Care Home: 1 and 1a Orchard Villas

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What the care home does well This service offers a safe and fulfilling home life for the people living here. People are treated with dignity and with care.There are social opportunities and support to develop life skills at the home and in the wider community accessed from the home. One relative said they found `Orchard Villas to be quite unique these days`, `enabling their relative to live as part of an extended family` and `lead a fulfilling life at their own level`. Relatives are welcomed and family contact is supported by telephone and visits. The home is comfortable, very clean and is well and safely maintained. What has improved since the last inspection? Staff training and supervision has been prioritised and there has been mandatory and specialist training during the past year. Recruitment has improved and the staff files are well organised. What the care home could do better: Care must be taken with recruitment practice that brings potential staff into the home to meet the people living there prior to the references and criminal record bureau checks being received. CARE HOME ADULTS 18-65 1 and 1a Orchard Villas Perry Street South Chard Chard Somerset TA20 2QF Lead Inspector Barbara Ludlow Unannounced Inspection 9 January 2008 16:45 th 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 and 1a Orchard Villas Address Perry Street South Chard Chard Somerset TA20 2QF 01460 220747 NA Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Edward Wright Mrs Sheila Grace Wright, Mrs Helen Anne Bond Mrs Sheila Grace Wright Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users in ground floor accommodation may have concurrent physical disabilities 30th October 2006 Date of last inspection Brief Description of the Service: Orchard Villas is a domestic scale residential home, providing care and support for three people who have learning disabilities. One person with significant care and support needs lives in the main house. One other person lives more independently in the adjoining bungalow; there is one vacancy at present. The providers, Mr & Mrs Wright live in the main house and provide the bulk of support. The home is located in a rural area south of Chard and has a larger sister home in Chard. Mr & Mrs Wright promote a family based ethos and the people living here are included in extended family activities and occasions. Recreational and occupational activities are encouraged on both an individual and group basis. There is a strong focus on outdoor activities including horse riding and stable management. Fee range: £404.00 per week dependent upon individual assessment. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of this inspection visit was to inspect relevant key standards under the Commission’s ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are: - excellent, good, adequate and poor. This inspection was announced at short notice. Holidays, trips out and home visits over Christmas meant the inspection was deferred until 2008. CSCI had received the completed Annual Quality Assurance Audit. Feedback from two relatives had been received this was very positive and the comments are incorporated in the appropriate sections of this report. The people living at the service are encouraged to lead active lives and one attends a work placement during the day. This visit commenced during the late afternoon and took place over a four-hour period. One person was celebrating their birthday and a party was organised in the bungalow. People from the sister home ‘Springside’ in Chard and one member of their staff team were due to visit for tea and the birthday celebration. Time was spent in the main house with the proprietors and one person living at the home. One visitor was seen and contributed to the feedback. Records were sampled, these included care plans, maintenance and staff recruitment. The bungalow and the person living there were seen after tea and the inspector was invited to join the celebration with the other guests. The inspector would like to thank the people living at the home, their relatives who wrote to the Commission for Social Care Inspection and the owners and staff for their contributions and cooperation with the inspection process. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: This service offers a safe and fulfilling home life for the people living here. People are treated with dignity and with care. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 6 There are social opportunities and support to develop life skills at the home and in the wider community accessed from the home. One relative said they found ‘Orchard Villas to be quite unique these days’, ‘enabling their relative to live as part of an extended family’ and ‘lead a fulfilling life at their own level’. Relatives are welcomed and family contact is supported by telephone and visits. The home is comfortable, very clean and is well and safely maintained. 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. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4,5 Quality in this outcome area is good. Pre admission assessment would be made. People would be invited to the home to visit and stay to meet and mix with the other residents. They would be offered the opportunity to experience the lifestyle and have a trial period prior to making a decision to stay on a permanent basis. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions to the home. The paperwork has been developed and a guide that has photographs and is informative is available for those enquiring for a place at the home. There is one vacancy at present. The proprietors explained to the inspector how they had received expressions of interest in the vacancy. They explained how they would proceed to ensure that any placement made would be compatible with the two people living at the home at the moment and that the lifestyle they could offer would be in the best interests of the person. There is a strong focus on riding and horsemanship skills; people enquiring had similar interests in their present lifestyle. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 9 Pre admission assessment would be made and the involvement of parents, relatives and carers would be included with the assessment of the community health and social care professionals involved with the person. One relative said they found ‘Orchard Villas to be quite unique these days’, ‘enabling their relative to live as part of an extended family’. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. The people at this home lead full and interesting lives. Risks in daily life are assessed and independence is nurtured within a safe and expanding framework. