Care Home: One-Six-One

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What the care home does well The Home is well managed in a way which puts the needs of the clients first. The staff support clients to live their lives in a way which respects their individual preferences and choices. The staff are enthusiastic about working with the clients and have a good understanding of individuals needs and how these should be met. The staff are respectful about the clients and we observed positive communication between staff and clients. The Home provides comfortable and homely accommodation for the clients and there is an ongoing maintenance and redecoration plan in place. Clients are encouraged to personalise their own bedrooms and to take part in household tasks. What has improved since the last inspection? The clients are being supported in a much more individualised way and the staffing is provided to do this. Clients are supported to take part in a greater variety of activities, both in the local community and at Home. Transport is provided to enable this to happen.The care plans and risk assessments are much more detailed and contain better guidance for staff about how to meet individuals needs. The clients are encouraged to be part of this process and to take part in reviews. The views of the clients are sought on a more regular basis, both informally and more formally at regular 1:1 time with staff. Training and support to the staff team has improved. The staff said that they are offered more opportunities to attend training that is relevant to the needs of the clients living at the Home. This has included training about diabetes, dementia, supporting people with challenging behaviours, mental capacity act. Regular staff meetings and staff supervision is taking place. Recruitment has taken place so there is less agency staff working at the Home. What the care home could do better: There is a need for clearer information within the care plans about the arrangements in place for looking after the clients money. There is also a need to provide relevant information in simpler formats which would make it easier for the clients to understand. CARE HOME ADULTS 18-65 One-Six-One The House 161 Wootton Road King`s Lynn Norfolk PE30 4DW Lead Inspector Lella Hudson Unannounced Inspection 9th September 2008 10:00 One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address One-Six-One DS0000027509.V371341.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service One-Six-One Address The House 161 Wootton Road King`s Lynn Norfolk PE30 4DW 01553 673194 01553 674395 onesixone@btopenworld.com 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) One-Six-One Limited Ms Sharon Jones Care Home 8 Category(ies) of Learning disability (8) registration, with number of places One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th September 2007 Brief Description of the Service: One-Six-One is a care home providing care to eight people with learning disabilities. It is situated in a residential area of Kings Lynn, approximately a mile from the town centre. There are local shops, a library and other amenities within the immediate vicinity of the home. The premises consist of accommodation on three floors accessed by stairs. There are two reception rooms, kitchen, dining area and laundry on the ground floor. Bedrooms are located on ground, first and second floors. The home was extended in the spring of 2002 to provide two further bedrooms and to improve the standard of accommodation to others. The home has patio, decking and garden areas to the rear. The home provides care for ambulant people who may require consistent support for their behavioural needs. Service users access a variety of day activities and services available locally. The home has its own transport. The fees for current service users range from £1000 to £4556. The Home is owned and managed by CareTech trading as One-Six-One Ltd. The Manager, Sharon Jones, was registered by the Commission in May 2008. One-Six-One DS0000027509.V371341.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 TWO STAR. This means that the people who use this service experience GOOD quality outcomes. This report contains information gathered about the Home since the last Key Inspection in September 2007. It also includes information provided by the Home in the form of notifications, information about concerns/complaints/allegations and also information provided with surveys that were completed by staff (1) and clients (1). The responses in both of the surveys that we received were positive about the Home. The organisation also owns and manages a three bedded Home (The Annexe) which is situated behind this Home. The smaller Home is managed and staffed by the same staff team as that at this Home. Both of the Homes were inspected at the same time although each Home has its own Inspection Report as they are registered separately. There are currently five clients living at the Home and therefore there are three vacancies. What the service does well: What has improved since the last inspection? The clients are being supported in a much more individualised way and the staffing is provided to do this. Clients are supported to take part in a greater variety of activities, both in the local community and at Home. Transport is provided to enable this to happen. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 6 The care plans and risk assessments are much more detailed and contain better guidance for staff about how to meet individuals needs. The clients are encouraged to be part of this process and to take part in reviews. The views of the clients are sought on a more regular basis, both informally and more formally at regular 1:1 time with staff. Training and support to the staff team has improved. The staff said that they are offered more opportunities to attend training that is relevant to the needs of the clients living at the Home. This has included training about diabetes, dementia, supporting people with challenging behaviours, mental capacity act. Regular staff meetings and staff supervision is taking place. Recruitment has taken place so there is less agency staff working at the Home. 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. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 5 Quality in this outcome area is GOOD This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place to ensure that effective assessments are carried out prior to a client moving into the Home. EVIDENCE: The Home currently has three vacancies. The Manager described the process that would take place following an enquiry about a vacancy. The organisation has procedures relating to the admission of clients and these include obtaining the views of the client and of ensuring that they were invited to visit the Home prior to moving there. The Manager is aware of the importance of ensuring that the Home can meet the needs of any prospective clients. The previous requirement about the need to update the Statement of Purpose for the Home has been met. Another document called ‘Welcome to The Mallards’ has been produced and the Manager is aware that a couple of minor alterations are needed to ensure that this is completely accurate and up to date. The Manager said that they are reviewing how this information can be provided in a way which clients may find easier to understand. