Care Home: Laurence House

What the care home does well The admission procedure is thorough, making sure the home can meet people`s needs before offering them a place. The staff understand the needs of the people who live at the home and know how to look after their health and well-being. This is reflected in the care plans, which are drawn up and reviewed with the person and/or their relatives. People are treated with respect and their dignity is maintained. One relative said he is `..happy with the place` and would not hesitate to recommend Laurence House to anyone. Relatives said that the staff keep them up to date with everything that happens and consult them about any changes.The home`s recruitment procedures are thorough and all the necessary preemployment checks are carried out, to make sure staff are suitable to work with the people who live at the home. There is a comprehensive staff training programme; to make sure staff have the necessary skills and knowledge to help them do their job well. What has improved since the last inspection? The Statement of Purpose and Service Users` Guide have now been updated, to better reflect the services the home offers. The medicines administration and recording systems have improved and are generally safer and more accurate than before. The care plans are being reviewed regularly to make sure they are up to date, and the individual and/or their relatives are involved. Risk assessments are now being carried out, in order to assess any potential risks for people and to determine how these can be minimised. This includes assessments and plans for people who are at risk of developing pressure sores. The home has started up a `Carers` group that meets regularly and gives support to the carers of people who live at the home. There is an improved programme of activities, co-ordinated by someone who is employed for this purpose. The numbers of staff on duty have been increased, to meet people`s care and support needs. The registered provider`s representative makes regular quality monitoring visits to the home and produces a report on their findings. People whose personal finances are held for them by the local authority are now having interest on savings itemised in a separate accounting system. CARE HOMES FOR OLDER PEOPLE Laurence House 5 Cliffe Road Bradford West Yorkshire BD3 0JP Lead Inspector Liz Cuddington Unannounced Inspection 13th June 2008 11:20 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 Laurence House DS0000033600.V366518.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. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Laurence House Address 5 Cliffe Road Bradford West Yorkshire BD3 0JP 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) 01274 641367 01274 627147 christine.harrison@bradford.gov.uk City of Bradford Metropolitan District Council Department of Social Services Christine Harrison Care Home 29 Category(ies) of Dementia (1), Dementia - over 65 years of age registration, with number (29) of places Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories 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 Dementia - Code DE and Code DE(E). The maximum number of service users who can be accommodated is 29. The place for DE is specifically for the service user named in the application for variation dated 14 March 2004 5th July 2007 2. 3. Date of last inspection Brief Description of the Service: Laurence House is a single storey, purpose built Local Authority residential and day care resource centre for older people with dementia. In addition to day care, the home provides residential and respite care, without nursing, for 29 men and women. Day care is not regulated and therefore is not inspected. The residential part of the home has a shared central lounge and lounges, dining rooms and bedrooms in three different wings of the house. The layout of the home makes it easy to get to all wings from the central lounge. Digital locks are fitted around the home and on all exit routes, making sure that people are safe. Bus stops are nearby and there is a small car park at the front of the home. Nearby there are shops, chemists, pubs and a local park. At the time of the visit weekly fees were from £102.90 for respite care and £435.68 for a permanent place. These charges do not include hairdressing, chiropody and other personal expenses. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. The purpose of the inspection was to assess the quality of the care and support received by the people who live at Laurence House. The inspection process included looking at all the information we have received about the service since the last key inspection in July 2007. We also made an unannounced visit to the home for a day. Since the last key inspection no complaints or adult protection referrals have been made to us. The methods used to gather information during the visit to the home, included conversations with the people living at the home, their relatives and the staff, as well as looking at care plans and examining other records. We received the home’s completed self-assessment questionnaire. This provided valuable information to help us form a judgement about the quality of the care and support the home provides. We would like to thank the people who live at the home, their relatives and the staff, for their welcome and hospitality and for taking the time to talk and share their views during the visit. What the service does well: The admission procedure is thorough, making sure the home can meet people’s needs before offering them a place. The staff understand the needs of the people who live at the home and know how to look after their health and well-being. This is reflected in the care plans, which are drawn up and reviewed with the person and/or their relatives. People are treated with respect and their dignity is maintained. One relative said he is ‘..happy with the place’ and would not hesitate to recommend Laurence House to anyone. Relatives said that the staff keep them up to date with everything that happens and consult them about any changes. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 6 The home’s recruitment procedures are thorough and all the necessary preemployment checks are carried out, to make sure staff are suitable to work with the people who live at the home. There is a comprehensive staff training programme; to make sure staff have the necessary skills and knowledge to help them do their job well. What has improved since the last inspection? What they could do better: The home should continue with the improvements to the care plans, in order to make them clearer and easier to use. The controlled drugs record book must have two staff signatures each time a dose is administered. A ‘brought forward’ system of recording amounts of medicines that are carried forward from one record chart to the next should be implemented, in order to keep an accurate account of all medicines kept in the home. Laurence House DS0000033600.V366518.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. Laurence House DS0000033600.V366518.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 Laurence House DS0000033600.V366518.