Care Home: St Huberts Lodge

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What the care home does well What has improved since the last inspection? People who used the service received their medication on time to ensure it was given as prescribed. A record was maintained for all medication entering the home to ensure the records were accurate records. The duty rota showed clearly the designation and numbers of staff to demonstrate there were sufficient numbers and skill mix to meet the needs of people who used the service. Further improvements to the medication system included a record of medication to be returned to pharmacy to ensure it was not mislaid. Information leaflets about the effects of medication were available for staff to gain advice and spot possible side effects. The deputy manager audited the system on a regular basis to ensure the administration of medication was safe. Plans of care had been updated on a regular basis to ensure staff were up to date and meet the needs of people who used the service. What the care home could do better: `As required` medication must be recorded to show the reasons why the people who use the service need the treatment to minimise errors. All the forms contained within the plans of care should be fully completed to ensure staff are aware of as much as they can be of each residents needs. The quality assurance system should be more formalised to ensure management can demonstrate they are a responsive and reactive team. CARE HOMES FOR OLDER PEOPLE St Huberts Lodge St Huberts Road Great Harwood Lancashire BB6 7AR Lead Inspector Mr Graham Oldham Unannounced Inspection 26th November 2008 09:00 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 St Huberts Lodge DS0000009440.V373186.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. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Huberts Lodge Address St Huberts Road Great Harwood Lancashire BB6 7AR 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) Category(ies) of registration, with number of places 01254 888581 01254 728668 Mr Thomas Cardwell Mr Ian Cardwell Care Home 13 St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Old age not falling within any other category (13) Date of last inspection 13th November 2007 Brief Description of the Service: St Huberts Lodge offers care to 13 older people. The building is a large detached house, which has been converted into a care home. It is situated in a residential area of the town of Great Harwood. Opposite the home is a Catholic Church. It is within walking distance of local shops and the town centre. There are 5 double bedrooms, one with an en-suite toilet, and 3 single bedrooms. A hand washbasin is present in all bedrooms. There is one communal toilet on the ground floor and 2 communal bathrooms, with toilet, and 1 communal toilet on its own, on the first floor. There are 2 communal lounges with dining facilities. The first floor can be accessed via a passenger lift. Ramped access is available to the front entrance. Car parking is available to the rear of the home. Information on the home is contained within a Service User’s Guide. A copy of this is kept in the hallway of the home and is also sent out to prospective residents. The charges are from £322 to £362-00 per week. Extra charges are made for hairdressing and may be made for escorting residents out of the home. St Huberts Lodge DS0000009440.V373186.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. A key unannounced inspection, which included a visit to the home, was conducted at St Hubert’s Lodge on the 13th November 2007. Much of the information gained was obtained from talking to residents and staff members. The views of residents were obtained on a variety of topics. Two residents were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking the plans of care, other documentation and talking to staff and the people who used the service. Two staff members were questioned about the care of the resident’s case tracked. Some of the views have been reported collectively with specific comments contained within the body of the report. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building was conducted. The service returned an AQAA. This is a document which the service provides to us with key information on how they feel they have progressed since the last key inspection and on how they can improve their service. What the service does well: The good assessment of people who used the service ensured they were correctly placed. One person who used the service and was involved in the case tracking process said, “We heard it was a good place and after my accident I got in here and have been all right since”. Information about the home was issued to prospective residents prior to admission. People who used the service were able to make an informed choice to enter the home. Plans of care had been developed by residents or their families and reviewed on a regular basis. During case tracking people said, “The staff tell my family what is going on and keep them up to date. ” and “they keep my daughter up to date with my care”. Information about people who used the service was kept passed on to family and friends to ensure their needs were being met. . St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 6 During case tracking people who used the service said, “they close doors and treat me privately. They have been very good to me – nothing is too much trouble” and “they treat me privately”. Staff were observed to undertake tasks in a professional yet friendly manner, which helped preserve the dignity of people who used the service. One person who used the service said, “you can choose to stay in bed or get up. You choose what you want to wear”. The personal preferences