Care Home: Norbury Hall

Similar services:

• Spinney (The)
• Queen Elizabeth House
• Henry Nihill House
• Birchwood
• The Infirmary
• Orchard House Nursing Home
• St Josephs Rest Home
• Red Court Nursing Home

What the care home does well The proprietors, Mr Dhir (owner and manager), Mrs Dhir and their daughter, are commended for responding to the new star rating system with great energy and enthusiasm. In each section of this report, reflecting the seven main sections of the National Minimum Standards, it is evident they have worked hard to improve the quality of their service and this is reflected in a higher star rating for Norbury Hall than when we visited in January 2008. There are ample communal areas, comprising two dining areas, two main lounges, and a `library` used as a quiet room, which can also be used as private meeting place for visitors. There is a well appointed conservatory, which is partially glazed and there is a second very small conservatory for use by any smokers living in the home. There is garden to the rear of the property and this overlooks the park. Residents tell us that the meals are very good. Visitors say, "We can`t think of a better home" and another said, "We are full of praise for the staff". Norbury Hall is described as tranquil and serene. What has improved since the last inspection? The owner/managers are now taking a much more `pro-active` approach towards meetings standards and this was evident throughout our visit. The most immediately obvious improvement is in the dining room and in bedrooms that have been upgraded and now look very presentable. What the care home could do better: Reflecting the considerable effort to address the shortcomings and safety issues identified in our last inspection in January very few issues requiring attention were identified on this occasion. Various locations around the home are still undergoing refurbishment such as the corridor and staff need refresher training in the procedures to follow when abuse is suspected. The staff team does offer choice in some aspects of diversity since there are no male carers. CARE HOMES FOR OLDER PEOPLE Norbury Hall 55 Craignish Avenue Norbury London SW16 4RW Lead Inspector Michael Williams Key Unannounced Inspection 26th August 2008 11:00 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 Norbury Hall DS0000025819.V370534.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. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Norbury Hall Address 55 Craignish Avenue Norbury London SW16 4RW 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) 020 8764 9164 020 8679 9636 info@norburyhall.co.uk Norbury Hall Residential Care Home Limited Mr Vijay Kumar Dhir Care Home 47 Category(ies) of Dementia - over 65 years of age (27), Old age, registration, with number not falling within any other category (20) of places Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow two specified service users in the Learning disability - over 65 (LD(E)) category and one specified service user in the Mental disorder (MD) category to be accommodated. 10th January 2008 Date of last inspection Brief Description of the Service: Norbury Hall is sited within the grounds of a public park, which was part of the old Norbury Hall estate. It is a short distance from the town centre. The home is a residential care home registered to provide personal care (not nursing care) for up to 47 elderly persons. It has changed its original registration to cater for residents with Dementia. The home has several lounges and dining areas so residents have a choice about where to spend the day. Accommodation in the home includes bedrooms on the ground floor and the first floor; in all there are 14 ensuite bedrooms, 17 single rooms, 8 double (some of which are used as single). Fees as at August 2008 were from £404 to £600 each week. The manager advises us that there have been no changes in the ownership, management or service registration details in the last 12 months other than the Commission’s review of registration for which a new certificate will be issued when the details are confirmed. The home has however advised us that their new email address is enquiries@norburyhall.com. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This visit was conducted on 26th August 2008 and included the distribution of questionnaires to residents, their relatives, and professional visitors and to staff in the home. The visit lasted from 11 am until 5 pm. Residents were given the opportunity to talk to the inspector; several relatives were visiting on this day and they most helpfully commented on the services provided in this care home. In addition to speaking to the various people on site we also toured the building and checked the documentation required to be maintained by care homes so as to be able to cross check, or ‘track’, information provided to us. What the service does well: What has improved since the last inspection? What they could do better: Reflecting the considerable effort to address the shortcomings and safety issues identified in our last inspection in January very few issues requiring attention were identified on this occasion. Various locations around the home are still undergoing refurbishment such as the corridor and staff need refresher training in the procedures to follow when abuse is suspected. The staff team does offer choice in some aspects of diversity since there are no male carers. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 6 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. