Inspection on 12/04/07 for Thorndale

This inspection was carried out on 12th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Thorndale 10/01/06

Thorndale 13/08/05

Thorndale 10/03/05

Thorndale 25/10/04

Thorndale 30/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Thorndale 8 Thornhill Park Sunderland SR2 7JZ Lead Inspector Sam Doku Unannounced Inspection 12, 13 and 18 April 2007 10:00 Thorndale DS0000015769.V334399.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 Thorndale DS0000015769.V334399.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. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thorndale Address 8 Thornhill Park Sunderland SR2 7JZ 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) 0191 564 2147 0191 567 2902 Tyne and Wear Autistic Society Mrs Jacqueline Fletcher Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10th January 2006 Brief Description of the Service: Thorndale is a care home for 6 younger adults with Autistic Spectrum Disorder. It is owned and operated by the Tyne & Wear Autistic Society (TWAS), which operates several care and educational services for children and adults in North East. Thorndale provides personal care and support services for up to six people who have an autistic spectrum disability. Nursing care cannot be provided, and the layout of the building is not suitable for people with a physical disability. The home is a large Victorian semi-detached villa, situated in a very pleasant residential area of Sunderland, within easy reach of a range of amenities. These include a post office, Churches of different denominations, a variety of small shops and public houses. Sunderland City Centre is only a short distance away and this may be reached by public transport, which passes frequently. The property has a garden to the front and a yard to the rear. Limited car parking is available in the rear yard. However visitors can park on the main avenue outside the home. Currently, all the service users are male and each person has his own room. The bedrooms are spacious and each person has furnished their room to their own taste. There is one communal lounge and a large dining room. The weekly fee is between £1231.00 and £2205.00, the average being £1805.00. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out by one inspector involving three separate visits. It was an unannounced visit on the first visit but the following two visits were known to the staff. The inspection process involved the inspector talking with the manager about staff arrangements, records, and how the home supports the people who live here. The inspector had a tour of the house and viewed some bedrooms with the permission of the service users. The people who live in the home have Autism Spectrum Disorder with communication difficulties. This makes it very hard for them to say what they think of the service they get at this home. A few months before the inspection, questionnaires were sent to relatives and service users to ask them about their views on the service. Five responses were received from relatives and six from the service users. The responses were positive and indicate that the service users are happy with the service they receive. There have been no complaints or concerns about the home since the last inspection. What the service does well: The home is clean well decorated and maintained to a good standard. It is very welcoming and homely. The staff promote the independence of the service users by supporting them in ways that enable them to exercise control and to make decisions for themselves. For example the service users are able to make decisions about holiday arrangements, food, clothes, entertainment and leisure activities. The staff provide the necessary support to enable the service users to lead fulfilling lifestyle. Service users are supported to attend “college”, a service that is provided by Tyne & Wear Autistic Society to engage the service users in daily activities. There is a busy, friendly atmosphere in the house. Staff are constantly engaging the service users and supporting them in different ways. The service users are able to use their own bedrooms whenever they wish. Two service users have keys to their rooms but others have chosen to let staff manage this on their behalf. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 6 There are good arrangements in place to ensure that the service users continue to receive good health care. Their healthcare needs are fully met, including specialist care such as psychiatric support. Staff show respect for the service users and take their lead from them, using communication systems that the service users are familiar with and able to use to express their wishes. Staff have good understanding of the needs of the service users. There are sufficient number of staff on duty to help the service users when they are at home. Staff have received training to help them provide good service. The staff maintain good communication with relatives. 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. Thorndale DS0000015769.V334399.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 Thorndale DS0000015769.V334399.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): 2, 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home undertakes comprehensive assessment of needs involving other health and social care agencies. This ensures that the care needs are identified and the home is identified as the most suitable place for the individual to live. Each service user has a signed contract with the Tyne & Wear Autistic Society. EVIDENCE: The service users have lived in the home for some time now and the files contain details of the assessments carried out before they moved into the home. The records show that their needs were assessed by multi-disciplinary teams before the decisions were made for individuals to come and live at Thorndale. These identified their care needs and plans were formulated to assist the staff in providing care for the individuals. The service users files contain evidence of the contracts with the provider, which have been signed by relatives or advocates. Thorndale DS0000015769.V334399.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, 9. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. Service user support plans are regularly reviewed to take account of the changing needs of the individuals, including the risks that the may face. This ensures that the care and support provided by the staff are relevant to the needs of the individuals. The staff support the service users to make decisions for themselves, using useful communications tools such as pictures. This promotes independence and empowerment of the service users. EVIDENCE: The service user support plans set out details of the actions to be taken by staff to support individuals consistently to promote their welfare and wellbeing. For example, the support plans tell staff how to support individuals in areas such as assistance with laundry, hovering, making drinks, assistance with Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 10 preparing food and other independent living skills. These plans are regularly reviewed and there is evidence of service users and relatives having input in putting the plans together. Support plans are written in plain English and one staff member described how they use pictures to get service users involve in the process. The service users are supported to make their own decisions as far as possible. They are encouraged to make decisions about what to eat, what to wear, where to go holidays, which recreational activities to be involved in and when to visit relatives. Staff described how they support service users to make informed decisions about their lives. Where service users are unable to make such decisions, the views of families are sought and used to make the final decision. There are risk assessment records in place about activities that people carry out that might involve some risks to the person. These include bike riding, bathroom safety, going out, horse riding, trampoline and rock climbing. Such risk assessments and the risk management plans protect service users from harm or injury. Thorndale DS0000015769.V334399.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): 11, 12, 13, 14, 15, 16, 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides the opportunity for service users to actively engage in fulfilling and meaningful community activities. This allows them to continue to engage in their preferred lifestyle. The way the home is managed enables the rights of the service users to be respected by the staff at all times, thus promoting their dignity and selfesteem. The home provides nutritious and appealing meals for the service users. This ensures that their dietary needs are met thus promoting good health. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 12 EVIDENCE: The home takes appropriate steps to address the communication difficulties that are experienced by the service users. There are structures programmes in place to support them to achieve personal goals. Care plans contain evidence of support for them to be involved in activities that would enable them to be as independent as possible. These included their involvement in personal care, domestic and social activities. Written and pictorial images are used to improve the communication skills of the service users. Staff have found this means of communication very effective and has enabled them to engage with the service users in meaning and effective way. There is a planned programme of activities for the service users on a weekly basis. The service users attend day services/college, provided by Tyne & Wear Autistic Society. This allows the service users to engage in, and acquire skills in computers, art and craft, and sports. Some of the items produced by the service users at the day service/college are sold at the TWAS shop. The service users enjoy good variety of social and recreational activities. Some of the activities that they engage in include bike riding, horse riding, rock climbing, swimming, bowling, walks, shopping and discos. The care plans and individual records show that the individuals decide which activities to engage in. In this way the home is promoting their independence and selfdetermination. Although it was not easy to seek the service users’ view on the services that they receive, their demeanour and the way they interacted with the staff indicate that they are happy with the service. This was confirmed by the practices observed during the inspection visits. It was noted that staff always sought the service users’ view on issues that affect them. This created an atmosphere of independence, respect and empowerment amongst the service users. Past menus confirmed that the service users enjoy healthy home made foods. The records show choices being offered through the involvement of the service users in the preparation of the menus. To ensure that the service users make informed decisions about what to eat, pictures/photographs are used to help them choose their meals. The service users are offered alternatives and are able to choose from the picture menus given to them. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. All aspects of the service users’ healthcare needs have been met and they are supported and encouraged to be involved in the planning of their personal care. There are suitable arrangements in place for the storage and safe administration of medicine, thus promoting the health and wellbeing of the service users. EVIDENCE: The good arrangements for meeting the healthcare needs of the service users remain in place. The service users continue to receive good medical and nursing support. Previous inspection reports had commented positively on the home’s ability to meet the healthcare needs of the service users. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 14 Records show evidence of service users attending GP surgeries, out –patient appoints with specialist medical officers, opticians, dentists and other healthcare services. There are suitable arrangements for the storage and administration of medicines. Examination of the medication system showed no discrepancies in the recording and stock of medicines held on behalf of the service users. All the staff who are responsible for the administration of medication have received appropriate training to equip them for their role. The written policies and procedures to guide staff on the correct drugs administration are clear and easy to understand. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are supported to understand the complaints procedure so that they can express their views about the service they receive. The training and robust recruitment procedures have enabled the service users to feel safe and protected from any form of abuse. EVIDENCE: All staff have received training in protection of vulnerable adults. Staff have good knowledge of the provider’s policies on protection. Staff described their understanding of the policies and what they would do if they witness any form of abuse. All service users and their relatives have copies of the complaints procedure. For the service users, the complaints procedure is in pictorial format to enable them to understand it. The staff stated that they regularly re-enforce the complaints procedures with the service users so that they are aware of their rights. A record is maintained which shows concerns raised by service users. No concerns or complaints have been received since the last inspection. The home has good arrangements in place to seek the views and opinions of the relatives. There are regular contacts between the home and relatives and also through questionnaires sent to them. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 16 The home’s complaints procedures are in line with the City of Sunderland adult protection policies. These are robust procedures for dealing with suspected abuse. All staff received training in Calm Aggression-Limitation Management (CALM). This is a method of physical intervention that requires minimal restraint. It is used only to prevent harm to the service user or to others. The recruitment process is robust and carried out to ensure that the service users are protected from any form of abuse from people who would otherwise be considered as unsuitable to work with vulnerable people. CRB checks are undertaken and satisfactory references obtained before an employee commences work. Thorndale DS0000015769.V334399.