Care Home: David Lewis Centre Adult Assessment Unit

Similar services:

• Sunny Bank (P.R.S.) Ltd
• Ruskin Lodge
• Ashwood Court Unit 1
• Clover House
• Dystlegh Grange
• Thornton Lodge
• The Good Companions
• Cuerden Grange Rest Home

What the care home does well The unit is well managed and run. Patients are kept informed about their planned treatment so they know what to expect when they are admitted to the unit. The unit has a friendly and relaxed atmosphere. It was clean, tidy and well maintained on the day of the site visit so people were living in comfortable surroundings.There are good relationships between staff, patients and consultants to make sure patients are provided with all the care they need whilst they are resident in the unit. Patients can choose where they sit, eat and the activities they take part in so they have some control over what they do within the limits of their assessments. Visitors are made welcome; residents` relatives are kept well informed so they know what is happening with the assessments. Care plans are well written and provide enough information so that staff know what to do to meet the patients` needs. Nursing staff are knowledgeable about epilepsy and associated conditions so they can provide appropriate care for the patients. What has improved since the last inspection? The manager has confirmed that any person to be admitted from other homes on the David Lewis Centre`s site will have a full pre admission assessment and will be visited by a member of staff before they move into the unit so that they know and understand the reasons for admission. Care plans detail each person`s needs and provide good information so staff are aware of the individual`s needs. The fire risk assessment has been reviewed and a summary provided to staff on the unit so that they are aware of the outcome of the assessment. What the care home could do better: The presentation of meals could be improved and members of staff should ensure that patient`s main meals are kept hot until they are ready to eat them. CARE HOME ADULTS 18-65 David Lewis Centre Adult Assessment Unit Assessment Unit Mill Lane Warford Alderley Edge Cheshire SK9 7UD Lead Inspector Helena Dennett Unannounced Inspection 19 February 2008 09:30 David Lewis Centre Adult Assessment Unit DS0000018800.V358863.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 David Lewis Centre Adult Assessment Unit DS0000018800.V358863.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. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service David Lewis Centre Adult Assessment Unit Address 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) Assessment Unit Mill Lane Warford Alderley Edge Cheshire SK9 7UD 01565 640159 01565 640355 cath.hutchinson@davidlewis.org.uk www.davidlewis.org.uk David Lewis Centre Ms Catherine Hutchinson Care Home 9 Category(ies) of Learning disability (9), Mental disorder, registration, with number excluding learning disability or dementia (9), of places Physical disability (2) David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This service is registered for a maximum of 9 service users who suffer from seizure disorders to include: * * * * Up to 9 service users in the category of MD (mental disorder excluding learning disability or dementia) Up to 9 service users in the category of LD (learning disability) Up to 1 service users in the category of PD (physical disability) One named service user in the category PD (physical disability) under the age of 18 years 5 March 2007 Date of last inspection Brief Description of the Service: The David Lewis centre is set in 170 acres of land and has a village atmosphere. The Centre’s drives are tree lined and there are extensive wellmaintained gardens and playing fields. The grounds are pleasant and well cared for. There is a swimming pool, gymnasium, workshops and a social club. There is also a school and college on the site. The Adult Assessment Unit is a nine-bedded unit and its purpose is to provide an informal environment for detailed assessment of adults with complex epilepsy and other associated problems. The unit has nine single rooms, including one suitable for disabled persons, and two video telemetry rooms. The scale of charges range from £4,300 - £5,600 per week. The manager provided this information during the site visit. Additional information can be obtained from the manager of the unit. The inspection report is available on the unit. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.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 stars. This means the people who use this service experience good quality outcomes. This unannounced visit, which is part of the key inspection, took place over 4 hours. The purpose of the Adult Assessment Unit is to provide an informal environment for the detailed assessment of adults with complex epilepsy and other associated problems. Video telemetry is used. This involves staying in a specificially equipped room (usually overnight) whilst the video records the patient’s activities and the EEG records brain activity. Due to the nature of the treatment and the fact that patients stay between two and six weeks, some of the national minimum standards are not applicable to this unit. The unit is registered to care for up to nine people. There were three people resident on the day of the inspection visit. Two of them had been admitted the day before. The people spoken with referred to themselves and others on the unit as ‘patients’. Therefore this term is used throughout the report. Before the visit the manager was invited to provide information about the service as part of the inspection process. During the visit we spoke to the manager, some staff members and some of the people using the service. Two people’s records were examined as part of the inspection process; in respect of the care they receive. Records of medication care plans and training were also examined as were some policies, procedures and paperwork used on the unit What the service does well: The unit is well managed and run. Patients are kept informed about their planned treatment so they know what to expect when they are admitted to the unit. The unit has a friendly and relaxed atmosphere. It was clean, tidy and well maintained on the day of the site visit so people were living in comfortable surroundings. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 6 There are good relationships between staff, patients and consultants to make sure patients are provided with all the care they need whilst they are resident in the unit. Patients can choose where they sit, eat and the activities they take part in so they have some control over what they do within the limits of their assessments. Visitors are made welcome; residents’ relatives are kept well informed so they know what is happening with the assessments. Care plans are well written and provide enough information so that staff know what to do to meet the patients’ needs. Nursing staff are knowledgeable about epilepsy and associated conditions so they can provide appropriate care for the patients. 