Care Home: Reside at Stour Road

What has improved since the last inspection? First inspection since the home`s new Registration. What the care home could do better: All pre-admission assessment notes should be recorded on the home`s preadmission assessment recording form to evidence that a person`s needs were assessed prior to being offered a place at the home.Reside at Stour RoadDS0000072225.V374952.R01.S.doc Version 5.2 Page 7Systems should be developed and monitored to ensure that important information, such as any known allergies are recorded onto the front of a person`s medication administration records. We recommended that the staff application form be changed to request information from applicants in line with the Care Homes Regulations 2001. Key inspection report CARE HOMES FOR OLDER PEOPLE Reside at Stour Road 14 Stour Road Christchurch Dorset BH23 1PS Lead Inspector Martin Bayne Key Unannounced Inspection 10th March 2009 10:00 DS0000072225.V374952.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Reside at Stour Road Address 14 Stour Road Christchurch Dorset BH23 1PS 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) 01202 481160 01202 481653 www.residecarehomes.co.uk Reside Care Homes Limited Mr Alan Johnston Care Home 20 Category(ies) of Dementia - over 65 years of age (20) registration, with number of places Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents accommodated in the two second floor rooms must be independently mobile. First Inspection. Date of last inspection Brief Description of the Service: Reside at Stour Road is registered to provide accommodation and personal care for up to 20 people in the category of dementia. The home is situated in close proximity to the shopping centre and amenities of Christchurch, with good connections to public transport. There is limited car parking at the front of the home. The home provides a large, light lounge/dining room and a conservatory that leads to a large, landscaped secure garden at the rear of the home. There are twenty single bedrooms, all of which have ensuite wc facilities. The home also has two bathrooms that are equipped with specialist bathing equipment. Reside at Stour Road DS0000072225.V374952.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. We, the Commission, carried out a key inspection of Reside at Stour Road between 9:15am and 2:45pm on 10th March 2009. The inspection was carried out by one inspector, but throughout the report the term ‘we’ is used, to show that the report is the view of the Commission for Social Care Inspection. The aim of the inspection was to evaluate the home against key National Minimum Standards for older persons. This was the first key inspection of the home since its registration in August 2008. The home was originally registered in March 2006 as Tops care home with Cheryl Hadland as the sole provider. Mrs Hadland formed a limited company, Reside Care Homes Ltd and is the managing director of the company. Mr Alan Johnston was registered as manager and also as a responsible individual for the company. We were assisted throughout the inspection by the Registered Manager, Mr Johnson and also by a manager who is currently in the process of registering to become the registered manager of the home. Mr Johnston will then act as a manager overseeing registered services within the company. During the inspection we spoke with seven of the residents, three relatives who were visiting the home on the day of the inspection and with two members of staff. Throughout the inspection we used the personal care files for three residents to track the records and paperwork that the home is required to maintain under the Care Homes Regulations 2001. Additional information that helped form to the judgements contained within this report was obtained from the Annual Quality Assurance Assessment document completed by the home. What the service does well: Prospective residents who wish to move to the home have their needs assessed before being offered a place at home. Residents’ health needs are met through a good care planning system. Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 6 Residents of the home are treated with respect and dignity. Medication was found to be stored, handled and administered in line with best practice. The home has a programme of activities and resident’s recreational interests are assessed and recorded. The home makes visitors welcome. Residents’ spiritual needs are met. The home provides a good standard of food. The home as a complaints procedure that meets the standards and all the staff have been trained in adult protection. The home is well maintained and provides a safe and comfortable environment for residents. The staff team were recruited in line with the Regulations and there are sufficient staff provided to meet needs of residents. The home is well managed and run in the interests of the residents. What has improved since the last inspection? What they could do better: All pre-admission assessment notes should be recorded on the home’s preadmission assessment recording form to evidence that a person’s needs were assessed prior to being offered a place at the home. Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 7 Systems should be developed and monitored to ensure that important information, such as any known allergies are recorded onto the front of a person’s medication administration records. We recommended that the staff application form be changed to request information from applicants in line with the Care Homes Regulations 2001. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 8 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 Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from having their needs assessed prior to being offered a place at the home to ensure that their needs can be met. They are also well informed about the services the home provides. EVIDENCE: We were told that a manager always carries out a pre-admission assessment of need for any person wishing to move to the home, to ensure that their needs can be met. We looked at the pre-admission assessments for the three residents who we tracked through the inspection. We found copies of preadmission assessments in all but one case and also we saw that the home had Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 10 obtained copies of care management assessments for residents funded by the local authority. Notes had been made concerning the pre-admission assessment of the person who did not have a pre-admission form. We recommend that all pre-admission assessments are recorded on the template form that the home uses to record pre-admission assessments. At the point of registration, the Statement of Purpose for the home was updated. We were told that all prospective residents or relatives are given a copy of the Statement of Purpose as well as a brochure and a copy of the home’s newsletter. By these means people who wish to move to the home are fully informed of the services provided at Reside at Stour Road. Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health needs were being met whilst being treated with respect and dignity and their medication administered to good practice standards. EVIDENCE: We looked at the care plans for the three residents who we tracked through the inspection. The care plans were up to date and provided comprehensive information about residents’ care needs and the expectations of staff in how to meet these. We also saw that residents or their relatives had signed the care plans, providing evidence that they were involved in their development. Care plans also linked to risk assessments, developed to minimise the risk of harm to residents when meeting their care needs. Care plans were personal and Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 12 informed of residents preferred form of address, their likes and dislikes, times they normally like to go to bed and to get up, their social and recreational and spiritual needs. We also saw there were monitoring systems and charts in place to ensure that residents receive sufficient dietary intake. We also saw that residents’ skin care and mobility needs were also being met through risk assessments and care planning. Within the personal care files we saw that general health care needs of residents were being met. A record was maintained of all doctors and district nursing visits to the home. We saw that specialist services had been sought appropriately through the community psychiatric nursing service. Dentistry, chiropody and other health needs were also being met and recorded. We spent time during the inspection sitting in the main lounge and were able to observe interactions between staff and residents. The staff were attentive with residents and it was clear that there were good relationships between the two. Residents were observed to be dressed in clean clothes with attention paid to their personal grooming. All of the relatives with whom we spoke gave a positive account of how their relatives were looked after in the home. We looked at how medication was administered in the home. When we arrived the new manager was administering medication to residents in accordance with the homes procedures with medication being given to one person and their records being completed before medication being administered to another person. We looked out the medication administration records for all of the residents. At the front of the medication records was a sample of staff signatures of those staff trained to administer medication. The records also informed of any known allergies and there was a photograph of each resident at the front of their records so that they could be easily identified. We noted within one person’s assessment that they were allergic to some medications. The information had not been transferred to the medication administration records and we recommend that systems are in place to check that this important information is entered on to their medication administration records. We looked at the facilities for storing medication. The home has two trolleys that are chained to the wall when not in use. The home also has a controlled medication cabinet that meets the new regulatory standards. We looked within medication cabinets and saw that medicines were stored correctly. We also carried out a small audit concerning one controlled medication and this tallied with the records maintained in the controlled drugs register. Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 13 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has taken steps to meet residents’ social and recreational needs and residents can maintain contact with relatives and friends. They also benefit from receiving a good standard of food. EVIDENCE: We were told that an activities co-ordinator had just been appointed to work 12 hours a week, part time in the home, as well as other homes within the group. Their role would be working mainly on a one to one basis with residents or within small groups with those residents who do not usually choose to partake in the communal activities. We were told that communal activities are arranged and carried out by the care staff. On the day of our visit a representative from ‘Pat the Dog’ was visiting and this activity was clearly enjoyed by residents. In the afternoon we saw that a manicure session Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 14 was held with some of the women residents. We were informed through the AQAA, that the home had recently purchased a people carrier for taking residents on outings. We also saw a programme of activities that informed that there were activities arranged each day with the occasional outside entertainer. The relatives we spoke with said that there was always something going on to meet residents’ social and recreational needs. We saw that people’s spiritual needs were assessed as part of the assessment process when a person moves into the home. One person goes out to attend church services in the community and a Baptist minister attends the home once a month to conduct a service in the home. Relatives we spoke with said that they were made welcome at the home and there were no restrictions on visiting. One person told us that they spent several hours each day in the home visiting a relative and they were satisfied with the care and entertainment offered to residents. During the morning residents were served drinks and it was noted that one person received black coffee as we had seen recorded within their records under ‘likes and dislikes’. Another person who requested another drink was served an additional drink as requested. Staff were seen to be asking and recording what each resident wanted from the choice for the main meal, which is served early evening. At lunchtime we observed staff appropriately assisting residents who required assistance. We saw the records of food provided, which reflected a varied and balanced diet. And from the records it was possible to determine what each resident had eaten. Specialist diets are catered for and we saw that a dietician’s advice had been sought for one person who had eating difficulties. We also saw that resident’s weights were being recorded. The relatives we spoke said that in their opinion the food was of a good standard. Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well-publicised complaints procedure and from the staff being trained in adult protection. EVIDENCE: Details of how complaints should be made and responded to are detailed within the home’s Statement of Purpose, as well as being displayed on the notice board in the reception lobby. There have been no complaints made to the management of the home since its new registration and none have been brought to the attention of the Commission. We saw that all of the staff have received training in adult protection through an outside trainer. The home has policies and procedures for the protection of vulnerable adults. Reside at Stour Road DS0000072225.V374952.