Inspection on 13/06/05 for West Farm House

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 but made no statutory requirements on the home.

Other inspections for this house

West Farm House 17/04/08

West Farm House 08/10/07

West Farm House 30/01/07

West Farm House 30/01/06

West Farm House 21/03/05

West Farm House 26/08/04

West Farm House 19/11/03

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE West Farm House Collingbourne Ducis Marlborough Wiltshire SN8 3DZ Lead Inspector Malcolm Kippax Announced 13 June 2005 th 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 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service West Farm House Address Collingbourne Ducis Marlborough Wiltshire SN8 3DZ 01264 850224 01264 850720 Not available Mrs Helen Burnett-Price and Mr Barry Price Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Helen Burnett-Price Care Home 10 Category(ies) of OP Old Age (10) registration, with number of places West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st March 2005 Brief Description of the Service: West Farm House is registered to provide board, accommodation and personal care to up to ten older people. The home is situated in a quiet village location. Village amenities, including a convenience store with post office counter, are within walking distance of the home. West Farm House is a two storey, period property. The style of decoration and furnishing of the accommodation is in keeping with the character of the building. Some adaptations have been made to meet the needs of older people. There is a large well-kept garden with a lawn and seating areas. The communal areas of the home include a lounge, a dining room and a sun lounge extension. The service users’ individual accommodation is on the ground and first floors. A passenger lift is available. At the time of this inspection each service user had a single room, although shared accommodation may also be available. All rooms have an en-suite facility. The owners, Mrs Burnett-Price and Mr Price, are both involved in the day to day running of the home. Mrs Burnett-Price overviews the care of the service users. During the day the service users receive support from a permanent staff team. At night the owners provide sleeping-in cover from their own accommodation, which is next to the home. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 9.30am and took place over eight hours. Eight of the nine service users in the home were spoken with. Staff members were met with during the day. Mrs Burnett-Price, the manager and joint owner, was available throughout the inspection. The accommodation, other than for two bedrooms, was looked at during a tour of the home. Service users were met with in their own rooms, in the garden and in the dining room during lunch. A number of the home’s records were examined, including a selection of the service users’ care records. What the service does well: What has improved since the last inspection? The safety of several service users has been improved by the fitting of covers to radiators in their own rooms. Staff training has taken place. The manager and one member of staff are enrolled on the registered managers award course. Some new forms are being developed which will provide a better means of recording assessments and care needs. On-going decoration and refurbishment are helping to maintain attractive surroundings for service users. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 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. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 and 3 Written information about the home is improving although there is insufficient information about the range of needs that can be met and how a change in needs will be responded to. The production of new assessment forms has been beneficial, however the completed assessments vary in content and in the case of the more dependant service users do not provide all relevant details about their care needs. EVIDENCE: Service users receive a well-presented brochure. This states that accommodation is for 13 residents although the home’s current registration is for 10. The home’s Statement of Purpose and service user’s guide are typed sheets and these were updated during the inspection. The range of needs to be met includes help with personal care, although the criteria for admission is that the service user can ‘feed and toilet independently’. There was no mention of whether care will be provided to people who have needs in relation to mental health and dementia. The home is registered for Old Age only and the information should reflect the limitations that this has on the service that can be provided. Other than a statement about nursing care, information about the type of care provided and how an increase in dependency will be West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 9 responded is not included in the Statement of Purpose. It is important that prospective service users are aware of this and that current service users receive information about how a change in their needs will be met, particularly at night when the usual arrangements mean that the service users are not directly monitored. A ‘needs at night’ assessment form is completed. In the case of two new service users these had been completed after their admission. It is important that these assessments are comprehensively reviewed and take into account the views of outside professionals where applicable. Service users could not recall seeing a copy of a C.S.C.I. inspection report. It is stated in the service user’s guide that these may be viewed at West Farm House offices, with a copy provided on request. Initially, the most recent inspection report needs to be given to service users as part of the service user’s guide. The assessment records covered relevant areas although lacked detail in significant areas, including ‘Mental State and Cognition’ and ‘Personal safety and risk. For example, in the case of the latter the assessment of ‘some risk’ needs to be described in more detail to highlight the specific areas of concern. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 10 Service users appreciate the assistance that they receive and feel that they are treated in a respectful manner by staff. Service users benefit from the arrangements made for the monitoring and follow up of their health care needs. Individual care plans provide a summary of care needs, however the lack of detail in particular areas has the potential to place service users at risk. EVIDENCE: Service users spoke very positively about their dealings with staff and the manner in which they are treated. Staff were observed to be knocking on doors and heard speaking to service users in a friendly and respectful way. Service users have the facilities to be private in their personal care. Individual care plans have been developed to include a summary of the physical support that is needed from staff. A section on ‘needs at night’ has recently been added. