Care Home: DRS (Annexe 4) Care Home

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What the care home does well The home has a friendly, relaxed and supportive atmosphere. The independence and rights of the people who use the service are given high priority. People who use the service are encouraged to make decisions about their lives and to take appropriate risks with support from the management and other professionals involved in their care. Detailed needs assessments are carried out prior to anyone moving into the home so that the person receiving the service knows the home can meet their needs. Occupational and leisure interests are encouraged. The manager is professional and ensures the health and safety of both staff and people who use the service. The building is clean and decorated to a very high standard. What has improved since the last inspection? This is the first inspection by the CSCI and as such no previous requirements or recommendations have been issued. What the care home could do better: Only one requirement has been issued as a result of this inspection. Although staff have received training in the administration of medication by invasive techniques the health care professional who trained them must sign them off as competent in this procedure. This should ensure that both residents and staff are confident that these procedures are carried out safely. Two good practice recommendations have been issued. One relates to maintaining clear records in relation to occupational development for each resident. The other recommendation is in relation to making sure that any staffreference is authenticated by a company stamp or letter headed paper. This should ensure that the manager knows the reference is from the person`s employer. CARE HOME ADULTS 18-65 DRS (Annexe 4) Care Home 4 New Villas Baronet Road Tottenham London N17 0LT Lead Inspector Jackie Izzard Announced Inspection 28th April 2008 09:30 DRS (Annexe 4) Care Home DS0000070602.V361751.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 DRS (Annexe 4) Care Home DS0000070602.V361751.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. DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service DRS (Annexe 4) Care Home Address 4 New Villas Baronet Road Tottenham London N17 0LT 020 8801 4860 020 8203 0430 raniedatoo@btinternet.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) DRS Care Homes Limited Ranie Safderali Datoo Care Home 6 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (6) of places DRS (Annexe 4) Care Home DS0000070602.V361751.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 the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD 2. Mental disorder, excluding learning disability and dementia - Code MD The maximum number of service users who can be accommodated is: 6 This is the first inspection of this service since it was registered with the CSCI. Date of last inspection Brief Description of the Service: DRS (Annex4) is newly registered with the CSCI and provides care and support for up to six people with mental health problems and/or a learning disability. DRS (Annex 4) is a large house in a residential street in Tottenham and is within a gated area with the other three homes owned by the company in the complex. Each is independently registered. The registered manager, Mrs Datoo is the registered provider for all the six other services as well as the registered manager for another home in the local area. The home is well served with local transport, shops, parks etc. All the six bedrooms have an en-suite facility consisting of a shower, toilet and washbasin. The rooms are decorated to a specific colour theme i.e. Blue room, red room etc. There is a large lounge and dining area as well as a walled garden, which is also where the office is located. The range of fees at the time of the inspection is £700 - £1800 per week. DRS (Annexe 4) Care Home DS0000070602.V361751.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 Key Announced inspection took place on Monday 28th April, and lasted five hours. This is the first inspection of the service since it was registered with the Commission. We were assisted throughout the inspection by the registered manager who was open and helpful. We spoke with three staff and three residents of the home. On the day of the inspection two residents were on a weekend holiday. We met with three residents and spoke with one person in private. We inspected the building and examined various care records as well as a number of policies and procedures. The interactions we observed between staff and residents were friendly and supportive. People we spoke with said they were happy at the home. One resident told us, “I think it’s good”. What the service does well: What has improved since the last inspection? What they could do better: Only one requirement has been issued as a result of this inspection. Although staff have received training in the administration of medication by invasive techniques the health care professional who trained them must sign them off as competent in this procedure. This should ensure that both residents and staff are confident that these procedures are carried out safely. Two good practice recommendations have been issued. One relates to maintaining clear records in relation to occupational development for each resident. The other recommendation is in relation to making sure that any staff DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 6 reference is authenticated by a company stamp or letter headed paper. This should ensure that the manager knows the reference is from the person’s employer. 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. DRS (Annexe 4) Care Home DS0000070602.V361751.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 DRS (Annexe 4) Care Home DS0000070602.V361751.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 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. There is also good information available to prospective residents to the home about the services and facilities available. EVIDENCE: The home’s Statement of Purpose and Service User Guide were examined. These documents were detailed and gave the prospective user of the service clear information about the aims and objectives of the home as well as information about the services provided. There were clear statements about equality and diversity issues and the rights of the individual. We examined the pre admission assessments for three people who had recently moved into the home. There was evidence that the home had received clear and detailed information from the placing authority regarding individuals, including risk factors and indicators of possible relapses. The manager told us that after receiving pre assessment information, either herself or the manager of the adjacent home would visit the person and carry out their own assessment of the person’s needs. We saw evidence that the DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 9 individual had been involved in this process. Records seen indicated that all people who use the service have visited the home on a number of occasions and for weekend stays before they made a decision to move in. We saw evidence that residents had a review of their placement four to six weeks after they moved into the home. This is to make sure that the home is right for them. DRS (Annexe 4) Care Home DS0000070602.V361751.