Care Home: Hurlfield View

What the care home does well The service was very good at managing people`s medication. The procedures were clearly followed, even though the task was often more complicated because of nature of the service. The direct audits and supervision of procedures means people receive their medication as prescribed. Staff receives regular training to update their competencies. Relatives said, "the service provided support to carers, was very good, especially attending carer group meetings". "Staff was always helpful; staff phones me and put my husband on the phone so I can still keep in contact". "We were offered a weeks stay and my relative really enjoyed the stay so now I am not worried". Mealtimes were well organised with people given discreet support where needed. People said the food provided was excellent, and there were always second helpings offered. The atmosphere within the home was calm and people appeared to be relaxed, indicating they were happy with how they were cared for. Opportunities for staff to access training were excellent. Staff confirmed that dementia care training was essential to their role. Robust recruitment procedures ensure people who use the service remain safe. The home had a stable staff group who had worked at the home for a number of years. They were motivated, enthusiastic and well trained, and relatives confirmed that the service was excellent. The team is led by a registered manager, who encourages staff to be involved in promoting an excellent service. What has improved since the last inspection? Since the last inspection staff had improved the way they gather information about people`s interests and hobbies. Staff said it helped to understand how to support people who were no longer people`s lifestyle before they became more dependants. What the care home could do better: The way that activities were organised could be improved by appointing an activity co-ordinator. The home has excellent facilities to provide activities although they were not used to their full potential. The secure garden area was overgrown and untidy which means people would not be able to move around the area safely. Staff could improve areas around the home with better signage, which was suitable for people with dementia. This would enable people to move around the home and orientate themselves to where their bedroom and communal areas were situated. CARE HOMES FOR OLDER PEOPLE Hurlfield View 203 Gleadless Common Sheffield S12 2UU Lead Inspector Valerie Hoyle Key Unannounced Inspection 23rd June 2008 09:15 X10015.doc Version 1.40 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 Hurlfield View DS0000067343.V366358.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 Older People. 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. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hurlfield View Address 203 Gleadless Common Sheffield S12 2UU 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) 0114 239 9633 0114 239 1573 sarah.burley@sct.nhs.uk None Sheffield Care Trust Miss Sarah Louise Burley Care Home 16 Category(ies) of Dementia (16) registration, with number of places Hurlfield View DS0000067343.V366358.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 category: Dementia - Code DE The maximum number of service users who can be admitted to the home is: 16 2nd July 2007 2. Date of last inspection Brief Description of the Service: Hurlfield View is purpose built single story building which provides 14 flexi beds and 2 permanent beds for older people who have dementia and two step-down beds, which are linked with the hospital. The home also has a 20 place day centre. The home is operated by Sheffield Health Care Trust. There are sixteen bedrooms none of which are en suite. There are sufficient bathrooms and toilets. There are three communal lounges, a dining room and games room. There are accessible secure garden accessible from the two lounge areas. The weekly charges are means tested and as of 23rd June 2008 range from £127.75 to £372 and do not include costs for hairdressing and chiropody. People who use the service and their relatives are able to have access to inspection reports by requesting them from the home. Hurlfield View DS0000067343.V366358.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 that the people who use this service experience excellent quality outcomes. This first key unannounced inspection of this service took place over 5.5 hours starting at 9:15 to 14:45; this included a partial inspection of the home. Three people who use the service, five staff was spoken to during the visit; their views are included throughout the report. The service provides a flexible respite/short stay service and 12 beds were occupied on the day of this inspection. The manager said occupancy remains high throughout the year, with approximately 90 people using the service at some time during the year. Two peoples care plans were looked at and policies relating to medication, complaints, protection of vulnerable adults and handling of people’s monies were looked at. Two staff recruitment and training records were examined to assess how people were protected. Surveys were not used to gather evidence at this inspection, although two relatives were contacted by telephone to gain their views. The registered manager Sarah Burley was appointed as manager in November 2007. She is currently registered and working towards achieving the Registered Managers Award (RMA) and continues to develop her own knowledge and experience by attending training within the organisation. She was sent the AQAA, this was returned to us before the time requested, which demonstrates responsiveness and cooperation. An annual quality assurance assessment (AQAA) is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their service. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. The inspector would like to thank everyone who agreed to being interviewed as part of the inspection process, and the friendliness of staff. What the service does well: The service was very good at managing people’s medication. The procedures were clearly followed, even though the task was often more complicated Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 6 because of nature of the service. The direct audits and supervision of procedures means people receive their medication as prescribed. Staff receives regular training to update their competencies. Relatives said, “the service provided support to carers, was very good, especially attending carer group meetings”. “Staff was always helpful; staff phones me and put my husband on the phone so I can still keep in contact”. “We were offered a weeks stay and my relative really enjoyed the stay so now I am not worried”. Mealtimes were well organised with people given discreet support where needed. People said the food provided was excellent, and there were always second helpings offered. The atmosphere within the home was calm and people appeared to be relaxed, indicating they were happy with how they were cared for. Opportunities for staff to access training were excellent. Staff confirmed that dementia care training was essential to their role. Robust recruitment procedures ensure people who use the service remain safe. The home had a stable staff group who had worked at the home for a number of years. They were motivated, enthusiastic and well trained, and relatives confirmed that the service was excellent. The team is led by a registered manager, who encourages staff to be involved in promoting an excellent service. What has improved since the last inspection? What they could do better: The way that activities were organised could be improved by appointing an activity co-ordinator. The home has excellent facilities to provide activities although they were not used to their full potential. The secure garden area was overgrown and untidy which means people would not be able to move around the area safely. Staff could improve areas around the home with better signage, which was suitable for people with dementia. This would enable people to move around the home and orientate themselves to where their bedroom and communal areas were situated. Hurlfield View DS0000067343.V366358.