Care Home: Old Roselyon Manor

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What the care home does well The registered provider ensures that good communications exist within the home and with other professional agencies. There is a clear commitment to staff development and NVQ training. This is an established home and the registered provider maintains day-to-day control, ensuring that the home is run for the benefit of the residents. The home responds well to the individual needs of residents, and maintains good links with other health care professionals. Residents, were complimentary about the care provided and the consideration and attention shown by the staff. What has improved since the last inspection? The registered provider continues to invest in the fabric and fittings of the home, with more improvements planned during the course of 2008, including a shaft lift. What the care home could do better: The registered provider could do more to ensure that activities are available to residents. The home could do more to obtain the feedback of residents and others. CARE HOMES FOR OLDER PEOPLE Old Roselyon Manor Old Roselyon Par Cornwall PL24 2DW Lead Inspector Alan Pitts Unannounced Inspection 20th February 2008 08:30 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 Roselyon Manor DS0000009200.V359931.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 Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Old Roselyon Manor Address Old Roselyon Par Cornwall PL24 2DW 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) 01726 814297 01726 813757 Mr John Graham Mobbs Mrs Marine Nicole Mobbs Mr Anthony James Small Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30), Physical disability (30), Terminally ill (30) of places Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service users to include up to 30 adults of old age (OP) Service users to include up to 30 adults with a physical disability (PD) Service users to include up to 30 adults with a terminal illness (TI) Total number of service users not to exceed a maximum of 30 Date of last inspection 13th March 2007 Brief Description of the Service: Old Roselyon is a detached 400-year-old Manor House that was converted for nursing home use in 1973 and has subsequently been extended. The home is registered to provide care with nursing for up to 30 service users. Service user accommodation is provided on two floors. The first floor is serviced by a stair lift. Single and double rooms are available. All rooms have washbasins and some have en-suite facilities. The property has pleasant well tended gardens and there is adequate car parking. The registered manager, Mr S. Small, has day-to-day responsibility of the home. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The fees charged range from £445 to 542.50 per week. This unannounced inspection took place over a period of approximately 5 hours on the 20th February 2008. The inspector met with the registered provider, staff, and residents, inspected documentation, and toured the premises. Also used for this inspection were residents’ surveys and the home’s selfassessment. Old Roselyon is an established care home with a core of long-serving, committed staff, ensuring continuity of care for the residents. The registered provider maintains day-to-day control at the home, and oversees the care provision. The home benefits form an established reputation in the local community. Old Roselyon has far more strengths than areas for improvement. There are no significant areas for improvement relating to the health and safety of people using the service or issues of poor management. The Commission for Social Care Inspection are confident the provider can manage. Where issues arise the registered provider recognises and manages them well. What the service does well: What has improved since the last inspection? The registered provider continues to invest in the fabric and fittings of the home, with more improvements planned during the course of 2008, including a shaft lift. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 6 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 Roselyon Manor DS0000009200.V359931.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 Roselyon Manor DS0000009200.V359931.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, 6 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The registered provider has provided a statement of purpose and service user guide that details the facilities and services available within the home. All residents receive a contract and are notified of any proposed fee changes. The registered provider assesses all prospective residents prior to admission to ensure that the home can meet their care needs. The home does not provide intermediate care. EVIDENCE: The home has a stable staff team that are resident focused, and committed to a high standard of care provision. There is a high value on responding to individual needs for information, reassurance and support. An appropriate Statement of Purpose and Service User Guide is in place. These documents are reviewed regularly and provided to every resident. The Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 9 inspector also saw copies of signed completed contracts and residents confirmed that they receive these. Proposed fee changes are notified to residents in writing at least 3 months before the planned implementation date. Residents confirmed that they feel that they have the information they need. Prospective residents and relatives are invited to the home and given appropriate information. The records for recent admissions were inspected and the assessment process and liaison with other agencies was detailed and recorded appropriately. The registered provider has developed a comprehensive assessment form that illustrates each resident’s individual needs and how these will be met in the home. The assessment includes consultation with all necessary agencies and ward staff to consider the residents’ social and nursing needs. Pre-admission assessments are usually carried out by the registered manager (a nurse) and another member of staff. Old Roselyon Manor DS0000009200.V359931.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 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The health care needs of residents are met, with evidence of multi-disciplinary working taking place on a regular basis. Each resident has a plan of care, which describes their care needs and the interventions necessary in order to maintain or improve the residents’ wellbeing. The home operates an appropriate medication policy, and staff adhere to this. Residents confirmed that staff respect them and their right to privacy. EVIDENCE: Each resident has a plan that has been agreed with him or her. This is written in plain language, is easy to understand and considers all areas of the individual’s life including health, personal and social care needs. The home has effective systems in place to ensure the care plan is reviewed and updated monthly and arranges additional reviews when changes take place. The people living at the home are very dependent, but the home could still do more to encourage their involvement in care plan reviews. The plan is updated and the necessary action taken to respond to any changes. All members of staff Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 11 regard the plan as a working tool, they understand the plan and work to it. The staff keep up to date with