Inspection on 14/06/07 for Thornton Lodge

This inspection was carried out on 14th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Thornton Lodge 05/01/06

Thornton Lodge 25/07/05

Thornton Lodge 10/02/05

Thornton Lodge 15/11/04

Thornton Lodge 10/02/04

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

CARE HOMES FOR OLDER PEOPLE Thornton Lodge 23 Trunnah Road Thornton Cleveleys Lancashire FY5 4HF Lead Inspector Christopher Bond Unannounced Inspection 14th June 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Thornton Lodge Address 23 Trunnah Road Thornton Cleveleys Lancashire FY5 4HF 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) 01253 856001 01253 804016 Thorntoncare@aol.com Mrs Lindsay Margaret Wylie Mrs Janette Brickman Care Home 14 Category(ies) of Dementia (14) registration, with number of places Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th January 2006 Brief Description of the Service: Thornton Lodge is a care home specialising in Dementia, situated on Trunnah Road in Thornton, near Blackpool. The home is registered for 14 people and was full at the time of the inspection. The service is situated close to a bus route into Blackpool and Cleveleys and there are local shops within walking distance from the home. Parking within the vicinity of the home is limited. The home has a regular social programme both within and outside of the establishment and a dedicated activities coordinator is employed. Visitors are welcome at all times. There are a number of shared rooms within the home; these have good screening to maintain the privacy and dignity of the people who live there. All other rooms are single and of good size. There is a stair lift up to the first floor. Information relating to the home’s Service User Guide and Statement of Purpose is included in the welcome pack, which is given to all prospective residents. This information explains the care service that is offered, who the owner and staff are, and what the resident can expect if he or she decides to live at the home. At the time of this visit, the information given to the Commission showed that the fees for care at the home are from £380.00 to £406.00 per week, with added expenses for hairdressing and chiropody. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of the inspection process an unannounced site visit took place over a total of 5 hours on the 14th June 2007. A tour of the home was carried out, which included bedrooms, lounge, dining areas, and bathrooms. All areas were clean and hygienic. The residents’ personal files and care plans were examined. Care staff records and recruitment records were also looked at. Safety certificates and medication records for the home were also examined. The managers, residents, care staff and visitors to the home were spoken to during the inspection and the lunchtime meal was sampled. The Commission for Social Care Inspection sent out survey comment cards to the residents and their families for them to express their views on the service. A number of these were returned and the results of this survey have been expressed in the report. What the service does well: This is a care home that specialises in the care of people who have Dementia. There is an extensive, planned activities programme specifically geared towards the abilities of the residents. There is also specialist training available to ensure that the care staff are skilled in dealing with the specific needs of people with this condition. The standard of care and support is also high. One relative wrote in reply to a care home survey, distributed by the Commission for Social Care Inspection, ‘this home provides good care and, most importantly, the staff have genuine affection for the residents.’ The residents’ care is well planned and reviewed regularly to promote positive outcomes. Health matters are dealt with properly and professionally. The care plans are detailed and informative and are used on a daily basis. The home itself is homely and comfortable. Because the home is only registered for 14 people the care staff are able to ensure that people get the proper level of care because of the high staffing ratio. The owner of the home and the manager positively encourage friends and families to meet and discuss how the home is run and whether improvements could be made. This helps to ensure that everyone has a say. There is also a monthly newsletter that is sent out to stakeholders. This helps to ensure that Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 6 everyone has current information about what is going on at the home. The owners of the home are directly involved with it’s day to day running. This helps to ensure that high standards are maintained. 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. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 3, and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information given to prospective residents and their families about this home is good meaning that an informed decision can be made about the suitability of the service. EVIDENCE: Thornton Lodge had a detailed Statement of Purpose that told prospective residents all about the service they were considering. A copy of this was left in the bedrooms for residents and their families to access. One relative that was spoken to said that they found this useful and that the family were able to look around the home before they made a decision that the home could meet their relative’s needs. Each of the personal files of the residents contained detailed assessments done by the manager, or assistant manager, before the person moved to the home. This means that their social, health and cultural needs had been looked at and a decision had been made as to whether the home could look after them properly and attend to all of their particular requirements. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents health and social care needs are met and well planned. Residents are supported and protected in their daily lives. The people in this home were looked after well and treated with dignity and respect. EVIDENCE: Everyone who lived at this home had a plan of care that documented all of their daily needs and how the staff would address these needs. There was lots of information written down. The inspector looked at five of the care plans and there was enough information in each of these plans to show that the care needs of the residents were being dealt with properly and appropriately. It was also evident that each resident had their needs assessed on a monthly basis to make sure that any changes in their condition was noted and acted upon. There was lots of good, recent information in the care plan about the health needs of the residents and how the staff at the home were addressing these Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 10 needs. There was also good information written down about how the home had asked for the involvement of health care professionals such as doctors, district nurses, psychiatrists, physiotherapists etc. No one at the home had any pressure sores. The residents were regularly monitored and action was taken to prevent these. There was