Care Home: Haydock House

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What the care home does well Service users are fully involved in life at the home. There is a relaxed and friendly atmosphere throughout the home and the support workers go about their daily work in a positive and lively manner. The registered manager and the support workers have a very good understanding of the service users current support needs and they provide this support in a respectful and sensitive way. A nutritious and well balanced menu has been devised and staff work hard to ensure that the service users receive a healthy and varied diet. All service users spoken with were satisfied with the support provided and all stated that they liked living at Haydock House. What has improved since the last inspection? A service user guide has been developed which is given to all new service users. An allotment has been obtained and service users are now able to help with growing fruit and vegetables for use in the home. A medical alert booklet has been developed to tell people about Prader-Willis Syndrome. This will be used if a service user has to go to hospital and will inform the hospital staff about the service users condition. An emergency information pack has also been developed for each service user. This again is to be used to inform hospital staff of the service users condition and the risk associated with this. Recreational groups including dance classes and theatre groups have been accessed and mosaic making sessions and nature walks are also now enjoyed. A number of training courses have been accessed for staff and service users have recently completed infection control training. A beautician visits the home on a regular basis to provide massages, nail care and general pampering sessions. What the care home could do better: Remember to record when care plans have been reviewed. CARE HOME ADULTS 18-65 Haydock House 89 Rockingham Road Kettering Northants NN16 9HX Lead Inspector Diane Butler Unannounced Inspection 30th July 2008 09:00 Haydock House DS0000067634.V369296.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 Haydock House DS0000067634.V369296.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. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Haydock House Address 89 Rockingham Road Kettering Northants NN16 9HX 01536 517080 01536 518182 kathrynclarke@btconnect.com www.concensusupport.com Consensus Support Services Ltd 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) Vicky Elaine Hamilton Care Home 8 Category(ies) of Learning disability (8), Mental disorder, registration, with number excluding learning disability or dementia (5) of places Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No person falling within the category of MD, Mental Disorder excluding Learning Disability or Dementia, may be admitted to Haydock House unless that person also falls within the category LD, Learning Disability ie. Dual Disability The maximum number of persons to be accommodated within Haydock House is 8 23rd August 2006 2. Date of last inspection Brief Description of the Service: Haydock house is a large well-appointed property in the town of Kettering. It is registered to support up to eight people. Service users at the home all have Prader-Willi syndrome, which is characterised by a range of symptoms including a compulsion to eat. The home has eight single rooms, all with ensuite showers, a pleasant lounge and dining room and a communal bathroom. Located close to the town centre the home is convenient for all transport networks and a range of facilities. A comprehensive statement of purpose is made available to prospective service user. Current charges range between £1752.33 and £2126.91 with extra charges being made for hairdressing, newspapers etc. A copy of the latest Inspection report is available at the home, or it can be accessed via the CSCI website: www.csci.org.uk. Further information about the home is available from the registered manager. Haydock House DS0000067634.V369296.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 3 star. This means the people who use the service experience excellent outcomes. This was an unannounced visit, which took place over a five and a half hour period in July 2008. The registered manager was on duty on the day of the visit. When undertaking key inspections the Commission for Social Care Inspection (CSCI) focuses upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the support they received through looking at their records and speaking with them. Staff on duty at the time of the visit were also spoken with. A further two service users also gave their views about living at Haydock House. Comments received during the visit included: “It’s a good place to live”. “I get lots of exercise and healthy eating”. “I like it here, I have my own room which is very nice”. “It’s a really nice place to work”. “I love it, it’s the best thing I’ve ever done”. Further planning for this visit included checking the service history of the home and the last Inspection report and looking through the AQAA document (Annual Quality Assurance Assessment), which was submitted to the Commission for Social Care Inspection prior to the visit. The AQAA document is the main way that providers inform us of how well their service is delivering good outcomes for the people using it. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Remember to record when care plans have been reviewed. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 7 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. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 8 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 Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users needs are appropriately assessed before moving into the home to ensure that their support needs can be met. EVIDENCE: A Statement of Purpose is in place. This document includes details of the services that can be provided and what training the staff have completed. A service user guide is also in place and copies of both of these documents are given to each service user when they arrive at the home. The Service user guide, which has been developed since the last inspection visit includes information on local amenities and how the staff will support the service users once they are living at Haydock House. One of service user spoken with confirmed that he had received all the relevant information before moving into the home. The registered manager explained that an assessment of need is obtained for all prospective service users and information is gathered from relatives and other parties who support the service user to ensure that they receive as much information as possible. This is then looked at very carefully to ensure that the needs of the service user can be met. