Care Home: Belford Care

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What the care home does well There was evidence that information about residents have been obtained before they went to live at the home. This means that staff can have an understanding of residents needs to ensure these can be met before an offer of admission is made. Residents made positive comments about the activities provided and examples were give of the variety. This means that residents have opportunities to engage in worthwhile activities. Residents said there is a good choice of food available and they are consulted regarding the choice of food. This means that residents are able to express their opinions and are provided with a varied diet. Staff receive training and are engaged in a National Vocational Qualification training programme. This means that they have more knowledge and skills to provide care for residents.Residents said they enjoyed living at the service and felt the environment was clean and comfortable. The management team consists of Mr Curtis and his family who are all directors of the company. All work with in the home and this lends the service to being a family operated business which one resident said "Makes it feel more your own home". What has improved since the last inspection? There were no requirements or recommendations from the last inspection. Miss Curtis has implemented a more comprehensive activities programme and residents spoke positively about this. The variety available means that residents of varying abilities are able to participate in at least one activity, which meets their needs and choices. Work has been carried out to replace guttering and soffits to maintain the upkeep of the building. The quality assurance system continues to be developed to enable residents to continue to make their views known. Staffing levels have been increased to provide a higher level of support to residents in the afternoon. What the care home could do better: There are no requirements or recommendations made on this occasion. CARE HOMES FOR OLDER PEOPLE Belford Care Ltd Belford House Care Home Lymington Bottom Four Marks, Alton Hampshire GU34 5AH Lead Inspector Kathryn Emmons Unannounced Inspection 29th July 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 Belford Care Ltd DS0000068833.V366960.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. Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Belford Care Ltd Address Belford House Care Home Lymington Bottom Four Marks, Alton Hampshire GU34 5AH 01962 773588 01962 772511 belfordhouse@aol.com 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) Belford Care Limited Mr Michael Richard Curtis Care Home 30 Category(ies) of Dementia - over 65 years of age (8), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (8), Old age, not falling within any other category (30) Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd July 2007 Brief Description of the Service: Belford House is a privately owned and registered care home providing care for up to 30 private and local authority residents 8 of whom may have dementia. The home, which is located in the village of Four Marks, is set in attractive gardens that are accessible to residents provides accommodation in 24 single and 3 double rooms. Ample parking is available. The North Hampshire town of Alton is within a short travelling distance as are the town of Basingstoke and the cities of Winchester and Portsmouth which are approximately 30-45 minutes travelling time. A large sheltered housing service under the same ownership but a separate management is located on the same campus. Fees varied from £327 to £510 per week. Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. A visit to the service took place on 29th July 2008. This visit was unannounced and took place over 6.5 hours. The registered manager who is also the registered individual was present during the visit. Care received by three residents was looked at in detail. This is a method called case tracking. This included looking at their personal records, a range of general home records and staff detail records. Staff were spoken with and the care they provided was observed. We received a completed self-audit document (AQAA) completed by the manager, to provide information before we did a site visit. We also looked at how the provider makes information about their service, including CSCI reports available to prospective service users. During the visit we spoke with four staff and eight residents. We sent out service user and staff surveys and we received three back where comments were made we have included these in the report. What the service does well: There was evidence that information about residents have been obtained before they went to live at the home. This means that staff can have an understanding of residents needs to ensure these can be met before an offer of admission is made. Residents made positive comments about the activities provided and examples were give of the variety. This means that residents have opportunities to engage in worthwhile activities. Residents said there is a good choice of food available and they are consulted regarding the choice of food. This means that residents are able to express their opinions and are provided with a varied diet. Staff receive training and are engaged in a National Vocational Qualification training programme. This means that they have more knowledge and skills to provide care for residents. Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 6 Residents said they enjoyed living at the service and felt the environment was clean and comfortable. The management team consists of Mr Curtis and his family who are all directors of the company. All work with in the home and this lends the service to being a family operated business which one resident said “Makes it feel more your own 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. Belford Care Ltd DS0000068833.V366960.