Inspection on 14/03/08 for Windmill Lodge

This inspection was carried out on 14th March 2008.

CSCI found this care home to be providing an Good service.

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

Other inspections for this house

Windmill Lodge 26/07/06

Windmill Lodge 17/10/05

Windmill Lodge 05/05/05

Windmill Lodge 30/11/04

Windmill Lodge 05/07/04

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 Windmill Lodge 26 Springhead Road Northfleet Gravesend Kent DA11 9QY Lead Inspector Anne Butts Unannounced Inspection 14th March 2008 10:30 Windmill Lodge DS0000059514.V359544.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 Windmill Lodge DS0000059514.V359544.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. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Windmill Lodge Address 26 Springhead Road Northfleet Gravesend Kent DA11 9QY 01474 354212 01474 354212 joe.hosanee@tiscali.co.uk 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) Mr Abdoollah Hosanee Mr Abdoollah Hosanee Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26 July 2006 Brief Description of the Service: Windmill Lodge provides accommodation and support for up to eight people with learning and some physical disabilities. Twenty-four hour care is provided. All service users have single en-suite bedrooms. There is a garden at the rear and a patio area at 1st floor level. The premises are about 15-20 minutes walk from the centre of Gravesend and there is easy access to public transport and to a range of amenities. The Owner/Manager is nurse trained, has a diploma in management studies and has achieved the Registered Managers Award. He manages the home on a daily basis and is supported by a Deputy Manager. The current fee structure at the time of inspection was £581.00; there are additional charges for hairdressing, clothes, toiletries, activities and holidays. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced site visit that was carried out by one inspector over the course of one day. The site visit included talking to four people who live in the home, the manager, deputy manager and members of staff on duty. A tour of the home was undertaken and observations were made on the support provided to people living in the home. A variety of records were inspected including care plans, staff files, medication records and the Statement of Purpose. The home had not completed an Annual Quality Assurance Assessment prior to the visit so information was obtained verbally. We (The Commission) have made our judgements with regards to each outcome area in this report, based on records viewed, observations and verbal responses given by those people who were spoken with. These judgements have been made using the Key Lines of Regulatory Assessment (KLORA), which are guidelines that enable The Commission for Social Care Inspection (CSCI) to be able to make an informed decision about each outcome area. Further information can be found on the CSCI website with regards KLORA’s and AQAA’s. What the service does well: People can be confident that they will have an assessment prior to them moving in so that that they are able to make a judgement as to whether the home can meet their needs. The service promotes the equality and diversity of the people living in the home and care plans are individualised for needs of each person. Individual needs and preferences are catered for including dietary requirements and personal choices. The home is pro-active in treating all people with equality. We observed a good rapport between people living in the home, staff and management. The home is proactive in ensuring that they are up to date and aware of new legislation, guidance and best practice. Windmill Lodge DS0000059514.V359544.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. Windmill Lodge DS0000059514.V359544.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 Windmill Lodge DS0000059514.V359544.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): 1, 2 and 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from a full assessment so that they can be confident that the home will be able to meet their needs. EVIDENCE: The home has produced a handbook that provides current and prospective residents with information about the home. The handbook contains photographs and describes the services and support provided by the home. The handbook sets out the homes philosophy of care and contains the complaints procedure. A copy is available for prospective residents. All people living in the home have undergone a holistic assessment that covers all areas of personal, health, behavioural needs and takes into account educational and employment aspirations. An assessment is carried out prior to a new service user moving into the home and ongoing needs are monitored. The home is pro-active in ensuring that the ongoing and changing needs of the service users are monitored and promoted. Service users (and their families or advocates) are encouraged to visit the home prior to moving in and spend time meeting staff and service users. Windmill Lodge DS0000059514.V359544.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, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from having clear and in-depth care plans that identify individual needs and give clear guidance to staff on how to support them in making decisions and participate in the running of the home. EVIDENCE: We looked at three files for people living in the home and they all showed that people are supported with a care plan that suits their needs. The care plans take into account agreed aims and objectives and how service users will be supported in meeting these. Care plans are developed with the individual and are reflective of individual diversity. Where people need more specific help in certain areas of support then the care plan identifies this. For example one person requires assistance with their personal care needs and their care plan sets this out in detail, whilst another person who does not need any support in this area has a less detailed plan in place for this. Another person, who has higher support needs for managing their weight, has more detailed guidance in Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 10 the care plan. Each care plan had an individualised procedure for assisting the person. Regular reviews are carried out with Care Managers and changes in need or aspirations are recognised and acted upon. People are supported to make decisions about their daily lives and this is evidenced through their care plans. The core objective of this home is to promote and support the independence of the service users. A high emphasis is placed on this with assessments supporting individuals’ rights to be as independent as possible. We spoke to people who live in the home and they confirmed that they were supported with making decisions and choices about their daily lives. People living in the home described to us how they take part in the daily running of the home and this includes menu planning, organised activities and any decorating plans. Care plans are supported by individual risk assessments that give guidance on how to support people. They take into account how the person can be supported in meeting their objective and explore how to minimise the risk in each area. The assessments evaluate each person’s strengths and needs and then outline a management plan that has been agreed with each person. The home had carried out an “About Me” assessment with everyone living in the home. People had completed this themselves, or with assistance if required. It was designed to show what people’s preferences were and what they liked doing, also where they felt they needed support. The Deputy Manager stated that although they used this for information they had not actually taken any pro-active action following this. The information in these would benefit the care plans and further promote the person centred care that the home provides. Information in maintained confidentially and held securely in locked storage. Windmill Lodge DS0000059514.V359544.