Inspection on 27/02/07 for Winton House

This inspection was carried out on 27th February 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Winton House 28/12/07

Winton House 16/02/06

Winton House 22/09/05

Winton House 15/02/05

Winton House 24/06/04

Winton House 24/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Langdale Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Winton House 51 Dedworth Road Windsor Berkshire SL4 5AZ Lead Inspector Jill Chapman Unannounced Inspection 27th February 2007 09:40 X10015.doc Version 1.40 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 Winton House DS0000011281.V325506.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 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. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Winton House Address 51 Dedworth Road Windsor Berkshire SL4 5AZ 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) 01753 856466 Abbeyfield (Maidenhead) Society Limited Mrs Susan Mary Howick Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2006 Brief Description of the Service: Winton House is owned and managed by The Abbeyfield (Maidenhead) Society. The management and executive committee responsible for the home are all volunteers. The home is located on the main road one mile west of central Windsor and is purpose built and designed for older people needing care. All rooms are single and en-suite; all have television points and telephone lines. The home has a well-maintained attractive garden and is easily accessible. There is a large dining room, separate lounge, hairdressing room and conservatory. Winton House has an Activity Centre called Helen Cottage which provides a unique feature to the home. The cottage has cooking facilities and an active arts and crafts group. The home employs the services of an activity organiser who resources and provides a range of stimulating activities. The current fees for the home are £475.00 per week. Winton House DS0000011281.V325506.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 unnounced ‘Key Inspection’. The inspector arrived at the service at 9.40am and was in the service for 7 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. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. The inspector had a look around the building and records relating to care, staffing and health and safety were sampled. The inspector spoke to the manager, deputy and staff on duty. A number of service users gave feedback on their care, some individually in their rooms and others in a group at lunchtime. Some relatives and professionals gave feedback via surveys sent out before the inspection. What the service does well: The Statement of Purpose provides updated information about the home. The home only admits service users whose needs it can meet. Service users have the chance to try out the home before deciding to live there. The home is meeting the differing religious needs of current service users and could also meet other cultural needs when they occur. Service users care needs are identified and met. Risk assessments help staff keep service users safe. Service users are supported to keep well and take their medication. Staff respect service users privacy and treat them in a dignified way. The home provides service users with excellent opportunities for in-house and community activities. Service users are encouraged to make choices and be as independent as possible. The home welcomes visitors and helps service users to keep in touch with family and friends. Service users benefit from a varied and healthy diet, which they help choose. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 6 Service users know that they can make a complaint and that it will be handled properly. Staff are trained to know how to protect service users from potential abuse. Service users benefit from a homely and well cared for environment. They have good access to toilet and bathing facilities. The home is kept clean and hygienic to help prevent infection. Service users are supported by enough trained staff to meet their needs. Recruitment checks make sure that potential staff are safe to work with vulnerable service users. Service users can be confident that the home is well managed. The home seeks the views of service users and others to help develop the service. There are good health and safety systems in place to protect service users. 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. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Winton House DS0000011281.V325506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 &6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose provides updated information about the home. The home only admits service users whose needs it can meet. Service users have the chance to try out the home before deciding to live there. The home is meeting the differing religious needs of current service users and could also meet other cultural needs when they occur. The home does not take service users with intermediate care needs. EVIDENCE: The home has a Statement of Purpose, which has recently been updated to include staff changes and additional information. The home has an admissions procedure, which includes carrying out a full assessment of need. This is carried out prior to admission to make sure that they can meet the needs of a potential service user. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 9 The file of a new service user was sampled and showed that this had been carried out. The service users confirmed that her admissions assessment was carried out. A copy of the Social Services Assessment of need was also seen. The homes assessment covers a variety of needs including religious and cultural needs. There was evidence that the home is meeting the differing religious needs of current service users and could also meet other cultural needs when they occur. There was written evidence that the home enables prospective service users to visit the home before deciding to live there and also have overnight stays. A service user said that she had visited the home before admission had several respite stays and also had a trial period. She said it gave her the chance to see if she liked the home. She said that staff make you feel at home, they are good and seem pleased to help you. Standard 6 does not apply to this home because they do not take service users with intermediate care needs. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 &10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users care needs are identified and met. Risk assessments help staff keep service users safe. Service users are supported to keep well and take their medication. Staff respect service users privacy and treat them in a dignified way. EVIDENCE: Service users care plans are well written and show that care needs are identified and met. Care plans are drawn up with service users and their relatives and are signed by all involved. Care plans are reviewed regularly and daily notes show that care plans are carried out. Risk assessments show that risks are identified and control measures are put in place to keep service users safe. Service users spoken with said staff were very caring and helpful. Relatives surveyed felt that staff ‘go the extra mile’ and are ‘friendly and supportive’. Some relatives felt that there could be some Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 11 improvements in communication about care issues but were very satisfied with the care provided. Health care needs are well documented and records of health appointments are kept. Service users spoke of GP, Chiropodist, and Audiologist visits. GP’s surveyed were very complimentary about the home, ‘Exemplary care, staff superb, very caring and balanced.’ ‘Very satisfied with the overall care given’ The homes medication system was seen and medication was stored and managed correctly. The home receives a six monthly visit from the pharmacist to give help and advice. The storage and administration procedures for controlled drugs were also satisfactory. Staff receive training from an accredited provider, only senior staff give medication but care staff are involved in witnessing and signing the record. If service users wish to take their own medication then a risk assessment s carried out to make sure that it is safe fro them to do so. From observation of practice and from speaking to service users it was found that staff treat service users with respect and maintain their dignity. Service users said that staff respect their privacy when carrying out their personal care and bathing them and they knock before entering their bedrooms. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home provides service users with excellent opportunities for in-house and community activities and to follow their chosen religion. Service users are encouraged to make choices and be as independent as possible. The home welcomes visitors and helps service users to keep in touch with family and friends. Service users benefit from a varied and healthy diet, which they help choose. EVIDENCE: There is an excellent range of activities provided in the home. There is a designated activity room called Helen Cottage, which has been designed in the style of a cottage, complete with fireplace, kitchen, and dining and lounge areas. It is furnished and decorated in a way to remind service users of their own homes. There is a designated member of staff who has responsibility for this area and planning the activities. Service users take part in baking, art and craft, exercise sessions, manicure sessions, play games and take part in discussion groups. There is reminiscence reading material and music. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 13 Service users said that one of the most popular activities in the home is Skittles and all spoken with were very happy with the range of activities provided. They said they like the cosy and homely environment in Helen Cottage. A shop is held twice weekly so that service users can buy small items such as toiletries. Daily activities are displayed on the homes notice board. The home supports service users to follow the religion of their choice, some attend communion services in the home given by visiting ministers, Methodist, Church of England and others go out to a Fellowship Club every Tuesday. Service users conformed that visitors are welcome in the home and several were in the home during the inspection. One service user had several family members, including children visit that day. They were served lunch in Helen Cottage so they could have a private visit. Staff help service users keep in touch with distant family or friends via e-mail or post. Feedback from relative surveys included the following comments. ‘Staff always friendly and supportive, keep me well informed, pleasure to work with.’ ‘Happy caring atmosphere, clean cheerful environment, a wonderful effort at Christmas’. The latter refers to a Christmas lunch party to which relatives are invited. Staff and service users confirmed that the minibus is used for visits to the local shops, outings and hospital appointments. One service user said she attends the local club for the blind. In speaking to service users it was clear that the homes routines are flexible to their preferences and needs. Staff encourage service users to be as independent as possible and some like to help out with daily routines, for example peeling vegetables and helping in the garden. Service users showed that they could bring their personal possessions and some of their own furniture into their rooms. An inventory of their belongings is kept on their file. Staff support service users to be as independent as possible but some service users have relatives or friends who act as their Power of Attorney if they are no longer able to manage their affairs. Menus were sampled and show that service users have a variety of nourishing meals. The day’s menu is displayed on the notice board. Service users confirmed that they can have choices at each meal and that they have regular drinks and snacks. There is a full time cook and food is freshly prepared. Fresh meat, fruit and vegetables are purchased from local suppliers. The inspector joined service users for a lunchtime meal, this was a sociable occasion and the meal was well presented, appetising and hot. It was seen that staff support service users who need help and are aware of service users preferences or special needs. Service users said that menus are discussed at Residents Meetings and their suggestions are taken on board. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 14 Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users know that they can make a complaint and that it will be handled properly. Staff are trained to know how to protect service users from potential abuse. EVIDENCE: In speaking to service users it was clear that they know about the complaints procedure and who to talk to if they have a concern. The Commission has received no information from service users or their relatives about complaints made about the home. Staff said they are made aware of the Complaints Policy during their induction. The home had received a concern from one service user about another service user and had resolved this satisfactorily. Staff spoken with had received formal training on how to protect service users from potential abuse. In addition there is in house video training. Staff spoken with were aware of what to do if they felt a service users was being harmed. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a homely and well cared for environment. They have good access to toilet and bathing facilities. The home is kept clean and hygienic to help prevent infection. EVIDENCE: A tour of the premises showed that it is spacious, well maintained and decorated; a full time handyman is employed and carries out day-to-day repairs. Service users bedrooms seen were spacious and homely. The garden is well kept and a volunteer regularly helps out. Service users spoken with were complimentary about their accommodation. Some have preferred areas where they like to sit. Some like the entrance hallway because they can see the ‘comings and goings’ and others prefer the spacious lounge. Some service users like the privacy of their own room. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 17 There are suitable toilet and bathing facilities. Service users confirmed that they can have a bath or shower twice weekly and that there is some flexibility in bath times. The three assisted baths have been replaced with ‘top of the range’ assisted baths. They have a Jacuzzi option that can also dispense special oils and the baths self clean before the next user. There is a walk in shower for those who prefer this. The home is kept clean and fresh smelling by the domestic staff. There is a laundry assistant who looks after service users clothes. Service users were very complimentary about the laundry service, ‘the laundry is well done, your clothes are labelled and you get it back the same day’ The Laundry Assistant was aware of infection control practice. The laundry has suitable equipment including a washing machine with a disinfection/sluice programme. There is a machine for the disposal of soiled incontinence pads. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 18 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by enough trained staff to meet their needs. Recruitment checks make sure that potential staff are safe to work with vulnerable service users. EVIDENCE: Rotas were sampled and show that during weekdays there are 5 care staff on from 8am –2pm and 3 care staff on from 2pm-10pm. At weekends there are 4 carers on duty from 8am-4pm and 2 carers on from 4pm-10pm. At night there are two waking night staff. The manager and deputy mainly work Mondays to Fridays and a senior carer is on shift during the day at weekends. Some relative surveyed felt there should be more staff on at weekends but there was no evidence from this inspection that current staffing levels do not meet the needs of the service users. The Shift Responsibility Plan outlines shift responsibilities for particular staff, for example shift leaders, key holders, fire co-ordinator, and care tasks. Care staff are well supported by ancillary staff. There are four domestic staff, one of whom is a supervisor, employed who work Monday to Friday. The laundry assistant works 6 days a week from 7.30 am to 1pm. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 19 The Maintenance man works 8am to 4 pm Mondays to Friday and is on call evenings and weekends, for emergencies. There is a full time Chef who works 7.30 am- 6pm Mondays to Fridays and 7.30am to 2pm Saturdays. A relief chef covers when he is not on duty. An administrative staff works 4 days per week from 9am to 2pm. There is a programme of National Vocational training in place and 80 of staff have NVQ 2 or above. Seven staff are qualified in First Aid. The home has a robust recruitment procedure in place. CRB and POVA checks are now carried out before employment is commenced as required from a previous inspection. References and other checks are carried out. Staff receive a Skills for Care accredited induction and core training programme and records show that training is updated as necessary. Staff spoken to confirmed their recruitment process and their training undertaken. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 20 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be confident that the home is well managed. The home seeks the views of service users and others to help develop the service. The registered persons need to carry out their legal responsibilities under Regulation 26 to make sure they are kept informed of the conduct of the care home. A formal staff supervision system needs to be developed to demonstrate that staff are adequately supervised. There are robust health and safety systems in place to protect service users. EVIDENCE: The home is well managed by a manager who has many years experience of elderly care and has NVQ 4 and the Registered Managers Award. There is a deputy manager who has NVQ 3 in care management. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 21 It was seen that the management style is hands on and approachable and the manager and deputy are available to staff and service users throughout the day. There are clear lines of accountability and some responsibilities are delegated to senior staff. There is a Quality Assurance system in place and an independent person audits this. Service users questionnaires were carried out in September 2006 and the results are used to further develop the service. Regular service user meetings are held and a Care Consultant is employed to seek service users views. It was noted that Regulation 26 visits have not been carried out since February 2006. These visits should be reinstated and copies of the reports should be made available in the home. There is a system for looking after service users personal monies. This was sampled and found to be accurate. There is a monthly independent audit carried out. Advice was given to check that service users monies are covered by the homes insurance policy and to check whether there is a limit to how much can be held for each service user. In discussion with staff and the manager it was clear that staff are supervised and supported on a day-to-day basis. There is no formal supervision system in place and this needs to be developed to make sure that staff have formal supervision at least six times per year. The Manager and Senior staff who will undertake formal supervision will need to attend a Supervision Skills course to help them with this task. The pre inspection checklist shows that regular servicing and health and safety checks are carried out. Health and safety records sampled were found to be up to date. Staff confirmed that they had received Health and Safety and Manual Handling training. Winton House DS0000011281.V325506.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 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X 4 X X X X 4 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 3 3 2 X 3 Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 23 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 OP33 2 OP36 18(2) Standard Regulation 26 Requirement Regulation 26 visits should be carried out monthly and copies of the reports kept in the home. Staff should receive formal, documented supervision at least six times a year. Timescale for action 27/04/07 27/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP36 Good Practice Recommendations Staff who undertake formal staff supervision should undertake a supervision skills course. Winton House DS0000011281.V325506.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 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 Winton House DS0000011281.V325506.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. 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