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living at the home are encouraged to develop life skills and become more self reliant. They gain independence within their safe; risk assessed and supported family lifestyle. Care plans were sampled, these were person centred and contained risk assessments for daily living. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 11 One person was aware of their care plan and said they were very happy and settled at the home. They appeared to be leading an active and interesting life and had a lot of independence in their daily life and routines. One relative said that their relation can phone them at any time and enabled to visit them. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16,17 Quality in this outcome area is good The people living at 1 and 1 a Orchard Villas have a lifestyle that is tailored to help them to lead varied lives developing their individual interests and abilities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The lifestyle is tailored to meet the interests and abilities of the individual. Attempts were made to schedule this inspection in 2007 however the people living at the home are supported to lead active lives. A holiday had been taken on one occasion and a day trip to Olympia for a horse show prevented another visit. The people share social activities with the proprietors and their family and the wider network of people from the sister home in Chard called Springside. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 13 On the day of the inspection a birthday party was held in the bungalow and the people from Springside had been invited for tea and a karaoke party. Which all attending seemed to really enjoy. They appeared to be leading an active and interesting life and had a lot of independence in their daily life and routines. Work placement and using public transport to make visit is supported. Hobbies and age appropriate leisure pursuits are encouraged. Photographs were seen of some of the activities open to people living at the home. Safety clothing is worn when riding and working with the horses that are owned and managed by the proprietors. Both people in residence attend Church each week with the providers and one person sings in the Church choir. Other community venues are used by the home such as the local social club; this is attended as a family. Summer holidays are taken, long weekends and trips out every Saturday. Holidays with families are encouraged and short breaks with them are supported. One relative said that ‘every aspect of life is absolutely geared to their wants and needs’, ‘they live a life of great contentment in a happy family atmosphere’. The inspector met a visitor to the home whose relative had spent a number of years receiving care at the home. The inspector heard very positive praise for the care given to their relative over a long period and it was evident that a strong relationship had developed with the family. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good People are supported to lead healthy lives receiving the support they need as a member of a close and caring family. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People were observed to be treated with kindness and respect by the owners and staff. The people in residence looked well and appeared to be in good health. Assistance is given with diet and fluids where required to maintain good health and hydration. The care plans seen showed input from health care specialists and active help and intervention when required. The care was very positively biased towards healthy living and lifestyle for the benefit of the people living at the home. People attending day care or going home have a note book to record how they are and to ensure messages pass between carers / parents and the home. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 15 One relative said their relation was accompanied to hospital by Mrs Wright and was brought home early to be nursed in familiar surroundings’, for which they expressed their gratitude’. Another relative expressed their confidence in the homeowners and felt that their relative receives ‘good care’ and said their relation is ‘very lucky indeed to be at Orchard Villas’. No one was receiving medication at the time of this inspection. Old Medication Administration Records were seen that had been used when one person received a course of antibiotics. This MAR demonstrated clear entries, timed administrations with no gaps and appropriate signatures. The storage used for medication was seen, it is lockable and is safe. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good People living at the home are protected from abuse and neglect by safe recruitment and good care practice and supervision at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The complaint procedure is clearly written in the service user guide. There have been no complaints or concerns raised with CSCI. The home has a complaints policy and procedure. The home belongs to a providers organisation they feel this helps them to keep up to date with changes and good practice, they were seen to use policies and guidance from this organisation. Mrs Wright confirmed that any concerns are dealt with straight away and they have a complaint form that would be completed if one was made. One person was asked if they would be able to raise concerns or worries if they had any and they confirmed that they would feel able to speak to the staff. Staff recruitment files were examined for new starters. The home brings prospective employees into the home to meet the people living here to ensure the people are happy and comfortable around the prospective employee. Mrs 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 17 Wright stated that they would not employ anyone at the home unless the people who live at the home were comfortable and confident in their company. Staff come to help out 1 and 1a Orchard Villas from the Springside home but generally the people here are cared for by the proprietors Mr and Mrs Wright who live on the premises. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This family style care home is very clean, well presented and comfortable. There is fire safety equipment and the home is safely maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well managed and is run as a family unit. One person lives in the house has a comfortable and personalised bedroom. They use the family communal accommodation, which is warm, very clean and hygienic, well decorated and comfortable. At the inspection the person living in the house, the owners, a visitor and the inspector sat together around the large dining table in the main house. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 19 Pleasant background music was playing. This was for the benefit of the person living there as they find it soothing. The lounge was used by the resident to sit and listen to their music prior to them joining the party in the bungalow. A tour of the premises was made; the bathroom at the house has unrestricted temperature hot water outlets. The person in residence is unable to use the bathroom or washbasin independently and the risk assessment for this is rated as low on their care plan. This has been maintained as an infection control measure within the house. Any changes within the household or with those who have access to the bathroom must result in the risk of scalding being reevaluated. With the risk of scalding re-assessed, action must be taken to reduce the risk to accordingly. The home has a fire alarm and hard wired smoke detection systems. These are services and are regularly checked. Records were inspected to confirm this. The Bungalow, which is adjacent to the main house, is currently occupied by one person who has been assessed and can live a fairly independent life there. The bungalow was very clean and tidy. It has a functioning kitchen, bathroom, lounge and two bedrooms. Bedrooms can be personalised and were comfortably furnished. The person in residence showed the inspector their room. There were family photographs and personal items around the room making it feel quite homely. The person said they were pleased with their room and seemed very content and relaxed. The owner said that the hot water has been regulated to a safe temperature at the bath outlet and the hot water had been used up at teatime for party washing up. The hot water ran only up to a warm temperature when checked at this visit. There are staff hand washing facilities and the laundry is managed in house. No infection control issues were detected or raised at the inspection. The premises has gardens and outdoor paved areas there are countryside views from the property. There are rails at the front of the property where the steps are steep. The home has a ramp that can be used for wheelchair access. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is adequate The home is family run by experienced care home providers. Staff are carefully selected for recruitment. Recruitment procedures must remain robust at all times. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mr and Mrs Wright and Mrs Bond, the proprietors, staff this home. In conjunction with their other care home Springside there is a staff team that may work at either home. The team of eight staff are 50 qualified to NVQ Level 2 and 3. Mrs Bond has the NVQ level 4 Managers award. Staff files were examined for training examples were seen of recent training in mandatory topics such as fire, manual handling and food hygiene but also vulnerable adults safeguarding training in abuse awareness and infection control. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 21 Recruitment processes were examined for all staff and 2 references were seen on the files and evidence of Criminal Record Bureau (CRB) checks. One recent recruitment process was in hand and the person had been invited into the home to spend time with the owner and people living at the home to see how they interacted with the people and if they were acceptable to them. This practice was viewed as an interview situation. This practice must be strictly supervised unless all other interview checks (CRB and 2 references) have been received and are satisfactory. Staff receive supervision and have annual appraisals. Staff meetings are also held and training is given at such times. Supervision was not recorded six times per year; this was discussed with Mrs Bond and ways to make the supervision more appealing to their experienced staff team. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good The home is well managed as family unit. The premises are very clean and are safely maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well managed and is in good decorative order and is very homely clean and comfortable. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 23 The registration certificate was displayed and the home has insurance policies including employer’s liability that was all in date. The maintenance records were inspected for fire safety. The home has hard wired smoke detection and a fire alarm system. This was serviced in November 2007. There is a carbon dioxide detector for the central heating boiler. Fire extinguishers were upgraded in November 2007. Invoices were seen for fees and the contracts were in place. One person is independent financially. Mrs Wright said she acts as appointee for one person on behalf of their relatives. This situation should be brought to the attention of the social services care manager for discussion at each review. All extra costs were confirmed as being invoice and refunded. The AQAA states that the home is run with the best interests of the people living at the service and one person and the relatives that had responded to the CSCI questionnaires confirmed this. No accidents had been recorded; the accident book is the latest style that is complaint with the data protection act. All records seen at this inspection were stored safely in the home. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 X X 3 X 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 25 NO 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. Standard YA34 Regulation Requirement Timescale for action 22/02/08 19(1)(5)(d)(i) The registered person shall not employ a person to work at he care home unless full and satisfactory information is available in relation to him in respect of the following matters - each of the matters specified in paraghs1to 6 of schedule 2 and schedule 4 point 6 of the Care Homes for Adults (18-65) National Minimum Standards Care homes regulations. This is with specific reference to ensuring that interviewing and recruitment practice do not compromise the safety of the people in residence. All of the above required information must be available in relation to the staff records, before anyone is allowed to work at the home. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA42 Good Practice Recommendations The risk of scalding from having unrestricted temperature hot water delivered to the bathroom in the main house should be re-evaluated whenever there is a change in the household or with the people having access to this bathroom. Action should be taken to accordingly. 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection South West Regional Office Colston 33 33 Colston Avenue Bristol BS1 4UA 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 1 and 1a Orchard Villas DS0000016213.V350868.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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