in the raising of funds for the charitable event. The Regency Version 1.10 Page 13 The home also employs an activities organiser, who was on duty on the day of the inspection and who discussed some of the entertainments he arranges, both on an individual basis as well as on a group footing. During the inspection the activities co-ordinator was involved in playing bingo with a difference, as he used playing cards drawn from a pack to indicate the symbol to be covered. This variation on a theme appeared to be very appealing to the patients with a large number of people participating in the game, although the inspector managed to distract some people whilst playing along. Later in the afternoon the activity being played had switched to a more physically challenging game of hoopla, which again appeared popular with those participating. Whilst touring the premises and meeting with people in their own rooms the topic of activities and events ongoing in the home arose, with one lady very clear about her appreciation for the time the activities co-ordinator spends with her playing cards and chatting. Throughout the day a number of visitors were noted arriving at the home and in conversation with one person it was established that the visiting arrangements of The Regency suited her and her relative, the home having a generally open visiting policy. The visitor was very pleased with the home and felt that her relative was well cared for and well supported by staff, who were felt to be welcoming and approachable. Details relating to the home’s visiting are contained within both the service users’ guide and statement of purpose document, as specified within the relevant legislation and good practice guidance documents. Mealtimes within the home are mainly social events with the majority of service users eating within the dining room/sun lounge area. Unfortunately the home does not have sufficient space to enable all of the service users to eat together, although a large body of the people residing at the home are either unable to sit at a table or prefer to eat elsewhere within the home. Several of the service users met within their rooms confirming that they prefer to remain within their own accommodation even for meals. Generally the food served appeared to be well balanced and well presented. The Regency Version 1.10 Page 14 The menus operate on a five weekly rotational basis and are created with the service users’ preferences/likes or dislikes taken into account, alongside factors such as seasonal vegetables, etc. In discussions with the cook it was pleasing to discover the efforts made by the home to support people with their dietary requirements, including a document completed on admission to the home and passed to the catering team, which details all dietary information, likes/dislikes, special diets, preferences, etc. The information gathered by this process is then transcribed onto a white board within the kitchen for quick reference purposes, although the cook stated that after a few weeks you get to know what people like and do not like. The kitchen itself was found to be extremely well run and organised and considering that the cook was in the midst of preparing the midday meal remarkably clean and tidy. The food stores for the home were plentiful and came directly from Sainsbury’s to the home, all orders placed over the internet and storage facilities were adequate for the needs of the home. The Regency Version 1.10 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 16. The home operates a complaints process, which includes records of complaints received and outcomes taken to address issues identified. EVIDENCE: Details of the home’s complaints procedure are contained within both the service users’ guide and statement of purpose documents. Any complaints received are, according to the proprietor, taken seriously and appropriately documented within the home’s complaints log, which records basic information about the complaint received. On reviewing the complaints logging book it was apparent that staff actively record basic information in relation to complaints and that the management team then transfer this information into one of two files, a service user specific and staff specific complaints file. The information contained within the files is more comprehensive and sets out what the management has done to remedy the situation, including investigations and outcome letters, meetings, etc. The latter files are not open for public scrutiny and are maintained separately from the logging book used by staff. As the inspection took place so close to the general election it was pleasing to note that people were being given the opportunity to participate in the voting The Regency Version 1.10 Page 16 process. Two ladies spoken to during the visit confirmed that they had voted by post and in conversation with Mrs Raven it was established that everyone was registered on the electoral register and that a large number of people had requested to use the postal voting system. The Regency Version 1.10 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 19, St 21, St 22, St 23, St 26. The home is well maintained both internally and externally with evidence of ongoing refurbishment and redecoration work noted during the visit, including the creation of a new shower facility on the second floor. All areas of the home are accessible to service users via the passenger lift, which covers both main and mezzanine floors, in addition to this large scale adaptation the premises also contained grab-rails, hoists, ramps and wheelchairs. The accommodation within the home is a mix of shared and single occupancy bedrooms, with many showing touches of individuality associated to the occupant. The tour of the premises revealed a property that was generally clean and tidy throughout and which is adequately maintained by the domestic staff team. EVIDENCE: The Regency Version 1.10 Page 18 A tour of the premises was undertaken with one of the proprietors who was able to talk the inspector through the ongoing redecoration programme, which presently was concentrating on repainting external aspects of the property and the refurbishment of an upstairs bathroom, which when finished would provide the service users with access to an additional shower facility. Minor remedial and redecoration works are undertaken by the home’s maintenance person, who attends to both routine and emergency jobs in order of priority, all maintenance issues identified are documented in a specific maintenance logbook with the jobs signed off once completed. All areas of the home are accessible to patients and their representatives, as the passenger lift services both the main and mezzanine floors of the premises, the annex is accessible via a ramp and level access to the property is possible from the street. Observations of people’s movements around the home during both the tour of the premises, and latterly when talking to service users and their visitors, confirmed that people were happy and confident in using the lift independently, although when required staff were available to assist service users. Whilst touring the home the opportunity arose on several occasions to stop and speak with the patients, often within their own bedrooms. During one of these conversations the inspector and service user discussed the benefit of the hospital style bed she occupied, which she felt gave staff the ability to engage in moving and handling practices safely, as they could work at an appropriate height, enabled her to talk with people at a more convenient level and thus maintain eye contact and that the manoeuvrability of the