Inspection on 02/02/07 for Three Oaks

This inspection was carried out on 2nd February 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Three Oaks 21/11/05

Three Oaks 20/12/04

Three Oaks 23/07/04

Three Oaks 22/03/04

Three Oaks 08/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Three Oaks Southwick Road North Boarhunt Wickham Hampshire PO17 6JF Lead Inspector Mrs Michelle Presdee Unannounced Inspection 2nd February 2007 10:00 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 Three Oaks DS0000046208.V325152.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. Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Three Oaks Address Southwick Road North Boarhunt Wickham Hampshire PO17 6JF 01329 833412 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) Camellia Care (Three Oaks) Limited Mrs Julie Jacobs Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2005 Brief Description of the Service: Three Oaks is a twenty-bedded residential care home, situated on the Southwick Road in North Boarhunt, providing care for older persons. The property is well maintained, double glazed throughout and a well-developed garden with pleasant views of the countryside. The home is privately owned. Three Oaks has sixteen single bedrooms and two double bedrooms, with six bedrooms provided with en suite facilities. There is ample communal space in the home, with three lounges, a separate dining room and a large conservatory, overlooking the garden. The fees for the home range from £327.04 to £486.17 per week. Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manager assisted the inspector during this unannounced inspection, which lasted over six hours. During the inspection the registered individual called into the home to discuss any issues. Nineteen service users were being accommodated; one service user was awaiting a nursing assessment. During the inspection the inspector looked around all areas of the home and randomly chose several bedrooms to view. Three service users were spoken to at length and one visitor. Staff on duty were also spoken with. Written records including medication, staff, assessments, care plans and policies and procedures were viewed. The home has regularly sent appropriate notifications to the commission and a pre inspection questionnaire was received before the inspection; which has been used to help form judgements for this report, What the service does well: What has improved since the last inspection? The home has fitted five more radiator covers to radiators. The physical environment is maintained and improvements made as they are seen, for example a new bath panel has been ordered to replace the cracked bath panel. Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 6 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. Three Oaks DS0000046208.V325152.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 Three Oaks DS0000046208.V325152.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): 3, 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are always assessed before moving into the home to ensure the home can meet their needs. EVIDENCE: The inspector was advised all potential service users and relatives are invited to call into the home at any time to have a look around or they can make an appointment to visit. All service users are given a home’s brochure before they move in, which includes details of the service user guide and the statement of purpose. The manager visits all service users in their own home or hospital before they move in, to carry out a pre admission assessment. The inspector looked at the pre admission assessments of the two service users to move into the home. It was noted these contained adequate information to enable carers to know what a service users needs were going to be. Pre admission assessments had been added to produce an on-going assessment. Two service Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 9 users spoken to stated they felt the home was meeting their needs and were very pleased with the home. The home does not provide inter-mediate care. Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide care staff with all information needed ensuring a service users needs are met and are regularly reviewed. Health care needs are well documented with a range of services available to meet service users needs. Medication procedures are well managed in the home. The core values of privacy and respect are promoted in the home. EVIDENCE: The care plans of three service users were viewed, two of service users who had recently moved into the home. It was noted care plans contained detailed information on a service users needs and how these should be met. Information was also recorded on risk assessments; manual handling and a falls risk assessment. It was noted one risk assessment had been completed stating the service user needed a cover on their radiator and this had been provided. Separate care plans were done for the night and for service users social needs. The inspector was told the home always encourages the family to Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 11 take part in the assessment and care a plan and provide a social history. It was noted all parts of the care plan had been reviewed monthly and the service user also signed the care plan and review. One new service user currently holds her own care plan as she wishes to write on it and sign it. The home clearly identifies health needs on the care plan. All visits by health professional are recorded on a separate sheet of the care plan in chronological order. The manager stated the home had very good relationships with health professionals in the area, with doctors and nurses calling on request. The home has access to a dentist, optician and chiropodist. One service user is currently awaiting an assessment for a nursing home, it was clear from discussions all professional and family members are communicating well and working together. The home has a clear medication procedure, which is followed by staff. The home is currently making an extra policy for one service user who wishes to part manage her own medication. No other service users manage their own medication. When the inspector first called into the home it was noted the medical administration records were available and it was noted all morning medication had been administered and signed for. The home for the purpose of medication is split into three blocks. Staff who are involved in the administration of medication have received training. The home uses a monitored dosage system, with a blister pack for each individual tablet for the specific time of the day. A photograph of the service user is on the blister pack. The records of four service users were checked and it was found all records were accurate with refused medication been signed for appropriately. No service users are currently on any controlled medication, but staff were aware of the necessary storage and recording procedures around this. The returns book for all medication returned to the pharmacist was seen and had been signed by the pharmacist. Service users spoken to on the day confirmed they felt they were treated at all times in a respectful manner. The home has a long established staffing group, which service users reported they were very fond of all staff. Staff were aware of maintaining service users privacy. It was noted and reported to the manager when the inspector was in discussion with a service user in their own room one member of staff did walk in without knocking. The service user reported this did happen but not very often. Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a range of social activities to meet service users needs. Service users are able to exercise choice and make decisions about their lives. Visitors are made welcome to the home and they can see service users in private. A varied menu is available and good quality food is served to service users. EVIDENCE: Service users spoken to felt the home offered adequate social activities within the home. The home has a mix of entertainment provided by the staff, which includes bingo, music to movement, games sing a long tapes and quiz mornings. Entertainers also call into the home on a regular basis. Three service users go to a local club and lately some of those who also attend the club have started calling into the home to play card games. One service user who recently moved into the home was able to bring her piano and had enjoyed playing it to the other service users. The vicar also calls in on a weekly basis to offer communion. The vicar also arranges cake afternoons where members of the local parish call in and it is taken in turns for them or the home to provide Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 13 the cakes. The home has three lounges and a large conservatory for service users to be able to make use of the communal space. The home has an attractive back garden, which has a patio area and suitable furniture for service users in the summer. On the day of the inspection some service users were enjoying reading newspapers in one lounge whilst other were joining in a quiz in another lounge. Outings are not often arranged by the home, one outing was arranged in conjunction with two other homes the proprietor owns last summer. Service uses spoken to on the day stated they enjoyed going out with their family and one service user spoken to was going out with her daughter for lunch. A visitor to the home stated she could call at any time and was always made welcome and could always see her relative in private. It was clear from discussions with the manager and service users the home encourages service users to have choices in their daily life. One service user is keen to try and manage part of her medication and the home is making a policy for her and staff are willing to try this and monitor the situation. One visitor stated the home “bends over backwards” to try and meet service users individual needs. Meals are served in the homes attractive dining room, which can seat all service users. Service users spoken to enjoyed the meals in the home. One service user spoken to felt there was a limited choice at breakfast and felt only one cereal was available. The inspector was shown five different cereals, tinned grapefruit, prunes a selection of jam and marmalade and eggs and fresh fruit were available; this was later relayed to the service user. A choice is not available at lunchtime, but if a service user does not like the main choice an alternative is offered. A choice is always available for pudding. At tea time carers ask service users what they would like from a small choice, records are maintained of each choice. A menu, which displays the breakfast and lunchtime menu, is currently not displayed but the manager felt this would be a good idea. The cook reported there were no restrictions on the budget and good quality food was bought. Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 14 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): 16, 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive complaints procedure is available, which service users and visitors felt able to use. Staff have knowledge and training on abuse, which offers protection for service users EVIDENCE: The home has a comprehensive complaints procedure, which details all the necessary information including names, addresses, telephone numbers and timescales. Details of the complaints procedure are included in the homes brochure, which is given to all service users. One service user confirmed she would feel comfortable complaining to the manager and one visitor confirmed she regularly spoke to the manager of the home and would be comfortable reporting a complaint to the manager. The home and the Commission have received no complaints since the last inspection. The home has relevant procedures and information relating to abuse and adult protection. The procedure was very clear and gave accurate information on how to proceed if abuse is suspected. Staff receive training on abuse, and staff spoken to on the day confirmed they had a good knowledge of the different types of abuse and the procedures they would take if abuse were suspected. Three Oaks DS0000046208.V325152.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): 19, 24, 25, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, safe, pleasant and well-maintained environment for the enjoyment of service users. EVIDENCE: Three Oaks is a chalet bungalow, with an extension, it has two chair lifts providing access to all floors. The home has three separate lounges, a large conservatory and a separate dining room all of which can be accessed at any time by service users. The home has a large back garden, with a patio area and suitable furniture. The garden has a large fishpond with a bridge going over it. It was advised a risk assessment should be carried out on the pond area. All parts of the home were decorated to a reasonable standard and all areas were clean with no unpleasant odours being detected. It was noted in Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 16 one bathroom the bath panel was cracked, the inspector was advised a new bath panel had already been ordered. Three service users were spoken with in their bedrooms, all were very happy with their rooms. One service user had furnished her room with all her own furniture and was pleased she had been able to do this. Another service user who was in a double room reported she had chosen to go into a double room as she enjoyed the company. Another service user reported she was especially happy with the “lovely” bed linen the home uses. Locks meeting the required standard have been fitted to seven bedrooms, the remainder have a privacy lock but this does not enable service users to lock their door from the outside. The registered individual reported the service users in these rooms do not have a problem with the current locks and it was agreed as these rooms become vacant appropriate locks would be fitted. Two rooms have access to the fire escape; the inspector was advised clarification has been sought from the fire officer and appropriate locks will be fitted to these rooms as they become vacant. Radiators have been fitted to some radiators and are fitted as risk assessments identify a need. Five radiator covers have recently been fitted. One service user and one visitor both stated they found the two steps at the front entrance of the home difficult. This was discussed with the proprietor of the home who showed the inspector the back of the home. It was agreed this would be brought to the attention of the service user and the visitor. Discussions were held on the fitting of handrails to the front two steps to assist service users, which the registered individual agreed to consider. The kitchen was clean and well organised. There was plenty of food in the home, with a good stock rotation. A selection of fresh fruit and vegetables were available. The cook advised all equipment was in working order. The home has a laundry room, which is kept locked when there is no one in it. The laundry is equipped with a domestic washing machine and tumble dryer. All clothes are labelled and each service user has their own basket, so clothes are returned to them Three Oaks DS0000046208.V325152.