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. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service and their representatives were provided with information they needed to choose a home that can meet their assessed needs. Intermediate Care is not provided at the home. EVIDENCE: Social Services or Sheffield Health Trust were responsible for the assessment of people who use the service. The nature of the service means that people may use the service for short, medium or longer term care. This enables carers to have a break from caring for their relative. Admission can also take place at short notice following a discharge from hospital or breakdown in the home environment. The manager said that no admission was accepted without a full needs assessment, although they do not generally visit people prior to admission. Two assessments were looked at that confirmed peoples needs could be met. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 10 Since the last inspection the staff gather more information about the social and lifestyle interests which helps staff to understand the person prior to their admission. One relative said the information provided helped to understand what the service could offer. The relative said although she was worried about using respite services, Hurlfield View provided the help needed to give a welcome break. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10, People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provided good information to protect people who use the service. Medication policies and procedures were well managed, which ensures the safe administration of medicines. EVIDENCE: Two care plans were looked at; these were well written and provided sufficient information to enable staff to meet the needs of the people who use the service. The care plans include regular evaluations, and daily records assess the individual’s progress. Comprehensive risk assessments ensure people can maintain their independence, while remaining safe. The care plans were reviewed regularly, usually before the following stay commences. Families and carers were involved in this process, which means care was appropriate. A relative was able to confirm that she had been asked about her mums care needs. People received personal and healthcare support using a person centred approach with support provided, based upon the rights of dignity, equality, Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 12 fairness, autonomy and respect. Personal healthcare needs including specialist health; nursing and dietary requirements were clearly recorded in the care plans looked at. Arrangements for people to receive their prescribed medication were quite complicated because people only stay at Hurlfield View for short periods. Sometimes people arrive with their medication in a monitored dosage system arranged by their local pharmacist but frequently medication arrives in original bottles and packets. All medication was checked and new prescriptions ordered if needed. Because medication was so variable there were more stringent monitoring systems in place to ensure people receive the correct medication. Medication was kept in a locked trolley or fridge in a locked room. Medication audit was carried out and records were clear and accurate, the deputy manager also undertakes regular audits to ensure procedures were followed. Staff who administers medication have received accredited training and also completes a four module competency booklet over 2 years. This means that staff continues with the development and understanding of policies and procedures. The local pharmacist provides support to the staff and undertakes regular audits to make sure the systems were safe People usually retain their own GP when they come for a short stay but if a GP is needed then the local GP practice was very happy to register people on a temporary basis. Relationships with local district nurses and other health professionals were reported as being very positive and supportive. Throughout this visit staff were seen interacting with people who use the service in a kind manner, they spent time talking to people and were observed knocking on bedroom doors before entering. All people were referred to by their first name and this was agreed in the care plans looked at. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People had limited opportunities to take part in activities during their stay at the home and mealtimes were well managed. EVIDENCE: Staff had improved the way they gather information to meet the social and emotional needs of people who use this flexible service. A daily task sheet was used to inform how people spend their leisure time. Sing-a-longs and watching television was offered during this inspection, although staff facilitates activities as part of their caring duties. Staff said it was not always possible to offer structured activities due to the demands of admitting and discharging people who use the service. The homes quality assurance systems has identified that this was an area of further development. A games room provides excellent facilities to provide quality activities. This would require a more structured approach to ensure it is used to it’s fully. Relatives confirmed that people were able to take part in activities, although this area could be improved further. One relative said I have visited when staff were sat with the residents reading newspapers to them and on other occasions they were having a sing-song. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 14 People who use the service were able to maintain contact with relatives while staying at the home. Relatives confirmed that they were able to telephone the home and speak to their relative, and they are encouraged to escort their relative on admission to the home. They said it helped settle their relative into the home. Mealtimes were well managed and the food nicely presented. People said they enjoyed all of the meals provided, as the cooks were very good. One person said they enjoyed the food so much they would like to have the food delivered to them in their own home. Staff were available to give assistance where needed, and the atmosphere throughout the meal was pleasant with people being offered second helpings. The dining area was big enough to seat the people currently using the service, although it would be difficult to accommodate people in wheelchairs or with other walking aids. The staff said the games lounge was used on those occasions. