Care Home: 31 Oak Road

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What the care home does well Each person who lives at the home has had their needs assessed to make sure the home can give them the care and support they need. Furthermore information is available to help people make an informed choice about the service before they decide to use it. The staff at the home treat the people as individuals and support them to live the life they choose as much as possible. They have new experiences and know that their opinions are valued. The staff are appropriately trained so they know how to provide the people who live at the home with good care. There are also sufficient numbers of staff in post to meet the needs of the people.Quality assurance systems are in place. This helps the service to ensure it is run in the best interests of the people who live there. What has improved since the last inspection? Staff in the home continues to encourage people to undertake projects they show an interest in. Two people who use the service had attended training in `Healthier Food and Special Diets` and completed a project in healthy living. Some people had recently been involved in a project about bullying and had written about how it would make them feel if they were bullied and whom they would tell. Two people had also written poems about being bullied. Since the previous inspection a policy had been put in place for `homely remedies`. There was evidence to show that permission to give homely remedies had been sought and agreed by the person`s General Practitioner. All staff has received training in Fire Safety. What the care home could do better: In the two sets of documentation examined there was inconsistency as to when the plans were reviewed and very little information was in place for the reviews. Each person also has an essential lifestyle plan, however in the two files examined there was no dates on the information and it was not clear how often these were updated. The plans covered areas such as important people, likes and dislikes of food, activities, how the person wants to be supported, routines, things that must not change and things that can be changed, hopes and dreams for the future. Risk assessments were in place for each person: financial management, medication, and emotional and sexual exploitation, cooking and bathing. There was evidence to show that the risk assessments were reviewed but these were not carried out regularly and there were no comments made within the review. Health plans identify needs such as; oral hygiene, weight management, eye sight, however in the two plans examined they were not dated nor was there any evidence to show that they had been reviewed regularly. The plans should also be updated when any tests or appointments are undertaken relating to a health need. Medication administration records had been completed, however a handwritten administration record had only one signature. The manager was advised that hand written records need to be checked and signed by a second member of staff. CARE HOME ADULTS 18-65 31 Oak Road Eaglescliffe Stockton-on-Tees TS16 0AT Lead Inspector Val Daly Key Unannounced Inspection 25th June 2008 10:00 31 Oak Road DS0000036219.V367240.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 31 Oak Road DS0000036219.V367240.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. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 31 Oak Road Address Eaglescliffe Stockton-on-Tees TS16 0AT 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) 01642 528611 Stockton-on-Tees Borough Council Mrs Elizabeth Sillitoe Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning disability - Code LD, maximum number of places: 6 The maximum number of service users who can be accommodated is: 6 29th June 2007 Date of last inspection Brief Description of the Service: Oak Road is a six-bedded care home providing long term care for younger adults with a learning disability. It is situated in a small council housing estate and blends well with surrounding properties and service user accommodation comprises on the first floor of one double bedroom and four single bedrooms. The ground floor accommodation includes a lounge/dining room, a separate lounge and a domestic style kitchen. There is a small garden to the front and a larger one to the rear of the property, which is laid to lawn. The home is close to local amenities and has easy access to the public transport system. Fees charged are dependent on the person’s individual circumstances and range from no charge to £536.00 per week. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use the service experience good quality outcomes. This inspection was a key unannounced inspection and was completed by an inspector in one inspection day. As a key inspection, all of the key standards were examined. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. A number of records were looked at including assessments of people who use the service and plans of care, staff recruitment records, complaints and maintenance records along with the annual quality assurance assessment. The manager had completed an Annual Quality Assurance Assessment prior to the inspection. The AQAA is the services self-assessment of how they think they are meeting the National Minimum Standards. This information is received prior to the inspection and it is then used as part of the inspection process. On the day of the visit the manager provided the information and documentation required. The Commission for Social Care Inspection sent a number of surveys to the home for people who use the service to complete. Four were completed and returned. Comments received can be read within the report. This was a positive inspection; people were open and friendly and welcomed discussion about the home. What the service does well: Each person who lives at the home has had their needs assessed to make sure the home can give them the care and support they need. Furthermore information is available to help people make an informed choice about the service before they decide to use it. The staff at the home treat the people as individuals and support them to live the life they choose as much as possible. They have new experiences and know that their opinions are valued. The staff are appropriately trained so they know how to provide the people who live at the home with good care. There are also sufficient numbers of staff in post to meet the needs of the people. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 6 Quality assurance systems are in place. This helps the service to ensure it is run in the best interests of the people who live there. What has improved since the last inspection? What they could do better: In the two sets of documentation examined there was inconsistency as to when the plans were reviewed and very little information was in place for the reviews. Each person also has an essential lifestyle plan, however in the two files examined there was no dates on the information and it was not clear how often these were updated. The plans covered areas such as important people, likes and dislikes of food, activities, how the person wants to be supported, routines, things that must not change and things that can be changed, hopes and dreams for the future. Risk assessments were in place for each person: financial management, medication, and emotional and sexual exploitation, cooking and bathing. There was evidence to show that the risk assessments were reviewed but these were not carried out regularly and there were no comments made within the review. Health plans identify needs such as; oral hygiene, weight management, eye sight, however in the two plans examined they were not dated nor was there any evidence to show that they had been reviewed regularly. The plans should also be updated when any tests or appointments are undertaken relating to a health need. Medication administration records had been completed, however a handwritten administration record had only one signature. The manager was advised that hand written records need to be checked and signed by a second member of staff. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 7 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. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 8 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 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service have their needs assessed prior to admission. EVIDENCE: Two sets of documentation were examined and they showed that a full assessment had been carried out prior to the person moving into the home. The assessment documentation covered areas such as: preferred recreational activities, personal care, nutrition, dress management, mobility, continence, night time, sensory loss, emotional status, medication and health, independence/leisure, culture/religion and finance. Assessments are reviewed annually. At the time of the inspection a person who would possibly be moving into the home was visiting at times for evening meals. He would then hopefully go on to have over night stays over a period of time before choosing to move into the home. The person was being gradually introduced to the other people living in the home. 31 Oak Road DS0000036219.V367240.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. People who use the service get the personal support they require and at the same time staff makes sure that their privacy and dignity is respected. People are supported to become as independent as possible but at the same time staff look at the risks to keep them as safe as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person who uses the service has an individual care plan, which showed involvement from the person, his or her key worker in the home and key worker in the day centre. Two sets of documentation were examined, which showed the information was detailed. However there was inconsistency as to when the plans were reviewed and very little information was in place for the reviews. Within the plans there was also a personal profile of the person and a ‘pen picture’. Daily notes detailed how the person spent their days, for 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 11 example a walk in Preston Park, a visit to the local pub, and overnight stay with family. One person was involved in a project for healthy living, which involved healthy eating, looking at lower fat alternatives within the diet and walking on a weekend. Each person also has an essential lifestyle plan, however in the two files examined there was no dates on the information and it was not clear how often these were updated. The plans covered areas such as important people, likes and dislikes of food, activities, how the person wants to be supported, routines, things that must not change and things that can be changed, hopes and dreams for the future. Risk assessments were in place for each person: financial management, medication, and emotional and sexual exploitation, cooking and bathing. There was evidence to show that the risk assessments were reviewed but these were not carried out regularly and there were no comments made within the review. People who use the service also have short and long term plans in place. The short term plans are usually achievable in one day such as: tidy room and clothing, go for a walk to the park and choose a drink and pay for it themselves, go to a garden centre, choose plants and put them into hanging baskets. Longer-term plans take longer to put in place with usually more people being involved in the process. One person wanted to sing at church, another would like to have a part time job, on a voluntary basis at a local hospital. 31 Oak Road DS0000036219.V367240.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): 12, 13, 15, 16 & 17 Quality in this outcome area is excellent. People at the home are supported by staff, while maintaining links with their families and friends. They are able to make choices about their lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who use the service attend day centres during the week, where they have an individual programme of activities. They each have a ‘home day’, spending one to one time with staff doing activities such as; baking, personal clothes washing, going to the Post Office, shopping. On evenings and weekends people take part in a variety of activities and enjoy socialising with friends, walking, going to the local pubs/restaurants, local cafes, line dancing, shopping and trips out. Some of the people use part of their allowances to pay for a carer from Adult Placement Services to take them out on a one to one basis, swimming, shopping or for a particular activity they may wish to do. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 13 There are pampering evenings at home where people have aromatherapy, hand, and foot shoulder massage. Following these sessions staff write an individual evaluation. Two people who use the service had attended training in ‘Healthier Food and Special Diets’ and completed a project in healthy living. Some people had recently been involved in a project about bullying and had written about how it would make them feel if they were bullied and whom they would tell. Two people had also written poems about being bullied. Holidays are very popular and at the time of the inspection two people were enjoying an overnight stay at Whitby. A short break to Blackpool had been organised for later on in the year. Staffs are flexible in their working hours to enable people to have their holidays. Family and friends are welcome to visit at any time and some people also spend time out of the home with them. The menus are varied, with each person choosing the main meal one day a week. Favourite meals were; lasagne, gammon and pineapple, Quiche, ham salad and spaghetti bolognaise On a Saturday evening the residents enjoy a take away meal. Comment cards from people who use the service stated ‘I am happy living at Oak Rd’. ‘I love living at Oak Rd, I have a good friend here and we are going on holiday together’. ‘We have brilliant days out and fantastic holidays’. ‘I always make decisions about what I want to do each day’. A relative commented ‘My family member leads a very busy social life. He loves swimming and goes line dancing each week. He also enjoys going to the cinema or to see a show’ . 31 Oak Road DS0000036219.V367240.