Inspection on 12/11/07 for Westlands

This inspection was carried out on 12th November 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Westlands 11/09/06

Westlands 10/08/05

Westlands 26/05/05

Westlands 01/11/04

Westlands 20/05/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Westlands Westlands West Hill Road Woking Surrey GU22 7UL Lead Inspector Mark Hemmings Unannounced Inspection 12th November 2007 08:30 Westlands DS0000013823.V349756.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 Westlands DS0000013823.V349756.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. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Westlands Address Westlands West Hill Road Woking Surrey GU22 7UL 01483 761067 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) Whitmore Vale Housing Association Alan John Horler Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (1) of places Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The total number of people to be accommodated shall not exceed seven. 11th September 2006 Date of last inspection Brief Description of the Service: Westlands (the Service) is registered to provide accommodation and personal care for up to seven adults who have a learning disability. One of the people in residence may be an older person. The premises are a large detached house located in a quiet residential street. All of the people have their own bedroom each of which has a private wash hand basin. There is a shared use lounge/dining room and various other rooms that you would expect to find in anyone’s home. The Registered Provider gives useful information to prospective people who might want to live in the Service. There is a Service Users’ Guide. This is a brochure that outlines the principal features of the facilities and services available in the Service. There is a document called the Statement of Purpose. This gives a more detailed account than does the Guide. Also, the Registered Provider ensures that a copy of the most recent Inspection Report from the Commission, is available for reference. The current weekly fee for residence in Westlands runs from £1228.14 to £1439.20. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 08.45 and was in the Service for six hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Service’s owner or manager and any information that CSCI has received about the Service since the last inspection. There are two Required Developments at the end of this Report. What the service does well: What has improved since the last inspection? The Registered Provider has completed quite a significant programme of improvements to the premises. A new passenger lift has been installed. A new bathroom has been created that is equipped with a special walk-in bath. Various rooms have been redecorated. Some new soft furnishings have been provided and various items of bedding have been replaced. Support workers have attended various training events and more are planned in the near future. Support workers are receiving regular professional supervision. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Westlands DS0000013823.V349756.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 Westlands DS0000013823.V349756.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): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There are arrangements to ensure that prospective people who might want to move in will have their needs assessed and their wishes acknowledged. EVIDENCE: There have not been any new admissions to the Service for some time. None are planned in the foreseeable future. However, a good deal of attention has been given to the steps that will be taken in the future to respond to someone moving in. This will involve the Registered Manager consulting closely with the person concerned about their needs for support and about their expectations of the Service. The Registered Manager will also speak with other people such as doctors, care managers (social workers) and family members, so that relevant background information can be acquired. Someone who might move into the Service is invited to visit beforehand. This is done so that they can get a first hand feeling of what it is like to live in Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 9 Westlands. Also, it gives everyone a chance to see how well the person will fit in with the group of people already in residence. The Registered Manager is aware of the need to ensure that all of the support workers are informed about the needs of a new person. This is done so that their needs for assistance can be met in a reliable and consistent manner from the start. The Registered Manager says that careful attention will be paid to managing the actual admission. He will make sure that the person is greeted and that special consideration is given to making him or her feel at home. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 10 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): Standards 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The health and personal care that people receive, is based upon their individual needs. People are actively involved in making decisions about things that affect them. Sensible provision is made to promote an independent lifestyle. EVIDENCE: The people who use the Service say and indicate by their relaxed manner that the support workers offer them all the assistance they need and that this is provided in a reliable and consistent manner. There is a written plan of support for each service user. These are important documents. This is because they form one of the means by which people who use the Service can be informed Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 11 about and can agree to the assistance they will receive. Also, the plans are a source of reference information for support workers. The level of the information contained in the plans is well developed. The information states what assistance the person needs and how this is to be delivered. The support workers know about this material and they organise their work accordingly. There is evidence that the people who use the service are actively consulted about what is included in their individual plans of care. This involves support workers taking the time to explain who is doing what and why. People are assisted to make decisions about their own lives. This means that they can be as independent as they want to be. When extra help is required, this is delivered in an appropriate manner. For example, people are assisted to manage aspects of the personal spending monies. This is done in a way that maximises the involvement of the person concerned so that support workers do not take over when it is not necessary. Sensible arrangements are in place to help the people in residence to lead normal lives, without entertaining unreasonable risks to their wellbeing. This involves the Registered Manager and the support workers carefully identifying potential risks to personal health and safety, so that they can be avoided or managed. This is not done in an intrusive manner and the result is not overly cautious. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 12 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): Standards 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The people who use the Service can choose to become involved in a range of social and vocational activities. They are helped to keep in touch with members of their families. Good quality meals are served. EVIDENCE: The people who use the Service are free to choose what to do each day. The pace of daily life is relaxed. There are no unnecessary rules or routines to disrupt the experience of a normal domestic setting. The people in residence say or indicate that their time is adequately occupied. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 13 The people who use the Service have individual weekly calendars of activities that they can undertake. These calendars show that considerable care has been given to selecting activities that are appropriate for the person concerned. The Registered Manager says that he wants to increase the range of vocational and social opportunities offered to some of the people in residence. He recognises that this will require a detailed consideration of the things that are most likely to engage the interests of the people concerned. He says that some of the activities he would like to introduce may not be available from other providers and so will have to be developed in-house. He anticipates that some of these will involve a measure of one to one support being given to the people concerned. The people who use the Service are assisted to keep in touch with family and friends. This is very important because most of the people in residence have special communication needs and so need a good deal of help to maintain contacts. People can receive visitors at any reasonable hour. They can meet with their visitors in the privacy of their bedroom if they wish to do so. The Registered Manager in consultation with the people in residence consults with their relatives. This is important because it keeps families in touch with how things are going and because it helps to promote their involvement. The people who use the Service say or indicate that they receive good quality meals and they always have enough to eat. The menu indicates that a range of dishes is served. The Registered Manager says that careful attention is given to ensuring that the people in residence are offered the chance to have a balanced diet that is likely to help with the promotion of good health. The people in residence are actively consulted about what dishes to have prepared and they are asked to suggest alterations and developments to the menu. The Registered Manager is aware of the need to accommodate special diets that may be necessary for particular health reasons. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. People are supported in accordance with their wishes. They are assisted to promote their physical health. Suitable arrangements are in place to manage medication. EVIDENCE: The people who use the Service say or indicate that the support workers are kind and considerate. They are relaxed in the company of the support workers. There is a family atmosphere. Support workers ensure that personal care is provided in private when appropriate. The people in residence are assisted to dress in the manner of their choice. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 15 The people who use the Service are assisted to maintain their physical health. Support workers keep a tactful eye open, so that medical attention is sought promptly should the need arise. Since the last inspection visit, family practitioners and various other medical resources have been involved in a timely manner to support the care provided in the Service. The people in residence are also assisted to promote their health. This is done by encouraging them to take steps such as watching their weight and attending to their dental hygiene. Suitable arrangements are in place to enable medication to be managed appropriately. This includes a stock management system that ensures that the medicines supplied to the Service are correct. Once in the Service, medicines are stored in a secure and orderly manner. There is a written procedure to guide support workers when dispensing medicines. Support workers are careful to ensure that the people in residence take medicines in the manner intended by their doctors. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There is an effective system for dealing with complaints. The wellbeing of the people who use the Service is safeguarded. EVIDENCE: The Registered Provider is aware of the need to ensure that complaints about the Service are investigated thoroughly and resolved promptly. Since the last inspection, neither the Registered Provider nor the Commission had received any formal complaints relating to the Service. There is a written procedure that explains how people can raise a concern about the Service. The Registered Manager says that he is considering how this procedure can be made more user-friendly. This will involve the greater use of pictures and other alternatives to the written word. In the interim, he says that support workers take the time necessary to liaise with each person so that they feel confident about raising any concerns should they have any. The people who use the Service say or indicate that they can approach members of staff if there is something on their mind. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 17 There is a written procedure that is intended to guide support workers about what constitutes good care practice and about what to do if they are concerned about someone’s wellbeing. The support workers are aware of the need to be alert to instances in which the well being of people who use the Service might become jeopardised. They say that they have not had any such concerns since the last inspection visit. The people in residence say or indicate that they feel safe living in Westlands. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The people who use the Service are provided with a homely setting that promotes their independence. EVIDENCE: The Service provides a suitably domestic setting in which the people in residence can make their home. They say or indicate that they are comfortable living in Westlands. Since the last inspection, the Registered Provider has completed a considerable programme of improvements to the accommodation. These have included the installation of a new passenger lift and the creation of a new bathroom that has a special walk-in bath. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 19 Some of the bedrooms have been redecorated and new soft furnishings have been provided. The Registered Manager says that careful attention will be given to the future maintenance of the accommodation. This will be done so that repairs can be completed in a timely manner and so that any worn items can be replaced quickly. The kitchen is clean and well organised. The local Department of Environmental Health has said that suitable food hygiene practices are in use. Some of the kickboards at the base of the units are rather worn and look unsightly. The Registered Manager says that they are due to be replaced in the near future. The Registered Provider has completed an organised assessment of the adequacy of the fire safety provisions in the Service. This assessment has not indicated the need for any additional measures to be introduced. The assessment is going to be forwarded to the Surrey Fire and Rescue Service by 1 January 2008. This is to be done so that the agency can take the information into account when evaluating the continued adequacy of the fire safety regime operated in the Service. Suitable facilities are in place to assist the people in residence to do their laundry. The Registered Manager is going to check that suitable steps have been taken to ensure that used water does not leak back into the Service’s main pipe-work. This will be done by 1 January 2008. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. There are enough members of staff on duty. Security checks are completed in relation to new employees. Support workers know what they are doing. EVIDENCE: There are at least three support workers on duty during the day and the evening. At nighttime, there are two people on duty. The people who use the Service say or indicate that support workers are always around and willing to help whenever they need them. Support workers think that the Service is well staffed. The Registered Provider completes a number of security checks for new members of staff. This includes taking up personal references and obtaining a suitable Criminal Records Bureau disclosure. This is done to ensure that they Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 21 are suitable people to have unsupervised access to the people who use the Service. Prospective members of staff are expected to meet with the people in residence. This is done so that they can give their reaction to the proposal that someone joins them in their home. New support workers receive introductory training. This is designed to ensure that they have the basic knowledge and skills they need in order to be able to work without direct supervision. This is important because the quality of care delivered in the Service, depends largely upon the adequacy of the competencies support workers have to hand. The Registered Manager is going to review aspects of the way in which the introductory training is organised and recorded. This is being done to ensure that all of the required subjects are indeed being suitably covered. He will be doing this exercise using a national model that the Commission considers to be a guide to good management practice. In addition to the introductory training, existing support workers undertake a number of additional training courses. These are selected to ensure that they are directly relevant to the support delivered in the Service. The support workers think that the training they have received to date has been very useful in that it has enabled them to develop and to reflect on their practice. The support workers have a suitably detailed knowledge of the personal requirements of each of the people in residence. They have the skills they need to deliver the assistance described in the individual plans of care. Each of the support workers meets with the Registered Manager on a regular basis. This is done so that their work can be reviewed and so that any problems can be resolved. The support workers consider these sessions to be useful and informative. The sessions are also used to identify the need for additional training. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the Service. The Service is well managed. There is only a basic quality assurance system. Various measures are in place to safeguard health and safety. EVIDENCE: The Registered Manager is qualified and he oversees a number of arrangements that are designed to ensure the efficient running of the Service. One of these involves ensuring that support workers are kept up to date with how things are going for each of the people in residence. This includes having Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 23 regular meetings at the beginning and at the end of each shift. Also, it includes the maintenance of diary records that show how things are going on a daily basis. The people who use the Service are invited to comment informally about how things are going. While this is very important, there also needs to be a more organised system to enable the people in residence and other stakeholders to contribute their views about the Service. The Registered Provider will need to give this matter careful attention in the manner described in the relevant Required Development at the end of this Report. The service documents confirm that items of equipment in use in the Service remain in good working order. For example, gas fired appliances and the electrical wiring installation. The Service is fitted with a modern fire detection and fire management system. The operation of this system is checked regularly. There are regular fire drills. There now needs to be an additional arrangement to double-check that all of the support workers know how to operate the Service’s fire safety system. There is a Required Development in relation to this matter at the end of this Report. The Registered Provider checks the building and the accommodation to ensure that potential environmental hazards to health and safety are addressed. The Registered Manager says that there are no hazards currently in the Service that are waiting to be addressed. Substances such as bleaches and other cleaning fluids are stored safely when not in use. Westlands DS0000013823.V349756.R01.S.doc Version 5.2 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 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 3 25 X 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 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 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA39 Regulation 24 Requirement The Registered Provider should ensure that a suitable system is in place to enable the people in residence and other stakeholders to comment about the Service and to ensure that they are informed about the improvements to be made (this Required Development is outstanding from the last inspection report. It should have been completed by 11/11/06). The Registered Provider should ensure that all members of staff are included within a system that is designed to double check (at least once in every period of six months) their ability to use reliably the Service’s fire safety procedure. Timescale for action 01/08/08 2. YA42 23 01/01/08 Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 26 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 Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Oxford Office 4630 Kingsgate Oxford Business Park South Cowley Oxford OX4 2SU 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 Westlands DS0000013823.V349756.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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