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a well maintained, comfortable and safe environment for residents and there are infection control measures to prevent the risk of cross infection. EVIDENCE: On the day of our inspection the home was found to be clean, in reasonable decorative order throughout and furniture and fittings in good repair. The home has been decorated with the needs of people with memory loss in mind, the doors being in bright, distinctive, different colours to differentiate Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 17 bedrooms from bathrooms. The home has an attractive, enclosed garden to the rear of the home, which residents can easily access through the large conservatory area. Radiators are of a low surface temperature type that ensures residents are not at risk of getting burnt. The hot water outlets of showers and baths have been fitted with thermostatic mixer valves to protect residents from scalding water. Communal areas of the home are situated on the ground floor with bedrooms on the first and second floor. All of the bedrooms provide ensuite WC and sink, with three rooms also having a shower facility. Access to the first floor is by means of stairs or a platform lift. We were told that the lift had not posed a difficulty to residents. There is no lift access to the two bedrooms on the second floor and residents accommodated in these rooms must be able to manage stairs safely. We saw that residents were able to personalise their rooms with their own furniture and that wardrobes had been attached to the wall so that they cannot be accidentally pulled over. Window restrictors are fitted to windows above ground level. In view of the risk of some residents leaving the home and getting lost, the front door is locked by means of a key pad that is linked to the fire panel. The home has a dedicated laundry area away from food preparation and storage areas. The laundry room is kept locked with a key pad to ensure that residents don’t have access to this area. The laundry room is equipped with sufficient washing and drying machines for the needs of the home. We saw that staff wore protective clothing and that gloves were available. The home has infection control policies and procedures and staff are provided with training in this field. Reside at Stour Road DS0000072225.V374952.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the home providing sufficient staffing to meet needs of residents and through staff being recruited and trained in accordance with the Regulations and standards. EVIDENCE: We were told that between 8am and 2pm there were always four care staff on duty and between 2pm and 8pm there were usually four or sometimes three care staff on duty. During the night time period there are two members of care staff who carry out awake night duties. We saw duty rosters that reflected the above staffing levels. When we arrived we saw that four care staff were on duty. In addition to the care staff, the manager is on duty throughout weekdays, office hours. Domestic staff are employed for 80 hours a week. The home employs two chefs who provide all the meals. A maintenance person and gardener are also employed. The manager said that staffing levels met the needs of the residents. During the inspection two Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 19 members of staff were spoken with who also told us that the staffing levels were satisfactory. We looked at the staff recruitment files for three members of staff who had been appointed since the last key inspection of the home. We found that all the required checks had been carried out prior to their being appointed, in accordance with the Regulations with required records filed. We recommend that the staff application form be reviewed as the form does not request information satisfying the Regulations; an example being the form requesting a reference from an applicant’s previous employer, rather than their previous employment of working with vulnerable adults or children for more than three months. The home has achieved a level above 50 of staff trained to the standard of NVQ level 2 or above. The two members of staff with whom we spoke told us that the home provided a good level of training and that they had been provided with induction training when they started working at the home. We saw copies of training certificates and courses completed in the staff recruitment files we saw. All of the staff are provided with core mandatory training in areas such as; fire safety, moving and handling, health and safety, infection control and basic food hygiene. We were told that there were sufficient staff trained in first aid for their to be one person on duty qualified at one time. Many of the staff have been provided with specialist training such as dementia care and the Mental Capacity Act. We were told that staff were to be provided with training on new deprivation of liberties legislation. Reside at Stour Road DS0000072225.V374952.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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31 33 35 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from the home being well managed and run in the interests of the residents. EVIDENCE: Mr Johnson, the Registered Manager has been running the home since the new Registration was granted and he is also the Responsible Individual for the organisation. A new manager has been appointed to manage the home, as Mr Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 21 Johnson will take up a new post overseeing the management of all the homes within the group. An application to become Registered Manager of the home has been submitted to the Commission. Generally, we found that the home was being well managed with a good standard of record keeping, staff being supervised and the building being maintained to a good standard. We found that the home carries out an annual quality review of the service as we were able to view returned survey forms from relatives; the feedback being positive. We looked at the fire log book and found that tests and inspections of the fire safety system were taking place to the required timescales. No health and safety hazards were identified as part of the inspection. Reside at Stour Road DS0000072225.V374952.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 X X 3 X X X 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 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP3 Good Practice Recommendations We recommend that all pre-admission assessments are recorded on the template form that the home uses to record pre-admission assessments. We recommend that systems are put in place to ensure that any information obtained at the point of assessment concerning allergies to medications, this information is transferred to the medication administration records. We recommend that the staff application form be changed to request information in line with the Regulations. 2. OP9 3. OP29 Reside at Stour Road DS0000072225.V374952.R01.S.doc Version 5.2 Page 24 Care Quality Commission South West Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Reside at Stour Road DS0000072225.V374952.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!