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 have personal support when they need it so they can be as independent as possible. Healthcare needs are met, which ensures that people stay healthy, however plans need to be reviewed regularly. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were examined which detailed the personal support given to the people who use the service. Each person has their own General Practitioner and they also consult with other health professionals when needed. People who use the service also have individual Health Action plans, which are completed by themselves, their family and key worker. Some of the plans had been personalised with pictures relating to a health need. Whilst health needs are identified such as; oral hygiene, weight management, eye sight, in the two plans examined they were not dated nor was there any evidence to show that they had been reviewed regularly. The plans should also be updated when any tests or appointments are undertaken relating to a health need. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 15 Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. Since the previous inspection a policy had been put in place for ‘homely remedies’. There was evidence to show that permission to give homely remedies had been sought and agreed by the person’s General Practitioner. Medication administration records had been completed, however a handwritten administration record had only one signature. The manager was advised that handwritten records need to be checked and signed by a second member of staff. 31 Oak Road DS0000036219.V367240.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. A robust complaints procedure is in place. Satisfactory protection procedures are in place to protect the people form risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure in place. There had been no complaints made to the home since the previous inspection. However there had been an incident of bullying between people living in the home and the manager need to direct staff to investigate this further and come to a satisfactory outcome. Staff are always available for people who use the service to come to if they have any concerns or are unhappy. The home has a safeguarding policy and procedure in place. There was evidence in staff training files to show that training in the protection of vulnerable adults had been carried out. Comment cards from people who use the service stated ‘I would tell the people higher up if I wanted to complain about something’. ‘I would complain to the manager’. ‘I would speak to the manager or my family’. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 17 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. The home is comfortable, warm and clean, providing people with a pleasant place to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home was carried out. All areas were very clean, tidy and well decorated. People who use the service are involved in choosing the décor and furnishings in their own rooms and also in the communal areas. Bedrooms were very individual containing personal possessions. The garden area had planters and hanging baskets with colourful flowers and plants. The manager said she had put forward a proposal for a conservatory to be built on, which would provide more space for people especially for friends and family visiting. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is excellent. Staff have opportunities for training so they know how to give the people who live at the home good care and meet their needs. The home has robust recruitment procedures in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a rota in place, which is flexible for the needs of the people who use the service. There is a policy and procedure in place for the recruitment of staff. Staff records showed that the required information, references and CRB checks were in place prior to staff commencing work in the home. On commencement of employment each member of staff has a corporate induction followed by a skills for care induction programme, which they work through with a mentor. Staffs receive appropriate training, which helps them with their work. There is very little turnover of staff in the home, they know the people well and positive 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 19 comments in the surveys reflected this. Staff training files were examined which showed training had been carried out in Safeguarding People, Health and Safety Management, Health Level 2 in Food Safety, First Aid, Infection Control and IT. At the time of the inspection 75 of staff had achieved NVQ level 2 or above. The manager said she was working towards all the staff completing an NVQ qualification. The home has a formal supervision system in place with staff receiving supervision every eight weeks. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. The views of people who live at the home are sought on how the home is run, so they know that their views are valued and are used to improve the service. Systems and practices are in place, which help make sure the people who live at the home are safe from risk of harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is qualified and competent to run the home. The home has an annual service plan in place and a quality assurance system. The service manager visits the home monthly and reports on many aspects of the home, the building, care records, accidents, health and safety. People who use the service are given a survey annually to complete to seek their views about life 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 21 in the home and the service provided and staffs give support to complete these. An action plan is then formulated to for any suggestions or concerns raised. There is also a survey to complete following the completion of a development plan which asks what the person got from the plan, how do they use the skills in everyday life, the most useful and least useful part and how could the plan be improved upon. Meetings are held weekly for people who use the service and bi-monthly for staff, and minutes are kept. The home has health and safety policies and procedures in place. Training files showed that staffs have received training in health and safety and fire safety. Comment cards from people who use the service stated, ‘The carers always listen to me at reviews and resident meetings’. 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 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 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 YA6 Good Practice Recommendations Care plans need to be reviewed regularly and more information is needed within the reviews. Essential Lifestyle plans need to be dated and also updated regularly. Risk assessments should be reviewed regularly and comments need to be made within the reviews Healthcare plans need to be dated and also reviewed regularly. Two members of staff should sign handwritten medication administration records. 2. 3. 4. YA9 YA19 YA20 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 31 Oak Road DS0000036219.V367240.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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