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 Belford Care Ltd DS0000068833.V366960.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): 1,3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Pre admission assessment systems enable residents to be confident that their assessed needs can be met when they are admitted to the home. An up to date service user guide and statement of purpose provides residents with information to make an informed choice regarding living at the service. EVIDENCE: We looked at three resident files and could see that information regarding resident’s needs had been obtained before they had been admitted to the home. We saw that residents had been able to visit the service with their relatives before making a decision to live at the home. In a file we saw that a comprehensive assessment had been obtained from a health care professional. This means that the service can be clear on a prospective residents needs and will be able to be confident that the needs can be met if the resident decided to live at the service. Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 9 Two documents are in place called the service user guide and the statement of purpose. These two documents are available to residents and their relatives and inform them of the services they can expect if they live at the home. Details also include who the staff are and what jobs they do, what bedrooms and communal areas are available and what activities are provided. We saw that contracts were in place, which had been signed by the resident or their relative. We were told by a couple of residents that they had received contracts when they came to live at the home. The contracts inform residents what service they can expect from the home. This enables residents to have confidence that they are going to live in a home where staff can meet their individual needs. Currently the service does not offer intermediate care for residents but people can stay at the home for short periods of time. This is called respite care. Belford Care Ltd DS0000068833.V366960.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans and risk assessments, which are regularly reviewed, minimize residents risk of not having their needs met. Medication systems enable residents to receive their medication safely. Good access to health care services enables residents to have their health needs met. Resident’s dignity and privacy and individual identity is acknowledged and maintained. EVIDENCE: We used a process called case tracking to look at the quality of care. This included looking at three residents care files. In each file there was a comprehensive assessment of residents needs. There were risk assessments for activities such as moving and handling and self-medication of tablets. We could see that care plans had been regularly reviewed by care staff and had been signed by either the resident or their relatives. We spoke to residents about their care plans and were told, “I know there is a plan as I saw it and I also signed it”. Another resident told us “the care is marvellous, they know Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 11 what help to give me”. We saw from comment cards that residents felt their care needs were known and were met and staff told us that they were given time to read care plans so they were able to deliver care safely. A verbal handover session takes place between each staff shift change and any change in a residents needs are told to the staff coming on shift and recorded in the daily notes. Residents were spoken to about how they were supported to access health care professionals such as Doctors and the district nurses. One resident told us “I have the district nurse visit me a couple of times a week and I can also contact them directly”. Another resident said “The carers are very good they will always call the doctor for you.” We could see from records and were told by residents and staff that opticians and a chiropodist also visited the service on a regular basis. The service tell us they are working towards getting a dentist to visit the service rather than residents always having to try and locate a dentist in areas some distance from the home. Medication records were seen for all residents. Records had been competed correctly. Stocks of medication were stored safely and all staff that administered medication had received training and we saw these certificates in their staff records. Residents told us they were treated with respect and addressed in their chosen form. Interactions were seen by us that were valuing and appropriate. Staff were seen sitting and speaking with residents and assisting them with their meals. The manager told us that staff are clear on the expectations regarding how residents are valued and treated as individuals. Residents made many positive comments about the care they received and comment cards all had positive comments such as” you would have to go a long way to find fault”, “care is wonderful and “couldn’t ask for more”. Belford Care Ltd DS0000068833.V366960.