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 7 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 Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 8 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): NMS 3: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Pre-admission assessments are in place for each service user and form the basis of the initial care plan and risk assessment. This ensures the care, including health care, needs of service users are assessed prior to admission so it is clear to prospective service users how their needs can be met if they choose to enter this home. EVIDENCE: Standard 3 has been assessed again as being met as it has in previous inspections and so it was not fully re-evaluated in great detail on this occasion but it was confirmed that service users do have information including a Guide and a Contract. As a minimum, each service user will have the home’s inhouse contract in addition to any local authority contract provided by a care manager when they eventually arrive. A copy of the Guide, which is going to be updated with a new glossy pictorial cover, is also available for each resident. Residents and relatives confirmed that they had an opportunity to visit the home prior to admission and have agreed to a ‘trial period’ before deciding to stay. Areas of strength include the information provided and the pre-admission assessments and as no matters requiring improvement arise this section, about choice, is assessed as good. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 9 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): NMS 7 to 10: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans are in place for residents so as to ensure their social and health care needs can be fully met. Residents confirm that they are treated with respect and dignity. Medicines are being handled safely. EVIDENCE: It remains the case that all residents have access to health care services both within the home and in the local community. Residents are visited regularly by a GP and either attend local dentists, opticians and other community services or, more usually these services call to the home to see residents. A visiting Community Nurse was on site when we visited and this confirms that community resources are called in as the need arises. So health care needs are monitored and appropriate action and intervention is being taken and this is being recorded in the daily notes. The home is able to provide the aids and equipment recommended, for example residents who need an alternating airflow mattress can be provided with one from the community occupational therapy service or other resources. There is a record of general health care information and evidence in the Care Plans of health and social care intervention. However, in January 2008 we found these care plans to be rather limited in scope and repetitive, so we Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 10 concluded then that they were not very ‘person centred’ nor individualised, they could apply to anyone at any time. The Deputy manager told me that care plans have now been refined and are much more focused upon the need of each, individual residents and in each set of care plans she has identified specific goals pertaining to the individual not the residents as group. The phrasing now used in care planning is in the form “You (the resident) have asked us to help you in this way”. We note and commend this approach. We also note that the home need not put all care plans onto a single sheet of paper; it is typical for each plan to be on a separate form so that greater detail can be provided as to what is the need, how it will be achieved, by whom, when and how and when the care need will be reviewed. The revised care planning now gets much nearer to the home’s own stated objective and philosophy which is for residents to, “Live your life your way”. The home has a medication policy which is accessible to staff, medication records were up to date for each resident and medicines received, administered and disposed of are being recorded we were advised. There was no evidence of any residents administering their own medication. Staff are aware of the need to treat individuals with respect and to consider dignity when delivering personal care and both residents and their visitors commended the staff for their approach. The home has a training plan and intends to train its staff in health care and we were shown examples of a detailed in-house training programme dealing with dementia for example. Residents are happy with the way that most staff deliver their care and respect their dignity. Areas of strength include the many commendations from residents, from relatives about the home and care staff. We make no requirements about this section of the report on this occasion and so this section, about health and social care, is again assessed as good. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 11 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): NMS 12 to 15: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users appreciate the comfort and lifestyle provided in this care home. They maintain contact with their families. So residents are given every opportunity to exercise choice and control commensurate within their health and abilities to do so. Service users say the meals are very nice in this home. EVIDENCE: As we have observed in previous reports, the most important aspect of this section is that the residents say they are happy in Norbury Hall, though many were unable to express a clear opinion because of their failing memory. This reflects the quiet, tranquil atmosphere evident during this visit and commented upon in letter to the home stating how the home had “An atmosphere of tranquillity and serenity”. There is ample space in this home for residents to sit where and with whom they please. It was suggested in 2006 that greater use is made of the layout of the ground floor to separate the Dementia Care Unit from the newer wing of Norbury Hall - where most residents without dementia reside. This suggestion has been taken up, so now residents have a choice - but most often choose to sit in the larger lounge and dining room rather than the newer, quieter