Care Home: Redwood Close 11

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What the care home does well Whilst there the people who live in the home were relaxed and appeared settled, interactions with staff were positive reflecting good relationships. The staff team complete assessments of people before they move into the home to help to make sure that the home can meet their needs. This information is used to develop care plans. Consequently people have detailed care plans, which identify their needs and how the staff are going to support them in the meeting of these. People are supported to keep daily diaries of their lives, which are used to help review how people are and if their needs are being met. People have varied and busy lives where they access both adult education and leisure activities. They are well supported in the home to relax. If people become unwell or if they have a health need the staff team support them to gain the necessary access to health professionals and have these needs met. People live in a warm and comfortable home, which helps them to meet their needs. What has improved since the last inspection? The laundry floor has been painted to make sure that it is impermeable. This helps to make sure that should any liquids spill onto this from the laundry systems they will not be absorbed into the flooring posing a health and safety risk. What the care home could do better: People are supported to live their lives and risk assessments are in place to help prevent people being harmed. However these must be kept up to date and contain the latest information for them to fully reflect the risks involved and help to protect people. The reporting of incidents within The Protection of Vulnerable Adults policies should be improved to make sure that all such incidents are reported within an appropriate timescale. This will help to make sure that any incidences are dealt with by the correct agency, within appropriate timescales and help to support the individuals concerned. Staff must be regularly supervised so that they can be fully supported both within their roles and with any training needs that they may have. This will assist them to continue to fully meet people`s needs. Evidence of the maintenance and safety checks undertaken must be kept within the home. This will assist the manager and staff team to monitor thatthese are up to date and that systems within the home do not place people at risk. In addition the fire risk assessment must be kept up to date in order for it to be an effective tool in identifying the risks in the home and control measures, for keeping people safe. CARE HOME ADULTS 18-65 Redwood Close 11 11 Redwood Close Bridlington East Riding Of Yorks YO16 7GX Lead Inspector Sarah Sadler Key Unannounced Inspection 13th November 2007 09:00 Redwood Close 11 DS0000019782.V348335.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 Redwood Close 11 DS0000019782.V348335.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. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Redwood Close 11 Address 11 Redwood Close Bridlington East Riding Of Yorks YO16 7GX 01262 675862 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) East Yorkshire Housing Association Limited Mr Barry Jordan Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Learning disabilities - Code LD The maximum number of service users who can be accommodated is: 3 5th December 2006 2. Date of last inspection Brief Description of the Service: 11 Redwood Close is owned by East Yorkshire Housing Association Limited. The home is registered to provide accommodation and care for three people, male or female who have a learning disability. There are currently 2 people living at the home. The home is generally well maintained and bedrooms are individually decorated to reflect the style and taste of the people living there. People have access to all communal areas and can spend time with others in the lounge and dining room or take time to be alone in their bedroom. The home has its own transport for taking people to day centres or on outings in the surrounding countryside and has good access to the local bus service. The registered manager confirmed that the weekly fees for living in the home are £344.50. With additional charges for toiletries, transport and petrol, of which the fees vary. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit commenced at 09.00 and was completed at 12.00. The manager was available for the whole of the visit. There were no relatives or visiting professionals available on the day of the visit to talk to. The people living in the home are unable to complete questionnaires or question and answer sessions and so could not formally participate in this inspection process. They were present in the home for a short while at the beginning of the visit as they both attend Adult Education services each day of the week. There was in addition to the registered manager, one staff member on duty and this person assisted with the inspection. A tour of the premises including people’s rooms was undertaken and people’s files; staff records, health and safety documents and other records were examined. An additional visit was undertaken to the head office of the organisation to review staff files, which were held there, and not in the home. The unannounced visit commenced on 13th November 2007 and forms part of this inspection, which includes a review of all information received relating to the home since the last visit or registration. As such this report reflects information from the site visit, views from people via surveys, the Annual Quality Assurance Assessment (AQAA) document provided by the registered person and referral to any other relevant letters or occurrences in the home. It also includes evidence from case tracking of people’s files and information Other information we considered included the AQAA. This is a self-assessment document which is completed by the registered person to evidence how well the home is meeting the National Minimum Standards, and what if anything needs to improve. From this information formal surveys were sent to the relatives and professionals. The relatives survey returned confirmed that they were happy with all aspects of the service, raising no concerns or comments. They also confirmed that the care service always meets the different needs of people, including considering their race, ethnicity disability or faith. During the inspection process and again in preparation for the site visit we assessed other information received by the CSCI regarding the home, which included any letters from the registered person or others and any complaints, of which there has been none. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: People are supported to live their lives and risk assessments are in place to help prevent people being harmed. However these must be kept up to date and contain the latest information for them to fully reflect the risks involved and help to protect people. The reporting of incidents within The Protection of Vulnerable Adults policies should be improved to make sure that all such incidents are reported within an appropriate timescale. This will help to make sure that any incidences are dealt with by the correct agency, within appropriate timescales and help to support the individuals concerned. Staff must be regularly supervised so that they can be fully supported both within their roles and with any training needs that they may have. This will assist them to continue to fully meet people’s needs. Evidence of the maintenance and safety checks undertaken must be kept within the home. This will assist the manager and staff team to monitor that Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 7 these are up to date and that systems within the home do not place people at risk. In addition the fire risk assessment must be kept up to date in order for it to be an effective tool in identifying the risks in the home and control measures, for keeping people safe. 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. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 8 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 Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 9 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): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are assessed prior to them entering the home to ensure that the home can meet these needs. EVIDENCE: The information in the AQAA included that through the admissions procedure people are invited on several visits prior to moving into the home. Also that all relevant agencies are involved in the assessment and planning process to help make sure that people’s needs are fully known. Both of the people currently living in the home have done so for some time. There are initial assessments in place, which have been developed into person centred plans with care plans that include the details of the support the individual requires living their lives. Redwood Close 11 DS0000019782.V348335.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s needs are met with good procedures in place supporting them to live their lives as they choose. EVIDENCE: A relative confirmed in their survey that they felt that their relative’s needs are being met in the home. The information provided in the AQAA included that the individual plans are developed with the people in the home and all significant others. People’s files included their care plan, which also held daily diary notes, monthly, quarterly, and annual reviews. The annual review is a formal review held with the Local Authority and the individual and their representatives may be present. By being involved in this process the individual is aware of and has the opportunity to make decisions relating to their care. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 11 The relative also confirmed that their relative is always supported to live their life as they choose. The information provided in the AQAA included that people are involved in the running of the home, for example, shopping, menus, household tasks and choice of furniture and décor. People’s diary notes included reference to the decisions that they make, for example, what time to get up and what time to go to bed, what to have to eat and whether to spend time alone or with others. There are comprehensive risk assessments held in each person’s file which cover a lot of areas from making a hot drink, to taking a bath or shower to going out in the local community. Staff have at times signed to say that they have read and understand these risk assessments, however there is no evidence that the risk assessments are regularly reviewed and kept up to date with the changing needs of the individual. This would ensure that the risk assessments take into account the latest needs and risks to the person when completing the activity. Redwood Close 11 DS0000019782.V348335.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, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to have active lives, with important relationships and their privacy being upheld and their dietary needs being met. EVIDENCE: The information in the AQAA included that people use the organisations outreach services, which offer activities including arts and crafts, music, IT and opportunities for annual holidays. People’s diary notes included details of them attending their Adult Education sessions, in addition diary notes contained details of how people spend their time at home. This included watching television, listening to music, enjoying a long soak in the bath and going for rides out. The staff member confirmed that both the people in the home enjoy gong for a ride out and that one person prefers rides out and one person likes to make the ride out into a shopping trip. With both people enjoying meals out. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 13 The relative confirmed that the home helps their relation to keep in touch with them. Some of the minutes of reviews reflected that relatives could attend if they wished and the staff member confirmed that relatives do visit the home and are welcome anytime. People’s case files included details of their next of kin and important people in their lives, including at times the date of peoples birthdays. Interactions with staff were observed to be appropriate and the member of staff interviewed confirmed that they help to maintain a person’s privacy by ‘ knocking on their door before entering their room and making sure people are left on their own when they request it’. There are menus in place in the home that allow people a variety of choice over a 4 week period. People’s choices are recorded both in their diary notes and in in house records for food provided. Both people have regular monitoring of their weight, where any changes would be seen and may be investigated further in case this relates to a health need. Redwood Close 11 DS0000019782.V348335.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s health, medication and personal needs are met. EVIDENCE: People are offered support so that their appearance reflects their individual personality. Their diary notes included details of the times they get up and go to bed with it being clear that this was the choice of the individual. The information in the AQAA included that annual health checks, weight management and that relevant health needs are met and recorded in the care plan. People’s personal files included a list of medical appointments, which had an additional sheet giving detailed information as to why the appointment had been undertaken and the outcome. In addition people’s files included letters from other medical professionals involved in supporting them in their lives and records of any visit undertaken to routine appointment, for example to the optician or dentist. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 15 There are forms in place, which identify that each person requires support with their medication. Medication is stored appropriately in a locked area, with records being kept of all receipt, administration and disposal of medicines. In addition there are records of staff signatures so that it can be clearly identified who has signed to confirm administration of any medicines. Redwood Close 11 DS0000019782.V348335.