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. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.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 David Lewis Centre Adult Assessment Unit DS0000018800.V358863.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&3 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Prospective patients and their families are given enough information so they can make a choice and know what to expect if they are admitted to the Adult Assessment Unit. EVIDENCE: Patients are admitted for assessment from various parts of the country. The unit accepts referrals from consultants. Where possible, a member of staff will visit the patient in their own home before admission. The records relating to two people recently admitted to the unit was looked at. This contained pre admission assessments and had all the relevant information about the person’s condition to ensure that staff on the unit could meet that person’s needs. A relative spoken with confirmed that the patient had been visited before admission and that a full explanation of the tests and investigations to be done had been given. This reduced the anxiety of the person being admitted to the unit. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 9 The manager said that this process would also be followed should a person living in one of the houses on site need to be admitted. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.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, & 9 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Care plans reflect individual’s needs and the care to be provided so patients can be confident that their needs will be met on the Adult Assessment Unit. EVIDENCE: Two people’s records were looked at during the site visit. These contained all the necessary information required to ensure that all staff could meet the person’s needs. Care plans were in place. These identified the nursing care and planned investigations required to ensure that the person’s needs would be met. Very good detailed daily records were kept. This included information on the person’s seizure activity so that the correct treatment is provided. One person using the service said that they felt comfortable in the unit and that staff had explained everything to them. They were aware of the restrictions placed on them and accepted these. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 11 A relative of a patient also spoke positively about the care and treatment provided. Staff had altered the way they carried out one of the investigations, as the person had not been comfortable with the original plan. Patients are consulted and agreement sought on the restrictions placed on them so that a thorough assessment of their needs can be made. The David Lewis Centre has a policy in place regarding the management of people’s money should anyone wish to access this service. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.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): 13, 15, 16 & 17 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Patients are provided with enough activities to meet their needs but meals are not always presented in an appetizing way so patients may not enjoy them or eat well. EVIDENCE: Standard 12 was not assessed on this inspection as it is not applicable to people using these services at the time of the inspection. There is a range of activities at the David Lewis Centre that patients can access depending on the assessment process and treatment they require. Because of the nature of some of the assessments it is not always possible for people using the service to be fully part of the local community. This is discussed with them before they are admitted to the unit. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 13 Patients who are able to use the day facilities of the centre are encouraged to do so. However the manager recognises that these services do not always fulfil the needs of the individual and staff are currently looking at other ways of meeting their patients’ needs. One of the patients spoken with confirmed she had visited the day care services. She said she had been out and about around the David Lewis Centre with a member of staff and that she has also enjoyed doing activities with staff in the Centre. Visitors are welcomed at any time. Information received before the inspection visit states that food menus have been reviewed and satisfaction surveys show that in the main patients are satisfied with the menu options and the quality of the food provided. We looked at the meals provided at lunchtime. The meals were sent to the unit in a hot trolley. Members of staff test the temperature of the meals when they arrive; however the main course was then left out of the trolley on the serving tray on a cold surface. This means that the main meal may be cold by the time the patients finish their soup and start the main course. Because meals are ordered in advance, two of the people on the unit were not given a choice of what they wanted to eat. One person sent their food back to the kitchen as they eat a particular type of food. The manager sent the request back to the kitchen and said that an alternative meal would be provided. The meals did not look appetizing. One of the burgers had a burnt cheese slice on the top and the cannelloni verdi looked dry. These were sent back to the kitchen and replacement meals were provided. Yogurts and small pieces of fresh fruit were delivered as puddings. The menus were looked at. The dessert menu consisted of yogurts and fresh fruit every lunchtime with a choice of dessert in the evening. A review to increase choice at lunchtime should be carried out. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. Patients on the unit are given the appropriate personal and healthcare support they need to make sure that their needs are met in full during their stay on the unit. EVIDENCE: Patients and relatives were very positive about the staff. They said they were welcomed into the unit and that staff were very friendly. The following are comments made on the David Lewis Centre’s customer satisfaction forms, which were returned to the unit. ‘I love the staff – you are great’ ‘A really friendly atmosphere is the first thing you notice from the very well run unit. The staff are kind and helpful in everyway. We are pleased with the treatment given to our daughter’ David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 15 ‘All my family have been pleasantly surprised at how comfortable clients are made to feel and the level of facilities available’ ‘Thank you for making it like a holiday I have never had. Now I realise what it is like to be treated with the utmost respect and to be treated as a whole person, not just a disabled mass.’ There was evidence in the care plan that staff were meeting the physical and emotional needs of the patients. Good daily records ensured that staff were monitoring their health and well being. Doctors and consultants visit the unit regularly and also monitor the health of the patients. A neuropsychiatrist and a psychologist visit the unit regularly. Patients also have access to a physiotherapist and occupational therapist as needed. A number of changes regarding the management of medicines are taking place across the David Lewis site following discussions with the CSCI pharmacist. The manager confirmed that the nursing staff on the Adult Assessment Unit assume responsibility for the administration of medicines. This is because of the nature of the assessment the type and dose of drugs given to patients can change quickly. A sample of medicine administration record sheets was looked at. These were satisfactory. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. There is enough information available to ensure that patients knew how to complain if they need to. EVIDENCE: Information about the complaints procedure was available on the unit so patients knew who to contact if they had any complaints or concerns. Members of staff spoken with also knew the procedure to follow if a complaint was made. The manager recognises the need to make the complaints procedure clearer for those patients who may have communication difficulties. A policy on adult protection was in place. Staff were aware of the action to take should an allegation of abuse or neglect be made. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.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 & 30 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The environment is well maintained, clean and tidy, with a programme of decoration in place to ensure that it is comfortable for patients to use. EVIDENCE: The unit was found to be clean and tidy during the inspection visit. There is a redecoration programme for the unit. As the Adult Assessment unit is a short stay unit patients have no input into the decoration of the rooms or the unit. There is no passenger lift in the unit so only people who can use the stairs are given an upstairs room. All bedrooms are equipped with en-suite facilities. A larger bedroom, which is suitable for someone with a physical disability to use, is available downstairs. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 18 There is a separate dining room situated off the kitchenette with a pool table at the back of the room. There are two lounge areas for patients to use, one of which is designated as a ‘quiet lounge’. Since the last inspection new carpet has been provided in two bedrooms, new furniture in room 8 and new units, worktops and flooring has been provided to the laundry room. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.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 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. There were enough qualified competent staff working on the Adult Assessment unit to ensure that patients are fully supported. EVIDENCE: There were plenty of staff working on the unit to meet the needs of the patients on the day of the site visit. Registered nurses work on the unit 24 hours per day. Patients spoken with were very complimentary about the staff and felt they were friendly and supportive. One member of staff was seen interacting with two patients in a positive way. The patients seemed to be enjoying the activity and had a good rapport with the member of staff. We spoke to two members of staff as well as the manager. Staff said they felt supported in their work and were offered training appropriate to the job they perform. The staff spoken with were knowledgeable about the patients and their associated medical condition. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 20 A supervision and appraisal system is in place. The David Lewis Centre operates a thorough recruitment procedure, which is based on equal opportunities, ensuring the protection of service users. A small sample of staff personnel files was examined. All of the necessary checks have been carried out to ensure that staff are suitable to work at the Centre. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.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, 39 & 42 People who use this service experience good outcomes in this area. We have made this judgement using available evidence including a visit to this service. The unit is well run with staff providing care and treatment for patients to ensure that their needs are met. EVIDENCE: The manager is a qualified nurse with management experience. Members of staff spoken with said they felt the manager was approachable and that the unit was well run. Patients’ meetings are held monthly so that they can influence the way the unit is run. Staff meetings are also held regularly. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 22 There is a quality assurance system in place, which is based on seeking the views of the patients. Every patient is given a survey form to complete following his or her stay. Discussion took place with the manager about the need to ensure that the form is available in different formats so that everyone has the opportunity to complete it. The David Lewis Centre has a system of auditing and the adult assessment unit is visited monthly and audits completed. The David Lewis Centre has its own training centre on the site which coordinates the induction and foundation programmes for all staff. The induction process has been developed into a two week programme. There are written policies and procedures in place for the Centre and the unit. Fire tests are carried out regularly. The manager has completed a fire marshal and fire responsible person training course. This means she can provide guidance to staff on the action to be taken should a fire break out. There are plans for all nurses to attend this. A fire risk assessment is in place. A fire safety officer visited last year and made some recommendations. The manager confirmed that this work has now been done. The manager confirmed that all essential equipment is serviced and maintained regularly in accordance with the manufacturers’ instructions. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.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 x 3 3 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 x 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 x 13 3 14 x 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.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 YA17 Good Practice Recommendations Staff should make sure that meals are kept hot until they are ready to be eaten. A review of the lunchtime desserts should be done to promote variety and give patients a choice. David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North West Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI David Lewis Centre Adult Assessment Unit DS0000018800.V358863.R01.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!