Care Home: Patron House

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What the care home does well People who live in this home can expect to have their needs met because of good assessment processes and detailed information being available about what the home has to offer. Care planning processes ensure that each person is well cared for and their individual needs are met. Medication systems are safe. People who live here are able to join in a number of different events and can continue with social activities outside of the home. They are provided with nicely presented, home cooked meals. People can be assured that they will be listened to and that any concerns will be acted upon, and that they will be safeguarded from harm. Patron House is a comfortable and well furnished home that is well maintained and safe.The people who live at Patron House are looked after by staff who are skilled and competent to meet their care needs. This is because the training opportunities for the staff team are commendable. People live in a care home that is well managed and run in their best interests. It is safe and their welfare is promoted. What has improved since the last inspection? No requirements or recommendations were made following the last inspection and the service continues to provide a very comfortable home for the people who live there, with the staff always striving to provide exactly what people want. CARE HOMES FOR OLDER PEOPLE Patron House 212 Stoke Lane Westbury On Trym Bristol BS9 3RU Lead Inspector Vanessa Carter Unannounced Inspection 18th September 2008 09:30 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 Patron House DS0000026513.V370400.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. Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Patron House Address 212 Stoke Lane Westbury On Trym Bristol BS9 3RU 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) 0117 9682583 0117 9691973 sam.hawker@blueyonder.co.uk www.AbleCare-homes.co.uk Willcox Bros Ltd t/a Ablecare Homes Miss Emma-Louise Marshall Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12) of places Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 12 persons aged 65 years and over requiring personal care The Flat should be shared by couples that have expressed a clear wish to share and who are: a) married couples b) living as a couple prior to admission c) living together in the community prior to admission May accommodate one named person aged 59 for one week requiring respite care 21st September 2006 3. Date of last inspection Brief Description of the Service: Patron House is a residential care home providing accommodation and personal care for a maximum of 12 persons aged 65 years and over. There is a flat within the homes that can be offered to couples needing care, who wish to share. The home is a detached property in a residential suburb in the city of Bristol. Accommodation is arranged over two floors, and a stair lift is provided. The home has a very homely feel and is comfortably furnished. Well-kept gardens surround the property. Ablecare Homes Ltd. own and operate five homes in the Bristol area, Patron House being one of those. The other homes are Rosewood House and Belvedere Lodge, also in Westbury-on-Trym, Hengrove Lodge in Hengrove South Bristol and Crossley House in Winterbourne, South Gloucestershire. The business is a family concern overseen by Mrs Sam Hawker, one of the directors of the company. The registered manager of the home is Miss Emma Marshall. The cost of placement at the home is between £550 - 600.00 per week and is dependent upon assessed need. Additional costs are made for a range of services and these are detailed in the Homes Brochure. Prospective residents are able to find about the home by requesting a copy of this from the Home Manager. Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This key inspection was unannounced and took place over one days. A total of five hours were spent in the home. Evidence to form the report has also been gathered from a number of other sources:• Information provided by the Home Manager in the Annual Quality Assurance Assessment (AQAA) • Talking with the Home Manager and a Director of Ablecare Homes • Talking with some of the care staff • Observations of staff practices and their interaction with the people who live in the home • A tour of the home • Case Tracking the care of a number of people • Talking with a number of the people who live in the home • Looking at some of the homes records • Information supplied in CSCI survey forms, that were completed by people who live in the home, and one healthcare professional who visits the home. What the service does well: People who live in this home can expect to have their needs met because of good assessment processes and detailed information being available about what the home has to offer. Care planning processes ensure that each person is well cared for and their individual needs are met. Medication systems are safe. People who live here are able to join in a number of different events and can continue with social activities outside of the home. They are provided with nicely presented, home cooked meals. People can be assured that they will be listened to and that any concerns will be acted upon, and that they will be safeguarded from harm. Patron House is a comfortable and well furnished home that is well maintained and safe. Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 6 The people who live at Patron House are looked after by staff who are skilled and competent to meet their care needs. This is because the training opportunities for the staff team are commendable. People live in a care home that is well managed and run in their best interests. It is safe and their welfare is promoted. 