Care Home: Old Alresford Cottage

Similar services:

• St Vincents
• The Cotswold Home
• Winton House
• Rush Court
• Hillyfield Rest Home
• The Maypole Nursing Centre
• The Briars

What the care home does well The service assesses prospective service users well so that they can be assured their needs can be met if they move to the home. The staff develop detailed care plans that continue to be improved, this gives the staff the information they need to care for each service user in a way that they prefer and that suits their needs. The staff are kind and caring, the service users said ` I like things here, they are very good` `They are kind, patient and understanding`. The cook makes every effort to provide food that people always like and that suits their dietary needs. Choices are always available and the cook knows each persons preferences. Service users said `I don`t like fatty food, they are very good here` ` The food is very nice, if they hear we like something they get it`. The staff are well trained and the opportunities for developing their skills are being improved, through access to National Vocational Qualifications and English language courses.The manager and the providers are identifying any improvements that need to be made and they are making plans to achieve improved outcomes for the service users. What has improved since the last inspection? This is the first inspection since the service reregistered after a change of ownership. What the care home could do better: One requirement to improve has been made following this inspection. The service is required to develop a quality auditing system so that the service users can formally give their views and these can be used to improve the service. CARE HOMES FOR OLDER PEOPLE Old Alresford Cottage Old Alresford Hampshire SO24 9DH Lead Inspector Kima Sutherland-Dee Unannounced Inspection 27th June 2008 11:30 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 Old Alresford Cottage DS0000071139.V365462.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. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Alresford Cottage Address Old Alresford Hampshire SO24 9DH 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) 01962 734121 01962 735341 philfowler@affinitycarehomes.co.uk Silversword Ltd C/O Affinity Care Homes LTD Mr Philip Fowler Care Home 36 Category(ies) of Dementia (0), Mental disorder, excluding registration, with number learning disability or dementia (0), Old age, not of places falling within any other category (0) Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Mental disorder, excluding learning disability or dementia (MD) 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 36. Date of last inspection Brief Description of the Service: Old Alresford Cottage is a care home providing care and accommodation for up to thirty-six male and female residents over the age of sixty-five. Up to fourteen older persons with mental disorder or dementia may be accommodated. The home is a three-storey building with a passenger lift providing access to all floors. There is a large well-maintained garden, with paved seating areas, which is accessible to all the service users. The home has thirty single bedrooms, four with en-suite facilities and three shared bedrooms, which do not have en-suite facilities. There are two lounges and two dining rooms. The home is situated in a rural setting near the village of Alresford. Transport is required to access the local amenities. The current fees for this service range from £445.00 to £675.00 per week. Old Alresford Cottage DS0000071139.V365462.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. The inspection included a site visit to the home over a period of five hours and thirty minutes with a twenty-minute break. During this time we spoke with the manager, staff and people who live in the home. Care plans, training records, policies and staff records were sampled, and a tour of the home took place. Other information used to make judgements about the standard of care in the home included any information received from the home, including their Annual Quality Assurance Assessment (AQAA) which was completed by the manager. This was received within the timescale requested by the Commission. These sources of information have been referred to throughout the report. We also received eight ‘Have Your Say’ surveys completed by the service users. What the service does well: The service assesses prospective service users well so that they can be assured their needs can be met if they move to the home. The staff develop detailed care plans that continue to be improved, this gives the staff the information they need to care for each service user in a way that they prefer and that suits their needs. The staff are kind and caring, the service users said ‘ I like things here, they are very good’ ‘They are kind, patient and understanding’. The cook makes every effort to provide food that people always like and that suits their dietary needs. Choices are always available and the cook knows each persons preferences. Service users said ‘I don’t like fatty food, they are very good here’ ‘ The food is very nice, if they hear we like something they get it’. The staff are well trained and the opportunities for developing their skills are being improved, through access to National Vocational Qualifications and English language courses. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 6 The manager and the providers are identifying any improvements that need to be made and they are making plans to achieve improved outcomes for the service users. 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. Old Alresford Cottage DS0000071139.V365462.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 Old Alresford Cottage DS0000071139.V365462.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): 1,2,3,4,5. Quality in this outcome area is good. Prospective service users have the information they need in a suitable format to make an informed choice about this home, and they know the service can meet their needs following an assessment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each prospective service user or their relatives are provided with a brochure and a service users guide, which gives them information about the service and the terms and conditions. New service users have a contract either between the home and themselves or between social services and the home. The AQAA states that the information is available in different formats suited to the needs of the service users. The AQAA also states that they have improved Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 9 and standardised the way the staff initially show prospective service users around the home. This means that they discuss all the commonly asked questions and try to make people feel welcome and gain a realistic view of the home. Prospective service users have opportunities to visit the home and meet the staff. The manager said that a number of service users knew the home from spending time there for respite stays, or because they had previously lived in the independent living flats adjoining the main house. The manager assesses the needs of each prospective service user prior to them moving in. The manager then contacts the service user or their family to discuss whether the service can meet their needs. The manager agreed that in future this confirmation would be made in writing. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 10 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): 7,8,9,10,11 Quality in this outcome area is good. The service users benefit from detailed care plans and appropriate health care. Medicines are managed safely and the service users are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four care plans were seen they included useful details about each persons needs and how the staff can meet their needs. The care plans are reviewed and updated and the manager said they plan to improve the plans by including more details about each persons preferred routines and their likes and dislikes. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 11 The care plans did include information about individual’s cultural and religious needs and details about disabilities and where appropriate details about their wishes regarding funeral arrangements. The AQAA states that the service aims to improve the care plan reviews by encouraging more family involvement and increasing communication between the service and families. Five out of the seven surveys that were returned said that service users always had access to health professionals, two surveys said they usually had access. The care plans showed that contact with health professionals is always recorded and daily records are kept which include information about people’s health and whether they have had treatment or a visit to a G.P or hospital. The activities co-ordinator said that the staff take photos of the service user and this helps the staff to identify whether people have the correct glasses. This is particularly useful for the service users who have dementia. The service has procedures for dealing safely with medication and staff are trained to follow these procedures. New staff have to be assessed as competent following their induction training before they can administer medicines. Medicines are stored safely and recorded correctly. The service users said they liked the staff and that they were kind. One comment said ‘ The staff are kind, patient and understanding.’ The staff were seen to be thoughtful and caring and they spoke to people with respect. Staff who were caring for the service users with dementia demonstrated their patience. They were observed taking time to speak to each person and using appropriate touch to reassure the service users. All seven surveys said that the staff listen to what the service users say. The manager said that service users are always seen in their rooms for any health or private appointments and two service users confirmed this. The care plans detail whether each service user needs to be checked at night and whether they want to be left undisturbed. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. The service users benefit from a range of individual and group activities, and they are able to exercise choice about how they spend their time. The service users are supported to keep in touch with their families. The food meets individual needs and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service users spoken with said they liked living in the home. They said they could choose what they did each day. The activities co-ordinator knew the service users well and they spent time talking, helping people write letters and reading the paper to service users. The co-ordinator also said they try to encourage people to participate in activities that interest them, and they organise group as well as individual activities. A range of activities were advertised on the notice board, these included a gardening club, hand and nail care, walks around the extensive gardens and a July the 4th themed celebration. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 13 Other resources are available and used in the home and these include reminiscence material, the activities co-ordinator said they use old photos to initiate conversations with some service users. Music from an appropriate era for the age of the service users was playing in one part of the home and a service user was enjoying dancing for short periods with a member of staff. The co-ordinator and the manager agreed that although the current activities suited the service users a separate budget would benefit the service users as more regular entertainments could be organised. The manager said they were discussing how this could be achieved with the provider. The service produces a monthly newssheet that informs the service users and their families about activities and staff training or changes to the team. Five surveys said that there were always activities in the home, one said they were usually available and one said that they were sometimes available. The homes policy recognises that people have the right to choose if they participate. The AQAA states that the service users are supported to follow their chosen religion and those leaders of different faiths attend the home. Service users religious and cultural needs are identified during the admissions process. The service users talked about their family and friends visiting and they said that they were made to feel welcome. The written brochure provided to service users has information about visiting. The care plans include information about the service users next of kin and family contacts. There is a pay phone in a private part of the home or service users can have phones installed in their own rooms and then they are billed for private phone calls. The AQAA states ‘There is no restriction on visiting and residents are free to see their families whenever they wish. Local community groups visit the home regularly and it has extended opportunities for local schools and colleges to provide work experience placements, for students studying for relevant qualifications. This has led to a greater degree of social interaction with some residents.’ The service users were very complementary about the food at the home. They said that they are given what they like and choices are always available. The cook has attended training courses and spoke knowledgeably about the likes and dislikes of the service users and how they can meet the special dietary requirements of each person. The menu is changed seasonally and the service users are consulted daily about their choices. The cook said that they are starting to build a photo library of different food to assist the service users with dementia to make real choices about their meals. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 14 Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. The service users are confident that their complaints will be acted upon. The Service users are protected from abuse by a trained staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has a policy about dealing with complaints and the manager and staff were clear about how they would respond if complaints were received. No new complaints have been received since the service was registered. The service users guide in each person’s room has information about how to complaint. All seven surveys said that the service users knew how to make a complaint. The staff are trained to respond appropriately to suspicions of alleged abuse. Two staff demonstrated that they would follow the services policy and they knew where to find the policy. Eight staff have recently been trained in abuse awareness and the manager said they intend to train all staff including night staff. This information is also discussed during induction training for new staff. The policy file also has the up to date ‘Hampshire County Council’ procedures in Safeguarding adults. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 16 The staff are also aware of their responsibilities to report abuse and the service has a policy on ‘whistle blowing’. There have been two safeguarding investigations by social services in the last six months following service users admissions to hospital. On both occasions the manager responded correctly and there were no ongoing concerns that required action. