Care Home: Lomack Lodge

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What the care home does well Residents expressed a good level of satisfaction with respect to the quality of care and support they receive. Their views including those of staff have been reflected throughout the report. Good assessments are carried out before people are admitted to the home. Lomack Lodge provides residents with a good standard of care in a comfortable environment. Activities to suit the taste and preference of residents are facilitated and this maintains a good level of stimulation. Relationships between the staff and the residents were positive. Staff appeared committed and they demonstrated a thorough awareness of the identified needs of each resident including equality and diversity issues. We saw that staff were very polite, helpful and caring towards the residents and were assisting people in a sensitive, dignified and appropriate manner. The meals provided at the home are of a good quality and residents like them. An alternative is offered if something is not liked. Menu planning takes place weekly and residents’ taste and preference is well catered for. There is a number of care and staff management systems including health and safety in operation; these are being implemented to good effect.Lomack LodgeDS0000067214.V367856.R01.docVersion 5.2 What has improved since the last inspection? The requirements made in the last inspection report dated 29 August 2007 have been addressed; this has resulted in an overall improved quality of service for residents. Each resident has been provided with a statement specifying the terms and conditions of residence. These have been signed and dated by the resident and their representative. This ensures that the rights of people living at the home are upheld. Each resident has a care plan reflecting a good level of information. This enables staff to satisfactorily meet the agreed needs of the people who use the service. Risk assessments for all residents are now in place to protect them from harm or abuse. Risk assessments for the environment and safe working practices have also been developed. Staff training and future development plan (for all staff) to incorporate induction, mandatory, specialist and NVQ training has been introduced. All staff receive regular supervision. What the care home could do better: There is one requirement and one recommendation arising from this report, which need addressing. Staff recruitment files must include a recent photograph as detailed in Schedule 2 of the Care Homes Regulations 2001. The name and signature of the resident and their representative should be included in the care plan. This would demonstrate their participation and agreement with its content. CARE HOME ADULTS 18-65 Lomack Lodge 10 St Georges Street Bedford Bedfordshire MK40 2LS Lead Inspector Mr Neil Fernando Unannounced Inspection 9th July 2008 10:00 am Lomack Lodge DS0000067214.V367856.R01.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 Lomack Lodge DS0000067214.V367856.R01.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. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Lomack Lodge Address 10 St Georges Street Bedford Bedfordshire MK40 2LS 01234 844031 01234 840094 cbrennan@lomackhealth.co.uk 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) Lomack Health Co Ltd Mr Stewart Wayne Simpson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th August 2007 Brief Description of the Service: Lomack Lodge is a small home for seven people with learning disabilities. The building is a detached house; it offers seven single bedrooms with en suite WC and shower and one room has a bath instead of a shower. The ground floor has two bedrooms and there are four bedrooms on the first floor, and one on the second floor. The home has a pleasantly decorated lounge, dining room and a kitchen. There is a communal laundry room on the first floor with a good size washing machine and dryer. There is a tarmac drive leading from the front to the rear of the house. The home has a garden with a table and chairs, which the residents use during the warmer weather. The home is not suitable for people who are wheel chair users. A copy of the last inspection report is kept in the office and is available to residents, visiting families and professionals. The charges for care range from £1300 a week; the fees are negotiable and depend on the assessed needs of each resident. Lomack Lodge DS0000067214.V367856.R01.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. We, the Commission for Social Care Inspection, undertook this unannounced key inspection on 9 July 2008. We spoke with two residents, the manager and 3 staff including a senior member. We spent a significant amount of time discretely observing residents and staff care practices. We had a look round the accommodation and viewed a range of records the home must keep. At the time of the visit, there were three residents accommodated with four vacancies. The “AQAA” (Annual Quality Assurance Assessment - a document, which gives the manager the opportunity to tell us how well outcomes are being met for people living in the home) has been sent to the manager but we have not received this as yet. Any information received would be dealt with as appropriate. We have received surveys from two residents and three staff members. The manager was present throughout the inspection. What the service does well: Residents expressed a good level of satisfaction with respect to the quality of care and support they receive. Their views including those of staff have been reflected throughout the report. Good assessments are carried out before people are admitted to the home. Lomack Lodge provides residents with a good standard of care in a comfortable environment. Activities to suit the taste and preference of residents are facilitated and this maintains a good level of stimulation. Relationships between the staff and the residents were positive. Staff appeared committed and they demonstrated a thorough awareness of the identified needs of each resident including equality and diversity issues. We saw that staff were very polite, helpful and caring towards the residents and were assisting people in a sensitive, dignified and appropriate manner. The meals provided at the home are of a good quality and residents like them. An alternative is offered if something is not liked. Menu planning takes place weekly and residents’ taste and preference is well catered for. There is a number of care and staff management systems including health and safety in operation; these are being implemented to good effect. