Care Home: St Mary`s Care Home

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What the care home does well The atmosphere in the home was comfortable, homely and relaxed ensuring that the home is a homely environment. People living in the home were seen to be treated with care and respect by staff and daily routines are flexible ensuring that people using the service have the opportunity to maintain control over their daily lives. Care planning systems are used effectively to enable all staff to provide high quality and consistent care. Currently activities are provided and there is a plan to extend the programme to provide additional activities for both the morning and afternoon periods. People are encouraged to bring their own possessions in order to personalise their individual rooms and many have done so. Meals are good ensuring that those living in the home have a varied and well balanced diet, with supplements provided as required. There are satisfactory systems for consulting with people living in the home, their family and representatives and staff to ensure it is run in the best interests of those using the service. What has improved since the last inspection? As this was the homes first inspection a history of the service is not available. What the care home could do better: Currently any concerns are recorded on the individuals records and all concerns and complaints need to be collated to facilitate the quality monitoring systems. Similarly accidents also need to be collated to ensure that any recurrent risks are identified and reduced. CARE HOMES FOR OLDER PEOPLE St Mary`s Care Home St George`s Retreat Ditchling Common Ditchling East Sussex RH15 0SF Lead Inspector Gwyneth Bryant Unannounced Inspection 19th June 2008 08:00 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 Mary`s Care Home DS0000071564.V365573.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 Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Mary`s Care Home Address St George`s Retreat Ditchling Common Ditchling East Sussex RH15 0SF 01444-235874 01444 248411 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) www.anh.org.uk The Trustees of the Order of St Augustine of the Mercy of Jesus Agnes Dunne (Sister Mary Thomas) Care Home 60 Category(ies) of Dementia (0), Learning disability (0), Mental registration, with number disorder, excluding learning disability or of places dementia (0), Old age, not falling within any other category (0), Physical disability (0) St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Physical disability (PD) Learning disability (LD) Mental disorder, excluding learning disability or dementia (MD) 2. Old age, not falling within any other category (OP). The maximum number of service users to be accommodated is 60. Date of last inspection N/A Brief Description of the Service: St Marys Care Home is a purpose built care home and is part of the St Augustinian Care Group and is situated close to Ditchling Common in an area of Outstanding Natural Beauty. The grounds are extensive and include a large lake and pond and newly planted gardens close to the building. Despite the size of the home every effort has been made to ensure it remains homely with small lounges and kitchen areas for every ten rooms. These are in addition to the main lounge and dining areas. The home is split into units and each unit has its own clinical room and nurse station. There is a passenger lift to facilitate access to al floors and the home has its own hairdressing salon and shop for use by service users. All bedrooms meet the minimum size standard and all are for single occupation. The Home provides care and accommodation for up to 60 service users with mental health problems, the elderly frail and a small group of people with learning disabilities. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 5 The service aims to provide unique, high quality care which enables service users to lead valued and fulfilled lives with freedom to make choices. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was an unannounced inspection and took place over seven hours. The purpose of the inspection was to check compliance with the requirements made at the last inspection and check key standards. Sixty people were in residence on the day of which five were spoken with. The Manager, her deputy, one staff nurse, and three relatives were also spoken with. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. The Deputy Manager facilitated the site visit for the most part but the Registered Manager was available throughout the day. Comments from people spoken with included: • • • • • • I’ve got everything I would wish for. I am just so happy here What more could I ask for? All of the staff are just wonderful I cant fault them for the care given I am always made very welcome Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was provided and the information included in this report as necessary. What the service does well: The atmosphere in the home was comfortable, homely and relaxed ensuring that the home is a homely environment. People living in the home were seen to be treated with care and respect by staff and daily routines are flexible ensuring that people using the service have the opportunity to maintain control over their daily lives. Care planning systems are used effectively to enable all staff to provide high quality and consistent care. Currently activities are provided and there is a plan to extend the programme to provide additional activities for both the morning and afternoon periods. People are encouraged to bring their own possessions in order to personalise their individual rooms and many have done so. Meals are good ensuring that those living in the home have a varied and well balanced diet, with supplements provided as required. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 7 There are satisfactory systems for consulting with people living in the home, their family and representatives and staff to ensure it is run in the best interests of those using the service. 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 Mary`s Care Home DS0000071564.V365573.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 Mary`s Care Home DS0000071564.V365573.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): 3 and 4 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People moving into the home benefit from an admission process that ensures their individual needs assessed and identified as being able to be met prior to moving into the home. EVIDENCE: As part of the care planning process all people moving into St Marys have a detailed assessment of their needs which is used as a basis for their individual plans of care. The admission assessments for four individuals were viewed and it was evident that a thorough assessment process had been undertaken prior to all four people coming to live at the home. Some people are placed in the home under the NHS continuing care programme and therefore certain criteria must be met by the home as part of this process. Intermediate care is not provided. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care planning systems reflect the current needs of people living in the home and effective risk assessments processes are in place as are the arrangements for the safe handling, recording and administration of medication. EVIDENCE: Six care plans were viewed in conjunction with other documents including daily notes and medication charts. The plans found to be satisfactory in that they included clear information on the care needs of people living in the home and the necessary action to be taken to meet those needs. The healthcare needs of people in St Mary are met in full ensuring that additional input from opticians, dentists and chiropodists is accessed and necessary. Care plans are comprehensive and include detailed information on preferred daily routines, meals and leisure activities. Work is on-going to provide a history of each person to enable the home to provide a tailored service for each individual. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 11 To ensure those living in the home have all needs met without delay a GP, physiotherapist and a psychiatrist are all retained by the home, with the GP visiting weekly and advising staff accordingly. People living in the home are encouraged to remain independent within a riskassessed framework. Daily notes are maintained with input from both carers and trained nurses each of which facilitates the review process. People spoken with said that they felt care needs were met and visitors mentioned the kindness and welcome given by all staff. Throughout the site visit staff were seen to treat individuals with care and respect and it was evident that comfortable working relationships had been developed. People are weighed regularly and action taken when weight loss is noted. One person has become very frail but is still weighed, this was discussed with the Deputy Manager and it was agreed that if weighing someone causes discomfort it might be better to make observations of weight such as clothing becoming lose. It was good to note that one person is enabled to assist in the kitchen within a risk-assessed framework. These activities allow people to build on existing skills and develop new ones. Medication Administration Records were viewed and found to be clear, accurate and up to date ensuring that it is clear whether or not medication has been given. The controlled drugs records were equally satisfactory as were medication storage arrangements. It appeared that there were gaps in the charts for the morning of the site visit. However, the Registered Manager explained that she had yet to administer some medication, as it is now part of the diversity policy to administer medication at a time suitable for individuals unless there is a clinical reason not to do so. The issue of administering medication covertly was discussed with the deputy manager who explained that there is a reluctance to use this method of administration but explained that it may be used under the guidance of the GP and only when all other methods have been explored. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People in the home have the opportunity to experience a lifestyle that matches their expectations, choice and preferences in respect of leisure activities and meals. EVIDENCE: People living in the home are offered a range of activities, based on their individual preferences and there are plans to extend the activities provided. There are staff who are supernumerary to care staff who take people for walks in the grounds or just have one-to-one chats throughout the day. A sensory machine has been purchased that consists of various fibre optic devices that are designed to either stimulate or relax people in the vicinity of the machine. There is an open house policy for visitors and there were a number of visitors on the day of which three bought pet dogs with them. The dogs appeared to be very popular with people living in the home and it was evident they welcomed the opportunity to stroke and pet them. Menus are varied and are designed to provide a balanced and nutritious diet and it was noted that were a pureed diet was necessary, foods were pureed separately ensuring that meals are attractively presented. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 13 During the breakfast period the Registered Manager explained that people living in the home are encouraged to place breakfast orders with the chef, thus they can have a range of cereals or cooked breakfast. This systems allows people to order second helping as and when required. There are at least two main meal choices and also for desserts. The small kitchen area in each unit allows people living in the home and visitors to make drinks when required. Discussion with the Registered Manager found that there is a bar on order that will be sited in the dining room, allowing people to buy alcoholic drinks. All staff are expected to assist with meals ensuring that all people living in St Marys can be assisted if required, even if they choose to have their meal in one of the smaller lounges. Visitors are encouraged to join their relatives for routine meals or for celebrations such as birthdays and other anniversaries. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that those living in the home feel that their views are listened to. People living in the home are further protected by satisfactory adult protection systems. EVIDENCE: Information in the AQAA demonstrated that there are policies and procedures for both complaints and Safeguarding Adults. To date neither the home nor the CSCI have received any complaints. Each individual is provided with a summary of the homes complaints policies and procedures and this is held in their rooms. Currently any concerns or issues raised are recorded in the individual’s records and it is necessary to collate any complaints centrally to ensure any recurrent concerns are identified and addressed. Comments from visitors included: • Absolutely no complaints whatsoever • I have never had reason to complain There have been two safeguarding adult alerts since registration of which one was unsubstantiated and the other remains on-going. It should be noted that the home has followed the correct policies and procedures for dealing with these issues and no one in the home is at risk. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 15 There is an on-going staff training programme in safeguarding adults to ensure all staff are familiar with what constitutes poor practice and what to do in the event of an allegation. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The standard of decor and maintenance within the home is excellent, providing people living in the home a safe, homely and comfortable environment. EVIDENCE: A tour of the premises was carried out and a random selection of rooms inspected. The home provides a safe and comfortable place in which to live. Individuals’ bedrooms were well designed and pleasingly decorated and it was evident that people are able to bring in their own possessions in order to personalise their bedrooms. There is a policy to ensure that not all rooms have the same colour scheme for soft furnishings, ensuring that people have a choice over décor in their rooms. The communal bathrooms are such that regardless of individual care needs, preferred ways of bathing can be met as there are ‘wet’ rooms, showers and assisted baths provided. There are hoists and lifting equipment provided that fully meet the needs of people living in St Marys. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 17 The hairdressing salon is used by the visiting hairdresser but staff are also able to provide a shampoo and set as required. The provision of small lounge and kitchen areas allow people living in the home to make hot drinks and have a level of privacy and quiet. The home has recently received the Pinders award for the design of the home. Attached to the dining room is a patio area for which tables and chairs have been added which allows people living in the home to take meals outside or just sit in the sun. The AQAA demonstrated that there are infection control procedures in place, with a plan to ensure all staff are trained in good practice. Staff were seen to observe good practice by wearing gloves and aprons as required. There is a well equipped laundry with different entry and exit doors to ensure that clean laundry cannot be contaminated by soiled laundry. There has been additional healthcare guidance in respect of providing hand gel for all staff and visitors entering and leaving the home. This was discussed with the Deputy Manager who agreed to explore the options to meet the latest guidance. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of suitably trained staff to ensure the needs of people living in St Marys are met and people are protected by robust recruitment practice. EVIDENCE: The staff rota showed that there are 12 care staff on duty for each weekday shift, in addition to three staff nurses and the Registered Manager and her deputy. Night shifts comprise four care staff and two staff nurses. Staff appeared to have sufficient time to meet individual care needs. In addition to care staff and nurses there are 2 chefs and 2 kitchen assistants and a maintenance person and 6 housekeepers. As mentioned earlier there are also two Sisters from the order who provide one-to-one time with individuals and generally assist as required. There is a policy that ensures all staff are familiar with the needs of all people living in St Marys and this is achieved by giving an overview of all individuals living in the home followed by a more detailed session for each unit. This system ensures senior staff are able to monitor the wellbeing of people even though they may be working in a different unit. Discussion with a staff nurse found that she was knowledgeable about the needs of a particular individual although she did not usually work in the relevant unit. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 19 The recruitment records for the last four members of staff to be employed were viewed and these showed that all the required information had been provided including Criminal Record Bureau and Protection of Vulnerable Adults checks, two written references and proof of identity. All new staff have a probationary period which includes induction to ensure they are familiar with the working practices of the home. Information in the AQAA showed that of the 41 care staff 24 either have or are working towards National Vocational Qualification level 2 so the home is on target to exceed the required 50 of care staff with this qualification. The AQAA also showed that only 13 staff have infection control training but discussion with the Deputy Manager found that infection control is covered during induction and as part of the National Vocational Qualification training so the numbers are much higher. The administrator maintains a staff training matrix to ensure all staff remain up to date on mandatory training such as manual handling and fire safety. Additional staff training is available such as dementia care, challenging behaviour, Parkinsons Disease, Care of the Dying, communication and pressure sore prevention. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service is well managed and all aspects of the welfare, safety and health of people living in the home are protected and promoted. EVIDENCE: Both the Registered Manager and her deputy have the required care and management qualifications in addition to being trained nurses. The atmosphere of the home is open and throughout the site visit people living in the home, staff and visitors were obviously comfortable approaching both the Registered Manager and her Deputy with any queries. There is a detailed quality monitoring system covering all aspects of the service that ensures the home is run in the best interests those living there. St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 21 These systems include regular meetings with staff and people living in the home, in addition to the staff handovers. Small amounts of money are held for people living in the home and all transactions are recorded and receipts provided as necessary. The details are held on computer and are audited regularly. Information in the AQAA showed that regular safety checks are carried out on all equipment, electrical and gas appliances and systems. In addition there is an on-going programme of maintenance of all parts of the home, including individual rooms. All staff receive regular fire safety training and a fire risk assessment has been carried out to ensure no part of the home poses a fire risk. Regular fire drills are carried and fire alarm systems regularly tested ensuring neither staff nor people living in the home are at risk in the event of fire. Self-closing devices, triggered by the fire alarm are fitted to all internal doors that require them. On the day of the site visit a person living in the home set off the fire alarm and it was good to note that staff responded in line with their training and all fire systems were seen to be in good working order. St Mary`s Care Home DS0000071564.V365573.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 3 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 4 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 St Mary`s Care Home DS0000071564.V365573.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. 1 2 Standard OP16 OP38 Regulation 22 (1) (3) (8) 24 (1) (2) Requirement That all complaints are recorded centrally as part of the quality monitoring system. That all accidents are recorded centrally to facilitate identification of risks. Timescale for action 19/07/08 19/07/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations St Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Mary`s Care Home DS0000071564.V365573.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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