Care Home: Branwell

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What the care home does well People who use the service can be assured that they are receiving a good service as the staff team, who support them, are well supported, appropriately trained and competent. People who use the service can be confident their views will be sought and their needs and preferences will be met. What has improved since the last inspection? People who use the service can now be assured that the bank staff members are working consistently as Brandon Trust has reviewed their arrangements to ensure that bank staff receive the appropriate training and supervision.People who use the service can be assured that are receiving a well-balanced diet as the staff team now record the type of sandwiches and all food eaten on the daily menus. What the care home could do better: The people who use the service would be more assured that any complaint they make would be dealt with appropriately if the recording of these complaints were reviewed. CARE HOME ADULTS 18-65 Branwell 354-356 Wells Road Knowle Bristol BS4 2QL Lead Inspector Jacqueline Sullivan Unannounced Inspection 9th September 2008 10:00 Branwell DS0000026571.V368727.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 Branwell DS0000026571.V368727.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. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Branwell Address 354-356 Wells Road Knowle Bristol BS4 2QL 0117 9077228 0117 9699000 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.brandontrust.org The Brandon Trust Mrs Judith Finnemore Care Home 8 Category(ies) of Learning disability (0) registration, with number of places Branwell DS0000026571.V368727.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 service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning Disability (Code LD) The maximum number of service users who can be accommodated is 8 Date of last inspection 12th September 2006 Brief Description of the Service: Branwell is registered with the Commission for Social Care Inspection as a registered care home in the category of 8 people with learning difficulties and associated mental health needs. It is also registered for 1 person with physical impairments. Currently all of the residents in the main house are male. Although one resident occupies a bungalow at the end of the garden in a more independent situation, the home does provide some services for her. Branwell is operated by Brandon Trust and is one of many similar homes in the locality of Knowle, Bristol. The large home is a pair of Victorian semi-detached houses that have kept many original features. Residents are able to access both houses. The home has a downstairs room for a disabled person with physical impairments, with its own en-suite bathroom and kitchen facilities. The remainder of the two houses are run as a family type home. Branwell DS0000026571.V368727.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 two star this means the people who use this service experience good quality outcomes. This unannounced inspection took place over one day. Evidence for the inspection was found from discussions with staff members and people who use the service. The service provider completed the Annual Quality Assurance Assessment (AQAA) for the service, and this was used in planning the inspection. We also looked in detail at care documentation for four people and crossreferenced these to other records, which are kept by the home in accordance with the regulations. The fees for this home are approximately £693.20. What the service does well: What has improved since the last inspection? People who use the service can now be assured that the bank staff members are working consistently as Brandon Trust has reviewed their arrangements to ensure that bank staff receive the appropriate training and supervision. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 6 People who use the service can be assured that are receiving a well-balanced diet as the staff team now record the type of sandwiches and all food eaten on the daily menus. 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. Branwell DS0000026571.V368727.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 Branwell DS0000026571.V368727.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 and 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home are given the necessary information to make informed choices on where to live. The people living in the home only move into the home after a thorough assessment has taken place. EVIDENCE: We looked at the statement of purpose and noted that it contained all the required information for the people living in the home to make informed choices. It was in an accessible pictorial format. Since the last inspection we were told that one person had left and there is a vacancy. All The people living in the home have a ‘place to live agreement’, which compliments the formal contracts. This document is in pictorial as well as written format and enables residents to have a better understanding of their terms and conditions of occupancy. For example there are pictures that show people how they will be supported by the staff team. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 9 The people living in the home confirmed and records show that assessments of need have taken place for all residents. The staff members stated that as the residents have all lived in the home for many years the initial assessments were in archived files. However it was evident that subsequent assessments were all based on the initial assessments. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to make decisions about their own lives and are aware of their assessed needs and associated risk assessments. EVIDENCE: The care plans that were seen showed that individuals’ needs are known to the staff team and that their goals, choices and aspirations are achieved. Members of the staff team explained that they plan to develop peoples’ choices either further by ensuring that more information they have is in a pictorial format. For example they are hoping to use pictures within the residents meetings. The minutes from frequent resident’s meetings showed that people are consulted on many aspects of the home and their lives i.e. daily tasks and planning future activities. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 11 There is a picture board where pictures of the people who use the service are placed alongside daily activities so that everyone knows who is doing what. Staff pictures are also displayed to show every-one who will be coming on duty. On the board are also pictures of cups of tea, snacks, the weather and the daily household tasks to be done by people who use the service. A member of staff stated that they use this board to assist them communicate with people. Some people were involved with the Brandon Trust Annual Review, a forum for encouraging people to voice their opinions and concerns and to be consulted regarding life in the home. Staff confirmed that people who use the service are encouraged to make their needs, wishes and concerns known. One staff member said “They tell us if they don’t want do something and we record their wishes”. We looked at the care files and noted that there were detailed risk assessments that were clearly written and linked to care plans. The statement of purpose (section 1 – Rights to Dignity, Choice etc) indicated that all people who use the service are to be able to take risks that have been assessed and are to be given the support to minimise those risks’. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The service continues to have a commitment to enabling residents to develop their skills, including social, emotional, communication, and independent living skills. People who use the service have the opportunity to develop and maintain personal and family relationships. People who use the service enjoy healthy well-balanced meals that they choose. EVIDENCE: All of the people who use the service are well supported by the staff team within the home to access the community. They enjoy a range of facilities Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 13 such as the local church and college as well as local employment. The people who use the service are able to take part in age, peer and culturally appropriate activities. One person was at home as their daycentre was closed for two days. They told me that they are a member of the black members group from the People First organisation. This person said they liked going to the group and that they also work two days a week at a city farm. They also enjoy cooking at the home. We looked at the monthly summary of this person’s care plan dated July 2008 and saw that they also went to Cardiff with a key worker, a BBQ and a sing-along. A staff member said that each month the people that use the service meet with their key worker and decide what activities they would like to do over the coming month. We read in the care files that the planned activities corresponded with the activities that actually took place. Two people go the Christian disabled fellowship three times a week. Others attend the Bush resource and activity centre and a local college where they do music and drama, shopping and cookery, arts and crafts. Holidays have included trips to Centre Parcs and Dorset. One person went on a day trip to Bournemouth to see a relative. One person who uses the service is gong to Paris as they told staff members they want to eat croissants Discussion with a staff member and recording in the care files confirmed that every person who uses the service has a” day back” at the home where they have one to one support to do “What they want”. For example we read that people go walking, swimming and go to horse world. An activity list with the pictures of the people who use the service is available in the home. The staff team said that twice a week they have more staff on duty so that the people in the house can go on outings to pubs and the cinema. There was a busy relaxed feel to the home with staff interacting with the people who lived there, in a caring informal way. Discussions with staff members and recording in the care files confirmed that visitors are welcomed at any reasonable hour and staff try to ensure friendships and contacts are maintained. This is further confirmed in the statement of purpose. One person who uses the service has been given a phone to ensure they can make and receive calls in the privacy of their own room. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 14 There is a four weekly winter and summer rolling menu in place at the home, based on the choices of the people who use the service. The menu showed that people receive a well-balanced, healthy diet. On the board in the kitchen there are pictures of each dish to show people the choices they have for the day. Individuals spoken with confirmed that they shop for food with the staff team and one person said, “I like the food here.” One person said that they particularly like working in the garden growing the food that is used by the home. At the last inspection it was recommended that the staff team record the type of sandwiches and all food eaten on the daily menus. This was to ensure the home can evidence that varied and well-balanced foods are offered. At this inspection it was noted that this had been completed. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who use the service receive personal support in the way they prefer and require. The people who use the service can be assured that their physical and emotional needs will be met by the staff team. EVIDENCE: Discussions with the staff team and evidence in the care files confirmed that peoples’ health needs are well met. As noted at the last inspection, there was evidence in care plans; daily records and the house diary that health care professionals, dentist, general practitioner and other allied healthcare services provide support to the residents. This is well documented and monitored through the care planning process. There is evidence of recording of forward planning for health needs appointments and regular use of medical report recording. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 16 Discussions with the staff team, observations during the inspection and evidence in the people who use the services files confirmed that the staff team provide sensitive and flexible personal support to maximise, dignity and independence. On the day of inspection one person who uses the service had a medical appointment. The staff team were aware of the anxiety this caused this person and dealt with it appropriately and sensitively. Discussions with the staff team and information in the staff training files showed that they are competent in the handling, storing and administration of medication. Appropriate records were seen at the time of this visit. Evidence in the staff files and records held at the home confirmed that there are adequate policies, procedures in place to ensure the safety of people who use the service in respect of the administration of medication. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service ’ views are listened to and acted upon therefore they feel safe in their own home. People who use the service can be confident they will be protected by the staff team. EVIDENCE: Discussions with the staff team confirmed that they were aware of the protection policies available in the home and confirmed that protection training was part of a ‘rolling programme’. The DOH guidance distributed by Bristol City Council entitled ‘No Secrets’ in Bristol was also available. There are no protection issues at the moment. Discussions with the staff team and evidence in the people who use the service files confirmed that there are systems in place to ensure that people are protected. One person, who lived there, said they felt safe in the house and would speak to the staff if there were a problem. The system for recording complaints has been reviewed and needs some additional work to ensure that it is clearly recorded that complaints have been resolved in the appropriate timescales to peoples, satisfaction. A recommendation has been made about this. However evidence in the people who use the service files confirmed that that they feel comfortable to complain and that the staff team try to resolve any issue of concern. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 18 Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a homely, comfortable physical environment appropriate to the needs of the current people who use the service .The home is clean and tidy with no unpleasant odours. EVIDENCE: We looked around the home and noted that it is a clean, bright environment for the people who use the service. One person that lives in the bungalow in the grounds of the house was in hospital following an emergency admission. A staff member said that this person will return to the home but may live in the main house temporarily. This person is usually well and self-supporting. The Trust is now going to install an alarm in the bungalow. There is an intercom between the bungalow to the sleeping in room of the house. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 20 At the time of inspection, there was work underway to move a downstairs lounge and make a bedroom. The office will be a small bedroom upstairs. One person showed us their bedroom. It was a comfortable room and they said that they liked it. It was personalised and homely. They showed us a leak in the ceiling of their bathroom. We told the staff member on duty who then immediately phoned the Trust’s maintenance department. The staff member said that this leak had been over looked. The maintenance book was seen and it showed that the home is well maintained with repairs being completed promptly. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 21 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 and 36. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are protected by a robust recruitment policy People who use the service can be assured that they are receiving a good service as the staff team, who support them, are well supported, appropriately trained and competent. EVIDENCE: As noted at the last inspection, the manager is able to examine the references and Criminal Record checks for all staff prior to them commencing employment at the home. Some copies of personal identification for staff were kept on file at the home. Records are mainly stored appropriately at the Brandon Trust HQ. One staff member confirmed that references had been obtained prior to employment and a Criminal Record Bureau (CRB) check had taken place. Staff members were able to explain their roles and responsibilities within the home and confirmed they had been given a job description. Discussions with the staff team and evidence in the team meeting minutes confirmed that each Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 22 staff member has a particular role or responsibility within the home which suits their individual skills. Staff members said they felt this was empowering. One staff member said that they had chosen they do health related tasks like ordering medication. One staff member said, “Here the manager asks what you would like to learn and then teaches you.”Another staff member said “It makes you more confident…. if you don’t feel comfortable doing something you can say no or have longer to learn it “. Members of the staff team stated that on Tuesdays there is extra staff on duty to allow people who live at the home to go to the gateway club and on Wednesdays to facilitate visits to play skittles or to go to the pub. Three staff members stated that staff morale was good. It is an established staff team with the majority being in post for over two years. At the last inspection it was required that the Brandon Trust consider what arrangements need to be put in place to ensure that bank staff receive the appropriate training necessary to meet the assessed needs of the residents that they support. They must also consider how best to provide ‘formal recorded’ supervision in order to ensure that individuals training and work needs are met. It was also recommended that this training include protection of vulnerable adults, Manual Handling, first aid, food hygiene, fire safety, general health and safety. It was also recommended that bank workers regular to the home are formally supervised and the responsible individual find some way of supervising bank staff that visit a number of homes. The manager addressed these requirements and recommendation in the AQAA she sent to the commission. She stated that head office of the Trust are ensuring that all bank workers carry a passport which will record all the training they have received. This training will be organised between the bank worker and the bank co-ordinator. She stated that there are no plans for her to carry out formal supervisions as this is carried out by the bank office at HQ, however, there is a system in place in the form of feedback forms that a manager can complete and send to the bank co- coordinator if their were any issues that needed to be dealt with. A bank member of staff stated at the inspection that these passports have started to be put in place. A Staff member said that bank staff have started having a portfolio which shows the mandatory training they have completed. The requirements and recommendations have therefore been removed. All staff have NVQ (National Vocational award) level 2, except 2 staff members who are in the process of completing the award. Three staff members have the level three award are three are currently undertaking this award. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 23 Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 24 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 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured they are getting a good service as they enjoy a well run home. People who use the service can be confident their views as listened to as they underpin review and development by the home. People who use the service health can be confident that they are safe as their health; safety and welfare needs are met by the staff team. EVIDENCE: As noted at the last inspection, the home is well managed by an experienced manager and a competent staff team. The manager has the necessary skills and confidence to manage the home appropriately. Members of staff that were Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 25 spoken with were very positive about the manager’s approach to running the home. They said that they felt that were encouraged to develop their practise and interests in the home. Staff confirmed and records show that all staff have completed the relevant statutory training including health and safety, fire, first aid, manual handling etc. This was also confirmed in the staff files seen at inspection. The Service Development Manager undertakes regular unannounced visits to the home and a copy of the report and any action plans available in the home. The CSCI also receive regulation 37 notifications promptly. These notices inform of any incident or accident that affects the well being of a resident. There is an annual development plan for the home based on a systematic cycle of planning-action-review this reflects the aims and outcomes for residents. The ethos of the home is positive, open and inclusive. The home has a clear direction and this is reflected in action plans that have derived from everyones input Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 26 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 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 3 X 3 X 3 X X 3 X Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA22 Good Practice Recommendations The registered manager should ensure that the recording of complaints is reviewed. Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Branwell DS0000026571.V368727.R01.S.doc Version 5.2 Page 29 - 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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