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 10 On checking the paperwork belonging to three service users it was evident that assessments had been obtained and staff were well aware of the needs of the service users prior to them moving into Haydock House. All prospective service users are invited to look around the home and stay for a meal or join the other service users on a trip out, this enables them to get a feel of the home, meet the other service users and to decide whether it is the right place for them to live. Prospective service users can visit the home as many times as they wish in order to get to know the staff and the other service users and a three month assessment period is always offered. Comments received included: “I had a look around before I came”. “Yes they gave me some papers and I gave them to my mum”. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 11 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): 6,7,8,9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users are consulted on, and participate in, all aspects of life in the home. EVIDENCE: Comprehensive care plans are in place. These are developed from the initial assessment information collected prior to the service user moving into Haydock House and during the three month assessment period. All three files checked had care plans in place, these cover the health, personal and social care needs of the service users and their likes and dislikes within daily living. A personal history section is also completed which gives the reader a really clear picture of the service user and the types of support they need. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 12 The registered manager explained that the service users key worker reviews the care plans every three months with the involvement of the service user every six months. The registered manager also carries out monthly reviews to check that they remain up to date and accurate. All service users spoken with confirmed that they were involved in developing their care plan and those checked had been signed by both the service user and key worker. It was noted that two of the care plans had not had a monthly review since May. Support workers enable the service users to take responsible risks on a daily basis both in the home and in the local community. Risk assessments are carried out for all activities undertaken and where a risk is identified measures are put into place to try to reduce the risk for the service user. Service users are fully involved in life at the home. Issues that arise are discussed on a daily basis and service user meetings are held every month. Minutes of the last meeting held on 25th June were seen. Service users are enabled to live an independent life style within the home and support workers support the service users to identify and meet their individual goals. Goals are recorded within the care plan documentation and are reviewed at regular interviews to check that they are being met. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Service users are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: All service users living at Haydock House are encouraged and supported to attend local colleges and day services. When these are not available such as during the summer holidays individual timetables are devised to ensure that activities are provided on a daily basis. On the day of the visit all the service users enjoyed a session at the Gym and Line dancing classes were to be attended in the afternoon. On checking the service users weekly planner and on speaking with the service users it was evident that they are well supported to access other community and leisure activities. These include supporting service users to go shopping, Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 14 regular trips to the swimming pool and tin pin bowling rink, visiting pubs and attending the local church. Trips out are also organised. Service users are able to choose where they wish to go and two vehicles are available for use. Trips arranged for this week include a trip to Wickstead Park and Stanwick Lakes and tickets have just been bought for all the service users to go to a Girls Aloud concert in August. Key Worker sessions are provided; these enable the service users to take part in individual activities/trips with a member of staff. On checking the records for three service users it was noted that Key workers had supported them to visit Grafham Water, attend a football match, visit the zoo and go to the cinema. One service user explained: I’m going to the museum, that’s my choice”. Daily routines in the home promote privacy, independence and choice. Service users can choose whether to be alone or join the other service users. All service users have keys to their bedroom doors and support workers ensure privacy by knocking and waiting to be invited in. All are encouraged and supported to clean and tidy their own rooms and all have the opportunity to attend baking sessions with the support workers. One service user explained: “I clean my room on Saturdays, but they do my shower for me”. The registered manager explained that contact with family and friends is strongly encouraged. This was evident as two service users were visiting their families on the day of the visit. The home specialises in caring for service users with Prader-Willis Syndrome and much effort is made to ensure that a healthy balanced diet is offered. A calorie controlled diet is provided and whenever possible food is home cooked to ensure that the service users receive only wholesome and nutritious meals. Service users are consulted with regard to the meals that are offered and once devised the menus are sent to the dietician to ensure they are suitable for the service users living at Haydock House. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users are looked after well in respect of their health and personal care. EVIDENCE: Service users are encouraged to be as independent as possible and support is offered in a relaxed and sensitive manner. Preferences regarding the delivery of support are included in the care plan documentation and service users spoken with felt that they were treated and supported well. One service user explained, “The staff are very good”. On checking daily records it was evident that the registered manager and the support workers enable the service users to access healthcare services when needed. Services contacted on their behalf included GP’s, community nurses, dentists, opticians and chiropodists. Each service user has a key worker and time is given for each key worker to spend one to one time with the service users. Service users choose what they wish to do and the support worker enables this. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 16 All support workers receive training on Prader-Willis Syndrome and all spoken with were well aware of the condition and symptoms that this condition presents. Support workers are alert to changes in the moods and behaviour of the service users and are aware of how to respond to this and the best action to take for each individual. Medication records were checked. Medication had been appropriately signed into the home and medication had been signed for when given to the service users. All support workers have received training in administration of medication and medication was being appropriately stored. It was evident on the day of the visit that the registered manager was having trouble regulating the temperature of the medication cupboard due to the temperature of the office it is held in. This had been shared with the organisations health and safety officer and it was agreed on the day of the visit to purchase an air conditioning unit to help regulate the temperature. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users feel safe and are protected from harm. EVIDENCE: A complaints procedure is in place and copies of this are displayed within the home. Details of how to make a complaint are also included in the statement of purpose and service user guide documents, which are given to each service user on moving into the home. The complaints procedure is also available on tape for those service users unable to access the paper copy. One complaint has been made in the last twelve months. On speaking with the Deputy Divisional Manager it was evident that this was investigated appropriately and actions were taken to address the issue raised. All service users spoken with during the visit were aware of whom to speak to if they had any concerns and all were confident that any concern would be taken seriously and appropriately dealt with. One service user explained: “I would talk to my key worker” a second stated, “I would talk to Vicky [registered manager] or xxxx [senior support worker] or my key worker”. All support workers attend training in the protection of vulnerable adults during their induction period and regular updates are also provided. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 18 The registered manager is aware of the procedures to follow to ensure that the service users in her care are protected and all support workers spoken with during the visit were aware of the actions to take, should they suspect any form of abuse. All service users spoken with said that they felt safe living in the home. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The standard of accommodation within the home is extremely good, providing the service users with a comfortable and homely place to live. EVIDENCE: The areas of the home seen on this occasion were well maintained and suited to the service users needs. Decoration is of a very good standard and furnishings in the communal areas are domestic in character and in very good condition. All bedrooms are single and offer ensuite facilities. These include a toilet, sink and shower area. Seven of the eight bedrooms were seen. All were clean, highly personalised and furnished appropriately. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 20 There is an attractive garden and patio area for the service users and their visitors to enjoy. Communal facilities include a large lounge and dining room and a communal bathroom with toilet facilities is also available. Due to the service users having Prader-Willis Syndrome access to the kitchen facilities is only available when support workers are around. The home is clean and fresh. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Service users living at Haydock House are supported by competent and qualified staff. EVIDENCE: There are currently two support workers on duty between the hours of 7.30am and 9.30pm and one sleep in staff member between the hours on 9.30pm and 7.30am to provide support for the eight service users living at the home. A housekeeper and cook are also employed each day. On speaking with the support workers on duty during the visit all stated that this was sufficient to meet the current needs of the service users in their care. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 22 A thorough recruitment procedure is in place, application forms are completed, references are collected and a POVA 1st (Protection of Vulnerable Adults) and CRB (Criminal Records Bureau) check are obtained. On checking two support workers files it was evident that all the necessary checks were in place. A comprehensive induction programme is in place. This is carried out over a four-week period and includes training in first aid, moving and handling, food hygiene, infection control and fire safety. Training in the administration and handling of medicines and protection of vulnerable adults is also provided. All staff receive training on Prader–Willis Syndrome during their induction to ensure they have the knowledge and understanding of the condition and all staff are required to complete the learning disability qualification (LDQ). A period of shadowing an experienced member of staff is also provided so that new staff are aware of the support workers role and what is expected of them. A training officer is employed to ensure that all required and relevant training is provided and on checking the training records it was evident that an ongoing training programme is in place. Supervision sessions are provided on a monthly basis to provide ongoing support to all staff and staff meetings are also held. Minutes of the last meeting held on 17th June 2008 were seen. All spoken with during the visit stated that they felt supported by the management team and there was always someone they could talk to if they had any concerns or issues of any kind. Comments received included: “You are very supported here”. “The management is always available, you can call them any time”. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home. EVIDENCE: The day to day running of the home is carried out by the registered manager with the support of the senior support worker. The registered manager has completed her NVQ Level 4 and Registered Managers Award and the senior support worker is currently completing her NVQ level 4. Policies and procedures for the health, safety and welfare of the service users are in place and all support workers are made aware of these during the induction process. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 24 Service user meetings are held on a monthly basis, this enables the service users to share their views on the service provided. Staff meetings are also held to enable the registered manager to gain the staffs view of the service they currently provide. Surveys are also used to gather service users views of the home Appropriate records for the safe keeping of service users money are in place, two signatures are obtained for any transaction carried out on the service users behalf to ensure that their finances are safeguarded. It was evident during the visit that the service users benefit from the ethos and management that is provided by the registered manager and her team. There was a friendly atmosphere throughout the visit and the interactions between support workers and service users were relaxed and informal. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 4 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 3 3 X X 3 X Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 26 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. 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 YA6 Good Practice Recommendations The registered person should ensure that when care plans are reviewed this is recorded to demonstrate that this has been done. Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Haydock House DS0000067634.V369296.R01.S.doc Version 5.2 Page 28 - 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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