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, 25, 26, 28, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe, comfortable and clean, and meets the needs of the service users. EVIDENCE: The good observations made in the last inspection regarding the premises have been maintained by the staff. The staff continue to strive to improve and maintain the high standard with involvement from the service users and their families. The service users live safely, surrounded by their own chosen items and furniture. The handyman has the overall responsibility for the maintenance of the house. All parts of the home were in god order. The handyman keeps record of all repairs and also fire safety checks, including safety checks for equipment are Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 18 documented. Water temperatures are tested throughout the home on a monthly basis. The communal areas are bright and cheerful with good standard of furniture and soft furnishings that are also practical and easily maintained. Bedrooms are decorated and furnished to individual taste and reflect their lifestyles. All electrical equipment is tested for safety. Each bedroom has a discreet vanity unit consisting of wash hand basin, electrical shaver point and storage. Bathroom facilities on each floor are shared and are of a good standard. The home has a planned redecoration and maintenance programme. The home is clean and maintained to a good standard. However, the microwave was found to be dirty which could be a source of food contamination. The worktop around the sink area is damaged and beginning to lift, which is a potential for food contamination. The laundry room is clean and tidy with suitable washing machines and dryers. Thorndale DS0000015769.V334399.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): 32, 33, 34, 35, 36. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff are competent, professional and have good understanding of their caring role. This ensures a competent service delivery that benefits the people who use the service. Staff receive good support from the management through regular supervision, which enhance their professional development for the benefit of the people who use the service. EVIDENCE: Staff training records show well-trained and highly motivated staff team. All the staff have NVQ III except four who are currently undertaking their training. Other training provided include foundation training, first aid, food hygiene, fire safety, infection control, CALM, health and safety and safe handling of medication. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 20 Staff receive regular individual supervision from the senior staff. Staff commented on the positive role model of the manager and the senior staff. Staff feel well supported by the TWAS and the manager. Staff carry out their duties in a professional manner and show regards for the service users’ rights and dignity. The positive and robust practices relating to recruitment ensure that the service users are protected from any form of abuse. CRB checks are undertaken and satisfactory references obtained before an employee commences work. Staff undergo a good induction programme of training and a six months probation period within which they are assessed to confirm their suitability for the job. Thorndale DS0000015769.V334399.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, 41, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager offers good leadership, ensuring that the staff receive proper direction and as a result the service users receive consistently high standard of care, which enhance their health, safety and welfare. EVIDENCE: The manager has long experience in managing a care home. She is well regarded by the staff and the service users. Staff confirmed that she runs the service for the benefit of the service users. Staff commented on her positive and reassuring attitude towards them. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 22 There are clear lines of accountability and management support within the organisation. This ensures that staff are clear about their role and responsibilities which benefit staff and service users. The provider has a comprehensive induction plan for all newly appointed staff. One newly appointed care staff was spoken with and he confirmed the arrangements for his induction and future training. Staff have received statutory training and other training specific to the service users. All the servicing records that were examined were up to date. These included fire fighting equipments, water treatment, electrical installation and gas servicing. Up to date servicing and maintenance ensure a safe environment for the service users and the staff who work there. A quality assurance system is in place and the manager ensures that this is up to date. This includes monthly visits on behalf of the provider by an officer of the organisation. She reports on her visit in writing and copies are made to the provider and the Commission for Social Care Inspection. The provider produced detailed Health and Safety policies and copies of these were made available for inspection. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). The manager stated that all staff have had training in food hygiene, fire precaution and first aid. The records relating to staff training confirm this. There is evidence that these policies have been adhered to by the staff thus ensuring the safety and welfare of the service users. Thorndale DS0000015769.V334399.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 X 2 X 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 3 3 X 2 3 X Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 24 Yes 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 YA30 Regulation 12(a) Requirement Timescale for action 01/06/07 2 YA30 12(a) The microwave cooker must be kept in good hygienic order at all times to prevent the risk food contamination which could potentially affect the health and wellbeing of the service users. The area around the washing 30/08/07 sink in the kitchen must be kept in good state or repair as the top is beginning to lift and could be a potential source of food contamination. This could potentially affect the health and wellbeing of the service users. 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 YA41 Good Practice Recommendations All incidents should be logged in the incident log book immediately or shortly after an incident had occurred in the home. Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Shields Area Office 4th Floor St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Thorndale DS0000015769.V334399.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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