Care Home: Fenn Court

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What the care home does well The service works hard to ensure it can meet the needs of people living in the home. The service now maintains good relations and works well with outside agencies to ensure the individual needs of people living in the home are appropriately supported. The staff team are friendly and enthusiastic and support people living in the home to make choices about their lives. People using the service told us they felt safe and that staff listened to them and took their views seriously. There is a good staff training programme to ensure the needs of people living in the home can be met and the manager has an open and inclusive approach and is keen to develop and improve the home further. What has improved since the last inspection? Since the last time we visited the service we saw evidence the provider and manager had worked hard to improve the home and most of the requirements we made previously had been implemented. We saw evidence of further redecoration of the home to ensure it provides an environment that is homely and safe. We saw that staff were being supervised more often to make sure they are can do their jobs properly and more of them had been now received training to make sure they can safely meet the needs of people living in the home. What the care home could do better: The home must have a manager who is registered with the Commission for Social Care Inspection. Care plans should be further developed to help staff support the individual strengths and abilities of people living in the home to have more active control of their lives and be as independent as is possible. The manager should think about providing more activity and information boards to help people living in the home choose what they want to do better. The complaints policy should be made more easy to read and staff should be trained about the Mental Capacity Act to help them support people using the service understand their rights better. More training should be given to the management team to help them maintain the home`s administrative systems and thought should be given to ensure that wherever is safely possible, the bedroom and bathroom doors are locked to maximise respect for the privacy and dignity of people living in the home. CARE HOME ADULTS 18-65 Fenn Court Broads Cottages Toothill Road Grimsby North East Lincs DN34 4ER Lead Inspector Rob Padwick Key Unannounced Inspection 17th March 2008 12:00 Fenn Court DS0000002914.V360646.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 Fenn Court DS0000002914.V360646.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. Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fenn Court Address Broads Cottages Toothill Road Grimsby North East Lincs DN34 4ER 01472 358369 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) h1m068adamson@mencap.org.uk www.mencap.org.uk Royal Mencap Society Position Vacant Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2007 Brief Description of the Service: Fenn Court is a care home providing personal care and accommodation for adults aged 18-65 years who have a learning disability. It is part of the Mencap organisation. The home is situated in a quiet residential area in the outskirts of Grimsby and is close to local shops and amenities. The accommodation is of a domestic nature and is provided in three houses. Each house has four single bedrooms with hand basin; bathrooms to the ground and first floor; separate toilet; lounge and dining-kitchen. In front of the houses is a communal courtyard with car parking space. Each house has it’s own private rear garden. Weekly fees are: £746.40 with additional fees for One to One support, toiletries and clothing. Information on the service is made available to prospective and current service users via the statement of purpose, service user guide and inspection report. Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since we carried out a random inspection of the service on 28th June 2007. Information we used included answers to a questionnaire we sent to the home manager before this Key Inspection visit, together with feedback from questionnaires sent to people living in the home, their relatives and professional staff who know them well. Further information used included official notifications received by the Commission for Social Care Inspection about the home. The inspection visit lasted for 5.30 hours and during this period, we spent time talking with people living in the home and observing their daily lives. Other time was spent inspecting the building, looking at care plans, other records and talking to staff. In order to improve the way the Commission for Social Care Inspection involves and engages with people who use services, someone with experience of receiving similar services, known as an “Expert by Experience” helped us with this inspection visit. This person, Andrew Bright, spoke to people living in the home and helped to look round the buildings as well as talking to staff. Andrew gave the home’s manager his feedback at the end of his visit and information collected by him, has helped us make judgements about the service provided at Fenn Court. What the service does well: What has improved since the last inspection? Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 6 Since the last time we visited the service we saw evidence the provider and manager had worked hard to improve the home and most of the requirements we made previously had been implemented. We saw evidence of further redecoration of the home to ensure it provides an environment that is homely and safe. We saw that staff were being supervised more often to make sure they are can do their jobs properly and more of them had been now received training to make sure they can safely meet the needs of people living in the home. 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. Fenn Court DS0000002914.V360646.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 Fenn Court DS0000002914.V360646.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 good outcomes in this area. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Up to date information about the home was available to help people and their representatives thinking about using the service make an informed decision about it. No new people had been admitted to the home since the last time we visited it, and most of them have lived there for a number of years. However, information was available to indicate the needs of people who move into the home in the future will have their needs fully assessed, to ensure it is suitable for them. We observed positive interactions throughout the site visit which indicated staff had a good understanding of the needs of people living in the home and that they knew them very well. Fenn Court DS0000002914.V360646.R01.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 this service experience good outcomes in this area. Whilst people living in the home are supported to make decisions about their needs and choices, more information about their individual strengths and needs would help staff to assist them with these better. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The group of people living in the home have a mixed range of needs with some able to make independent choices with little support, whilst others are much more dependent on staff for this. The case files belonging to people living in the home contained very thorough assessments of their needs, in order to ensure the service can meet these satisfactorily. Some of the people using the service have little or no ability to communicate verbally, but evidence was seen that despite this staff worked hard to understand them. The Expert by Experience said, “I felt staff were very supportive and able to understand individual communication needs”. Questionnaires returned from staff stated, “there is a tremendous focus on the needs of the service users” and the case files and staff records we inspected contained evidence of a strong commitment to this, with specialist professional support obtained and staff Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 10 training about the range of needs of people living in the home. Care plans belonging to people using the service contained details about their assessed needs, together with actions required from staff, to ensure they are appropriately met. People living in the home told us they were involved in reviews of their care to ensure it was right for them and evidence was seen that these were being regularly evaluated, to ensure they are keep up to date. Whilst being generally satisfactory, the care plans tended to focus on needs of people living in the home, whilst paying less attention to their individual strengths and abilities. It is recommended these are further developed to be more holistic and person centred, in order take account of these factors and provide further opportunities for promoting further wellbeing. People living in the home told us staff supported them to be as independent as possible and the case files we inspected, contained details about the management of risks to them, which reflected an approach consistent with their everyday lives. Their was evidence this included the involvement of specialist professionals where this was needed. Fenn Court DS0000002914.V360646.R01.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, 15, 16 and 17 People who use this service experience good outcomes in this area. People living in the home are supported to take part in a range of activities in order to ensure their lifestyle skills needs are appropriately met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People using the service indicated they were supported to be as independent as possible and took part in a variety of activities. As a result of a re assessment of their needs and changes in the availability of traditional day care placements locally, some of them had recently experienced a reduction in hours they could use this type of provision. However, information provided by the manager indicated additional funding had now been obtained to enable staff to provide alternative support where this was required. Staffing levels were observed to be appropriate and evidence was seen of sensory equipment in use for people with more profound disabilities, together with plans to develop the use of these further. Some people living in the home were observed coming home for lunch before returning to college in the afternoon, whilst others told us about courses they attended to help them develop their Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 12 skills and abilities. People using the service told us they attended regular discos, clubs and pubs and the Expert by Experience said he was “very impressed to see a picture based activities board for one resident to choose different activities”. The Expert recommended these are used in all of the houses, to enable people using the service have more active control of the choice of activities they want to do. Whilst the Expert said, “there is a good range of activities for residents to join in” comments received from one relative indicated “it would be better if they had some form of transport”. The manager provided information about plans to develop regular meetings with relatives and case files inspected confirmed people living in the home were encouraged and supported to maintain links with families and friends. The home had a relaxed atmosphere throughout and we observed a flexible routine, which enabled people using the service to have choice of what they wanted to do. The Expert by Experience said people told him they contributed to help take responsibility with tasks around the home and that staff helped them go shopping for what they wanted to eat, whilst the case files we inspected contained evidence that the nutritional needs of people living in the home were being carefully monitored where this was required. Fenn Court DS0000002914.V360646.R01.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 this service experience good outcomes in this area. Staff training on health and personal care issues had been provided to ensure the individual needs of people living in the home could be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home told us staff supported them with their health and personal care and evidence of this was seen in the case files inspected. Support plans detailed how staff supported the individual needs and preferences of people using the service, whilst the homes records provided evidence of a range training to ensure staff were equipped to deal with specialist needs. A GP commented the home “manages very difficult clients usually very successfully” and a specialist nurse who we spoke to indicated no concerns about the home. Detailed Health Action plans were in place for people using the service and case files inspected contained evidence of extensive monitoring and charting of individual needs and behaviours. The staff records we inspected contained evidence of training about the safe use and handling of medication and a random check of the records of medicines kept in the home indicated these were being correctly maintained. We saw evidence of good working relationships with members of the Local Primary Health Care Teams and a member of staff told us about a meeting held Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 14 recently, to ensure the individual rights and best interests of an individual needing medical treatment were properly respected. The staff records indicated training had not yet been formally provided about the Mental Capacity Act and a recommendation is made about this. Fenn Court DS0000002914.V360646.R01.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 this service experience good outcomes in this area. The views of people living in the home are taken seriously and staff had been trained to ensure they can safeguard them from potential harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Policies and procedures were in place to ensure the concerns of people living in the home are taken seriously and that they are safeguarded from abuse. People using the service indicated they were happy living in the home and told us they felt safe and trusted staff. The Commission for Social Care Inspection had received no official complaints about the service since the last time we visited and the home’s complaints log contained none that had been made to the home. The manager provided information that indicated training had been given to staff about the Protection of Vulnerable Adults and confirmation of this was contained in the staff records we inspected. Since the last time we visited an allegation of abuse in the home had been referred to the Local Authority for investigating and we saw evidence of appropriate action taken by the service about this. Whilst the complaints policy for the home had recently been updated, it is recommended this is further developed to help people using the service understand their rights better. Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 16 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 good outcomes in this area. The home provides people with an environment that is comfortable, safe and clean although some improvements could be made to ensure the individual needs of people living in the home are better met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The three houses were all clean, tidy and homely and we saw evidence it had continued to be upgraded since the last visited. Information provided by the manager indicated new carpeting had been laid and some rooms redecorated and plans were in place to improve the home further. Staff comments received confirmed “a lot of effort has gone into sprucing up the residents rooms and general areas” and the Expert by Experience stated he “liked the way the homes were decorated differently and that residents were able to choose how they had their bedrooms decorated”. On a previous visit we recommended the provider audits the building against the requirements of The Disability Discrimination Act, as it was not purpose built. Whilst the building is not ideal, we saw evidence the provider had taken steps to ensure it continues to meet the needs of the mixed group of people living in the home. The Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 17 manager told us she was aware of this difficulty and saw evidence of plans to develop a sensory garden to give additional space that is more peaceful and relaxing for those with more profound disabilities. The Expert by Experience noticed some bedroom and bathroom doors left unlocked in the home, and recommended that locks are used wherever possible, to ensure the privacy of people using the service and give them a greater choice and sense of control. A recommendation is made about this. Information provided by the manager indicated the building and equipment were regularly checked and we saw evidence of this in the maintenance records we inspected to ensure it provides an environment that is safe and well maintained. Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 18 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. Appropriate training was provided to staff to ensure they could support the needs of people living in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We observed friendly and positive interactions between staff and people living in the home and people using the service said they trusted the staff and felt safe with them. We saw evidence that staff were committed to meeting the needs of people living in the home and feedback received from them indicated they worked well as a staff team. The staff files and training records inspected contained evidence the manager had worked hard to develop this aspect of the service and ensure staff are equipped with the necessary skills to meet the changing needs of people using the service. However it is recommended more formal NVQ training is provided. The home had recruitment policies and procedures to ensure staff are safe to work with people using the service and saw evidence these were being appropriately followed. The files of staff employed since the last time we visited all contained evidence the required checks had been properly carried out. The Expert by Experience said, “I felt staff were very supportive” and that “residents had a good relationship with staff.” Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 19 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. Whilst appropriate administrative systems were in place, further training for the management team would enable them to carry out their role more effectively. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Relatives told us the home was “well run all round” and saw evidence of continued progress in developing the service. Staff comments confirmed the manager was approachable and listened to their views and we saw evidence of regular meetings with staff and people living in the home to ensure they are consulted about issues affecting the home. Whilst the manager has been in post for approximately two years, she had still to formally register with the Commission for Social Care Inspection. This remains a requirement outstanding from a previous inspection visit. Information provided by the manager’s self-assessment of the service was generally of good quality and we Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 20 saw evidence of appropriate management and administrative systems to support the effective running of the home. The records we inspected indicated staff were being regularly supervised and appraised of their skills and saw evidence of plans to address any identified shortfalls. Neither manager nor the team leader had yet to obtain formal management qualifications and it is recommended the Provider address this issue as a priority. Systems were in place to monitor progress of the service to meet its aims and objectives, but whilst evidence was seen of these being regularly checked, it is recommended these are further developed and more formalised and that feedback is obtained about the service from those who know it well. The maintenance records inspected confirmed regular checks were carried out to ensure the health, safety and welfare of people using the service. The staff records we inspected confirmed a range of training had been provided about health and safety matters and saw evidence the requirements concerning these issues had been implemented since the last time we visited. Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No 31 32 33 34 35 36 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X 2 X 3 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000002914.V360646.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fenn Court Score 3 3 3 X 2 X 2 X X X 3 Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 1. Regulation Requirement The registered provider must provide a manager for the home who is registered as a fit person by CSCI. (Timescales of 30/10/04,30.01.05,31/03/06,15/09/06, 15/11/06 and 30/8/07 not met) Timescale for action 01/07/08 YA37YA37 8 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 YA6YA6 Good Practice Recommendations The registered person should develop the care plans belonging to people living in the home to be more holistic and person centred, in order to build on their individual strengths and abilities, and highlight the support required for promoting their choices and further wellbeing. The registered person should consider extending the use of activities boards in all of the houses, in order to enable people living in the home to choose better the activities they want to do and help them feel more in control of their lives. DS0000002914.V360646.R01.S.doc Version 5.2 Page 23 2 YA12YA12 Fenn Court 3 4 5 YA19YA19 YA22YA22 YA24YA24 6. 7 8 YA32YA32 YA37YA37 YA39YA39 The registered person should ensure Mental Capacity Act training is delivered to staff to enable them to better support the individual rights of people living in the home. The registered person should develop the complaints policy for the service so that people living in the home can understand their rights about this better. The registered person should wherever is safely possible ensure the wishes of people living in the home for their bedroom and bathroom doors to be locked to maximise respect for their privacy and dignity. The registered person should ensure that 50 of care staff achieves NVQ 2. The registered person should ensure the management team receive appropriate training to support their role. The registered person should develop and formalise the home’s Quality Assurance systems to ensure feedback is obtained from stakeholders and that an annual development plan is developed from this. Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 24 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 Fenn Court DS0000002914.V360646.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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