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. Patron House DS0000026513.V370400.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 Patron House DS0000026513.V370400.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 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in this home can expect to have their needs met because of good assessment processes and detailed information being available about what the home has to offer. EVIDENCE: The home’s statement of purpose and service user guide has been reviewed and updated since the last inspection and therefore continues to meet the standard required. It provides a true reflection of the service and what it has to offer. Copies of both documents are available in the small lounge area. Those people who completed CSCI survey forms said they had been provided with enough information about the home prior to taking up residency. The service users guide contains pictures of previous events that have happened in the home, information about the staff team and mealtime arrangements. It also makes clear that insurance cover is not available for people’s personal possessions. Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 9 Each person is provided with a statement of terms and conditions at the start of their stay in the home. The manager explained that in the main residents who come to live at Patron House are privately funded. When a resident is funded by the local authority a contract would be set up with the funding authority – currently this is in place for only one resident. The home does not admit people into the home until after an assessment of needs has been completed. The manager will visit people in either their own home, or the hospital. A number of people have moved to live at Patron House, to be near their Bristol relatives – in these circumstances the manager will obtain as much information as possible from family and social workers, in order to be able to make a judgement that the home can meet the person’s needs. This is good practice and ensures that placement is only offered to those people whose needs can be met. The home offers placement to older people. It cannot accommodate those with any form of dementia however, will continue to care for those people who develop mild memory problems and confusion, as long as the home can meet their needs and there is no detrimental affect upon the others. The home currently has a number of vacancies and is only accommodating nine people – the flat is being used by just one at present, thereby reducing the total number of people who can live at Patron House to 11. Where appropriate, people are encouraged to visit the home prior to moving to live at the home. One person stated that their family had arranged everything for them and that they had visited the home “because I was in hospital. I am very happy here and feel so much safer”. Patron House DS0000026513.V370400.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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning processes ensure that each person is well cared for and their individual needs are met. Medication systems are safe. EVIDENCE: Three people’s care plans were looked at, including that of the most recently admitted person. For each person there was a detailed assessment of their specific care needs and a plan for how these needs should be met. The plans were person-centred, evidencing that the home looks at each person as an individual. The plans had evidently been written in conjunction with the person as where appropriate, the person had signed their agreement to the plan. Also recorded was personal preference information – including diet, way of dressing and grooming, religion and past time interests. For one person there could be better recording in their care plan regarding dietary advice provided by a visiting healthcare professional although it is recognised that this advice is the ‘norm’ for all of the people who live at Patron House. Along side the care plans a number of risk assessments are completed – these are in respects of any manual handling procedures that may need to be Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 11 followed and the risk of falls. There is to be a review of how this information can be better recorded so that information is clearer and the management strategy much more robust. This should include timescales for review of any plans put in place. A record of all visits by healthcare professionals is kept. Examination of the daily records evidenced that the GP is contacted and visits, when people are ill. Also chiropodists, opticians, and the district nursing services, are regular visitors to the home. There are safe procedures in place for the ordering, receipt, storage, administration and disposal of medicines. Staff will not administer medications until they have been trained and have been deemed as competent to do so. One staff member spoken with during the inspection confirmed that they have received training in safe administration of medications. Evidence of those who have completed the training was not seen at this inspection however compliance has previously been demonstrated. Risk assessments are completed around self-medication and one person was able to administer some of their medicines. Staff were observed going about their duties in a professional and calm manner and responding to people’s needs in a familiar and friendly manner. Each person was treated respectfully. One person said, “I am very well looked after and don’t want for anything”, whilst another said, “the staff make me feel safe. They are very kind and do their very best”. Patron House DS0000026513.V370400.