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 9 We saw one of the clients contracts. This contains the majority of the information about what is covered within the clients fees but does not contain information about costs for transport. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The care plans provide clear guidance for staff about how to meet the clients needs. EVIDENCE: We looked at two of the care plans and risk assessments. These have been improved since our last visit to the Home and are now more personalised and individual to each client. The format of the care plan has been changed so that the most relevant information relating to individuals care is now kept in a smaller file which is more accessible. The other information, which is not necessarily needed on a daily basis, is still easily accessible to staff. The care plans contain assessments, risk assessments and detailed guidance about how to meet individuals needs. The two care plans that we saw contain information about a range of needs, including health and personal care, behavioural support, social and emotional support. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 11 Risks are recognised by staff and clear guidance is in place for staff to be able to manage risks effectively. The records that we saw show that the rights of the clients to make choices is considered alongside the risks to themselves or others. Where restrictions are in place these are clearly recorded, as well as the reasons for this. Staff who spoke to us said that they regularly read the care plans and are involved in reviewing and updating them. Minutes of the staff meetings indicate that the individual care needs of the clients are regularly reviewed and discussed. These are discussed with each client on an individual basis during their ‘Talk Time’ sessions as well as during more formal reviews. ‘Talk Time’ is a concept recently introduced by the organisation. It means that each of the clients has one to one time with their key worker to discuss a specified area, such as ‘activities’, ‘relationships’ etc. The staff said that they use the opportunity to also discuss other aspects of care that they client may wish to talk about. There is evidence that the care plans are regularly reviewed and that information and guidance provided by health and social care professionals is incorporated into them. There is also evidence that the clients are involved in the care planning process. The staff complete daily records which includes information relating to the individuals care plans. The care plans do not contain detailed information about the arrangements in place to look after clients money. The Manager explained the system that is in use but is not clear about how much money each client is entitled to each week. We checked the records kept which relate to one of the clients money and found that the receipts and the record of expenditure matches the cash actually held at the Home. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The clients are supported to take part in a range of activities that are meaningful to them. The clients are encouraged to be involved in planning menus, shopping and cooking. EVIDENCE: There have been improvements in the quality and quantity of activities that the clients are involved in. The AQAA included information about a range of activities that clients are supported to access and discussions with staff and clients confirmed that these take place. There are currently five clients living at the Home. One of the clients does not have any kind of formal day service. Two clients attend formal day services Monday to Friday. Two of the clients each have individualised 2:1 staff support during each day from morning until late afternoon/early evening. The One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 13 organisation owns other houses located close by and these are used by the clients as a base during the day. Discussions with staff and observation of records show that for one of the clients in particular the range and quality of the activities that he is taking part in has greatly increased. The staff rotas show that the appropriate staffing support is available to support the two clients on a 2:1 basis. The client who does not receive formal day services is supported by the staff on duty at the house to take part in household tasks or activities in the local community depending on her choice. The client told us about the recent celebrations for her 40th birthday which included a visit to London and communication from the Queen. Staff had worked hard to ensure that the client had a birthday which she would enjoy and have supported her to keep photographs and other souvenirs as a reminder of the day. The Home is located close to the town of Kings Lynn and the clients either walk to local facilities, use the bus or use one of the three vehicles that are available for the clients living at the main house and in the Annexe. The care plans include information about how individual clients like to spend their time and also the arrangements in place to enable them to maintain contact with relatives and friends. The Home no longer has a dedicated cook and so all of the care staff are involved in planning menus and preparing meals. One of the clients told us that she likes to help with cooking and was seen to prepare her own lunch on the day of our visit. One of the clients likes to have a continental breakfast and so the staff prepare this for him and leave it in the fridge for him to have whatever time he gets up. Staff and clients said that there are no set times for mealtimes and that meals take place at times that suit the clients and whatever activities they are involved in. Menus are agreed between the clients but staff said that there is always flexibility around the menus. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The personal and healthcare needs of the clients are met, this includes the safe administration of medication. EVIDENCE: The care plans contain detailed information about the personal and healthcare needs of the clients. It also includes information about how the individual clients prefer to receive their care. Discussions with staff showed that staff are aware of the individuals needs and gave consistent answers to questions about how care is provided to particular clients. Information in the care plans show that clients are supported to have regular appointments with the dentist, optician and chiropodist as required. There has also been increased involvement of other health/social care professionals as clients needs have changed. Staff have recognised when clients need the support from other professionals and have made appropriate referrals. They have also worked hard to support clients when they find situations difficult. For example, one of the clients would not attend the diabetic clinic and so arrangements were made for the diabetes nurse to visit One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 15 the client at home in order to prevent distress to the client and to ensure that the she received the necessary healthcare. Discussions with staff provided evidence that staff are now receiving training in a more timely way