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 17 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): 19,20,21,23,24,26 Quality in this outcome area is good. The service users would benefit from a refurbished environment although the home is clean, comfortable and maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is comfortably furnished with the equipment that people need to maintain their independence. Areas of the home have worn decoration and fittings including the bathrooms although these were clean. The manager stated that the providers plan to refurbish the home this year, and priorities have been set such as replacing the windows. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 18 Two of the bathrooms/toilets were small and could only be used by independent service users. The service users who require support to access the bath can only use one bathroom that has the space and necessary equipment. The service users said they liked their bedrooms and they had brought small items of furniture with them. Four bedrooms were seen and they had a better standard of decoration than the communal areas. The kitchen is very worn although it is kept clean and the environmental health department have awarded the home an ‘excellent safer food for better business’ certificate in 2006, which is displayed in the hallway. The cleaner said they had attended an infection control training course and the training records demonstrate that staff are trained. The service also has a policy on infection control and the equipment that staff need. It was noted that on the third floor there is an attic bedroom that is mainly used for respite care stays. The room has a large Velux window that tilts outwards with a just above waist height windowsill. The manager agreed that they would risk assess this area and decide whether a restrictor or other safety measures need to be used. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. The service users benefit from a safely recruited and well trained staff team. The outcomes for service users with dementia would be improved by increasing the numbers of staff at busier times of the day in that area of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Six out of the eight surveys returned said that staff were always available when needed. A member of staff said that there were usually enough staff to meet people’s needs without being rushed. One member of staff said that there could be more staff on duty in the area of the home for people with dementia. It was noted that two out of the ten service users who have dementia appeared not to have had their hair brushed. A member of staff agreed with this observation. They said there was usually one member of staff available for ten service users and although they could request help they often had to leave the room to make sure a service user who moved around the home didn’t fall. The manager agreed that they would review the staffing level in this area. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 20 The manager did say that they have reviewed the staffing levels by monitoring how long the staff spend with different service users. The staff files demonstrate that staff are recruited safely and all the pre employment checks are carried out. The providers have employed staff from overseas due to the difficulties recruiting locally in a rural area. The manager and the service users see the overseas staff as a positive contribution to the home. Service users made comments such as ‘They are lovely, very kind’ ‘I can always understand them, and they are patient’. The manager and a member of staff talked about how the overseas staff were helped to settle in and how the manager and staff had made efforts to understand each other’s culture. Overseas staff also have the opportunity to attend classes to improve their English language skills. All new staff have an induction training period and then they go on to develop their skills through further training. The manager said that since the home ownership changed they were retraining all staff including the night staff. The AQAA said that all the care staff have gained or are working towards National Vocational Qualifications. The AQAA states that offering student placements enhances community links. Students always have a criminal records checks and they are never involved in direct care or personal care. During the site visit one student who was working with the administrator said the staff had been supportive. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 21 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): 31,32,33,35,38 Quality in this outcome area is good. The home is managed effectively for the benefit of the service users. An improved formal quality audit system would offer the service users increased opportunity to contribute their views. The manager is aware of changes that could be made to improve the outcomes for the service users. This judgement has been made using available evidence including a visit to this service EVIDENCE: The home manager is qualified and experienced and has been managing the home for two years. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 22 The home has recently been re-registered after a change of ownership, and this has lead to a period of uncertainty for a number of staff. The manager was clear that they have tried to communicate the changes to the staff, although the new providers could have reassured the staff by providing information more quickly on one occasion. One member of staff said that the manager was effective and they worked closely with the senior carers. The team leaders are briefed each day and there are regular staff meetings. The manager said that they are currently reviewing the formal quality auditing process after the change of ownership, although the service users views are sought, during care plan reviews. They also said that the activities coordinator spends time with the service users each day and tries to encourage people to put forward their opinions. The AQAA states that ‘The Registered Manager constantly monitors all aspect of the residents care, ensuring the continuing protection of their rights, dignity and respect, without compromising their individual needs.’ It was not clear during the site visit how this is achieved in practice. The records were seen for the service users who have asked the home to look after their valuable items or money. None of the current service users have asked the home to look after their money every week, but a policy is in place to enable this to happen if required. The manager spoke about staff supervisions and the team leaders supervise the carers. The records demonstrated that supervision is taking place regularly. One member of staff said they felt supported to do their job, the regional manager supports the manager. The home is maintained although there had been a delay in having all the portable appliances tested, this was due to be completed in March 2008. The manager was aware of this and had informed the provider. Other safety checks such as the electrical installation were up to date. The fire records were complete and a fire risk assessment was kept on record. The service has developed health and safety policies and the staff know where these are kept and how to access them. Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 23 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 X 3 3 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 3 2 X 3 3 X 3 Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 24 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 OP33 Regulation 35 Requirement The manager must develop a Quality Auditing system that enables the service users and their relatives to formally and regularly record their veiws, and these views are used to improve the service. Timescale for action 30/09/08 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 Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Old Alresford Cottage DS0000071139.V365462.R01.S.doc Version 5.2 Page 26 - 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!