Care Home: St Matthews Avenue, 1

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What the care home does well The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. Residents were observed to be treated with respect by staff and to have their privacy and dignity respected. Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. The home has a settled staff group and has the numbers and skill mix of staff sufficient to meet residents` needs. The ethos of the home is that it welcomes complaints and suggestions about the service, uses these positively and learns from them. What has improved since the last inspection? All staff are receiving relevant training that is focussed on delivering improved outcomes for residents. The home is currently in the process of converting more of their paperbased documents to a digital versatile disk (DVD) formats to make them more accessible to a wider audience. HFT have successfully secured funding to support their commitment to resident involvement through the use of multi media styles. Staff and residents are receiving training in the use of digital photography, video filming and lifestory work. This is being used to create accessible information for the individuals and the service. The home is using more photo boards with residents to clearly outline individual programmes. It is also working towards creating a secure virtual community which will enable people with a disability to maintain electronic contact with others. The home has further developed its Person Centred Plan (PCP) process with more interactive meetings, using pictures and planning tools. New furniture and equipment have been bought for the home.New windows have also been fitted. What the care home could do better: CARE HOME ADULTS 18-65 St Matthews Avenue, 1 Surbiton Surrey KT6 6JJ Lead Inspector Mohammad Peerbux Unannounced Inspection 25th September 2008 09:30 St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Matthews Avenue, 1 Address Surbiton Surrey KT6 6JJ 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) 020 8390 3734 020 8390 3734 stuart.noble@hft.org.uk www.hft.org.uk Home Farm Trust Mr Stuart Mark Noble Care Home 8 Category(ies) of Learning disability (8) registration, with number of places St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Bedroom 7 is undersized at 9.19 sqm - due to inclusion of insulation to the outer wall. To be reviewed annually. 5th October 2007 Date of last inspection Brief Description of the Service: 1, St Matthews Avenue is a registered care home for eight adults with learning disabilities. The home is owned and managed by Home Farm Trust Limited. The home is residential road in Surbiton, close to local shops and amenities with good transport links. The home is not identifiable as a care home and is in keeping with neighbouring houses. Information about the service is available in the Statement of Purpose and Service User Guide. The range of weekly fees is between £1330 and £1335. The registered manager provided this information on 25/09/08. St Matthews Avenue, 1 DS0000013389.V372589.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 two stars. This means the people who use this service experience good quality outcomes. This unannounced visit to the home was undertaken as a part of the inspection process for the year 2008/2009. In writing the report, consideration has also been given to information received throughout the year such as comments from people who use the service, reports of incidents and complaints. The registered manager and service manager facilitated this inspection. They are all thanked for their time and all of those who provided feedback for their support in the inspection process. A tour of the building was also carried out. All registered adult services are now required to fill in an annual quality assurance assessment (AQAA).It is a self-assessment that the provider (owner) must complete every year. The completed assessment is used to show how well the service is delivering good outcomes for the people using it. Some information from this AQAA is included in the report. What the service does well: The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. Residents were observed to be treated with respect by staff and to have their privacy and dignity respected. Residents are actively encouraged to keep in contact with family and friends living in the community. Visitors are welcome at any time and facilities are available for them. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. The home has a settled staff group and has the numbers and skill mix of staff sufficient to meet residents’ needs. The ethos of the home is that it welcomes complaints and suggestions about the service, uses these positively and learns from them. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: It was previously required that for the benefit of people who use the service hot water temperatures must be maintained at around 43°C and action taken if there is a variation is recorded. This remains a concern as from records being kept by the home it was identified that the hot water temperatures were either too hot or too cold at times. On the day of the inspection there was no hot water in the home. This was discussed at length with the service manager and registered manager and we were given assurance that they would look into the situation. The plumber visited the home that afternoon and the immersion heater was switched on so that residents could have hot water. Following our visit we wrote to the service manager to raise our concern as this was an ongoing issue. We will continue to monitor the situation and any further failure might lead to enforcement action being taken against the provider. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 7 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 Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 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 undertakes an assessment of the healthcare needs of residents prior to their admission to ensure that their needs would be met. EVIDENCE: Admissions to the home only take place if the service is confident staff have the skills, ability and qualifications to meet the assessed needs of the prospective resident. Prospective residents are invited to join the staff and other residents for dinner and to stay overnight and are also invited to join in with a planned activity to help them make an informed decision. The organisation is at the next stage of rolling out a computerised assessment and recording tool called SPARS. This is due to reach St Matthews february 2009. An example was seen and it is very comprehensive. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 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. Generally, residents’ care plans include detailed information about their needs and personal goals. This helps staff to know the residents’ needs and how to meet them. EVIDENCE: The key principle of the home is that people using the service are in control of their lives and they direct the service. All residents have an individual plan which they are working towards. This includes all aspects of their lives including health, physical, social, emotional, spiritual and intellectual. The residents are at the centre of this process and are encouraged to explore new opportunites and develop skills and interests. Plans are reviewed, monitored and evaluated and updated to reflect changes in the individuals needs or wishes. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 11 Maintaining independence and enabling residents to make their own decisions about how they wish to live is a key objective of the home. The home recognises the right of individuals to take control of their lives and to make their own decisions and choices. There is evidence that individuals are involved in decision making about the home, such as day to day living and social activities. All residents are also supported and encouraged to have an active role in the community. Each care plan includes a risk assessment, which is reviewed regularly. Management of risk is positive addressing safety issues whilst aiming for better quality of life. Where limitations are in place, the decisions have been made with the person and are recorded. The organisation is currently reviewing the risk assessment processes to incorporate the Mental Capacity Act legislation. The Home Farm Trust (HFT) has also developed an online risk assessment system which all staff will be trained in by 2009. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 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 are being provided with a range of opportunities for recreational and social activity that is in accord with their social, cultural and religious needs. They are assisted to maintain contact with family and friends, and links with the local community are encouraged. Dietary needs are well catered for and a well balanced diet is provided, to ensure health and enjoyment of food. EVIDENCE: Generally staff are aware of the need to support residents to develop their skills, including social, emotional, communication, and independent living skills. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 13 People who use services are involved in meaningful activities of their own choice and according to their individual interests and capability. These are identified through a wide range of forums from personal PCP meetings to group meetings. Staff collect and share a wide range of information and materials about opportunities available for people to attend / join. All residents are encouraged to have a meaningful and active role in the local community. This includes using local facilities and services.The home raised money locally through fundraising events to help pay for activities not generally funded through the usual funding streams. They completed a 5 miles sponsored walk in August 2008 which residents, staff and families took part in. People who use the service have the opportunity to develop and maintain important personal and family relationships. The staff practices promote individual rights and choice, but also consider the protection of individuals in supporting them to make informed choices. The home tries to be flexible and attempts to provide a service that is as individual as possible, using its staff and resources effectively. The service actively supports people to be independent and involved in all areas of daily living in the home. For example residents are fully involved in food planning / cooking and meal times. It was clear from the menus that a wide variety of different food options were available in the home with a lot of consideration given to the nutritional value of the meals provided. Residents are fully involved in food planning / cooking and meal times. This is a very social time. The majority of the residents eat together and lots of informal communication and planning takes place at this time. Healthy and balanced diet are encouraged. Special attention is also paid to specific dietry requirements for example diabetic needs. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 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. Overall the arrangement for health care needs of the residents is good and they receive personal support in the way they prefer. EVIDENCE: People receive personal and healthcare support using a person centred approach with support provided based upon the rights of dignity, equality, fairness, autonomy and respect. There is a keyworker system in place. The keyworker is responsible for ensuring that all other staff are aware of the residents particular likes and needs. All aspects of personal care and support and health needs are incorporated into the support plan. This ensures that each individual is able to receive support in the way they wish.Health action plans are in place and are continually being updated. Personal healthcare needs including specialist health and dietary requirements are clearly recorded in each person centred plan or health action plan. They give a comprehensive overview of their health needs and act as an indicator of St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 15 change in health requirements. Staff encourage residents to understand their health needs and to monitor their own health.The home has access to a wide range of health professionals to ensure that all needs are being met. This includes services from dieticians, physios, speech and language etc. The home has a medication policy which is accessible to staff, medication records are generally up to date for each resident and medicines received, administered and disposed of are recorded. All staff have received external medication training. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 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. Complaints are generally managed well, which should ensure that residents’ and relatives’ concerns are listened to. EVIDENCE: The home has an open culture that allows residents to express their views and concerns in a safe and understanding environment. The home has a complaints procedure that generally meets the national minimum standards and regulations. It keeps a full record of complaints and this includes details of the investigation and any actions taken. Unless there are exceptional circumstances the service always responds within the agreed timescale. Since the last inspection there has not been any complaint. The home has however received compliments from relatives. Families are encouraged to share any concerns or complaints and these are responded to by either the unit manager or the service manager. The organisation regularly monitors complaints and how they are managed through their quality management and auditing tools. The home understands the procedures for safeguarding adults and will always attend meetings or provide information to external agencies when requested. Staff receive regular training in vulnerable adults protection and recognition of abuse, communication awareness, awareness of behaviour that challenges, advocacy and empowerment. All staff have had training in the mental capacity St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 17 act (MCA).Residents are also supported to understand the MCA and their rights. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 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 is generally hygienic and clean, homely and comfortable; this environment therefore facilitates the residents’ health and emotional well being. EVIDENCE: St Matthews Avenue is a converted building. It has been designed to meet the needs of the residents who occupy it.The environment is aesthetically pleasing and the furniture is of good quality and maintained to a good standard. The house has been redecorated with involvement from the residents in the colour of the décor. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 19 The home is kept clean and hygienic and free from offensive odours throughout. Systems are in place to control infection in accordance with relevant legislation and published professional guidance. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 People using the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has the numbers and skill mix of staff sufficient to meet residents’ needs and ensure their safety. There is a staff training and development programme in place. This ensures that staff fulfil the aims of the home and meet the changing needs of residents. EVIDENCE: People have confidence in the staff who care for them. Copies of staff rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. All staff are offered the opportunity to complete a NVQ award after they have successfully completed their induction and probation. 60 of permanent staff have completed or are currently working on their NVQ at level 2 or above. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 21 Recruitment procedures seemed appropriate. Three staff files were examined at random and found to contain all the information required by the Care Homes Regulations 2001 including a completed job application, terms and conditions of employment, an enhanced Criminal Record Bureau (CRB) check and proof of their identity. Job descriptions and job specifications are available for posts within the service. All staff are obliged to comply with the General Social Care Council code of conduct and HFT standards. The home ensures that all staff receive relevant training that is focussed on delivering improved outcomes for people using the service. The manager puts a high level of importance on training so as to meet the individual needs of people using the service. From staff files sampled at random there were evidence that staff are attending mandatory training as and when required. Individual training plans are developed and progress monitored though supervision and annual appraisal system. HFT has designed a professional passport, this indicates clear lines of expectations within roles through the use of a capability matrix. Measurable targets in relation to job role and development are set annually. Diversity awareness is a regular topic of discussion through team meetings and activities and supports HFT philosophy of valuing diversity.HFT successfully aquired reaccreditation from Investor in people (Iip) in 2007 for 3 more years. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 People using the service experience good outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home management generally provides guidance and direction to staff to ensure residents receive consistent quality care. There is a quality monitoring system and this ensures the home is run in a way that is in the best interests of the residents. EVIDENCE: The registered manager has been in post at St Matthews since 2005. He has a wide experience in a relevant care background. He has both the NVQ 4 and RMA.The registered manager has a comprehensive job description which enables him to fully understand and implement the requirements of the role. He works to continuously improve services and provide an increased quality of St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 23 life for residents. There is a strong ethos of being open and transparent in all areas of running of the home. Effective quality assurance and quality monitoring systems, based on seeking the views of residents, are in place to measure success in meeting the aims, objectives and statement of purpose of the home. HFT has just achieved reaccreditation of Investor in people status, where their communication systems and staff support where applauded. The AQAA was received on time and contained clear, relevant information that was supported by a wide range of evidence. The AQAA lets us know about changes the home has made and where they still need to make improvements. It shows clearly how they are going to do this. Records with regards to health and safety are of a good standard and are routinely completed. Certificates relating to health and safety were up to date servicing certificates. However it was noted that the hot water temperature was still not within recommended level at times and there were no hot water available on the day of the inspection. This was discussed at length with the service manager and registered manager and we were given assurance that they would look into the situation. The plumber visited the home that afternoon and the immersion heater was switched on so that residents could have hot water. Following our visit we wrote to the service manager to raise our concern as this was an ongoing issue. We will continue to monitor the situation and any further failure might lead to enforcement action being taken against the provider. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA42 Regulation 13(4)(c) Requirement For the benefit of people who use the service hot water temperatures must be maintained at around 43C and action taken if there is a variation is recorded. Timescale for action 25/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. St Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Matthews Avenue, 1 DS0000013389.V372589.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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