Inspection on 15/03/07 for Victoria Cottage

This inspection was carried out on 15th March 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 found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Victoria Cottage 17/03/09

Victoria Cottage 23/11/05

Victoria Cottage 17/05/05

Victoria Cottage 14/12/04

Victoria Cottage 22/06/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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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 Victoria Cottage Victoria Cottage 37 St Andrews Road Bedford Beds MK40 2LW Lead Inspector Katrina Derbyshire Unannounced Inspection 26th March 2007 14:20 Victoria Cottage DS0000044185.V329872.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 Victoria Cottage DS0000044185.V329872.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. Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Victoria Cottage Address Victoria Cottage 37 St Andrews Road Bedford Beds MK40 2LW 01234 271225 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) Victoria Cottage Limited Ms Jill Garner Care Home 14 Category(ies) of Learning disability (14), Physical disability (14) registration, with number of places Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home shall only admit service users between the ages of 18 and 65 years. The home may also admit up to 2 service users who have a physical disability in addition to their learning disability. Any service users who have physical disabilities in addition to their learning disabilities must be provided with a bedroom on the ground floor. The home is permitted to accommodate one named service user over the age of 65 years. 23rd November 2005 Date of last inspection Brief Description of the Service: Victoria Cottage is located in a pleasant residential area of Bedford within walking distance of the local park and the town centre. The home is registered to provide for fourteen younger people who have a learning disability, two of whom may also have physical disabilities. Most people go out from the home during the day to various day care activities, although the home also provides day care for two service users. The accommodation is arranged over two floors with single bedrooms on each floor and a double room on the ground floor. Each bedroom has a washbasin facility and a call bell. Eight of the bedrooms have ensuite shower facilities. Two of the bedrooms share the ensuite facility. A combined shower toilet room is located on the lower floor and a separate toilet is located on the upper floor. The communal facilities of a large lounge, an all weather conservatory and a dining room are all located on the ground floor. To the rear of the property is a well-maintained garden with an enclosed pond. The fees for this home vary from £405.00 to £1000.00 per week. Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this visit was to undertake a key inspection. This unannounced visit took place on 15th March 2007. The Manager was present throughout the inspection. During the inspection communal areas and private rooms in the home were visited and the inspector spent time with several residents in the sitting area of the home. The care of two residents’ was examined by looking at their records and interviewing the residents’ and staff who look after them. The views of residents were also received and their feedback has been used alongside information from the home through a pre inspection questionnaire to assess the outcomes within each standard. Evidence used and judgements made within the main body of the report include information from this visit alongside their views. Observations of care practice and communication between the residents’ and staff was also made at the inspection. The focus of this inspection was to look at the key standards and to follow up on previous requirements. What the service does well: The way the home supports residents in maintaining personal relationships is good. The staff enable residents to continue to visit, telephone and welcome their friends and family into the home. One resident said, “ l have my friends and family to come and see me here”. The other people living at the home also spoke of the help that staff gave them, to continue with relationships that were important to them. Residents are also able to make day-to-day decisions about their own lives: From the clothes that they wear, how they spend their day to social activities in the evening. People living at the home regularly choose to go into town shopping if able to, and/or spend time on their own in their room listening to music or watching television. How the staff speak to and support the residents is also very good. They always make sure that the residents are treated with dignity and respect, making sure that they always knock on the door before entering and always checking that the residents are safe. Victoria Cottage DS0000044185.V329872.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. Victoria Cottage DS0000044185.V329872.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 Victoria Cottage DS0000044185.V329872.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments of residents are to a satisfactory level and frequency to ensure a review of current need is in place for residents. EVIDENCE: Examination of the care records of two residents showed that both contained documents to show that an assessment of their needs had taken place. These documents had been undertaken prior to their admission to the home. In place for one person was also information from their funding authority and this document gave further background information on the likes and dislikes of that person. The information in place described both the physical, social and emotional needs of the person. It was also clear what the person liked to do and who were the important people in their lives. Evidence was also seen to indicate that residents had been given the opportunity to visit the home, before a decision was made to move in on a permanent basis. There were also documents in place to show that further assessment of needs was undertaken and a review of the care provided had taken place with the involvement of social services. Victoria Cottage DS0000044185.V329872.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. The support from staff to enable residents to make personal choices and decisions is good, so residents feel they are able to maintain an acceptable level of independence. EVIDENCE: The care records seen through the case tracking undertaken on this inspection showed documentary evidence of the involvement of residents in planning their care. Where possible residents signed care plans and the plans provided clear document to tell care staff what they liked to do and what they didn’t and how they could help in assisting them to achieve their individual interests. Daily records were not as comprehensive as the care plans however these were supplemented by further documentation, which contained entries by staff to show for example the activities that the resident had been involved in. A discussion was held with the manager at this visit who confirmed that all plans would follow the person centred approach. Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 10 Through interview feedback from staff and alongside observations made on the care and guidance offered to residents on the day of inspection; supports the conclusion that this standard continues to be met. The scope of risk assessments within the care records of residents included all circumstances under which the resident’s choices were limited. The risk assessments seen reflected and made clear the assessment surrounding this and the reason for the limitation on the resident’s choices; one example was leaving the home. The way, in which the home approached risk taking for the residents had also changed, the risks that residents wished to take in their lives were supported by the staff team. One resident spoke of going out on their own and how important this was for them. Plans were in place to support and encourage residents in their individual pursuits and if restrictions were in place the reason and consultation with the resident was documented. Decision-making is managed informally due to the small number of residents living at the home. Residents and staff spoke of meeting together to discuss social activities for example. Victoria Cottage DS0000044185.V329872.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. Links with the community continue to be good they help to support and enrich residents’ social and educational opportunities. EVIDENCE: A choice of meals was available over the week; menus submitted by the home reflected a varied diet and staff informed the inspector that residents were involved in setting the menus in the home and on occasions assisted in the homes ‘ shopping’. The kitchen was seen to be clean and tidy. Residents through discussion and through feedback confirmed that they were satisfied with the food at the home. One resident spoke of the contact with their family, they could visit family members at their own home. Documents seen within the individual care records of residents gave clear guidance to staff in how they should support the resident in maintaining these close relationships with the family members. Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 12 Management advised that none of the resident’s were engaged in paid employment at this time. Residents through discussion spoke of their attendance at varying local day facilities and described their programme of learning. Information examined supported this as records were maintained to show that one resident for example had received help through aromatherapy. Entries made within the care records described the social and leisure activities the resident’s had received. Records viewed on the day of inspection indicated that activities that had been provided for example were shopping trips, walks and going out for a pub meal/drink. Another resident attended the corner club. The care records seen also identified very different individual interests of the residents and they were specific in the identification of the residents preferred leisure interests, regular contact with family members and visits to their homes were also included. Residents spoke of their favourite things that they liked to do and these included for one resident an interest in music; which they had access to in their room with audio equipment in place. Staff spoke of links with the local community and the home is known in the area enabling residents to participate in a variety of social and educational facilities. The home describes throughout its literature the importance of integration into community life; the residents who are able use local shops and parks on a regular basis and the home owns transport to assist in this. Victoria Cottage DS0000044185.V329872.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 & 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The support available to residents in gaining access to healthcare continues to be good with residents benefiting from specialist medical advice and attention. EVIDENCE: There was documentary evidence that the home accessed outside healthcare professionals and services as required; in order to meet the healthcare needs of resident’s. The home is supported by a variety of health and medical advisors through local General Practioners. Medical visits were being recorded separately to daily notes, and a variety of healthcare monitoring charts were in use. Two of the resident’s spoken with confirmed that they were able to see their General Practitioner when needed, staff would arrange the appointment for them and in addition provide transport to the local surgery. The home was supporting a number of residents with specific health care issues and/or a sensory impairment. One resident had recently undergone Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 14 some health tests. However it was noted that a health assessment of residents had not been undertaken. The home now needs to seek initiating a Health Action Plan for all residents, with the appropriate healthcare professionals in accordance with the guidance from the Valuing People White paper 2001. Medication stocks were examined. Medication administration records had been signed and gave clear information on the medication to be given and the times that this should be done. The manager advised that one staff member has overall responsibility for ordering the supplies of medicines for the residents at the home. Medication was seen to be stored in a locked cupboard. Training records submitted by the home showed that all staff designated to administer medication had received training in this area. Within the care records examined specific entries had been made to guide and direct staff in how resident’s wished to receive personal care. One entry indicated a specific request by a resident on how staff should ensure that their privacy was maintained, when having a bath. Staff through discussion demonstrated an awareness of this and confirmed that this guidance was followed. Observation at this visit of the support offered to one resident when they required assistance, showed staff to communicate with them in an appropriate manner. Victoria Cottage DS0000044185.V329872.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure in the home is sufficient so resident’s benefit from having a system where they are listened to if dissatisfied. EVIDENCE: The homes complaints procedure was seen to be clearly on display in the home, this directed the reader in plain terms on how to make a complaint if they were unhappy with anything about the home. However the use of pictures must be used alongside words to make this more accessible to some of the people living at the home. The home also had a detailed policy in this area, this gave the necessary guidance to staff on how they should handle a complaint and the actions that they should take if they receive one this included recording the response by the home. Residents when asked agreed that they were aware that they could complain and several knew of the policy on display and its location. All residents said that they would feel comfortable with approaching the staff or manager if they were unhappy. Responses to some concerns received by the home were noted to have been investigated and an appropriate response made to the complainant. No referrals had been made under the local guidance for the protection of vulnerable adults. Training records submitted by the home show that staff have also undertaken training in the reporting of suspected abuse. Victoria Cottage DS0000044185.V329872.