and likes of people who used the service were documented within the plans of care to help them retain some control over their lives. Several people who used the service said the food was good and met their tastes. During case tracking people who used the service said, “my daughter comes every night. Staff are very nice with my family. They can come anytime. I could go to my room to speak to them.” and “they treat my daughter nicely when she comes”. Visitors were observed during the inspection and were very inclusive to all residents, which provided a stimulating and enjoyable experience for those residing in the home. The décor and furniture was of a satisfactory standard and provided a homely atmosphere for people who resided at the home. Two people who were involved in the case tracking process said, “I would tell my daughter if there was anything wrong” and “I would talk to my daughter if I had a problem”. The complaints procedure was readily available and people who used the service felt able to voice their concerns. Both people who used the service said they felt safe at the home. Policies, procedures and safeguarding training helped protect residents from possible abuse. Two people who used the service said, “I wanted to stop here after I settled in. There are enough staff here. The staff are very kind and they come when you ask them. You cannot wish for a better place. I am very happy here and they look after you – we are not short of anything” and “the staff are very nice. I like it here. The atmosphere observed on the day of the inspection provided people who used the service with a friendly gathering type atmosphere rather than a formally run home, which is a credit to the staff. Staff said, “I have worked here for 7 years. I love it here. I really enjoy it. The owners are nice people to work for. We have a good staff team. I think the care we give is good. I try my best” and “I like it here because they are like family. There is a good family atmosphere and we have a laugh with the residents. I feel supported by the management at all times. We give good care to our residents”. The open and relaxed management style was appreciated by staff and motivated them to give good care. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 7 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. St Huberts Lodge DS0000009440.V373186.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 St Huberts Lodge DS0000009440.V373186.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. JUDGEMENT – we looked at outcomes for the following standard(s): OP3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The good assessment of residents ensured they were suitably placed at the care home. EVIDENCE: Two plans of care were examined during the case tracking process. Plans of care contained assessment documentation gained prior to admission. Both plans of care examined contained an assessment from the local authority. A suitably experienced member of staff visited hospital or a resident’s home to undertake the assessment. Families were involved where possible to gain their views. The assessment of residents ensured their needs could be met at the home. The care home did not provide intermediate care. St Huberts Lodge DS0000009440.V373186.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): OP7, OP8, OP9 and OP10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans of care contained sufficient information for staff to deliver care to residents. Staff arranged suitable access to specialists to meet their health care needs. Administration of medication was satisfactory and protected the health and welfare of residents. Residents were treated with respect and dignity to ensure they were comfortable with the personal care they received. EVIDENCE: Two plans of care were examined during the case tracking process. Plans of care detailed the care each resident received. Plans of care were updated regularly and residents or their family members signed documents to show their involvement. Staff members were accurate in describing the care they gave matched what was written in the plans. People who used the service said the care they received was what they needed. Plans of care gave staff updated details to deliver effective care. The plans of care for two residents case tracked contained information that residents attended specialists such as their GP, District Nurses, Psychiatrists, St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 11 Chirpodists and Opticians. Plans contained a falls risk assessment; nutritional assessment and pressure area care assessment in a recognised format. Appropriate equipment was provided when necessary. Resident’s health care needs were met by attending health care specialists. There were policies and procedures for staff to follow for the administration of medication. There was a controlled drug cupboard and register. Drugs were securely stored. The medication administration chart was examined and contained no errors. Two staff signed for hand written prescriptions. Records were maintained of medication entering and leaving the home. There was a British National Formulary and a copy of the Royal Pharmaceutical Society’s guidelines. Staff had undertaken medication training. The temperature of stored medication was recorded. One person who used the service said staff administered her medication at the required times. Residents or their family members gave consent for staff to administer medication. It would be good practice to ensure any as required medications are labelled in a manner to inform staff of the reasons for administration. The good administration of medication protected residents from possible harm. Staff were observed interacting with the people who used the service. Staff were professional and discreet when providing personal care. On the several occasions the inspector was in communal areas the atmosphere was lively with a lot of good-natured banter between staff, family members and people who resided at the home. Care was given to people who used the service in a manner, which preserved their dignity. St Huberts Lodge DS0000009440.V373186.