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): 11, 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported with leading independent lifestyles in which they can make positive choices. EVIDENCE: People are supported with accessing pastimes and activities that suit their needs. Staff in the home are aware of individual capabilities and preferences and support them in making informed choices. Some people attend day centres and the local Mencap community awareness centre. One person carries out voluntary work and is being supported to find employment in a particular occupation. As yet they have been unsuccessful, but they continue to support with this. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 12 Care plans reflect people choices and risk assessments support people in being able to access their chosen activities independently so that lifestyles are not restricted. One person sits on a panel in a Kent County Council Partnership Board to represent service users and contribute to care practices for people living in a care home environment. Another person described how when their bedroom was redecorated that they had helped with the painting. They said, “I really enjoyed doing that”. Another person is interested in music and computers and is supported with this. People have the benefit of transport in the home’s minibus and this allows them to be able to go and about on a regular basis including day trips to the coast and other places of interest that the people choose. Regular nights out are arranged including meals and local clubs. A holiday has been arranged and people have chosen to go to Devon. Where individuals have chosen to attend church services, they are supported with this and the home is aware of individual cultural and religious beliefs. People are fully involved with different aspects of the home and are encouraged to participate in daily living activities and take some responsibility with regards to their own daily chores, including helping out with some duties around the home and maintaining their own bedrooms. Individuals are also supported to make their own sandwiches, microwave meals and drinks. Family and friends are encouraged and welcomed into the home, people are also supported in making visits to relatives. Where residents are happy to do so, family involvement is also encouraged in care planning and reviews. People living in the home are fully involved in menu planning and people sit together and organise the shopping list and work out menus as a group. Changes are made in agreement with everybody and if a person wants something different then this is arranged. Special diets are monitored and catered for. One person who has a dairy intolerance is supported with dairy substitutes so that they also have the benefit of eating the same meals as everyone else and not discriminated against. We saw evidence of fresh fruit, vegetables and choice of snacks. People living in the home all spoke highly of the meals and said that they enjoyed them. Windmill Lodge DS0000059514.V359544.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported with their care needs in a sensitive and discreet manner that suits their individual needs. EVIDENCE: Care plans demonstrated how staff assist people with any personal care if needed, and they were tailored to the individual need and where more support is needed this was reflected. Comments from people using the service included “Everyone is really nice here – the staff are great” and “They always listen to me and have time to talk to me”. There are no restrictions on getting up or going to bed. Healthcare needs are well met and records evidenced that the home monitors people’s needs to healthcare and supports them in attending appointments for the G.P., Dentist, Optician and any specialist needs for individual service users. Care plans indicate where additional healthcare support is needed. For example additional support with diet or visiting the dentist is recorded with Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 14 guidance for staff on how to offer or give assistance with this. Behaviour patterns are monitored and people are generally supported with this. We saw evidence of appropriate healthcare professional input in supporting people with any difficult behaviour. Care plans would benefit from the support information being incorporated so that staff are aware of any action they should take. Medication records were inspected. The Medication Record Administration (MAR) records had been completed in accordance with good record keeping practices, with no unexplained gaps. Only staff who are trained in giving medication do so, and regular competency checks are carried out. There are currently no people in the home who have chosen to manage their own medication although one person is supported in collecting their own prescriptions. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and adult protection procedures within the home serve to safeguard the people living here. An easier read format would benefit some people. People are supported in managing their own finances, which promotes their independence. EVIDENCE: There is a complaints procedure in place and this is available in the Residents’ Handbook. People are encouraged to voice any concerns and records are maintained. Individual people spoken to confirmed that they were confident that they could speak to staff if they had any problems. The complaints procedure is not in another format to make for easier reading for people living in the home and this is recommended. There is an Adult Protection policy and procedure in place and staff are provided with clear guidance on protecting people living in the home. The majority of staff have been trained in Safeguarding Adults. There are robust procedures for managing peoples money. Individual spending money is recorded and audited on a regular basis. Receipts are in place for any purchases made. People are supported in managing their own money and guidance is in the care plans. Windmill Lodge DS0000059514.V359544.