Inspection on 26/10/07 for Timber Grove

This inspection was carried out on 26th October 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Timber Grove 27/11/06

Timber Grove 07/11/05

Timber Grove 07/06/05

Timber Grove 26/01/05

Timber Grove 24/09/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Timber Grove Whitepost Farm London Road Rayleigh Essex SS6 9DT Lead Inspector Helen Laker Unannounced Inspection 26 October 2007 10:00 th Timber Grove DS0000018036.V349857.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 Timber Grove DS0000018036.V349857.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. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Timber Grove Address Whitepost Farm London Road Rayleigh Essex SS6 9DT 01268 780233 01268 784385 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) www.efitzroy.org.uk Elizabeth Fitzroy Support Ms Deborah Housman Care Home 15 Category(ies) of Learning disability (8), Physical disability (7) registration, with number of places Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th November 2006 Brief Description of the Service: Timber Grove provides care for up to fifteen younger adults that have a learning and physical disability. The basic cost of care at this home ranges from £862.92 - £1088.75. Timber Grove is situated 3/4 of a mile from Rayleigh train station and buses stop outside the home. The home is approximately 1.5 miles to Rayleigh town centre and there are some local shops nearby. Timber Grove also has its own vehicles for transporting residents. The home is set in large grounds and car parking is available. It is understood by the CSCI that the registered provider is considering plans for rebuilding the home, to improve services and facilities that will be on the same site and more appropriate and conducive in meeting the residents needs. Plans were submitted in April 2007 and it is understood that planning permission has now been agreed. The proprietor is advised to contact the registration team to ensure compliance at all stages with registration issues. The main area provides accommodation for twelve service users in single bedrooms on two corridors. There is also a self contained flat that accommodates three residents. All areas used by the residents are on the ground floor. The Service User Guide and Statement of Purpose are available and the residents and their representatives can be provided with this information and the inspector was informed that the home would provide them with Commission for Social Care Inspection reports as well. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key inspection site visit took place over one day. The site visit consisted of a tour of the home, talking with staff and residents, observing the care given and reading of documents. Most of the residents were seen and some were spoken to. The assistant managers’ on duty assisted with the inspection as the manager was away on leave. In addition, the survey forms that were received back from the residents and their relatives were used and contributed evidence to this report. Three relatives surveys were received back. Two out of three were generally satisfied with the care that was provided to their relative with one being not entirely satisfied depending on what staff were on duty. Eight residents surveys were received back. All expressed a positive experience of living at Timber Grove with one relative survey saying they would like staff to interact more with their relative and not leave them for long periods of time on their own in the bedroom. An AQAA was received back from the home. The inspector would like to thank the staff and residents for their help and hospitality during the visit. What the service does well: The residents living at the home have a range of care needs. Most residents need help to communicate and there is a good key worker system that encourages staff and residents to get to know each other well, to improve communication. There are residents that need full care and are immobile and there are residents that are able bodied with challenging behaviour. The manager, along with a stable and knowledgeable staff team, is able to meet the needs of each individual. During the week activity co-ordinators as well as staff take the residents out to their various clubs or college sessions. This allows residents to use the facilities in the local area. Residents generally live an active lifestyle at this home and can look forward to going on trips and holidays through the year. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 6 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. Timber Grove DS0000018036.V349857.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 Timber Grove DS0000018036.V349857.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 admission procedure includes an assessment which ensures that service users needs can be met. EVIDENCE: This standard remains unchanged overall since the last inspection. There have not been any new service users admitted to the home since 2001 therefore the evidence was gained from written records and comments from surveys. For some residents that have resided at the home for 23 years there are no written records regarding choosing a home. Information from the admission policy indicates that the assessment process is undertaken by an experienced member of staff. There is a comprehensive written admission procedure that gives prospective residents time to try the home out before accepting a place. A contract that is in picture format is in place for all the residents. Fees are now included in the service user guide. Timber Grove DS0000018036.V349857.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 is good. This judgement has been made using available evidence including a visit to this service. Service users have individual plans and are supported to take risks as part of an independent lifestyle via a process of assessment. Due to service users learning disabilities they are only able to make limited decisions but staff facilitate this as much as possible. EVIDENCE: Each resident has a person centred plan. These plans have been developed with the resident, their family, their key worker and other professionals. The plans that were seen on the day of inspection were good and informed the carer how the resident likes to be cared for. For example, the way that they like carers to approach them and the way that they liked to be moved. Key workers that were spoken to were knowledgeable about the resident’s care and were familiar with the documentation that was used. The person centred plan is reviewed at regular intervals via key worker meetings and monthly reviews. The plans are presented in picture format with text that is easy to understand Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 10 and follow. Risk assessments have been undertaken for most residents and incorporate their individual needs, however for those service users in wheelchairs it was noted that documentation and risk assessment, pertaining to wheelchair users using lap belts was not in place as this could be considered a restraint issue. This was discussed on the day of inspection with the deputy manager and the actions required regarding choice and consent. All the residents that responded to the resident’s survey said that they either usually or always get a choice about what to do each day. For some residents choices are limited because of their ability. However staff try to ensure that residents are listened to and that their future goals are recorded. Surveys reported that “Staff are good at interpreting needs”. Timber Grove DS0000018036.V349857.