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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to raise concerns and to be safe. However use of procedures does not make sure that people re fully protected from harm. EVIDENCE: Information in the AQAA included that there is a complaints procedure and a multi-agency procedure in protecting people in place to support the people living in the home. We confirmed this at the visit, as the complaints policy and a copy of the Local Authority’s procedure The Protection of Vulnerable Adults were available within the home. There have been no complaints made either to the home or to the CSCI. In one person’s notes there is reference to an incident, which requires reporting within the guidelines of the Protection of Vulnerable Adults, and the registered manager was made aware of the need to complete this. The staff member was aware of the Adult Protection procedures and gave positive responses when discussing the actions they would take when responding whether to a complaint or allegation of harm. People are supported to handle their finances and records are kept in the home of transactions for both personal cash amounts and bank accounts. These were individual with receipts being kept for expenditure. Redwood Close 11 DS0000019782.V348335.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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People continue to live in a clean warm and comfortable home. EVIDENCE: Information provided in the AQAA included that the home is warm and comfortable. Also that as people’s needs change the home provides adaptations as necessary. The home continues to be very clean, warm and comfortable. People continue to have individual rooms, which are personalised to their own tastes. There are two bathrooms which people may access one offering bathing and the other offering showering facilities. The staff use the shower room as necessary, as there is not a separate staff shower or bathroom. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 18 The laundry room continues to be external to the main part of the home, with the flooring in here being made impermeable by being painted. There are records of regular fire drills and tests, with the emergency lighting and fire systems checks being up to date, there had been a visit from the representative of the local fire department in April of this year and the home was found to be satisfactory. There was a recommendation that the fire assessment be regularly reviewed, however this had not been completed since the fire officer’s visit. The registered manager was advised to contact the Local Fire officer to ensure that the fire risk assessment is reviewed as to their guidelines. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 19 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, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are supported by well recruited and trained staff, however the lack of supervision does not make sure that people’s needs will continue to be fully met. EVIDENCE: Of the three staff files examined only one contained an application form, reflecting that person previous relevant experience for their post. This file also contained references from their last employers. None of the files contained a copy of the person’s Criminal Records Bureau check (CRB) which would be undertaken to ensure that they did not hold a criminal conviction which may prevent them from working with vulnerable people. The registered manager confirmed that the majority of the staff files are held at the central office of the organisation. A further visit was undertaken to the main office and at this visit it was found that all three of the latest staff to be employed had application forms, references and a CRB (Criminal Records Bureau check undertaken on them). A representative of the organisation told us that all of the organisation’s homes now hold the recruitment details for al of their staff. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 20 Information in the AQAA included that all staff undertake a comprehensive induction programme and training. Also that 98 of the staff are National Vocational Qualification (NVQ) trained or working towards this. Evidence in people’s files showed that people had undertaken, Fire, infection control, Medication, Adult Protection, First Aid and Health and safety training. The relative confirmed in their survey that they felt the care staff have the right skills and experience to look after the people in the home. Of the files examined only one had evidence of staff supervision. However this had not been completed this year with the last supervision session being in December 2006. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 21 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, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by a trained manager, who makes sure that their health and safety needs are met. EVIDENCE: Information in the AQAA included that the manager holds a Registered Managers Award and is working to achieve a National Vocational Qualification (NVQ) at level 4. However the registered manager confirmed that they have yet to achieve a management qualification. The registered manager stated that the quality assurance system had been completed this year and that the paperwork for this had been sent to head office for the preparation of the annual report. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 22 Information in the AQAA included that maintenance certificates are available in order to comply with standard 42. Evidence of maintenance checks were available which included portable appliance testing, fridge temperature checks, Gas safety and the fire fighting equipment. The registered manager confirmed that the emergency lighting had just been checked and is to forward the evidence of this to the CSCI. An electrical safety certificate was in place in the home, however this stated that the electrical wiring did not need re-checking for 3 years, this was now in need of being completed. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 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 X 34 3 35 X 36 1 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 2 X X 1 X Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA7 Regulation 13 Requirement The registered person must make sure that risk assessments are kept up to date and reflect the latest needs of the people in the home. The registered person must make sure that all safeguarding incidents are handled as per the policy. The registered person must make sure that staff are appropriately supervised, with records being kept. The registered person must make sure that the CSCI receives the latest copy of the quality assurance report relating to the home. The registered person must make sure that the CSCI receives evidence that the fire risk assessment meets the requirements of the local fire department. The registered person must make sure that the CSCI receives evidence that the emergency lighting and electrical wiring checks have been satisfactorily completed. DS0000019782.V348335.R01.S.doc Timescale for action 15/12/07 2 YA23 13(6) 13/11/07 3 YA36 18(2) 13/01/08 4 YA39 24(2) 13/01/08 5 YA42 13 15/12/07 6 YA42 13, 23 15/12/07 Redwood Close 11 Version 5.2 Page 25 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 YA24 Good Practice Recommendations Ideally, staff should be provided with separate toilet and bathing/shower facilities. Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Redwood Close 11 DS0000019782.V348335.R01.S.doc Version 5.2 Page 27 - 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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