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, 25 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in an environment that is largely well maintained and reflects their choices and lifestyle. EVIDENCE: We toured the building and overall the property is clean and well maintained. There is a large communal sitting room and a separate dining area. There is large patio area at the rear of the home and a small garden. There are no shared bedrooms and all are en-suite. A selection of bedrooms was viewed and they reflected individual choices and personal belongings. The rooms are spacious and service users have been able to personalise their rooms and these are decorated to a good standard. People are able to choose their own colour schemes and all bedrooms viewed showed individual tastes and preferences. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 17 The home has installed additional safety equipment for people with different needs including strobe lighting to alert people with a hearing impairment in place of the fire alarm. They have installed a new fridge, freezer and tumble dryer and all areas of the home were clean and tidy. There are ongoing plans for the continued refurbishment including both communal and private space. Windmill Lodge DS0000059514.V359544.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): 31, 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their care and support needs are met by competent staff, who respect their preferences and choices. The deployment of unsupervised staff for escorting people away from the premises prior to a full and satisfactory Criminal Records Bureau Check being received does not fully protect the people living in the home. EVIDENCE: The Registered Provider also manages the home and he is supported by a Deputy Manager and a small staff team. Staff are aware of their different roles in the home and emphasis is placed on building good working relationships with the people living in the home. People confirmed their confidence in the staff and comments included, “There is always someone there if I need them” and “They are all very good and I can always ask if I want something”. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 19 We observed positive interactions in the home and we saw staff treat people with respect. People were confident with speaking to staff and asking advice or for any assistance. Staffing arrangements are sufficient to meet the needs of the people living in the home. Agency staff are used, but maintain continuity of care by making sure that it is the same people wherever possible. There are no ancillary staff and support workers are responsible for cleaning and cooking. People living in the home assist with small household duties as part of their care plans. Recruitment records showed that the procedure is in line with the National Minimum Standards with a fully completed application form, references, proof of identity and appropriate checks for Protection of Vulnerable Adults (POVAfirst) and Criminal Records Bureau (CRB) being carried out. Staff start work after the home has received a clear POVAfirst check, although their permanent employment is dependent on a satisfactory CRB. They do not support people with personal care until their CRB has arrived. We did see that a new member of staff who had only received confirmation of a POVAfirst had escorted a service user into the community. The Care Home Regulations state that new workers do not escort people away from the care home premises unless accompanied by a staff member. The home was advised of this at the time of the visit and they stated that they would resolve this. A requirement has been made. There is a structured induction programme and the Registered Manager spends time with new employees going through the different aspects of the programme. This covers the areas that are identified within the Skills For Care Common Induction standards. Training is ongoing with staff being trained in mandatory areas of care such as adult protection, medication, food hygiene and fire safety. The Registered Manager confirmed that there is an ongoing training programme for support workers. Windmill Lodge DS0000059514.V359544.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, 38, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a home that is run in their best interests so they can be confident that views and opinions are listened to. The continued development of quality assurance processes will further benefit the people living in the home. EVIDENCE: The home is managed by the owner, who is registered with NMC (Nursing & Midwifery Council) as a registered nurse. He also completed his Registered Managers Award. The Deputy Manager has also undertaken her NVQ level 4. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 21 The manager and staff all demonstrated a good awareness of promoting positive outcomes for people living in the home. Individual diversity is a priority with person centred care and support plans. There was good evidence of people being supported to make choices on a day-to-day basis with people living in the home talking about their lifestyles in a positive manner. Less clear, however, was evidence of formal quality assurance processes. People are part of the daily running of the home and a questionnaire / selfassessment had been provided to everyone to gain feedback on their views and preferences. No formal action had been taken following this and it is recommended that the home reviews how they manage their quality assurance processes. The home is pro-active at ensuring that new health and safety procedures and guidelines are adhered to. Safe working practices are adhered to and staff are trained in First Aid. Areas of the home we viewed were hazard free. Windmill Lodge DS0000059514.V359544.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 3 2 3 3 3 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 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 2 X X X 3 Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA34 Regulation (19) (11) (c) Requirement Where a registered person permits a new worker to start work pursuant to paragraph (9) the registered person shall— (c) Ensure that the new worker does not escort service users away from the care home premises unless accompanied by the staff member. Timescale for action 30/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 Refer to Standard YA6 YA22 YA39 Good Practice Recommendations That behavioural management procedures are updated in all care plans. That the complaints procedure is presented in an alternative format that meets individual needs. That there are effective quality assurance processes in place to measure the homes success in meeting their stated aims and objectives. Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Windmill Lodge DS0000059514.V359544.R01.S.doc Version 5.2 Page 25 - 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!