Inspection on 17/09/08 for The White House

This inspection was carried out on 17th September 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

Extracts from inspection reports are licensed from CQC, this page was updated on 09/11/2008.

CARE HOME ADULTS 18-65 The White House 91 Heathfield North Twickenham Middlesex TW2 7QN Lead Inspector Sandy Patrick Unannounced Inspection 17th September 2008 13:00p The White House DS0000070484.V371655.R01.S.doc Version 5.2 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 White House DS0000070484.V371655.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 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. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The White House Address 91 Heathfield North Twickenham Middlesex TW2 7QN 020 8744 0600 020 8891 0646 whitehouse.care@tiscali.co.uk 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) Richmond Fellowship Foundation International Miss Diana Bidwell Care Home 5 Category(ies) of Learning disability (5) registration, with number of places The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The Registered Person may provide the following categories of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 5 This is the first inspection of this service Date of last inspection Brief Description of the Service: The White House is a care home for up to 5 adults with a learning disability. Each person has their own bedroom. The home is located close to Twickenham and Whitton town centres and public transport links. The home is staffed twenty-four hours a day. The Registered Persons have produced a Service User Guide, which includes information on the aims and objectives of the service. People have their places funded by the Local Authority. The people who live at the home pay a contribution out of their benefits. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We visited the home on the 17th September 2008 and this visit was unannounced. We met with people who live at the home, staff on duty, the Manager and the consultant supervisor. We looked at records and the environment and saw how people were being cared for. We wrote to the Manager and asked her to complete a quality self assessment. We wrote to people who live at the home, their visitors and staff and asked them to tell us what they thought about the home. All the people who live at the home, two visitors and five members of staff contacted us. We looked at all the information we had received about the home, including notifications of incidents and accidents and reports from the provider. The home is newly registered with a new Owner, although it has been operating for some time and the people who live there have done so for many years. The Manager has worked at the home for two years. Some of the things that people told us about the White House were: ‘We have been greatly impressed with all aspects of the home.’ ‘My relative has lived at the home for over 10 years. During this time we have been extremely appreciative of the way they have been looked after – both physically and emotionally.’ ‘The philosophy of the White House is that it should be home in the true sense of the word.’ ‘We are entirely happy with the care.’ ‘I am always happy here.’ ‘I enjoy living at the White House and I am comfortable here.’ What the service does well: People are happy living at the White House. People have varied and active lives and try new things. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 6 Everyone is involved in planning menus, shopping, cooking and keeping the house tidy. There is information which helps the people who live at the home understand what is happening and which staff are working. The staff are well trained and supported. The Manager wants to make more improvements so that things get even better. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The White House DS0000070484.V371655.R01.S.doc Version 5.2 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 The White House DS0000070484.V371655.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at the home have information to help them to understand about the services and facilities. There are good procedures to assess people’s needs and make sure the home can meet these. EVIDENCE: People who live at the home told us that they had information about the home and the things they are entitled to. Most people have lived at the home for many years, however one person has recently moved there. They told us that they had enough information to help them make a decision about moving to the home. They said that they had visited the home and met everyone before they decided to move there. We saw evidence that the person who moved to the home had their needs assessed and that information from different people helped to form this assessment. The Manager told us that she is reviewing the service user guide and terms and conditions of residency and hopes to produce these in a more accessible format, using pictures and easy words and sentences. The White House DS0000070484.V371655.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported to meet their individual needs and wishes. They understand about the things the staff are there to help them with. They are able to make choices and take risks. EVIDENCE: People who live at the home said that they were able to make choices about what they did and about everyday things like meals and activities. People told us that they chose the décor of their bedrooms and made choices about their clothes and the way they wanted to look. Everyone knew they had a care plan and that this helped staff to understand about their needs and wishes. We saw that people had signed their care plans. Everyone has a care plan that records their needs and the things staff need to do to support them to meet these. The staff work with other organisations to look at how they can record these in a more accessible way and how they can The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 10 use people’s friends, family and others to help create even better care plans. They have started to do this for some people. They need to do this for everyone. Each person has their needs and care plan reviewed regularly and this is recorded. The staff support people to make choices. Some of the things that visitors told us about this were, ‘Our relative is able to voice their opinions and choices’ and ‘My relative desires are always taken into account and they are given explanations which they can understand about what is happening.’ Information about the things people in the home use everyday is created so that they can understand this. Drawers and cupboards are labelled with pictures of the contents, menus and staff rotas are recorded using pictures and photographs to make it easier for people to understand. There are leaflets and labels to help people understand about activities and routines. The staff have had training to help them understand about different ways to communicate and support people to make choices. They put this training into practice and the people living at the home are supported to be in control of their lives. The Manager told us that the staff are looking at ways to make more records accessible to people who live at the home, using pictures and clear plain writing. They have started to make care plans more accessible and are now looking at different policies and procedures. There are regular meetings for the people living at home, where they are told about changes and important events and able to contribute their ideas. There are records of these. People are supported to take risks and there is good evidence of risk assessment. These assessments are regularly reviewed and are discussed with the people they are about. The service plan, which is a guide to the things that the Manager wants to improve over the next year, indicates that people will be given more control over their own lives and make more informed choices in the future. The White House DS0000070484.V371655.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People are supported to take part in different education and social activities which they have chosen. People are valued members of the local community and have a network of friendships and relationships outside the home. People have tried new things and are continuously learning new skills. EVIDENCE: People who live at the home said that they did lots of different things, which they had chosen. They said that they learnt new skills at home, college and work. People told us that they had lots of friends and regular contact with their family. People told us that they liked the food and that they chose and helped prepare this. Some of the things people told us were, ‘the home is a true community where people are happy’, ‘I help around the house with tidying up after dinner and I The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 12 clean my room once a week’ and ‘relatives are kept informed and there are regular meetings where feedback is welcome. Visits are welcomed.’ Each person is assigned a key member of staff who gives them special support to help them plan the things they want to do and who is a key point of contact for families and other professionals. Everyone at the home has a varied timetable of planned activities each week. These include jobs, college courses and attending groups, centres and local community facilities. Each person does things that reflect their needs and wishes and these are regularly reviewed. The Manager told us that staff have started supporting people to think about different physical activities, sport, swimming or walking which they could take part in to help them have a healthy life style. The Manager said that people have started to try new activities and had become more confident over the last year. Some people have joined new groups or tried new activities or jobs, such as a women’s group and work creating greeting cards. We talked to people about these new experiences and they said that they enjoyed these. The Manager told us that people had started to use public transport more regularly and some people travelled independently. People told us that they liked finding new ways to be independent and learn new skills. There is a range of leisure and entertainment equipment, including games, videos and music for everyone to use in communal areas and people are encouraged to purchase their own leisure equipment. People are supported to attend places of worship. The Manager told us that recent special events have included a party, a ‘pamper evening’ and attending different sporting events. Everyone was supported to go on a summer holiday of their choice. told us that they had enjoyed these. We saw photographs of special events and holidays on display. Some of the things people said about the things that they did were, ‘I like watching football and I go to work’, ‘holidays and outings are popular and people are encouraged to be active’ and ‘I like going out’. People The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 13 Visitors are welcome at the home and people are supported to make friends and stay in touch with them. Relatives told us that they were well informed and able to be involved in caring for people at the home. There are regular relatives meetings. On the day we visited the atmosphere at the home was relaxed. People were entertaining themselves, watching TV and listening to music, socialising and taking part in preparing meals. There are two kittens at the house and people told us about these. We saw people using communal and private rooms. Everyone was welcoming and we saw the staff being polite, positive and supportive to people. Everyone in the home helps to plan the menu and is involved with preparing meals. We saw people preparing the evening meal, drinks and snacks. The staff help people to think about healthy eating and how to plan a nutritious diet. One person told us, ‘the food is plentiful and residents take part in menu planning and preparation’. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are supported to stay healthy and have their personal and medication needs met. EVIDENCE: People told us that the staff helped them to stay healthy. They said the staff respected their privacy and gave them the support they needed. Everyone is registered with a local GP and sees other health care professionals as needed. The local community team support and work with staff to help them meet each person’s health needs. They provide training, guidelines and information. There is a medication procedure and all staff are trained and assessed in administering medication. Medication is stored securely. We saw that most medication records were accurate however some records had not been signed and needed to be. Most medication was labelled but some did not have labels. One person manages their own medication. The Manager needs to make sure The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 15 medication held on behalf of this person is recorded. One person is prescribed a variable dose of one medication. The Manager needs to make sure there are guidelines for staff so that they know what dose they should to administer. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Procedures are in place to help keep people safe. EVIDENCE: People told us that they knew what to do if they had a complaint or were unhappy about anything at the home. There is a complaints procedure and a record for all complaints. The Manager told us that she has got information on how to make the complaints procedure easier for people who live at the home to understand, and she is going to do this. There have been no complaints since the last inspection. There is a copy of the local authority protection of vulnerable adults procedure and staff have had training in this area. The staff support people to manage and understand their own money. They hold small amounts of cash for people and keep records of all transactions. We looked at some of these and saw that some of the records were inaccurate. Checks of records and money held are not made each day and should be to minimise risks of mistakes or financial abuse. The White House DS0000070484.V371655.