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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live here are able to join in a number of different events and can continue with social activities outside of the home. They are provided with nicely presented, home cooked meals. EVIDENCE: People are encouraged to continue attending any clubs or outside activities when they live at Patron House. One person continues to go along to their church meetings whilst another attends a weekly club in the village. This evidences that the home encourages people to be as independent as possible and to retain their involvement in the community. The previous day, one person has visited Horseworld with people from the other Ablecare homes and staff members. In addition, the home arranges some activities using external entertainers, examples being musical entertainers, singers and parties. Events are always arranged to celebrate people’s birthdays and other festivals. Two people spoken with during the inspection said they liked to sit quietly, do the crossword and read their newspapers. Another person said that they liked to have the television on all the time as “it is company for me and I like to hear all the chattering voices”. In the most recent customer service questionnaire (completed by Abelcare Homes), a relative had commented “I think the residents would chat more if the TV was turned off”, but from observations Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 13 made during the inspection, people did speak to each other even when the television was on. Visitors are welcomed in the home at any reasonable time. One person said that they regularly went out with their relatives. A well balanced diet is provided with an emphasis on home cooking and the use of fresh vegetables and fruit. People who completed CSCI survey forms said there was a good choice and alternatives were offered when necessary – “I get choice in what I eat” and “I can have my meals served in my room if I wish”. On the day of inspection, a casserole with fresh vegetables and potatoes was served followed by homemade apple pie. Breakfasts are usually served in people rooms and on the whole everyone takes their midday meal in the dining room. Patron House DS0000026513.V370400.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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that they will be listened to and that any concerns will be acted upon, and that they will be safeguarded from harm. EVIDENCE: A copy of the complaints procedure is included in the statement of purpose and is also displayed in the main reception area of the home. People spoken with during the course of the inspection said they would talk to the manager or any of the staff if they were not happy about anything. The home has dealt with one complaint since the last inspection, and the complainant also contacted CSCI for clarification of the outcome. The complaint was handled appropriately. As a result of this complaint, the service users guide was updated to provide clearer information in respect of insurance cover for peoples personal possessions. The home also maintains a log of compliments received – and they had received many of these. One person commented “if I do have any crumbles they are always sorted out”. All five people who completed a CSCI survey form said they knew how to make a complaint and one wrote “I can talk to the manager anytime and she is very approachable”. During the course of the inspection visit, it was obvious that the people who live there feel able to speak out and are able to talk easily with the staff. There are policies and procedures in place to ensure that the residents are safeguarded from any form of abuse. Most staff have attended adult abuse Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 15 awareness training delivered by the Bristol City Council, whilst others will be attending training that the home has arranged for later in the year. Staff who were spoken with during the inspection demonstrated good awareness of safeguarding issues and of the procedures to be followed. Patron House DS0000026513.V370400.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, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Patron House is a comfortable and well furnished home that is well maintained and safe. EVIDENCE: Patron House is a detached residence with accommodation provided over two floors. The shared communal space is on the ground floor and consists of a lounge, dining room, and a quiet area, that leads out into the patio and rear gardens. New carpeting has been laid in the hallway and on the stairs. Some bedrooms and the hallway have recently been redecorated, but the whole home is well maintained and neat. All areas viewed were clean, tidy and domestically furnished. There is a stair lift in place to enable those people with reduced mobility to access the first floor. Despite the installation of this equipment, it is still possible for those able to walk up and down the stairs to do so. A number of people are able to use the chair lift independently, whilst others needs some assistance. Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 17 The home looks well maintained and any repairs and alterations are reported to the owners. Ablecare Homes have their own maintenance team, who look after all five homes. The home has two bathrooms, one on each floor, but the ground floor bathroom is little used and has no adaptations. A battery operated bath seat is installed in the flat and is used by one person and the bathroom upstairs is fitted with a swivel bather seat. There are separate toilets located on each floor. A number of aids have been installed throughout the home, including a newly fitted ramp by the front door, a dorguard for one bedroom door, raised toilet seats, grab rails, a call-bell system, and the stair lift. There is one small step out on to the patio at the back of the house with a number of steps down to the rear gardens, but grab rails are fitted. Apart from the shared flat (currently only used by one person), the ten other bedrooms are for single occupancy, each having their own en-suite toilet, and wash hand basin. The rooms are comfortably furnished. People are encouraged to have their own belongings around them, and to personalise their rooms to their own taste. The home was warm, well lit, clean and tidy and free from any malodour. Patron House DS0000026513.V370400.