equipment within the home to help prevent pressure sore development. The manager said that she would seek the help and advice of the district nurses should a pressure sore be discovered. The medication record sheets of each resident were looked at and they were completed appropriately. Everyone had a photograph attached to his or her records to help identification. Systems were in place that ensured that all medication was handled correctly and professionally ensuring the safety of service users. None of the residents were able to look after their own medication. None of the residents were prescribed controlled medication. This is medication that is recorded and administered separately because of its content or strength. The manager was aware of the home’s responsibility regarding controlled medication and the actions that the home should take should controlled medication be prescribed. The Commission for Social Care Inspection Pharmacist had recently done a random inspection at this service and had recommended that several changes be made to ensure that medication is handled properly. These changes had been completed and this standard has now been met. There were lots of good examples seen during this inspection of how the residents were treated with respect and dignity. The staff were speaking to people politely, care was being taken when assisting residents to move around the home. Some of the bedrooms were shared rooms and care was taken to ensure that there was enough privacy for the residents. Screens had been built between beds that incorporated shelves and a wardrobe. Eleven relatives completed a care home survey, regarding their relation, provided by the Commission for Social Care Inspection. All eleven surveys stated that the home always gave the support and care that was expected or agreed. One resident that was able to speak of her experiences at the home commented: “It’s very comfortable, you can’t suit everybody but you’d have to go a long way to improve it (the home), they’re very kind here.” Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Activities were varied and well planned, which contributed to the well being of the residents. Visitors were welcomed and valued family relationships were encouraged. EVIDENCE: There was a key –worker system in operation at the home. This meant that particular care staff had the responsibility of ensuring that the needs of individual residents were being met properly. A recording system called a ‘Lifestyle Improvement Plan’ had been devised to help the staff to ensure that individual interests and activities were being regularly provided and enjoyed to their full extent. Extra help is available to enable residents to enjoy some of the things that others take for granted. This system helped both residents and staff to ensure that areas such as joining in household tasks or enjoying a manicure could be productive. This home had two activities coordinators who were responsible for providing daily activities within and outside of the home. There was a four-week programme of activities on the notice board. All of the activities that were provided were aimed at ensuring that all the people who lived at the home were included as often as possible. There were group activities, including Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 12 bingo, reminiscence groups, sing-along, exercise groups, craftwork and aromatherapy/massage. The inspector was able to watch an aromatherapy session where a residents hands were massaged by a trained therapist. The therapist said that she visited the home on a regular basis and was able to advise on relaxation techniques as well as practice holistic therapy to aid relaxation. One relative commented via a care home survey, ‘They provide plenty of stimulus, entertainment and activities for the residents, realising the importance that this holds for them.’ An entertainer appeared at the home on a regular basis. The home also had a newsletter, which went out to the residents and their friends and relatives. One resident had recently celebrated her hundredth birthday. A party had been arranged in the home and 25 people attended. The menus for Thornton Lodge were available and lunch was being prepared during the inspection. Meals were well planned and nutritionally balanced. Fresh fruit, vegetables and meat were delivered regularly from the local supermarket. The dining area was pleasant and tables were set properly and attractively for the lunchtime meal. The care plans showed that the residents’ likes and dislikes regarding food were recorded properly. It was also written down when someone had a special diet, or needed specific help with their eating. The inspector sat with the residents during the meal and all that were spoken to said that they enjoyed the meal and that they looked forward to meal times. There were visitors to the home during the inspection. One visitor said, “I think they do a great job here and they’re always welcoming.” Visitors to the home were welcome at any time. It is important that visitors to the home are encouraged because it helps to maintain valued relationships, particularly for those who have dementia. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 16 and 18. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are safeguarded through good training, and robust policies and procedures. Complaints are treated seriously to ensure that the residents’ rights are protected. EVIDENCE: All of the staff that were spoken to said that they knew what to do if someone was unhappy about the service. The complaints procedure was displayed in the home and was part of the Service User Guide. The manager was aware of her role regarding the complaints procedure and how complaints can be used as a quality tool to ensure that the home is run in the best interests of the residents. Most of the relatives who responded to a care home survey sent out by the Commission for Social Care Inspection stated that they had been satisfied by the response of the home when dealing with a concern about the care of their relative. Those who did not respond stated that they had no concerns about the quality of care. The staff at the home respect the rights of the residents and their representatives. There had been no recent complaints regarding the home. All of the responses stated that they knew how to make a complaint if they wished, showing that information about making complaints was readily available within the home. There were policy documents for the staff to read about how to ensure that people were safeguarded from harm. All of the staff that were spoken to said Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 14 that they had a good awareness of this important issue and knew what to do if they were not happy about something they had seen. The manager was aware of her responsibilities and knew whom to contact should there be any question regarding how the residents were being supported and safeguarded. Recent training had taken place regarding safeguarding adults for most of the staff. All of the care staff that work at the home have access to this information, which helps to ensure that any safeguarding issues are dealt with properly. Copies of all the home’s policies and procedures were available in the main office for the staff to read to help them in their roles as carers. The manager was aware of the implications of the mental Capacity Act and how this could affect the rights of the residents at Thornton Lodge, as many of them need help to make important decisions, which may affect their lives. The manager had enabled some of the relatives and friends of the residents to meet together as a ‘client support group’. Concerns could be raised and presented as part of the group’s function. Many of the residents at Thornton Lodge have cognitive disorders, which prevent them from speaking out on their own behalf, and so this support group would provide a valuable function. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents lived in a pleasant, homely and well maintained environment. EVIDENCE: There were a number of shared rooms at Thornton Lodge and care was taken to ensure privacy and dignity when giving personal care. There were permanent screens between the beds. Each room had plenty of personal possessions in to help ensure that the occupants felt at home with their photographs, ornaments and personal possessions around them. There were bathrooms on both floors of the home, which had aids to assist the residents of the home. There are plans to replace the bathroom suites to improve the facilities and make the bathrooms a more relaxing place to be in. The owner of the home was visiting during the inspection to undertake maintenance tasks. The home was very well maintained and the manager Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 16 confirmed that maintenance tasks were completed with minimum disruption to the running of the home and residents were not unduly disturbed. There were two lounge areas at the home. Both lounges were fairly spacious and there plans to increase the communal areas by adding a conservatory at the rear of the house. This will give the residents extra space in which to relax. There were places for people to sit in the garden during warmer weather. The dining area was fairly spacious and light. Tables had been set nicely for the lunchtime meal. People can enjoy their meals in pleasant surroundings. The home was very clean and hygienic throughout ensuring that people lived in a pleasant and homely environment. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were protected by good staffing numbers and well trained care staff. Good recruitment practices helped to make sure that only suitable people are employed to work at the home.. EVIDENCE: There were enough care staff on duty during the inspection to ensure that the assessed needs of the residents were adequately dealt with. The staff rotas showed that staffing was good and that there were plenty of staff on each shift to ensure that people were being properly looked after. The rota also showed that the residents were being properly supported at night. Most of the care staff had achieved a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). There was also a good training programme to ensure that the care staff were able to improve their skill and learn new ways to care for people. There had been recent training in customer care, risk assessment and fire safety. Two of the care staff were spoken to during the inspection and it was clear that they had the knowledge, skills and abilities to provide a good standard of care for the residents of the home. There was a good induction process for new care staff ensuring that staff were taught how the care home operated before starting to care for people and being included on the rota. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 18 The staff are taught how to help move people who may not be able to move properly themselves. There had been regular moving and handling training to ensure that people were assisted to move the residents safely and professionally. Staff records showed that new carers had been properly checked before starting their jobs, including obtaining Criminal Records Bureau checks. This helped to make sure that the residents were safer by ensuring that suitable staff are employed. There was evidence within the care staff files to show that the correct information had been gathered prior to employment. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 35, 36 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home is managed well and is run in the best interests of the people who live there. The residents live in a safe home where the care staff are aware of health and safety matters. EVIDENCE: The manager of the Thornton Lodge has a nationally recognised management qualification. This means that she is well qualified to run the home and has the necessary skills and ability to do this successfully. She still needs to complete a qualification in care (National Vocational Qualification level 4).Two of the care staff were spoken to during the inspection and both commented on their positive relationship with the manager and how well the home functioned. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 20 Good records were being kept of safety checks within the home. These showed that professionals were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a safe home. Trained maintenance people were also checking the lifting equipment in the home on a regular basis. Staff were being instructed in safety aspects within the service. They were being shown how to move those residents, who had difficulty in supporting their own weight, safely and respectfully. Other safety training included fire safety awareness, food hygiene and health and safety. All of the care staff that were spoken to were able to confirm that they had received safety training. There was evidence on the personal files of the care staff to show that everyone was being supervised properly. Time was set aside for regular one to one meetings with the staff to ensure that they were happy and doing there jobs successfully and professionally. There were several weekly and monthly quality checks undertaken by the manager on all aspects of the running of the home. Questionnaires were given to the families and friends of the residents asking them to comment on how the home is run and whether or not the service is meeting people’s needs. There is another home close by that is part of the Thornton Care group and the manager of that home also does unannounced quality checks on Thornton Lodge. All of these things help to make sure that this home remains a good service. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X 3 3 X 4 Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 22 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. 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 OP31 Good Practice Recommendations The manager should complete the National Vocational Qualification level 4 in management and care. Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 Thornton Lodge DS0000009703.V339270.R01.S.doc Version 5.2 Page 24 - 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. 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