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 1, 2, 4 and 5 Quality in this outcome area is good. Information available about the home helps prospective residents decide whether or not the home is where they wish to live. Their needs are thoroughly assessed and this ensures a place is only offered to the resident whose needs it can meet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose and service user’s guide have been reviewed and updated by the manager. They are in pictorial form and suitable for residents with learning disabilities. Evidence shows that a copy of the service user’s guide is provided to the resident and their representative. All referrals are made through the local authority. Care files for all three residents show that when the home receives a new referal, a detailed assessment of needs is completed involving the manager, potential resident, representative and other important people. We learn from staff members that the prospective resident and their representative have the opportunity to visit the home for a meal or over night Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 9 stays until a decision could be made about whether they could live at the home or not. “We would do our utmost best to help the prospective resident decide if the home is suitable for them”, said a staff member. Each resident has been provided with a statement specifying the terms and conditions of residence. These have been signed and dated by the resident and their representative. This clearly demonstrates that positive actions are being taken to uphold the rights of people living at Lomack Lodge. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,9, 10 Quality in this outcome area is good. The care and support provided at the home is of a good standard. Care plans are in place to ensure that staff have sufficient information to satisfactorily meet the residents’ assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans for all three residents were viewed. The information they contain is generally detailed and up to date. The residents’ identified needs regarding their physical, health, social and recreation, finance, culture and religion are clearly documented. However, staff should obtain the name and signature of the resident and their representative in the care plan. This would demonstrate their participation and agreement with its content. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 11 Care plan reviews have been undertaken to ensure that any changes in the individual’s care can be recorded and addressed as appropriate. Reviews are documented; the resident, their representative and other significant people are encouraged to participate in the review process. “Staff give me information about my reviews”, explained one resident. All residents have a key worker who is involved in care planning and assisting with daily living skills. Records examined indicate that staff seek to involve the residents and their representatives in various aspects of their care. Action is taken to minimize identified risks and hazards. Risk assessments are in place and these have been reviewed and updated regularly. The home’s policy and procedure on confidentiality is available and accessible to staff members. The issues around confidentiality and security of records have been explained to residents and their relatives. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14, 15, 16 and 17 Quality in this outcome area is good. The residents are encouraged to make choices for their activities, and to be involved according to their abilities in developing their skills for independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Everyone takes part in their own choice of activities, either individually or in groups. The activities and outings that each person takes part in are recorded in their care plans. Daily living activities are written in the care plan as goals. Residents help with the laundry, meal preparation, washing up after meal times, food shopping and their own shopping as well. One resident said, “Staff help me tidy my room and we go shopping, and do cooking together”. Alterations to the plan occur only when the resident decides that they do not wish to pursue a certain activity; this demonstrates that staff respect the Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 13 wishes and feelings of residents. There have been numerous organised social and recreational activities taking place, which have been chosen by the residents. The staff spoken with described a range of services and facilities, which the residents accessed during the evenings and at weekends. Two residents also attend day care facilities between two and three days weekly. The home has its own vehicle, which is helpful to access activities in the community. The residents plan their own menus every week with the staff; a wellbalanced, nutritious diet is available to the residents. Menus take into account taste, preferences, culture and dietary requirements of each person. Mealtimes are very much a social occasion and residents are encouraged to eat at the table together with staff. A spacious and suitable dinning room is available. Records examined indicate that residents are supported to maintain contact with their families and friends. Staff members spoken with were clear that residents’ bedrooms are their own space and “staff members would normally not enter anyone’s room in their absence”. “We would always knock and wait for a reply, where appropriate, before entering a resident’s bedroom”, said one staff member. Residents’ rooms were seen and these were neat and tidy. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good. Residents receive appropriate health and personal care; this is indicative that their identified needs are being met satisfactorily. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff continue to support residents with personal care where necessary and accompany them to access outpatient appointments when required. Appropriate aids and equipment are in place. These are detailed in the daily notes in the resident’s file. All residents are registered with a local GP service. A variety of healthcare specialists are also available when required including speech and occupational therapists, as well as dentist and optician. Health care support is detailed in individual care plans. There have been no further significant changes to healthcare arrangements in the home since the last inspection in August 2007. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 15 The procedure on medication is available and it was reviewed in June 2008. All staff have received training on medication. Records are kept of all medicines received, administered and disposed of. The medication administration records (MAR) charts were viewed for two residents and these were noted to be in order. Evidence shows that the residents receive their medicines on time. Medication is stored in a locked cabinet located in the staff office. The manager undertakes regular checks as part of the quality assurance systems, in order to ensure that medication is being administered safely. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. Residents know that their concerns will be addressed; all staff have received training in safeguarding adults; this will help them ensure that residents are safe from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s procedure on complaints is in widget form, which makes it easier for residents to understand. Completed surveys show that two of the residents know how to complain. “Staff has explained how I could make a complaint”, said a resident. Staff spoken with said that given the learning disability of the current residents, it is more appropriate to frequently informed the residents about the complaints procedure and how to raise any concerns they may have about the service. The home maintains a complaints record. There have been no recorded complaints since the last inspection carried out in August 2007. There have been no complaints made to the Commission during this period. The home has a satisfactory procedure on safeguarding adults, which is in line with the local authority procedure. Care staff receive ongoing training to ensure they are aware of adult protection principles and procedures. Staff surveys and those members spoken to demonstrate that they have received PoVA (Protection of vulnerable Adults) training. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 17 We observed that care staff spoke to residents in a friendly and social manner, appropriate to the individual’s needs. Surveys received from two residents are complimentary regarding the care and support that is provided at Lomack Lodge. “Staff listen to me and treat me very well”, said one resident. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 18 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): Standards 24, 27 and 30 Quality in this outcome area is excellent. The environment is homely, clean and well maintained, and suitable for the needs of those people living at Lomack Lodge. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A brief tour of the home was undertaken accompanied by the manager. The home was pleasantly decorated and a good standard of cleanliness was evident throughout those areas viewed. Bedrooms are spacious and they all have en suite shower or bathroom, and toilet facilities. The rooms are personalised to suit the taste and preference of the residents. Residents spoken with expressed a high level of satisfaction with their physical environment. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 19 The lounge and dinning room are well planned to meet the requirements of the residents accommodated. A quiet room is also available for residents to sit quietly and or meet with their friends. The kitchen and laundry are domestic in character and designed to enable and promote the involvement of the people living in the home Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 20 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): Standards 32, 33, 34, 35 and 36 Quality in this outcome area is good. The home’s recruitment policy and processes are robust, which means that residents are protected from harm. Accessing appropriate training ensures that staff are competent to deliver good quality care to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There are between two and three staff members on duty on each day shift; there is one staff sleeping in each night. On the day of inspection there were three care staff on day duty. The manager stated that the home also makes use of regular agency staff who are well known to the residents and this is to ensure there is adequate and consistent cover provided. A member of the management team is accessible for guidance and support, in the absence of the manager. The day and night staff arrangements are adequate to meet the needs of the current residents. “The ratio of staff to residents is very good in our home”, indicated one staff member in their survey. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 21 All staff receive training to update their skills to ensure an approach, which is knowledgeable and sensitive. Three staff including a senior member spoken to confirmed that they have received a wide variety of training including PoVA, Fire Training and Basic Food Hygiene. NVQ (National Vocational Qualification) level 2 training for staff members continues to be addressed. There is a robust recruitment procedure in operation to ensure that only appropriate people are employed. References and CRB checks are received prior to employment. Three staff files were examined and they contained two references, CRB checks and application forms. It was however noted that a recent photograph must be added to few of the staff files. All staff spoken with said that they are well supported by the manager. They receive regular recorded supervision sessions approximately every four to six weeks. “I am very pleased with the supervision I receive”, said one staff. Staff also receive an annual appraisal. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 22 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): Standards 37, 38, 39, 41 and 42 Quality in this outcome area is good. The manager provides support and guidance to the staff team; this ensures residents receive good quality care. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has worked in the residential care field for a significant length of time; he has held a registered manager’s post since 1997. He will be starting NVQ level 4 in management in July and the Manager’s Award, in August 2008. The manager has the skills and experience to manage the home well. Staff were complimentary regarding the support they received from him. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 23 They stated that they find the manager “very approachable and that he always has time for the staff and residents”. The head office is undertaking an annual survey in July 2008 to seek the views and experience of residents regarding the quality of service offered to them. The manager said that the outcomes together with remedial actions, if any, would be shared with residents. The manager was aware that a copy of the survey report must be sent to the Commission. A designated person on behalf of the owner also undertakes monthly visits to the home; a copy of the visits reports is provided to the manager. A daily progress record of relevant occurrences is maintained as part of the care plan; this was noted to be in good detail. Other records viewed were in good order. Health and safety are being attended to; however some staff have not completed their mandatory training in Basic Food Hygiene and Moving and Handling. The manager said that arrangements were in hand for staff to complete these courses by August 2008. With this in mind, although this standard is not met, a requirement is not being made. Lomack Lodge DS0000067214.V367856.R01.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 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 4 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 3 2 X Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 25 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA34 Regulation 17 (3) (a) Requirement Staff files must include a recent photograph as detailed in Schedule 2 of the Care Homes Regulations 2001. Timescale for action 31/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA6 Good Practice Recommendations The care plan should reflect the name and signature of the resident and their representative. This would demonstrate their participation and agreement with its content. Lomack Lodge DS0000067214.V367856.R01.doc Version 5.2 Page 26 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 Lomack Lodge DS0000067214.V367856.R01.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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