Care Home: Clifford Villa

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What the care home does well Clifford Villa provides a homely, supportive environment that helps to promote opportunities for fulfilling lives, independence, responsible risk taking and choice. It is person centred in its approach. Positive comments were received from service users, relatives and staff about all aspects of the service. It is well established and there are good links with the local community. It has a people carrier and access to a minibus, which helps meet service users` transport needs, including outings. Typical comments received from service users and relatives included: "I like it here very much." "It`s lovely here and the staff are very good." "I`m very happy here and well looked after." "The food`s very good here and I have what I like." "The staff try hard to ensure that every one takes part in activities that are personal and meaningful to them." What has improved since the last inspection? The home has made progress with redecorating, refurnishing and re-carpeting and more is planned for October and November 2008. Other refurbishment is being considered, including the provision of en suite facilities in some bedrooms. Risk assessments and care plans have been developed and are useful documents, incorporating a person centred approach. Improvements have been made to policies and procedures concerning staff recruitment, staffing levels, staff supervision and pre-admission assessments of prospective service users. What the care home could do better: The service has increased its charges for transport costs, which service users pay out of their personal monies. In one or two cases, such arrangements need to be revisited, as discussed on the day with management, to make sure that the service users concerned can comfortably afford the charges without significant, negative impact on other areas of their lives. CARE HOME ADULTS 18-65 Clifford Villa 3 Clifford Street Redcar TS10 1RW Lead Inspector Stephen Ellis Key Unannounced Inspection 8th September 2008 10:45 Clifford Villa DS0000071646.V371672.R02.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 Clifford Villa DS0000071646.V371672.R02.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. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Clifford Villa Address 3 Clifford Street Redcar TS10 1RW 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) 01642 474155 01642 474155 Potensial Limited Miss Gillian Simpson Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Clifford Villa DS0000071646.V371672.R02.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 the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD, maximum number of places 15 The maximum number of service users who can be accommodated is: 15 12th September 2007 Date of last inspection Brief Description of the Service: Clifford Villa comprises two terraced houses linked to provide one home but which functions as three separate units. The house provides accommodation for up to 15 adults with a learning disability. Accommodation is on two floors and provides homely, family style living. There are three dining areas, the main one being in the sun lounge extension, which gives access to the rear garden. Kitchens are domestic in size and style and are fully accessible to residents. The laundry is equipped with commercial and domestic machines. The basic weekly fee of £520 includes all accommodation, meals and personal care. However, the actual amount people pay depends on their individual circumstances. Clifford Villa DS0000071646.V371672.R02.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 stars. This means the people who use this service experience good quality outcomes. This unannounced fieldwork visit to Clifford Villa took place over 6.25 hours on 8th September 2008 as part of the statutory inspection of the service. Information received prior to the fieldwork visit was used in preparation and during the visit. The visit to the home included a tour of the building, examination of a sample of some of the records that the home is required to keep, and discussions with service users and staff. Comments were received during the visit and from surveys that we carried out before the visit. In total, there were comments received from 7 service users, 2 relatives and 7 staff, including the manager. What the service does well: What has improved since the last inspection? The home has made progress with redecorating, refurnishing and re-carpeting and more is planned for October and November 2008. Other refurbishment is being considered, including the provision of en suite facilities in some bedrooms. Risk assessments and care plans have been developed and are useful documents, incorporating a person centred approach. Improvements have been made to policies and procedures concerning staff recruitment, staffing levels, staff supervision and pre-admission assessments of prospective service users. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 6 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. Clifford Villa DS0000071646.V371672.R02.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 Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 People who use the service experience good quality outcomes in this area. Prospective service users and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Comprehensive and detailed assessments were found in service users’ case files. The manager and staff confirmed that the home’s admission policy is followed, so that only people whose needs are known and whose needs can be met, are admitted, bearing in mind the needs of other service users. Prospective service users are introduced gradually to the home, going on introductory visits, shared activities and overnight stays etc. Service users and relatives said they felt there was enough information provided by the service to enable them to make a decision about the suitability of Clifford Villa for them. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People who use the service experience good quality outcomes in this area. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: There were numerous examples of responsible risk taking by service users. Service users lead active lives, participating in a variety of recreational and educational activities, including attendance at adult centres, holidays and outings to places of interest. Residents exercise choice and act independently, with support and encouragement from staff (such as choice of clothing, times of getting up and going to bed, choice of menu, choice of activities). It was observed that service users were treated with respect and their individuality was acknowledged. Members of staff adopt a ‘person-centred’ Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 10 approach, with attention given to promoting people’s dignity, privacy and human rights. These values were reflected in the service users’ plans of care/support plans. These had been updated and transferred into new, more accessible formats over the past 12 months. Several residents confirmed that they discussed their needs and personal goals with members of staff, such as their key workers, who took note of these issues and helped them. There was evidence of such communication and personal care planning found in the plans of care. The home has introduced person centred planning for each service user, so that people’s individual needs and personal aspirations can be fully known, supported and reviewed. There were several impressive examples on the walls of service users’ bedrooms, complete with supporting pictures and plain English text. Typical comments received from service users and relatives included: “I like it here very much.” “It’s lovely here and the staff are very good.” “I’m very happy here and well looked after.” Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. People who use the service experience good quality outcomes in this area. People who use services are able to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals’ expectations. We have made this judgment using a range of evidence, including a visit this service. EVIDENCE: It was observed that residents were treated with warmth and respect and were addressed in an appropriate manner by their preferred name. Residents and staff got on very well together. There was an easygoing and relaxed atmosphere in the home, with routines that were flexible and allowed residents to exercise personal choice and control over their own lives. Each resident had an individual programme of daytime activities, either based in the home, at an educational or work centre, or in the local community. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 12 to Staff members were good at providing each resident with a wide range of opportunities to lead interesting and fulfilling lives. Residents and staff confirmed details seen in service users’ plans of care, including person centred plans, which showed that service users took part in a wide range of activities, including TV, DVD and videos, karaoke, pool, visits to clubs, restaurants/cafes, concerts, pubs, shops, craft fairs, Beamish, Dr Who Exhibition in Liverpool, walks along the seafront, swimming, day trips to the coast and countryside including Whitby, Flamingo Land and traction rally at Pickering, holidays in this country and abroad, helicopter and hot air balloon rides, plus visits to local parks, railway museum, football matches, and local theatres. However, it was observed that the service has increased its charges for transport costs, which service users pay out of their personal monies. In one or two cases, such arrangements need to be revisited, as discussed on the day with management, to make sure that the service users concerned can comfortably afford the charges without significant, negative impact on other areas of their lives. Staff recognised the importance of residents maintaining contact with relatives and friends and encouraged visitors to the home. One visiting relative confirmed that she was always made welcome and could visit at any reasonable time. Menus reflected residents’ choice. Service users are offered a varied and balanced diet, with alternatives readily available should people not like the main meals. Residents said that they liked the food at the home and felt their preferences were well catered for. Menus are amongst the items discussed each week at the residents’ meeting, with records kept. Typical comments received from service users and relatives included: “The food’s very good here and I have what I like.” “The staff try hard to ensure that every one takes part in activities that are personal and meaningful to them.” Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. People who use the service experience good quality outcomes in this area. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Comments from service users, relatives and staff indicated good levels of satisfaction concerning the health care, personal care and social care of service users. Medical and community nursing care was described as being readily available and very helpful. All residents are registered with a GP, optician and dentist and each has a health care plan. External health and social care personnel, such as hospital consultants, physiotherapists, occupational therapists and social workers, provide professional input, as documented in service users’ plans of care. Residents and relatives spoke highly of the staff, describing them as friendly, understanding and supportive. Each resident has a named key worker from the home’s team of staff, taking into account service user choice wherever possible. Staff members confirmed that they have defined roles and responsibilities and are encouraged to recognise their own professional expertise and limitations. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 14 Most members of care staff had either completed Safe Handling of Medicines training or medicine awareness training. Staff members were also trained in the home’s own policies and procedures for the safe handling of medicines. Further training and development in the safe handling of medicines is planned. Policies and procedures for the safe storage, administration and disposal of medicines are satisfactory and good practices were observed. An independent pharmacy audit was carried out earlier this year and the findings were satisfactory. In practice, residents tend to delegate responsibility for their medicines to the staff, although they may administer their own medicines, subject to risk assessment. Medicines were observed to be correctly stored in metal cabinets secured to the wall. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. People who use the service experience good quality outcomes in this area. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Pre-employment checks are carried out on staff, including enhanced checks with the Criminal Record Bureau plus Protection of Vulnerable Adult checks. Also, two references are obtained in respect of each new employee, with special attention given to the last employment. This is to ensure that unsuitable people are not employed to care for vulnerable adults. New staff members go through induction and foundation training so that they have the right knowledge and skills to do their jobs competently. Residents and relatives indicated a caring, supportive atmosphere in the home, and this was observed during the fieldwork visit. They said that they got on well with each member of staff and felt they could confide in them. The home has a user-friendly complaints procedure that was developed with the needs of the residents in mind. Staff expressed confidence in the manager and seniors, describing them as being supportive, approachable and understanding. They would not hesitate to approach the manager and/or seniors about any suspected abuse or neglect of residents. Most members of staff have undergone training in the Protection of Vulnerable Adults (POVA), such as ‘No Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 16 Secrets’ training, and are aware of the local multi-agency safeguarding adults policy and the lead role taken by the Adult Social Services Department. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 17 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, 26 and 30. People who use the service experience good quality outcomes in this area. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home was clean, hygienic and free from unpleasant odours. All areas of the home, including the kitchen were accessible to residents. Lounges were, in the main, pleasantly decorated and comfortably furnished and bedrooms had been individualised by the inclusion of personal effects such as posters, soft toys, ornaments, photographs, radios, CD/DVD players, TVs etc. Most bedroom doors were lockable with safe, suitable locks, providing service users with opportunities for choice and privacy. Radiators were fitted with suitable guards, thereby minimising the risk of accidental burning. Similarly, hot water temperatures are thermostatically controlled so that they do not exceed 43 Celsius, including wash hand basins, baths and showers. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 18 A programme of redecoration and renewal of floor coverings was examined. The property was redecorated externally last year and some internal painting and refurnishing has also been completed. Further redecoration internally is planned for October 2008, with many floor coverings being renewed in November 2008. Some alterations to a number of rooms are being considered and they will not be redecorated until a decision has been made about their development (e.g. installation of en suite toilets and wash hand basins in some bedrooms). The home has made good progress with addressing the environmental issues identified at the last inspection, and the planned work scheduled for this autumn will only serve to enhance the material standards, which is most welcome. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 19 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. People who use the service experience good quality outcomes in this area. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Staffing levels were found to be appropriate, in accordance with the guidance issued by the Commission for Social Care Inspection and residents’ assessed needs. At the time of inspection, there were 10 residents being accommodated, with staffing levels being typically 4 to 6 members of care staff (including the manager) on duty throughout the day (7:30 am to 10:00 pm). At night (10:00 pm to 8:00 am) there are 2 members of staff awake on duty, plus another on-call on the premises (on sleep-over). Comments received from both residents and staff confirmed observations that staffing levels and skills were sufficient for the needs of the home. At least one experienced carer is always deployed on each shift. The home has a dedicated administrator plus cleaning domestic assistant. The registered manager’s hours are not included Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 20 in the care hours provided, although the post holder does contribute towards the direct care of residents when management duties permit. A full staff-training programme is provided, including managing challenging behaviour, safe handling of medicines, protection of vulnerable adults, end of life care, food hygiene, moving and handling, first aid, risk assessment, fire safety and National Vocational Qualifications in health and social care at levels 2, 3 and 4. Comprehensive induction and foundation training is provided for all staff. Individual records of staff training and development are kept, as well as staff group records. All permanent members of care staff have achieved National Vocational Qualification (NVQ) level 2 or above in health and social care, which is commendable. There were numerous examples of specialist training having been delivered when required by service users and staff. Staff members and staff records confirmed that members of staff are well supervised, including 1 to 1 supervision taking place 6 times per year. The home’s recruitment policy and practice is sound, ensuring that all preemployment checks are carried out as required, including Criminal Record Bureau enhanced checks, Protection of Vulnerable Adults checks and the taking up of two written references. Service users’ views concerning the suitability of new staff are taken into consideration and there is a probationary period of 3 months for new staff to serve. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 21 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, 38, 39 and 42. People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect and has effective quality assurance systems, being developed by a capable manager who hopes to complete her qualification in management in 2009. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home had policies and procedures that complied with current legislation and recognised professional standards and covered all aspects of the management of the home. Records were kept to safeguard service users’ rights and best interests and to ensure the safe and effective running of the home. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 22 The registered manager has substantial, senior experience of working with service users with learning disabilities. She is working towards achieving a recognised management qualification (Registered Manager’s Award at National Vocational Qualification level 4). Staff, residents and relatives spoke well of the manager and felt the home was well managed and that their individual contribution was appreciated. She is well supported by an experienced staff team, including a well-qualified deputy manager and separate administrator. There are good policies and procedures for health and safety issues, including regular discussion at staff meetings, dedicated staff to carry out health and safety checks, plus on going health and safety training. The home has various systems, both formal and informal, to measure success in meeting its aims, objectives and statement of purpose. These include monthly audits conducted by the provider’s Area Manager, regular resident reviews, weekly residents’ meetings, staff meetings and feedback from residents’ relatives. Also, the provider sends out annual questionnaires to service users and/or their representatives, to help encourage feedback on all aspects of the service. Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 23 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 3 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 3 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 X X 3 x Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 24 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 YA23 Good Practice Recommendations Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Clifford Villa DS0000071646.V371672.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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