Inspection on 07/12/05 for Woodham Grange

This inspection was carried out on 7th December 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Woodham Grange 07/01/08

Woodham Grange 02/05/07

Woodham Grange 15/05/06

Woodham Grange 02/02/05

Woodham Grange 03/09/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Woodham Grange Burn Lane Newton Aycliffe Durham DL5 4PJ Lead Inspector Mr Paul Emmerson Unannounced Inspection 7 December 2005 11:00 Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 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 Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 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. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Woodham Grange Address Burn Lane Newton Aycliffe Durham DL5 4PJ 01325 310493 01325 310493 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) Milbury Care Services Limited Judith Ayre Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th July 2005 Brief Description of the Service: Woodham Grange is a large two-storey property, situated in its own grounds. It was purpose built to accommodate people who use wheelchairs. The home is owned by Milbury Care Services Limited and is registered to provide care for up to 8 adults who have learning disabilities, complex needs and/or physical disability. The home is in the Woodham area of Newton Aycliffe, within walking distance of the town centre and local amenities. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. By law we have to inspect all care homes at least twice a year. This unannounced inspection was carried out in accordance with this obligation. The inspection took place over 6 hours, on the morning and afternoon of Wednesday 7 December 2005. In line with current CSCI policy on ‘Proportionality’, the inspection focused upon a number of key standard outcomes for service users. The key standard outcomes not inspected on this occasion were assessed during the last inspection of the home. The inspector looked around the building and a number of records were examined. 7 members of staff were spoken to. Within the limits of their communication and understanding, service users were also spoken to. On the day of the inspection there were no visitors to the home. What the service does well: What has improved since the last inspection? What they could do better: 7 requirements have been made as a result of this inspection. These are listed on pages 22 & 23 of this report. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 6 To ensure that service users’ needs can be met, staffing levels must be maintained. Care planning and a number of administrative documents need to be updated. Although it is acknowledged that redecoration work has been carried out, as highlighted in previous inspection reports, the following repair / maintenance work is still required: • The kitchen floor requires renewal. • There are a number of rooms, which still need decorating. • Carpets in 2 bedrooms, the hallways, conservatory and corridors look tired and worn and need to be replaced. • The laundry requires redecoration and a review of working space to ensure easier accessibility by service users and staff. An action plan setting out work to be undertaken and timescales for completion must be forwarded to CSCI. The Care Homes Regulations 2001 require that (amongst many other things) the service provider is responsible for ensuring that the home is kept reasonably decorated. The service provider must pay any costs associated with this responsibility. However, documents in the home show that the service users who occupy 2 of the 4 recently redecorated bedrooms have paid for the work to be done - £250 & £280. This money must be refunded. 8 recommendations have also been made as a result of this inspection and are listed on page 23 & 24 of this report. A number of these are about administrative processes, but some are to suggest ways of improving the care and services people receive at Woodham Grange. 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. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 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 Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. EVIDENCE: NA Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, as highlighted in the previous inspection report, to enhance communication, and provide an additional forum to consider care planning arrangements and any other issues in the home, house meetings that were regularly held until last year should be reconvened. EVIDENCE: NA Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, as highlighted in the previous inspection report, if additional drivers cannot be found, it is recommended that alternative forms of transport should also be considered. Although the mini-bus is underused, service users are still paying contributions towards it from their Disability Living (Mobility) Allowances. For most people this amounts to some £15 per week. If this service is not being provided, this money should be refunded. Further, as also highlighted in the previous inspection report, service users in long-term placements should have as part of the basic contract price the option of a minimum seven-day annual holiday outside the home, which they help choose and plan. EVIDENCE: NA Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Personal and healthcare needs are appropriately met. Any medicines required are dealt with correctly. EVIDENCE: Although the inspector was unable to communicate with service users to any significant degree, the inspector spent time in their company. The service users accommodated have a high level of care needs. However, they were seen to be well cared for and comfortable in their home. The people who live at Woodham Grange are on the whole dependent upon staff and others to make choices and decisions on their behalf and best interests. However, within the limits of their communication and understanding, service users’ preferences are accommodated. The inspector observed that although uncertain management arrangements and staff shortages have impacted on the home’s ability to meet social, activities and lifestyle needs, staff’s commitment to team-working, and good communication between them, ensures that service users’ personal and health care needs are met. From discussions with staff, where personal support is required it is provided appropriately. Care plans examined show that wherever possible, service users Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 12 are provided with guidance and encouragement to undertake their own selfcare tasks, thus promoting independence in a dignified and respectful manner. Although care plans need to be reviewed and updated, the