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a safe, attractive and well maintained environment. EVIDENCE: People told us that they liked the home and their bedrooms. They said that the home was always clean and tidy and that they took a pride in their environment. The home is well maintained and there is a programme of decoration and refurbishment. Since our last inspection a flood damaged areas of the home and caused everyone to move into temporary accommodation for a short time. This was well managed and the repairs to the home are complete. Other repairs and changes include a new en suite shower for one person, some bedrooms have been redecorated and there is new flooring in some areas. The garden is well maintained and people are growing their own herbs. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 18 Everyone has personalised their bedroom and helped to personalise communal areas of the home. The home was clean throughout on the day of our visit. People are supported to participate in cleaning and laundering their own clothes. One visitor told us, ‘the accommodation is good – comfortable and safe, with full provision for privacy and socialising’. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are cared for by well trained and supported staff. EVIDENCE: People who live at the home told us that they liked the staff. They said that they thought they were kind and helpful. The majority of the staff told us that they were happy working at the home, that they felt well supported, they said that they had training to help them and regular meetings with each other and the Manager. A new Deputy Manager was appointed shortly after our visit. There are two senior support workers and a team of support workers. Everyone has delegated responsibilities to help with the day-to-day management of the home. Some of the things people said about the staff were, ‘the staff are professional, knowledgeable, caring, friendly, proactive and well managed’ and ‘the staff understand about our different needs’, ‘the staff are always kind to me’. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 20 Staff undertake a thorough induction which helps them to understand about supporting people. When they have completed this they enrol on NVQ training. Two members of staff have completed their NVQ training. We saw evidence of regular staff training. Records show that this is updated and staff have training in key areas including administration of medication, fire safety, protection of vulnerable adults, first aid and food hygiene. There are regular meetings for the team and for individuals with the Manager. We saw records of these. Reference checks and criminal record checks are made on all staff before they start work at the home. We saw evidence of checks and staff interviews for the two most recently employed members of staff. Not all staff have up to date contracts of employment. The Manager needs to make sure all staff have accurate and up to date contracts. Some of the things the staff told us were, ‘we have regular team meetings and lots of feedback’, ‘there is a good working atmosphere’ and ‘we have lots of information in our induction which tells us what we need to know.’ The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a well managed home, where there is a philosophy of continuous improvement and self audit. EVIDENCE: The Manager has worked at the home for two years. She has experience working in other care homes and has management and social work qualifications. The Manager demonstrated an excellent knowledge of each of the people living at the home and the support they needed. She showed a commitment to continuous improvement of the service and to challenging practices. She spoke about people at the home with genuine fondness and she showed respect and kindness to everyone. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 22 People told us that the home was well managed. They said that they could speak to the Manager whenever they wanted and that she listened to their opinions. One of the people who lives at the home told us, ‘the Manager is a very sweet lady’. Some of the things the staff said about the Manager were, ‘the Manager is really supportive and communicates with us’, ‘the Manager provides lots of support’ and ‘I am happy with the support I get from my Manager’. The organisation employs a consultant supervisor who visit the home each week. He gives the Manager support and offers training to the staff. There is a good plan of regular team meetings, training and group work. The Manager is a member of a local group of care home providers who meet regularly to share ideas and offer one another support. The Manager and consultant supervisor have created a service plan for home which shows areas they plan to improve over the coming year. supervisor makes monthly quality inspections and writes a report of findings. The organisation is in the process of reviewing all policies procedures. There are regular reviews for people living at the home, meetings to consult with them, their families and staff. the The his and and In general records are well organised and presented. Information is clear. The staff are working towards making some records more accessible for people who live at the home. Some records needed to be reviewed and updated and some records needed to be reorganised to make information clearer. We saw evidence of regular health and safety checks, fire safety checks and fire drills. We saw evidence that action was taken where there were identified risks. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 2 3 3 3 4 3 5 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 4 3 4 3 3 3 X The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13 Requirement The Registered make sure: All medication appropriately. Person is Timescale for action must 31/10/08 labelled Medication records are always signed. Medication received, held disposed of is recorded. or Health professionals write guidelines for all PRN or variable dose medication. 2 YA23 13 The Registered Person must 31/10/08 make sure records of money held on behalf of people who live at the home are accurate. Records and balances should be checked whenever there is a changeover of staff to minimise the risks of mistakes and financial abuse. The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 25 3 YA31 18 The Registered Person must 31/12/08 make sure all staff have accurate and up to date contracts of employment. 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 YA8 Good Practice Recommendations The staff should continue to look at ways to make records, including care plans, policies and procedures more accessible to the people who live at the home. The organisation needs to make sure all policies and procedures are up to date, reflect practice and are regularly reviewed. The Manager needs to make sure all records are dated and signed. 2 YA40 3 YA41 The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The White House DS0000070484.V371655.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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