Care Home: Applecroft Residential Care Home

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What the care home does well People living in the home told us they are generally happy with the care and facilities provided. Assessments are done before a person moves in to Applecroft care home so they can make an informed judgement on whether the home is suitable for them. Staff communicate well with other professionals to ensure that the health care needs of people living in the home are maintained. People living in the home told us they were very satisfied with the food provided in the home so they enjoy a good diet. There are a good variety of activities offered so that people living in the home are stimulated and kept active. Staff are offered plenty of training so are competent and skilled in their work. The manager of the home is suitably qualified and competent and has an open management approach. Most of the people we spoke with said they felt comfortable approaching the manager if they had any concerns or issues so they were confident that their concerns would be listened to. What has improved since the last inspection? Care planning practices have improved. The manager discussed further improvements she intends to make. The home environment has been improved since the last inspection. The refurbishment of the first floor is now complete. This provides a safe and homely environment for people with dementia to live in. The manager told us that all essential equipment is now maintained regularly to make sure that it continues to be safe. What the care home could do better: The management of medicines needs to be improved to ensure that all medicines are stored correctly and handwritten records are countersigned to prevent mistakes happening. The manager should make sure that the chef wears protective clothing when cooking to minimise the risk of cross infection. A Criminal Record Bureau disclosure should be obtained for the temporary chef. His personnel file should be available in the home. The owner of the home must write a report following his unannounced visits to ensure that the quality of the care and the services provided is maintained. CARE HOMES FOR OLDER PEOPLE Applecroft Residential Care Home 48/50 Brunswick Street Congleton Cheshire CW12 1QF Lead Inspector Helena Dennett Unannounced Inspection 15 May 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 Applecroft Residential Care Home DS0000045159.V363316.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 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. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Applecroft Residential Care Home Address 48/50 Brunswick Street Congleton Cheshire CW12 1QF 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) 01260 280336 01260 299862 Applecroft@fsmail.net B & L Property Investments Ltd Mrs Tracy Pointon Care Home 23 Category(ies) of Dementia (7), Old age, not falling within any registration, with number other category (16) of places Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only: Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP (Maximum number of places: 16) Dementia - Code DE (maximum number of places: 7) The maximum number of people who can be accommodated is: 23 Date of last inspection 31st July 2007 Brief Description of the Service: Applecroft is a privately owned care home located near to Congleton town centre and close to local shops. It was formerly two private dwellings that have been converted and extended to provide a care home for older people. It is a three-storey building and residents can be accommodated on all floors. Access to all floors is via a passenger lift or stairs. People suffering from dementia are accommodated on the first floor. There are 22 single bedrooms in the home; 14 of them have en-suite facilities, three with showers and three with baths. There are currently two communal bathrooms and three communal toilets in the home. Day space consists of two lounges and two dining rooms. The current range of fees is £390.00 – £535.00 per week. Additional charges are made for newspapers and hairdressing. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This key unannounced inspection visit took place over 5 hours. Before the visit the manager was asked to provide information about the home as part of this inspection process. The information we received back did not provide us with enough detail to determine whether standards had been met. Therefore a lot of the information used in this report was gained during the visit to the home. 13 CSCI surveys were received back from people who live in the home. Although these were completed (tick boxes completed) we only received one comment back. 12 staff surveys were also received back before the visit. We talked to four people living in the home and gained their views about the care and services that are provided. We also spoke to five members of staff during the day. Their views are incorporated into the findings of this report. Two sets of care records were looked at during the visit to check on the care people who live in the home receive. Records of medication, care plans, and staff training records were also examined, as were policies and procedures. What the service does well: People living in the home told us they are generally happy with the care and facilities provided. Assessments are done before a person moves in to Applecroft care home so they can make an informed judgement on whether the home is suitable for them. Staff communicate well with other professionals to ensure that the health care needs of people living in the home are maintained. People living in the home told us they were very satisfied with the food provided in the home so they enjoy a good diet. There are a good variety of activities offered so that people living in the home are stimulated and kept active. Staff are offered plenty of training so are competent and skilled in their work. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 6 The manager of the home is suitably qualified and competent and has an open management approach. Most of the people we spoke with said they felt comfortable approaching the manager if they had any concerns or issues so they were confident that their concerns would be listened to. 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. Applecroft Residential Care Home DS0000045159.V363316.R01.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 Applecroft Residential Care Home DS0000045159.V363316.R01.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): 3&6 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People considering moving into the home have their needs assessed before moving in so they know that staff at the home can meet their needs. EVIDENCE: The manager or a senior member of staff visits the person considering moving into Applecroft and completes an assessment of their needs. This is to ensure that the home has the facilities available and staff have the necessary skills to look after that person adequately. Two people’s records were looked at. A pre- admission document was completed and this, in conjunction with the admission assessment and social worker’s assessment, was used as a basis for developing a plan of care. We discussed the need to gather more information on the mental health needs of people moving into the dementia unit before they come in so that staff will have a better insight into the person’s behaviour. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 9 Intermediate care is not provided so standard 6 does not apply. Applecroft Residential Care Home DS0000045159.V363316.R01.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 & 10 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People living in the home receive health and personal care based on their individual needs to make sure their wellbeing is maintained. Their privacy is maintained so their dignity is respected. EVIDENCE: Individual plans of care are in place for every person living in the home. Two care records were looked at in detail during the site visit. The care plans have improved since the last inspection in that people’s needs are clearly identified on them. Some of the care plans need to be more personalised to make sure that individual’s choices are recorded. The manager told us that temporary care plans are put in place for people new to the home. This means that staff can get to know the person and new care plans are then written once the person has settled and staff have identified all their needs. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 11 Members of staff together with the person using the services and/or their representative review the care plans every three months. This ensures that the plan of care is suitable to meet the person’s needs and that it is kept up to date. People with dementia are now admitted to the home. We discussed with the manager the need to make sure that care plans covering mental health needs are more detailed to make sure that all of their needs will be met. Everyone on the dementia care unit appeared well cared for and staff were seen to interact very well with the people on this unit. There was evidence that specialists such as the GP and district nurse are asked to visit when a need is identified. We spoke to a district nurse who was visiting the home on the day of our visit. She told us that staff contact the surgery if there is a problem and that communication is good. She felt that staff looked after the people in the home well. People living in the home told us they are well looked after. One person said, ‘staff are wonderful, you get good care here’ The management of medicines is in need of improvement. Although it appears that everyone receives their medicines as prescribed, the storage and documentation of medicines needs to be improved. Several creams were stored in people’s bedrooms. These should be stored in the medicine cupboard at the correct temperature. Several handwritten entries on the medicine administration record sheets (MAR) were made. The manager told us that this happens when a person initially comes into the homes because the pharmacy will not provide a pre printed MAR sheet until the medicines are due to be reordered. We discussed the need to make sure that two people sign the MAR sheet when transcribing instructions from medicine boxes to the record sheets to make sure that mistakes do not occur. The manager agreed to address this. One person looks after some of her own tablets herself. Although a risk assessment was in place, this should be more detailed covering all aspects of risk e.g. storage of the tablets. Some inappropriate items were found stored in the medicines room. These were removed during the site visit. Staff were seen to treat people with respect and maintain their dignity. They knocked on bedroom doors before entering and made sure that bathroom and bedroom doors were shut when personal care was carried out. A friendly atmosphere existed in the home. Five members of staff spoke to us during the visit. It was evident that staff knew the people in the home well, knew their likes/dislikes and were very committed to ensuring that people’s choice is promoted. Applecroft Residential Care Home DS0000045159.V363316.R01.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 & 15 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The range of recreational activities provides stimulation and interest for people living in the home so they can stay active. EVIDENCE: There are enough activities going on in the home to keep people stimulated and active. Activities include painting, ball darts, scrabble, crosswords and music and dance. Regular entertainers also visit the home and people living on the dementia unit come downstairs to take part in the entertainment. Exercise for health is held weekly, an outside entertainer visits monthly, music for health is provided every two weeks and a puppeteer/entertainer also comes in monthly. In addition people living in the home go out to the theatre or go on trips e.g. on a barge etc. Members of staff also involve the people living in the home on one to one activities. There are no restrictions placed on visitors. The home had links with local schools and churches. Religious ministers visit regularly. Members of staff told us they would take residents to church if they wished. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 13 People living in the home told us that they are able to make choices about aspects of daily living such as times of rising and retiring to bed, choosing what clothes they wear, how they spend their time, and joining in activities. One person told us that she wanted to stay in her bedroom, which is on the first floor (now the dementia care unit). Staff have respected her decision and have enabled her to remain on that floor. We spoke to the person who said she was happy with her room and didn’t wish to move, as she liked the view from the window. Bedrooms are personalised with small items of furniture, pictures, ornaments etc. that are brought in from people’s homes when they move in. Everyone we spoke to was complimentary about the food. One person said, ‘the food is excellent’. Another person told us ‘you can’t complain about the food here, it is very good’ Although a choice is not given at lunch time staff told us they take into account everyone’s likes and dislikes. Fresh produce is used. There was plenty of fresh fruit available around the home. The two dining rooms were very pleasant and homely and tables were nicely set. Everyone appeared to enjoy his or her lunch. The regular chef was ill on the day of the site visit and a replacement chef was working. He did not use protective clothing whilst cooking the meals. He told us that he had brought in a change of clothes to cook in, as the whites were not comfortable for him to wear. However in accordance with environmental health standards, all staff working in the kitchen should wear protective clothing. Applecroft Residential Care Home DS0000045159.V363316.R01.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 & 18 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. People living in the home have access to a good complaints procedure and they are protected from abuse so have their rights protected. EVIDENCE: A complaints procedure is available in the home. This lists the action to be taken should anyone have a complaint or concern. The procedure needs to be updated to make sure that it contains our correct address should anyone wish to contact us. No complaints have been made about the home since the last main inspection. A large number of cards thanking staff for their care were placed on the notice board in the office. People living in the home told us that they would approach the manager or the owner if they had any concerns. Staff spoken with knew the action to take should anyone have a concern or complaint. They were aware of the safeguarding adults procedure and every member of staff had attended training on safeguarding so people living in the home are protected from abuse. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 15 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 & 26 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The home is well maintained, enabling residents to live in a safe and comfortable environment EVIDENCE: The owners of the home continue to improve the environment, making it a pleasant and safe place for people to live in. People suffering from dementia are now accommodated on the first floor. This is a small but homely unit and is staffed twenty-four hours per day. The owners are also improving the gardens of the home. Work is in progress on developing an outside secure garden for people with dementia. This will contain raised flowerbeds and outside seating area for people to enjoy in the better weather. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 16 One of the bedrooms downstairs is in the process of being converted to a ‘wet room’ so people living in the home can have a shower. There are also plans in place to incorporate a quiet room with Internet access so that people living in the home can keep in touch with family/friends who live abroad. The quiet lounge has been converted to a bedroom as the manager told us that this lounge was never used. The home was found to be clean and tidy on the day of the site visit. People’s clothes are well cared for. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 17 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 & 30 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. There are enough suitably trained and competent staff working in the home to make sure that the needs of the people who live in the home are met. EVIDENCE: There was plenty of staff working in the home to meet people’s needs. There was a relaxed atmosphere in the home and people appeared to be well cared for. The surveys received back from people using the services indicated that they thought there were enough staff working in the home to meet people’s needs. Duty rotas confirmed this. The manager told us that she intends to increase the number of staff working on the dementia care unit from one to two during mornings so that a member of staff will always be present to supervise people on the unit should someone need help in their room. Two staff members’ personnel files were looked at. These contained all the necessary checks to ensure that they are suitable to be employed in care. The personnel file for the temporary chef was not available on the day of the site visit. The temporary chef told us he did not have a Criminal Record Bureau Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 18 disclosure done; however as he is related to the owner of the business he said that the owner knows he is suitable to be working in care. A CRB disclosure must be obtained. We spoke with five members of staff during the visit. They told us that they are supported in their training. All staff have recently done abuse training as well as training on the care of people suffering from dementia and managing challenging behaviour. Thirteen members of staff completed survey forms, which were returned to us before the site visit. The following comments were made: ‘We have lots of training. We work with the manager a lot of the time.’ ‘As I have worked here for a long time I have seen Applecroft grow and improve to a high standard caring and understanding for clients. ‘Training is always regular and we are kept up to date.’ According to the information received back from the manager 95 of the carers in the home have a national vocational qualification (NVQ) in care. This means that people living in the home can be confident that the staff have the knowledge and skills to care for them. Staff said they are supervised regularly and new staff go through an induction process to make sure that they know the needs of the people living in the home before they are asked to provide care. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 19 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, 35 & 38 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Applecroft care home is well managed so it is run in the best interests of the people living there. EVIDENCE: The manager of the home is registered with us. She has made considerable improvements over the past year and has developed as a manager. The office is more organised and care plans are better. The manager is committed to providing a good quality service to people and is keen to learn and do things ‘right’. People we spoke with knew the manager and were positive about her approach. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 20 The following comments were made on the staff surveys that were returned to us before the site visit: ‘In the few months that I have worked here I have fully enjoyed working here, the staff, managers and the home are lovely and run to the highest standard always putting the residents first.’ ‘The manager keeps us informed of all the service users needs as well as staff needs.’ There is a quality assurance system in place and the manager does audits regularly to make sure that the quality of care provided is maintained. The manager told us the owner visits the home regularly to provide support to staff and the manager and to talk to the people living in the home. The owner is required to write a report on the unannounced visits he undertakes. This report should include the views of the people living in the home, any relatives spoken with, staff spoken with and the records he has looked at. This is to make sure that the quality of care and services provided are maintained. We discussed the need to complete this report at the last inspection; however this has not been done. The manager told us that only small amounts of money are kept in the home on behalf of people living there. Receipts are kept for any transactions and the money is kept in separate wallets in a locked safe. The manager told us that all essential equipment has been maintained. A sample of records was looked at to check this; all the records seen were satisfactory. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 21 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP29 Regulation 19 (1) (b) Schedule 2. Requirement A Criminal Record Bureau disclosure/POVAfirst must be obtained for the temporary chef to demonstrate that he is suitable to work in a care home. The registered person or a representative must visit the home unannounced at least once a month and prepare a report on the conduct of the home. This report must be available in the home. This is to ensure that the quality of care and facilities provided are maintained. Timescale for action 14/06/08 2 OP33 26 30/06/08 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 OP27 Good Practice Recommendations The manager should make sure that the chef wears protective clothing whilst working in the kitchen to prevent DS0000045159.V363316.R01.S.doc Version 5.2 Page 23 Applecroft Residential Care Home the risk of cross infection. 2 OP9 Staff should make sure that medicines are stored and recorded correctly so that people living in the home are not placed at risk. Applecroft Residential Care Home DS0000045159.V363316.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Region CSCI Preston Unit 1 Tustin Court Port Way Preston PR2 2YQ 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 Applecroft Residential Care Home DS0000045159.V363316.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!