Inspection on 25/02/06 for Valleyfield

This inspection was carried out on 25th February 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Valleyfield 14/02/07

Valleyfield 23/10/05

Valleyfield 20/10/04

Valleyfield 06/05/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Valleyfield 69 Grange Lane Gateacre Liverpool Merseyside L25 4SA Lead Inspector Pat Kearney Unannounced Inspection 25th February 2006 11:00 Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 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 Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 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. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Valleyfield Address 69 Grange Lane Gateacre Liverpool Merseyside L25 4SA 0151 428 6388 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.c-i-c.co.uk. Community Integrated Care Annette Lea Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd October 2005 Brief Description of the Service: Valleyfield is a single storey three bedroomed detached property with a small garden to the front of the property and a larger accessible enclosed garden to the rear. The property is situated in the Gateacre area of Liverpool and is close to shops, pubs post office and a short distance from other places of local interest. The property is owned by Maritime Housing Association each of the service users have a tenancy agreement. All three-service users have been tenants since the home opened in 1990. Valleyfield is a home for three female service users with learning disabilities. The home is part of the Community Integrated Care Group. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This statutory announced inspection took place on 25th February 2006 and lasted approximately four hours. A full tour of the premises took place. A range of records such as care plans, Essential Lifestyle Plans, staff personnel files, policies & procedures and medication charts were examined. The Registered Manager was on duty. Staff on duty and the three service users was spoken to during the course of this inspection. What the service does well: What has improved since the last inspection? Advice has been sort from a number of healthcare professionals and equipment has been obtained to meet the individual assessed needs of the service users. This additional equipment has improved the quality of life for service users. Service users bedrooms have been reorganised to meet the service users changing needs. A support worker has been recruited to the vacancy and the new member of staff has attended a corporate induction course. The majority of repairs caused by the installation of the gas central heating system have been completed. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 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. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 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 Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1.2.3.4.5. The home’s Statement of Purpose and Service Users Guide are well written and comprehensive providing service users and/or their representatives and any potential service users with details of the services the home provides enabling an informed decision about admission to the home. EVIDENCE: The home’s Statement of Purpose and Service User Guide have been reviewed and updated in July 2005. A copy of the Service Users’ Guide is kept in each of the service users’ bedrooms. All three-service users currently living at the home has been resident there for a number of years. Each service user has an Essential Lifestyle Plan (E. L. P) which is reviewed and updated annually. This document is intended to cover every aspect of a service users life and includes their preferences, choices, hobbies and interests and provides a detailed insight into the person being cared and the lifestyle they wish to have. The plan is especially useful as the services users have severe communication difficulties. The Registered Manager said that all three service users had visited the home several times prior to being admitted. The Manager confirmed that any future service users would be able to visit prior to admission and their family and friends would be included in the process. Copies of costed contracts are kept on service users files. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6.7.8.9.10. The individualised care plans for each service user clearly evidence how the service users needs and goals are met on a daily basis. The staff have a good understanding of the service users’ support needs. This is evident from the positive relationships, which have been formed between staff and service users. EVIDENCE: All service users in the home have a comprehensive and detailed individual care plan, which is formulated on admission to the home. The Registered Manager and key-workers regularly review these documents. Daily health records are documented on each shift for each service users, and this includes any critical incidences plus any visits from GPs, specialists, etc. Care plans are comprehensive and contain very detailed information regarding the individual needs of the service users. Each service user has an Essential Lifestyle Plan (E.L.P) which records service users individual choices and Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 10 preferences interests and hobbies, social history, daily routines and documents what is important to the individual service user. Personal and environmental risk assessments are completed for each service user. Care plans show that service users and /or their relatives are involved in the care planning and review process. Relatives spoken to have said that they are kept regularly informed and updated of any changes in the service users health and well being. Full involvement of NHS and other healthcare professional agencies was clearly evident on all service user care plans examined. There have been a number of new aids and adaptations obtained at the home all assessed by healthcare professionals to improve the quality of life of the service users. Equipment obtained includes profiling bed, new individually fitted body moulds for wheelchair use and a new showering aid. On the day of this inspection a service user was helped to assist the support worker with the preparation of lunch which they enjoyed. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11.12.13.14.15.16.17. Service users are actively encouraged and supported by the staff team to participate as much as possible in age appropriate activities, which enhances their quality of life. Links with the community are good and support and enrich service users’ social and leisure opportunities. EVIDENCE: All three-service users at Valleyfield have an Essential Lifestyle Plan, which details their individual interests hobbies and aspirations. The information in the E.L.P. and care plan forms the basis of the activities service users participate in. All three service users require the support of staff to participate in any social or leisure activities. Family members spoken to said that “Staff work hard to ensure that the service users are provided with all sorts of leisure opportunities - which they enjoy” Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 12 Relatives confirmed that they are invited to attend any of the functions held at the home and are kept updated and are included in reviews of care. One service user celebrated a milestone birthday last year. The staff team organised a birthday party at the home with all members of the service users family travelling from home and abroad to mark the occasion and join in the celebrations. Relatives spoken to said the staff group “work tirelessly to ensure my sister enjoys a full and varied life” The family also expressed how confident the family were that their sister was receiving “the best possible care” The support staff who act as keyworkers write to relatives who are unable to visit the home on a regular basis for a variety of reasons keeping them up to date with events in the service users lives. This benefits the families and expressions of thanks for the effort made to keep in touch have been received. Prior to Christmas the staff accompanied a service user to visit their relatives who are unable, for health reasons to visit the home. The home arranged for the service users father to be collected and given a lift to the family home where both parents and their daughter could spend time together. Gifts and cards had been purchased so that the service users could give her parents Christmas gifts. The staff left the service user with the family for the afternoon so that they were able to spend family time together. Both the father and service user were collected from the mothers home. The father was then taken to his address and staff saw him safely into his home and then brought the service user back to Valleyfield. This is just one example of how the manager and staff work hard to ensure that service users and their families are able to maintain contact and the quality of the service users life is enhanced by the intervention of staff. All three service users have enjoyed a holiday in Portugal last year supported by staff. On the day of the inspection discussion and planning was in progress for the 2006 holiday. The three service users will be accompanied by to staff to their individually chosen holiday venues. One service user was deciding whether she wanted to visit her niece who lives in Barcelona or holiday in Dublin. A new van was purchased last year and is used for service users outings which include visits to the cinema, local swimming baths meals in pubs and visits to the light room. All three service users keep appointments at the local hairdressers. They also enjoy occasional visits to the local pub for lunch. The service users are known in the local shops and newsagents. The neighbours next door occasionally come in to the care home for a cup of tea Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 13 Service users accompany staff to the supermarket and are actively encouraged to select food for the menu. One service user has been involved in an arts based social inclusion project which they thoroughly enjoyed. Relatives told the inspector that the “project made such a difference she was very happy during the project. –and she gained much enjoyment from being involved. While this project has finished now staff are looking for alternative arts based projects that they can become involved in. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18.19.20.21. Medications are managed safely in accordance with the National Minimum Standards and safeguard the service users from risk of harm. The staff team has an excellent understanding of the service users’ support needs. This is evident from the positive relationships, which have been formed between the staff and service users. The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. EVIDENCE: No current service user in the home self medicates, medications for service users are administered by the key-workers in the home. The protocols for the receipt, storage, disposal, and documentation of medications in the home are in accordance with the National Minimum Standards (NMS). All three service users at the care home require the intervention of staff for all their personal support and health care needs. Staff spoken to during the inspection were fully aware of the personal support needs of the service users and how important it was that those needs should be met in a way that is sensitive to the service users preferences respecting their dignity at all times. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 15 There was evidence in the care plans that a number of health and social care professionals had recently been involved in reviewing the service users needs. Service users have a 6 monthly medication review by the G.P. Regular visits to the dentist, optician and other healthcare professionals. Since the last inspection a service user has attended the dental hospital to have invasive dental work. Details of all planned visits are recorded. Information and advice given by healthcare professionals is also recorded. The Manager informed the inspector that relationship between the service users G.P. surgery and district nurses is very good. There is currently a physiotherapist visiting the home to work with a service user to maximise and maintain their limb movements. Since the last inspection advice has been sought from the physiotherapist regarding another service users at the home. Since the last inspection the home has continued seeking the views of service users and/or their families to establish the preferred funeral arrangements of the service users. One service users family has responded and a funeral plan is now in the service users care plan. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22.23 Valleyfield has a comprehensive complaints system. The home’s commitment to ongoing training and development helps protect the service users from neglect and risk of harm. Appropriate checks are completed on all staff to ensure the protection of service users. EVIDENCE: A clear complaints policy and procedure is available for both service users and their representatives. Included in this are contact details of the local CSCI. Office. All three service users are unable to communicate verbally but staff said that they were able to use non verbal communication if they were unhappy. On the day of this inspection it was evident that a service user was bad tempered and being nasty towards another service user. The inspector saw that the manager intervened in the situation and resolved the dispute in a sensitive and diplomatic manner which resulted in the differences being settled in a way which was amicable to both parties. Relatives spoken to said they were confident that any concerns they had would be listened to and acted upon. Relatives are sent questionnaire annually to assess their satisfaction with the service provided. Staff training files evidenced that protection of vulnerable adults training is commenced on induction and is annually updated. The member of staff spoken to confirmed that training on abuse and adult protection issues had been given and was regularly updated. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 17 All staff at the home have had appropriate checks made on them to ensure that the service users are protected. No complaints have been received either by the Commission or Valleyfield since the previous inspection. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24.25.26.27.28.29.30. The standard of the environment within Valleyfield is good, providing service users with an attractive and homely place to live. EVIDENCE: The home is situated in the Gateacre area of Liverpool and is close to shops, pubs and other amenities. The home is a three bedroom bungalow leased from Maritime Housing Association. The home is warm, comfortable and homely and on the day of the inspection odour free. Each service users bedroom is individualised to reflect their personal taste and preferences, the home is due for its 3 yearly redecoration programme in 2006. Since the last inspection service users bedrooms have been rearranged to meet the changing needs of the service users. There has been several improvements to the environment this has included external painting, regular garden maintenance, new shed, new shower trolley Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 19 three piece suite and gas cooker. A new gas central heating system has recently been installed at the home Since the last inspection repairs caused by the installation of the new gas central heating have been completed. Attempts have been made to “make good “ the bathroom following the installation of the new shower aid however there remains work to be done to bring the bathroom up to standard this includes tiles are cracked and broken and need replacing the skirting board, architrave and walls needs repair. Grouting on the floor tiles which was replaced is lifting and looks unsightly The replacement of the wooden toilet seat with a white plastic cover against the dark green of the toilet makes the bathroom looked uncoordinated and piecemeal. Further attention is required to complete these repairs to ensure that Valleyfield returns to its usual high standard of maintenance. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31.32.33.34.35.36. Staff morale is high resulting in an enthusiastic staff group that works positively with service users to improve their whole quality of life. EVIDENCE: The personnel files reviewed showed that a rigorous recruitment and selection process is in place an Enhanced Criminal Records Bureau (CRB) Vulnerable Adults (POVA) checks, plus reference checks are completed prior to any staff being employed. Agency staff are never used at the home. A random selection of staff personnel files were examined all seen evidenced ongoing mandatory and specialist training. A detailed induction is given to all staff along with regular supervisions and annual appraisal. Relatives spoken to commented that” the staff group work hard to ensure that the service users receive the best possible care and are aware of the individual needs and preferences of the service users”. A member of staff had left the home since the last inspection the staff group have covered the additional hours to maintain continuity of care for the service users. A new member of staff has joined the staff group the person was working for the organisation in another establishment so has transferred across to Valleyfield. The member of staff had visited the home and been Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 21 introduced to the service users and staff prior to taking up her post. The new member of staff has attended the organisations corporate induction course. Mandatory and specialist training for the staff group has been arranged and a copy of the training schedule was available at the inspection. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 22 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37.38.39.40.41.42.43. This is a well managed home with clear leadership, quality assurance processes are in place to ensure the service user’s best interests are safeguarded and protected EVIDENCE: The Registered Manager has many years experience working with the service user group and has completed the N.V.Q. Level 4 Registered Managers award. Relatives commented that her commitment and enthusiasm ensures that the service users are able to enjoy a very full and varied life. Relatives said that “she pays regular attention to the service users individual changing needs, making sure that any intervention to maximise and maintain their individual health and welfare is sought from healthcare professionals” All necessary certificates such as gas, electricity and risk assessments were up to date. Service user specific risk assessments are also in place, with updates and reviews involving the service user and or their relatives being completed. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 23 Fire alarm testing and fire drills are completed and were up to date. The fire officer last visited in April 2004 which records a satisfactory visit. The inspector spoke to the staff on duty, staff informed the inspector that they enjoyed their work and felt supported. Staff are supervised regularly and an annual appraisal is completed written records are kept on the individual staff personnel files. Quality assurance is undertaken in-house and via the company’s own audit process. The Operations Manager visits the home monthly and completes the Regulation 26 audit. Copies of the regulation 26 visits are forwarded to the C.S.CI. Service user’s views and involvement is sought as far as possible, and the results of audits are made available to interested parties, including the CSCI. A copy of the service users financial accounts are kept on the care plan with all expenditure recorded. The account is in the service users name and interest is paid three monthly in arrears. Policies and procedures are continuously reviewed and updated by C.I.C. All records are kept in accordance with the Data Protection Act 1998, in a safe, limited access facility. Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 4 3 3 3 3 3 Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 25 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA27 Regulation 23 Requirement The registered person shall ensure that the premises to be used as a care home are of sound construction and kept in a good state of repair externally and internally so that the home is safe and well maintained meets service users individual and collective needs in a comfortable and homely way;therefore the following repairs, and redecoration work needs to be addressed;- Bathroom broken or damaged wall tiles need replacing, skirting board and architrave needs repair or replacing Floor tiles need to be regrouted. . Timescale for action 01/05/06 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 Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Liverpool Satellite Office 3rd Floor Campbell Square 10 Duke Street Liverpool L1 5AS National Enquiry Line: 0845 015 0120 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 Valleyfield DS0000025144.V286812.R01.S.doc Version 5.1 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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