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 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The people who live at Patron House are looked after by staff who are skilled and competent to meet their care needs. This is because the training opportunities for the staff team are commendable. EVIDENCE: The staffing levels at the home are appropriate to meet the needs of the current people who live there, many of whom are still fairly independent, and require only minimal assistance. The staff rota’s show that each morning there are two care staff, two in the afternoon and evening, and over night one waking member of staff. On the day of inspection, the home manager plus two other staff were on duty. Duty rota’s are arranged over a two week period, the staff team is stable and there has been little turnover – this means that the people who live here are looked after by staff who are familiar with their care and support needs. The home have made significant improvements in the numbers of staff who are trained to at least an NVQ level 2, going from 10 to 50 since the last inspection. In addition there is one member of staff with a Level 3 NVQ, the home manager is trained as an NVQ Assessor, and an apprentice has been recruited via a government scheme who is working towards an NVQ2 in care. These measures evidence that the people who live at Patron House are looked after by well-trained staff Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 19 The home has good recruitment procedures although there has been very little staff turnover since the last inspection. Applicants who want to work at Patron House will be expected to complete an application form, provided two satisfactory written references from previous employers, and have POVA 1st and CRB clearance. Two staff files were examined and evidenced that safe vetting procedures had been followed. For any new recruits that is a robust induction- training programme for staff to follow. The training programme is comprehensive, and expected to have been completed within 12 weeks. It meets the Skills for Care common induction standards. It also links with NVQ training and the homes policies and procedures. Alongside the induction and NVQ training programme, other training sessions are arranged. A look at the staff training files evidenced that the team have attended courses in safe administration of medications, manual handling, food hygiene and health & safety, first aid and fire awareness. Patron House DS0000026513.V370400.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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a care home that is well managed and run in their best interests. It is safe and their welfare is promoted. EVIDENCE: The home manager Emma Marshall has been in post for a number of years and has already achieved the registered managers award and is an NVQ Assessor. During this inspection she demonstrated a good understanding of each persons particular care needs, and continues to show a commitment to providing a good service for the people who live there. Observations of the working practices, and the interactions between the staff and the people who live there, evidenced that the home is run in the people’s best interests, their views are important, that they are listened to and any concerns are acted upon. Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 21 Ablecare Homes completed a ‘customer service satisfaction’ survey at the beginning of the year and the outcome was that in general people were happy with the service they received. The survey covered meals, choice of activities arranged, home arrangements, involvement in care planning and ability to express any concerns or complaints. An action plan was prepared based upon the results and some of the new ideas were trialled, for example menu choices and different activities. The director completes monthly reports for CSCI, visiting the home on a regular basis and monitoring the standards of care and staff satisfaction and dealing with any management issues. The home holds monies for a number of people. An examination of the accounts kept of transactions in and out of the accounts were checked and tallied with amounts held. The administrative procedures in place ensure that people’s money is protected. The home is well maintained both inside and out. The fire records were checked and evidence that all the necessary checks of the alarm system, emergency lighting and fire fighting equipment have taken place. Fire instruction and drills are carried out with the staff team on a regular basis. Patron House DS0000026513.V370400.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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Patron House DS0000026513.V370400.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP8 Good Practice Recommendations Review the format for recording risk assessments and the management strategies. To include a timescale for review. Patron House DS0000026513.V370400.R01.S.doc Version 5.2 Page 24 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 Patron House DS0000026513.V370400.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. 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. 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