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): 1&3 Standard 6 does not apply 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. The home’s information details the services the home offers. People are assessed before they are admitted to the home to make sure their needs can be met. EVIDENCE: The Statement of Purpose and Service Users Guide have been updated, to better reflect the range of services the home offers. People said that they were given enough information about the home before deciding to move in, and they have also received a contract. The care plans include pre-admission assessments completed by the home and Social Services. Before offering someone a place, a senior member of staff will Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 10 visit the person at home or in hospital to talk to them and make sure that Laurence House can meet their needs. The home also invites people to come and spend time at the home if they are able to. This means that the home can get to know the person’s needs and the individual has the information he or she needs to make a decision. Laurence House DS0000033600.V366518.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. People’s personal and healthcare needs are met. People are protected by the medication systems. Staff treat people with respect, care and consideration at all times. EVIDENCE: Three care plans were looked at, to make sure that people’s health and personal care needs are being met in the way the person prefers. The plans are well organised and cover each area of the individual’s health and care needs. They all contained information to guide staff in how to care for and support each individual. Some had photographs of the person on the front page. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 12 From observation and discussions with staff and people living at the home, it was clear that the staff are aware of each person’s needs and preferences. The staff make sure they provide the help people need in the way they prefer. People said that they receive the medical and healthcare support they need. People’s relatives also said that they thought the care staff provide a good level of care and support and understand the individual’s care needs. People who need assistance with their mobility have a moving and handling plan. Where they are needed, pressure relieving cushions and mattresses are used. This makes sure that when people’s skin is delicate, any risk of soreness is minimised. Everyone has an assessment of their nutritional needs, their ability to maintain their independence, and any continence issues they may have, as well as assessments of other health and care needs. Records of visits by GPs and other healthcare professionals are kept. The care plans are reviewed regularly and showed that, where possible, the individuals and their families are involved in developing and reviewing the plans. The relatives said that regular reviews of care plans take place with family members. Relatives said that the staff keep them up to date with everything that happens. They said that they are informed straight away about any health concerns and the home consults them when outside health professionals need to be involved. The Deputy Manager is in the process of re-organising all the care plans, to make them clearer and easier to follow. At present there is a lot of information in the individual files. Much of it could be stored separately as it does not all relate to people’s current care and support needs. Some of the information in the plans was not up to date. For example, there was no information about the changes to one person’s ability to eat. This should have been recorded and an action plan put in place to show what steps were being taken to address and improve the situation. Another person’s plan had not been updated since a major change had occurred that had caused improvements to their well-being. The home has recently set up a ‘Carers’ Group’ that meets regularly to offer support to the carers of the people who live at the home. The deputy manager said the results of this were good and it has given some people the confidence to take their family member home for the weekend, knowing that the home’s staff are available to help them at any time of the day or night, should they need it. The inspection visit was on a Friday and during the afternoon two Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 13 people went home for a few days. People’s relatives also said they thought the group was a good idea. The medicines are kept safe and secure and the Medicines Administration Record (MAR) charts are securely stored. Most of the medicines are supplied by the pharmacy in a monitored dosage system, but some is kept in the original packaging. The MAR charts, which must show clearly the quantities of medicines received and in stock for each person, were examined. The records of amounts received, administered and left in stock of some medicines supplied in their original packaging, did not always agree. For example, one record showed different numbers of tablets in stock than there were in the packages. In this instance the discrepancy was small. However, it is important that all medicines records are completely accurate so that staff can account for all the medicines received and administered and people are confident they are receiving their medicine exactly as prescribed. In order to keep an accurate record of the medicines that are supplied in their original packaging, a ‘brought forward’ system should be put in place. This would show the quantity of any medicines that are carried forward from one four-week MAR chart to the next, in addition to any new supply of the medicine. The medicines supplied in the monitored dosage system appeared to be administered and recorded accurately. There were signatures to confirm that staff had administered the medicine. The controlled drugs record book should have two people’s signatures to confirm the amounts of these drugs that have been administered and how many are left in stock. There were some signatures missing. During the visit, all the staff were seen to treat people with respect and maintain their dignity. The people who commented said that they receive the care they need and are supported to maintain their independence for as long as they are able. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 14 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 are supported to take part in a range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. EVIDENCE: The atmosphere at the home is calm and friendly and families and friends are always welcome to visit. People are treated as individuals, and their choices and wishes are respected. People’s social and leisure preferences are recorded in their care plan, so that staff know what people prefer to do and, where needed, can offer people support to follow their chosen activities. The plans included a ‘pen picture’, which gives staff good information about the person and helps them to offer suitable activities that relate to their interests. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 15 An activities co-ordinator works at the home and provides a variety of different activities to keep people interested and occupied. The home aims to offer different activities in the day and in the early evening. These include quizzes, bingo, discussions, singing and reminiscence sessions. Outside entertainers come into the home and people go out to the theatre. A trip to the circus has also been arranged. The meals are very good and everyone seemed to be enjoying their lunch and tea. People said they enjoyed their food. Plenty of drinks are available throughout the day and night and there was fresh fruit in all the small kitchens attached to the three dining rooms. Some people prefer to eat their meals in the lounge or their own room, rather than in the dining room. Some people need assistance to eat. We saw staff offering help quietly and at the person’s own pace. Special occasions are celebrated and one family said the home had put on an ‘excellent party’ to celebrate a special birthday. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 16 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. All of the staff have received suitable training and understand the adult protection policies and procedures, which makes sure that people at the home are safe. EVIDENCE: As Laurence House is owned and run by Bradford Council, the home uses the Social Services’ complaints procedures to handle any concerns or complaints people raise. Any complaints or concerns are recorded in a complaints file. The actions taken and the outcomes are recorded. Staff said they know what to do if anyone has concerns. The relatives said the home always responded appropriately to any concerns. People who live at the home said they know what to do if they have a concern or complaint. One relative said that they would be confident that any concerns would be dealt with effectively, although they had never had any cause for concern so far. Newly employed staff are made aware of the home’s ‘whistle blowing’ policies and procedures, to be used if they suspect abuse or see examples of poor Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 17 practice. The care staff have had adult protection training, and further training is planned. All the appropriate policies and procedures are in place to guide staff. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 18 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, 20, 25 & 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. The home provides a safe, comfortable and well-maintained environment. EVIDENCE: The house is clean and well furnished and the armchairs in the large lounge are arranged in small, sociable groups. The layout of the house gives people plenty of room to walk about safely. Each wing has a different colour theme, to help orientation. Some of the rooms have pictures on the doors, to help people identify the room they want. There is a small, enclosed garden for people to sit in. The home is on the edge of a park and people like to go there if they want a longer walk. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 19 There is an odour in one area of the house, but the reason for this is known and there are plans to prevent this re-occurring. The home has effective infection control measures in place and the house is hygienically maintained throughout. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 20 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are employed to meet people’s needs. People are protected by thorough recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Suitable training is provided to make sure staff have the skills and knowledge they require to meet people’s needs. EVIDENCE: The staff rotas confirmed our observations that there are enough staff on duty to meet people’s care, social and leisure needs. Staff confirmed that staffing levels are adjusted to meet people’s needs. During the afternoon handover period the only member of staff in the main lounge was the activities co-ordinator. He had to leave the activity he was running for a long period in order to find staff to assist someone who was distressed. All staff complete an application form and provide two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 21 register checks are obtained and no new staff begin work until these checks have been completed satisfactorily. Staff have a copy of the terms and conditions of their employment. The staff files are well organised and all the information needed was clear and easily available. Staff said that they have plenty of training opportunities to support them in their roles. They said their training was relevant, helped them understand their role and kept them up to date. The majority of the care staff have completed a suitable National Vocational Qualification (NVQ) in care at level 2 or above. The relatives we spoke to said the staff are competent and provide good care. All new staff take induction and foundation training which meets the Skills for Care criteria. This gives them good training to help them do their job effectively, and provides a sound basis for taking an NVQ course. All the staff have taken adult protection and moving and handling training. The training records show that staff also take all the mandatory health and safety training as well as other courses, including dementia care, infection control and palliative care. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 22 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, 36 & 38 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. The home is safe and well managed. EVIDENCE: The manager and deputy manager have the necessary qualifications and experience to run the home effectively and in the best interests of the people who live there. People’s personal information is securely stored at all times in an office, which is locked when there are no staff around. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 23 The home’s policies and procedures are kept up to date, to make sure they provide relevant information to guide staff on how to act in every situation. All the regular health and safety checks for the home are carried out in a timely manner. These measures make sure that the health, safety and welfare of the people at the home is promoted and safeguarded. Where people’s pensions are paid through Social Services, people have their own bank accounts and the interest on their savings in paid. Any financial transactions carried out on people’s behalf by the home are recorded accurately and receipts are kept. The staff have regular one to one supervision with their line manager, which helps them plan their training and personal development as well as being an opportunity to discuss any work related concerns. A quality assurance questionnaire was sent out to relatives in May this year. There were a lot of responses and the results will be analysed and an action plan developed to make any improvements that people suggest. The results of this will be discussed at the Carers’ Group. The home’s kitchen has recently had an Environmental Health Officer’s inspection. The kitchen was awarded four stars and, when we looked, the kitchen was clean and hygienic. When a significant incident occurs, such as an admission to hospital or the death or of someone who lives at the home, we are always notified. This gives us information about how the home manages such events and confirms that they are being handled correctly, in order to safeguard and promote the wellbeing of the people who live at the home. Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 24 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 25 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. 1. Standard OP7 Regulation 15 Requirement To make sure people’s care needs are met, their care plans must be kept up to date and reflect their current assessed needs. To make sure all medicines are accounted for safely, the controlled drugs book must be signed by two staff. Any medicines carried forward to the next MAR chart must be recorded using a ‘brought forward’ system. Timescale for action 31/08/08 2. OP9 13 (2) 31/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 26 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 Laurence House DS0000033600.V366518.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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