training, professional research and literature, in both the social care and clinical fields. Care plans are written in clear language, and include a comprehensive risk assessment. Management of risk takes into account the needs of residents balanced with their aspirations for independence and choice. The staff keep up to date with training, professional research and literature. The registered provider and staff actively promote the residents’ right of access to the health and remedial services that they need, both within the home and in the community. Regular appointments are seen as important and there are systems in place to make sure residents appointments are not missed. Records show that the home arranges for health professionals to visit frail residents in the home and provides facilities to carry out treatment. Equipment is effectively maintained, making sure it is working effectively, and each resident has the necessary aids to improve their quality of life. There have been no significant changes in medication procedures since the last inspection. The home operates appropriate and efficient medication policy, procedure and practice guidance. Staff have access to the written information and understand their role and responsibilities. Medicine Administration Records were inspected and seen to be in order, and staff were observed to administer medicines in the proper manner. Medicines are properly stored and secured. There are systems in place for the ordering, receipt and disposal of medicines. The registered provider has daily contact with residents in the home. Personal and nursing care is carried out with due regard to privacy and dignity, and staff were observed interacting with residents in a respectful and relaxed manner. Residents are able to accept visitors in the privacy of their own rooms, or if they wish, in one of the communal areas. Relatives are also welcome to stay overnight if they wish. Residents confirmed that the staff treat them with respect, and all felt that their right to privacy was upheld. The care documentation allows for the collection of information relating to resident’s wishes and preferences. Old Roselyon Manor DS0000009200.V359931.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. This judgement has been made using available evidence including a visit to this service. Residents were complimentary about their lifestyle at the home. Residents exercise their choice to enjoy the privacy of their own rooms or join others in communal areas for company or meals. Residents maintain contact with visiting relatives and friends at the home. Residents were also complimentary about the quality of the food provided. EVIDENCE: Residents were complimentary about the lifestyle offered at the home and the kindness of the staff, but also said that they were not always aware of recreational/social activities. These comments are reflected in the daily care notes, which though they have improved, could still do more to show the residents’ lifestyle as well as recording the nursing care provided. Similarly, more could be done to ascertain the wishes of residents. There are clearly activities happening on a regular basis, but as discussed, more could be done. The registered provider said he would consider including two hours a day as activity coordinator in the role of one of the care staff to improve in this area. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 13 Visiting is open, and the visitors book shows regular and frequent visitors to the home and the people that live there. Comments from relatives show that staff talk to visitors and share information appropriately. The design of the home provides seating areas within the communal areas of the home where residents can entertain their visitors, in addition to the privacy of their own room. Two representatives of local churches visit regularly and frequently for those residents who wish to see them. Residents’ rooms are personalised to varying degrees, and residents confirmed that they are able to exercise choice and autonomy over their own lives. The home has flexible routines that allow for personal preferences and dependency levels. Members of the local community, such as the church visit. Meals are unhurried and residents requiring assistance to eat are supported discreetly by staff. Hot and cold drinks and snacks are available at all times and offered regularly to residents. The menu does not show that a choice is available to residents, and this was identified at the last inspection. The registered provider should ensure that the menu demonstrates a choice being available at meals, that residents are asked for their choice, and that the record of food provided shows the choices made. The registered provider said that this would be implemented. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 14 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, 17, 18 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents confirmed that they would feel able to express any concerns or dissatisfaction should the need arise. The registered provider ensures staff have an appropriate understanding and information to protect residents from abuse. EVIDENCE: A complaints policy is in operation and is widely distributed. Neither the home nor the Commission for Social Care Inspection have received any complaints in the last 12 months. Residents confirmed that they would feel able to express any concerns or dissatisfaction should the need arise. The registered provider confirmed that the complaints procedure would be made available in a variety of formats (including a variety of languages, tape, Braille, symbol, large print) if the need arose. A strength of this home is the confidence the residents and their relatives have in the registered provider and the staff as shown in the comments received in survey responses and the large number of ‘thank you’ cards sent. There is a commitment to dealing with complaints or concerns at a local level with sensitivity. Residents’ mail is delivered unopened, assistance is available if required or where necessary the mail is kept unopened for the residents’ representative. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 15 Residents confirmed that they have the opportunity to participate in civic processes, and there is a record of residents being registered to vote. A Protection Of Vulnerable Adults procedure is in place. The registered provider has reviewed and amended this procedure since the last inspection to ensure that it provides clear step-by-step practical instruction on what to do in the event of an allegation of abuse (with reference to county procedures) and the relevant contact information for staff. Staff are aware of this procedure, and training is provided. The registered provider and staff are clear when an incident needs external input, and is open in discussing incidents with external bodies (CSCI, local adult protection) to clarify difficult judgements. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is fit for purpose. Residents’ rooms are comfortable and appropriate to their care needs. The home offers safe, clean, and comfortable surroundings. EVIDENCE: There have been no detrimental changes to the environment since the last inspection, and the registered provider continues to invest in the fixtures and fittings to improve the environment for the people that live there. Plans for 2008 include the installation of a shaft lift to aid access between floors and to improve compliance with the requirements of the Disability Discrimination Act. Access externally and on the ground floor is generally level and wheelchair friendly. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 17 The management and staff encourage residents to see the home as their own home. The environment provides a very well maintained, safe, comfortable, attractive home, which has all the specialist equipment and adaptations needed to meet individual resident’s needs. There is a selection of communal areas, according to the numbers of residents, this means that residents have a choice of place to sit quietly, meet with family and friends or be actively engaged with other residents. Residents’ rooms are personalised to varying degrees. The home provides furnished accommodation, but residents may choose to bring items of furniture and belongings to personalise their rooms. Reclining chairs are provided in all rooms. Heating, lighting and ventilation within the home is flexible and appropriate. Radiators are guarded and water temperatures are regulated. The home has a refurbishment and development plan, and a number of improvements have been made in keeping with this in the last 12 months (new boiler, new carpet on order for lounges and dining room, new flooring in ground floor corridors). The home has an infection control procedure. Laundry facilities are located in a separate building and appliances are commercial in nature. Protective clothing is available and used by staff. The home is clean and free from offensive odours. The home provides a sluice on each floor level, personal laundry is provided for by the in-house equipment and bed linen is provided for through an external contractor. Relevant maintenance contracts are in place for equipment such as hoists, fire equipment, etc. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care staff have a good understanding of residents’ support needs and sufficient, competent, staffing are provided to meet these needs. The home enjoys a good reputation and the registered provider is aware that this is largely dependent on the home’s effective and robust staff selection procedure. EVIDENCE: There have been no significant changes to the staff team since the last inspection. The home is supported by a stable team of staff, sufficient in numbers and skill mix to meet the needs of the residents. In addition to the registered provider there is usually 1 qualified nurse and 5 care assistants per shift throughout the day. At night there is 1 waking qualified nurse and 1 waking care assistant. All staff left in charge of the home are at least 21 years of age. Staff were observed to be busy, but not unnecessarily so, and were observed to have the time to chat with residents and generally ‘pass the time’ with them whilst carrying out their duties. The home is organised and functions to provide for the welfare of residents. Residents spoken with expressed approval of the attitude of care staff, they did not have to wait for attention from staff, and they felt safe at the home. The records show that the home has an effective and robust recruitment policy and Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 19 procedure. All prospective staff fill in an application form and attend an interview prior to appointment. All staff are issued with a statement of terms and conditions and a copy of the General Social Care code of conduct and practice. Enhanced Criminal Records Bureau checks are completed for all staff. The home has a comprehensive ‘in-house’ induction package and the registered provider presents short training sessions to staff on a regular basis. The registered provider is aware of the need to use an National Training Organisation compliant induction programme, and this is in use with one new staff member. The last 2 carers at the home without an NVQ qualification commence this training in April of this year. There are 29 carers employed at the home, of which all but 4 (who are doing the training) have achieved NVQ Level 2 or above. Eight staff have achieved NVQ Level 3. There is regular, almost daily, in-house training provided, and a record of attendance and content is kept for these sessions. Staff confirmed that training opportunities are provided, one nurse having a course booked for April 2007. The registered provider has daily contact with the staff. The home operates with comprehensive policies and procedures, which are regularly reviewed. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered provider is providing clear and effective leadership and management to maintain a safe and comfortable home for service users. The home could do more to obtain the feedback of residents and others. The registered provider protects residents financial interests. EVIDENCE: In June of this year the home will celebrate 21 years of service. The registered provider is a registered nurse who has achieved NVQ level 4 in care and management. Mr Small has extensive experience of managing a home. The registered provider is open and approachable and communicates a clear sense of direction and leadership, having daily contact with the residents and staff. There are clear lines of accountability within the home. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 21 Although the home has, in the past, made use of quality assurance questionnaires, this practice has lapsed. This was identified at the last inspection. The registered provider said that this would be implemented. The home has established, secure, financial procedures, and there has been no significant change since the last inspection. The registered provider has no involvement in residents finances at all, preferring to invoice for costs retrospectively with relevant receipts. The registered provider will hold only small amounts in safe keeping (usually brought in by relatives) for which there are accurate records. The registered provider keeps detailed and efficient records securely. Appropriate policies and procedures are in operation. Contractors carry out appropriate maintenance and safety checks, and safety related training is provided for staff (e.g. fire training). Appropriate insurance is in place. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 22 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 4 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 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 3 18 4 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 2 X 3 X X 3 Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 23 YES 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 OP33 Regulation 24 Requirement The registered provider must seek the views/feedback of residents, their representatives, and other people who have involvement with the home (e.g. GP, CPN), analyse the responses, take any action where necessary, and publish a summary of the findings (possibly in the home’s service user guide). Timescale for action 01/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP15 Good Practice Recommendations The registered provider should ensure that the menu demonstrates a choice being available at meals, that residents are asked for their choice, and that the record of food provided shows the choices made. Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 24 Old Roselyon Manor DS0000009200.V359931.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Roselyon Manor DS0000009200.V359931.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!