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service have a detailed plan of care, which is reviewed together with staff and changes made when required. Risks to residents as part of their individual life styles are recorded and reviewed. The management and staff work hard to assist and facilitate residents to make decisions about their life. EVIDENCE: We examined three people’s care plans. These plans clearly set out the individual’s needs and personal goals and, where appropriate, were geared to a progressively more independent lifestyle. There was evidence that people who use the service had been involved in their plan of care and these plans were being regularly reviewed. We saw examples throughout the inspection where staff was following these plans. Plans included person specific risk assessments as well as information about possible relapse indicators. The person we spoke with confirmed that staff were supportive and that he was able to make decisions about his life at the home. There was evidence from daily reports DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 11 that people who use the service are encouraged to take risks, with staff support, in order to maintain their independence as far as possible within clearly defined boundaries. Residents meeting take place as well as one to one key worker meetings. There was evidence that care plans had been informed by the initial pre assessment information obtained from the placing authorities. Staff interviewed were knowledgeable about the residents at the home and were able to describe how people were treated as individuals with individual needs and wishes. DRS (Annexe 4) Care Home DS0000070602.V361751.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 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to enjoy a range of occupational and leisure activities. These activities are based on their individual interests. They are also supported to maintain good family contact and to eat nutritious meals based on their individual dietary needs. EVIDENCE: There was evidence from daily reports and care plans that residents regularly visit their family and friends, attend leisure facilities as well as going to local shops and cinemas. On the day of the inspection two people were away for a weekend break in Dover. All three residents who were at the home in the morning also went out of the home during the inspection. One person told us that he would be enrolling at a college soon and he confirmed that visitors were welcomed and encouraged. People’s interests and hobbies were recorded in their care plans and staff were able to tell us how they enabled people to engage in these activities. The home has clear policies regarding sexuality and DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 13 relationships. There is also an expectation that residents help out around the home as part of their occupational development. The home has a general activity programme for all residents at the home. This programme was quite generic and did not match the individual activity programme on peoples’ care plans. This was discussed with the manager and a good practice recommendation has been issued that individuals’ activity programmes detail any occupational activity they are to undertake and are “person centred” in approach. This should enable staff to have a clear picture of the activities and interests of each person in the home and should provide residents with a clear plan of their occupational development. People who use the service help out with shopping, cooking and cleaning as well as devising the menus for the home. The kitchen was clean and we saw lots of fresh food in the fridge. Menus seen indicated that people were offered a healthy diet and one that meets their own cultural expectations. Records of residents’ meetings showed that people had commented on food at the home and as a result more culturally diverse meals had been devised. One resident told us the food at the home is, “Quite nice”. The home has recently been awarded four stars by Haringey Environmental Health department. DRS (Annexe 4) Care Home DS0000070602.V361751.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 and 20 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using the service receive the care and support they need to maintain their independence. People have good access to health care professionals and their health needs are monitored by the home. There are generally satisfactory systems in place to deal with the receipt, administration and disposal of medication at the home. EVIDENCE: Care plans we examined gave clear information to staff regarding how residents’ physical and emotional health needs are to be met. Staff were able to tell us how they meet these needs in a way that maximises peoples’ independence, choice and privacy. People who use the service confirmed that staff were respectful and friendly. Some residents require support with personal care and staff were able to describe how they supported people in a respectful and dignified manner. Interactions we observed between staff and residents were friendly and supportive. People are registered with the local doctor and there was evidence from care plans that they also have access to other health care professionals as required. Residents’ health is monitored and recorded. DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 15 Satisfactory records were examined in relation to the receipt, storage, administration and disposal of medication in the home. No resident currently self-administers their own medication. A list of staff who are authorised to administer medication was seen along with current medication training certificates. Sometimes staff have to administer rectal Diazepam. The manager told us that staff have been trained to carry out this emergency procedure and staff confirmed this. This is called the administration of medication by invasive techniques. A requirement has been issued that all staff who have been trained in this procedure are “signed off” as competent by the health care professional who trained them with the date the training took place. This is to ensure that residents are safe in the knowledge that staff are competent to carry out this procedure. DRS (Annexe 4) Care Home DS0000070602.V361751.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 and 23 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. People who use the service are protected from abuse by clear policies and procedures and by a knowledgeable and trained staff team. EVIDENCE: The home has a satisfactory complaints policy and procedure, which provides timescales for action and reference to the CSCI. This policy is made available to people who use the service as well as their families and representatives. A copy of this procedure was on display in the home. One complaint has been received by the home and records indicated that it had been dealt with appropriately. The person we spoke with said they had no complaints about the staff or the service but knew what to do if they had any concerns. There is a satisfactory procedure in relation to safeguarding residents from abuse. This also includes a “Whistle Blowing” policy, which staff were aware of. The manager was knowledgeable about the procedure including who to contact if any allegations were made. The resident we spoke to said he felt safe at the home. Staff interviewed had a good understanding of the issues and were able to describe what signs they would look out for if they suspected any abuse was occurring at the home. Staff have undertaken training in adult protection. DRS (Annexe 4) Care Home DS0000070602.V361751.