bed allowed staff to move her out onto the patio if she wished. The Regency offers a mixture of single and shared accommodation, although no room is used to accommodate any more than two people. During the tour of the premises visits were made to several occupied bedrooms, some it was noted showing signs of having been personalised by the occupant(s), who used photos, ornaments, pictures and furniture from their own homes to create a sense of ownership and familiarity, whilst others showed little sign of alteration or modification by the occupant. One person spoken to did comment that it was difficult to fit a lifetime’s worth of possessions into a single space and that she had brought only those items of greatest significance with her into the home. It should be pointed out that the service user was not criticising the home or blaming anyone for the fact that she was unable to retain all of her possessions but was just talking about the practicalities of moving into a residential setting. The Regency Version 1.10 Page 19 Throughout the tour of the premises it was noticed to be clean and tidy, with the domestic staff team observed on several occasions undertaking their duties around the home. In conversation with service users it was established that the domestic staff are as supportive and friendly as the care staff and that they make time during their chores to talk and socialise with the occupants of the rooms. It was also noted whilst touring the home that signs are displayed in prominent positions instructing staff on the benefits of good hand washing and that liquid soap and paper towels were provided in staff facilities and key areas of the property. The Regency Version 1.10 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 27, St 30 Staff are deployed across three shifts and in sufficient numbers to meet the needs of the service users. The staff training programme takes into account both core and specialist training activities. EVIDENCE: A review of the home’s staffing rota identified that staff are deployed across three shifts per day, starting with a morning shift: 07.30 hrs to 14.00 hrs 1 qualified and 6 carers Afternoon shift: 14.00 hrs to 20.30 hrs 1 qualified and 5 carers Night shift: 20.30 hrs to 07.30 hrs 1 qualified and 2 carers. In addition to the care staff, the matron/manager and proprietor(s) are also available within the home and catering, maintenance, domestic and the activities co-ordinator are also employed. At no time during conversations with the service users did anyone raise concerns with regards to the numbers of staff available, with most comments about the staff being very positive and praiseworthy, with one lady very The Regency Version 1.10 Page 21 pleased with not only the level of physical care delivered to her by the staff but also very happy at the social stimulation provided by staff, who she described as keeping her abreast of local issues and news. The proprietor(s) and matron/manager continue to be committed to staff training and development, providing access to both core training such as moving and handling, first aid, fire safety, etc. as well as specific training events such as National Vocational Qualifications (NVQ). Currently eighteen out of the home’s twenty-six care staff have completed NVQ at level 2 and above, the matron/manager has gained her Registered Manager’s Award (RMA) and Mrs Raven is completing both an NVQ level 4 in care and the RMA. The management retain a record of the training undertaken and completed by staff and a matrix system is employed to track dates when courses are due for renewal and update. The Regency Version 1.10 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) St 31, St 32, St 38. The Registered Manager holds both an appropriate professional and managerial qualification. The atmosphere within the home is relaxed, comfortable and cheerful. Issues of health and safety are prominent considerations in the practice of the manager and proprietors. EVIDENCE: The matron/manager was not on duty when the inspector arrived, although out of a sense of commitment to the service she came into the home to meet with the inspector and offer assistance with the inspection process. The matron/manager is still relatively new to the service having only completed the registration process in January 2005. She is an experienced nurse who has previously managed other registered services and holds not The Regency Version 1.10 Page 23 only her professional qualification but also the Registered Manager’s Award, a specific management qualification developed for the health and social care sectors. Since taking up her new post, matron/manager has obviously worked hard at establishing good working relations with both members of the staff team and the proprietor(s), as evidenced by her interactions with all parties. She also appears to have a reasonable working relationship with external professionals and was witnessed supporting a visiting General Practitioner with her duties during the inspection. Generally the atmosphere within the home was good with people appearing to be relaxed and contented. Those involved with the activities co-ordinator were obviously enjoying their leisure time, whilst others appeared happy dozing, watching television, interacting with each other (on many levels) or socialising with visitors. The staff were noted to be in constant flux monitoring the activities and needs of the service users both within the lounge, sun lounge or their individual bedrooms. When socialising with the staff the inspector found them to be friendly and knowledgeable about the needs of the service users, although no specific oneto-one interviews with staff were undertaken on this visit. The issue of health and safety takes on many guises within a residential setting and not all aspects of this vast and complex area were reviewed at this visit. However, the issue of fire doors being held open by wedges, etc. was entered into with the management, as several doors throughout the building were noted to be held open by this means. The proprietor(s) offered assurances that the practice of the home is only to hold doors open in this manner when being used by staff or the service users and that once whatever the activity ongoing is completed the wedge is removed and the door shut. As this was the first visit to the home by the inspector and no similar concerns had previously been raised it has been agreed that a full review will take place at the next visit and the issue of wedges monitored. The inspection of the kitchen revealed that steps are taken to minimise the likelihood of the spread of infection/food poisoning by the catering staff, who monitor the temperatures of all foods served to patients, keep records of the fridge temperatures to ensure food is stored appropriately and date open food items to ensure it is disposed of appropriately if not used by the due date. The Regency Version 1.10 Page 24 In conversation with the cook it was established that at the last environmental health inspection the kitchen was found to be running so efficiently that a decision to re-inspect every other year was taken. The Regency Version 1.10 Page 25 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x 3 3 3 x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 x 3 3 x x x x x 3 The Regency Version 1.10 Page 26 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations The Regency Version 1.10 Page 27 Commission for Social Care Inspection Mill Court Furrlongs Newport PO31 2AA 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 Regency Version 1.10 Page 28 - 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!