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 11 One service user’s care plan showed the involvement of a consultant psychiatrist. Another service user also had specialist needs and Mrs BurnettPrice confirmed that these would now be followed up with the involvement of outside professionals. In the case of both service users, further information was needed about the care and support that is needed in relation to specialist areas of need. It needs to be evident from the records that the care needs of new service users can be appropriately met and are consistent with the home’s category of registration. The care plans stated that service users are able to manage under the arrangements that are in place at night. Service users had signed the care plans but had not received their own copy. The care and assessment records are kept in a number of different files. A ‘Medical Treatment Log’ is kept for the recording of healthcare matters and visits to GPs and other healthcare professionals. Healthcare matters are also recorded on the care plans when these are updated. Prior to this inspection, ‘Comment Cards’ were received from seven service users and from two relatives. Feedback from the respondents about their experience of the home was very positive. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 15 Service users enjoy a relaxed and informal atmosphere, with encouragement to keep in contact with relatives and outside interests. The meal arrangements are of a good standard. Service users appreciate the surroundings and the manner in which food and drinks are prepared and presented. EVIDENCE: Service users spoke about their different interests and the contact that they have with friends and visitors. There is an ‘open door’ policy and relatives visit the home on a regular basis. Some service users said that they were already familiar with the home and the local area before moving in. A convenience store with post office counter is within walking distance of the home. One service user continues to use their own car for local trips. Eight service users had lunch together in the dining room and one person had chosen to eat in their own room. Lunch was a freshly prepared and wellpresented meal that was enjoyed by the service users. There is a set menu. Service users were generally complimentary about the content of the meals. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 13 They did not know what was to be served during the day. Service users were happy with the breakfast arrangements (served to service users in their own rooms) and particularly liked the serving of morning coffee and afternoon tea. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 Recent training has helped to increase staff awareness of abuse. The home’s policies and procedures on abuse provide some safeguards for service users although do not give information about the local arrangements for the protection of vulnerable people. EVIDENCE: A Police Officer has visited the home and held a session with staff about abuse awareness. Written guidance about abuse is included in the home’s policies and procedures file. This does not refer to the arrangements that are made locally for the protection of vulnerable adults. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 25 and 26 Service users appreciate the location of the home and enjoy their surroundings, both internal and external. Service users benefit from the provision of particular aids and facilities, although the lack of a portable hoist and of hot water temperature controls on the baths present a risk to their safety. EVIDENCE: West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 16 West Farm House is located in a quiet location close to a number of village amenities. The position and layout of the home are in keeping with its stated purpose. The home is comfortably furnished and well decorated. Service users said that they like the home’s position and the accommodation that is available. A number of service users also spoke about their enjoyment of the garden, both as a sitting area and as a view from the house. There is a choice of well furnished communal rooms. The dining room has been extended to provide a garden room / sun lounge which serves as an additional sitting and recreational area. The room is centrally heated and designed for use throughout the year. Service users can choose to use a passenger lift or a staircase to the first floor. These are conveniently situated within the home. There are two bathrooms, both of which are on the first floor. The bath in one of the rooms has a hydraulic chair. There is no portable hoist available in the home and this has been the subject of recommendations at previous inspections. Advice must be sought from a suitably qualified person about the circumstances in which a hoist is needed and the correct way for staff to support a service user who has had a fall. It is reported that wash hand basins in the service users’ rooms are fitted with thermostatic controls to the hot water supply although these have not been fitted to the baths. Mrs Burnett-Price said that the bathrooms were kept locked to ensure that service users did not have access to these areas. Rooms are centrally heated with adjustable radiators. Radiator covers have been fitted in a number of bedrooms in recent months. The remaining uncovered radiators should continue to be risk assessed until covers are fitted. Emergency lighting is provided throughout the home. The service users’ rooms receive natural light and have a range of ceiling and table lights. Mrs Burnett-Price has said that all the windows at first floor level have restricted openings. The home looked clean. Refurbishment of the laundry has begun with the fitting of a new floor. This is due for completion later in the year. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 29 Relationships between staff and service users are friendly and positive. Service users’ needs are well met by staff during the day, although there is less awareness and monitoring of the service users’ needs during the night. The recruitment procedures in connection with recent staff appointments have not been as robust as they should be. EVIDENCE: Service users said that staff members are friendly and there were compliments about the mature approach of individual staff members. Service users said that ‘the girls are very helpful’. The staff team covers care duties during the day, usually working alongside one of the owners. A minimum of two people are working throughout the day, with a third person deployed for certain shifts. After 9 pm, cover is provided by the owners until 8 am the following day when a staff member comes on duty. The staff rota does not show when ‘sleeping-in’ cover starts. Service users who need assistance during the night are expected to summon assistance by using the call alarm system or telephone to the owners in their own accommodation. The service users spoken with were aware of this arrangement. A ‘needs at night’ assessment form is completed. Given the inherent risks involved