lounge/dining area. This newer wing has been called the ‘Norbury Wing’. Since the inspection in January 2008 the manager has made changes to the layout of chairs in the main lounge such that there are now several groups of Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 12 chairs instead of the single large circle. The Deputy explained how this has had a positive impact upon residents; they now make much more active choices about where they will sit at different times of the day and residents make a conscious decision whether to watch television or sit and chat with friends. It is expected that a care home will support residents to maintain links with their family, friends and the wider community and this appears to be the case. Visitors are welcomed and representatives from the community come in regularly including church members and entertainers. Several visitors were on site to confirm that they may visit freely and are welcomed by staff. The home displays several lists of activities, daily events, weekly events and special events including outings and entertainers. In respect of diversity, the manager advised the inspector that all residents use English as their language of choice although one or two are not English by birth. As the range of staff are from a diverse background it is the case that some staff shore a common language with residents with limited spoken English. Other aspects of diversity were discussed such as the accommodation of residents who may sensory or mobility problems – the home seeks to meet such needs whenever possible. Matters of sexual diversity have been also discussed and the manager said residents will be treated with tolerance and forbearance whatever their lifestyle or sexual orientation. The manager and staff do have some training and experience in dementia care; this has been largely in-house. For example, we were shown a training manual, which a senior member of staff is using to train staff - if it is followed through it will at regular intervals it will provide very detailed and thorough knowledge of the special needs of people with dementia. We also recommended that the home establish contact with the Alzheimer Society, and other experts, for advice on caring for people with dementia - with particular regard to recreation, occupation and sustaining mental skills - and for their advice on supporting the relatives of people with dementia and the senior involved in training has taken up the suggestion, for which she is commended. The inspector also checked the kitchen and in particular confirmed that fresh fruit and vegetables are available and were served for the midday meal to an acceptable standard. The manager confirmed that if and when a resident requests meals to be provided in a particular manner the cook works hard to meet those requests - and this appeared to be the case on the day of inspection. The service of meals had been very protracted in the past but on the day of inspection it appeared that most residents were waiting no more than about a quarter of an hour for their meal to come to the table. The home has purchased a hot trolley again this was to give residents choice at the point of service and we are advised this is working very well because residents can be showed what meals are offered and make at choice then and there. The Deputy thinks this new arrangement is working very well. Areas of strength include residents’ opinion that this is a lovely setting for them to be cared for in and the efforts the staff make to ensure residents are happy and comfortable. No requirements arise in this section about, daily life, and it is assessed as good. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 13 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): NMS 16 and 18: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Arrangements are in place for service users and their representatives to either complaint or compliment the service. Effective procedures are in place to deal with complaints. Arrangements are in place to protect vulnerable residents. EVIDENCE: No complaints arose during the course of the inspection and no further complaints have been made directly to the Commission since the earlier inspection in January 2008. Suitable arrangements for dealing with complaints were in place and the manager and staff were aware of how to refer untoward incidents to the local social service department. An example of good practice was underway when we inspected in January in so far as incident was referred to the local authority care management team so that it could be investigated thoroughly. This demonstrates that the managers of the home know how and where to report serious incidents and have done so when the need arises. The home has ample evidence of letters of thanks from many relatives, several on display in the corridor. This can be regarded as ‘customer satisfaction’ feedback. Areas of strength are the procedures for dealing with complaints and representations and as no matters requiring improvement arise this section, about complaints and protection, is assessed as good. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 14 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): NMS 19, 23 and 26: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. The improvements to the accommodation are inevitably the most noticeable when you visit and so residents can be assured they are living in an increasingly comfortable and safe environment. EVIDENCE: The owners have decided to take a proactive approach to upgrading the environment - not just make do and mend – they have had the dining room floor relayed in oak and it looks very smart indeed. The new red/black carpet in the hall and corridor also looks very good (but marred by a small area of damage that will need attention). Some bedrooms have been redecorated and their presentation is also very good with new curtains and matching soft furnishings; we are sure they will be popular with any new residents that choose to enter the home. The radiators have been boxed-in with very stylish units and are now much safer than we visited in January. The home was clean, tidy, safe and free from offensive odours. Areas of strength include the considerable improvements to the presentation of the home. No requirements arise this section about the premises is assessed as good. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 15 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): NMS 27 to 30: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are praised for being very kind and are now being thoroughly trained residents can be confident they are in safe hands. EVIDENCE: Two areas are noteworthy in this section of the report; firstly visitors describe staff as being, “Tremendously kind and caring” and secondly, the managers have worked hard to put together a training package that will better meet the needs of residents in the coming months. As we have reported in previous inspections, staffing levels must be no less than required by the previous regulators; that is, 13 day-care hours per service user, per week for the older person category and 15 day care hours per service user to care for those with dementia. The manager makes sure all staff have the correct police and other checks before employing staff including those from overseas, we checked a sample of staff records to confirm this was the case. Whilst noting that foreign staff bring with them a range of skills and qualifications the quality of spoken English is not as good as might be expected in a care setting, and this is particularly true when residents are forgetful and confused. It is acknowledged that the manager says he encourages these foreign staff to attend courses designed for people whose first language is not English. It is of course to the benefit of residents if a member of staff can speak the same (foreign) language as a particular resident and this was the case when we visited in August. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 16 When we last visited it was difficult to identify any methodical system for checking what staff had received what training but on this occasion the pattern of training was quite clear. We were provided with table of training both accomplished and in the planning stages. The home is commended for the hard work put into addressing this in a clear and systematic way. It is clear staff are being offered relevant training in all aspects of care including specialist learning in respect of the care of older people with dementia. However, we did observe a couple if minor incidents when the dignity of residents’ was being a little compromised, for example staff standing to feed a resident the midday meal; as the member of staff was new this indicated a need to for new staff to receive adequate induction training in providing personal care in a dignified manner and for senior staff to provide adequate supervision of day to day practice. Areas of strength include staff recruitment practices and the care training packages offered to all staff. No requirements arise in this section but a recommendation is made to improve induction training in respect of care practices. This section, about staffing, is assessed as good. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 17 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): NMS 31, 33, 35, 37 and 38: People using this service experience good quality outcome in this area. We have made this judgement using a range of evidence, including a visit to this service. A competently run care home so residents can be assured that the home is being managed to ensure their health and well being. EVIDENCE: A series of satisfactory inspection reports suggests this home can be competently run but not without some lapses in standard for example in January when we saw hazardous some radiators and a poorly maintained fire door; however on this occasion we saw that all the safety issues identified when we visited in January, (including radiators, hot water and fire doors), have been addressed promptly and satisfactorily and no safety issues were identified on this visit. The service users attest to the quality of the services including personal care, catering and comfort of the setting. The lapse in recruitment checks identified in the previous inspections was critical to the welfare of residents but has now been corrected. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 18 A range of records were checked including food records; medication; residents’ files; staff files; complaints; accidents; incidents; fire safety and visitors record book. Record keeping is to an acceptable standard in this care home. The records used to account for residents’ money held by the home has been checked on several occasions and the system still appears sound and so safeguards residents’ monies. Areas of strength include the renewed enthusiasm for achieving standards in all areas of the home including the environment, care practises, staffing and general management of the home. This section, about management and administration, is assessed as good. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 19 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X X X 3 X X 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 X 3 3 Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 20 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 Refer to Standard OP30 Good Practice Recommendations Induction: All care staff must receive adequate induction training and supervision of practice thereafter so as to ensure the safety, dignity and care of residents is not compromised. Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Norbury Hall DS0000025819.V370534.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!