about issues relating to individuals needs. For example, the staff have received training with regard to supporting clients with difficult behaviours, including the use of restraint as well as training about diabetes, epilepsy and the mental capacity act. Staff are clear about the importance of good communication and understanding the function of behaviour when supporting clients whose behaviour can be challenging. Records show that the incidence of difficult behaviours has reduced over the last few months. The Home has started to use the Health Action Plans which are recommended to be used for people with a learning disability. This document contains all relevant information relating to clients physical and emotional health needs and is easily updated. This is in addition to the information being contained within the care plans. The medication system was seen and evidence provided to show that the requirement made at the last Inspection has been met. Medication is stored appropriately and records are kept of the receipt, administration and disposal of medication. There is a communication book kept by the medication cupboard which is used to record any changes in medication. Staff are not able to administer medication until they have received appropriate training. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The clients feel that their views are listed to and that staff take action to address any issues. Staff receive training with regard to protecting the clients from abuse. EVIDENCE: The complaints procedure has been put into a simpler format which the clients can more easily understand. We have not received any complaints about the service and the Manager said that they have not either. One of the clients told us that she feels she can speak to any of the staff and that they listen to what she says. The staff said that they feel that the clients are able to speak to them about issues, either in their one to one sessions or through more informal everyday discussions. The staff receive training with regard to Safeguarding vulnerable adults and also other relevant training such as working with people with challenging behaviours. Staff who spoke to us were very clear that the use of restraint is only ever used as a last resort and they were able to give consistent answers to questions about the possible triggers to individuals behaviours and how to respond to these. The Manager has made one referral to the Safeguarding team since the last Inspection. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The Home provides comfortable and homely accommodation which meets the needs of the clients living there. EVIDENCE: The Home has an ongoing maintenance and redecoration plan. Since the last Inspection the sun lounge and some of the bedrooms have been redecorated. The clients are encouraged to personalise their own bedrooms and to be involved in keeping them clean/tidy. The clients have access to all areas of the Home apart from each others bedrooms. On the day of our visit the Home was clean and there were no unpleasant odours. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The clients are supported by an effective staff team who receive appropriate training and support. Appropriate recruitment procedures are followed. EVIDENCE: The staff who spoke to us said that the training opportunities and the support provided to the staff team has increased since the last Inspection. Staff said that they are supported to attend training in subjects relevant to individual clients needs as well as to complete NVQs. One of the staff spoke highly of the induction that she was currently undertaking and said that she has received good training and ongoing support from her mentor. Staff said that staff meetings take place on a regular basis and that the Manager is always available to discuss issues with as well as providing formal supervision sessions. The staff confirmed that less agency staff are used now and that recruitment has meant that the staff team is more stable and consistent. They said that there is good staff morale and that communication amongst the staff team is good. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 19 We looked at the staff rotas and these confirm the information gathered from staff and the Manager about the staffing levels provided. There are additional staff on duty at weekends when all of the clients are at home although this is flexible depending on whether any of the clients go to stay with relatives. The staffing situation at night has reverted back to just one sleep in staff as the client who required a waking night staff no longer lives at the Home. The Manager is aware of the importance of ensuring that staffing levels are adequate when new clients are admitted to the Home. We looked at a selection of recruitment files and could see that appropriate checks are carried out prior to a member of staff starting work at the Home. One of the staff confirmed that this took place before she was offered a job. One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Clients benefit from living in a Home which is well managed and which is run around the needs of the clients. Procedures are in place to ensure that the health and safety of the clients and staff is protected. EVIDENCE: The Manager has completed the registration process with the Commission since the last Inspection. She has suitable experience and skills to manage the Home. Staff who spoke to us said that they receive good support from the Manager and that she is approachable. The deputy manager now takes on a more specific role of managing The Annexe (the small home next door). The improvements that have been made since the last Inspection are in relation to ensuring that the clients are viewed as individuals and that their One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 21 needs are met in ways which respect their choices and preferences. There are a range of ways in which the views of the clients are sought, ranging from daily informal chats to the more formal ‘Talk Time’ sessions and reviews. One of the clients said that the staff always ask for her opinion and that she chooses what she does. We had discussions with the Manager about the use of questionnaires as a tool for obtaining others views of the service and of the need to bring all of the quality assurance information together into an annual report. We looked at a selection of records relating to health and safety and could see that regular maintenance and servicing of equipment, including fire safety equipment, takes place and that staff receive appropriate training. One-Six-One DS0000027509.V371341.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 Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 23 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 YA7 Regulation 17 (2) Schedule 4 Requirement A financial care plan must be kept for each client to ensure that there is clear information about what money the client is entitled to and how this is managed on their behalf Timescale for action 31/10/08 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 One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI One-Six-One DS0000027509.V371341.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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