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): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities take place and service users are generally happy with the choices in routine available to them. Visitors are made welcome and overall the service users rights and responsibilities are recognised in their daily lives. EVIDENCE: The home has a full activities plan and employs four activity co-ordinators as well as care staff enabling activities to be undertaken inside and outside the home. Service users have individual pictorial activity plans. The residents have an active lifestyle and access community facilities in the local area. Some residents have planned college sessions to go to, whilst others have an activity programme that includes horse riding and swimming. Residents have the opportunity to go to social clubs in the evening and can go to church on a weekly basis if they choose. The home also has close links with the rugby Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 12 sports and social club and service users can participate in fishing and golfing activities at a local driving range. Holidays have taken place for residents and staff have been resourceful in getting NHS help in the chosen holiday destination to ensure residents health needs are met. Destinations include Lourdes, Blackpool, Devon and Kent. The home has an open visitors policy and family can visit relatives when they choose. Staff were observed to talk to residents and communicate with them in a respectful way, spending time with residents and observing their body language. Makaton sign language is used and was observed on the day of inspection. Residents have access to most areas of the home. For health and safety reasons some areas are secured. Residents are not allowed into other resident’s rooms without being invited and staff support residents to open their own mail. Meal times are flexible and a resident chooses the main meal of the day. A new menu system is in operation. At lunch time meals are either eaten out depending on the resident’s activity or a sandwich / snack is prepared. Staff sit with those residents that need support with feeding. One person has a special diet. Drinks are on offer throughout the day. Timber Grove DS0000018036.V349857.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 good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that the health care needs of service users are identified and met. Medication administration and recording was generally being addressed appropriately with some isolated recording issues requiring attention. EVIDENCE: Staff reported that where possible residents can choose who assists them with their personal care. Personal choice records are kept and were seen. Healthcare is monitored well. Residents are escorted to appointments such as the special wheel chair centre and other health professionals visit the home for example occupational therapists and District Nurses. All residents health care are recorded and an OK health check is undertaken each year for all of the residents. The home now has a robust medication training schedule for staff. Medication is stored correctly and a record is kept of medicine received into and leaving the home. Some minor recording errors regarding transcribed medication for one service user was noted. The deputy manager was advised that any Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 14 transcribed medication must have two signatures but any transcription is not considered best practice. At the last inspection the policy was checked for inclusion of storage time of drugs after death. This was not seen in the policy at this inspection either. Staff agreed to follow this up so that there is clear guidance on this subject. Timber Grove DS0000018036.V349857.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): 22 and 23 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. The home has effective procedures in place to ensure that service users are protected from abuse, neglect and self harm. EVIDENCE: The inspector was informed that no complaints have been received since the last inspection. No complaints book was available on request at the inspection and it was reported that information was held in the communications diary. A formal recording system needs to be in place. A pictorial complaints procedure is in place Residents reported via the survey questionnaires that making a complaint is a difficult issue due to communication and understanding the concept of making a complaint and they would not know how to make a complaint. However the staff or their key worker would understand if there was a problem and help them to make a complaint. Most of the questionnaires received back reported that they always felt listened to by staff overall. Information on how to complain is held available in the residents file. Staff spoken to were aware of whistleblowing procedures and policies and procedures relating to POVA legislation and training is undertaken. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome are is adequate. This judgement has been made using available evidence including a visit to this service. Timber Grove was clean, bright and well maintained and provides the service users with homely and comfortable surroundings. The layout of the communal area is unsafe for some residents. EVIDENCE: This standard remains unchanged overall since the last inspection. The environment was clean and warm and free from offensive odours. The communal areas are bare and uninviting and serve a practical purpose and provide a dining area. For vulnerable and immobile residents the open areas of the home can be unsafe. This is due to other residents that are mobile displaying challenging behaviour in these areas, which can cause damage to the furniture or anyone unable to move themselves out of the way. Staff are aware of these dangers to some of the residents and reported that they will act quickly to safeguard the vulnerable residents. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 17 The residents’ bedrooms are personal and contain their own possessions with furniture that is domestic in style. As stated earlier in the report the home are waiting for new buildings to be erected in the grounds of Timber Grove. This will allow residents to live in smaller units creating a better environment to meet their needs. As yet there is no start date for this project to commence but it is understood planning permission has been agreed last September and possible work will start early in the new year 2008. The CSCI should receive a schedule of works and confirmation that appropriate consultations have been undertaken with all service users and relatives. The proprietor should also contact the regional registration team of the CSCI as it is a completely new building being built to ensure compliance with site registration issues. This should be undertaken at the appropriate time. The staff use various pieces of equipment to move and support the residents. This equipment is checked regularly to ensure that it is safe for use. Staff are trained in the use of moving and handling equipment. New equipment is introduced only after risk assessments are carried out. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 18 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, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The procedures for the recruitment and training of staff did not have sufficient safeguards in place to offer protection to people living in the home. The home has an effective and competent staff team. EVIDENCE: From the surveys there was mixed views about the staff. Service users found staff “kind and supportive”. Relatives felt that some staff were better than others and felt communication was not as good as it should be and staff were not briefed enough on service user’s conditions. There is a stable staff team with a low use of agency workers. The staff spoken to were knowledgeable about the residents they cared for. The residents were comfortable approaching and being with the staff and staff communicated well with them. Through the day there are six staff members on duty. The manager tries to ensure that at each shift, one of the four assistant managers is on duty. From Monday to Friday the residents also have four activity co-ordinators to enable Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 19 them to access the community. At night there are two support workers with one staff member sleeping in. Staff spoken to reported that supervision is undertaken. Staff have access to and undertake various training. Of the twenty-nine staff at the home thirteen have either completed or are undertaking the NVQ in care at level two or above. Training is in line with the REACH standards. Four recruitment records were checked. They all contained most of the documents required by regulation. Two records checked did not evidence sufficiently permission to work in the United Kingdom, one had no photographic ID and wages were being paid into someone else’s account which is not considered best practice. Full CRB checks were not available to inspect and although the proprietors have an agreement regarding the location of staff records a full CRB check for staff could not be viewed but a letter confirming the details of the same was on most staff files. Although CRB checks are undertaken evidenced POVA first checks are not. A thorough recruitment process was not totally evidenced on this occasion ensuring that vulnerable residents are cared for by people safe to do so. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 20 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. 39 and 42 Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. There is leadership, guidance and direction to staff and the home has in place practices that promote and safeguard the health, safety and welfare of the people using the service. EVIDENCE: The manager has the experience and qualifications to manage this home. The management is described as open and approachable. For quality assurance the home use the REACH set of standards. This covers a range of areas and is undertaken with each resident. There is a checklist of areas some of which are as follows: - Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 21 “I choose who I spend my time with, I choose what happens in my service, I am supported to be healthy and safe on my terms and that I have the same rights and responsibilities as other citizens.” The standards have also been used to help the resident in their future transition to live in new houses in the grounds of Timber Grove. For example they are choosing whom it is they would like to live with. The practical use of these standards helps the resident to participate in the review and development of the home. A random selection of safety certificates and maintenance records were checked and these were all up to date. The manager does need to ensure that the recruitment process is adhered to and is safe. Accident records were available and were detailed. The home displays health and safety law posters and staff receive training in this area. The last health and safety meeting was held on 28/08/07. Cleaning fluids were locked safely away and fire safety risk assessments were available for staff to read. Staff are aware of the fire procedure and how to keep residents safe and fire risk assessments have been updated. The last unplanned drill was on 2/09/07. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 22 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 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? YES 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 YA7 Regulation 13 (7) & (8) Requirement Service users must not be restricted with lapbelts or similar permanently for any reason or be subject to any form of restraint. This also with reference to bedrails and where mattresses are on floors. Consideration must be given to the issue of formulating individual plans within a riskmanaged strategy. The registered person must ensure that there is a policy and staff adhere to the procedures for the receipt of recording, storage, handling administration and disposal of medicines, and service users are able to take responsibility for their own medication if they wish, within a risk management framework. This with specific reference to medication recording errors and must ensure that the medication policy includes how long drugs are to be kept following a resident’s death. Timescale for action 18/01/08 2. YA20 13(2) 18/01/08 Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 24 3 YA34 7, 9, 19 (1) to (7) Schedule 2 The registered person must operate a robust and thorough recruitment procedure based on equal opportunities and ensuring the protection of service users. 18/01/08 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. 2. Refer to Standard YA22 YA24 Good Practice Recommendations The manager should ensure recording of informal and formal complaints is maintained. The CSCI should receive a schedule of works and confirmation that appropriate consultations have been undertaken with all service users and relatives. The proprietor should also contact the regional registration team of the CSCI as it is a completely new building being built to ensure compliance with site registration issues. All this should be done at the appropriate time. Timber Grove DS0000018036.V349857.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Timber Grove DS0000018036.V349857.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!