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 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are provided with appropriate activities and are supported to continue with hobbies they enjoyed before living at the service. Staff have an awareness of residents’ spiritual and emotional needs. Residents have control over who visits them. Dietary needs and preferences are catered for. Residents have clear ownership of the home and are the people who decide how the service operates EVIDENCE: We spoke with residents who told us that since the last inspection there had been more activities introduced. An example of this was a recent Wimbledon cream tea afternoon and the following week a sports day was taking place with each of the care staff representing a resident in sports games such as egg and spoon race. Residents said they always felt there “is plenty to do” and “I really like sitting with the others (residents) and watching countdown”. A library visits fortnightly and residents are supported to go to the sheltered housing scheme which is located in the same grounds to play scrabble and visit friends. Within the care plans detailed information is in place to identify the lifestyle Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 13 residents led before living in the service. The AQQA informs us that the staff support residents to continue to be as independent as possible. Examples we saw ranged from assisting with visits to access the local community to sitting and spending time looking at the daily newspapers. An events calendar is on display. The home has a policy in place for equalities and diversity and this was evident in care practices we saw. Residents gave us examples such as “I get up when I want to”;“they are very easy going here, it’s definitely your home with help given when needed”. There is a communion service held monthly and residents are supported to attend other religious services if they chose to. Visiting clergy from other denominations are welcomed into the home. Resident all indicated through comment cards that they were “Always” satisfied with the activities and lifestyle they enjoyed at the home. On the day of the visit comments made included,” There is always something to do” and “The girls do their best to come and chat to you, they always can find a few minutes”. Residents told us that they could have visitors when they chose and there were various spaces around the home where residents can meet with visitors in private if they don’t want to use their bedroom. Staff were seen to be welcoming and accommodating to visitors who attended the home during our visit. A resident told us that they were able to chose who they saw and the staff would always check with them first to see if they wanted to receive their visitor. Through comment cards and direct discussion with residents we were told that residents “always” enjoy the food and “The food is glorious” and “The cook works so hard to provide lovely food”. We saw during our visit that the cook was very busy and was providing three different meal options. . We saw the main meal and this was well presented. We could see from the pre inspection information that specialised diets such as sugar free and high fibre are also catered for. Residents confirmed that they received the food they chose and that they were able to change their mind if they wanted to. Belford Care Ltd DS0000068833.V366960.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The services complaints policy enables people to know how to make a complaint. Residents and relatives are confident that any concerns will be listened to and acted upon. A Safeguarding adult’s policy provides staff with a working awareness of what constitutes abusive practice. EVIDENCE: The AQAA we received and information we hold about the service identified that since the last inspection no safeguarding issues had been raised and no complaints have been made. We saw from the complaint log that no complaints had been made since the last inspection A complaints procedure is in place and is on display and at various points around the home. Comment cards received ,and from what residents told us during the visit residents were satisfied that any issues raised would be listened to and looked into. The manager who is also the registered individual, and the other directors of the company, who are immediate family members are in the service each day and speak with most residents daily. Residents spoken with were clear who to speak to if they had any concerns. Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 15 A safe guarding adults policy is in place. Two staff we spoke with confirmed they had received safeguarding adult training and were aware of the services policy. Two of the staff spoken with were given a scenario regarding safe guarding adults and asked what action they would take. They answered appropriately and said that they were sure that all staff knew what constituted abuse and that all staff were expected to report any practice which they though was not appropriate. Belford Care Ltd DS0000068833.V366960.R01.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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a clean and pleasant home. Décor and furnishings are of resident’s choice, and specialised equipment such as hoists and assisted baths enable them to be as independent as possible. EVIDENCE: Since the last inspection an external refurbishment programme has been taking place. This has included replacing all guttering and general landscaping of the gardens. Each resident is able to choose the décor of their room when they are admitted to the home, and on a rolling programme rooms are redecorated and furniture replaced when needed. Some residents, who gave permission to us, were spoken to in their bedrooms. We could see that residents had been able to personalise their rooms with their own furniture, Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 17 paintings and own décor choice. There are two lounges on the ground floor of the home and a large dining area and quiet lounge. There is sufficient seating for everyone and ample room to manoeuvre wheelchairs and trolleys and hoists when needed. The gardens are landscaped and resident lounges overlook these. The home was clean, tidy and fresh throughout. We saw residents able to move independently around the service. All corridors were free from hazards and had hand rails fitted to provide support for residents. An infection control policy is in place and staff were seen wearing gloves and aprons when working with food. Staff were able to tell us about infection control measures in place and we saw certificates for this training in staff files. The laundry area is separate from resident’s areas and we could see that infection control measures were in place. Belford Care Ltd DS0000068833.V366960.R01.