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): 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels ensure all service users needs can be met. Training is promoted in the home ensuring all staff have the skills and knowledge to be able to meet service users needs. Recruitment procedures are followed for all staff ensuring the safety of all service users. EVIDENCE: The home has an established staff group, the majority who have worked in the home for some considerable time. It was clear from the comments received by service users they were very fond of the staff and felt they worked hard. One service user stated, “it has a lovely atmosphere and the staff never fall out”. Another serviced user stated “we have wonderful staff and we get very good attention”. The staff rota is organised so three members of care staff are on duty in the morning, two carers are on duty from 1.30 pm until 4 .00 pm and from 4.00 pm until 8.00pm three carers are on duty and from 8.00pm until 10.00pm two carers are on duty. Two members of staff work a waking night duty. The home has a cook on duty seven days a week working from 9.00am until 1.00 pm. Domestic staff also work in the home five days a week. The manager is also on duty as extra to the staff on the duty rota and when she is not in the home she is on call. Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 18 The home employs twenty-four members of care staff. Currently only two members of staff have a National vocational Qualification Level 2. The manager explained the staff in the home are reluctant to undertake this qualification and some staff have said they would leave the home if forced to undertake this training. One member of staff on duty confirmed this on the day of the inspection. The staffing records of the last three members to join the home were examined. The inspector was advised the same process is followed for all new staff. The files showed evidence of an application form being completed. All necessary checks had been undertaken and each applicant had two written references. Each member of staff shadows an experienced staff member before starting work in the home. All members of staff undergo an induction period; records were seen demonstrating both the manager and staff member sign once the staff member is competent in each area. Despite staff being reluctant to undertake National Vocational Training, other training is taken very seriously in the home. The inspector was shown training records for each member of staff, which was up to date and highlighted when training in each area was due. The three managers of the Camellia Care Home’s undertake training in all three homes. Each has completed the Train the Trainer course in the areas they teach. At least one session of training is offered on a monthly basis. Control of Substances Harmful to Health (COSHH) training had been arranged for the week following the inspection. The manager reported all staff has in date training in the core areas of moving and handling, fire training, basic food hygiene, health and safety. Currently eight members of staff have in date training in first aid, ensuring there is always one member of staff who is trained in first aid on each shift. Staff spoken to on the day all stated they felt the home offered adequate training to equip them to do their job. One member of staff stated if they asked for training in a new area this would be facilitated. Three Oaks DS0000046208.V325152.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): 31, 33, 35, 36, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed. Service user views are considered when decisions are made in the home. Health and safety procedures in the home ensure service users are protected. EVIDENCE: The manager has worked in Three Oaks since September 1999. She has completed the registered manager’s award for N.V.Q. level 4 in management and care. It was clear from discussions with service users, one visitor and care staff the manager is held in high regard. One service user remarked on how patient the manager was; a visitor stated how helpful she had been over her relative’s admission. Staff spoken to on the day stated they felt supported in Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 20 their role by the manager and could discuss any concerns with her. Regulation 26 visits and reports are carried out a monthly basis and the inspector was shown these reports. It was clear from observations and discussions on the day the home is run in the best interests of service users. One service user reported how the home had worked hard to fit her electric scooter into the home. The same service user reported she would like her breakfast later, the manager confirmed this could be arranged for the service user. Service user surveys are carried out twice a year and service user’s can remain anonymous. The home does not become involved in the finances of any service user’s. The home does not manage the personal allowance for any service user. Records were seen and staff reported they receive supervision every two months. Staff reported they felt this was helpful and gave them the opportunity to discuss any issues with the manager. From observations on the day it was clear health and safety is promoted in the home. All areas were safe and staff were aware of maintaining a safe environment for service users. Control of substances harmful to health assessments had been carried out on all hazardous products and these were locked away. Practices in the kitchen complied with health and safety legislation. The temperature of the fridge and freezers were recorded on a daily basis. There was a good selection of food, which was being stored appropriately. The laundry room was clean and kept locked. Disposable gloves and aprons were seen around the home and were used appropriately by staff. The home keeps up maintenance contracts for equipment in the home, which were seen. The home has a very workable policies and procedures file, which is regularly up-dated. The fire logbook demonstrated all the necessary checks were being carried out in the necessary timescales. Staff receive a minimum of two sessions of fire training in a twelve-month period. Three Oaks DS0000046208.V325152.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 3 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Three Oaks DS0000046208.V325152.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. Refer to Standard Good Practice Recommendations Three Oaks DS0000046208.V325152.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Three Oaks DS0000046208.V325152.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. 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