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): OP12, OP13, OP14 and OP15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient leisure activities were offered to residents to provide stimulation and prevent boredom. Visiting was open and unrestrictive to encourage families to enter the home. Residents were able to exercise choice and retained some independent living. The good quality and quantity of food served at the home met residents’ needs. EVIDENCE: Two residents case tracked demonstrated choice was well documented in the plans of care in areas such as how much assistance they needed, what they liked to wear and their daily routine. People who used the service confirmed they had choice within the routines of the home. The leisure activities record showed attendance at quite a lot of different activities from listening to the radio to games and entertainment. Exercise sessions promoted good health with a qualified physiotherapist. People who used the service said they liked to socialise and this was apparent with visiting families being involved with several residents. The registered person said they held quizzes, socialising and watching television. Some residents liked to take a drink. They had a CD, which they used for reminiscing therapy. Some residents read a newspaper. Some played dominoes. Some people who used the service were observed St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 13 reading and watching television. Choice and leisure activities provided residents with a stimulating atmosphere. The kitchen was clean and tidy. Environmental records were maintained such as fridge, freezer and food temperatures. There was a record of food taken. Three cooked meals were offered each day with the main meal at teatime. There was a choice of meal and mealtimes. All the people who used the service said food was good. No residents were observed being fed. Residents said they preferred to sit with a table in front of them rather than sit at the table. Specialised eating equipment was observed for two residents. The mealtime was a social event. Food served at the home suited resident’s tastes. St Huberts Lodge DS0000009440.V373186.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): OP16 and OP18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were aware of their right to complain and confident to approach management with any concerns. Policies, procedures and safeguarding training for staff protected residents from possible abuse. EVIDENCE: There was a complaints policy and procedure which met CSCI guidelines. No complaints had been made to the Commission or the service since the last inspection. The registered person said he went round the home and spoke to the people who resided at the home every day he visited. Residents confirmed this. It would be good practice to record some of his findings to help build up quality assurance systems. The complaints procedure was accessible. Residents each had a copy and there was a copy prominently displayed in the hallway. The accessible complaints procedure ensured people had the information to raise any concerns. The care service retained a copy of the Lancashire social services adult abuse procedures to follow a local initiative. There had not been any safeguarding issues since the last key inspection. There was a copy of the ‘No Secrets’ document for staff to gain advice from. There were policies and procedures for the protection of adults. Some staff had received training in the protection of vulnerable adults. Staff interviewed were aware of abuse issues and the whistle blowing policy. Residents were protected as much as possible from abuse. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 15 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): OP19 – OP26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents lived in a clean, tidy and safe environment. The home’s décor and furnishings were domestic in character and provided a homely atmosphere for residents. EVIDENCE: The home was well maintained. There was a system for recording and reacting to faults and maintenance was ongoing. Outdoor space was accessible to residents. There was no CCTV. In general the home was warm, clean and fresh smelling. The general décor was satisfactory. The communal space was the same as 2002. Residents said they were satisfied with communal space although not all residents could sit at dining tables. The registered person said the table could extend for events such as at Christmas and all the residents – including those in wheelchairs were able to St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 16 sit together. He said they preferred to have the meal more informal. I observed the meal and residents continued to talk to each other during the meal. The lounges and dining room contained good quality furniture and carpets and curtains were satisfactory. There were toilets near to the lounge and dining room and around the building. There were baths and one seen was an assisted type. There were grab rails and equipment for the disabled. The lift was seen in working order and there was a hoist. All bedrooms were visited. Double rooms had good screening curtains around the beds and sinks. All rooms visited had been personalised and contained equipment provided for their disability needs. The home as a whole had a domestic and homely feel to it. The sizes of the rooms had not been changed since the last inspection. Radiators had been covered, the windows were aptly restricted and the temperature of water was controlled to reduce the risk of scalding. The water supply met current guidelines and speciality valves had been fitted to ensure this. The laundry contained a very good level of equipment with three washers and a dryer. One washer had a sluicing facility. There were polices and procedures for the control of infection. The laundry was situated from away from any food preparation areas and both floors and walls could be cleaned. Both staff spoken to had received training for infection control. Overall the facilities and services met the needs of the people who resided at the home. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 17 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): OP27, OP28, OP29 and OP30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s needs were met by the numbers and skill mix of a well-trained staff group. The robust recruitment procedures protected residents from possible abuse. EVIDENCE: Two staff files contained evidence staff had undertaken training relevant to their role. 90 of staff had successfully completed NVQ 2 training and some staff were either NVQ 3 qualified or were completing further training. More staff were on the shifts than was generally recognised for a home of this type and numbers of residents. There was a staffing rota which demonstrated there were sufficient numbers of well trained staff on each shift. Two staff files examined during the inspection contained documents to prove the home had recruited staff in a responsible manner. Copies had been retained of training undertaken. Staff had received a copy of the codes of conduct. Two members of staff confirmed the training had been undertaken and gave a good account of the staff team, management and care. There was a well-trained staff team to care for the residents needs. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 18 Evidence was observed that staff undertook a recognised induction when they were first employed to give them confidence to meet the needs of the people who used the service. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 19 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): OP31, OP33, OP35 and OP38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered person was suitably qualified and competent to run the home. Quality assurance systems had not been fully developed to take into account the views of residents, family members and stakeholders. The health, safety and welfare of residents and staff were promoted and protected. EVIDENCE: The registered person and the deputy manager were both suitably qualified to run the home. The registered person said, ““I update my training. The deputy is also a trainer for moving and handling. She is also a qualified trainer for fire safety. I do everything the staff do”. The registered person updated his knowledge to maintain his leadership skills. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 20 The care service did not handle any finances or pocket money for residents to ensure financial abuse was minimised. The registered person gained the views of residents in an informal way every day he attended the home by talking to them. Staff said the registered person was regularly available and amenable to provide support. People who used the service had a good rapport with the registered person and this was obvious when touring the home. Some advice was issued upon how to formalise this good quality assurance work without changing the ethos of the home. The registered person said they had undertaken surveys some time ago and were going to complete another batch and produce a summary for interested parties. The quality assurance systems needed to be more formalised to ensure the registered person can demonstrate how the service reacts to the needs of people who used the service. There were health and safety polices and procedures for staff to access. There was a system for reporting accidents and handling substances hazardous to health. There had been a fire risk assessment and the system had been serviced. Fire alarm testing and drills had been completed. The registered person undertook a weekly health and safety check and fixed what he was able and used qualified personnel to maintain equipment. The water system complied with current legislation. Electrical equipment and installation had been maintained. Health and safety policies, procedures and training helped protect the health and welfare of residents and staff. St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 21 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 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 4 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 22 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 OP7 Good Practice Recommendations The registered person should ensure all forms contained within the plans of care are completed to give staff all the information they need to meet the needs of people who use the service. The registered person should ensure ‘as required’ medication clearly shows what it is to be given for to ensure possible errors are minimised. The registered person should ensure the views of residents are formalised. Questionnaires taken from people who use the service, relatives and stakeholders should be gained and a summary produced for interested to show how their views are acted upon. 2. 3. OP9 OP33 St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 St Huberts Lodge DS0000009440.V373186.R01.S.doc Version 5.2 Page 24 - 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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