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were able to express their concerns, and have access to a robust, effective complaints procedure, and were protected from abuse, and had their rights protected. EVIDENCE: The home had a complaints procedure that was available to people and visitors. The procedure was also referred to in the information given to new people, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection was included in the procedure, although the address and telephone number needed to be updated. The manager confirmed that no complaints had been made in the last twelve months. Relatives confirmed that they were aware of the complaints procedure and who to speak to if they had a concern. One person said they had made a complaint a long time ago and it was dealt with immediately, to their satisfaction. The policies and procedures regarding safeguarding of people were of a high quality and were regularly reviewed and updated. The manager was clear when incidents need external input including who to refer the incident to. The manager said, staff receives regular training to update their knowledge. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 22, 26 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are provided with a clean, comfortable environment and there were sufficient staff to maintain good hygiene standards. EVIDENCE: Hurlfield View was purpose built a number of years ago and has had some adaptations in order for it to meet the needs of the people who stay there. The building is shared with a day centre and office space for staff. There are keypad entries systems throughout the building which help keep people safe but allow them space to move about freely. None of the bedrooms are en suite but there are sufficient bathrooms and toilets located close to communal and bedroom areas. Although most people do not stay for long periods at Hurlfield people are still encouraged to bring their own possessions with them to personalise their bedroom. The staff have addressed recommendations made at the last inspection to improve the way peoples bedrooms were identified. Small white tiles are now Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 17 used to identify the person using the room. The inspector discussed with the manager how signage around the home could be improved, which would make it easier for people to find their way around the home. The garden area in the centre of the home provides a safe area for people to sit in. It was overgrown and untidy and did not provide a safe area for people to spend their time. The manager had made contact with the company who maintains the area, although they had not acted on her requests, at the time of writing of this report. The home is kept spotlessly clean so that the risk of people becoming ill from poor hygiene is unlikely. The home was free from offensive smells for the duration of the inspection and made the environment pleasant. Hand wash scrub, gloves and aprons are available throughout the home so as to minimise the risk of cross infection from one person to another. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff had the skills and knowledge to fulfil their roles within the home, and there was a stable staff group. Recruitment policies were followed ensuring the safety and protection of people who live at the home. EVIDENCE: Staff rotas and observation during this visit show there were sufficient staff to meet the needs of people who use the service. Staff were deployed to work in the two areas of the home, and the manager has authority to increase staffing to meet the needs of the service. There were robust recruitment and selection procedures that ensure people who use the service are safe and protected. A number of staff recruitment files were examined, and there was evidence that all the required employment checks have been undertaken prior to commencing work at the home. The staff had excellent opportunities to access training, they said training was ongoing throughout the year, and they found service specific training valuable when caring for people with dementia. A number of staff had accessed a vocational award in dementia awareness and there were further plans to extend the training to other staff. Staff continues to work towards achieving NVQ qualifications, although they do not meet the required 50 of staff obtaining the award. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were protected by sound management practises, and their views were actively sought to improve the service. The financial interests of people were safeguarded, and good health and safety procedures ensured they are protected. EVIDENCE: The manager has a wealth of experience and knowledge and was able to demonstrate her ability to manage the home. She was appointed into her current position in November 2006, although she had worked for a number of years as deputy manager. She continues to work towards achieving the RMA (Registered Managers Award) and also hold an NVQ assessors award. She operated an open door policy to ensure she was accessible to staff and people Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 20 that use the service. Relatives and staff spoke highly of the manager and said she was very caring, well organised and competent. Staff and group meetings ensured that staff were informed about training opportunities and the day to day running of the home, they were also encouraged to be involved in decision making. People who use the service were unable to manage their own finances due to limited capacity. A number of peoples financial records were examined, the records were accurate and there were clear auditing procedures to ensure peoples monies are managed in their best interests. Quality systems were in place, and the home ensures that people’s views were gained. Staff are commended for their efforts in maintaining an excellent service. The views of people who use the service were difficult to gain using a survey due to their limited capacity; therefore staff discuss the quality of care provided with visitors and relatives. Completed relative surveys were looked at and all described the service as very good. Accident reports were analysed by the manager to ensure risk assessments were developed where required. Maintenance and service records examined were up to date and current to the services provided. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Staff training was excellent and ensures that staff have the right skills to follow health and safety procedures. Fire safety procedures are in place and service records were looked at and were current, ensuring the safety of people who use the service. Hurlfield View DS0000067343.V366358.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 4 3 X 3 X X X X 3 STAFFING Standard No Score 27 4 28 3 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 4 X X 4 Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP12 OP19 OP22 OP28 Good Practice Recommendations Consideration should be given to appoint a dedicated activity co-ordinator to promote social activities for people who use the service. The secure garden should be better maintained to ensure it is safe for people to spend their time. Signage around the home could be improved, to make the environment more conducive to people with dementia. 50 of staff should been qualified to NVQ Level 2. Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 23 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 Hurlfield View DS0000067343.V366358.R01.S.doc Version 5.2 Page 24 - 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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