Care Home: Albert House

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What the care home does well Albert House provides a homely and caring atmosphere for people to live in. The registered provider Mr Esland is committed to providing a high level of care to people living in the home. This is evident in the support staff receive to attend training appropriate to the care needs of the people living there. Surveys received were all complimentary with residents and relatives commenting on welcoming and caring staff who are ready to meet their needs with a cheerful and friendly approach. One survey stated `excellent care could not ask for any better, staff are approachable, all needs are well met a good quality of life is experienced by my relative.` Whilst another said `Staff are always welcoming, an excellent range of activities is provided, there is a genuine caring atmosphere.` People living in the home said `I am happy here,` `I like the staff they are always friendly and cheerful.` This was evident when we observed working practices in the home. Staff clearly cared about the way in which they interacted with residents. Staff work hard to provide appropriate and meaningful activities that residents said they enjoyed. These activities also reflect the social and cultural background of residents and staff working in the home. What has improved since the last inspection? Albert House is in the middle of a total refurbishment and rebuild. Residents commented on their refurbished rooms and the new lounge area that is flooded with natural light. Staff now receive regular structured supervision giving them the support they need to provide a high level of care. Plans are in place to widen the range of needs assessed prior to admission to reflect the Mental Capacity Act and to include advance directives about end of life decisions. A new fire system has been installed and new fire screens were being installed on the day of the inspection. The registered provider has carried out a review of plans for future developments in the home. What the care home could do better: No requirements or recommendations were made following this inspection CARE HOMES FOR OLDER PEOPLE Albert House 19 Albert Road Weston Super Mare North Somerset BS23 1ES Lead Inspector Juanita Glass Key Unannounced Inspection 5th and 14th February 2008 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Albert House Address 19 Albert Road Weston Super Mare North Somerset BS23 1ES 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) 01934 622869 01934 613807 info@yeomancare.co.uk www.yeomancare.co.uk Yeoman Care Limited Mrs Catherine Blanche Barron Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Albert House DS0000020267.V354618.R03.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 with nursing - Code N to service users whose primary care needs on admission to the home are within the following category: 2. Old age, not falling within any other category - Code OP The maximum number of service users who can be accommodated is 28. 12th July 2006 Date of last inspection Brief Description of the Service: Albert House is run by Yeoman Care Ltd. The Responsible Individual for the company is Mr W. Esland, and the registered manager is Mrs C Barron. The home provides nursing care for to up to 28 people whose needs include sickness, injury and infirmity. The home is set near the seafront in a quiet residential area. Shops and other community facilities are nearby and the main town centre is a short journey away. The premises are comfortably furnished and designed to create a relaxing homely atmosphere. There is a sheltered and private back garden, which is due to be replanted and laid following extensive building work. Current fees range from £ 443 to £592 Albert House DS0000020267.V354618.R03.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 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection took place over two days in the presence of the Manager Mrs C Barron and the Registered Provider Mr W Esland. A total of 9 hours were spent in the home. Evidence to support the findings of this inspection was obtained through written surveys from people living in the home and their relatives. Reponses to our written survey were received from 5 people living in the home, 7 relatives and 1 GP. An Annual Quality Assurance Assessment (AQAA) was completed by the homeowner and forwarded to the Commission for Social Care Inspection (CSCI). We also carried out a review of documentation in the home. This included documentation in peoples care plans, staff personnel records and records maintained for the day-to-day running of the home. Whilst in Albert House we discussed the care provided with 8 people living there both on a one to one basis and in a group. We also spoke to 2 relatives, 8 staff members working on the day of the inspection, the home manager and the Registered Provider (the home owner). What the service does well: Albert House provides a homely and caring atmosphere for people to live in. The registered provider Mr Esland is committed to providing a high level of care to people living in the home. This is evident in the support staff receive to attend training appropriate to the care needs of the people living there. Surveys received were all complimentary with residents and relatives commenting on welcoming and caring staff who are ready to meet their needs with a cheerful and friendly approach. One survey stated ‘excellent care could not ask for any better, staff are approachable, all needs are well met a good quality of life is experienced by my relative.’ Whilst another said ‘Staff are always welcoming, an excellent range of activities is provided, there is a genuine caring atmosphere.’ Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 6 People living in the home said ‘I am happy here,’ ‘I like the staff they are always friendly and cheerful.’ This was evident when we observed working practices in the home. Staff clearly cared about the way in which they interacted with residents. Staff work hard to provide appropriate and meaningful activities that residents said they enjoyed. These activities also reflect the social and cultural background of residents and staff working in the home. 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. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5. 6 does not apply Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People intending to move into Albert House benefit from plenty of up to date information to help them make an informed choice. They are not offered a place unless the manager is confident the home can meet their needs. EVIDENCE: The home’s Statement of Purpose has been reviewed and reflects the service provided by the home. A copy of the Service User guide is made available on request. Four care plans were reviewed they all contained pre admission assessments which identified the specific needs of the prospective resident. The manager confirmed that they would only take new residents when they were sure they could meet their needs. The pre admission assessment forms the basis of the full care plan, which is then agreed with the resident or relative when the Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 9 resident is unable to express an opinion. The manager takes into consideration the people’s personal likes, dislikes and hobbies so that the home can design a care package which is specific to their needs. People wishing to move into the home are offered the chance to visit and spend some time there when they can talk to staff and residents about their experiences. People living in the home did not comment on their experience of looking for a home. One survey from a relative said they had received plenty of information and the chance to visit the home enabling them to make an informed choice. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. People living in the home benefit from clear guidelines that enable them to receive care in a person centred way respecting their right to equality, privacy and dignity. They are also protected by robust policies and procedures for the Administration of Medication. EVIDENCE: We looked at four care plans chosen at random. They were all written in a way that reflected the personal needs of the person rather than a group of people or tasks that needed completing. They included the likes and dislikes and the history of the persons life before they moved into the home. This enabled staff to provide care that was individual to peoples needs. Staff spoken to were clear about the way they looked after people living in the home. They knew they could read care plans to find out their personal likes and dislikes. The staff could also identify specific health care needs people had. The care plans also gave them clear guidelines about types of illnesses and conditions. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 11 People living in Albert House were only too pleased to talk about their experience of being in the home. One person said they were very impressed by the care provided to them, another person said nothing was too much for the people working in the home. One person said ‘I am really happy living here they understand my needs and look after me very well.’ We spoke to two relatives who were both very pleased with the care being provided. One relative said she did not feel there are any necessary improvements the care provided was excellent and the staff in the home excelled in ensuring her relative was treated with respect and dignity. We watched the way staff spoke to people living in the home they were polite and respectful treating everyone as individuals. Some care staff in particular was noticed to have a very close rapport with some of the people living in the home. The care plans we looked at showed people living at Albert House continued to have access to healthcare specialists such as the dentist, the optician, the chiropodist and the diabetic nurse. Two GPs from local a practice alternately visit the home every two weeks to check on any resident who might be ill and to review medication if required. Feedback from the local GP practice was all positive. We carried out a random audit of the medication administration record sheets there were no errors found. We observed staff administering medication and the procedure was carried out correctly. Controlled medication was appropriately stored and records were maintained to monitor the stock. We discussed with the manager and owner the proposed plans to have advanced directives in place for all residents so their wishes for end of life can be observed. This will be assessed at the next inspection. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from appropriate activities that reflect the cultural differences of both the residents and staff. They are offered a balanced and nutritional diet, which is flexible and respects personal preferences and cultural backgrounds. EVIDENCE: When we first arrived at the home we noted a photograph album, which recorded parties, and events that had been organised for both residents and relatives to attend. We spoke to people living in the home who said they really enjoyed going on their ‘home holidays.’ One resident explained that their ‘holidays’ were organised in the home, they would celebrate the cultural background of either a resident or a member of staff. The residents said they had visited India and a Chinese day was being organised. Staff confirmed that residents helped prepare decorations and fancy dress for their holidays in the home. Photographs were seen of people dressed in a sari and enjoying an Indian meal, we also saw photographs for seasonal parties. One resident said it was really nice to understand the cultural background of people working in Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 13 the home. On the second day of the inspection the Chinese party had been held. Residents said they had now requested Chinese food is included in the menu. Impromptu activities carried out during both days of the inspection were observed two residents thoroughly enjoyed a game of ‘soft darts.’ one resident talked about the books he was reading, about the short stories he had written and the way the home had helped him resume his hobby. The preadmission assessment includes peoples likes, dislikes and hobbies. On the second day of inspection people have been taken for a walk along the promenade with the hope of enjoying the warmer weather that day. Everybody spoken to said there was plenty to do in the home if they wanted to but they also felt they could decline any activity and return to their room. The statement of purpose says that the home will encourage residents to maintain contact with their local community, place of worship or any social club that they attend. There are no restrictions on visiting times and relatives said they always received a warm welcome in the offer of a cup of tea or coffee when they arrived. One resident said nobody has ever said my visitor cant come. A varied, balanced and nutritional menu is provided, which includes choices and people can make requests if they do not like either choice. Cultural preferences are recorded in care plans and included as a choice on the menu. For example some residents had chosen to eat fish on Fridays due to their religious beliefs therefore they were always provided with a choice of fish on a Friday. One resident said the food was always very good. And other residents said they had enjoyed their lunch. Mealtimes were observed to be relaxed and peaceful affairs and people who required assistance were helped in a dignified and respectful manner. We sampled a meal on the first day of the inspection it was very well presented and prepared with fresh meat and vegetables. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home are protected by very clear policies and procedures that make it possible for them to feel they can raise issues and concerns with the manager and staff. Policies and procedures also included very clear guidelines protecting vulnerable people from abuse and neglect. EVIDENCE: The home’s complaints policy and procedure shows a clear timeline and action to be taken in event of a complaint. A copy is clearly displayed in the home and subsequent copies are available on request. The policy and procedure also directs the complainant to the CSCI. A clear record is maintained by the manager of all complaints or concerns raised by anyone involved with the home. This record includes the action taken and the eventual outcome. It was evident that the manager deals with complaints in an open and inclusive way. The manager views any complaint or concern as a learning process enabling them to improve the service provided in the home. Residents spoken to said they knew who they could talk to and would be happy that their concerns were being dealt with. Staff spoken to were all aware of the homes policy and procedure for the safeguarding of vulnerable adults. They had all attended appropriate training Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 15 and they all confirmed that they also knew of the homes whistleblowing policy and would be prepared to use the policy if they felt someone was being placed in an abusive situation. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Albert House benefit from a comfortably furnished homely atmosphere. They are encouraged to personalise their room so that it reflects their interests and family. EVIDENCE: Despite the major works being carried out in the home we found it peaceful and un-cluttered. Residents spoken to said they were not affected badly by the building works, they said that they could hear things happening occasionally but it had not made life difficult. The Registered Provider and staff are to be commended for the way they have minimised the effect of the rebuild on residents. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 17 We spent some time in the new lounge with residents, every effort has been made to utilise natural light for people to read by and it is a very pleasant room. Residents said they like the bright room. Whilst a few others said they liked the smaller lounge where they could have a chat amongst friends. The registered provider showed us the work that needs to be finished. This will mean all the people living in the home will have en-suite rooms with Internet and telephone access and appropriate equipment to meet their needs. They will also have access to a paved and safe garden area. Resident’s rooms reflected their lives with personal photographs and pictures. One resident said they liked their room, which had been refurbished. One relative survey said the home was always clean and tidy and when the building work was finished would be ‘greatly improved.’ Improvements to the home include the provision of a sluice facility recommended at the last inspection. Infection control in the home is of a good standard and staff exhibited an awareness of the importance of observing strict measures. Appropriate protective clothing was provided and staff confirmed that they had ample supply. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from staffing levels that are flexible and staff who have the skills and training to meet their needs. They are protected by the homes robust recruitment procedure, which the manager follows. EVIDENCE: We looked at past and present duty rotas, they showed that there is consistently a good skill mix of staff working at anyone time in the home. Staffing levels are flexible so extra staff can be on duty to cover events in the home, trips out or increased needs of people living there. As well as care staff there is also a dedicated maintenance, cleaning and catering team. Staff felt that although they were busy they had plenty of time to spend with residents to talk or take them out without feeling understaffed or over pressured. We observed staff working in the home they were cheerful and relaxed, residents said their bells were answered in good time and that the staff were always very helpful. The registered provider is committed to enabling staff to continue with personal development and training. We looked at the training records for both the care staff and qualified nurses. All mandatory training had been attended Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 19 and people had also attended training in areas that were specific to the needs of people living in the home. Such as dementia Care, wound care and catheter and stoma care. Staff spoken to said they received support to attend training and to obtain their NVQ in Health and Social Care, they said that some staff had gone on to do their nurse training. The home has very robust policies and procedures for the recruitment of new staff. We looked at staff personnel records to check that these policies and procedures were being followed. All new staff members had all the relevant documentation in place. This showed that they did not start work in the home until a POVA 1st, CRB and two references had been received. This protects people living in the home from potential harm. All new staff completes a full induction and only work unsupervised when they have been assessed as competent to do so. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Albert House benefit from a manager with knowledge of the diverse needs of people in the home, who maintains an open and inclusive atmosphere. Their opinions are sort to support the homes Quality Assurance process. Adequately supervised staff and a robust health and safety policy and procedure protect people from harm. EVIDENCE: Mr Esland the registered provider and Mrs Barron the manager were present on both days of the inspection, we discussed the progress that has been made in the home with the new build and future plans to maintain a high level of care. Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 21 Mrs Barron is a registered Nurse with experience in managing a care home she has attained the NVQ level 4 Registered Managers Award. Training records showed that Mrs Barron had maintained a high level of training enabling her to run the home efficiently. Mr Esland also gives management support on a regular basis overseeing the business. Formal staff supervision has been carried out for all staff working in the home, a clear record is maintained and this supports staff in recognising personal development and training needs. Staff spoken to said they received support with areas they felt uncertain in and could talk to the manager or other qualified staff at any time as well as the formal dates set. Mr Esland confirmed that they were in the process of completing a Quality Assurance process. This would include looking at all areas of the home and taking into consideration comments raised by people living in and involved with the home. We discussed the AQAA and how that was also a Quality Assurance tool giving a clear detail of how the home had improved the service they provide over the last year. Residents spoken to said they felt they had been asked about the service they received and felt they could talk to the manager and request changes if necessary. Records relating to servicing of equipment in the home were reviewed. All records were up to date and available for inspection. The implementation of health and safety within the home was satisfactory. All residents have personal risk assessments. Generic risk assessments are in place and reviewed regularly. A review of the fire log showed all tests, training and drills were being carried out to the Avon and Somerset Fire Brigade guidelines. Albert House DS0000020267.V354618.R03.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 3 Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations Albert House DS0000020267.V354618.R03.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Regional Office 4th Floor, 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 Albert House DS0000020267.V354618.R03.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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