Care Home: 44 Sedgley Road

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What the care home does well The home provides spacious personal rooms for the people who live there and these are decorated according to each person`s age and preferences. The home has a team of trained staff who have a good knowledge of the needs of the people in their care. They support the people who live there to take part in a range of activities in the home and community and to follow their chosen hobbies and interests. The staff encourage the people who live in the home to be as independent as possible and to make choices about their lives. Staff provide people with choices of healthy food and encourage them to make drinks and snacks when they wish to. Staff help people to stay in touch with family members and people who are important to them. There are good systems to make sure that people`s health needs are identified and met. There are good systems to protect people from abuse, including checks on staff prior to employment and a complaints system for people to use, should they be dissatisfied with the care provided for themselves or someone else. People who live in the home benefit from systems which monitor the quality of care and make changes when improvements are needed. What has improved since the last inspection? Some aspects of the management of medication have improved and staff are better trained in the administration of medication by relevant specialist techniques. The home had recently opened at the time of the last inspection. People are now more settled in the home and bedrooms are more personalised. What the care home could do better: Although the staff team provide a good standard of care for the people who live in the home, there is a need for improved communication between members of the team. The team may benefit from training in effective teamwork and better communication so that the people who live in the home continue to receive a good quality of care from a consistent team. The previous manager has been replaced but no application has yet been submitted to the CSCI to register a manager for this home. The company should submit an application to register a suitable person. CARE HOME ADULTS 18-65 44 Sedgley Road Woodsetton Dudley West Midlands DY1 4NG Lead Inspector Chris Lancashire Key Unannounced Inspection 2nd and 9 September 2008 10:30 th 44 Sedgley Road DS0000068643.V371342.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 44 Sedgley Road DS0000068643.V371342.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. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 44 Sedgley Road Address Woodsetton Dudley West Midlands DY1 4NG 01902 887630 01902 887630 jacqui_churchhill@yahoo.co.uk 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) Swan Village Care Services Limited Manager post vacant Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st July 2007 Brief Description of the Service: 44 Sedgley Road is a 5 bedded detached property situated in a residential area, on a main road in the Woodsetton area of Dudley. The home is registered to provide care for up to five adults who have a learning disability. 44 Sedgley Road is located close to Dudley town centre and is within easy access of a local nature reserve. There is good access to community facilities and public transport bus routes. The property offers five single en-suite bedrooms well in excess of the minimum space requirements, some with a lounge area. There is a communal lounge on the ground floor, and there adequate WC’s, bath and shower facilities through out the building. There is an easily accessible garden at the rear with a small car parking space which is shared with another adjacent care home. The fees for this service are available on application to the home. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We visited the home on two weekdays, without giving anyone prior notice. Before the inspection, the managers had provided us with information about the home and the people who live there in response to a questionnaire (AQAA). At the inspection we met the four people who live in the home, the manager of another home, who is acting as mentor to the newly appointed manager and a relative who was visiting that day. We also spoke with five members of the staff team and looked round the house. We looked at the medication and sampled the records for people in the home and staff. We looked at records relating to the running of the home, safety and quality monitoring. We used this information to make our judgement about the outcomes for people who live in the home. The overall rating for this home is two stars. This means that the people who live there receive a good service. What the service does well: The home provides spacious personal rooms for the people who live there and these are decorated according to each person’s age and preferences. The home has a team of trained staff who have a good knowledge of the needs of the people in their care. They support the people who live there to take part in a range of activities in the home and community and to follow their chosen hobbies and interests. The staff encourage the people who live in the home to be as independent as possible and to make choices about their lives. Staff provide people with choices of healthy food and encourage them to make drinks and snacks when they wish to. Staff help people to stay in touch with family members and people who are important to them. There are good systems to make sure that people’s health needs are identified and met. There are good systems to protect people from abuse, including checks on staff prior to employment and a complaints system for people to use, should they be dissatisfied with the care provided for themselves or someone else. People who live in the home benefit from systems which monitor the quality of care and make changes when improvements are needed. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 44 Sedgley Road DS0000068643.V371342.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 44 Sedgley Road DS0000068643.V371342.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): 2. Quality in this outcome area is good. People’s needs and individual aspirations are assessed so that staff will be able to meet them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We sampled files and found that people’s needs had been assessed before they moved to the home. The reports which we saw included assessments by the placing authorities, relevant health professionals and the home’s manager. They covered all relevant aspects of the person’s life and included their preferences and dislikes as well as their preferred routines. The records also showed that people had been provided with the opportunity to be introduced to the home slowly and to make a decision about whether or not to stay. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. People’s needs are reflected in their plans, which are updated as necessary. They are encouraged and supported to make decisions about their lives and to take risks in order to maintain and develop independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We sampled the files and looked in details at those for two people in the home. The plans for each person are in two folders, which are well organised and properly completed. One contains health care information and relevant support plans related to this subject. The second folder contains care plans regarding topics such as showering and bathing, communication, personal hygiene, choosing clothes, oral hygiene, personal grooming, nail care, night time routines, privacy, supporting relationships, daily life skills, activities and behavioural support. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 10 We found the plans easy to understand with agreed support needs, short term and long term goals and detailed actions needed to meet the needs identified. People who are able to read and write are encouraged to sign the care plans to demonstrate their understanding and agreement. A recently employed member of staff confirmed that the plans contain the required information to provide suitable support to each person. We saw staff responding to people’s requests to participate in activities, for example going out to the shops. There are communication plans and these include information provided by relatives and previous carers. Advocates are also arranged when needed. We saw staff communicating well with people who live in the home and giving clear indications of what would be happening. We saw a range of risk assessments covering activities of daily living and tasks relating to independence. Depending on their abilities, people are supported to make snacks and drinks. We saw one person being supported to bring us a drink. Staff were careful to warn about it being hot and made sure that the person was holding it firmly before they let go of the mug. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 11 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 and 17. Quality in this outcome area is good. The people who live in this home are supported to take part in activities and to develop their skills and abilities in a variety of areas. They are assisted to maintain relationships with people in the community. They are provided with a healthy diet, which they enjoy. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the first day of the inspection, we met three of the people who live in the home and they were all involved in different activities with staff, including getting ready to go out shopping, listening to music and drawing. One person had a visit from a family member. There are activity programmes for the people in the home, but staff can also be flexible and respond to people’s preferences based on the weather or their mood. The records show that people take part in a range of in-house and community based activities with lots of 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 12 access to the local community. For example, these include housework tasks, walks to the shops, watching movies, arts and crafts, bus trips to local towns, a pub lunch, going to the cinema, bingo and visits to a local places of interest. Staff complete daily reports and these include the activities. Use is also made of local colleges when possible. There are examples of arts and crafts by people in the home in various places, including their bedrooms. The staff confirmed to us that people are supported to keep in contact with their family and friends. People have varying levels of contact, with some people visiting several times a week. We met one relative who confirmed that their family member was ‘very settled’ at the home and that she had ‘no concerns’. We saw that daily routines are flexible and promote independence. For example, people may have snacks and drinks when they wish to. Bedrooms and bathrooms are fitted with privacy locks. There are pictorial signs on the bedroom doors to ask people to knock before entering. The welcome pack given to people when they move in contains a range of policies in pictorial formats informing residents of their rights for example with regard to voting, advocacy and opening of correspondence. We looked at the menus and records of what people had chosen to eat. Staff told us that they have been making efforts to make sure that there are healthy options for people in the home. These include meat, fish, vegetables, salads, pasta, rice, traditional English foods and spicy meals. Fresh fruit is also available. A nutritional screening tool is used as part of the assessment process and the person in charge informed us that use has been made of the community dietician for further advice. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 13 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 and 20 Quality in this outcome area is good. Residents receive personal support in the way they prefer and require so that their physical and emotional health needs are met. They are protected by the home’s procedures and staff practice in relation to the storage and administration of medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at daily reports completed by staff and found that the people who live at this home are provided with choices about their daily routines. The sampled support plans were detailed and show how each person needs and prefers to be supported. There are male and female staff available so that each person can have a choice about who they want to support them. Staff told us that the senior staff decide who will work with whom on each shift, but the preferences of the people who live there are taken into consideration. This means that staff have a chance to work with different people and this eases the possible strain of being with someone who exhibits extremely challenging 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 14 behaviour for long periods. It also provides the people in the home with access to staff with a range of different interests and skills. Our observations and examination of daily reports confirmed that staff are fully aware of the need to promote people’s dignity for example by ensuring appropriate clothing is worn. We saw helping one person to do her hair before going out. Each person in this home has a health care action plan. There are checklists of actions with regard to making appointments to see health care specialists, attending health care screening and other routine appointments. There are care plans for specific health care issues. For example, there is a detailed support plan in place for management of epilepsy, accessing health professionals and supporting people with clinical procedures. We looked at the arrangements for the storage, administration and recording of medication and found that these are good. We saw certificates to confirm that staff had been trained in the administration of medication. The person in charge told us that there is now improved guidance for staff in relation to medicine which is taken ‘as required’. We saw that there are clear instructions for staff in this area. Staff have also received training in administrating a medication which requires specific techniques. We saw detailed records of the receipt of medication into the home and the returns to the pharmacist. There were no gaps in the medication charts. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 15 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 and 23. Quality in this outcome area is good. The home has a satisfactory complaints procedure which ensures that people’s views are listened to and acted upon. The people who live in this home are protected from abuse, neglect and self-harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw a comprehensive complaints procedure which is openly displayed within the home. There is a pictorial complaints procedure for people who live in the home and copies are held in their ‘welcome packs’. We saw that there is a safeguarding policy and a copy of the Department of Health’s guidance ‘no secrets’ held in the manager’s office. There is also a copy of the Local Authority’s safeguarding and protecting vulnerable adults policy. Staff have been trained in vulnerable adult abuse awareness and we interviewed six members of staff, all of whom confirmed that they felt that people in this home are well protected. We saw risk assessments which identify the types of action which need to be taken in the case of challenging behaviour, in order to protect staff and people in the home. Since the last inspection, two complaints have been made regarding staff practices. Similar information has been sent to the CSCI and the local 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 16 authority. We saw that the complaints had been investigated by the company and the results had been recorded, with suitable action being taken. We also looked at the issues raised as part of this inspection and found that appropriate actions had been taken to ensure that staff are fully aware of the practices which they must follow. 44 Sedgley Road DS0000068643.V371342.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 and 30. Quality in this outcome area is good. This home provides people with a safe, comfortable home with spacious bedrooms. Staff take suitable action to make sure that people are protected against the risk of cross infection. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We toured the premises and three people showed us their bedrooms. They bedroom were very spacious and decorated according to their tastes, interests and age. All bedrooms are en-suite, large and airy. Communal areas are decorated and furnished to a good standard. Staff told us that there is a lot of wear and tear due to some challenging behaviour and the television has been boxed in to avoid damage and causing harm to someone who lives there. There is an enclosed patio area and separate, attractive garden space. There is car parking off road, accessible by means of a drive between this home and the home next door. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 18 On the day of our inspection the home was clean, hygienic and free from offensive odours. There is a small laundry area adjacent to the kitchen which has impermeable walls and flooring. We saw that communal areas and toilets had supplies of liquid soap and paper towels. We saw risk assessments in relation to the home, the people who live and work there and the practices. These are regularly updated and changed to reflect current risks. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 19 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 and 35. Quality in this outcome area is good. The people who live in this home are supported by adequate numbers of staff who have a diverse range of skills and experience and who receive training in relevant areas. They are protected by the home’s recruitment practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We looked at the rotas and saw that there are adequate numbers of staff on each shift. For example, on the day of the inspection, there were five members of staff and a manager to support four service users. There have been recent losses of staff and the person in charge told us that efforts are being made to replace them. Staff told us that they are supported by other staff who will change shifts if, for example, one is attending a training session, but the general view was that they would welcome more people in the team. Newly recruited staff confirmed that they received a suitable induction and we saw the materials used. This complies with the requirements in this area. Staff also attend a variety of training in relevant areas such as food hygiene, 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 20 epilepsy, medication and manual handling. Staff are encouraged to attend NVQ training and over 50 have achieved level 2 or above. The matrix on the office wall shows the plans for all staff over the coming year and this includes new training as well as refresher courses in basic areas. We interviewed six members of the staff team and they had diverse backgrounds and experiences. They all brought different perspectives to the job and had skills in a variety of areas apart from care work. However, it was apparent that communication within the team could be improved and we discussed the possibility of teamwork training with the supporting manager. It is important that the team communicates well so that the staff can continue to provide a good standard of care for the people who live in the home. Staff are recruited through a standard company procedure and they are checked through the Criminal Records Bureau. There have been times when staff have started work after receiving a ‘POVA first’ check. In these cases, risk assessments have been recorded and the company procedure is that they are also supervised closely. These measures help to protect the people who live in the home. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. The people who live in this home benefit from a well run home where they can be confident that their views underpin self-monitoring, review and development. There are good arrangements to ensure that the health, safety and welfare of all people who use the building are promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is currently no registered manager for this home as the previous manager has recently left her post. A member of staff has been promoted to the position of manager and she is being supported by the manager of another of the company’s homes. The manager was not present during the inspection as it was unannounced and took place when she was not on duty. However, the person who is supporting her came to assist in the inspection and provide the necessary records. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 22 The company has a quality assurance system and this includes seeking the views of people using the service and their representatives. There are regular visits from a representative of the registered provider and checks are made to ensure that the standards are maintained. The previous manager completed a questionnaire prior to the inspection (AQAA) and this showed that there are regular checks and servicing on equipment in the home. We sampled the safety records and found that these are up to date. There are also regular checks on fire safety equipment and water temperatures. There are relevant risk assessments, including a fire safety risk assessment. We looked at food hygiene practice and saw that this was efficient. There is a food hazard analysis, regular testing of cooked food, fridge and freezer temperatures. High risk foods are labelled with the date of opening and stored in the fridge. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 23 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 3 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 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 3 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 X 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 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 2 Refer to Standard YA32 YA37 Good Practice Recommendations The staff should undergo training in communication and teamwork, so that they can continue to provide a good service to the people who live in the home. An application should be submitted from a suitable person to be registered as manager. 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 44 Sedgley Road DS0000068643.V371342.R01.S.doc Version 5.2 Page 26 - 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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