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 and 30 People who use this service experience excellent outcomes in this area. This judgement has been made using available evidence including a visit to this service. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home is clean, safe and decorated to a high standard. EVIDENCE: The service is new and the building has been extensively refurbished to a high standard. People’s rooms were well decorated, clean and all contained en-suite showers and toilets. The person we spoke to told us he was happy with his room and commented, “I like it”. Each person’s room were individualised and contained their personal possessions. Communal areas were also clean and decorated to a high standard. Records indicated that staff have attended infection control training and a refresher course has also been booked. The manager told us that the home employs a domestic worker and staff are expected to help out from time to time. The laundry area was satisfactory and contained a domestic washer and dryer. DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 18 Toilets and bathrooms were clean and there were no offensive odours detected throughout the home. Cleaning chemicals were being stored safely. DRS (Annexe 4) Care Home DS0000070602.V361751.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 and 35 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support. EVIDENCE: The rota examined indicated that there are two staff on duty throughout the day and one waking staff on during the night. The manager is based at this home during the morning and goes to the other home she manages in the afternoon. There is also a domestic worker employed at the home who also drives the home’s mini bus. Interactions observed between staff and residents were supportive and friendly. Staff interviewed had a good understanding of the needs of the people they support. One person commented that the staff were, “Cool”. A sample of staff files were examined. These contained the information required by this standard including proof of identity, two written references and satisfactory CRB disclosures. This information is important and protects DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 20 people from unsuitable staff being employed. The home has its own reference format and these were filled out but did not always contain a company stamp or letter headed paper. A good practice recommendation has been made that a company stamp or letter headed paper is enclosed with the professional reference to further evidence its authenticity. Appropriate training certificates were seen on staff files and it was clear from discussion with the manager and staff that training is given a high priority. Two of the care staff are undertaking the NVQ level 4 in management. There were also a number of training courses booked for staff in the future. Staff were positive about the training opportunities available to them at the home. DRS (Annexe 4) Care Home DS0000070602.V361751.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 and 42 People who use this service experience good outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a well run home and a professional manager. The quality assurance system, although not fully tested, should ensure that residents and their representatives have a say in how the service is run. The health, safety and welfare of residents are promoted and protected. EVIDENCE: The registered manager has completed the Registered Managers Award, which is a requirement of all registered managers. There was evidence that the manager also attends training courses with her staff as required. This should ensure that the manager is up to date with her professional development. Staff and residents were positive about the manager and the staff told us that the manager was, “Supportive”. DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 22 Although the manager currently manages two small homes she told us that she was coping well with this and had not come across any problems so far. There was evidence that residents meetings take place on a regular basis and records of these meetings indicated that residents could have a say in how the home is run. We saw that where suggestions had been made these were acted upon by the staff team. The manager has devised a quality monitoring system and hopes to have this completed by November this year. Satisfactory records and certificates were examined in relation to health and safety at the home including fire safety, electrical and gas safety. Training records indicated that staff have completed the required health and safety training and further refresher courses have also been booked. DRS (Annexe 4) Care Home DS0000070602.V361751.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 4 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 4 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 3 X 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 DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 24 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA20 Regulation 13(2) Requirement The registered person must ensure that where the administration of invasive techniques are to be undertaken by staff the following records must be maintained: • What the carer has been trained to do. • The name of the person providing the training. • The date of the training. • The signature of the care worker who is trained and accepted delegation of the task from the health care professional. This is to ensure that all staff are competent to carry out such tasks at the home in a safe manner. Timescale for action 01/06/08 DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 25 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 YA12 Good Practice Recommendations The registered person should ensure individuals’ activity programmes detail any occupational activity they are to undertake and are “person centred” in approach. This should enable staff to have a clear picture of the activities and interests of each person in the home and should provide residents with a clear plan of their occupational development. The registered person should ensure a company stamp or letter headed paper is enclosed with any professional reference obtained to further evidence its authenticity. 2. YA34 DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Contact Team Caledonia House 223 Pentonville Road London N1 9NG 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 DRS (Annexe 4) Care Home DS0000070602.V361751.R01.S.doc Version 5.2 Page 27 - 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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