care plans read by the inspector were seen to document service users’ personal and health care needs and the actions required and being taken to meet them. Care plans are thus a record of the care provided, but also inform the delivery of care within the home. Nevertheless, care plans must be reviewed and updated. Although none of the service users accommodated retain, control or administer their own medication, because of their needs and dependency this is considered appropriate. Senior support workers administer medication in the home. From discussions with staff, these people have received appropriate training in this area. Other staff also receive instruction to understand the medicines prescribed, potential side effects etc. Medicines were seen to be stored appropriately. The home uses a monitored dosage system. There are adequate policies, procedures and systems in place relating to the receipt, recording, storage, handling, administration and disposal of medicines. However, where medicines need to be stored in a refrigerator, at or below a certain minimum temperature, a suitable refrigerator (other than that used to store foodstuffs) should be used. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Within the limits of their communication and understanding, service users’ views are obtained. Complaints and adult protection systems in the home serve to safeguard service users. EVIDENCE: The home, through its parent organisation Milbury Care Services Limited, has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Information about complaints, how and who to make them to, is also provided in the home’s ‘Service Users Guide’. House meetings, when held, serve as an additional forum to discuss concerns or potential difficulties. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. However, only some of the staff interviewed had received training specifically relating to adult protection. Although it is acknowledged that issues relating to abuse and adult protection are considered in NVQ and other such courses, as highlighted in previous inspection reports, staff should receive training in adult protection. Policy and procedure documents relating to adult protection provide information and guidance to staff. However, a copy of ‘Durham & Darlington Adult Protection Committee’s Inter-Agency Adult Protection Policy & Procedures’ on abuse and the protection of vulnerable adults should also be obtained and be available in the home. The home’s own policies and procedures in this area should then be reviewed, and where necessary amended, to reflect any local protocols, contact information and the initial action to be taken (things to do and things not to do) if an allegation of abuse arises. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these outcomes / standards were assessed on this occasion. They were examined during the last inspection of the home. However, it is acknowledged that substantial redecoration to communal areas throughout the home has been carried out. Nevertheless, as highlighted in previous inspection reports, the following repair / maintenance work is still required: • The kitchen floor requires renewal. • There are a number of rooms, which still need to be decorated. • Carpets in 2 bedrooms, the hallways, conservatory and corridors look tired and worn and need to be replaced. • The laundry requires redecoration and a review of working space to ensure easier accessibility by service users and staff. • As also highlighted in the previous inspection report, the first floor bathroom should be refitted to better meet the needs of people with physical impairments. The financial implications associated with this need to be considered within any business plans and budgetary arrangements for the continued running of the home. An action plan setting out work to be undertaken and timescales for completion must be forwarded to CSCI. It must also be noted that The Care Homes Regulations 2001 require that the registered person is responsible for ensuring that the home is kept reasonably Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 15 decorated. Any costs associated with this responsibility, must be paid by the service provider and not by service users. However, documents in the home show that the service users who occupy 2 of the 4 recently redecorated bedrooms have paid for the work to be done - £250 & £280. This money must be refunded. EVIDENCE: NA Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35. Sufficient staff are employed. The home has a settled and well-trained staff team. EVIDENCE: Care is provided by a committed, well-trained staff team. Although the home has been operating with uncertain staffing and management arrangements for some time, many of the staff have worked at Woodham Grange for a number of years and know the service users well. Virtually all staff have NVQ (National Vocational Qualification) qualifications at level 2 or 3. Most of the home’s staff have also completed LDAF (Learning Disability Award Framework) training courses. Although some updates are required and some courses have been difficult to access, training in for example First Aid, Moving & Handling, Food Hygiene etc. is provided by Milbury Care Services Limited through its regional training plan. However, an audit of staff training needs should be carried out and staff training updates must be provided where required. Recruitment procedures through Milbury’s regional office are considered to be satisfactory and safe. Appropriate references are obtained and CRB (Criminal Records Bureau) disclosure checks are carried out. Although staff records for recently appointed members of staff were not available for inspection and must Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 17 be obtained from the regional office for retention in the home, from discussions with the staff concerned, safe recruitment practices were followed. Due to the needs of the service users accommodated, the agreed staffing levels for the home require at least four staff to be on duty throughout the waking day. With night staffing arrangements (1 person awake, 1 person asleep) this equates to 492 weekly care hours for the home. From discussions with staff, rosters and other documents examined, four staff have not always been rostered. As highlighted in previous inspection reports, staffing hours within the home must be appropriate to the needs of the service users being accommodated. However, it is noted that additional staff and a manager are transferring from another Milbury service later this month. Staff shortfalls will thus be addressed. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Woodham Grange runs well. However, although quality assurance systems are in place, remedial action to rectify issues raised takes too long. EVIDENCE: The home’s previous manager left earlier this year. It is understood that a new appointment has been made and the person appointed is due to start soon and will be applying to The Commission to become registered manager. Although the post has been vacant for some time and the manager’s appointment should bring greater stability to the home, in the meantime Milbury’s operations manager, the manager of a neighbouring home and senior support workers within Woodham Grange have covered management arrangements. Appropriate systems are in place to ensure service users’ health and safety is protected. For example, risk assessments and control measures relating to the safe use of bed-rails. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 19 Milbury Care Services Limited has policies, procedures and systems relating to quality assurance. Regular audit checks are undertaken and forwarded to the regional office. However, previous failings to address outstanding issues rendered the company’s quality assurance systems meaningless. Quality assurance systems should be reviewed to ensure any issues arising are addressed in a more timely manner. Monthly reports required under Regulation 26 of the Care Homes Regulations 2001 are now being provided to CSCI detailing the action being taking to address shortfalls in the home. However, staff records for recently appointed members of staff must be obtained from the regional office for retention in the home. Until recently, Milbury Care Services Limited had a local administrative base, however this has moved to Sheffield. To provide sufficient admin’ support to the home, and reduce difficulties and delays experienced with forwarding paper work, it is recommended that the home should acquire IT equipment and utilise electronically communicated alternatives. In the meantime, appropriate facilities for communication by facsimile transmission must be provided. Further, to ensure that the home is competently managed and accountable, annual development, business and financial plans for the establishment should be prepared and be available for inspection on the premises. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 3 2 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Woodham Grange Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 3 X DS0000007523.V267741.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA18& YA19 YA24 Regulation 15(2)(b) 23 Requirement Care plans must be reviewed and updated. As highlighted in previous inspection reports: The kitchen floor requires renewal. There are a number of rooms, which still need decorating. Carpets in the hallways, conservatory and corridors look tired and worn. Replacements are required. Carpets in two of the service users bedrooms look tired and worn and need to be replaced. The laundry requires redecoration and a review of working space to ensure easier accessibility by service users and staff. Money paid by 2 service users to decorate their bedrooms (£250 & £280) must be refunded. As highlighted in previous inspection reports, staffing hours within the home must be appropriate to the needs of the service users being accommodated. DS0000007523.V267741.R01.S.doc Timescale for action 01/03/06 01/03/06 3. YA24,YA25 & YA26 YA33 23(2)(d) 01/03/06 4. 12(1&2), 17(1,2&3) 01/02/06 Woodham Grange Version 5.0 Page 22 5. 6. YA32 YA41 7. YA43 Staff training updates must be provided where required. 17(2) & Staff records for recently Schedule 4 appointed members of staff must be obtained from the regional office for retention in the home. 16(2)(a)(ii) Appropriate facilities for communication by facsimile transmission must be provided. 18(1) 01/03/06 01/03/06 01/03/06 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 YA7 Good Practice Recommendations As highlighted in the previous inspection report, to enhance communication, and provide an additional forum to consider care planning arrangements and any other issues in the home, house meetings that were regularly held until last year should be reconvened. As highlighted in the previous inspection report, if additional drivers cannot be found, it is recommended that alternative forms of transport should also be considered. Although the mini-bus is underused, service users are still paying contributions towards it from their Disability Living (Mobility) Allowances. For most people this amounts to some £15 per week. If this service is not being provided, this money should be refunded. As highlighted in the previous inspection report, service users in long-term placements should have as part of the basic contract price the option of a minimum seven-day annual holiday outside the home, which they help choose and plan. Where medicines need to be stored in a refrigerator, at or below a certain minimum temperature, a suitable refrigerator (other than that used to store foodstuffs) should be used. As highlighted in previous inspection reports, staff should receive adult protevtion training. A copy of ‘Durham & Darlington Adult Protection Committee’s Inter-Agency Adult Protection Policy & Procedures’ on abuse and the protection of vulnerable adults should also be obtained and DS0000007523.V267741.R01.S.doc Version 5.0 Page 23 2. YA12 3. YA14 4. YA20 5. YA23 Woodham Grange 6. YA27 7. 8. YA39 YA43 be available in the home. The home’s own policies and procedures in this area should then be reviewed and where necessary amended, to reflect any local protocols, contact information and the initial action to be taken (things to do and things not to do) if an allegation of abuse arises. As highlighted in the previous inspection report, the first floor bathroom should be refitted to better meet the needs of people with physical impairments. The financial implications associated with this need to be considered within any business plans and budgetary arrangements for the continued running of the home. Quality assurance systems should be reviewed to ensure any issues arising are addressed in a more timely manner. As highlighted in the previous inspection report, until recently Milbury Care Services Limited had a local administrative base, however this has moved to Sheffield. To provide sufficient admin’ support to the home, and reduce difficulties and delays experienced with forwarding paper work, it is recommended that the home should acquire IT equipment and utilise electronically communicated alternatives. Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Woodham Grange DS0000007523.V267741.R01.S.doc Version 5.0 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. 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