Inspection on 30/11/06 for Woodend

This inspection was carried out on 30th November 2006.

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

Woodend 10/12/07

Woodend 01/02/06

Woodend 18/07/05

Woodend 12/01/05

Woodend 05/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

SignHealth

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

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

CARE HOMES FOR OLDER PEOPLE Woodend Atherton Street Springhead Oldham OL4 5TQ Lead Inspector Steve Chick 30 th Unannounced Inspection November and 1 December 2006 12:00 st 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 Woodend DS0000005546.V320352.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. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Woodend Address Atherton Street Springhead Oldham OL4 5TQ 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) 01616244739 01616520764 Mr Gregory Leigh Miss Susan Leigh Care Home 19 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (19), of places Physical disability over 65 years of age (1), Sensory Impairment over 65 years of age (1) Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 19 OP up to 10 DE)(E) up to 1 S) (E) and up to 1 PD(E). Maximum number of persons accommodated - 19. Date of last inspection 03/02/06 Brief Description of the Service: Woodend is a small, detached residential home situated in the Springhead area of Oldham. It is registered to provide care for service users over the age of 65, in the following categories: dementia, old age, physical disability and sensory impairment. Accommodation is provided in nine single rooms, eight of which have en-suite facilities. The en-suites are shared with the adjoining rooms in four cases. There are five shared rooms, four of which have en-suites. A conservatory and two lounges provide communal rooms. Woodend is a privately owned, family run business, owned by Mrs T Kelly and Mr G Leigh (mother and son) and managed by Ms S Leigh, Mr Leighs sister. At the time of this report (December 2006) the fees ranged from £313.88 to £322.75. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection included an unannounced site visit to the home. All key standards were assessed. For the purpose of this inspection three service users were interviewed in private, as were four relatives of service users. Additionally discussions took place with the manager and three staff members were interviewed in private. The inspector also undertook a tour of the building and looked at a selection of service user and staff records as well as other documentation, including staff rotas, medication records and some maintenance documentation. All service users and visitors spoken to during the visit were positive in connection with the standard of care offered at Woodend. One visitor stated that their relative was not in a home, but at home. This visitor also described the home as comfortable and very welcoming. Another visitor described the nice homely atmosphere at Woodend. One service user, when asked what was the best thing about Woodend, replied its pleasant to live here and there are always friends with you. What the service does well: Woodend provides a warm friendly and welcoming atmosphere where the individuality of service users is promoted. Staff are encouraged and enabled to spend time just sitting and chatting with service users. The home strives to undertake activities which are significant for individual service users. All service users are regularly asked to give feedback in connection with their experiences at Woodend. The physical environment is homely and non-institutional. Vetting and recruitment procedures for new staff are undertaken rigorously, which would serve to minimise the risk of appointing people who may pose a risk to vulnerable adults. Woodend DS0000005546.V320352.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. Woodend DS0000005546.V320352.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 Woodend DS0000005546.V320352.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): 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ needs are appropriately assessed and they, or their representatives, are able to visit before a decision is made that the home is appropriate for them. EVIDENCE: A selection of service users’ files was looked at. All but one had a copy of an assessment undertaken by an appropriate community-based professional. In the example seen where there was no written assessment, the manager reported that she had undertaken an assessment herself, before the service user was admitted, but a specific record was not on file. The care plan relating Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 9 to the service user did indicate that an appropriate range of issues were assessed in order to ensure that the home could meet their needs. Documentary evidence was seen on files to confirm that the home considered whether it could meet the identified needs of prospective service users before a decision was made to move to the home. Woodend also confirmed, in writing, that the service user’s needs could be met. Visitors who were asked, confirmed that they were able to visit Woodend before their relatives started to live there, in order to assess its suitability. Woodend does not offer intermediate care. Woodend DS0000005546.V320352.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have individual plans of care which are regularly reviewed to ensure they reflect current physical needs. Service users have access to appropriate community based medial services to ensure their health needs are met. Practices in the home promote the dignity of service users. EVIDENCE: A selection of service users’ files was looked at. All had a written copy of a care plan. The written care plans are presented as containing sufficient detail to enable staff to offer appropriate care. There was also a documentary Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 11 evidence that care plans were regularly reviewed and that service users were involved in creating and reviewing their care plan. In the files seen there was evidence that Woodend had sought a social history of each service user. This included a getting to know you questionnaire. This level of information in connection with each person assisted staff to relate to people as individuals. One visitor spoken to, cited the fact that Woodend was not “institutional” as one of the best things about it. Staff who were spoken to presented as understanding the individuality of service users very well. The need to respond to each service user’s individuality appears to be an important part of the ethos of Woodend, which would also serve to ensure the diverse needs of service users are met. There was documentary evidence that service users have access to the full range of medical and paramedical services available in the community. All service users, visitors and staff who were spoken to expressed confidence that appropriate medical support was sought in a timely manner. The home uses a pre-dispensed monitored dosage system to administer service users’ medication. Medication was seen to be stored safely. Medication administration records are pre-printed and provided by a local pharmacist. Some of these were seen to have errors relating to dating. This had been identified by the home, but the action taken to rectify the situation was inappropriate. Whilst there was no evidence to suggest that service users were not getting the correct medication at the correct time, the recording system made an effective audit of medication for some individuals very difficult. Some omissions were noted on the medication administration records, relating to a lack of direction as to when medication should be given. Again this was not the direct responsibility of Woodend, but the omissions should have been identified and reported back to the pharmacist. Observation, and discussion with service users, visitors and staff, indicated that service users were treated with respect and that their dignity was maintained. All visitors and service users spoken to, were positive about the care offered at Woodend. Staff were described by one visitor as being very patient, kind and able to anticipate the needs of service users clearly through getting to know them very well. Another visitor said its just the job for my mum, it suits her needs well. One service user said its very nice living here. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 12 Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate social contacts and activities are facilitated within the home to give service users the opportunity for social fulfilment. Service users are able to maximise their autonomy within the context of communal living. The provision of food to maintain service users’ health and well being is good. EVIDENCE: A range of social activities are available for service users to participate in, if they wish. The manager reported that a relative of a service user comes in each Monday to organise different craft activities. Service users were able to confirm their enjoyment at recently making Christmas crackers. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 14 An effective activity record is maintained on a twice daily basis where the name and social activity of individuals is recorded. This includes staff taking time to sit and chat with people, which is seen as a valuable and important use of staff time. There was evidence that the manager periodically audited these records to ensure that all service users were being offered personal experiences. The manager was able to demonstrate an example from the previous month, where a service user was identified as needing a more ‘proactive’ approach from staff to ensure their social needs were not overlooked. Service users, who are asked, expressed satisfaction with the social activities available at Woodend. Similarly visitors who expressed a view, believed the level of activities to be appropriate for their relatives. Woodend has a policy of no unreasonable restrictions on visiting times. Service users, visitors, and staff all confirmed this was the reality. Several visitors appreciated the fact that they felt welcomed at Woodend. One visitor commented that they were always asked if they wanted a cup of tea. Another visitor was appreciative of the fact that Woodend did not mind visitors at mealtimes as this made visiting easier given their work commitments. Service users are encouraged to go out with their relatives whenever possible. One visitor commented that when mum is out to she talks about going home, meaning back to Woodend. Observation and discussion with service users and visitors confirmed that visitors are free to see their relatives in private if they wish. Discussion with service users confirmed that they are free to exercise choice and autonomy within the context of communal living. One service user commented that one of the things she liked about Woodend was that she was not forced to do anything. Another service user reported that [ you] are not tied to doing anything, you can do what you want. During the tour of the building it was obvious that service users were able to bring in as many of their personal possessions as they wished, given health and safety considerations. During the site visit a meal was sampled. This was pleasantly presented and tasty. Service users who were spoken to were positive about the provision of food at Woodend. One visitor queried the variety of food which was available, but acknowledged that their relative really liked the food as it was. One service user cited the food as amongst the best things at Woodend. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 15 One visitor reported that mother loves the food and staff give her space to eat in her own time. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 16 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that any complaint they may have would be dealt with appropriately. Service users are protected from abuse or exploitation by the homes policies and practices. EVIDENCE: Woodend has previously always had an appropriate complaints procedure, therefore it was not re-looked at on this visit. All service users and visitors spoken to were confident that any complaints they may have would be taken seriously by the staff and manager. Similarly, staff spoken to were confident that any complaints or concerns raised with the manager would be appropriately dealt with. All service users, staff and visitors who were spoken to expressed the view that service users were safe at Woodend in so far as they were protected from abuse or exploitation. Staff, who were interviewed demonstrated an understanding of the need for vigilance and, while they were confident that Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 17 appropriate action would be taken by the manager, they understood the whistleblowing policy. The home had experienced several relatively small thefts from both service users and staff in the period before this site visit. The manager had taken appropriate action within the ‘protection of vulnerable adults’ procedures and the matter presented as having been resolved. The manager reported that all service users who had suffered a possible loss had been reimbursed by Woodend. Staff at Woodend had not received formal training in issues relating to the protection of vulnerable adults, other than through the NVQ II training. It was recommended that senior staff should consider attending an appropriate course and cascade its contents to the remaining staff team. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 18 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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is appropriately maintained, decorated and cleaned to enable service users to live in a pleasant, safe and hygienic environment. EVIDENCE: During the site visit a tour of the building was undertaken. This included a random selection of service users bedrooms. The bedrooms showed a clear range of personalisation reflecting the personal tastes and wishes of the service users. Service users who are asked said that they liked their rooms. One service user spoken to also commented on how much they appreciated sitting out in the pleasant patio area when the weather allowed. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 19 As reported in the last inspection report some of the corridors look a little tired. Some of the double glazed units in the windows had become misty. One of the two lounges has been redecorated since the last visit. Work to improve the flooring outside the kitchen had also been completed. During the tour of the premises no issues requiring remedial work were identified which had not been identified for action by the manager. This related to one broken drawer in a service user’s chest of drawers. The manager reported that at the time of his visit only one of the double bedrooms was being used by two people. The home presented as clean and tidy throughout with no offensive odours. This was confirmed as the usual state of building by service users, visitors and staff. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 20 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skills mix of staff on duty promotes the independence and well being of service users. Recruitment and vetting procedures are effectively applied to minimise the risk to service users of inappropriate staff being employed. EVIDENCE: The staff rota for the week beginning the 20th November 2006 was looked at. This demonstrated that a minimum of two carers were on duty at all times, both during the day and at night. In addition to these carers was the manager and domestic staff. The manager reported that five carers held NVQ II or above and one was currently undertaking this training. Of these staff two held NVQ level 3 and two more were planning to undertake the level 3 qualification. A range of framed certificates were available to be seen, on the corridor wall. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 21 Discussion with staff and the manager confirmed that new staff receive an appropriate induction period. Staff were also able to confirm that other training opportunities are available and that the manager is generally supportive of training. It was reported by the manager that six members of staff were going on a food hygiene training course the following week, this was confirmed by staff spoken to. A selection of files relating to the recruitment procedures for new staff was looked at. These provided documentary evidence that appropriate vetting was undertaken before any member of staff commenced employment. Service users and visitors were very positive about the attitude, approach and competence of staff. One service user said the staff are very good here, thats what I like … if you ask for something they get it. another service user liked the fact that there is always somebody here to talk to. Staff were perceived by relatives as being very patient and one relative identified the staff as the best thing about Woodend. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 22 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is appropriately experienced to run a care home for the benefit of service users. Quality Audit processes provide a potential framework to further improve services for the service users. Service users’ financial interests are protected by the home’s procedures and practices. Service users and staff are protected by the implementation of the home’s health and safety procedures. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 23 EVIDENCE: The manager has extensive experience of managing Woodend. She reported that she had nearly completed the registered managers award and there was documentary evidence to confirm that most of the units had been successfully completed. The manager was described by staff as being approachable and supportive. Similarly service users and visitors were positive about the attitude and approach of the manager. The manager is related to the owner of the home and consequently there are clear lines of communication and accountability. There was a good documentary evidence of potentially effective quality assurance and quality monitoring procedures. These included questionnaires, and several examples of a range of tasks being routinely audited. It was reported that service users are individually asked, on a monthly basis, if they have any complaints or concerns. There was also documentary evidence to confirm this. As at the previous inspection, these different strands of quality assurance had not yet been pulled together to form a written report and action plan. Given the size of the home, the level of consultation with service users and the approach of staff and the manager, it is unlikely that a written report would result in any dramatic difference. However an action plan would assist in demonstrating the homes commitment to responding to the views of service users. A selection of records relating to money held on behalf and service users by Woodend, was looked at. These records presented as being appropriately maintained with an effective system to locate receipts for items purchased on behalf of service users. This provided an effective and transparent audit trail. Health and safety procedures presented as being effectively implemented. A small selection of records relating to the maintenance of equipment and the fire detection systems was looked at. These presented as being appropriately maintained. It was reported by the manager, and confirmed by staff spoken to, that moving and handling training is provided internally for all staff. It was also reported that one of seniors was to attend an accredited moving and handling facilitators course. This would help to ensure that the training offered to staff involved up-to-date thinking and techniques. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 24 Several first aid certificates seen were beyond their three year validity. Staff confirmed they were always provided with appropriate personal protective equipment, including disposable gloves and aprons to minimise the risk of cross infection. As an additional safety measure staff are also provided with alcohol gel hand cleaner. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 25 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 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 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 2 X 3 X X 3 Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 26 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 OP9 Regulation 13 Requirement The registered person must ensure that the arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines into the home are appropriate (records are completed in such a way as to enable a clear audit trail of all medication and transparency of the process). Timescale for action 05/01/07 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 2 3 Refer to Standard OP3 OP18 OP19 Good Practice Recommendations The registered person should ensure that assessments undertaken, by the home, in respect of prospective service users are recorded. The registered person should ensure that staff receive external training in connection with the protection of vulnerable adults. The registered person should ensure that consideration is given to redecorating the corridors, and replacing the DS0000005546.V320352.R01.S.doc Version 5.2 Page 27 Woodend 4 OP33 5 OP38 ‘failed’ double glazing units. The registered person should ensure that the outcome of Quality Audit and Quality Monitoring systems are compiled, made available to service users and their representatives, together with an action plan. The registered person should ensure that staff receive updated training in first aid. Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Woodend DS0000005546.V320352.R01.S.doc Version 5.2 Page 29 - 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!