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. An enthusiastic and trained care team cares for residents. The organisations recruitment procedures ensure safely recruited staff care for residents. EVIDENCE: We spoke with 3 staff who told us that they enjoyed working at the home and that the atmosphere was “good and supportive” and “I’ve worked here a long time as they are a lovely bunch of people”. The service employs 20 care staff and we could see from the AQAA that sometimes agency staff are used only when needed. This means that residents benefit from continuing to receive care from people who understand their needs. Staff told us about and we saw, that an induction programme is in place. When staff start work at the service they work alongside a senior member of staff. This means they are able to deliver care in a safe way and learn the individual needs of each resident. There are polices and procedures in place and staff are expected to read the policies to ensure that they are providing the correct care. Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 19 Pre inspection information showed that training in health and safety, moving and handling and food hygiene and fire had been given. Staff records also showed us this. One comment card returned stated that the member of staff wanted more training in learning more of a management role and felt that they would want more training for their job role. Another comment card from a member of staff said that they felt one of the strengths of the service was that a lot of training was provided. Several staff are working towards a National Vocation Qualification (NVQ) in Care. This means that they have a more in depth knowledge and skill base to use when providing care which may improve the quality of the service residents receive. Three recruitment files were looked at. A recruitment policy is in place and all files seen contained the correct checks such as references, completed application form and Criminal Record Bureau checks and identification. This means that staff have been recruited safely and residents can be confident that they are cared for by people who have the necessary skills and attitude to care for them. Residents spoken with made positive comments about staff such, as “they are so good”,”it’s a hard job to do but they always employ the right ones”. We looked at the duty rota and saw that staffing levels were consistent. Staff said that there were normally enough staff on shift and that they felt confident the registered person would amend levels if resident’s needs increased. Since the previous inspection the staffing levels on an afternoon have increased to meet the changes in residents needs. Residents felt that generally there were enough staff on duty. During our visit we saw staff carrying out their work in an unhurried manner and were able to attend to residents promptly. Belford Care Ltd DS0000068833.V366960.R01.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): 31,33,35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A manager who is also the registered provider manages the service. Residents are protected by the services health and safety polices and procedures. Financial management systems keep residents monies safe. Quality assurance systems show how the service is run in the best interests of the residents and how the service continues to develop. EVIDENCE: The registered manager is Mr Michael Curtis. Mr Curtis has owned the service for many years and recently became a limited company so thefor the service is newly registered and this is its second inspection. The directors are Mr Curtis Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 21 His wife and daughter. All of these people work in the service and Mr Curtis remains as the registered manager. We received comments such as “The care is wonderful”, “they are good employers, they listen to you” and “Mr Curtis is easy to get on with and you can speak to any of them”. A quality assurance system is in place so residents and visitors to the home can see how the providers intend to improve the service and action any points residents raise. Residents and relatives are given a questionnaire to complete every year. Residents are always encouraged to make their views known and regular resident meetings take place. Supervision sessions and appraisals take place so the manager can ensure staff continue to provide quality care and any training needs are identified and met. Staff confirmed to us that they received supervision sessions which included working alongside senior staff to have their work assessed. Pre inspection information evidenced that polices and procedures are maintained. Records are in place at the home, which show that servicing of equipment and systems such as the fire safety system, heating system and waste contracts are up to date. Belford Care Ltd DS0000068833.V366960.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 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 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 4 13 4 14 4 15 4 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 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Belford Care Ltd DS0000068833.V366960.R01.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 Belford Care Ltd DS0000068833.V366960.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection 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 Belford Care Ltd DS0000068833.V366960.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. 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