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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Improvements are needed in some areas in the home to ensure that a suitable environment is provided for the residents to live in. EVIDENCE: All areas seen at this visit were noted to be clean, tidy and free of any odours. Within the lounge of the home pictures were in place alongside domestic style lighting to assist in creating a homely atmosphere. The dining area of the home was brightly decorated and the standard of furnishings in these two areas was good. However other areas in the home require attention. There were large cracks on the wall as you walk up the staircase at the home. A shared bedroom was in use and an alternative bed must be considered for one resident at the home and this was discussed with the manager at the time of this visit. In addition frosted glass was in place at the windows and must be replaced. Curtains in Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 17 this room must also be provided. The replacement of pink bedroom furniture must also take place for one resident at the home; again this was discussed with the manager at the time of this visit. Victoria Cottage DS0000044185.V329872.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 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The approach and systems in place at this home for staff training are good, so residents receive support from staff with sufficient knowledge and understanding of their needs. EVIDENCE: Staff files examined on this visit contained the information listed in schedule 2 and 4. The home had obtained in all circumstances all matters in relation to this standard. Criminal Record Bureau checks had been received prior to the employment of an employee. Staff confirmed that they had been issued copies of the codes of conduct and practices set by the General Social Care Council. All further recruitment checks had also been undertaken. Induction checklists on the staff files seen on this inspection showed that the required areas of the staff’s roles and responsibilities had been covered and met all the Sector Skills Council specifications for induction or foundation training. The use of the Learning Disability Award Framework-accredited Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 19 training needs was being accessed to provide underpinning knowledge for new care staff. Training records and staff confirmed that alongside statutory training staff had undertaken further training in relation to their roles. The home had been active in commencing staff on a National Vocational Qualification programme and all staff had development and appraisal plans in place. Information supplied by the home to the Commission for Social Care Inspection showed 30 of staff with a national vocational qualification at level 2 or above. Certificates of attendance were maintained for all courses undertaken. Staffing rotas submitted by the home to the Commission for Social Care Inspection showed there to be sufficient numbers to meet the needs of the people living at the home. Victoria Cottage DS0000044185.V329872.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health and safety systems in this home are sufficient to provide an environment for residents that reduce the risks associated with this area. EVIDENCE: The manager had worked with staff at the home since her commencement to make improvements to the standard of care. Changes implemented under her management included the introduction of person centred planning. Staff when interviewed stated that they found her to be supportive and felt she had the “best interests of the residents at heart”. The home was noted to continue to carry out consultation with the residents in different forms. Staff reported that on a day-to-day basis residents are asked Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 21 for their views and these decisions are then integrated into the care plans of the resident, examples included evening activities. More formal methods such as residents meetings had taken place in the past and minutes were available for inspection, but the home recognised that the views of all residents could not be sought in this way. The home must seek to gain the residents views through a quality assurance and monitoring system. The manger confirmed that this had not taken place since 2005 and a requirement is made. In-house health and safety checks were taking place approximately as needed. Health and safety systems at the home were seen to be carried out in accordance with the guidance within the homes policy. The most recent fire and environmental health inspection reports show that the home had met the standards in these areas, with revised risk assessment relating to fire being undertaken. In addition cleaning products were seen to be locked away, risk assessments had been undertaken for areas and activities in the home. No other concerns relating to health and safety were noted during this inspection. Victoria Cottage DS0000044185.V329872.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 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 23 NO 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 YA22 Regulation 22 Requirement Timescale for action 30/06/07 2. YA24 3. YA24 4. YA24 5. 6. 7. YA24 YA24 YA39 The use of pictures must be used alongside words to ensure the complaints procedure is in a format suitable for all people living at the home. 23 Repair and make good the walls on the staircase to create a suitable environment for the residents to live in. 23 The frosted glass in the shared bedroom must be changed so that people can see out of the windows. 23 The pink bedroom furniture must be replaced for one person living at the home to reflect his personal tastes. 23 A suitable replacement of a bed for one person must be made that does not restrict them. 23 Curtains and/or blinds must be provided in the shared bedroom to offer privacy. 24(1)(2)(3) The home must show the results of resident’s views and how they have been used to influence the running of the home. 31/07/07 31/07/07 31/05/07 31/05/07 31/05/07 30/08/07 Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA19 Good Practice Recommendations The home should initiate with the relevant medical professionals for all residents to have a Health Action Plan in accordance with the Valuing People White Paper 2001. Victoria Cottage DS0000044185.V329872.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 Victoria Cottage DS0000044185.V329872.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. 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