in this arrangement and the absence of night staff, it is important that these assessments are regularly reviewed (refer to ‘Choice of West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 18 Home’ section). Regular monitoring of service users’ activities and routines during the night should be part of the assessment process. Reports showed that on occasions a staff member has ‘sat up’ with a service user. The service users’ records also included some comments about incidents during the night although further information is needed about the background to these events and how they have been responded to. A form of ‘night diary’ would be a means of recording any monitoring and support that service users receive during the night. For reasons of confidentiality this would need to have separate sections for each service user. C.R.B. disclosures have been obtained on members of staff, other than for two staff members who were returning to work in the home and came with disclosures that had been obtained elsewhere. A letter was sent to the registered persons after the inspection confirming the action that needed to be taken in respect of the P.O.V.A. checks and new CRB disclosures. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 38 The standard of record keeping is improving however there are shortfalls in some areas. Systems are in place for the safe working of facilities and equipment but greater awareness and a more pro-active approach is needed concerning areas of risk. EVIDENCE: The inspection identified a number of areas where the recording needs to be more comprehensive and to provide more detailed information about the service users’ needs. Servicing arrangements are in place for the lift and the bath chair. A record of water checks (re: legionella) is being maintained. A variety of objects were being used to hold open bedroom doors to assist service users. This is not a safe practice as a long-term arrangement and comprises the home’s fire West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 20 precaution arrangements. Approved devices are available for this purpose and for the convenience of service users. The fire log book was up to date in respect of alarm tests, emergency lighting, means of escape. The fire fighting equipment had been serviced in June 2005 although there was no record of monthly checks. The dates on which fire instruction is given is not being recorded. Risk assessments have been undertaken in relation to service users, including the risk of service users smoking in their own rooms. A number of the risk assessment forms were not dated and did not have a review dated identified. A number of requirements have been identified at this and previous inspections concerning health & safety and the reduction of risk to service users. Training in these areas will help to increase awareness of risk and of the safety measures that need to be put into place. West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 2 3 x 2 x 3 x x STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 1 x x x x x x 2 1 West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 22 YES 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 1 Regulation 4 Requirement Documentation produced about the home must be accurate and include fuller information about the range of needs that the home aims to meet and how a change in dependency will be responded to. A copy of the most recent inspection report must be included in the service users guide The assessment records must give more comprehensive information about a new service users needs. The needs at night assessments must be completed prior to admission and comprehensively reviewed on a regular basis, taking into account the views of outside professionals, where applicable The care plans must give more detailed information about how a service users specialist needs are to be met in the home The homes policies and procedures on abuse must include information about the local arrangements for the protection of vulneralbe adults Timescale for action BY 31/07/05 2. 1 5 FROM 14/06/05 FROM 14/06/05 FROM 14/06/05 3. 3 14 4. 3 14 5. 7 15 FROM 14/06/05 BY 31/07/05 6. 18 13 West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 23 7. 22 23 8. 25 13 9. 27 18 10. 29 19 11. 38 23 12. 13. 14. 38 38 38 23 23 13 and the appropriate contact details. Each member of staff must be aware of this information Advice must be obtained from an appropriate authority about the circumstances in which a hoist is needed and the correct way for staff to support a service user who has had a fall. This information needs to be detailed in the homes Health & Safety policy The temperature of the hot water supply to the baths must be reduced to a safe level by the use of individual thermostatic controls A record must be kept of any care and support that is provided to service users between the hours of 9 pm and 8 am. This record needs to show the time and the reason for any intervention. A P.O.V.A. check must be undertaken prior to a new member of staff starting in the home. P.O.V.A. checks for staff who have been appointed since the introduction of the scheme must be undertaken by 23 June 2005 Fire doors must not be held open unless they are fitted with an appropriate device approved by the fire officer That the dates on which fire instruction is given are recorded in the homes fire log book Checks of the fire fighting equipment must be recorded in the homes fire log book That the risk assessments concerning the safety of service users smoking are dated and reviewed on a regular basis BY 31/07/05 BY 31/08/05 FROM 14/06/05 FROM 14/06/05 FROM 14/06/05 FROM 14/06/05 FROM 14/06/05 FROM 14/06/05 West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 24 15. 38 13 The Commission must be informed of the arrangements that have been made and a date for the manager to start an appropriate course in health & safety and risk assessment BY 12/08/05 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 1 7 Good Practice Recommendations That the homes Statement of Purpose and service users guide are presented in a more user-friendly format That service users are more involved in the care planning arrangements and that the care plans reflect the service users own preferences for personal care and support with social needs etc That the assessment and care plan records are kept together on an indivual basis for each service user for ease of cross-referencing. Consideration should be given to the best way of maintaining the records to ensure that they are readily available to service users and staff That service users are informed of the days menu and given the opportunity to choose an alternative dish to that on the set menu That regular monitoring of service users’ activities and routines during the night is part of the assessment process 3. 7 4. 5. 6. 7. 15 27 West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 West Farm House D51_S28653_WESTFARMHOUSE_v191617_130605stage4.doc Version 1.30 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!