Care Home: Allanby House

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What the care home does well Allanby House is a small home for only six people and is run very much like any other family house. The people who live in this house receive good care from the staff team. Staff look after their medicines properly and make sure they see a doctor or nurse if they are ill. The residents said they enjoyed the food they get and people with poor appetites are helped to eat as well as possible. The home is good at helping people as they grow older and in supporting them at the end of their lives.People told us that they like to go out in the homes own minibus, some people like to go out to classes but most residents are happy with the activities provided in the home. The manager and staff team are careful to protect people from harm and they listen to any complaints people may make. The house is nicely decorated and furnished and kept clean and fresh for all the residents. There is a pleasant garden and the house is not far from local shops. The manager makes sure that the staff in the home are the right kind of people to work with the residents. The staff told us that they get plenty of support and training for the job they do. The manager has done this kind of work for a long time and runs a well organised home. She makes sure that the house is safe and comfortable for people and that their needs are met. What has improved since the last inspection? We could see that the manager tries to improve things all the time so that residents will be happy and well cared for. These are some of the things we thought had been improved since our last visit: The care plans have more detail and are easier for people to understand as there are plenty of pictures and line drawings in them. Residents told us that they had had new bedroom furniture and new floor covering. Staff said that they had plenty of training and they felt this made them better at their job. What the care home could do better: The company, CIC, need to look at how they help people manage their money. We judged that some people could be helped to look after their own money. CARE HOME ADULTS 18-65 Allanby House Wedgewood Drive Flimby Maryport Cumbria CA15 8QX Lead Inspector Nancy Saich Unannounced Inspection 20th May 2008 9:00 Allanby House DS0000022533.V364550.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 Allanby House DS0000022533.V364550.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. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Allanby House Address Wedgewood Drive Flimby Maryport Cumbria CA15 8QX 01900 819039 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) www.c-i-c.co.uk Community Integrated Care Mrs Carol Wignall Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. The home is registered for a maximum of 6 service users to include: up to 6 service users in the category of LD (Learning disabilities) up to 6 service users in the category of LD(E) (Learning disabilities over 65 years of age) 24th May 2006 Date of last inspection Brief Description of the Service: Allanby House is a modern, purpose built home situated in a residential area of Flimby. It can take up to six residents with learning disability who may also be older people. The home is owned by Community Integrated Care. They have services for people with learning disability throughout the country. Carol Wignall manages the home on their behalf. At the time of this inspection the charges for people accommodated in the home are £1,042 per week. Allanby House DS0000022533.V364550.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 that the people who use this service experience good quality outcomes. This was the main or key inspection for the year. The lead inspector Nancy Saich asked the manager to fill out a form called the Annual Quality Assurance Audit (the AQAA). This asks for details of what has improved in the home since the last inspection and for the plans for the coming year. This was completed promptly with plenty of detail. We then sent out postal surveys to people who live in the home and their relatives and friends and to the staff group. We had a good response to these surveys and we quote from them in the report. The responses were fairly positive and gave us a good picture of what its like to live and work in the home. We toured the building spoke to residents, staff and the manager. We also looked and files and documents that backed up what was said and what was seen. What the service does well: Allanby House is a small home for only six people and is run very much like any other family house. The people who live in this house receive good care from the staff team. Staff look after their medicines properly and make sure they see a doctor or nurse if they are ill. The residents said they enjoyed the food they get and people with poor appetites are helped to eat as well as possible. The home is good at helping people as they grow older and in supporting them at the end of their lives. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 6 People told us that they like to go out in the homes own minibus, some people like to go out to classes but most residents are happy with the activities provided in the home. The manager and staff team are careful to protect people from harm and they listen to any complaints people may make. The house is nicely decorated and furnished and kept clean and fresh for all the residents. There is a pleasant garden and the house is not far from local shops. The manager makes sure that the staff in the home are the right kind of people to work with the residents. The staff told us that they get plenty of support and training for the job they do. The manager has done this kind of work for a long time and runs a well organised home. She makes sure that the house is safe and comfortable for people and that their needs are met. 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. Allanby House DS0000022533.V364550.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 Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager makes sure that she can care for any new resident and that the new person will fit in with people who already live in the home. EVIDENCE: We looked at all the information the home provides for new residents or for people who buy care on their behalf. We saw that both the Statement of Purpose and the residents’ brochure were up to date and detailed. The residents’ brochure was in an easy read format and gave a good picture of what it was like to live in the home. We spoke to the manager and staff and looked at some files and we judged that the home is good at making sure that when they have a vacancy they are careful about who will come in to live in the house. We saw that someone who was thinking about moving into the home had been visited by the manager and that they were going to make their second visit to the house. The other residents had been kept informed of what was happening. We judged that this new admission was being dealt with in a sensitive manner and everyone was given plenty of time to come to the right decision. Allanby House DS0000022533.V364550.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in this home are treated in a very individual way and are supported to take some risks so that they can have quite a full life. EVIDENCE: Every person living in this home had an up to date written plan that told staff what sort of people they were and what they wanted out of life. We thought that these plans were very good in that they were in an easy to read format and had pictures and line drawings on every page. They were written from the perspective of the residents themselves and covered the things that people were able to do as well as those they need help with. We particularly liked the way that positive things were written about every person. These care plans included risk assessments, details of activities people wanted to become involved in and showed staff how to give people support when they were unwell or needed support to manage their behaviour. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 10 As one resident said: • “They help me write it down so that everyone does what I want”. We heard residents being asked on the day about what they wanted to do. We also saw evidence in the files that showed that people were asked their opinions in a more formal way. We also found that people were supported to take suitable risks. The lead inspector and the manager discussed this issue and looked at some areas where the home might be able to work on this so that some people might become a little more independent. Allanby House DS0000022533.V364550.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, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in this home have the kind of lifestyle that suits their age and needs. EVIDENCE: We read all of the written care plans and we could see that each of them had details that helped people to talk about the things they wanted to do that made their lives worthwhile. We also spoke to residents and checked on the surveys we had received. We discovered that people were happy with the things that were on offer in the house. Some residents are more active than others -- and they are given the opportunity to go out to education classes and to social activities. Some residents who were a little older prefer a quieter lifestyle but their care plans showed the kind of hobbies and entertainments they preferred. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 12 This house has its own transport and people are taken out for meals and to activities or just simply to shop or have a coffee. There was evidence to show that people went out to buy their own clothes or to choose their own furnishings for their bedrooms. The home has television and music centre in the main lounge but residents can also have their own equipment in their own rooms. Some people like to listen to radio or watch TV on their own and this is encouraged. Relatives are encouraged to visit the home and some people go to stay with families or friends. We spent some time with residents in the lounge and also observed how people were in the home. We judged that everyone was very relaxed and he or she could choose whether to spend their time in their own room or with the others. Staff took a leisurely approach to the routines of the day and residents were not afraid to ask for what they wanted. All the residents said they enjoyed the food in the home. We checked on menus and the food stored in the kitchen. We judged that residents were encouraged to tell staff what they wanted and were given good quality, nutritious meals. Where people had problems with their diet a nutritional plan was written into the care plan. The manager said she was going to do some more work on this for people who had a poor appetite. Allanby House DS0000022533.V364550.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, 20, 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home get good standards of personal care and are helped to stay as well as possible. EVIDENCE: During the visit we saw staff give people support when they needed help with things like bathing, getting dressed and eating. Staff did this in a caring and sensitive way and they also encouraged people to do as much as they could for themselves. The care plans had very detailed descriptions of daily routines and we judged that this meant that every person was given the kind of individual care that allows people to feel happy and secure. We judged that the staff know the residents very well and pay particular attention to the small details that we all find important in life. One person told us: • “I like living here – people know what to do for me and what I like.” We spoke to staff, relatives and the manager about health care. We also spoke directly to two of the residents about their health care needs. We found Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 14 that all the residents saw the consultant who specialises in caring for people who are learning disabled. We saw that staff took her advice and her directions were written into care plans. We also saw that people who had health problems relating to their age also saw consultants and specialists in this area who could give them the right kind of treatment. The manager helps people to get care and treatment from other healthcare professionals -- like dieticians, chiropodists and opticians. We also saw evidence to show that this home has a very good relationship with the local GP surgery and that the district nursing service visit regularly. Everyone had had their medication reviewed by the GP earlier in the year and several people had had different medication after seeing the consultant. We checked on the medication kept on behalf of residents. We found that this was being ordered, stored and administered correctly. We judged that this home does not rely on sedative medication but that for one or two people this can be used if necessary. We also saw that, after consulting the GP, some residents took some forms of alternative medicine that helped with minor conditions. We saw the CIC training pack that helped staff to understand their responsibilities where medication was concerned. We thought this was of a very good standard and we were very pleased to see that several members of staff were going to undertake further training on medication. We saw evidence to show that the staff in this home have a very good understanding of how to help the residents to deal with any problems that ageing might bring them. We also had plenty of evidence to show that they had managed to support someone at the end of the life by working together as a team and using all the available help. One of the residents had died in the home and we had evidence from surveys and from staff team to show that this had been done with great care and sensitivity. Allanby House DS0000022533.V364550.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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents in this home are listened to and protected from harm and abuse. EVIDENCE: The home had received no formal complaints since the last inspection. There was one matter of concern raised during the inspection. Someone from social services dealt this with on the day. We also checked out this concern and did not find any major problems that we needed to deal with. We saw that the home had a good complaints procedure and that there were systems in place to allow residents to complain if they were not happy. There had been one safeguarding issue that the manager had raised with Social Services. This had been managed appropriately and the action taken had prevented anyone from coming to harm. CIC have good policies and procedures in place and staff are trained in safeguarding issues. We asked a very new member of staff about how she would protect residents and she answered in a very competent and confident manner. We judged that the manager makes sure that staff know how to protect people in this home. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 16 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, 25, 29, 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents live in a purpose built, well-designed house that is tastefully furnished and decorated and this allows people to feel relaxed and ‘at home’. EVIDENCE: Allanby House is a six-bedroom bungalow with a separate lounge and dining room and a small domestic kitchen. It is in fact very much like any family home. It was, however, designed with people’s mobility in mind and is therefore very suitable for people with physical disabilities. The house is situated near to the village amenities and they also have their own transport so people can be taken to Workington and other local towns or places of interest. The home has its own enclosed garden with plenty of seating for residents to use when the weather is fine. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 17 Each person has his or her own bedroom with an ensuite toilet and wash hand basin. The residents allowed us to look at these bedrooms and we saw that they were decorated and furnished to very high standard. The company had recently put down new non-slip, wood effect flooring in bedrooms and had bought some new bedroom furniture. Residents said they liked their rooms and most people spent some time there during the visit. Each room was personalised to the individual taste of the person who lived there. The home has a specially adapted bathroom and a small shower room. The lounge and dining room are also very well decorated and furnished with good quality furniture. We judged that everything in the home was clean and tidy. We also liked all the little touches that made this house homely and comfortable. The general impression is of a bright, modern and airy house that encourages people to feel relaxed and free to move around. Allanby House DS0000022533.V364550.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, 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home has a settled, well-trained and committed staff team who put the residents at the centre of everything they do. EVIDENCE: We looked at four weeks worth of rosters and we found that normally there were three people on during the day and two people awake all night to care for the five residents and to look after the house. We judged that these staffing levels were suitable. We also asked staff about this and they said that staffing levels were good and they had plenty of time to spend with residents. Residents were able to show us that they were satisfied with these staffing levels. We were able to check by talking to the manager and to new staff that this company makes sure that they only take on new staff once they are certain that they are the right kind of people to be given the responsibility of caring for vulnerable adults. On this occasion we did not check on individual, confidential Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 19 recruitment files but were given the opportunity to check this out centrally with CIC. A new member of staff was spoken to at length and she was able to confirm that she had been recruited correctly and had gone through all the appropriate checks. She was also able to explain how she was introduced to the service users and given in-house training on the role she was expected to carry out. She told us that she had been trained in fire safety, food hygiene, manual handling, person centred planning, safe handling of medication and safeguarding matters. We also observed her being monitored by the manager and by a more senior member of staff whilst she did her work. We spoke to a long serving staff member who said that she was still encouraged to do as much training as possible. We saw the manager’s training plan for the coming year and records that ensured that all staff were given suitable training and support to do their job well. This home has a good mixture of staff with different skills, and with different life experiences. The manager told us that over 50 of the staff team had National Vocational Qualifications in care. Our observations and the comments received in the surveys led us to believe that this home has a staff team who worked closely together and are committed to giving very high levels of care to vulnerable people. We did not check on the details of individual supervision but were told by staff that they were given the chance to talk to their manager about their work at least once every six weeks. We were also told that senior staff checked on their competence when they were at work and gave them guidance and support. Allanby House DS0000022533.V364550.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, 41, 42, 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Allanby House has good systems in place so that things run smoothly and residents are happy and secure. EVIDENCE: Carol Wignall has been the registered manager of this home for some years. Her original training was as a specialist learning disability nurse and she has a number of years of experience in the field. She also has attended management training and is keen to keep her practice up to date. Staff and residents were happy with the way she managed the home. She impressed us with her knowledge of each individual persons care needs and with the systematic way she ran the home. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 21 CIC have a suitable Quality Assurance system in place. They ask relatives, residents and other people involved with the home about the quality of the service on a regular basis. The company also bring in officers from outside who undertake an audit of the way the home is running. This is done annually. We also saw evidence to show that the operations manager does monthly checks to make sure that things are running smoothly in the home. We saw the quality audit for the year and the business plan for the next 12 months. We asked the manager to put a little more detail in her future planning but generally these things meet the expected standard. We saw all the records that related to safe working practices and these were all in order with things like maintenance and repair being done as part of the day-to-day routine. We checked on fire safety and this was being done very well. We made a small suggestion about recording temperatures of cooked food that would just protect everyone in the home. We looked at a wide range of records and policies and procedures. Again we made the suggestion about how staff should use the daily record book. We would like to see staff only using this to signpost records kept for each individual. The manager said she would change this straight away. There was one matter where we felt that the company needed to upgrade their policies and procedures. This was in relation to who was responsible for supporting residents to manage their own finances. We would like to see the company reviewing the current arrangements -- especially in the light of the new Mental Capacity Act. Currently CIC act as the appointed person who would manage residents’ money. We judged that there needs to be more options for supporting residents with things like savings and with making choices about how they spend their money. Allanby House DS0000022533.V364550.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 3 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 4 25 3 26 X 27 X 28 X 29 4 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 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 4 3 3 X 3 X 2 X 3 Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 YA41 Good Practice Recommendations It is recommended that the registered person review and update the company policies and procedures on individual financial management for residents. Allanby House DS0000022533.V364550.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Manchester Local Office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Allanby House DS0000022533.V364550.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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